Deck 31: Health Supervision

Question 1

The nurse is caring for children in a physician's office where health supervision is practiced. Which of the following is a key focus of health supervision? Select all answers that apply.

A) Making referrals for all health care needs
B) Monitoring disease incidence
C) Optimizing level of functioning
D) Monitoring quality of care provided
E) Teaching parents to prevent injury
F) Providing care developed from national guidelines

Answer 1

Optimizing level of functioning
Teaching parents to prevent injury
Providing care developed from national guidelines

Question 2

The nurse is providing care for children in a pediatric medical home. Which of the following is a characteristic of care in these types of facilities?

A) All insurance except Medicaid is accepted.
B) Ambulatory care is not provided
C) A centralized database contains all child information.
D) Continuity of care is provided from infancy through adulthood.

Answer 2

A centralized database contains all child information.

Question 3

The nurse is preparing a presentation to a local parent group about pediatric health supervision. Which of the following would the nurse emphasize as the focus?

A) Injury prevention
B) Wellness
C) Health maintenance
D) Developmental surveillance

Answer 3

Wellness

Question 4

A large portion of the nurse's efforts is dedicated to health supervision for children who use the facility as their primary medical contact. At which of the following facilities does the nurse work?

A) An urgent care center
B) A pediatric practice
C) A mobile outreach immunization program
D) A dermatology practice

Question 5

The nurse strives to provide culturally competent care for children in a health clinic that follows the principles of health supervision. Which of the following nursing actions reflects this type of care?

A) The nurse treats all children the same regardless of their culture.
B) The nurse negotiates a care plan with the child and family.
C) The nurse researches the child's culture and provides care based on the findings.
D) The nurse provides future-based care for culturally diverse children.

Question 6

The nurse is aware that the community affects the health of its members. Which of the following statements accurately reflect a community influence of health care? Select all answers that apply.

A) A community can be a contributor to a child's health or be the cause of his or her illnesses.
B) The child's health should be separated from the health of the surrounding community.
C) Community support and resources are necessary for children with significant problems.
D) Poverty has not been linked to an increase in health problems in communities.
E) The breakdown of community and family support systems can lead to depression and violence.
F) Ideally, the child's medical home is located outside the community.

Question 7

The nurse is conducting a psychosocial assessment of a child with asthma brought to the physician's office for a check-up. Which of the following are psychosocial issues that might be assessed? Select all answers that apply.

A) Health insurance coverage
B) Transportation to health care facilities
C) School's response to the chronic illness
D) Past medical history
E) Future treatment plans
F) Health maintenance needs

Question 8

The nurse is examining a 2-year-old child who was adopted from Guatemala. Which of the following would be a priority screening for this child?

A) Screening for congenital defects
B) Screening for abuse
C) Screening for childhood illnesses
D) Screening for infectious diseases

Question 9

The mother of a 5-year-old child with eczema is getting a check-up for her child before school starts. Which of the following will the nurse do during the visit?

A) Change the bandage on a cut on the child's hand
B) Assess the compliance with treatment regimens
C) Discuss systemic corticosteroid therapy
D) Assess the child's fluid volume

Question 10

During the health history, the mother of a 4-month-old child tells the nurse she is concerned that her baby is not doing what he should be at this age. What is the nurse's best response?

A) "I'll be able to tell you more after I do his physical."
B) "Fill out the questionnaire and then I can let you know."
C) "Tell me what concerns you."
D) "All mothers worry about their babies. I'm sure he's doing well."

Question 11

A 3-year-old child is scheduled for a hearing screening. The nurse would prepare the child for screening by which method?

A) Auditory brain stem response
B) Evoked otoacoustic emissions
C) Visual reinforcement audiometry
D) Conditioned play audiometry

Question 12

A 2-week-old child responds to a bell during an initial health supervision examination. The child's records do not show that a newborn hearing screening was done. Which of the following is the best action for the nurse to take?

A) Do nothing because responding to the bell proves he does not have a hearingdeficit.
B) Immediately schedule the infant for a newborn hearing screening.
C) Ask the mother to observe for signs that the infant is not hearing well.
D) Screen again with the bell at the 2-month-old health supervision visit.

Question 13

The nurse is performing developmental surveillance for children at a medical home. Which of the following infants are most at risk for developmental delays? Select all answers that apply.

A) A child whose birthweight was 1,600 g
B) A child whose parent has a mental illness
C) A child raised by a single parent
D) A child with a lead level above 10 mg/dL
E) A child with hypertonia or hypotonia
F) A child with gestational age more than 33 weeks

Question 14

The nurse is examining a 15-month-old child who was able to walk at the last visit and now can no longer walk. What would be the nurse's best intervention in this case?

A) Schedule a full evaluation since this may indicate a neurologic disorder.
B) Note the regression in the child's chart and recheck in another month.
C) Document the findings as a developmental delay since this is a normal occurrence.
D) Ask the parents if they have changed the child's schedule to a less active one.

Question 15

During a physical assessment of a 5-month-old child, the nurse observes the first tooth has just erupted and uses the opportunity to advise the mother to schedule a dental examination for her baby. Which of the following is the correct time for the dentist visit?

A) By the first birthday
B) By the second birthday
C) By entry into kindergarten
D) By entry into first grade

Question 16

A mother and her 4-week-old infant have arrived for a health maintenance visit. Which of the following activities will the nurse perform?

A) Assess the child for an upper respiratory infection
B) Take a health history for a minor injury
C) Administer a varicella injection
D) Plot the child's head circumference on a growth chart

Question 17

The nurse is screening a 6-year-old child for mental ability. Which of the following tests would the nurse use to assess intelligence?

A) Denver Articulation Screening
B) Denver PRQ
C) Goodenough-Harris Drawing Test
D) Parents' Evaluation of Developmental Status (PEDS.

Question 18

When assessing the vision of a 2-month-old, the nurse would use which of the following?

A) Black-and-white checkerboard
B) Red and blue circles
C) Gray and blue animal drawings
D) Green and yellow letters

Question 19

The nurse is performing a risk assessment of a 5-year-old and determines the child has a risk factor for cystic fibrosis. What type of screening would the nurse perform to confirm or rule out this disease?

A) Universal screening
B) Selective screening
C) Hyperlipidemia screening
D) Developmental screening

Question 20

The nurse is caring for an infant who had hyperbilirubinemia requiring exchange transfusion. Based on this information, this infant is at risk for what type of disorder?

A) Vision loss
B) Hearing loss
C) Hypertension
D) Hyperlipidemia

Question 21

The nurse is performing a vision screening for a 4-year-old child. Which of the following screening charts would be best for determining the child's visual acuity?

A) Snellen
B) Ishihara
C) Allen figures
D) Color Vision Testing Made Easy (CVTME)

Question 22

The nurse is explaining the difference between active and passive immunity to the student nurse. Which of the following statements accurately describes a characteristic of the process of immunity?

A) Active immunity is produced when the immunoglobulins of one person are transferred to another.
B) Passive immunity can be obtained by injection of exogenous immunoglobulins.
C) Active immunity can be transferred from mothers to infants via colostrum or the placenta.
D) Passive immunity is acquired when a person's own immune system generates the immune response.

Question 23

The nurse is administering a hepatitis B vaccine to a child. What is the classification of this type of vaccine?

A) Killed vaccines
B) Toxoid vaccines
C) Conjugate vaccines
D) Recombinant vaccines

Question 24

A 15-month-old girl is having her first health visit at a clinic. The mother has no immunization record but says the child was immunized 3 months ago at the local health department. Which of the following is the best action for the nurse to take?

A) Ask the mother to bring the records to the next health maintenance visit.
B) Start the catch-up schedule since there are no immunization records.
C) Keep the child at the facility while the mother returns home for the records.
D) Call the local health department and verify the child's immunization status.

Question 25

The nurse is discussing vaccination for Haemophilus influenzae type B (Hib) with the mother of a 6-month-old child. Which of the following comments provides the most compelling reason to get the vaccination?

A) "These bacteria live in every human."
B) "Young children are especially susceptible to these bacteria."
C) "You have a choice of two excellent vaccines."
D) "Your child needs this final dose for protection."

Question 26

The mother of a 15-month-old child is questioning the nurse about the need for the hepatitis B vaccination. Which of the following comments provides the most compelling reason for the vaccine?

A) "The most common side effect is injection site soreness."
B) "This is a recombinant or genetically engineered vaccine."
C) "Immunizations are needed to protect the general population."
D) "This protects your child from infection that can cause liver disease."

Question 27

When preparing to administer the polio vaccine to an infant, the nurse would expect to administer the vaccine by which route?

A) Intramuscular
B) Subcutaneous
C) Oral
D) Intradermal

Question 28

After teaching the mother about follow-up immunizations for her daughter, who received the varicella vaccine at age 14 months, the nurse determines that the teaching was successful when the mother states that a follow-up dose should be given at which time?

A) When the child is 20 to 36 months of age
B) When the child is 4 to 6 years of age
C) When the child is 11 to 12 years of age
D) When the child is 13 to 15 years of age

Question 29

The nurse working in a community clinic attempts to establish a free vaccination program to refer low-income families. What is the key strategy for success when implementing a health promotion activity?

A) Partnership development
B) Funding for projects
C) Finding an audience
D) Adequate staffing

Question 30

The nurse is providing anticipatory guidance to an obese teenager. Which of the following interventions would be most likely to promote healthy weight in teenagers?

A) Make the focus of the program weight centered.
B) Begin directly advising children about their weight at age 6.
C) Focus physical activity on competitive sports and activities.
D) Obtain nutritional histories directly from the school-age child and adolescent.