Deck 17: Role Relationships

Question 1

During a well child examination on an infant who has colic, the primary care
pediatric nurse practitioner learns that the infant's mother is 17 years old and that the father, who is in the military, was deployed to wartime duty shortly after the baby was born. To determine the immediate risk of child maltreatment for this infant, the nurse practitioner will ask about
A. childrearing and parenting styles.
B. role responsibilities of the parents.
C. spiritual beliefs and religious practices.
D. the location of extended family members.

Answer 1

the location of extended family members.

Question 2

The parent of an adolescent female tells the primary care pediatric nurse
practitioner that the child may be the victim of cyber­bullying at school but won't talk about it with her parents. What is the nurse practitioner's initial response?
A. Ask about the adolescent's school performance and friends.
B. Interview the adolescent separately from the parent.
C. Reassure the parent that suicide is a rare response to bullying.
D. Suggest that the parent discuss this with the school counselor.

Answer 2

Interview the adolescent separately from the parent.

Question 3

The primary care pediatric nurse practitioner is examining an infant who has otitis
media and learns that the mother and child are homeless. Besides assisting the mother to obtain medication to treat this illness, what is a priority during this visit?
A. Assisting the mother to obtain transportation for health care needs
B. Determining well child examination history and immunization status
C. Making sure the family has access to WIC and food stamps resources
D. Obtaining a tuberculosis skin test and scheduling a return office visit

Answer 3

Determining well child examination history and immunization status

Question 4

Adolescent children are more likely to smoke cigarettes and drink alcohol if they live with
A. cohabitating parents.
B. grandparents.
C. homosexual parents.
D. single parents.

Question 5

The primary care pediatric nurse practitioner is counseling a family whose parents
are divorcing. To help support the children and reduce their stress through this process, the nurse practitioner will recommend
A. allowing children to choose the custodial parent.
B. being open about ongoing parental conflicts.
C. establishing a single custody living arrangement.
D. maintaining a civil relationship when discussing children.

Question 6

The primary care pediatric nurse practitioner is assessing a special needs school­
age child whose family has just moved to the area. What is a priority concern at this initial visit?
A. Asking the parents to describe the child's illness, treatments, and unique needs
B. Connecting the family to local support groups, school programs, and resources
C. Gathering information about financial concerns related to the child's condition
D. Providing expert information about the child's condition and its management

Question 7

The primary care pediatric nurse practitioner learns that a school­age child
continues to hope that his parents will remarry 1 year after they have divorced. What will the nurse practitioner tell this child's parents?
A. "If one of you remarries, he is more likely to understand that this is permanent."
B. "This is a normal response and is an expression of hope that things will be OK."
C. "You will need to help him accept the reality of the permanence of the divorce."
D. "Your child is most likely blaming himself for your separation and divorce."

Question 8

The primary care pediatric nurse practitioner is discussing newborn care with a
mother who is pregnant with triplets. When counseling the mother about feeding issues, the nurse practitioner will recommend
A. developing a plan to rotate breastfeeding for her infants.
B. making sure that the triplets are on the same feeding schedule.
C. pumping her breasts so she can feed breastmilk to all three.
D. supplementing with formula to ensure adequate nutrition.

Question 9

The primary care pediatric nurse practitioner is performing a well baby
examination on a newborn whose mother is 17 years old. The mother states that she is living with her parents and plans to finish high school. The maternal grandmother will care for the infant while she is in school. What will the nurse practitioner discuss with this mother at this visit?
A. Early child intervention programs
B. Her needs for socialization with peers
C. Immunizations and well child visits
D. Referral to a community health nurse

Question 10

The primary care pediatric nurse practitioner is examining a young child who has
cerebral palsy. Which part of the family history raises concerns about potential child maltreatment?
A. Child attends day care
B. Limited financial resources
C. Mother works outside the home
D. No membership in a church

Question 11

The primary care pediatric nurse practitioner is examining a young child who was
brought in by a grandmother for evaluation of a partial­thickness burn on one arm. The PNP suspects that this is an intentional injury, but the grandmother states that the parents are "just careless" and that the child is now living with her. What will the PNP do?
A. Flag this as a concerning incident in the child's record.
B. Reassure the grandmother that she is doing the right thing.
C. Refer the child's parents to a parenting resource center.
D. Report a suspicion of abuse to child protective services.

Question 12

The primary care pediatric nurse practitioner suspects that the parent of a child
who is doing poorly in school is being abused by a partner. What is a priority response by the nurse practitioner?
A. Notifying the child's school counselor about this problem
B. Referring the child and family to a social worker
C. Reporting this according to any mandated reporting laws
D. Suggesting that the parent avoid the abusive situation

Question 13

The primary care pediatric nurse practitioner is evaluating a 12­year­old girl who
reports penile penetration of her vagina by her mother's boyfriend the day before yesterday. The PNP reports this to the local child abuse hotline. What is the PNP's next action?
A. Attaining a history of the abuse from the child
B. Obtaining urethral specimens for STI testing
C. Performing a colposcopic examination to evaluate for trauma
D. Referring the child to the ED for forensic specimen collection

Question 14

The primary care pediatric nurse practitioner is performing an examination on a
2­year­old child who has been placed in emergency foster care with a grandparent after the child's mother has been arrested for drug use. The child has a history of asthma with frequent exacerbations because of parental smoking. What is a priority for the nurse practitioner at this visit?
A. Evaluation of financial resources, medical insurance, and access to health care and medications
B. Providing a list of websites and community­based support groups for grandparents parenting grandchildren
C. Referral to a social worker to help the child deal with emotional conflict related to separation from the parent
D. Teaching the grandparent about the need for consistency in routines and discipline for the child

Question 15

The mother of two school­age children tells the primary care pediatric nurse
practitioner that she and the children's father are divorcing and asks for advice to help the children cope with the situation. The nurse practitioner will counsel her to
A. allow visitation only on weekends.
B. maintain her own social life.
C. notify the children's teachers.
D. use a social support network.