Question 1

A nurse is working with the family of a child who is overweight.What action by the nurse is most appropriate?
A)Help the family identify fun activities.
B)Instruct the child to exercise for an hour each day.
C)Place the child on a restricted-calorie diet.
D)Set a weight-loss goal for the child.

Accepted Answer

The nurse should encourage the entire family to engage in physically active and fun events.What people like,they will continue to do.The nurse can help the family members identify activities they enjoy or help them discover new ones.Setting rigid and unrealistic exercise goals is likely to fail.Restricted diets are also not recommended for children,as they contribute to eating and weight problems.The nurse should not set goals for the child,but rather plan goals together with the child and family.

Question 2

A nurse is making a referral for a family whose teenage daughter has anorexia nervosa.Which referral is the most appropriate?
A)Crisis intervention counseling
B)Family-oriented therapy
C)Multidisciplinary team
D)Psychiatrist

Accepted Answer

Eating disorders are difficult to treat,and often the entire family is involved in therapy.The best approach is often a multidisciplinary team with expertise in this topic.The other services may be needed on a case-by-case basis,but overall the best referral is to a treatment center that uses a multidisciplinary team.

Question 3

A nurse is teaching a class to new mothers who are also high school students.What action by the nurse is the most appropriate in order to decrease the risk of child maltreatment?
A)Explain the laws regarding child abuse and neglect.
B)Provide education on normal childhood development.
C)Refer all the young mothers to a social service agency.
D)Teach the mothers signs and symptoms of abuse.

Accepted Answer

Young mothers (and fathers)may have unrealistic expectations for their child's behavior based on ignorance of normal growth and development.This can lead to anger,resentment,and harsh discipline,especially if the parent feels the child is acting out deliberately.Teaching normal growth and development along with age-appropriate disciplinary strategies can reduce the incidence of child maltreatment.Simply explaining laws and manifestations will not result in major decreases in child abuse.Not all young mothers need social service intervention;this can be offered based on individual and family assessments.

Question 4

A student nurse wants to know what substances adolescents are at highest risk for abusing.Which information is the most appropriate for the pediatric nurse to share with the student?
A)It depends on what is popular at the time in their schools.
B)Alcohol and prescription drugs,because they are in most homes.
C)Substance abuse varies greatly between age groups and level of school.
D)There are no reliable data on substances abused most by adolescents.

Accepted Answer

The major factors determining what substances are abused most are availability and cost.Alcohol,tobacco,and prescription drugs are found in most homes,making them readily available and cheap.Substance abuse may depend somewhat on what peers are using and the age of the user,but bigger factors are cost and availability.

Question 5

A pregnant woman asks the nurse how much alcohol must be consumed to put her fetus at risk of fetal alcohol spectrum disorder.What answer by the nurse is the most appropriate?
A)Any alcohol during the third trimester
B)Any amount at any time during the pregnancy
C)More than 2 drinks/day in the first trimester
D)Three or more drinks/day throughout pregnancy

Accepted Answer

Data show that alcohol intake at any time of pregnancy is harmful.The nurse should educate the woman that drinking any amount of alcohol at any time during her pregnancy can increase the risk of fetal alcohol spectrum disorder.

Question 6

A community nurse approaches the organization's manager wanting to set up screening for risk factors for Tourette's syndrome in children.Which response by the manager is the most appropriate?
A)Allocate funding for a family psychosocial or cognitive condition screening.
B)Deny the request because Tourette's syndrome has very little impact.
C)Explain that Tourette's syndrome is most likely inherited.
D)Facilitate cooperative agreements with a community laboratory facility.

Accepted Answer

Tourette's syndrome is an inherited neuropsychiatric disorder.Children with Tourette's syndrome are often teased or bullied,and the disorder can have a major impact on social functioning and relationships.A family psychosocial or

Question 7

A nurse is assessing a child who has a large head,an elongated face,and prominent ears.Which discharge instruction is most important?
A)"Create a family pedigree so I can assess for Down syndrome."
B)"Please make an appointment with a pediatric cardiologist."
C)"We will call you regarding a referral for genetic testing."
D)"You will need to abstain from alcohol in your next pregnancy."

Accepted Answer

This child has manifestations of fragile X syndrome.The family needs to have genetic testing done for this inherited condition.The other instructions are not necessary.

Question 8

A nurse has identified substance abuse in an adolescent.In addition to a treatment center referral,what other referral is most important?
A)Counseling for parents
B)Law enforcement
C)Mental health provider
D)Social services agencies

Accepted Answer

Untreated psychiatric disorders increase the risk of substance abuse,so the family should be referred to a mental health provider.Many treatment centers include this service,but if not,the nurse needs to facilitate this referral.The other referrals are not necessarily needed.

Question 9

A nurse is caring for a child with attention deficit-hyperactivity disorder (ADHD).Which medications does the nurse anticipate may be prescribed for this child? (Select all that apply.)
A)Adderall (amphetamine salts)
B)Haldol (haloperidol)
C)Prozac (fluoxetine hydrochloride)
D)Ritalin (methylphenidate hydrochloride)
E)Strattera (atomoxetine)

Accepted Answer

Drugs most commonly used for ADHD include stimulants such as Ritalin and Adderall,and Strattera (a nonstimulant).Haldol is an antipsychotic.Prozac is an antidepressant.

Question 10

The mental health nurse is preparing a presentation for nurses who work with pediatric patients.Which barriers to mental health screening should the nurse include in the presentation? (Select all that apply.)
A)Belief that children do not have psychosocial or cognitive conditions
B)Family shame related to psychosocial or cognitive conditions
C)High level of health literacy regarding psychosocial or cognitive conditions
D)Minimizing of psychosocial or cognitive conditions symptoms by health-care providers
E)Stigma of psychosocial or cognitive conditions in society

Accepted Answer

There are many barriers to adequate health care for psychosocial or

Question 11

A pediatric nurse is explaining child abuse and neglect to a class of nursing students.Which information does this nurse provide the students during the presentation? (Select all that apply.)
A)Children with disabilities are at higher risk.
B)Diagnosing physical child abuse is easy and quick.
C)Each week,about 5 children die from abuse.
D)Neglect is most common,but is difficult to identify.
E)Unexplained,recurrent conditions may be caused by abuse.

Accepted Answer

Children with disabilities have a higher risk of abuse than do nondisabled children.Child neglect is the most common form of child maltreatment but may be difficult to identify.One type of child maltreatment is Munchausen by proxy,in which a parent causes recurrent,unexplained conditions in the child for attention.Diagnosing child abuse may take a long time due to the thorough family and child assessments needed.In fact,more than 5 children die each day as a result of maltreatment.

Question 12

The nurse is assessing a child for an anxiety disorder.What manifestations noted by the nurse are common to all anxiety disorders? (Select all that apply.)
A)Distress or avoidance of feared situations
B)Does not go away or gets worse over time
C)Impaired functioning or development
D)Leads to avoiding social situations
E)Physical symptoms such as palpitations and sweating

Accepted Answer

General manifestations common to all anxiety disorders include: anxiety that does not go away or gets worse over time,anxiety that pervades more than one aspect of the child's life,significant distress or avoiding of feared situations,and impaired functioning or development as a response to anxiety.Avoiding social situations is specific to social anxiety disorder.Physical symptoms such as palpitations and sweating are specific to panic disorder.

Question 13

A nurse is teaching a classroom of middle school students sleep hygiene.Which information does the nurse provide? (Select all that apply.)
A)Create a healthy environment for sleep in your room.
B)Go to bed at the same time every night of the week.
C)Only use your bed for sleeping and reading.
D)Set your cell phone to vibrate or low volume.
E)Turn off your computer 1 hour before bedtime.

Accepted Answer

Many strategies exist for improving sleep.The nurse should teach the children to create a healthy sleep environment in their rooms,to go to bed at the same time each night,and to turn off technological devices such as computers and cell phones 1 hour before bedtime.The bed should only be used for sleeping.

Question 14

A child has the possible diagnosis of autism spectrum.While awaiting the results of further testing,which action by the nurse is the most appropriate?
A)Continue to monitor the child for late signs of autism.
B)Reassure the parents that concerns are probably not valid.
C)Refer the child to audiology to rule out a hearing impairment.
D)Wait for results before referring the child to early intervention or a local school program.

Accepted Answer

Because children on the autism spectrum have difficulties in communication,a hearing test is in order to rule out any physiological cause contributing to this manifestation.Continued monitoring is always appropriate,but that is not the best option.Parents usually do have concerns that are valid regarding their child.Referrals to school-based or early intervention programs should not wait for a definitive diagnosis.

Question 15

A mother brings a child to the clinic with concerns about attention deficit-hyperactivity disorder (ADHD).Which behavioral assessment findings support this diagnosis? (Select all that apply.)
A)Compulsive "collecting"
B)Inability to stay in chair for a meal
C)Nonstop talking
D)Refusal to complete homework
E)Sleeping whenever possible

Accepted Answer

ADHD is characterized by behaviors related to inattention,hyperactivity/impulsivity,or both.The child's inability to sit in a chair for meals,nonstop talking,and refusal to complete homework are all signs of possible ADHD.Compulsive "collecting" could relate to an anxiety disorder such as hoarding.Excessive sleeping could indicate depression.

Question 16

A nurse is assessing families in the community for child maltreatment.Which family would the nurse identify as being at highest risk?
A)Children involved in many activities
B)Family with multiple children
C)Older parents with only children
D)Single mother living in poverty

Accepted Answer

Identified risk factors for child maltreatment include: children with disabilities;children of very young parents;children of single mothers who live in poverty;parents who suffer from mental or chronic physical illness;parents who have rigid ideas of discipline,excessive stress,or marital conflict;parental substance abuse;and intergenerational history of abuse.

Question 17

A nurse in the pediatric clinic suspects a patient is the victim of child abuse.What action takes priority?
A)Ask a coworker to confirm the suspicions.
B)Confront the parents with this information.
C)Document the findings in the child's chart.
D)Report the suspicions according to state law.

Accepted Answer

All states have mandatory reporting laws for suspected child maltreatment.The nurse's priority action is to report the findings per state law and facility policy.The other actions are not incorrect;they just are not the priority.

Question 18

A child with Down's syndrome has been admitted to the hospital with a respiratory condition and is producing thick,tenacious mucus.Which nursing action is the priority?
A)Ensuring a patent airway
B)Involving child-life therapy
C)Preventing nosocomial infection
D)Relieving stress at hospitalization

Accepted Answer

All answers are appropriate nursing interventions;however,the child with Down's syndrome has a small oral cavity and small airway,which can be easily occluded.The priority action of the nurse is to maintain the child's airway.

Question 19

A nurse is providing education to the parents of a child who has anxiety.Using the FRIENDS strategy for managing anxiety,what techniques does the nurse teach? (Select all that apply.)
A)Explore plans
B)Fight the anxiety
C)Inner thoughts
D)Reward yourself
E)Stay calm

Accepted Answer

FRIENDS is an acronym for feeling worried,relax and feel good,inner thoughts,explore plans,nice work so reward yourself,don't forget to practice,and stay calm…you know how to cope.Fight the anxiety is not part of the acronym.

Question 20

A nurse working with at-risk children recognizes that vulnerability to psychosocial or cognitive disorders depends on which risk factors? (Select all that apply.)
A)Environment
B)Genetics
C)Immunity
D)Temperament
E)Timing of exposure

Accepted Answer

Vulnerability is defined as those characteristics that may predispose the child to a disorder.Vulnerability is affected by a number of risk factors,including environment,genetics,temperament,and timing of the exposure to the threat to mental health.Immunity is not recognized as a risk factor that affects a child's vulnerability to

Quiz 22: Caring for the Child With a Psychosocial or Cognitive Condition

A nurse is working with the family of a child who is overweight.What action by the nurse is most appropriate?

A nurse is making a referral for a family whose teenage daughter has anorexia nervosa.Which referral is the most appropriate?

A nurse is teaching a class to new mothers who are also high school students.What action by the nurse is the most appropriate in order to decrease the risk of child maltreatment?

A student nurse wants to know what substances adolescents are at highest risk for abusing.Which information is the most appropriate for the pediatric nurse to share with the student?

A pregnant woman asks the nurse how much alcohol must be consumed to put her fetus at risk of fetal alcohol spectrum disorder.What answer by the nurse is the most appropriate?

A community nurse approaches the organization's manager wanting to set up screening for risk factors for Tourette's syndrome in children.Which response by the manager is the most appropriate?

A nurse is assessing a child who has a large head,an elongated face,and prominent ears.Which discharge instruction is most important?

A nurse has identified substance abuse in an adolescent.In addition to a treatment center referral,what other referral is most important?

A nurse is caring for a child with attention deficit-hyperactivity disorder (ADHD) .Which medications does the nurse anticipate may be prescribed for this child? (Select all that apply.)

The mental health nurse is preparing a presentation for nurses who work with pediatric patients.Which barriers to mental health screening should the nurse include in the presentation? (Select all that apply.)

A pediatric nurse is explaining child abuse and neglect to a class of nursing students.Which information does this nurse provide the students during the presentation? (Select all that apply.)

The nurse is assessing a child for an anxiety disorder.What manifestations noted by the nurse are common to all anxiety disorders? (Select all that apply.)

A nurse is teaching a classroom of middle school students sleep hygiene.Which information does the nurse provide? (Select all that apply.)

A child has the possible diagnosis of autism spectrum.While awaiting the results of further testing,which action by the nurse is the most appropriate?

A mother brings a child to the clinic with concerns about attention deficit-hyperactivity disorder (ADHD) .Which behavioral assessment findings support this diagnosis? (Select all that apply.)

A nurse is assessing families in the community for child maltreatment.Which family would the nurse identify as being at highest risk?

A nurse in the pediatric clinic suspects a patient is the victim of child abuse.What action takes priority?

A child with Down's syndrome has been admitted to the hospital with a respiratory condition and is producing thick,tenacious mucus.Which nursing action is the priority?

A nurse is providing education to the parents of a child who has anxiety.Using the FRIENDS strategy for managing anxiety,what techniques does the nurse teach? (Select all that apply.)

A nurse working with at-risk children recognizes that vulnerability to psychosocial or cognitive disorders depends on which risk factors? (Select all that apply.)