Question 1

The primary care pediatric nurse practitioner performs a physical examination
on a 9monthold infant and notes two central incisors on the lower gums. The parent states that the infant nurses, takes solid foods three times daily, and occasionally takes water from a cup. What will the pediatric nurse practitioner counsel the parent to promote optimum dental
health?
A. To begin brushing the infant's teeth with toothpaste
B. To consider weaning the infant from breastfeeding
C. To discontinue giving fluoride supplements
D. To make an appointment for an initial dental examination

Accepted Answer

The nurse practitioner should initially ask if the parents have an individualized family service plan (IFSP) as it provides information about the child's current services and needs, helping to guide further referrals and support.

Question 2

During a well child assessment of an 18&#173;month&#173;old child, the primary care&#10;pediatric nurse practitioner observes the child becoming irritable and uncooperative. The parent tells the child to stop fussing. What will the nurse practitioner do?&#10;A. Allow the parent to put the child in a &#34;timeout.&#34;&#10;B. Ask the parent about usual discipline practices.&#10;C. Offer the child a book or a toy to look at.&#10;D. Stop the exam since the child has reached a &#34;meltdown.&#34;

Accepted Answer

Offering the child a book or a toy can help distract and calm the child, making it easier to continue the assessment.

Question 3

During a well child exam, the primary care pediatric nurse practitioner learns
that the parents of a young child fight frequently about finances. The parents state that they do not fight in front of the child and feel that the situation is temporary and related to the father's job layoff. What will the nurse practitioner do?
A. Reassure them that the child is too young to understand.
B. Recommend that they continue to not argue in front of the child.
C. Suggest counseling to learn ways to handle stress.
D. Tell them that the conflict will resolve when the situation changes.

Accepted Answer

Although the child may not understand the direct language of the arguments, they may still be affected by the parents' stress and tension. Suggesting counseling can help the parents learn healthy ways to handle stress and improve their communication, which can ultimately benefit the child and the family as a whole.

Question 4

The primary care pediatric nurse practitioner performs a physical examination
on a 9monthold infant and notes two central incisors on the lower gums. The parent states that the infant nurses, takes solid foods three times daily, and occasionally takes water from a cup. What will the pediatric nurse practitioner counsel the parent to promote optimum dental
health?
A. To begin brushing the infant's teeth with toothpaste
B. To consider weaning the infant from breastfeeding
C. To discontinue giving fluoride supplements
D. To make an appointment for an initial dental examination

Accepted Answer

The nurse practitioner should acknowledge the parent's concerns and point out the tasks that the infant can perform during the assessment. This will help to reassure the parent and provide information about the infant's current abilities. It is not appropriate to predict future developmental delays, as this can cause unnecessary anxiety. Additionally, referring the infant to a specialist for a complete evaluation may not be necessary at this time, as the infant has just been discharged from the neonatal intensive care unit and may need time to adjust to life outside of the hospital.

Question 5

The primary care pediatric nurse practitioner performs a physical examination
on a 9monthold infant and notes two central incisors on the lower gums. The parent states that the infant nurses, takes solid foods three times daily, and occasionally takes water from a cup. What will the pediatric nurse practitioner counsel the parent to promote optimum dental
health?
A. To begin brushing the infant's teeth with toothpaste
B. To consider weaning the infant from breastfeeding
C. To discontinue giving fluoride supplements
D. To make an appointment for an initial dental examination

Accepted Answer

The nurse practitioner should interpret the behavior as of moderate concern for parenting problems since the mother may not be giving the infant proper attention during the visit. However, this behavior alone is not enough to make a definitive diagnosis of postpartum depression or parental neglect.

Question 6

The primary care pediatric nurse practitioner performs a physical examination
on a 9monthold infant and notes two central incisors on the lower gums. The parent states that the infant nurses, takes solid foods three times daily, and occasionally takes water from a cup. What will the pediatric nurse practitioner counsel the parent to promote optimum dental
health?
A. To begin brushing the infant's teeth with toothpaste
B. To consider weaning the infant from breastfeeding
C. To discontinue giving fluoride supplements
D. To make an appointment for an initial dental examination

Accepted Answer

Care coordination and collaboration are important roles for the nurse practitioner when caring for children with special health care needs as they often require multidisciplinary care and coordination between various healthcare providers, community resources, and the child's family. The nurse practitioner can facilitate this coordination and collaboration as part of their role in managing the child's overall health and wellbeing. Developing protocols, monitoring IEPs, and providing lists of resources are also important aspects of care for these children, but they are not the primary role of the nurse practitioner in managing their care.

Question 7

A single mother of an infant worries that living in a household with only one
parent will cause her child to be maladjusted. To help address the mother's concerns, the primary care pediatric nurse practitioner will suggest
A. developing consistent daily routines for the child.
B. exposing her child to extended family members when possible.
C. not working outside the home during the first few years.
D. taking her child to regular play date activities with other children.

Accepted Answer

The answer of A single mother of an infant worries...

Question 8

Which recommendation will a primary care pediatric nurse practitioner make
when parents ask about ways to discipline their 3yearold child who draws on the walls with crayons?
A. Give the child washable markers so the drawings can be removed easily.
B. Provide a roll of paper for drawing and teach the child to use this.
C. Put the child in "timeout" each time the child draws on the walls.
D. Take the crayons away from the child to prevent the behavior.

Accepted Answer

At the age of 3, children are curious and playful. Drawing on walls is a common behavior that should be addressed with age-appropriate strategies. Giving the child a roll of paper and teaching them to use it can redirect their behavior towards an acceptable alternative. This alternative also promotes creativity and expression. It is important to avoid punishment or negative reinforcement, as it may have adverse effects on the child's emotional and mental health.

Question 9

The primary care pediatric nurse practitioner performs a physical examination
on a 9monthold infant and notes two central incisors on the lower gums. The parent states that the infant nurses, takes solid foods three times daily, and occasionally takes water from a cup. What will the pediatric nurse practitioner counsel the parent to promote optimum dental
health?
A. To begin brushing the infant's teeth with toothpaste
B. To consider weaning the infant from breastfeeding
C. To discontinue giving fluoride supplements
D. To make an appointment for an initial dental examination

Accepted Answer

The American Academy of Pediatrics and American Academy of Pediatric Dentistry recommend that children have their first dental visit by age 1 or within 6 months of the eruption of the first tooth. Therefore, the pediatric nurse practitioner should counsel the parent to make an appointment for an initial dental examination. It is not necessary to begin brushing the infant's teeth with toothpaste at this time, and there is no indication to wean the infant from breastfeeding. Additionally, fluoride supplements are not recommended for infants under 6 months old and the decision to continue supplementation should be based on the infant's fluoride exposure sources and individualized assessment.

Question 10

The primary care pediatric nurse practitioner performs a physical examination
on a 9monthold infant and notes two central incisors on the lower gums. The parent states that the infant nurses, takes solid foods three times daily, and occasionally takes water from a cup. What will the pediatric nurse practitioner counsel the parent to promote optimum dental
health?
A. To begin brushing the infant's teeth with toothpaste
B. To consider weaning the infant from breastfeeding
C. To discontinue giving fluoride supplements
D. To make an appointment for an initial dental examination

Accepted Answer

The nurse practitioner should initially teach the parents exercises to encourage motor development, as mild gross motor delays can often be addressed with targeted activities at home.

Deck 4: Developmental Management in Pediatric Primary Care