Deck 13: Physical Activity and Sports for Children and Adolescents

Question 1

The primary care pediatric nurse practitioner is examining a 17­year­old male
who is on his high school swim team. The adolescent is concerned about "lumps" on his chest. The nurse practitioner notes a marked increase in weight since the last visit along with worsening of the adolescent's acne. Given this set of symptoms, which performance­ enhancing substance will the nurse practitioner be most concerned about and ask about?
A. Creatine
B. Dehydroepiandrosterone (DHEA)
C. Ephedra
D. Growth hormone

Answer 1

Dehydroepiandrosterone (DHEA)

Question 2

The parent of a 12­year­old child who has sickle cell trait (SCT) asks the
primary care pediatric nurse practitioner whether the child may play football. What will the nurse practitioner tell this parent?
A. Children with SCT should not play any contact sports.
B. Children with SCT may not play for NCAA schools in college.
C. Children with SCT should follow heat acclimatization guidelines.
D. Children with SCT should not participate in organized sports.

Answer 2

Children with SCT should follow heat acclimatization guidelines.

Question 3

The primary care pediatric nurse practitioner diagnoses a high school
basketball player with mononucleosis. The adolescent asks when she may resume play. What will the nurse practitioner tell her?
A. After 3 weeks, she may begin lifting weights but not full sports.
B. After 4 weeks, she may return to full play and practice.
C. At 4 weeks, she must have an exam to determine fitness for play.
D. She may engage in moderate exertion and practice after 3 weeks.

Answer 3

At 4 weeks, she must have an exam to determine fitness for play.

Question 4

The primary care pediatric nurse practitioner is performing a well child
examination on a high school age adolescent who plays football who has hypercalciuria. Which dietary supplement will the nurse practitioner question the adolescent about?
A. Protein supplements
B. Salt tablets
C. Sports drinks
D. Vitamin C

Question 5

The primary care pediatric nurse practitioner is counseling a parent about
bicycle helmet use. The parent reports having a helmet used a year previously by an older child and wonders about using it for a younger child since they are so expensive. What will the nurse practitioner tell the parent?
A. "As long as the helmet does not have cracks, you may use it."
B. "If the helmet is free from marks, you may use it."
C. "You may continue to use a helmet up to 10 years."
D. "You should always purchase a new helmet for each child."

Question 6

The primary care pediatric nurse practitioner counseling the parent of an
overweight school­age child about improving overall fitness. What will the nurse practitioner include?
A. Encourage the child to begin by engaging in swimming or cycling.
B. Exercise will help lower total cholesterol and low­density lipoproteins.
C. School­age children need 60 minutes of moderate exercise daily.
D. Strength training exercises are not safe for school­age children.

Question 7

A 12­year­old child who plays soccer is diagnosed with vocal cord
dysfunction. What will the primary care nurse practitioner say when the child's parents ask about continued sports participation?
A. The child may continue to participate in soccer.
B. The child should limit activity to non­aerobic sports.
C. This condition is a contraindication for all sports.
D. This condition predisposes the child to sudden cardiac death.

Question 8

The primary care pediatric nurse practitioner is performing a pre­participation
sports physical examination on a 14­year­old male who will be on the wrestling team at school. What will the nurse practitioner include when discussing healthy practices with this adolescent?
A. Risks associated with repeatedly losing and gaining weight
B. The need for an electrocardiogram or echocardiogram prior to participation
C. The need to consume 20 to 30 grams of protein after exercise
D. To consume water with CHO prior to activity lasting up to an hour

Question 9

The parents of a pre­pubertal female who is on the local swim team tell the
primary care pediatric nurse practitioner that their daughter wants to begin a strength training program to help improve her swimming ability. What will the nurse practitioner recommend?
A. Avoiding strength training programs until after puberty to minimize the risk for injury
B. Enrolling their daughter in a program that uses fixed weight machines or resistance bands
C. Having their daughter participate in weight training 4 or 5 times each week for maximum effect
D. Making sure that their daughter begins with the greatest weight tolerable using lower repetitions

Question 10

The parent of a high school basketball player tells the primary care pediatric
nurse practitioner that the adolescent becomes short of breath only when exercising. What will the nurse practitioner recommend?
A. Permanent discontinuation of all strenuous and aerobic activities
B. Enrollment in a conditioning program to improve performance
C. Evaluation for underlying cardiac causes of this symptom
D. Treatment for exercise­induced asthma with a bronchodilator

Question 11

The primary care pediatric nurse practitioner is evaluating a heart murmur
during a pre­participation examination of a high school athlete. Which finding would be a concern requiring referral to a cardiologist?
A. A murmur that is louder when squatting and softer when standing
B. A murmur that is quieter when squatting and louder with a Valsalva maneuver
C. A murmur with narrow and variable splitting of S2
D. A systolic murmur that is grade 1 or 2

Question 12

The primary care pediatric nurse practitioner is discussing fitness and
exercise with the parents of a 5­year­old child who ask what kinds of activities are developmentally appropriate for their child. What will the nurse practitioner recommend?
A. Bike riding
B. Interactive play
C. Martial arts
D. Organized sports

Question 13

The parent of a child newly diagnosed with epilepsy asks the primary care
pediatric nurse practitioner if the child will ever be able to participate in gym or sports. What will the nurse practitioner recommend?
A. Bicycle riding is not safe for children with seizures.
B. Contact sports should be avoided.
C. Direct supervision of some activities is necessary.
D. Underwater sports are not recommended.

Question 14

The parent of a child who has asthma asks the primary care pediatric nurse
practitioner about whether the child may engage in strenuous exercise. What will the nurse practitioner tell the parent?
A. Children with asthma should be excluded from vigorous exercise and most strenuous sports.
B. Children with asthma show improved aerobic and anaerobic fitness with moderate to vigorous/physical activity.
C. Physical activity has been shown to improve overall pulmonary function in children with asthma.
D. Vigorous exercise helps improve symptoms in children with poorly controlled asthma.

Question 15

A 15­year­old female basketball player who has secondary amenorrhea is
evaluated by the primary care pediatric nurse practitioner who notes a BMI in the 3rd percentile. What will the nurse practitioner counsel this patient?
A. That amenorrhea in female athletes is not concerning
B. That she should begin a program of plyometrics and strength training
C. To consider a different sport, such as volleyball
D. To work with a dietician to improve healthy weight gain

Question 16

A 10­year­old is hit in the head with a baseball during practice and is
diagnosed with concussion, even though no loss of consciousness occurred. The primary care pediatric nurse practitioner is evaluating the child 2 weeks after the injury and learns that the child is still experiencing some sleepiness every day. The neurological exam is normal. The child and the parent are adamant that the child be allowed to return to play baseball. What will the nurse practitioner recommend?
A. Continuation of cognitive rest only
B. Continuation of physical and cognitive rest
C. Continuation of physical rest only
D. Returning to play

Question 17

The parent of a 14­year­old child asks the primary care pediatric nurse
practitioner how to help the child prevent injuries when basketball tryouts begin later in the school year. Which recommendation will be of most benefit?
A. Preseason conditioning
B. Proper footwear
C. Protective knee braces
D. Stretching before practices

Question 18

The primary care pediatric nurse practitioner is discussing lifestyle changes
with an adolescent who has hypertension. What will the nurse practitioner recommend about exercise for this client?
A. Regular to vigorous activity initially with a combination of resistance and aerobic exercise to maintain lower blood pressure
B. Moderate daily exercise such as walking for 20 minutes daily with increasing intensity as blood pressure drops
C. Vigorous aerobic exercise combined with maximal strength training to lower blood pressure
D. Vigorous aerobic exercise only to reduce blood pressure and then to maintain lowered blood pressure

Question 19

The primary care pediatric nurse practitioner is offering anticipatory guidance
to the parents of a 6­year­old child who has Down syndrome. What will the nurse practitioner tell the parents about physical activity and sports in school?
A. Children with Down syndrome get frustrated easily when engaging in sports.
B. Children with Down syndrome should not participate in strenuous aerobic activity.
C. Their child should have a cervical spine evaluation before participation in sports.
D. Their child should only participate in sports sanctioned by the Special Olympics.