NFDN 2005 MIDTERM EXAM QUESTIONS AND
ANSWERS SET A+
✔✔Trends & Issues - ✔✔- Smaller families
- Increased knowledge
- Increased family involvement
- Alternative families
✔✔Culture - ✔✔a pattern of learned beliefs, values and practices that are shared within
a group
- Ex: practices, customs, views on roles and relationships
- Be sensitive
- Perform a cultural assessment
- Use an interpreter or draw pictures if child does not speak english
✔✔Ethnicity - ✔✔particular cultural group or country into which a person was born
✔✔Informed Consent - ✔✔permission granted before conducting a healthcare
intervention on a person
- Children usually cannot give informed consent; get consent from the parents
- Get assent from the child (permission to touch the child)
- Use age-appropriate language
✔✔Legal Issues - ✔✔- Religious beliefs (ex: Jehovah witness cannot receive blood
products)
- Emancipated minors
- Parenting agreements (custody)
✔✔Ethical Dilemmas - ✔✔- Parents disagree on treatments
- Parents may not want to tell the child about a terminal illness
· Respect the parents' wishes
,- Parents demanding unnecessary tests/treatments
· "Dr. Google" phenomenon
· Antibiotic overuse
· Explain and validate why test/treatment is not appropriate
✔✔Child Abuse - ✔✔- Physical, emotional, sexual, neglect
- Factors that contribute to child abuse:
· Alcoholic parents
· Children with disabilities
· Parents that have been survivors of abusers
✔✔Signs of Physical Abuse - ✔✔- Unusual bruising
- Burn marks/patterns (small round burns from cigarettes or mitten/boot shape burns
from hand in hot water)
- Bite marks
- Pattern injuries
- Fractures (spiral fracture in the arms from twisting)
- Evidence of previous healed injuries
✔✔Signs of Emotional Abuse - ✔✔- Shy, introverted child
- Aggressive, angry child
- Does not respond to affection
- Inappropriate parent/child interaction
- Name-calling or belittling from the parent
- Destruction of child's belongings
- May be hard to detect
✔✔Signs of Sexual Abuse - ✔✔- Vaginal tears
- Unexpected STIs
- Vaginal discharge
- Anal itching
- Anal injuries
- Genital injuries
- Inappropriate sexual behavior/knowledge
✔✔Sexual Assault Response Team Of Edmonton (SARTE) Team - ✔✔designed to
improve the flow of communication for rape victims
- Ensure that you follow agency policy when caring for a victim of a reported rape
✔✔Neglect - ✔✔- Differentiate between intentional neglect and lack of
resources/parenting skills
- Types of Neglect:
1. Physical - skinny, not clean, clothes don't fit or not seasonally appropriate, not going
to school
2. Psychological
, ✔✔Types of Bullying - ✔✔- Physical
- Emotional
- Cyber-bullying
✔✔Assessment of Intimate Partner Abuse - ✔✔- May be observed in adolescents
- Ask how an adolescent received any injuries that you see
- Ask at routine check-ups and office visits if they are ever afraid of their partner
✔✔Date Rape - ✔✔form of acquaintance rape and dating violence. Most common forms
of rape in adolescence
- May be made easier by the use of date-rape drugs (GHB & Rohypnol)
- Make sure adolescents, especially females, know about safe dating
✔✔Shaken Baby Syndrome - ✔✔violently shaking a baby causing permanent brain
damage
- Most common as a result of frustration
- Symptoms = pale/blue skin & lethargic eyes
✔✔Munchausen's Syndrome by Proxy - ✔✔illness induced or pretended in someone
else to get attention
- Rare
- Usual perpetrator is parent
- Indicator = symptoms that don't add up, overbearing, symptoms increase when the
parents are there and decreases when parents are not
✔✔Handling Abuse - ✔✔- Alert the physician
- Talk to the parents about your concerns
- Do not confront the child
- Report to the appropriate authorities
· Document everything
· Report to Child and Family Services
· Involve the hospital social worker
✔✔Unborn Baby Alerts - ✔✔unborn babies placed on pregnant women with a history of
abuse/neglect of their children
✔✔Prevention of Abuse - ✔✔- Teach parents how to appropriately discipline children
- Teach parents how to cope with a baby's crying
- Screen parents for evidence of financial issues and make appropriate referrals
- Teach adolescents about love vs. abuse
- Teach children about good and bad touching
ANSWERS SET A+
✔✔Trends & Issues - ✔✔- Smaller families
- Increased knowledge
- Increased family involvement
- Alternative families
✔✔Culture - ✔✔a pattern of learned beliefs, values and practices that are shared within
a group
- Ex: practices, customs, views on roles and relationships
- Be sensitive
- Perform a cultural assessment
- Use an interpreter or draw pictures if child does not speak english
✔✔Ethnicity - ✔✔particular cultural group or country into which a person was born
✔✔Informed Consent - ✔✔permission granted before conducting a healthcare
intervention on a person
- Children usually cannot give informed consent; get consent from the parents
- Get assent from the child (permission to touch the child)
- Use age-appropriate language
✔✔Legal Issues - ✔✔- Religious beliefs (ex: Jehovah witness cannot receive blood
products)
- Emancipated minors
- Parenting agreements (custody)
✔✔Ethical Dilemmas - ✔✔- Parents disagree on treatments
- Parents may not want to tell the child about a terminal illness
· Respect the parents' wishes
,- Parents demanding unnecessary tests/treatments
· "Dr. Google" phenomenon
· Antibiotic overuse
· Explain and validate why test/treatment is not appropriate
✔✔Child Abuse - ✔✔- Physical, emotional, sexual, neglect
- Factors that contribute to child abuse:
· Alcoholic parents
· Children with disabilities
· Parents that have been survivors of abusers
✔✔Signs of Physical Abuse - ✔✔- Unusual bruising
- Burn marks/patterns (small round burns from cigarettes or mitten/boot shape burns
from hand in hot water)
- Bite marks
- Pattern injuries
- Fractures (spiral fracture in the arms from twisting)
- Evidence of previous healed injuries
✔✔Signs of Emotional Abuse - ✔✔- Shy, introverted child
- Aggressive, angry child
- Does not respond to affection
- Inappropriate parent/child interaction
- Name-calling or belittling from the parent
- Destruction of child's belongings
- May be hard to detect
✔✔Signs of Sexual Abuse - ✔✔- Vaginal tears
- Unexpected STIs
- Vaginal discharge
- Anal itching
- Anal injuries
- Genital injuries
- Inappropriate sexual behavior/knowledge
✔✔Sexual Assault Response Team Of Edmonton (SARTE) Team - ✔✔designed to
improve the flow of communication for rape victims
- Ensure that you follow agency policy when caring for a victim of a reported rape
✔✔Neglect - ✔✔- Differentiate between intentional neglect and lack of
resources/parenting skills
- Types of Neglect:
1. Physical - skinny, not clean, clothes don't fit or not seasonally appropriate, not going
to school
2. Psychological
, ✔✔Types of Bullying - ✔✔- Physical
- Emotional
- Cyber-bullying
✔✔Assessment of Intimate Partner Abuse - ✔✔- May be observed in adolescents
- Ask how an adolescent received any injuries that you see
- Ask at routine check-ups and office visits if they are ever afraid of their partner
✔✔Date Rape - ✔✔form of acquaintance rape and dating violence. Most common forms
of rape in adolescence
- May be made easier by the use of date-rape drugs (GHB & Rohypnol)
- Make sure adolescents, especially females, know about safe dating
✔✔Shaken Baby Syndrome - ✔✔violently shaking a baby causing permanent brain
damage
- Most common as a result of frustration
- Symptoms = pale/blue skin & lethargic eyes
✔✔Munchausen's Syndrome by Proxy - ✔✔illness induced or pretended in someone
else to get attention
- Rare
- Usual perpetrator is parent
- Indicator = symptoms that don't add up, overbearing, symptoms increase when the
parents are there and decreases when parents are not
✔✔Handling Abuse - ✔✔- Alert the physician
- Talk to the parents about your concerns
- Do not confront the child
- Report to the appropriate authorities
· Document everything
· Report to Child and Family Services
· Involve the hospital social worker
✔✔Unborn Baby Alerts - ✔✔unborn babies placed on pregnant women with a history of
abuse/neglect of their children
✔✔Prevention of Abuse - ✔✔- Teach parents how to appropriately discipline children
- Teach parents how to cope with a baby's crying
- Screen parents for evidence of financial issues and make appropriate referrals
- Teach adolescents about love vs. abuse
- Teach children about good and bad touching
