Burns Pediatric Final Exam Study Guide
1. The primary care pediatric nurse practitioner understands that a major child health outcome
associated
with worldwide climate change is :
a. cost of living.
b. education.
c. nutrition.
d. pollution. - ANS 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.
2. 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?
a. Antibiotics
b. Optimal nutrition
c. Vaccinations
d. Water purification - ANS 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.
3. 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 :
a. focusing less on development and more on illness prevention and nutrition.
b. following guidelines established by the Bright Futures publication.
c. scheduling well-baby visits to coincide with key developmental milestones.
d. seeing the infant at ages 2, 4, 6, and 12 months when immunizations are due. - ANS 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.
4. Which is true about the health status of children in the United States?
a. Globalism has relatively little impact on child health measures in the U.S.
b. Obesity rates among 2- to 5-year-olds have shown a recent significant decrease.
c. The rate of household poverty is lower than in other economically developed nations.
d. Young children who attend preschool or day care have higher food insecurity. - ANS 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.
5. Which region globally has the highest infant mortality rate?
a. Indonesia
b. Southern Asia
c. Sub-Saharan Africa
d. Syria - ANS 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.
1. 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?
a. Administer a Childhood Autism Rating Scale (CARS) in the clinic.
b. Consult a specialist to determine appropriate early intervention strategies.
c. Refer the child to a behavioral specialist for further evaluation.
d. Tell the parent that this result indicates that the child has autism. - ANS 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.
2. 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?
a. Three-generation pedigree
b. Review of systems
c. Genogram
d. Ecomap - ANS 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 problems of recurring significance in a family. The
ecomap
is used to identify relationships in the family and community that are supportive or harmful.
3. 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?
a. Perform an in-depth developmental assessment screen at this visit to evaluate this child.
b. Reassure the parent that the child will catch up to normal development by age 2 years.
c. Re-evaluate this child's development and milestone achievements at the 2-year visit.
d. Refer the child to a specialty clinic for evaluation and treatment of developmental delay. -
ANS 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.
4. When formulating developmental diagnoses for pediatric patients, the primary care pediatric
nurse
, practitioner may use which resource?
a. DC: 0-3R
b. ICD-10-CM
c. ICSD-3
d. NANDA International - ANS 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.
5. The primary care pediatric nurse practitioner is evaluating health literacy in the mother of a
new
preschool-age child. How will the nurse practitioner assess this?
a. Ask the child how many books he has at home.
b. Ask the mother about her highest grade in school.
c. Ask the mother to determine the correct dose of a drug from a label.
d. Ask the mother to read a health information handout aloud. - ANS ANS: A
The "newest vital sign," or health literacy, can be determined quickly by asking the parent how
many
children's books are in the home. Greater than 10 books in the home is an independent positive
predictor
of adequate parent health literacy. The other questions may determine a specific level of literacy
in
general but are not as efficient.
6. The primary care pediatric nurse practitioner learns that the mother of a 3-year-old child has
been
treated for depression for over 5 years. Which aspect of this child's development will be of the
most
concern to the nurse practitioner?
a. Fine motor
b. Gross motor
c. Social/emotional
d. Speech and language - ANS ANS: D
Maternal depression in the first year of life has been associated with poorer language
development at 3
years of age.
7. The primary care pediatric nurse practitioner sees a 3-year-old child who chronically
withholds stools,
1. The primary care pediatric nurse practitioner understands that a major child health outcome
associated
with worldwide climate change is :
a. cost of living.
b. education.
c. nutrition.
d. pollution. - ANS 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.
2. 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?
a. Antibiotics
b. Optimal nutrition
c. Vaccinations
d. Water purification - ANS 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.
3. 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 :
a. focusing less on development and more on illness prevention and nutrition.
b. following guidelines established by the Bright Futures publication.
c. scheduling well-baby visits to coincide with key developmental milestones.
d. seeing the infant at ages 2, 4, 6, and 12 months when immunizations are due. - ANS 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.
4. Which is true about the health status of children in the United States?
a. Globalism has relatively little impact on child health measures in the U.S.
b. Obesity rates among 2- to 5-year-olds have shown a recent significant decrease.
c. The rate of household poverty is lower than in other economically developed nations.
d. Young children who attend preschool or day care have higher food insecurity. - ANS 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.
5. Which region globally has the highest infant mortality rate?
a. Indonesia
b. Southern Asia
c. Sub-Saharan Africa
d. Syria - ANS 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.
1. 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?
a. Administer a Childhood Autism Rating Scale (CARS) in the clinic.
b. Consult a specialist to determine appropriate early intervention strategies.
c. Refer the child to a behavioral specialist for further evaluation.
d. Tell the parent that this result indicates that the child has autism. - ANS 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.
2. 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?
a. Three-generation pedigree
b. Review of systems
c. Genogram
d. Ecomap - ANS 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 problems of recurring significance in a family. The
ecomap
is used to identify relationships in the family and community that are supportive or harmful.
3. 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?
a. Perform an in-depth developmental assessment screen at this visit to evaluate this child.
b. Reassure the parent that the child will catch up to normal development by age 2 years.
c. Re-evaluate this child's development and milestone achievements at the 2-year visit.
d. Refer the child to a specialty clinic for evaluation and treatment of developmental delay. -
ANS 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.
4. When formulating developmental diagnoses for pediatric patients, the primary care pediatric
nurse
, practitioner may use which resource?
a. DC: 0-3R
b. ICD-10-CM
c. ICSD-3
d. NANDA International - ANS 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.
5. The primary care pediatric nurse practitioner is evaluating health literacy in the mother of a
new
preschool-age child. How will the nurse practitioner assess this?
a. Ask the child how many books he has at home.
b. Ask the mother about her highest grade in school.
c. Ask the mother to determine the correct dose of a drug from a label.
d. Ask the mother to read a health information handout aloud. - ANS ANS: A
The "newest vital sign," or health literacy, can be determined quickly by asking the parent how
many
children's books are in the home. Greater than 10 books in the home is an independent positive
predictor
of adequate parent health literacy. The other questions may determine a specific level of literacy
in
general but are not as efficient.
6. The primary care pediatric nurse practitioner learns that the mother of a 3-year-old child has
been
treated for depression for over 5 years. Which aspect of this child's development will be of the
most
concern to the nurse practitioner?
a. Fine motor
b. Gross motor
c. Social/emotional
d. Speech and language - ANS ANS: D
Maternal depression in the first year of life has been associated with poorer language
development at 3
years of age.
7. The primary care pediatric nurse practitioner sees a 3-year-old child who chronically
withholds stools,
