,The primary care pediatric nurse practitioner is ANS: A
performing a well child check-up on a 20-month-old This child should be at a 19-month adjusted age for prematurity so, according to
child. The child was 4 weeks premature and, according to the parent screen, is 4 months behind. The PNP should perform a more in-depth
a parent-completed developmental questionnaire, has screen to evaluate this delay. Waiting to see if the child will "catch up" or assuring
achieved milestones for a 15-month-old infant. Which the parent that this will happen will cause the delays to become more severe. A
action is correct? referral to a specialty clinic should not be made solely on the basis of the parent-
Perform an in-depth developmental assessment screen at completed questionnaire but only after further evaluation of possible delays.
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.
When formulating developmental diagnoses for pediatric ANS: A
patients, the primary care pediatric nurse practitioner The DC: 0-3R refers to the Diagnostic Classification of Mental Health and
may use which resource? Developmental Disorders of Infancy and Early Childhood and is useful for
DC: 0-3R developmental problem diagnosis. The ICD-10-CM is the International
ICD-10-CM Classification of Diseases-Tenth Revision, Clinical Modification and is useful for
ICSD-3 identifying physiologic diseases. The ICSD-3 is the International Classification of
NANDA International Sleep Disorders - 3rd edition. NANDA International is used to label problems in
the functional health domain.
The primary care pediatric nurse practitioner is evaluating ANS: A
health literacy in the mother of a new preschool-age The "newest vital sign," or health literacy, can be determined quickly by asking the
child. How will the nurse practitioner assess this? parent how many children's books are in the home. Greater than 10 books in the
Ask the child how many books he has at home. home is an independent positive predictor of adequate parent health literacy. The
Ask the mother about her highest grade in school. other questions may determine a specific level of literacy in general but are not as
Ask the mother to determine the correct dose of a drug efficient.
from a label.
Ask the mother to read a health information handout
aloud.
The primary care pediatric nurse practitioner learns that ANS: D
the mother of a 3-year-old child has been treated for Maternal depression in the first year of life has been associated with poorer
depression for over 5 years. Which aspect of this child's language development at 3 years of age.
development will be of the most concern to the nurse
practitioner?
Fine motor
Gross motor
Social/emotional
Speech and language
The primary care pediatric nurse practitioner sees a 3- ANS: C
year-old child who chronically withholds stools, in spite Encopresis is a medical diagnosis, classified in the ICD-10-CM, and is recognized
of the parents' attempts to stop the behavior, requiring for reimbursement purposes. "Altered elimination pattern" and "Parenting
frequent treatments with laxative medications. Which alteration" are NANDA International diagnoses and are not recognized for
diagnosis will the nurse practitioner use to facilitate third- reimbursement. "Elimination disorder" is a developmental diagnosis.
party reimbursement?
Altered elimination pattern
Elimination disorder
Encopresis
Parenting alteration
, A child is in the clinic for evaluation of an asthma action ANS: D
plan. The primary care pediatric nurse practitioner notes The PNP should remember that young children are learning "scripts" for health
that the child's last visit was for a pre-kindergarten care visits and may be stressed when recalling previous visits, especially if those
physical and observes that the child is extremely anxious. involved immunizations. The PNP should explain the purpose and any anticipated
What will the nurse practitioner do initially? procedures for this visit to help put the child at ease.
Ask the child's parent why the child is so anxious.
Perform a physical assessment to rule out shortness of
breath.
Reassure the child that there is nothing to be afraid of.
Review the purpose of this visit and any anticipated
procedures.
When meeting with a new family, the primary care ANS: C
pediatric nurse practitioner develops a database that The genogram is an approach to developing a family database to provide a
identifies family members and others living in the graphic representation of family structure, roles, and problems of recurring
household, relationships with others outside the significance in a family. The CRAFFT tool is used to assess substance abuse in
household, and significant behavioral and emotional adolescents. The ecomap is used to identify relationships in the family and
problems. Which tool will the nurse practitioner use to community that are supportive or harmful. The pedigree is used to identify
record this information? potential genetic disorders.
CRAFFT
Ecomap
Genogram
Pedigree
The primary care pediatric nurse practitioner evaluates a ANS: C
school-age child whose body mass index (BMI) is greater A problem should never be included on the problem list that is not supported by
than the 97th percentile. The nurse practitioner is subjective and objective data found and recorded in the database. This child has a
concerned about possible metabolic syndrome and BMI that suggests obesity, so this may be used as a diagnosis. Metabolic
orders laboratory tests to evaluate this. Which diagnosis syndrome is a diagnosis that is determined by laboratory data, which has not been
will the nurse practitioner document for this visit? evaluated yet. Nutritional alteration is a NANDA diagnosis and not acceptable for
Metabolic syndrome reimbursement. "Rule out" should not be used as a diagnosis, but may be
Nutritional alteration: more than required considered part of a plan.
Obesity
Rule out type 2 diabetes mellitus
The primary care pediatric nurse practitioner performs a ANS: B
developmental assessment on a 3-year-old child and Development should be monitored over time and within the context of the child's
notes normal cognitive, fine-motor, and gross-motor overall well-being, rather than at an isolated testing session. The child has normal
abilities. The child responds appropriately to verbal development in observed measures and appears to hear and understand well. By
commands during the assessment but refuses to speak parental report, the child is able to speak. The PNP should continue to evaluate
when asked questions. The parent tells the nurse speech over time, since this refusal to speak may be associated with shyness or
practitioner that the child talks at home and that most intimidation in the clinic. It is not necessary to tell the parent that the child has a
other adults can understand what the child says. The possible speech delay. Unless an actual speech delay is observed, a referral is not
nurse practitioner will : indicated, nor is it necessary to implement a home therapy.
ask the parent to consider a possible speech delay and
report any concerns.
continue to evaluate the child's speech at subsequent
visits.
refer the child for a speech and hearing evaluation.
tell the parent to spend more time in interactive
conversations with the child.
performing a well child check-up on a 20-month-old This child should be at a 19-month adjusted age for prematurity so, according to
child. The child was 4 weeks premature and, according to the parent screen, is 4 months behind. The PNP should perform a more in-depth
a parent-completed developmental questionnaire, has screen to evaluate this delay. Waiting to see if the child will "catch up" or assuring
achieved milestones for a 15-month-old infant. Which the parent that this will happen will cause the delays to become more severe. A
action is correct? referral to a specialty clinic should not be made solely on the basis of the parent-
Perform an in-depth developmental assessment screen at completed questionnaire but only after further evaluation of possible delays.
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.
When formulating developmental diagnoses for pediatric ANS: A
patients, the primary care pediatric nurse practitioner The DC: 0-3R refers to the Diagnostic Classification of Mental Health and
may use which resource? Developmental Disorders of Infancy and Early Childhood and is useful for
DC: 0-3R developmental problem diagnosis. The ICD-10-CM is the International
ICD-10-CM Classification of Diseases-Tenth Revision, Clinical Modification and is useful for
ICSD-3 identifying physiologic diseases. The ICSD-3 is the International Classification of
NANDA International Sleep Disorders - 3rd edition. NANDA International is used to label problems in
the functional health domain.
The primary care pediatric nurse practitioner is evaluating ANS: A
health literacy in the mother of a new preschool-age The "newest vital sign," or health literacy, can be determined quickly by asking the
child. How will the nurse practitioner assess this? parent how many children's books are in the home. Greater than 10 books in the
Ask the child how many books he has at home. home is an independent positive predictor of adequate parent health literacy. The
Ask the mother about her highest grade in school. other questions may determine a specific level of literacy in general but are not as
Ask the mother to determine the correct dose of a drug efficient.
from a label.
Ask the mother to read a health information handout
aloud.
The primary care pediatric nurse practitioner learns that ANS: D
the mother of a 3-year-old child has been treated for Maternal depression in the first year of life has been associated with poorer
depression for over 5 years. Which aspect of this child's language development at 3 years of age.
development will be of the most concern to the nurse
practitioner?
Fine motor
Gross motor
Social/emotional
Speech and language
The primary care pediatric nurse practitioner sees a 3- ANS: C
year-old child who chronically withholds stools, in spite Encopresis is a medical diagnosis, classified in the ICD-10-CM, and is recognized
of the parents' attempts to stop the behavior, requiring for reimbursement purposes. "Altered elimination pattern" and "Parenting
frequent treatments with laxative medications. Which alteration" are NANDA International diagnoses and are not recognized for
diagnosis will the nurse practitioner use to facilitate third- reimbursement. "Elimination disorder" is a developmental diagnosis.
party reimbursement?
Altered elimination pattern
Elimination disorder
Encopresis
Parenting alteration
, A child is in the clinic for evaluation of an asthma action ANS: D
plan. The primary care pediatric nurse practitioner notes The PNP should remember that young children are learning "scripts" for health
that the child's last visit was for a pre-kindergarten care visits and may be stressed when recalling previous visits, especially if those
physical and observes that the child is extremely anxious. involved immunizations. The PNP should explain the purpose and any anticipated
What will the nurse practitioner do initially? procedures for this visit to help put the child at ease.
Ask the child's parent why the child is so anxious.
Perform a physical assessment to rule out shortness of
breath.
Reassure the child that there is nothing to be afraid of.
Review the purpose of this visit and any anticipated
procedures.
When meeting with a new family, the primary care ANS: C
pediatric nurse practitioner develops a database that The genogram is an approach to developing a family database to provide a
identifies family members and others living in the graphic representation of family structure, roles, and problems of recurring
household, relationships with others outside the significance in a family. The CRAFFT tool is used to assess substance abuse in
household, and significant behavioral and emotional adolescents. The ecomap is used to identify relationships in the family and
problems. Which tool will the nurse practitioner use to community that are supportive or harmful. The pedigree is used to identify
record this information? potential genetic disorders.
CRAFFT
Ecomap
Genogram
Pedigree
The primary care pediatric nurse practitioner evaluates a ANS: C
school-age child whose body mass index (BMI) is greater A problem should never be included on the problem list that is not supported by
than the 97th percentile. The nurse practitioner is subjective and objective data found and recorded in the database. This child has a
concerned about possible metabolic syndrome and BMI that suggests obesity, so this may be used as a diagnosis. Metabolic
orders laboratory tests to evaluate this. Which diagnosis syndrome is a diagnosis that is determined by laboratory data, which has not been
will the nurse practitioner document for this visit? evaluated yet. Nutritional alteration is a NANDA diagnosis and not acceptable for
Metabolic syndrome reimbursement. "Rule out" should not be used as a diagnosis, but may be
Nutritional alteration: more than required considered part of a plan.
Obesity
Rule out type 2 diabetes mellitus
The primary care pediatric nurse practitioner performs a ANS: B
developmental assessment on a 3-year-old child and Development should be monitored over time and within the context of the child's
notes normal cognitive, fine-motor, and gross-motor overall well-being, rather than at an isolated testing session. The child has normal
abilities. The child responds appropriately to verbal development in observed measures and appears to hear and understand well. By
commands during the assessment but refuses to speak parental report, the child is able to speak. The PNP should continue to evaluate
when asked questions. The parent tells the nurse speech over time, since this refusal to speak may be associated with shyness or
practitioner that the child talks at home and that most intimidation in the clinic. It is not necessary to tell the parent that the child has a
other adults can understand what the child says. The possible speech delay. Unless an actual speech delay is observed, a referral is not
nurse practitioner will : indicated, nor is it necessary to implement a home therapy.
ask the parent to consider a possible speech delay and
report any concerns.
continue to evaluate the child's speech at subsequent
visits.
refer the child for a speech and hearing evaluation.
tell the parent to spend more time in interactive
conversations with the child.
