29 - Child and Adolescent Health Flashcards
A family with children has income too high to qualify for state health insurance, but does not have enough money to purchase private health insurance. Which program would a nurse refer this family to for the children to receive health care coverage?
a. ) Medicare
b. ) Children’s Health Insurance Plan (CHIP)
c. ) Medicaid
d. ) Social Security
b.) Children’s Health Insurance Plan (CHIP)
CHIP is a federal and state partnership that is directed toward uninsured children and pregnant women in families with incomes too high to qualify for state Medicaid programs but too low to afford private coverage.
Medicare is a government insurance program primarily offered to the elderly population.
Social Security is not a health care insurance program.
A mother tells the nurse she is afraid to have her infant immunized. Which of the following statements would be the most appropriate response by the nurse?
a. ) “It is normal to be concerned, as some immunizations have been linked to autism.”
b. ) “Researching the Internet will provide you more information as to the importance of immunizations.”
c. ) “Choosing not to vaccinate your child puts your child and others at risk.”
d. ) “Your infant received active immunity at birth, so immunizations are not indicated until 4 months of age.”
c.) “Choosing not to vaccinate your child puts your child and others at risk.”
The child who is not immunized and others around the child are at risk if immunizations do not occur. Scientific studies have not found a relationship between immunizations and autism. Information that is researched on the Internet may not be a reliable source of information as the nurse has no control over the information the client receives. Infants receive natural passive immunity at birth through the placental transfer of maternal antibodies; this protection lasts for about 2 months.
A nurse is caring for a preschool-aged child who has been exposed to environmental tobacco smoke (ETS) on a regular basis. Which of the following is the child at greater risk for because of this exposure?
a. ) Middle ear infections
b. ) SIDS
c. ) Living in poverty
d. ) Behavioral disturbances
a.) Middle ear infections
Children exposed to ETS experience increased episodes of middle ear infections, asthma, upper respiratory tract infections, and more missed school days.
SIDS incidence increases with ETS exposure, but this is not a concern with a preschool-aged child.
Which statement about sudden infant death syndrome (SIDS) is true?
a. ) SIDS occurs most often in female infants.
b. ) Maternal cigarette smoking increases risk.
c. ) Most deaths occur between 2 and 8 months of age.
d. ) Most victims had a previous episode of cyanosis or apnea.
b.) Maternal cigarette smoking increases risk.
Maternal smoking increases risk three to four times. SIDS occurs most often in male infants, most deaths occur between 1 and 5 months, and only a small number of victims have had a previous episode of cyanosis or apnea.
A nurse is caring for a client who has a medical home. Which of the following best describes what is being used by the client?
a. ) A building that houses multiple primary care providers and specialists
b. ) A partnership between a community health nurse, a client, and a family
c. ) A system that meets the needs of the individual, family, and community
d. ) A collaboration of care provided by an interprofessional team
d.) A collaboration of care provided by an interprofessional team
A medical home emphasizes an integrated health system with collaboration of care from an interprofessional team of primary care physicians, specialists and subspecialists, other health professionals, hospitals and health care facilities, and public health and community working with children and families.
The medical home may not necessarily all be housed in the same building. The partnership is bigger than only the nurse, client, and family. The medical home is specific to meeting the needs of the child and family.
Which statement is true about the role of nurses in community health?
a. ) The nurse provides direct services to children and their families.
b. ) A major role of community health nurse is the provision of immunizations.
c. ) Children are not the primary focus of community health, since they are often acutely ill.
d. ) Complementary therapies and environmental toxins are often the focus of the health care of children.
a.) The nurse provides direct services to children and their families.
The nurse provides direct services to children and their families: assessing and managing care, education, and counseling. Provision of immunizations is not a major role of community health nurses. Children are not often acutely ill nor are complementary therapies and environmental toxins the focus of health care.
A nurse is assessing a child with chronic health problems and his family. Which of the following factors should be taken into account?
a. ) The ability of the family to pay for expensive equipment
b. ) The degree of impairment to the child’s ability to develop
c. ) How often recreational activities will take place
d. ) Special needs “camp” placement for the child in the summer
b.) The degree of impairment to the child’s ability to develop
The degree of impairment to the child’s ability to develop is a concern of the community health nurse. Financial resources need to be assessed and adaptations may need to be made to avoid expensive equipment. The frequency of other treatments and therapies should be considered in addition to recreational activities. A special needs “camp” placement may not be an appropriate suggestion for every child with chronic health problems.
A nurse is educating parents about sports safety. Which of the following information would be included in the education? (Select all that apply.)
a. ) Grouping children according to weight, size, and skill level
b. ) Providing adequate supervision by competent teenagers if adults are not available
c. ) Using appropriate-size equipment
d. ) Encouraging attendance at events by medical personnel
e. ) Having an automated external defibrillator (AED) onsite
a.) Grouping children according to weight, size, and skill level
c.) Using appropriate-size equipment
Grouping children by size and skill level and using appropriate-size equipment are the best actions to promote sports safety. Teenagers cannot adequately supervise children in sports activities, and medical personnel do not need to be present at all sports events. Having an AED onsite is ideal, but may not be realistic.
A nurse is aware that there is a rising incidence of abusive head trauma (AHT). Which of the following would be a focus of the nurse?
a. ) Taking at-risk babies out of violent households
b. ) Placing babies under the care of community health nurses
c. ) Educating and providing support to new parents
d. ) Helping those affected seek proper legal representation
c.) Educating and providing support to new parents
Prevention strategies are necessary to reduce the incidence of AHT. Parental education and support is necessary to prevent child maltreatment. Taking at-risk babies out of violent households, placing babies under the care of community health nurses, and helping those affected seek proper legal representation are not prevention strategies.
A nurse is working with a child who lives in poverty. Which of the following best describes this child?
a. ) A child who has poor academic performance
b. ) A child whose parents have a college education
c. ) A child of Caucasian descent
d. ) A child living in a single-parent household
d.) A child living in a single-parent household
Characteristics that put children at risk for living in low-income families are parents without a high school degree, lack of parental employment, and living in a single-parent household.
The group with the lowest injury death rate is:
a. ) infants.
b. ) toddlers and preschoolers.
c. ) school-age children.
d. ) adolescents.
c.) school-age children.
School-age children have the lowest death rate among younger age groups. Infants have the second highest injury rate of all groups of children; their small size contributes to some types of injury. Adolescents are at the highest risk of any age group for motor vehicle deaths and fatal poisonings.
A nurse is using motivational interviewing when communicating with a family about improving their eating habits. Which of the following questions would the nurse most likely ask when using this technique?
a. ) “Do you feel comfortable restricting foods your child eats?”
b. ) “Why do you choose unhealthy snacks?”
c. ) “What changes would you like to make to improve your diet?”
d. ) “Where do you do your grocery shopping?”
a.) “Do you feel comfortable restricting foods your child eats?”
Motivational interviewing is a focused communication strategy in which the parents are encouraged to set goals, identify personal barriers, and identify potential mechanisms to overcome the barriers to make safety and health promotion changes for their child. Nurses use open-ended questioning and reflection to encourage sharing from the child and parents. The other questions may be viewed as being judgmental from the perspective of the client and the client may not answer the question truthfully.
A nurse is counseling a family about the management of childhood obesity. Which of the following recommendations should be made by the nurse? (Select all that apply.)
a. ) Set goals related to having a healthier lifestyle, not dieting
b. ) Have low-calorie, nutritious snacks available and ready
c. ) Allow snacking in front of the TV for short periods of time
d. ) Decrease computer time and replace it with activities and chores
e. ) Invest in a gym membership at a local facility
a. ) Set goals related to having a healthier lifestyle, not dieting
b. ) Have low-calorie, nutritious snacks available and ready
d. ) Decrease computer time and replace it with activities and chores
A nurse is conducting a developmental screening to assess for domain-specific development, including gross and fine motor skills. Which developmental screening tool would the nurse most likely use?
a. ) Pediatric Symptom Checklist
b. ) Ages and Stages Questionnaire
c. ) Parents’ Evaluation of Developmental Status
d. ) Denver II
d.) Denver II
The Denver II screening tool assesses domain specific development (gross and fine motor, social, and language).
The Pediatric Symptom Checklist assesses coping and mental health concerns, the Ages and Stages Questionnaire assesses social and emotional development, and the Parents’ Evaluation of Developmental Status assesses general developmental and behavioral screening.
A nurse is providing anticipatory guidance to parents who have a child under 1 year of age. Which of the following would be the most important topic to discuss?
a. ) Occluded airway
b. ) Burns
c. ) Poisoning
d. ) Falls
a.) Occluded airway
Children under 1 year of age are most frequently injured by occluded airways. Burns, poisoning, and falls are risks for all age groups and are more likely to happen with children over age 1.
