Question 1

Because of county need,a school nurse was transferred from a new suburban school to a large inner-city school in an older low-income neighborhood.Which of the following changes in role should be anticipated by the nurse? (Select all that apply.)

Accepted Answer

Because cheap food is often high in portion size and sugar and fat,school may be the only place where children have the opportunity to eat fruits,vegetables,and protein choices.Thus,it will be important to make sure these choices are included in the school lunch program.Because old neighborhoods often have lead pipes and old lead paint,lead screening is crucial in older neighborhoods,particularly low-income neighborhoods where parents have fewer resources and are often in aged housing.Stereotypes such as "only poor people get head lice" abound.Head lice do not respect socioeconomic class,so such screening might be done in any school.Similarly,child abuse occurs among families of all social economic classes.Free immunizations are available,so this is probably not as big a problem as stereotypes about the poor might suggest.Indeed it is usually in wealthier neighborhoods that parents are concerned about mercury poisoning and try to avoid having their children immunized.There is unlikely an increased absentee rate because of infectious disease,as these are not seen at an increased incidence in suburban versus urban neighborhoods.

Question 2

A nurse is trying to determine who would be the most appropriate person to make a health care decision for an adolescent,the adolescent or the parent.Which of the following considerations will the nurse need to make?

Accepted Answer

This situation addressed the need for client autonomy.When considering client autonomy,the nurse must consider the following questions.In the specific case,who should make health care decisions for a young client,especially when opposing opinions arise? The client? The parents or guardian? The nurse or other health care professional? At what age does a child become mature enough to participate in such decision making? What laws does any given state have that affect adolescent client autonomy? What should the community health nurse do if he or she believes the client's or parent's decisions are not in the best interest of the client?

Question 3

Which of the following would be a source of care if families are employed at a salary above the poverty line,but at too low of an income for health insurance?

Accepted Answer

Although families may be able to get some assistance from any of the listed resources,the CHIP is a publicly subsidized health insurance program for children.It was specifically created for children whose family income is above Medicaid limits but whose families do not receive health insurance through the parents' employment (i.e.,the working poor).

Question 4

Using a public health perspective,which of the following has responsibility for a child's health?

Accepted Answer

Child health is affected by many factors; therefore,the responsibility for improving children's health rests with the entire community.This responsibility begins with parents and includes health care professionals,community groups,businesses,and the public sector.When a child gets older,he or she can be responsible for practicing healthy behaviors and obtaining proper health care.

Question 5

Which of the following best explains why an employer would care about the health needs of local children?

Accepted Answer

Business and industry have an enormous stake in the health of the nation's children.A strong,productive workforce is ensured only when the health,social,and educational needs of the next generation of workers are met.Furthermore,health risks cost employers in lost productivity and increased health care costs.Avoiding scandal and negative media coverage would not be a reason why employers would care about the health needs of the local children.The community does not provide greater support to businesses that have family-based policies.Although,businesses want to keep their employees at work instead of at home taking care of ill children,businesses are concerned with more than just the children of their employees.All children in the local community are a concern for employers as these are the future workforce.

Question 6

Which of the following individuals is most likely to be the victim of violent crime?

Accepted Answer

Black males are the racial group most likely to be victimized.Violence is more likely to occur with an adolescent than a child.

Question 7

When the school health nurse suggested the school health clinic include sexual counseling and free condoms if requested,an angry woman yelled,"Why do I care if some girls have no morals and sleep around?" Which of the following would be the most appropriate response by the nurse?

Accepted Answer

Preventing pregnancy among teenagers can reduce the dropout rate,welfare dependency,low birth weight,and infant mortality.According to an analysis by the National Campaign to Prevent Teen Pregnancy,the estimated cost of teen childbearing in the United States cost taxpayers (federal,state,and local)is at least $109 billion.

Question 8

A mother was debating whether or not to take her son to the clinic.His temperature was 104° F and rising so she gave him acetaminophen (Tylenol).Which of the following will most likely be the deciding factor in the mother's decision?

Accepted Answer

The ability to pay for health care greatly influences whether a parent takes a child to see a health care provider.Having health insurance would be the most important deciding factor in this situation,more important than if the child is crying,if the fever goes down,or if the child seems to be getting better.

Question 9

How do the policies on children's health in the United States differ from the policies on children's health in other industrialized nations?

Accepted Answer

In the United States,the government's role in promoting or ensuring children's health is more limited than in many other countries.Other countries often have defined policies on children's health; the United States does not.Not only do such policies indicate that children are a priority of the citizenry,but they also help shape the operation of programs and their funding.

Question 10

According to the U.S.Department of Commerce,which of the following rules must be followed by makers of toy guns?

Accepted Answer

The U.S.Department of Commerce requires toy guns to be distinguished from real guns.In many cases,the toy industry has established voluntary safety standards to minimize risk of injury.There is not specific legislation from the U.S.Department of Commerce that outlines the materials that must be used in darts of toy guns or banning the use of reflective or lead-based paint or lead products.

Question 11

Which of the following best describes the screening tests that are completed on all newborns in the United States?

Accepted Answer

Every infant born in the United States is screened shortly after birth for a number of genetic disorders.Newborn screening is state-based so the number of conditions that babies are screened for varies from state to state.All U.S.states and territories currently test for 26 health conditions including phenylketonuria,galactosemia,congenital hypothyroidism,and sickle cell disease.

Question 12

A school nurse is trying to determine health trends when making plans for health programming in the school for the upcoming school year.Which of the following would be the most appropriate action for the nurse to take?

Accepted Answer

The federal,state,and local governments and many national organizations collect and analyze data to track the well-being of children and adolescents.For example,the U.S.Department of Health and Human Services (USDHHS)generates a yearly report,Child Health USA,on more than 50 indicators of the well-being of America's children and youth.Such data are readily accessible online.A number of key indicators are tracked on a regular basis by the federal statistical system so that trends are revealed.State and local data also are used to track the well-being of children.The most efficient use of the nurse's time would be to use data that already exists rather than trying to create new data.This could be done by performing an online search for existing data.Once the existing data is collected,the nurse may then need to look specifically at the data at the school or create new data to examine new or existing problems.

Question 13

A nurse is developing a community education program about how to prevent sudden infant death syndrome (SIDS).Which of the following information would be included in the presentation? (Select all that apply.)

Accepted Answer

Some of the recommendations to reduce the risk of SIDS include: always place a baby on his or her back to sleep,for naps and at night; use a firm sleep surface,covered by a fitted sheet; the baby should not sleep in an adult bed,on a couch,or on a chair alone or with anyone else; keep soft objects,toys,and loose bedding out of the baby's sleep area; do not smoke during pregnancy,and do not smoke or allow smoking around the baby; and do not let the baby get too hot during sleep.

Question 14

Which of the following factors is the single largest threat to child health?

Accepted Answer

Poverty is the greatest threat to child health.Children in poverty have less access to nutritious food,shelter,and health care.They are often deprived of advantages such as good schools and may live in substandard housing,have stressful home lives,live surrounded by drugs and crime,and lack positive and nurturing adult role models.

Question 15

A school nurse has identified that there has been an increase in sexually transmitted infections (STIs)among the adolescents attending the school.Which of the following interventions should be completed by the nurse?

Accepted Answer

Barriers to health care such as lack of transportation,concerns about confidentiality,and lack of access to preventive health services contribute to a high prevalence of STIs among teens.Having a free clinic in the school removes some of the barriers.

Question 16

When considering the benefits for the recipients,which is more beneficial: Medicaid or private insurance?

Accepted Answer

Through the Early Periodic Screening,Diagnosis,and Treatment program,a child covered by Medicaid can receive a range of health and health-related services beginning in infancy.The program is designed to ensure availability and accessibility of health care resources and to help Medicaid recipients and their parents effectively use these resources.The program's services far exceed those usually covered by private insurance.Private insurance may not be accepted by all providers,as many insurance plans may limit the providers that can be seen under a certain insurance plan.Medicaid is not available for all children,only those from low-income families.

Question 17

A man,who looked about 45 years old,gave a cashier at a grocery store the Special Supplemental Nutrition Program for Women,Infants,and Children (WIC)vouchers for some of the food he had just selected.Which of the following conclusions can be drawn from this scenario?

Accepted Answer

WIC provides federal grants to states for the purpose of serving nutritionally at-risk,low-income pregnant and postpartum women and their children up to five years of age.WIC programs provide highly nutritious foods,nutrition education and counseling,and screening and referral to needed services.To be eligible,women and children must meet income guidelines established by each state,and a health professional must determine they are at "nutritional risk." Women and children who participate in Medicaid,the Food Stamp program,or the Temporary Assistance for Needy Families program are automatically income eligible for WIC.This man would not be eligible for WIC assistance himself because this program is for women and children.

Question 18

A school nurse brought a young boy back into a private office and asked him to remove his shirt.Fresh welts across his back were seen.Which of the following would most likely cause the nurse to be concerned about the parents? (Select all that apply.)

Accepted Answer

Most often,the perpetrators of maltreatment are parents and victims themselves from a cycle of abuse.The two dominant characteristics of abusive parents include a history of substance abuse and abuse from their own parents.They may be stressed by poverty,illness,or disability,and they may lack social support systems or coping skills.In cases of abuse,it is unlikely that the child "asked for it".Because of a possible past history of abuse or substance abuse,parents may be more likely to abuse their own children,it would not be because they do not like their own child.Not having health insurance for the boy would not play a role in whether he was being abused.

Quiz 16: Child and Adolescent Health