Pediatric Primary Care 6th Edition Burns Test Bank

Pediatric Primary Care 6th Edition Burns Test Bank Chapter 1: Health Status of Children: Global and Local Perspectives Test Bank Multiple Choice

• The primary care pediatric nurse practitioner understands that a major child health

outcome associated with worldwide climate change is :

• cost of living.
• education.
• nutrition.
• pollution.

ANS: C

There is growing evidence that climate change is having a dramatic effect on food crops that leads to food distribution issues and food insecurity among families.

• The primary care pediatric nurse practitioner understands that, to achieve the greatest

world-wide reduction in child mortality from pneumonia and diarrhea, which intervention is most effective?

• Antibiotics
• Optimal nutrition
• Vaccinations
• Water purification

ANS: C

Rotavirus is the most common cause of diarrhea globally and Strep pneumonia is the leading cause of pneumonia, and together these are the leading infectious causes of childhood morbidity and mortality globally. Both are vaccine-preventable diseases.Antibiotics to treat pneumonia, optimal nutrition, and clean water all help to reduce morbidity and mortality, but vaccination prevents the diseases from occurring.

• When providing well child care for an infant in the first year of life, the primary care

pediatric nurse practitioner is adhering to the most recent American Academy of

Pediatrics Recommendations for Preventive Pediatric Health Care guidelines by :

• focusing less on development and more on illness prevention and nutrition. 1 / 4

• following guidelines established by the Bright Futures publication.
• scheduling well-baby visits to coincide with key developmental milestones.
• seeing the infant at ages 2, 4, 6, and 12 months when immunizations are due.

ANS: C

In the most recent AAP Recommendations for Preventive Pediatric Health Care, there is a greater emphasis on behavioral and developmental issues and a recommendation that well child care be based on child and family development rather than the periodicity of immunization schedules. This will require a revision of the current recommendations in Bright Futures.

• Which is true about the health status of children in the United States?
• Globalism has relatively little impact on child health measures in the U.S.
• Obesity rates among 2- to 5-year-olds have shown a recent significant decrease.
• The rate of household poverty is lower than in other economically developed

nations.

• Young children who attend preschool or day care have higher food insecurity.

ANS: B

Obesity rates are a major concern for child health in the U.S. but recently have stabilized in the rate of increase and have declined among 2- to 5-year-olds between 2004 and 2013.Globalism has an increasing effect on child health in the U.S. The rate of household poverty in the U.S. is higher than in other economically developed nations. Young children who attend preschool or day care have lower food insecurity.

• Which region globally has the highest infant mortality rate?
• Indonesia
• Southern Asia
• Sub-Saharan Africa
• Syria

ANS: C

Although Sub-Saharan Africa and Southern Asia together account for 81% of the infant mortality rate globally, Sub-Saharan Africa has the highest infant mortality rate in the world. 2 / 4

Chapter 2: Child and Family Health Assessment

Test Bank Multiple Choice

• The parent of a toddler is concerned that the child may have autism. The primary care

pediatric nurse practitioner completes a Modified Checklist for Autism in Toddlers (M-CHAT) tool, which indicates several areas of concern. What will the nurse practitioner do?

• Administer a Childhood Autism Rating Scale (CARS) in the clinic.
• Consult a specialist to determine appropriate early intervention strategies.
• Refer the child to a behavioral specialist for further evaluation.
• Tell the parent that this result indicates that the child has autism.

ANS: C

The M-CHAT is a screening tool and is useful for detecting behaviors that may indicate autism. This instrument has been found to have acceptable sensitivity, specificity, and significant positive predictive value. If these behaviors are detected, the PNP should refer the child to a specialist for further assessment, using more diagnostic tools. The CARS may be used but requires specialty training and proper credentials. Until the diagnosis is determined, strategies for intervention are not discussed. The M-CHAT is a screening tool and is not diagnostic.

• The mother of a newborn tells the primary care pediatric nurse practitioner that she is

worried that her child will develop allergies and asthma. Which tool will the nurse practitioner use to evaluate this risk?

• Three-generation pedigree
• Review of systems
• Genogram
• Ecomap

ANS: A

The three-generation pedigree is used to map out risks for genetic diseases in families, as well as conditions with modifiable risk factors. The review of systems is used to evaluate the history of the child’s body systems. The genogram is an approach to developing a family database to provide a graphic representation of family structure, roles, and 3 / 4

problems of recurring significance in a family. The ecomap is used to identify relationships in the family and community that are supportive or harmful.

• The primary care pediatric nurse practitioner is performing a well child check-up on a

20-month-old child. The child was 4 weeks premature and, according to a parent- completed developmental questionnaire, has achieved milestones for a 15-month-old infant. Which action is correct?

• Perform an in-depth developmental assessment screen at this visit to evaluate this

child.

• Reassure the parent that the child will catch up to normal development by age 2

years.

• Re-evaluate this child’s development and milestone achievements at the 2-year

visit.

• Refer the child to a specialty clinic for evaluation and treatment of developmental

delay.

ANS: A

This child should be at a 19-month adjusted age for prematurity so, according to the parent screen, is 4 months behind. The PNP should perform a more in-depth screen to evaluate this delay. Waiting to see if the child will “catch up” or assuring the parent that this will happen will cause the delays to become more severe. A referral to a specialty clinic should not be made solely on the basis of the parent-completed questionnaire but only after further evaluation of possible delays.

• When formulating developmental diagnoses for pediatric patients, the primary care

pediatric nurse practitioner may use which resource?

a. DC: 0-3R

• ICD-10-CM
• ICSD-3
• NANDA International

ANS: A

The DC: 0-3R refers to the Diagnostic Classification of Mental Health and

Developmental Disorders of Infancy and Early Childhood and is useful for developmental problem diagnosis. The ICD-10-CM is the International Classification of Diseases-Tenth Revision, Clinical Modification and is useful for identifying physiologic diseases. The ICSD-3 is the International Classification of Sleep Disorders – 3rd edition.NANDA International is used to label problems in the functional health domain.

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