NR602 Pediatric Midterm Study |! |! |! |!
Set questions with precise |! |! |! |!
answers & rationales |! |!
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. - Correct answer ✔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 - Correct answer ✔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.
|!
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. - Correct answer ✔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? |!
DC: 0-3R |!
ICD-10-CM
ICSD-3
NANDA International - Correct answer ✔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.
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?
|! |! |! |!
Ask the child how many books he has at home.
|! |! |! |! |! |! |! |! |!
, Ask the mother about her highest grade in school.
|! |! |! |! |! |! |! |!
Ask the mother to determine the correct dose of a drug from a
|! |! |! |! |! |! |! |! |! |! |! |! |!
label.
Ask the mother to read a health information handout aloud. -
|! |! |! |! |! |! |! |! |! |! |!
Correct answer ✔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.
|! |! |! |!
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?
|! |! |! |! |! |!
Fine motor |!
Gross motor |!
Social/emotional
Speech and language - Correct answer ✔ANS: D
|! |! |! |! |! |! |!
Maternal depression in the first year of life has been associated
|! |! |! |! |! |! |! |! |! |! |!
with poorer language development at 3 years of age.
|! |! |! |! |! |! |! |!
The primary care pediatric nurse practitioner sees a 3-year-old
|! |! |! |! |! |! |! |! |!
child who chronically withholds stools, in spite of the parents'
|! |! |! |! |! |! |! |! |! |!
attempts to stop the behavior, requiring frequent treatments
|! |! |! |! |! |! |! |!
with laxative medications. Which diagnosis will the nurse
|! |! |! |! |! |! |! |!
practitioner use to facilitate third-party reimbursement? |! |! |! |! |!
Altered elimination pattern |! |!
Set questions with precise |! |! |! |!
answers & rationales |! |!
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. - Correct answer ✔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 - Correct answer ✔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.
|!
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. - Correct answer ✔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? |!
DC: 0-3R |!
ICD-10-CM
ICSD-3
NANDA International - Correct answer ✔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.
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?
|! |! |! |!
Ask the child how many books he has at home.
|! |! |! |! |! |! |! |! |!
, Ask the mother about her highest grade in school.
|! |! |! |! |! |! |! |!
Ask the mother to determine the correct dose of a drug from a
|! |! |! |! |! |! |! |! |! |! |! |! |!
label.
Ask the mother to read a health information handout aloud. -
|! |! |! |! |! |! |! |! |! |! |!
Correct answer ✔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.
|! |! |! |!
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?
|! |! |! |! |! |!
Fine motor |!
Gross motor |!
Social/emotional
Speech and language - Correct answer ✔ANS: D
|! |! |! |! |! |! |!
Maternal depression in the first year of life has been associated
|! |! |! |! |! |! |! |! |! |! |!
with poorer language development at 3 years of age.
|! |! |! |! |! |! |! |!
The primary care pediatric nurse practitioner sees a 3-year-old
|! |! |! |! |! |! |! |! |!
child who chronically withholds stools, in spite of the parents'
|! |! |! |! |! |! |! |! |! |!
attempts to stop the behavior, requiring frequent treatments
|! |! |! |! |! |! |! |!
with laxative medications. Which diagnosis will the nurse
|! |! |! |! |! |! |! |!
practitioner use to facilitate third-party reimbursement? |! |! |! |! |!
Altered elimination pattern |! |!
