Deck 44: Social and Environmental Influences on the Child

Question 1

When examining a 2-year-old child during a well child physical,it is most important for the nurse to assess:

A)Visual acuity.
B)Helmet use.
C)Risk of lead exposure.
D)Whether household drinking water contains fluoride.

Answer 1

Risk of lead exposure.

Question 2

A 7-year-old child is being seen in the clinic for a well child visit.The parent of the child reports the child is timid,seems anxious,and actually fears going to school.The nurse should counsel the parent that the child might be:

A)A victim of a bully.
B)Bullying other children at school.
C)Doing poorly in math class.
D)Doing poorly in physical education class.

Answer 2

A victim of a bully.

Question 3

A concerned parent calls the school nurse because of changes in his 15-year-old's behavior.In counseling the parent,the nurse would inform him that the behavior most likely to be abnormal and indicate possible substance abuse is the adolescent's:

A)Buying baggy,oversized clothing at thrift shops and dying her hair a dark black shade.
B)Becoming very involved with participating with friends on a basketball team,never seeming to be home,and when she is home,preferring to be in her room with the door shut.
C)Receiving numerous detentions lately from teachers for sleeping in class.
D)Becoming very moody,dramatically crying,and weeping one minute and then cheerful and excited the next.

Answer 3

Receiving numerous detentions lately from teachers for sleeping in class.

Question 4

The school nurse is planning a smoking-prevention program for middle school students.The strategy that is most likely to be effective in preventing middle school children from smoking is:

A)Having a local high school basketball star come talk to the students about the importance of not smoking.
B)Having the school's biology teacher demonstrate the pathophysiology of the effects of smoking tobacco on the body.
C)Developing colorful posters with catchy slogans and placing them all over the school.
D)Having a pledge campaign with prizes awarded where students sign contracts saying that they will not use tobacco products.

Question 5

The nurse is giving a health promotion class to adolescents.In counseling an adolescent about lifestyle choices,the nurse discusses the fact that the most preventable cause of adult death in the United States is:

A)Alcohol use.
B)Obesity.
C)Tobacco use.
D)Cocaine use.

Question 6

A child is admitted to the hospital unit with physical injuries.The nurse is taking the child's history.Which statement by the parent is most suspicious for abuse?

A)"I did not realize that my baby was able to roll over yet,and I was just gone a minute to check on dinner when the baby rolled off of the couch and onto our tile floor."
B)"The baby's 18-month-old brother was trying to pull the baby out of the crib and dropped the baby on the floor."
C)"I placed the baby in the infant swing.His 6-year-old brother was running through the house and tripped over the swing,causing it to fall."
D)"I feel so bad.I was holding the baby in one arm and some towels in the other and did not see my toddler's toys on the floor.I tripped,and when I fell,the baby slipped out of my arms."

Question 7

A mother of two children,an 8-year-old and a 10-year-old,tells the nurse her husband recently has been deployed to the Middle East.The mother is concerned about the children's interest in constantly watching TV news coverage of activities in the Middle East.Which is the most appropriate suggestion for the nurse to make to this mother?

A)"Allow the children to watch as much television as they want.This is how they are coping with their father's absence."
B)"It will just take some time to adjust to their father's absence,then everything will return to normal."
C)"The less that you discuss this,the quicker the children will adjust to their father's absence.Try to keep them busy,and use distractions to keep their mind off of it."
D)"Spend time with your children and take cues from them about how much they want to discuss."

Question 8

A recently divorced mother who must return to work is concerned about the effects of placing her child in day care full-time.In counseling the mother,the nurse knows that the factor that is most influential in determining whether day care has a positive or negative effect on the child is:

A)The ratio of day care workers to children.
B)The closeness of the parent-child relationship.
C)The amount of time that the children spend playing outside.
D)The cleanliness of the facility.

Question 9

While working at a weekend "free clinic," the nurse is assessing a 3-year-old when the mother of the child confides that it has been very difficult providing for her family of four children on her limited budget,and that she is not sure that she has enough money to buy food for the rest of the month,let alone the antibiotic that is needed for the child's ear infection.Which is the intervention by the nurse that would be most beneficial for the child and this family?

A)Giving the mother enough free samples of the antibiotic for the recommended course of treatment
B)Putting the mother in contact with a local agency that provides food on a regular basis to needy families and helps them access other resources in the community
C)Talking with the mother about the factors that increase a child's risk of acquiring an ear infection
D)Talking with the mother about the importance of a balanced diet in the growth and development of children,and providing her with a list of inexpensive,nutritious foods

Question 10

A 7-year-old child has been seen in the pediatric clinic three times in the last 2 months for complaints of abdominal pain.Physical exam and all ordered lab work have been normal.Which statement or question by the nurse working with this child would be most helpful to determine the etiology of this child's abdominal pain?

A)"Have there been any changes in your child's school or home life recently?"
B)"Tell me what your child usually eats on a normal day."
C)"Are your child's immunizations up to date?"
D)"Has your child had any fevers or viral illnesses in the last 3 months?"

Question 11

During a well child exam,the parents of a 4-year-old child inform the nurse that they are thinking of buying a television for their child's bedroom,and ask for advice as to whether this is appropriate.Which is the best response from the nurse?

A)"Research has shown that children with a television in their bedroom spend significantly less time playing outside than other children do,and physical inactivity in children has been linked to many chronic diseases,such as obesity and type 2 diabetes."
B)"Research has shown that watching educational television shows improves a child's performance in school."
C)"Don't buy a television for your child's room;he is much too young for that."
D)"It is okay for your child to have a television in his room as long as you limit the amount of time he watches it to less than 2 hours per day."

Question 12

While giving the history of a 10-year-old child,the parents admit to owning firearms.Which are appropriate safety measures for the nurse to suggest? Select all that apply.

A)Using gun locks on all firearms in the house
B)Taking the child to a shooting range for lessons on how to use a gun properly
C)Storing the guns and ammunition in separate places
D)Keeping all the guns in a locked cabinet
E)Explaining the dangers of a gun to the child and telling her explicitly never to touch it

Question 13

A high school student calls to ask the nurse for advice on how to care for a new navel piercing.Which is the nurse's best reply?

A)"Apply warm soaks to the area for the first 2 days to minimize swelling."
B)"Do not move or turn the jewelry for the first 3 days."
C)"Avoid contact with another person's bodily fluids until the area is well healed."
D)"Apply lotion to the area,rubbing gently,to prevent skin from becoming dry and irritated."

Question 14

The nurse works in a pediatric unit.In working with a parent who is suspected of Munchausen syndrome by proxy,it is very important for the nurse to:

A)Confront the parent with concerns of possible abuse.
B)Carefully document parent-child interactions.
C)Try to keep the parent separated from the child as much as possible.
D)Explain to the child that her parent is causing her illness,and that the health team will prevent her from being harmed.

Question 15

Using the ecologic theory as a guide,which statement correctly indicates the effects of the environment on children?

A)Children's adaptation to the environment is based on their specific risks and protective factors,and these can change health outcomes.
B)Children and the environment surrounding them influence each other,and can change health outcomes.
C)Children can use people in the environment to develop coping strategies to deal with risk factors.
D)Children handle stressors better than adults do because they can use aspects of the environment to change as needed.