Question 1

What are some common health problems associated with the poor and/or homeless child? Select all that apply.

Accepted Answer

B,D,E

Question 2

The school nurse is implementing a program to decrease bullying. Which interventions are appropriate for the school nurse to implement? Select all that apply.

Accepted Answer

These interventions are all appropriate for the school nurse to implement as part of a program to decrease bullying. Training teachers about the behaviors of bullying, ensuring adult supervision in the hallways, and teaching children to report behaviors are all important steps in preventing and addressing bullying.

Question 3

A high school student calls to ask the nurse for advice on how to care for a new navel piercing. Which response by the nurse is the most appropriate?

Accepted Answer

The most appropriate advice is to avoid contact with another person's bodily fluids until the area is well healed to prevent infection. Warm soaks might help with swelling, but the primary concern with a new piercing is infection control. Moving or turning the jewelry can actually help prevent it from getting stuck and aid in healing, contrary to option B. Applying lotion (option D) is not recommended for a new piercing as it can introduce bacteria and cause infection.

Question 4

A social service coordinator is consulted to arrange for a phototherapy blanket at discharge for an infant/family with multiple social difficulties. Which social difficulty is more than likely to have the greatest influence on discharge?

Accepted Answer

The fact that the family is homeless is likely to have the greatest influence on discharge because it greatly impacts the ability of the family to provide and care for the infant, and may pose major obstacles to obtaining and using the phototherapy blanket as needed. Financial difficulties and lack of a healthcare provider may also be significant, but the high level of instability associated with homelessness is likely to be the most challenging factor to address. Cultural practices, rituals, and religious beliefs may be considered and accommodated, but are unlikely to have the same level of immediate impact on discharge.

Question 5

While the nurse is conducting the history of a school-age child, the parents admit to owning firearms. Which safety measures are appropriate to include in the teaching plan for this family? Select all that apply.

Accepted Answer

The answer of While the nurse is conducting the history...

Question 6

In counseling an adolescent female about safe sex practices, which question is the most appropriate for the nurse to ask?

Accepted Answer

Asking if the adolescent has one or more sexual partners (C) is the most appropriate and inclusive question. It does not assume the gender of the partner(s) or the nature of the relationship, and it opens the conversation to discuss safe sex practices with multiple partners if applicable.

Question 7

The pediatric nurse is working with a parent who is suspected of Münchausen Syndrome by Proxy. Which action by the nurse is the priority?

Accepted Answer

The priority action for the nurse is to carefully document parent-child interactions to provide evidence of possible abuse. Confronting the parent may cause them to become defensive and make it harder to gather evidence, while keeping the parent separated from the child may not be feasible in all situations. Explaining to the child that the parent is causing the illness may also not be appropriate or helpful in this situation.

Question 8

While working at a weekend "free clinic," the nurse is assessing a toddler when the mother of the child confides that it has been very difficult providing for her family of four children on her limited budget. She is not sure that she has enough money to buy food for the rest of the month and the antibiotic that is needed for the child's ear infection. Which intervention would be the most beneficial for this family?

Accepted Answer

Putting the mother in contact with a local agency that provides food on a regular basis to needy families and helps them access other resources in the community would be the most beneficial intervention for this family. This would address their immediate need of food and would also help them access other resources that could assist them in the long-term. Providing free samples of the antibiotic may alleviate the immediate medical need, but does not address the underlying issue of poverty. Talking about the risk factors for ear infections and the importance of a balanced diet may be helpful information, but does not address the family's immediate need for food and medical care. Providing a list of inexpensive, nutritious foods may be helpful, but does not address the family's immediate need for food and medical care.

Question 9

A child is admitted to the hospital unit with physical injuries. The nurse is taking the child's history. Which statement by the parent would arouse suspicion of abuse?

Accepted Answer

The statement about the baby's 18-month-old brother trying to pull the baby out of the crib and dropping the baby on the floor raises suspicion because an 18-month-old child typically does not have the physical capability or understanding to attempt such an action, suggesting the explanation may not be truthful or accurate.

Question 10

The nurse is conducting a health promotion class for adolescents. In counseling an adolescent about lifestyle choices, what should the adolescent eliminate in order to decrease the risk of the most preventable cause of adult death?

Accepted Answer

Tobacco use is the most preventable cause of adult death, and eliminating it from one's lifestyle can significantly decrease the risk of developing life-threatening diseases such as lung cancer, heart disease, and stroke. Alcohol, obesity, and cocaine use are all harmful and should be avoided, but they are not the leading cause of preventable death in adults.

Question 11

The school nurse is planning a smoking-prevention program for middle school students. Which intervention is most likely to be effective in preventing middle school children from smoking?

Accepted Answer

Having a local high school basketball star come to talk to the students about the importance of not smoking is likely to be the most effective intervention. Adolescents often look up to older peers and celebrities, especially athletes, as role models. A message from a respected and admired figure about the dangers of smoking can have a significant impact on their attitudes and behaviors towards smoking.

Question 12

A mother of two school-age children tells the nurse that her husband has recently been deployed overseas. The mother is concerned about the children's constant interest in watching TV news coverage of military activities overseas. Which suggestion from the nurse is the most appropriate?

Accepted Answer

The most appropriate suggestion from the nurse is to spend time with the children and take cues from them about how much they want to discuss. This allows the mother to provide support to her children and address their concerns while letting them express themselves in a way that is comfortable for them. Ignoring their interest or allowing them to watch as much television as they want may not be helpful for their emotional well-being. Simply waiting for everything to return to normal is not a realistic or helpful suggestion. Finally, distracting the children from their concerns may not help them process their emotions and could cause more problems in the long run.

Question 13

During a well-child exam, the parents of a preschool-age child inform the nurse that they are thinking of buying a television for their child's bedroom and ask for advice as to whether this is appropriate. Which response by the nurse is the most appropriate?

Accepted Answer

The most appropriate response would be to provide the parents with evidence-based information on the potential negative effects on physical activity and health that a television in the child's bedroom may have. Option B is not the best choice, as educational TV shows are not the same as being physically active and do not address the potential dangers of sedentary behavior. Option C is too definitive and may not fit the family's specific situation, as some families may choose to allow their children to have a TV in their room at a young age. Finally, option D puts a limit of two hours per day without any context or explanation, which may not be sufficient to address the potential physical and developmental concerns.

Question 14

A school-age child has been seen in the pediatric clinic three times in the last two months for complaints of abdominal pain. Physical exam and all ordered lab work have been normal. Which question by the nurse would most likely help determine the etiology of the child's abdominal pain?

Accepted Answer

The child's repeated complaints of abdominal pain without any physical or laboratory findings suggest that stress or emotional factors may be contributing to the symptoms. Asking about changes in school or home life may give insight into potential stressors that could be causing the child's symptoms. The other questions are not likely to provide as much relevant information in determining the etiology of the abdominal pain.

Question 15

The nurse teaches a group of parents' strategies to reduce the risk of lead exposure for their children. Which statements indicate an appropriate understanding of the content presented? Select all that apply.

Accepted Answer

- A) Foods high in iron and calcium can help reduce the absorption of lead in the body.- B) Washing surfaces with peeling paint can help reduce lead dust and chips that children might ingest.

Question 16

A recently divorced mother who must return to work is concerned about the effects of placing her child in day care full time. In counseling the mother, which factor does the nurse share as the most influential in determining whether or not day care has a positive or negative effect on the child?

Accepted Answer

Research consistently shows that the quality of the parent-child relationship is the most important factor in determining whether day care has a positive or negative effect on a child's development. This means that if the parent-child relationship is strong and responsive, the child is more likely to thrive in day care.

Question 17

The nurse is conducting an admission assessment for a preschool-age client in the emergency department. When using the resiliency theory, which findings place this client at risk? Select all that apply.

Accepted Answer

The resiliency theory suggests that risk factors can include lack of access to healthcare (such as loss of health insurance and no primary care provider) and incomplete immunizations. The presence of a supportive family member (such as a grandmother who is able to room-in) and high level language skills would be protective factors.

Question 18

When examining a toddler-age child during a well-child physical, which assessment is the priority?

Accepted Answer

Risk of lead exposure is a priority assessment in toddler-age children because of their increased risk of ingesting lead paint chips and dust, which can cause developmental and cognitive impairments. Visual acuity, helmet use, and fluoride in the household drinking water are important assessments but not as high of a priority as lead exposure.

Question 19

The nurse is providing care to a toddler-age child. Which assessment finding is indicative of abuse?

Accepted Answer

Inconsistency of stories between caregivers can be an indicator of abuse, as it suggests that there may be attempts to cover up the true cause of the child's injuries or behavior. While bruising on the knees and shins can be common in toddlers, it may also indicate abuse if the pattern, location, or severity of the bruising is suspicious. Parents indicating that they did not see the event occur may also raise concerns, but should not be solely relied upon as evidence of abuse. Acting out behavior of the child can have many different causes and may not necessarily be related to abuse.

Question 20

Concerned parents call the school nurse because of changes in their 15-year-old adolescent's behavior. Which behavior would the nurse indicate as indicative of adolescent substance abuse?

Accepted Answer

Receiving numerous detentions for sleeping in class can be indicative of substance abuse among adolescents, as it may suggest changes in sleep patterns, energy levels, or disinterest in activities, which can be associated with substance use.

Quiz 17: Social and Environmental Influences on the Child