Question 1

The parent of a 12-year-old 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?

Accepted Answer

Children with SCT should follow heat acclimatization guidelines, but they may participate in organized sports, including football. However, they should stay well hydrated, take frequent rest breaks, avoid extreme temperatures, and acclimate to hot weather before beginning activities. While they are not prohibited from playing for NCAA schools, they must be aware of the medical implications and possible risks.

Question 2

The parent of a 14-year-old 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?

Accepted Answer

Preseason conditioning is the best choice as it helps to improve strength, flexibility, and endurance, reducing the risk of injury. Proper footwear, protective knee braces, and stretching before practices are also important but not as effective as preseason conditioning.

Question 3

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?

Accepted Answer

Protein supplements have been linked to an increased risk of hypercalciuria, which is the excretion of too much calcium in the urine. This can lead to the formation of kidney stones and other complications. The nurse practitioner should ask the adolescent about their use of protein supplements and advise them on the potential risks associated with their use. Salt tablets, sports drinks, and vitamin C are not typically associated with hypercalciuria.

Question 4

The primary care pediatric nurse practitioner is discussing fitness and exercise with the parents of a 5-year-old child who ask what kinds of activities are developmentally appropriate for their child. What will the nurse practitioner recommend?

Accepted Answer

The answer of The primary care pediatric nurse practitioner is...

Question 5

The primary care pediatric nurse practitioner is evaluating a heart murmur during a pre-participation examination of a high school athlete. Which finding would be a concern requiring referral to a cardiologist?

Accepted Answer

A murmur that is quieter when squatting and louder with a Valsalva maneuver suggests a possible hypertrophic cardiomyopathy, which requires prompt referral to a cardiologist. The other options are commonly seen in innocent heart murmurs and do not require immediate referral.

Question 6

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?

Accepted Answer

Mononucleosis can affect the spleen, leading to an increased risk of splenic rupture, especially with physical activity. Before resuming sports, patients often need a medical evaluation at around 4 weeks to assess their fitness for play and ensure the spleen is not enlarged.

Question 7

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?

Accepted Answer

The nurse practitioner should recommend that direct supervision of some activities is necessary for the child with epilepsy. It is important for the child to remain active and participate in physical activities, but some modifications and supervision may be necessary to ensure safety. Banning all sports or physical activities can lead to social isolation and decreased self-esteem in the child. It is important to work closely with the child's health care team to identify appropriate activities and safety measures.

Question 8

The primary care pediatric nurse practitioner is performing a pre-participation sports physical examination on a 14-year-old male who will be on the wrestling team at school. What will the nurse practitioner include when discussing healthy practices with this adolescent?

Accepted Answer

The nurse practitioner should discuss with the adolescent the risks associated with repeatedly losing and gaining weight, as this is a common practice in wrestling to meet weight class requirements. This can have negative effects on the wrestler's physical and mental health. Option B is not necessary unless there is a specific medical indication. Option C may be discussed as a general guideline for athletes, but specific protein requirements may vary based on individual factors. Option D is not applicable to wrestling, as matches typically last longer than an hour and consuming water with carbohydrates before activity may not be necessary.

Question 9

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?

Accepted Answer

Regular to vigorous activity with a combination of resistance and aerobic exercise is recommended to help maintain lower blood pressure in adolescents with hypertension.

Question 10

A 15-year-old 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?

Accepted Answer

The low BMI suggests that the patient may not be consuming enough calories to support her athletic activity and may need to work with a dietician to improve healthy weight gain. Amenorrhea in female athletes is a concerning sign and is often a result of inadequate caloric intake and/or excessive exercise. Beginning a program of plyometrics and strength training or considering a different sport would not address the underlying issue of inadequate caloric intake.

Question 11

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?

Accepted Answer

Shortness of breath only with exercise can be a sign of an underlying cardiac issue. Therefore, the adolescent should be evaluated for any cardiac issues before further recommendations are made.

Question 12

A 10-year-old 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?

Accepted Answer

Since the child is still experiencing sleepiness, it is important to continue both physical and cognitive rest to allow the brain to fully heal. Even though the neurological exam is normal, returning to play could cause further injury and delay recovery. The child and parent should be educated on the risks of returning to play too soon and the importance of following the recommended rest and recovery plan.

Question 13

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?

Accepted Answer

Research has shown that regular physical activity actually improves pulmonary function and decreases the severity of asthma symptoms in children. The American Academy of Pediatrics recommends that children with asthma be encouraged to participate in a wide range of physical activities, including those that are moderately to highly intensive. However, it is important for the child to have a proper asthma management plan in place and for the parents to communicate with the child's healthcare provider about any concerns.

Question 14

The primary care pediatric nurse practitioner is offering anticipatory guidance to the parents of a 6-year-old child who has Down syndrome. What will the nurse practitioner tell the parents about physical activity and sports in school?

Accepted Answer

Children with Down syndrome have a higher risk of cervical spine instability, which can lead to injury if the child participates in contact sports or activities that involve rapid neck movements. Therefore, the child should have a cervical spine evaluation before participation in sports. It is important for the child to engage in physical activity and sports, as it can improve their physical, mental, and social well-being. However, the type and intensity of physical activity should be tailored to the child's individual abilities and interests. It is important to encourage the child to participate in sports and physical activity, while also being aware of their limitations and ensuring their safety.

Quiz 19: Physical Activity and Sports for Children and Adolescents