Question 1

When counseling an adolescent with a family history of hyperinsulinemia and type 2 diabetes, the primary care pediatric nurse practitioner will recommend avoiding

Accepted Answer

Processed breads should be avoided because they are typically high in refined carbohydrates which increase blood sugar levels and can lead to insulin resistance, which is a precursor to diabetes. Baked potato chips, canned vegetables, and high-fiber cereals can be consumed in moderation.

Question 2

The primary care pediatric nurse practitioner provides anticipatory guidance for a
6­month­old infant who is breastfed who takes 400 IU of vitamin D daily. The parent reports that the infant has begun taking cereals, fruits, and vegetables in addition to nursing. What will the nurse practitioner recommend to promote healthy nutrition?

Accepted Answer

Continuing to nurse as long as desired is recommended to promote healthy nutrition for the infant. The American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months of life and continuing to breastfeed while introducing solid foods until at least 1 year of age. Iron supplementation may be necessary if the infant is not getting enough iron from their diet, but this should be determined through a blood test and consultation with a healthcare provider. Discontinuing the vitamin D supplement is not recommended unless advised by a healthcare provider. Stopping breastfeeding at 1 year of age is not necessary if both the parent and infant desire to continue.

Question 3

The parents of a toddler tell the primary care pediatric nurse practitioner that they
get frustrated trying to get the child to eat any vegetables other than squash and carrots. What will the nurse practitioner recommend?

Accepted Answer

The nurse practitioner should recommend continuing to offer a variety of foods without forcing the child to eat them. It may take several exposures to a new food before a child will try it, and forcing a child to eat a food can create a negative association with it. Offering a variety of vegetables at each meal and encouraging the child to try them at their own pace can eventually lead to a more diverse diet. Snacks should not be offered to make up for missed vegetables, as this can create a negative cycle of filling up on less nutritious foods. Similarly, preparing dishes the child likes can reinforce picky eating habits and does not encourage trying new foods. Requiring the child to take bites of each food can also create negative associations with trying new foods and does not promote a positive approach to eating.

Question 4

The primary care pediatric nurse practitioner sees a 3­year­old child whose
parents report is a picky eater in spite of their continued efforts to provide nutritious meals. The parents ask whether a multivitamin is necessary. How will the nurse practitioner respond?

Accepted Answer

Asking for a 3-day food diary will provide a better understanding of the child's overall nutrient intake and allow for targeted recommendations to be made based on specific deficiencies or inadequacies. Simply prescribing a multivitamin or telling them supplements are unnecessary may not address the root of the issue. Reinforcing the need to meet DRIs each day is also important, but a food diary will provide more specific information.

Question 5

The primary care pediatric nurse practitioner is performing a well child
examination on a 15­year­old girl who consumes a vegan diet. Based on this assessment, which nutrients may this adolescent need to supplement?

Accepted Answer

A vegan diet is a plant-based diet that excludes all animal products. It may lead to deficiencies in certain nutrients that are primarily found in animal products, such as iron, folic acid, and vitamin B12. Therefore, it is recommended that individuals on a vegan diet supplement these nutrients to prevent deficiencies. While other nutrients listed may also be important, iron, folic acid and B12 are the most critical.

Question 6

The primary care pediatric nurse practitioner is evaluating a school­age child who,
after removal of a pituitary tumor, has altered hypothalamic control over hunger and satiety. The child is morbidly obese and expresses feeling depressed because of the obesity. What will the nurse practitioner recommend?

Accepted Answer

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

Question 7

The primary care pediatric nurse practitioner is providing anticipatory guidance to
the mother of a breastfed 6­month­old infant who asks about "baby­led weaning." What will the nurse practitioner tell her about this practice?

Accepted Answer

Baby-led weaning involves giving infants soft, mashable table foods that they can self-feed. It is an approach that allows the infant to control their own feeding process, which is thought to foster healthy eating habits and reduce the risk of picky eaters. However, it is important to note that iron-rich foods should still be provided and that breastfeeding or formula should remain the primary source of nutrition until 12 months of age. Infants do not need to be able to grasp and feed themselves from a spoon to practice baby-led weaning.

Question 8

The primary care pediatric nurse practitioner is examining a toddler who is below
the 3rd percentile for weight even though the parents claim that the child eats "constantly." What
will the nurse practitioner do initially?

Accepted Answer

The initial step in evaluating a toddler with poor weight gain is to assess the child's feeding and elimination behaviors, as well as the family's mealtime routines. This can help identify any potential issues that may be contributing to the child's poor weight gain, such as inadequate intake or picky eating habits. Referring the child to a feeding evaluation clinic or suggesting high-calorie foods or formulas may be considered later, depending on the findings of the initial assessment.

Question 9

The parent of a toddler tells the primary care pediatric nurse practitioner that the
family has adopted a plant­based diet and the child is receiving rice and almond milk instead of cow's milk. The nurse practitioner will counsel the parents about

Accepted Answer

The answer of The parent of a toddler tells the...

Question 10

The parent of a school­age child reports that the child is on a gluten­free diet.
When questioned about the reason for this diet, the parent states that the child has fewer stomach aches since beginning the diet but has never been diagnosed with celiac disease. The parent reports using gluten­free grain products for all family members. The nurse practitioner will tell this parent that gluten­free diets

Accepted Answer

Gluten-free diets may be deficient in essential nutrients such as fiber, iron, zinc, and B vitamins, as some gluten-free products are not fortified with these nutrients. It is important for individuals on a gluten-free diet to work with a healthcare provider or a registered dietitian to ensure they are meeting their nutritional needs. The other choices are incorrect as gluten-free diets can still be high in sugar and fat, and do not necessarily prevent obesity. While gluten-free grain products can provide protein, it is important to consider the overall nutrient profile of the diet.

Question 11

The mother of a 6­year­old child tells the primary care pediatric nurse practitioner
that the child only wants to eat French fries and hamburgers and refuses most vegetables. What will the nurse practitioner recommend?

Accepted Answer

Providing a variety of healthy foods at each meal is the best choice because it allows the child to have access to different types of foods and encourages them to try new things. Giving a multivitamin may help with vitamin deficiencies but does not teach the child healthy eating habits. Having the child eat vegetables before getting the hamburger may cause a power struggle with the child and may not result in the child actually consuming the vegetables. Putting extra lettuce and tomatoes on hamburgers may increase the child's vegetable intake slightly, but alone it is not enough to provide a well-rounded and healthy diet.

Quiz 10: Breastfeeding

When counseling an adolescent with a family history of hyperinsulinemia and type 2 diabetes, the primary care pediatric nurse practitioner will recommend avoiding

The parents of a toddler tell the primary care pediatric nurse practitioner that they get frustrated trying to get the child to eat any vegetables other than squash and carrots. What will the nurse practitioner recommend?

The primary care pediatric nurse practitioner sees a 3yearold child whose parents report is a picky eater in spite of their continued efforts to provide nutritious meals. The parents ask whether a multivitamin is necessary. How will the nurse practitioner respond?

The primary care pediatric nurse practitioner is performing a well child examination on a 15yearold girl who consumes a vegan diet. Based on this assessment, which nutrients may this adolescent need to supplement?

The primary care pediatric nurse practitioner is providing anticipatory guidance to the mother of a breastfed 6monthold infant who asks about "babyled weaning." What will the nurse practitioner tell her about this practice?

The primary care pediatric nurse practitioner is examining a toddler who is below the 3rd percentile for weight even though the parents claim that the child eats "constantly." What will the nurse practitioner do initially?

The parent of a toddler tells the primary care pediatric nurse practitioner that the family has adopted a plantbased diet and the child is receiving rice and almond milk instead of cow's milk. The nurse practitioner will counsel the parents about

The mother of a 6yearold child tells the primary care pediatric nurse practitioner that the child only wants to eat French fries and hamburgers and refuses most vegetables. What will the nurse practitioner recommend?

Quiz 10: Breastfeeding

When counseling an adolescent with a family history of hyperinsulinemia and type 2 diabetes, the primary care pediatric nurse practitioner will recommend avoiding

The parents of a toddler tell the primary care pediatric nurse practitioner that they get frustrated trying to get the child to eat any vegetables other than squash and carrots. What will the nurse practitioner recommend?

The primary care pediatric nurse practitioner sees a 3­year­old child whose parents report is a picky eater in spite of their continued efforts to provide nutritious meals. The parents ask whether a multivitamin is necessary. How will the nurse practitioner respond?

The primary care pediatric nurse practitioner is performing a well child examination on a 15­year­old girl who consumes a vegan diet. Based on this assessment, which nutrients may this adolescent need to supplement?

The primary care pediatric nurse practitioner is providing anticipatory guidance to the mother of a breastfed 6­month­old infant who asks about "baby­led weaning." What will the nurse practitioner tell her about this practice?

The primary care pediatric nurse practitioner is examining a toddler who is below the 3rd percentile for weight even though the parents claim that the child eats "constantly." What will the nurse practitioner do initially?

The parent of a toddler tells the primary care pediatric nurse practitioner that the family has adopted a plant­based diet and the child is receiving rice and almond milk instead of cow's milk. The nurse practitioner will counsel the parents about

The mother of a 6­year­old child tells the primary care pediatric nurse practitioner that the child only wants to eat French fries and hamburgers and refuses most vegetables. What will the nurse practitioner recommend?

The primary care pediatric nurse practitioner sees a 3yearold child whose parents report is a picky eater in spite of their continued efforts to provide nutritious meals. The parents ask whether a multivitamin is necessary. How will the nurse practitioner respond?

The primary care pediatric nurse practitioner is performing a well child examination on a 15yearold girl who consumes a vegan diet. Based on this assessment, which nutrients may this adolescent need to supplement?

The primary care pediatric nurse practitioner is providing anticipatory guidance to the mother of a breastfed 6monthold infant who asks about "babyled weaning." What will the nurse practitioner tell her about this practice?

The parent of a toddler tells the primary care pediatric nurse practitioner that the family has adopted a plantbased diet and the child is receiving rice and almond milk instead of cow's milk. The nurse practitioner will counsel the parents about

The mother of a 6yearold child tells the primary care pediatric nurse practitioner that the child only wants to eat French fries and hamburgers and refuses most vegetables. What will the nurse practitioner recommend?