BURNS PEDIATRIC EVALUATION TEST QUESTIONS
AND ANSWERS SURE A+
\
✔✔10. An adolescent exhibits mild depressive symptoms and tells the primary care
pediatric nurse
practitioner that he is most concerned about difficulty falling and staying asleep. The
adolescent does
not want to take medication to treat the depressive symptoms. What will the nurse
practitioner
recommend?
a. A program of sleep hygiene and gradual sleep extension
b. A sedative-narcotic will help both sleep and depression
c. Cognitive therapy can help the adolescent to sleep better
d. Using an antidepressant will improve sleep patterns - ✔✔ANS: A
Depression is linked to sleep problems and both predict and are predicted by a
diagnostic cluster that
includes ODD, GAD, and depression. One study found that gradual sleep extension
combined with sleep
extension advice had a beneficial effect on depressive symptoms of adolescents with
chronic sleep
reduction. Sedatives will not affect depression. Cognitive therapy is useful for insomnia
related to
anxiety. Antidepressants do not necessarily treat insomnia.
✔✔11. The primary care pediatric nurse practitioner is performing a well child
examination on a 4-year-old
child. The parent reports that the child snores frequently, often awakens during the
night, and seems
cranky during the day. What will the nurse practitioner tell this parent?
a. Most sleep disorders are benign and will be outgrown.
b. Sleep disorders are symptomatic of underlying behavior problems.
c. Sleep disorders at this age can have long-term impacts on learning.
,d. The child will need longer daytime naps to compensate for lost sleep. - ✔✔ANS: C
Behavioral sleep disorders and sleep-disordered breathing before age 5 can result in
increased special
education needs in children by 8 years of age. Sleep disorders are not usually benign or
outgrown. Sleep
disorders can result in behavioral difficulties but are not symptomatic of behavioral
problems. Sleep-
disordered breathing disrupts all sleep
✔✔napping will not produce adequate quality sleep. - ✔✔
✔✔12. The parent of a 3-year-old child tells the primary care pediatric nurse practitioner
that the child has
never been able to fall asleep without a parent in the room. The child has a new sibling
and the parent
is concerned that the toddler's cries will awaken the infant. What will the nurse
practitioner counsel
the parent?
a. Leaving the room as the child is falling asleep and returning at intervals to check on
the child
b. Offering a reward for each night the child falls asleep without the parent in the room
c. Putting the child to bed at the same time every night and ignoring all sleep interfering
behaviors
d. Taking away a favorite activity or video for each night the child fusses about the
parent not being
in the room - ✔✔ANS: A
Leaving the room as the child becomes drowsy and checking on the child at intervals is
called graduated
extinction and allows parents to ensure safety while helping the child to initiate and
maintain sleep
independently. The other measures may result in the toddler becoming upset and
crying, which would
awaken the baby. Rewards and punishments are not necessarily successful.
✔✔1. The primary care pediatric nurse practitioner is performing a well child exam on
an 8-year-old girl
and notes the presence of breast buds. What will the nurse practitioner include when
initiating
anticipatory guidance for this patient?
a. A discussion about the risks of pregnancy and sexually transmitted diseases
b. Information about sexual maturity and menstrual periods
c. Material about the human papillomavirus vaccine
d. Sexual orientation and the nature of sexual relationships - ✔✔ANS: B
Since this child is 8 years old, it is early to discuss sexual behavior and reproduction
given the level of the
, child's cognition and understanding. However, with these early changes in telearche
marking the onset of
puberty, it is wise to discuss menstruation in an age-appropriate manner before it
occurs so that the child
can be prepared. Since this child is showing signs of early puberty, this information can
be included in
anticipatory guidance.
✔✔2. The mother of a 3-month-old male infant tells the primary care pediatric nurse
practitioner that she
occasionally notices he has a penile erection just after nursing. What will the nurse
practitioner tell the
mother?
a. Infants should be prevented from masturbating.
b. The infant is conscious of the pleasure associated with nursing.
c. This is a form of infantile priapism.
d. This is a normal, reflexive behavior at this age. - ✔✔ANS: D
Newborn infants are reflexive beings, and sexual reflexes, which are present prenatally,
are easily
stimulated. A penile erection may occur while nursing. Infants explore with their hands
and may touch
their own genitalia for pleasure and for the purpose of soothing, and this is normal. A
penile erection at
this young age is reflexive and not conscious and intentional. It is not a form of priapism.
✔✔3. During a well child exam on a 13-year-old female, the primary care pediatric
nurse practitioner notes
that the child is at Tanner Stage 3. During the exam, when the nurse practitioner
initiates a
conversation about healthy sexuality education, the parent states that this topic is "off
limits." What
will the nurse practitioner do?
a. Ask the adolescent whether she wishes to discuss these matters since she is
becoming an adult.
b. Separate the parent from the adolescent to discuss the adolescent's concerns in
private.
c. Spend private time with the parent to discuss how sexuality education reduces the
risk of early
sexual intercourse and risky sexual behaviors.
d. Tell the parent that this information is a routine part of adolescent well child
examinations and
must be included. - ✔✔ANS: C
Research has shown that sexuality education leads to a reduction in early onset of
sexual intercourse and
risky sexual behaviors. It is important for the PNP to be sensitive to the values of the
family but also to
AND ANSWERS SURE A+
\
✔✔10. An adolescent exhibits mild depressive symptoms and tells the primary care
pediatric nurse
practitioner that he is most concerned about difficulty falling and staying asleep. The
adolescent does
not want to take medication to treat the depressive symptoms. What will the nurse
practitioner
recommend?
a. A program of sleep hygiene and gradual sleep extension
b. A sedative-narcotic will help both sleep and depression
c. Cognitive therapy can help the adolescent to sleep better
d. Using an antidepressant will improve sleep patterns - ✔✔ANS: A
Depression is linked to sleep problems and both predict and are predicted by a
diagnostic cluster that
includes ODD, GAD, and depression. One study found that gradual sleep extension
combined with sleep
extension advice had a beneficial effect on depressive symptoms of adolescents with
chronic sleep
reduction. Sedatives will not affect depression. Cognitive therapy is useful for insomnia
related to
anxiety. Antidepressants do not necessarily treat insomnia.
✔✔11. The primary care pediatric nurse practitioner is performing a well child
examination on a 4-year-old
child. The parent reports that the child snores frequently, often awakens during the
night, and seems
cranky during the day. What will the nurse practitioner tell this parent?
a. Most sleep disorders are benign and will be outgrown.
b. Sleep disorders are symptomatic of underlying behavior problems.
c. Sleep disorders at this age can have long-term impacts on learning.
,d. The child will need longer daytime naps to compensate for lost sleep. - ✔✔ANS: C
Behavioral sleep disorders and sleep-disordered breathing before age 5 can result in
increased special
education needs in children by 8 years of age. Sleep disorders are not usually benign or
outgrown. Sleep
disorders can result in behavioral difficulties but are not symptomatic of behavioral
problems. Sleep-
disordered breathing disrupts all sleep
✔✔napping will not produce adequate quality sleep. - ✔✔
✔✔12. The parent of a 3-year-old child tells the primary care pediatric nurse practitioner
that the child has
never been able to fall asleep without a parent in the room. The child has a new sibling
and the parent
is concerned that the toddler's cries will awaken the infant. What will the nurse
practitioner counsel
the parent?
a. Leaving the room as the child is falling asleep and returning at intervals to check on
the child
b. Offering a reward for each night the child falls asleep without the parent in the room
c. Putting the child to bed at the same time every night and ignoring all sleep interfering
behaviors
d. Taking away a favorite activity or video for each night the child fusses about the
parent not being
in the room - ✔✔ANS: A
Leaving the room as the child becomes drowsy and checking on the child at intervals is
called graduated
extinction and allows parents to ensure safety while helping the child to initiate and
maintain sleep
independently. The other measures may result in the toddler becoming upset and
crying, which would
awaken the baby. Rewards and punishments are not necessarily successful.
✔✔1. The primary care pediatric nurse practitioner is performing a well child exam on
an 8-year-old girl
and notes the presence of breast buds. What will the nurse practitioner include when
initiating
anticipatory guidance for this patient?
a. A discussion about the risks of pregnancy and sexually transmitted diseases
b. Information about sexual maturity and menstrual periods
c. Material about the human papillomavirus vaccine
d. Sexual orientation and the nature of sexual relationships - ✔✔ANS: B
Since this child is 8 years old, it is early to discuss sexual behavior and reproduction
given the level of the
, child's cognition and understanding. However, with these early changes in telearche
marking the onset of
puberty, it is wise to discuss menstruation in an age-appropriate manner before it
occurs so that the child
can be prepared. Since this child is showing signs of early puberty, this information can
be included in
anticipatory guidance.
✔✔2. The mother of a 3-month-old male infant tells the primary care pediatric nurse
practitioner that she
occasionally notices he has a penile erection just after nursing. What will the nurse
practitioner tell the
mother?
a. Infants should be prevented from masturbating.
b. The infant is conscious of the pleasure associated with nursing.
c. This is a form of infantile priapism.
d. This is a normal, reflexive behavior at this age. - ✔✔ANS: D
Newborn infants are reflexive beings, and sexual reflexes, which are present prenatally,
are easily
stimulated. A penile erection may occur while nursing. Infants explore with their hands
and may touch
their own genitalia for pleasure and for the purpose of soothing, and this is normal. A
penile erection at
this young age is reflexive and not conscious and intentional. It is not a form of priapism.
✔✔3. During a well child exam on a 13-year-old female, the primary care pediatric
nurse practitioner notes
that the child is at Tanner Stage 3. During the exam, when the nurse practitioner
initiates a
conversation about healthy sexuality education, the parent states that this topic is "off
limits." What
will the nurse practitioner do?
a. Ask the adolescent whether she wishes to discuss these matters since she is
becoming an adult.
b. Separate the parent from the adolescent to discuss the adolescent's concerns in
private.
c. Spend private time with the parent to discuss how sexuality education reduces the
risk of early
sexual intercourse and risky sexual behaviors.
d. Tell the parent that this information is a routine part of adolescent well child
examinations and
must be included. - ✔✔ANS: C
Research has shown that sexuality education leads to a reduction in early onset of
sexual intercourse and
risky sexual behaviors. It is important for the PNP to be sensitive to the values of the
family but also to
