MIDTERM EXAM: NR 602 / NR602 (NEWEST
UPDATE) PRIMARY CARE OF THE
CHILDBEARING AND CHILDREARING FAMILY
PRACTICUM | 153 COMPREHENSIVE
QUESTIONS & ANSWERS | GRADE A | A+ SCORE
SOLUTION – CHAMBERLAIN
Quiz_________________?
pediatric NP -
Answer☑️
health promotion, protection, and disease prevention
Quiz_________________?
Primary care NP -
Answer☑️
well childcare and prevention and/or management of both common pediatric acute illness and
any childhood diseases.
Quiz_________________?
Acute care NP -
Answer☑️
acute, chronic, or critically ill children. Unstable, experiencing life-threatening illness, medically
fragile and tech dependent.
Primary prevention -
Answer☑️
1
,keep diseases from being established. Eliminate cause or increase people's resistance. 2 types of
primary prevention are health promotion and specific protection. Health promotion includes
efforts, including lifestyle changes/choices, nutrition, and maintenance of safe environments.
Specific protection involves actions targeted at specific diseases, such as immunizations, anti-
malarial prophylaxis, and environmental modifications (such as fluoride).
Quiz_________________?
secondary prevention -
Answer☑️
early diagnosis and prompt treatment- interrupt disease process- screening early detection and
prompt treatment. Goal is to eliminate or reduce symptoms/progression..
Quiz_________________?
Tertiary care -
Answer☑️
requires both specialized expertise and equipment. Goal improves survival and quality of life.
There are 2 types: 1) disability limitation-early symptom management 2) rehabilitation- late
symptom management.
Quiz_________________?
Quaternary care -
Answer☑️
highly specialized expertise and highly unusual or specialized equipment
Quiz_________________?
Barriers to vaccination -
Answer☑️
patients feel vaccines are unsafe, may cause autism, overload or weaken a child's immune
system, or are traumatic for the child. Parents may feel there is a lack of concern about the
diseases that are being prevented. Poverty was a factor, as was a lack of education.
2
, Quiz_________________?
How to encourage parents to get vaccines for their kids -
Answer☑️
• Acknowledge and respect the trusted relationship between provider and parent.
• Communicatjm0h e a strong shared commitment with the parent to the health and well-being
of their child.
• Listen to and query parents' reasons for refusing or delaying vaccines; not all vaccine-hesitant
individuals have the same concerns.
• Be familiar with misconceptions and controversies regarding vaccines and be prepared to
address them (e.g., thimerosal-free vaccines).
• Emphasize the safety of vaccines, the extensive testing before licensure, and the post-licensure
safety surveillance programs. Explain the serious consequences of not vaccinating.
• Educate the family about the safety of multiple vaccines to be given simultaneously. Mention
that a healthy infant's/child's immune system capably fights off an estimated 2000 to 6000 germs
(antigens) daily when playing, eating, and breathing. The number of antigens in any combination
of vaccines on the current schedule is much lower than the daily exposure to many substances
(150 antigens for the entire Advisory Committee on Immunization
Quiz_________________?
live vaccine -
Answer☑️
an attenuated form of the virus that induces immunity but does not produce disease. Broader
and longer-lived immunity. Common fever and rash. This means the immune system has
responded appropriately. Do not give before 1 year of age. When you give live attenuated
vaccines, you must give both on the same day or you have to wait 4 weeks to give the second
one or neither will be effective. NOT TO BE GIVEN WHILE PREGNANT OR 28 days prior to
being preg.
● Precautions- pay close attention when giving immunocompromised indv live vaccine.
Recommendations differ according to condition.
● Measles mump rubella-trivalent vaccine.MMR (2 doses, starting age 12mos)- after receiving 2
vaccines, efficacy is 98%. S/E rash, high fever 5-12 days after the vaccine. If given varicella in the
quad valiant, the chance of seizures is 2-fold. It is reduced by giving at the same time and in
different spots. NOT TO BE GIVEN WHILE PREGNANT OR 28 days prior to being preg.
3
, Quiz_________________?
Vaccines -
Answer☑️
Varicella(2 doses)- 98% efficacy after the 2nd dose. Severe cases have become uncommon.
● Rotavirus(2 doses)- side effect and contraindication could be intussusception. (an exception
to the rule to not give before age 1).
● Smallpox(0)- irradicated.
● Passive immunization Involves administering an exogenous antibody such as immunoglobulin
○ Immunoglobulins:
■ ***Respiratory Syncytial Virus Prophylaxis (RSV)
■ Palivizumab (Synagis) is the only product on the American market for use in infants at high
risk for adverse outcomes from respiratory syncytial virus (RSV) infection
■ Given IM, and is a humanized mouse monoclonal antibody, given in 5 monthly IM injections
during RSV season (usu Nov- march or april)
■ and effective in reducing RSV hospitalizations in high-risk infants by 39% to 82%
■ Consider RSV Prophylaxis:
● Infants born 29 wks and 0 days of gestation during RSV season until 12 months old
● Children born prematurely at or before 32 weeks and 0 days of gestation who are younger
than 2 years old with chronic lung disease (CLD) and who required treatment for their CLD
within 6 months of the onset of RSV season (including oxygen therapy); prophylaxis can be
given to 2-year-old children with CLD of prematurity who continue to require medical support
during the 6 months prior to the onset of RSV season
● Infants up to 12 months old with hemodynamically significant cyanotic or complicated
congenital heart disease
● Infants up to 12 months old with neuromuscular disorder or congenital anomalies that
compromise clearing of respiratory secretions
Quiz_________________?
killed (inactivated) vaccine -
Answer☑️
4
UPDATE) PRIMARY CARE OF THE
CHILDBEARING AND CHILDREARING FAMILY
PRACTICUM | 153 COMPREHENSIVE
QUESTIONS & ANSWERS | GRADE A | A+ SCORE
SOLUTION – CHAMBERLAIN
Quiz_________________?
pediatric NP -
Answer☑️
health promotion, protection, and disease prevention
Quiz_________________?
Primary care NP -
Answer☑️
well childcare and prevention and/or management of both common pediatric acute illness and
any childhood diseases.
Quiz_________________?
Acute care NP -
Answer☑️
acute, chronic, or critically ill children. Unstable, experiencing life-threatening illness, medically
fragile and tech dependent.
Primary prevention -
Answer☑️
1
,keep diseases from being established. Eliminate cause or increase people's resistance. 2 types of
primary prevention are health promotion and specific protection. Health promotion includes
efforts, including lifestyle changes/choices, nutrition, and maintenance of safe environments.
Specific protection involves actions targeted at specific diseases, such as immunizations, anti-
malarial prophylaxis, and environmental modifications (such as fluoride).
Quiz_________________?
secondary prevention -
Answer☑️
early diagnosis and prompt treatment- interrupt disease process- screening early detection and
prompt treatment. Goal is to eliminate or reduce symptoms/progression..
Quiz_________________?
Tertiary care -
Answer☑️
requires both specialized expertise and equipment. Goal improves survival and quality of life.
There are 2 types: 1) disability limitation-early symptom management 2) rehabilitation- late
symptom management.
Quiz_________________?
Quaternary care -
Answer☑️
highly specialized expertise and highly unusual or specialized equipment
Quiz_________________?
Barriers to vaccination -
Answer☑️
patients feel vaccines are unsafe, may cause autism, overload or weaken a child's immune
system, or are traumatic for the child. Parents may feel there is a lack of concern about the
diseases that are being prevented. Poverty was a factor, as was a lack of education.
2
, Quiz_________________?
How to encourage parents to get vaccines for their kids -
Answer☑️
• Acknowledge and respect the trusted relationship between provider and parent.
• Communicatjm0h e a strong shared commitment with the parent to the health and well-being
of their child.
• Listen to and query parents' reasons for refusing or delaying vaccines; not all vaccine-hesitant
individuals have the same concerns.
• Be familiar with misconceptions and controversies regarding vaccines and be prepared to
address them (e.g., thimerosal-free vaccines).
• Emphasize the safety of vaccines, the extensive testing before licensure, and the post-licensure
safety surveillance programs. Explain the serious consequences of not vaccinating.
• Educate the family about the safety of multiple vaccines to be given simultaneously. Mention
that a healthy infant's/child's immune system capably fights off an estimated 2000 to 6000 germs
(antigens) daily when playing, eating, and breathing. The number of antigens in any combination
of vaccines on the current schedule is much lower than the daily exposure to many substances
(150 antigens for the entire Advisory Committee on Immunization
Quiz_________________?
live vaccine -
Answer☑️
an attenuated form of the virus that induces immunity but does not produce disease. Broader
and longer-lived immunity. Common fever and rash. This means the immune system has
responded appropriately. Do not give before 1 year of age. When you give live attenuated
vaccines, you must give both on the same day or you have to wait 4 weeks to give the second
one or neither will be effective. NOT TO BE GIVEN WHILE PREGNANT OR 28 days prior to
being preg.
● Precautions- pay close attention when giving immunocompromised indv live vaccine.
Recommendations differ according to condition.
● Measles mump rubella-trivalent vaccine.MMR (2 doses, starting age 12mos)- after receiving 2
vaccines, efficacy is 98%. S/E rash, high fever 5-12 days after the vaccine. If given varicella in the
quad valiant, the chance of seizures is 2-fold. It is reduced by giving at the same time and in
different spots. NOT TO BE GIVEN WHILE PREGNANT OR 28 days prior to being preg.
3
, Quiz_________________?
Vaccines -
Answer☑️
Varicella(2 doses)- 98% efficacy after the 2nd dose. Severe cases have become uncommon.
● Rotavirus(2 doses)- side effect and contraindication could be intussusception. (an exception
to the rule to not give before age 1).
● Smallpox(0)- irradicated.
● Passive immunization Involves administering an exogenous antibody such as immunoglobulin
○ Immunoglobulins:
■ ***Respiratory Syncytial Virus Prophylaxis (RSV)
■ Palivizumab (Synagis) is the only product on the American market for use in infants at high
risk for adverse outcomes from respiratory syncytial virus (RSV) infection
■ Given IM, and is a humanized mouse monoclonal antibody, given in 5 monthly IM injections
during RSV season (usu Nov- march or april)
■ and effective in reducing RSV hospitalizations in high-risk infants by 39% to 82%
■ Consider RSV Prophylaxis:
● Infants born 29 wks and 0 days of gestation during RSV season until 12 months old
● Children born prematurely at or before 32 weeks and 0 days of gestation who are younger
than 2 years old with chronic lung disease (CLD) and who required treatment for their CLD
within 6 months of the onset of RSV season (including oxygen therapy); prophylaxis can be
given to 2-year-old children with CLD of prematurity who continue to require medical support
during the 6 months prior to the onset of RSV season
● Infants up to 12 months old with hemodynamically significant cyanotic or complicated
congenital heart disease
● Infants up to 12 months old with neuromuscular disorder or congenital anomalies that
compromise clearing of respiratory secretions
Quiz_________________?
killed (inactivated) vaccine -
Answer☑️
4
