Question 1

The primary care pediatric nurse practitioner evaluates a school­age child
whose body mass index (BMI) is greater than the 97th percentile. The nurse practitioner is concerned about possible metabolic syndrome and orders laboratory tests to evaluate this. Which diagnosis will the nurse practitioner document for this visit?

Accepted Answer

The primary concern in this case is the child's BMI being greater than the 97th percentile, which indicates obesity. The nurse practitioner is ordering laboratory tests to evaluate for metabolic syndrome as a potential complication of obesity. Documenting "obesity" as the diagnosis is appropriate in this case. "Metabolic syndrome" may be documented as a secondary diagnosis if the laboratory tests confirm this condition. "Nutritional alteration: more than required" is not a specific enough diagnosis, as it does not clearly indicate the impact on the child's health. "Rule out type 2 diabetes mellitus" is a potential concern, but it is not the primary diagnosis at this point.

Question 2

The primary care pediatric nurse practitioner is performing a well child
assessment on an adolescent and is concerned about possible alcohol and tobacco use. Which assessment tool will the nurse practitioner use?

Accepted Answer

The CRAFFT tool is specifically designed to screen for substance-related risks and problems in adolescents, including alcohol and tobacco use.

Question 3

The primary care pediatric nurse practitioner is assessing a toddler whose
weight and body mass index (BMI) are below the 3rd percentile for age. The nurse practitioner learns that the child does not have regular mealtimes and is allowed to carry a bottle of juice around at all times. The nurse practitioner plans to work with this family to develop improved meal patterns. Which diagnosis will the nurse practitioner use for this problem?

Accepted Answer

D

Question 4

The primary care pediatric nurse practitioner performs a developmental
assessment on a 3­year­old child and notes normal cognitive, fine­motor, and gross­motor abilities. The child responds appropriately to verbal commands during the assessment but refuses to speak when asked questions. The parent tells the nurse practitioner that the child talks at home and that most other adults can understand what the child says. The nurse practitioner will

Accepted Answer

While a speech and hearing evaluation may be necessary if the child continues to refuse to speak during subsequent visits, it is important to continue to evaluate the child's speech and language development at subsequent visits first. It is not necessary to refer the child for a speech and hearing evaluation immediately as there may be other factors influencing the child's behavior during the assessment. Additionally, telling the parent to spend more time in interactive conversations with the child is not necessarily helpful as the parent has already stated that the child talks at home and interacts with other adults. It is important to continue to observe and monitor the child's speech and language development to determine if there are any issues that need to be addressed.

Question 5

The primary care pediatric nurse practitioner is evaluating health literacy in
the mother of a new preschool­age child. How will the nurse practitioner assess this?

Accepted Answer

The answer of The primary care pediatric nurse practitioner is...

Question 6

When meeting with a new family, the primary care pediatric nurse practitioner
develops a database that identifies family members and others living in the household, relationships with others outside the household, and significant behavioral and emotional problems. Which tool will the nurse practitioner use to record this information?

Accepted Answer

The answer of When meeting with a new family, the...

Question 7

When formulating developmental diagnoses for pediatric patients, the primary care pediatric nurse practitioner may use which resource?

Accepted Answer

The DC: 0­3R (Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised Edition) is a resource specifically designed for diagnosing developmental disorders in children from birth to age three. It takes into account the unique developmental stages and challenges during this period and is frequently used by pediatric healthcare providers in assessing and diagnosing developmental disorders. The other options (ICD­10­CM, ICSD­3, NANDA International) are resources for diagnosing medical and sleep disorders and nursing diagnoses, respectively, but are not specific to developmental disorders in young children.

Question 8

A child is in the clinic for evaluation of an asthma action plan. The primary
care pediatric nurse practitioner notes that the child's last visit was for a pre­kindergarten physical and observes that the child is extremely anxious. What will the nurse practitioner do initially?

Accepted Answer

It is important to address the child's anxiety before proceeding with any evaluation or treatment. By reviewing the purpose of the visit and any anticipated procedures, the nurse practitioner can help alleviate the child's anxiety and reduce any fears or concerns they may have. This will also help establish a good rapport with the child and their family, leading to a more successful asthma action plan. Asking the parent or performing a physical assessment may not initially address the child's anxiety and may make them feel more scared or uncomfortable. Reassuring the child that there is nothing to be afraid of may also not be enough without providing specific information about the visit and procedures.

Question 9

The primary care pediatric nurse practitioner learns that the mother of a 3­
year­old child has been treated for depression for over 5 years. Which aspect of this child's development will be of the most concern to the nurse practitioner?

Accepted Answer

The most concerning aspect of this child's development would be social/emotional development due to the mother's history of depression. Children of depressed mothers are at an increased risk for social and emotional problems themselves, including behavior problems, anxiety, and poor relationships with peers. It is important for the nurse practitioner to assess this child's social and emotional development and to monitor for any signs of problems in this area.

Question 10

The primary care pediatric nurse practitioner is obtaining a medical history
about a child. To integrate both nursing and medical aspects of primary care, which will be included in the medical history?

Accepted Answer

The answer of The primary care pediatric nurse practitioner is...

Question 11

The mother of a newborn tells the primary care pediatric nurse practitioner
that she is worried that her child will develop allergies and asthma. Which tool will the nurse practitioner use to evaluate this risk?

Accepted Answer

A three-generation pedigree allows the nurse practitioner to assess the family history of allergic diseases, such as asthma and allergies. This can help identify any potential genetic susceptibility to developing these conditions. Review of systems, genogram, and ecomap may be helpful in identifying health and social issues, but they will not provide information specific to allergy and asthma risk.

Question 12

The primary care pediatric nurse practitioner is performing a well child check­
up on a 20­month­old child. The child was 4 weeks premature and, according to a parent­ completed developmental questionnaire, has achieved milestones for a 15­month­old infant. Which action is correct?

Accepted Answer

The child was born 4 weeks premature, so their adjusted age is 19 months. Since the child is achieving milestones for a 15-month-old, there is a developmental delay. An in-depth developmental assessment screen is necessary to evaluate the extent of the delay and determine the appropriate interventions.

Question 13

The parent of a toddler is concerned that the child may have autism. The
primary care pediatric nurse practitioner completes a Modified Checklist for Autism in Toddlers (M­CHAT) tool, which indicates several areas of concern. What will the nurse practitioner do?

Accepted Answer

The answer of The parent of a toddler is concerned...

Question 14

The primary care pediatric nurse practitioner sees a 3­year­old child who
chronically withholds stools, in spite of the parents' attempts to stop the behavior, requiring frequent treatments with laxative medications. Which diagnosis will the nurse practitioner use to facilitate third­party reimbursement?

Accepted Answer

Encopresis is a recognized medical diagnosis for chronic stool withholding and is necessary for insurance reimbursement.

Quiz 2: Child and Family Health Assessment

The primary care pediatric nurse practitioner is performing a well child assessment on an adolescent and is concerned about possible alcohol and tobacco use. Which assessment tool will the nurse practitioner use?

The primary care pediatric nurse practitioner is evaluating health literacy in the mother of a new preschoolage child. How will the nurse practitioner assess this?

When formulating developmental diagnoses for pediatric patients, the primary care pediatric nurse practitioner may use which resource?

A child is in the clinic for evaluation of an asthma action plan. The primary care pediatric nurse practitioner notes that the child's last visit was for a prekindergarten physical and observes that the child is extremely anxious. What will the nurse practitioner do initially?

The primary care pediatric nurse practitioner learns that the mother of a 3 yearold child has been treated for depression for over 5 years. Which aspect of this child's development will be of the most concern to the nurse practitioner?

The primary care pediatric nurse practitioner is obtaining a medical history about a child. To integrate both nursing and medical aspects of primary care, which will be included in the medical history?

The mother of a newborn tells the primary care pediatric nurse practitioner that she is worried that her child will develop allergies and asthma. Which tool will the nurse practitioner use to evaluate this risk?

The primary care pediatric nurse practitioner is performing a well child check up on a 20monthold child. The child was 4 weeks premature and, according to a parent completed developmental questionnaire, has achieved milestones for a 15monthold infant. Which action is correct?

The parent of a toddler is concerned that the child may have autism. The primary care pediatric nurse practitioner completes a Modified Checklist for Autism in Toddlers (MCHAT) tool, which indicates several areas of concern. What will the nurse practitioner do?

Quiz 2: Child and Family Health Assessment

The primary care pediatric nurse practitioner is performing a well child assessment on an adolescent and is concerned about possible alcohol and tobacco use. Which assessment tool will the nurse practitioner use?

The primary care pediatric nurse practitioner is evaluating health literacy in the mother of a new preschool­age child. How will the nurse practitioner assess this?

When formulating developmental diagnoses for pediatric patients, the primary care pediatric nurse practitioner may use which resource?

A child is in the clinic for evaluation of an asthma action plan. The primary care pediatric nurse practitioner notes that the child's last visit was for a pre­kindergarten physical and observes that the child is extremely anxious. What will the nurse practitioner do initially?

The primary care pediatric nurse practitioner learns that the mother of a 3­ year­old child has been treated for depression for over 5 years. Which aspect of this child's development will be of the most concern to the nurse practitioner?

The primary care pediatric nurse practitioner is obtaining a medical history about a child. To integrate both nursing and medical aspects of primary care, which will be included in the medical history?

The mother of a newborn tells the primary care pediatric nurse practitioner that she is worried that her child will develop allergies and asthma. Which tool will the nurse practitioner use to evaluate this risk?

The primary care pediatric nurse practitioner is performing a well child check­ up on a 20­month­old child. The child was 4 weeks premature and, according to a parent­ completed developmental questionnaire, has achieved milestones for a 15­month­old infant. Which action is correct?

The parent of a toddler is concerned that the child may have autism. The primary care pediatric nurse practitioner completes a Modified Checklist for Autism in Toddlers (M­CHAT) tool, which indicates several areas of concern. What will the nurse practitioner do?

The primary care pediatric nurse practitioner is evaluating health literacy in the mother of a new preschoolage child. How will the nurse practitioner assess this?

A child is in the clinic for evaluation of an asthma action plan. The primary care pediatric nurse practitioner notes that the child's last visit was for a prekindergarten physical and observes that the child is extremely anxious. What will the nurse practitioner do initially?

The primary care pediatric nurse practitioner learns that the mother of a 3 yearold child has been treated for depression for over 5 years. Which aspect of this child's development will be of the most concern to the nurse practitioner?

The primary care pediatric nurse practitioner is performing a well child check up on a 20monthold child. The child was 4 weeks premature and, according to a parent completed developmental questionnaire, has achieved milestones for a 15monthold infant. Which action is correct?

The parent of a toddler is concerned that the child may have autism. The primary care pediatric nurse practitioner completes a Modified Checklist for Autism in Toddlers (MCHAT) tool, which indicates several areas of concern. What will the nurse practitioner do?