Question 1

The primary care pediatric nurse practitioner is providing anticipatory
guidance to the parent of a school­age boy. The parent expresses concerns that the child prefers to play with dolls, is worried that the child will be a homosexual, and asks what can be done to prevent this from happening. What will the nurse practitioner tell this parent?

Accepted Answer

D

Question 2

The primary care pediatric nurse practitioner is performing a well child
examination on a 3­year­old. The child's parent reports that the child has recently begun masturbating. What will the nurse practitioner counsel this parent?

Accepted Answer

The nurse practitioner should counsel the parent to teach the child about privacy and hand hygiene. While masturbation is a normal activity for children of this age, it is important to teach them to do it in private and to practice good hygiene to prevent the spread of germs. Discussing sexuality with the child or exploring whether the child is being abused are not necessary at this time.

Question 3

The mother of a 3­month­old male infant tells the primary care pediatric
nurse practitioner that she occasionally notices he has a penile erection just after nursing. What will the nurse practitioner tell the mother?

Accepted Answer

This is a normal, reflexive behavior at this age. Infantile erections are common in male infants, often occurring during sleep, and are due to reflexive stimulation of the parasympathetic nervous system. It is a normal developmental process and does not indicate any sexual activity or awareness. The nurse practitioner should reassure the mother that this is a normal finding. A and B are incorrect as they are both inappropriate and incorrect responses. C is incorrect as infantile priapism is a rare medical condition that results in a prolonged erection and requires medical intervention.

Question 4

The primary care pediatric nurse practitioner is performing a well child exam
on an 8­year­old girl and notes the presence of breast buds. What will the nurse practitioner include when initiating anticipatory guidance for this patient?

Accepted Answer

Breast buds indicate the onset of puberty, so the nurse practitioner would provide anticipatory guidance on sexual maturity and menstrual periods. This would include discussing how the body changes during puberty and offering information about menstruation and personal hygiene. It is not appropriate to discuss pregnancy, sexually transmitted diseases, sexual orientation or the nature of sexual relationships with an 8-year-old patient. The human papillomavirus vaccine may be mentioned in passing as part of a larger discussion about immunizations, but it is not a primary focus of anticipatory guidance for this patient.

Question 5

During a well child examination of a 6­year­old girl, the primary care pediatric
nurse practitioner notes that the child becomes embarrassed and resists taking off her underwear for the exam. What should the nurse practitioner infer from this observation?

Accepted Answer

It is normal for young children to feel embarrassed or uncomfortable when undressing for a physical exam, especially when it involves sensitive areas. This behavior is not necessarily indicative of sexual abuse or mistreatment by the examiner or parent. The nurse practitioner should provide reassurance and explain the necessity of the exam in language appropriate for the child's age and developmental level.

Question 6

The parent of an 8­year­old child tells the primary care pediatric nurse
practitioner that the child has begun to ask questions about why a schoolmate has "2 daddies" and wonders how to talk to the child about this. What will the nurse practitioner recommend?

Accepted Answer

Explaining that not all families are the same and what is most important is that they love and care for their children is a developmentally appropriate response for an 8 year old. It acknowledges the child's question and offers a simple and non-judgmental explanation. It is important to validate the child's curiosity and promote acceptance and tolerance of diverse family structures. A and B may be too advanced for an 8 year old and D may perpetuate confusion and distance the child from understanding and accepting diversity in adults' relationships.

Question 7

During a well child exam on a 13­year­old female, the primary care pediatric
nurse practitioner notes that the child is at Tanner Stage 3. During the exam, when the nurse practitioner initiates a conversation about healthy sexuality education, the parent states that this topic is "off limits." What will the nurse practitioner do?

Accepted Answer

Spending private time with the parent to discuss how sexuality education reduces the risk of early sexual intercourse and risky sexual behaviors is the most appropriate action for the nurse practitioner to take.

Question 8

During a well child examination, a 15­year­old female tells the primary care
pediatric nurse practitioner that some of her friends have begun having sex. She has a boyfriend but denies engaging in sex with him. What will the nurse practitioner do initially?

Accepted Answer

Initially, it's important to understand the teenager's perspective and definition of "sex" to ensure that any advice or information provided is relevant and addresses the teenager's actual situation or questions. Different individuals may have varying understandings of what constitutes sexual activity, and clarifying this can guide the healthcare provider in offering appropriate guidance and support.

Question 9

The primary care pediatric nurse practitioner is counseling the parents of a
13­year­old female who has Down syndrome about sexual maturation. What will the nurse practitioner tell these parents?

Accepted Answer

All individuals have a right to discuss and learn about healthy sexuality, including individuals with Down syndrome. It is important to provide appropriate education and support to promote a positive and healthy view of sexuality.

Quiz 15: Sexuality

The primary care pediatric nurse practitioner is performing a well child examination on a 3yearold. The child's parent reports that the child has recently begun masturbating. What will the nurse practitioner counsel this parent?

The mother of a 3monthold male infant tells the primary care pediatric nurse practitioner that she occasionally notices he has a penile erection just after nursing. What will the nurse practitioner tell the mother?

The primary care pediatric nurse practitioner is performing a well child exam on an 8yearold girl and notes the presence of breast buds. What will the nurse practitioner include when initiating anticipatory guidance for this patient?

During a well child examination of a 6yearold girl, the primary care pediatric nurse practitioner notes that the child becomes embarrassed and resists taking off her underwear for the exam. What should the nurse practitioner infer from this observation?

The parent of an 8yearold child tells the primary care pediatric nurse practitioner that the child has begun to ask questions about why a schoolmate has "2 daddies" and wonders how to talk to the child about this. What will the nurse practitioner recommend?

During a well child examination, a 15yearold female tells the primary care pediatric nurse practitioner that some of her friends have begun having sex. She has a boyfriend but denies engaging in sex with him. What will the nurse practitioner do initially?

The primary care pediatric nurse practitioner is counseling the parents of a 13yearold female who has Down syndrome about sexual maturation. What will the nurse practitioner tell these parents?

Quiz 15: Sexuality

The primary care pediatric nurse practitioner is performing a well child examination on a 3­year­old. The child's parent reports that the child has recently begun masturbating. What will the nurse practitioner counsel this parent?

The mother of a 3­month­old male infant tells the primary care pediatric nurse practitioner that she occasionally notices he has a penile erection just after nursing. What will the nurse practitioner tell the mother?

The primary care pediatric nurse practitioner is performing a well child exam on an 8­year­old girl and notes the presence of breast buds. What will the nurse practitioner include when initiating anticipatory guidance for this patient?

During a well child examination of a 6­year­old girl, the primary care pediatric nurse practitioner notes that the child becomes embarrassed and resists taking off her underwear for the exam. What should the nurse practitioner infer from this observation?

The parent of an 8­year­old child tells the primary care pediatric nurse practitioner that the child has begun to ask questions about why a schoolmate has "2 daddies" and wonders how to talk to the child about this. What will the nurse practitioner recommend?

During a well child examination, a 15­year­old female tells the primary care pediatric nurse practitioner that some of her friends have begun having sex. She has a boyfriend but denies engaging in sex with him. What will the nurse practitioner do initially?

The primary care pediatric nurse practitioner is counseling the parents of a 13­year­old female who has Down syndrome about sexual maturation. What will the nurse practitioner tell these parents?