NR602 PEDIATRIC MIDTERM STUDY
SET ACTUAL EXAM ALL QUESTIONS
AND WELL ELABORATED ANSWERS
TOP RATED VERSION FOR ALREADY
A+ GRADED HIGHLY RECOMMENDED
|NEW AND REVISED
Themparentmofmamtoddlermismconcernedmthatmthemchildmmaymhavemautism.mThemprimarymcarempedia
tricmnursempractitionermcompletesmamModifiedmChecklistmformAutismminmToddlersm(M-
CHAT)mtool,mwhichmindicatesmseveralmareasmofmconcern.mWhatmwillmthemnursempractitionermdo?
AdministermamChildhoodmAutismmRatingmScalem(CARS)minmthemclinic.
Consultmamspecialistmtomdeterminemappropriatemearlyminterventionmstrategies.
Refermthemchildmtomambehavioralmspecialistmformfurthermevaluation.
Tellmthemparentmthatmthismresultmindicatesmthatmthemchildmhasmautism.m-
mCORRECTmANSWERmANS:mC
ThemM-
CHATmismamscreeningmtoolmandmismusefulmformdetectingmbehaviorsmthatmmaymindicatemautism.mThism
instrumentmhasmbeenmfoundmtomhavemacceptablemsensitivity,mspecificity,mandmsignificantmpositivem
predictivemvalue.mIfmthesembehaviorsmaremdetected,mthemPNPmshouldmrefermthemchildmtomamspeciali
stmformfurthermassessment,musingmmoremdiagnosticmtools.mThemCARSmmaymbemusedmbutmrequiresms
pecialtymtrainingmandmpropermcredentials.mUntilmthemdiagnosismismdetermined,mstrategiesmforminter
ventionmaremnotmdiscussed.mThemM-CHATmismamscreeningmtoolmandmismnotmdiagnostic.
Themmothermofmamnewbornmtellsmthemprimarymcarempediatricmnursempractitionermthatmshemismworri
edmthatmhermchildmwillmdevelopmallergiesmandmasthma.mWhichmtoolmwillmthemnursempractitionermus
emtomevaluatemthismrisk?
Three-generationmpedigree
Reviewmofmsystems
Genogram
Ecomapm-mCORRECTmANSWERmANS:mA
,Themthree-
generationmpedigreemismusedmtommapmoutmrisksmformgeneticmdiseasesminmfamilies,masmwellmasmcondi
tionsmwithmmodifiablemriskmfactors.mThemreviewmofmsystemsmismusedmtomevaluatemthemhistorymofmth
emchild'smbodymsystems.mThemgenogrammismanmapproachmtomdevelopingmamfamilymdatabasemtompro
videmamgraphicmrepresentationmofmfamilymstructure,mroles,mandmproblemsmofmrecurringmsignificanc
eminmamfamily.mThemecomapmismusedmtomidentifymrelationshipsminmthemfamilymandmcommunitymthatm
aremsupportivemormharmful.
Themprimarymcarempediatricmnursempractitionermismperformingmamwellmchildmcheck-upmonmam20-
month-oldmchild.mThemchildmwasm4mweeksmprematuremand,maccordingmtomamparent-
completedmdevelopmentalmquestionnaire,mhasmachievedmmilestonesmformam15-month-
oldminfant.mWhichmactionmismcorrect?
Performmanmin-depthmdevelopmentalmassessmentmscreenmatmthismvisitmtomevaluatemthismchild.
Reassuremthemparentmthatmthemchildmwillmcatchmupmtomnormalmdevelopmentmbymagem2myears.
Re-evaluatemthismchild'smdevelopmentmandmmilestonemachievementsmatmthem2-yearmvisit.
Refermthemchildmtomamspecialtymclinicmformevaluationmandmtreatmentmofmdevelopmentalmdelay.m-
mCORRECTmANSWERmANS:mA
Thismchildmshouldmbematmam19-
monthmadjustedmagemformprematuritymso,maccordingmtomthemparentmscreen,mism4mmonthsmbehind.m
ThemPNPmshouldmperformmammoremin-
depthmscreenmtomevaluatemthismdelay.mWaitingmtomseemifmthemchildmwillm"catchmup"mormassuringmth
emparentmthatmthismwillmhappenmwillmcausemthemdelaysmtombecomemmoremsevere.mAmreferralmtomams
pecialtymclinicmshouldmnotmbemmademsolelymonmthembasismofmthemparent-
completedmquestionnairembutmonlymaftermfurthermevaluationmofmpossiblemdelays.
Whenmformulatingmdevelopmentalmdiagnosesmformpediatricmpatients,mthemprimarymcarempediatric
mnursempractitionermmaymusemwhichmresource?
DC:m0-3R
ICD-10-CM
ICSD-3
NANDAmInternationalm-mCORRECTmANSWERmANS:mA
,ThemDC:m0-
3RmrefersmtomthemDiagnosticmClassificationmofmMentalmHealthmandmDevelopmentalmDisordersmofmIn
fancymandmEarlymChildhoodmandmismusefulmformdevelopmentalmproblemmdiagnosis.mThemICD-10-
CMmismthemInternationalmClassificationmofmDiseases-
TenthmRevision,mClinicalmModificationmandmismusefulmformidentifyingmphysiologicmdiseases.mThemICS
D-3mismthemInternationalmClassificationmofmSleepmDisordersm-
m3rdmedition.mNANDAmInternationalmismusedmtomlabelmproblemsminmthemfunctionalmhealthmdomain.
Themprimarymcarempediatricmnursempractitionermismevaluatingmhealthmliteracyminmthemmothermofmam
newmpreschool-agemchild.mHowmwillmthemnursempractitionermassessmthis?
Askmthemchildmhowmmanymbooksmhemhasmatmhome.
Askmthemmothermaboutmhermhighestmgrademinmschool.
Askmthemmothermtomdeterminemthemcorrectmdosemofmamdrugmfrommamlabel.
Askmthemmothermtomreadmamhealthminformationmhandoutmaloud.m-mCORRECTmANSWERmANS:mA
Them"newestmvitalmsign,"mormhealthmliteracy,mcanmbemdeterminedmquicklymbymaskingmthemparentmh
owmmanymchildren'smbooksmareminmthemhome.mGreatermthanm10mbooksminmthemhomemismanmindepe
ndentmpositivempredictormofmadequatemparentmhealthmliteracy.mThemothermquestionsmmaymdeterm
inemamspecificmlevelmofmliteracyminmgeneralmbutmaremnotmasmefficient.
Themprimarymcarempediatricmnursempractitionermlearnsmthatmthemmothermofmam3-year-
oldmchildmhasmbeenmtreatedmformdepressionmformoverm5myears.mWhichmaspectmofmthismchild'smdevel
opmentmwillmbemofmthemmostmconcernmtomthemnursempractitioner?
Finemmotor
Grossmmotor
Social/emotional
Speechmandmlanguagem-mCORRECTmANSWERmANS:mD
Maternalmdepressionminmthemfirstmyearmofmlifemhasmbeenmassociatedmwithmpoorermlanguagemdevel
opmentmatm3myearsmofmage.
, Themprimarymcarempediatricmnursempractitionermseesmam3-year-
oldmchildmwhomchronicallymwithholdsmstools,minmspitemofmthemparents'mattemptsmtomstopmthembeha
vior,mrequiringmfrequentmtreatmentsmwithmlaxativemmedications.mWhichmdiagnosismwillmthemnursem
practitionermusemtomfacilitatemthird-partymreimbursement?
Alteredmeliminationmpattern
Eliminationmdisorder
Encopresis
Parentingmalterationm-mCORRECTmANSWERmANS:mC
Encopresismismammedicalmdiagnosis,mclassifiedminmthemICD-10-
CM,mandmismrecognizedmformreimbursementmpurposes.m"Alteredmeliminationmpattern"mandm"Paren
tingmalteration"maremNANDAmInternationalmdiagnosesmandmaremnotmrecognizedmformreimbursemen
t.m"Eliminationmdisorder"mismamdevelopmentalmdiagnosis.
Amchildmisminmthemclinicmformevaluationmofmanmasthmamactionmplan.mThemprimarymcarempediatricmnu
rsempractitionermnotesmthatmthemchild'smlastmvisitmwasmformampre-
kindergartenmphysicalmandmobservesmthatmthemchildmismextremelymanxious.mWhatmwillmthemnursem
practitionermdominitially?
Askmthemchild'smparentmwhymthemchildmismsomanxious.
Performmamphysicalmassessmentmtomrulemoutmshortnessmofmbreath.
Reassuremthemchildmthatmtheremismnothingmtombemafraidmof.
Reviewmthempurposemofmthismvisitmandmanymanticipatedmprocedures.m-mCORRECTmANSWERmANS:mD
ThemPNPmshouldmremembermthatmyoungmchildrenmaremlearningm"scripts"mformhealthmcaremvisitsman
dmmaymbemstressedmwhenmrecallingmpreviousmvisits,mespeciallymifmthoseminvolvedmimmunizations.m
ThemPNPmshouldmexplainmthempurposemandmanymanticipatedmproceduresmformthismvisitmtomhelpmput
mthemchildmatmease.
Whenmmeetingmwithmamnewmfamily,mthemprimarymcarempediatricmnursempractitionermdevelopsmamd
atabasemthatmidentifiesmfamilymmembersmandmothersmlivingminmthemhousehold,mrelationshipsmwith
mothersmoutsidemthemhousehold,mandmsignificantmbehavioralmandmemotionalmproblems.mWhichmto
olmwillmthemnursempractitionermusemtomrecordmthisminformation?
CRAFFT
SET ACTUAL EXAM ALL QUESTIONS
AND WELL ELABORATED ANSWERS
TOP RATED VERSION FOR ALREADY
A+ GRADED HIGHLY RECOMMENDED
|NEW AND REVISED
Themparentmofmamtoddlermismconcernedmthatmthemchildmmaymhavemautism.mThemprimarymcarempedia
tricmnursempractitionermcompletesmamModifiedmChecklistmformAutismminmToddlersm(M-
CHAT)mtool,mwhichmindicatesmseveralmareasmofmconcern.mWhatmwillmthemnursempractitionermdo?
AdministermamChildhoodmAutismmRatingmScalem(CARS)minmthemclinic.
Consultmamspecialistmtomdeterminemappropriatemearlyminterventionmstrategies.
Refermthemchildmtomambehavioralmspecialistmformfurthermevaluation.
Tellmthemparentmthatmthismresultmindicatesmthatmthemchildmhasmautism.m-
mCORRECTmANSWERmANS:mC
ThemM-
CHATmismamscreeningmtoolmandmismusefulmformdetectingmbehaviorsmthatmmaymindicatemautism.mThism
instrumentmhasmbeenmfoundmtomhavemacceptablemsensitivity,mspecificity,mandmsignificantmpositivem
predictivemvalue.mIfmthesembehaviorsmaremdetected,mthemPNPmshouldmrefermthemchildmtomamspeciali
stmformfurthermassessment,musingmmoremdiagnosticmtools.mThemCARSmmaymbemusedmbutmrequiresms
pecialtymtrainingmandmpropermcredentials.mUntilmthemdiagnosismismdetermined,mstrategiesmforminter
ventionmaremnotmdiscussed.mThemM-CHATmismamscreeningmtoolmandmismnotmdiagnostic.
Themmothermofmamnewbornmtellsmthemprimarymcarempediatricmnursempractitionermthatmshemismworri
edmthatmhermchildmwillmdevelopmallergiesmandmasthma.mWhichmtoolmwillmthemnursempractitionermus
emtomevaluatemthismrisk?
Three-generationmpedigree
Reviewmofmsystems
Genogram
Ecomapm-mCORRECTmANSWERmANS:mA
,Themthree-
generationmpedigreemismusedmtommapmoutmrisksmformgeneticmdiseasesminmfamilies,masmwellmasmcondi
tionsmwithmmodifiablemriskmfactors.mThemreviewmofmsystemsmismusedmtomevaluatemthemhistorymofmth
emchild'smbodymsystems.mThemgenogrammismanmapproachmtomdevelopingmamfamilymdatabasemtompro
videmamgraphicmrepresentationmofmfamilymstructure,mroles,mandmproblemsmofmrecurringmsignificanc
eminmamfamily.mThemecomapmismusedmtomidentifymrelationshipsminmthemfamilymandmcommunitymthatm
aremsupportivemormharmful.
Themprimarymcarempediatricmnursempractitionermismperformingmamwellmchildmcheck-upmonmam20-
month-oldmchild.mThemchildmwasm4mweeksmprematuremand,maccordingmtomamparent-
completedmdevelopmentalmquestionnaire,mhasmachievedmmilestonesmformam15-month-
oldminfant.mWhichmactionmismcorrect?
Performmanmin-depthmdevelopmentalmassessmentmscreenmatmthismvisitmtomevaluatemthismchild.
Reassuremthemparentmthatmthemchildmwillmcatchmupmtomnormalmdevelopmentmbymagem2myears.
Re-evaluatemthismchild'smdevelopmentmandmmilestonemachievementsmatmthem2-yearmvisit.
Refermthemchildmtomamspecialtymclinicmformevaluationmandmtreatmentmofmdevelopmentalmdelay.m-
mCORRECTmANSWERmANS:mA
Thismchildmshouldmbematmam19-
monthmadjustedmagemformprematuritymso,maccordingmtomthemparentmscreen,mism4mmonthsmbehind.m
ThemPNPmshouldmperformmammoremin-
depthmscreenmtomevaluatemthismdelay.mWaitingmtomseemifmthemchildmwillm"catchmup"mormassuringmth
emparentmthatmthismwillmhappenmwillmcausemthemdelaysmtombecomemmoremsevere.mAmreferralmtomams
pecialtymclinicmshouldmnotmbemmademsolelymonmthembasismofmthemparent-
completedmquestionnairembutmonlymaftermfurthermevaluationmofmpossiblemdelays.
Whenmformulatingmdevelopmentalmdiagnosesmformpediatricmpatients,mthemprimarymcarempediatric
mnursempractitionermmaymusemwhichmresource?
DC:m0-3R
ICD-10-CM
ICSD-3
NANDAmInternationalm-mCORRECTmANSWERmANS:mA
,ThemDC:m0-
3RmrefersmtomthemDiagnosticmClassificationmofmMentalmHealthmandmDevelopmentalmDisordersmofmIn
fancymandmEarlymChildhoodmandmismusefulmformdevelopmentalmproblemmdiagnosis.mThemICD-10-
CMmismthemInternationalmClassificationmofmDiseases-
TenthmRevision,mClinicalmModificationmandmismusefulmformidentifyingmphysiologicmdiseases.mThemICS
D-3mismthemInternationalmClassificationmofmSleepmDisordersm-
m3rdmedition.mNANDAmInternationalmismusedmtomlabelmproblemsminmthemfunctionalmhealthmdomain.
Themprimarymcarempediatricmnursempractitionermismevaluatingmhealthmliteracyminmthemmothermofmam
newmpreschool-agemchild.mHowmwillmthemnursempractitionermassessmthis?
Askmthemchildmhowmmanymbooksmhemhasmatmhome.
Askmthemmothermaboutmhermhighestmgrademinmschool.
Askmthemmothermtomdeterminemthemcorrectmdosemofmamdrugmfrommamlabel.
Askmthemmothermtomreadmamhealthminformationmhandoutmaloud.m-mCORRECTmANSWERmANS:mA
Them"newestmvitalmsign,"mormhealthmliteracy,mcanmbemdeterminedmquicklymbymaskingmthemparentmh
owmmanymchildren'smbooksmareminmthemhome.mGreatermthanm10mbooksminmthemhomemismanmindepe
ndentmpositivempredictormofmadequatemparentmhealthmliteracy.mThemothermquestionsmmaymdeterm
inemamspecificmlevelmofmliteracyminmgeneralmbutmaremnotmasmefficient.
Themprimarymcarempediatricmnursempractitionermlearnsmthatmthemmothermofmam3-year-
oldmchildmhasmbeenmtreatedmformdepressionmformoverm5myears.mWhichmaspectmofmthismchild'smdevel
opmentmwillmbemofmthemmostmconcernmtomthemnursempractitioner?
Finemmotor
Grossmmotor
Social/emotional
Speechmandmlanguagem-mCORRECTmANSWERmANS:mD
Maternalmdepressionminmthemfirstmyearmofmlifemhasmbeenmassociatedmwithmpoorermlanguagemdevel
opmentmatm3myearsmofmage.
, Themprimarymcarempediatricmnursempractitionermseesmam3-year-
oldmchildmwhomchronicallymwithholdsmstools,minmspitemofmthemparents'mattemptsmtomstopmthembeha
vior,mrequiringmfrequentmtreatmentsmwithmlaxativemmedications.mWhichmdiagnosismwillmthemnursem
practitionermusemtomfacilitatemthird-partymreimbursement?
Alteredmeliminationmpattern
Eliminationmdisorder
Encopresis
Parentingmalterationm-mCORRECTmANSWERmANS:mC
Encopresismismammedicalmdiagnosis,mclassifiedminmthemICD-10-
CM,mandmismrecognizedmformreimbursementmpurposes.m"Alteredmeliminationmpattern"mandm"Paren
tingmalteration"maremNANDAmInternationalmdiagnosesmandmaremnotmrecognizedmformreimbursemen
t.m"Eliminationmdisorder"mismamdevelopmentalmdiagnosis.
Amchildmisminmthemclinicmformevaluationmofmanmasthmamactionmplan.mThemprimarymcarempediatricmnu
rsempractitionermnotesmthatmthemchild'smlastmvisitmwasmformampre-
kindergartenmphysicalmandmobservesmthatmthemchildmismextremelymanxious.mWhatmwillmthemnursem
practitionermdominitially?
Askmthemchild'smparentmwhymthemchildmismsomanxious.
Performmamphysicalmassessmentmtomrulemoutmshortnessmofmbreath.
Reassuremthemchildmthatmtheremismnothingmtombemafraidmof.
Reviewmthempurposemofmthismvisitmandmanymanticipatedmprocedures.m-mCORRECTmANSWERmANS:mD
ThemPNPmshouldmremembermthatmyoungmchildrenmaremlearningm"scripts"mformhealthmcaremvisitsman
dmmaymbemstressedmwhenmrecallingmpreviousmvisits,mespeciallymifmthoseminvolvedmimmunizations.m
ThemPNPmshouldmexplainmthempurposemandmanymanticipatedmproceduresmformthismvisitmtomhelpmput
mthemchildmatmease.
Whenmmeetingmwithmamnewmfamily,mthemprimarymcarempediatricmnursempractitionermdevelopsmamd
atabasemthatmidentifiesmfamilymmembersmandmothersmlivingminmthemhousehold,mrelationshipsmwith
mothersmoutsidemthemhousehold,mandmsignificantmbehavioralmandmemotionalmproblems.mWhichmto
olmwillmthemnursempractitionermusemtomrecordmthisminformation?
CRAFFT
