Module 3 (Ch. 6, 19, 20, 18, 14) Flashcards
The primary care pediatric nurse practitioner is evaluating a 2yearold with a documented speech delay. Screenings to assess motor skills and cognition are normal, and the child passed a recent hearing test. What will the pediatric nurse practitioner do next?
Ask the child’s parents whether they read to the child.
The primary care pediatric nurse practitioner performs a developmental assessment on a 32monthold child. The child’s parent reports that about 70% of the child’s speech is intelligible. The pediatric nurse practitioner observes that the child has difficulty pronouncing “t,” “d,” “k,” and “g” sounds. Which action is correct?
Reassure the parent that this is normal
During a well child assessment of an 18monthold child, the primary care pediatric nurse practitioner observes the child point to a picture of a dog and say, “Want puppy!” The nurse practitioner recognizes this as an example of
telegraphic speech.
The primary care pediatric nurse practitioner is offering anticipatory guidance to the parents of a 12monthold child. The parents are bilingual in Spanish and English and have many Spanishspeaking relatives nearby. They are resisting exposing the child to Spanish out of concern that the child will not learn English well. What will the pediatric nurse practitioner tell the parents?
Most bilingual children are able to shift from one language to another when appropriate.
The primary care pediatric nurse practitioner is counseling the parents of a toddler about appropriate discipline. The parents report that the child is very active and curious, and they are worried about the potential for injury. What will the pediatric nurse practitioner recommend?
Allow the child to explore and experiment while providing appropriate limits.
The mother of a 3yearold child takes the child to a play group once a week. ID: 13348437961 She expresses concern that the child plays with toys but does not interact with the other toddlers. What will the primary care pediatric nurse practitioner counsel the mother?
Toddlers may be interested in other children but usually do not engage in interactive play
The parent of a 4yearold points to a picture and says, “That’s your sister.” The child responds by saying, “No! It’s my baby!” This is an example of which type of thinking in preschoolage children?
Realism
The parent of a 24monthold child asks the primary care pediatric nurse practitioner when toilet training should begin. How will the pediatric nurse practitioner respond?
“Tell me about your child’s daily habits.”
The primary care pediatric nurse practitioner performs a physical examination on a 9monthold infant and notes two central incisors on the lower gums. The parent states that the infant nurses, takes solid foods three times daily, and occasionally takes water from a cup. What will the pediatric nurse practitioner counsel the parent to promote optimum dental health?
To make an appointment for an initial dental examination
The parents of a 3yearold child are concerned that the child has begun refusing usual foods and wants to eat mashed potatoes and chicken strips at every meal and snack. The child’s rate of weight has slowed, but the child remains at the same percentile for weight on a growth chart. What will the primary care pediatric nurse practitioner tell the parents to do?
Place a variety of nutritious foods on the child’s plate at each meal.
During a well child examination on a 4monthold infant, the primary care pediatric nurse practitioner evaluates mental health issues. Which statement by the parent indicates a potential problem with the parentinfant relationship?
“I let my baby cry a while to learn to be patient.”
A child has a difficult temperament. What will the primary care pediatric nurse practitioner tell the parent about managing this child’s behavior?
It is important for the parent to learn to manage criticism and power struggles.
During a well child assessment of a preschoolage child, the parent voices concerns that, because the child has behavior problems at school, the child may have a mental health disorder. Which initial approach will provide the best information?
Take time to actively listen to the parent’s and child’s perceptions of the problem
- The primary care pediatric nurse practitioner attempts to learn more about the emotional health of an 18monthold child through which assessment strategy?
Observation of the child with caretakers in structured and unstructured situations
A middleschoolage child is skipping school frequently and getting poor grades since the child’s father was killed while deployed in the military. How will the primary care pediatric nurse practitioner manage this situation?
Refer the child to a mental health specialist for evaluation and treatment
The parent of a 4yearold child reports that the child seems to be having trouble adjusting to a new day care and reportedly is always engaging in solitary play when the parent arrives to pick up the child. What will the primary care pediatric nurse practitioner do?
Ask the parent if the child is slow to warm up to other new situations
The parent of a schoolage child is concerned because the child has started to express anger about a grandparent’s death even though this occurred when the child was a toddler. What will the primary care pediatric nurse practitioner tell the parent?
The significance of this loss must be reworked at each developmental level.
The parent of a schoolage child reports that the child doesn’t like being alone in rooms because of a fear of aliens hiding in closets. What will the primary care pediatric nurse practitioner tell the parent?
“Fear of imaginary creatures does not usually occur at this age
The parent of a preschoolage child reports that the child often appears anxious and nervous and that this is associated occasionally with a rapid heart rate and tremors. What is the best type of referral that the primary care pediatric nurse practitioner could recommend?
Play therapy
A 9yearold child exhibits school refusal and a reluctance to attend sleepovers with classmates. The parent is concerned because the child has recently begun sleeping in the parents’ bed. Which initial action by the primary care pediatric nurse practitioner is appropriate?
Assess for environmental stress, parental dysfunction, and maternal depression.
The parent of a schoolage child reports that the child becomes frustrated when unable to perform tasks well and often has temper tantrums and difficulty sleeping. Which disorder may be considered in this child?
Generalized anxiety disorder (GAD)
The parent of a schoolage girl reports that the child has difficulty getting ready for school and is often late because of a need to check and recheck whether her teeth are clean and her room light has been turned off. What will the primary care pediatric nurse practitioner recommend to this parent?
Cognitivebehavioral therapy
The parents of a 4yearold boy are concerned because he has begun twisting and pulling out his hair, especially when he is tired or stressed. What will the primary care pediatric nurse practitioner recommend as part of an initial approach to treat this behavior?
Cutting his hair so that it is too short to pull
newly divorced mother of a toddler reports that the child began having difficulty sleeping and nightmares along with exhibiting angry outbursts and tantrums 2 months prior. The primary care pediatric nurse practitioner learns that the child refuses to play with usual playmates and often spends time sitting quietly. What will the nurse practitioner doinitially?
Ask the mother about the child’s relationship with the father