Deck 20: Social and Environmental Influences on Child and Adolescent Health

Question 1

A seven-year-old child has been seen in the pediatric clinic three times in the last two months for complaints of abdominal pain. On each occasion, the physical exam and all ordered lab work have been normal. The most important information to assess at this time would be:

A)The child's normal eating habits.
B)Recent viral illnesses or other infectious symptoms.
C)Review of the child's immunization history.
D)Changes in school or home life.

Answer 1

Changes in school or home life.

Question 2

A mother of two children, an 8-year-old and a 10-year-old, tells you that her husband has recently been deployed to the Middle East. The mother is concerned about the children's constant interest in watching TV news coverage of activities in the Middle East. The most appropriate suggestion for the nurse to make to this mother would be:

A)"Spend time with your children, and take cues from them about how much they want to discuss."
B)"Allow the children to watch as much television as they want.This is how they are coping with their father's absence."
C)"The less that you discuss this, the quicker the children will adjust to their father's absence.Try to keep them busy and use distractions to keep their mind off of it."
D)"It will just take some time to adjust to their father's absence and then everything will return to normal."

Answer 2

"Spend time with your children, and take cues from them about how much they want to discuss."

Question 3

The school nurse in the high school recognizes that teenage pregnancy is a major problem in the school. The nurse recognizes that many high school girls hide their pregnancy to prevent adults from knowing they are pregnant. Therefore, it is important that the nurse insure that all pregnant teenagers are aware of:

A)Safe haven laws.
B)Birth control available to all teenagers.
C)Domestic abuse protection.
D)The father's financial responsibility for the infant.

Answer 3

Safe haven laws.

Question 4

The nurse recognizes that the person guilty of child abuse may have which symptoms?

A)Physical illness
B)Alcoholism
C)Many friends and families nearby
D)Unrealistic expectations for their child
E)The abuser has no relationship to the child.

Question 5

A child is brought to the emergency department in a coma. The mother thinks the child may have ingested a poison. The nurse will assess: Standard Text: Select all that apply.

A)For burns around the mouth.
B)The child's breath.
C)The child's vomitus.
D)Hair samples.
E)Blood and urine toxicology screens.

Question 6

The child is admitted to the hospital unit for injuries. The mother's boyfriend is suspected of child abuse. The nurse's primary role, in addition to reporting to the proper authorities, is:

A)Gathering information about how the injuries occurred.
B)Collecting evidence against the suspected abuser.
C)Encouraging the child to talk about his experience.
D)Protecting the child from further injury.

Question 7

The mother tells the nurse that her maternity leave is almost over and she will be returning to work soon. She will need to place her infant in a day care, and she asks the nurse how to know which day care is best. The nurse will tell the mother to investigate day care programs that: Standard Text: Select all that apply.

A)Are close to her work in the event of an emergency
B)Require all staff have criminal background checks
C)Are attractive in appearance, with bright colors and interesting visual stimulation
D)Provide regular training of the staff and administration
E)Have policies regarding child health and emergencies, such as immunization requirements and emergency medical forms

Question 8

A high school student calls to ask the nurse for advice on how to care for a new navel piercing. How should the nurse respond?

A)"Avoid contact with another person's bodily fluids until the area is well healed."
B)"Do not move or turn the jewelry for the first three days."
C)"Apply lotion to the area, rubbing gently, to prevent skin from becoming dry and irritated."
D)"Apply warm soaks to the area for the first two days to minimize swelling."

Question 9

While working at a weekend "free clinic," the nurse is assessing a three-year-old when the mother of the child confides that it has been very difficult providing for her family of four children on her limited budget. She is not sure that she has enough money to buy both food for the rest of the month and the antibiotic that is needed for the child's ear infection. Which intervention by the nurse would be most beneficial for the child and this family?

A)Talking with the mother about keeping the child's ear clean by using a Q-tip
B)Putting the mother in contact with a local agency that provides food on a regular basis to needy families and helps them access other resources in the community
C)Providing the mother with samples of food and food stamps for the child
D)Giving the mother free samples of an antibiotic.

Question 10

A young infant is admitted to the hospital unit with physical injuries. The nurse is taking the child's history. The statement by the parent that would be most suspicious for abuse is:

A)"I was walking up the steps and slipped on the ice, falling while carrying my baby."
B)"The baby's 18-month-old brother was trying to pull the baby out of the crib and dropped the baby on the floor."
C)"I placed the baby in the infant swing.His six-year-old brother was running through the house and tripped over the swing, causing it to fall."
D)"I did not realize that my baby was able to roll over yet, and I was just gone a minute to check on dinner when the baby rolled off of the couch and onto our tile floor."

Question 11

The nurse is providing care to homeless teens at an outreach clinic. Which of the following is most important for the nurse to understand?

A)Teens who are homeless will get a job and somewhere to live.
B)Teens who are homeless will seek help when needed.
C)Teens who are homeless will not be fearful of authority figures.
D)Teens who are homeless are most likely to have unprotected sex.

Question 12

During a well-child exam, the parents of a four-year-old child inform the nurse that they are thinking of buying a television for their child's bedroom and ask for advice as to whether this is appropriate. The best response from the nurse would be:

A)"It is okay for children to have a television in their room as long as you limit the amount of time they watch it to less than two hours per day."
B)"Research has shown that watching educational television shows improves a child's performance in school."
C)"Don't buy a television for your child's room; he is much too young for that."
D)"Research has shown that children with a television in their bedroom spend significantly less time playing outside than other children."

Question 13

A parent is concerned about her eight-year-old child's recent behavior and calls the nurse for advice. According to the parent, her child is constantly crying, is not sleeping well, and has withdrawn from activities. The nurse should recognize that this behavior could be a response to:

A)Bullying.
B)Normal behavior for the age.
C)Lead poisoning.
D)Drug abuse.

Question 14

A concerned parent calls the school nurse because of changes in his 15-year-old's behavior. Which behaviors would the nurse identify as most likely to be abnormal and indicate possible substance abuse in an adolescent?

A)Becoming very involved with friends and in activities related to the basketball team that she is on, never seeming to be home, and, when she is home, preferring to be in her room with the door shut
B)Becoming moody, crying, and weeping one minute and then cheerful and excited the next
C)Receiving numerous detentions lately from teachers for sleeping in class
D)Buying baggy, oversized clothing at thrift shops and dyeing her hair black

Question 15

The pediatric public health nurse visits a facility for the homeless. The nurse would evaluate the children staying at the facility for what type of medical/health issues? Standard Text: Select all that apply.

A)Dental caries
B)Infections secondary to tattoos
C)Lack of immunizations
D)Nutritional deficits
E)Munchausen syndrome by proxy

Question 16

A child is admitted for scald burns to his buttocks and thighs. According to the mother, she was preparing the child's bath and before she could test the water, the child fell in and was scalded. The nurse would suspect child abuse because:

A)The burns are uneven, with some burns deeper than others.
B)The child's hands and feet are free of burns.
C)In addition to the main burn site, there are splash burns surrounding the area.
D)The mother was home alone with the child.

Question 17

The school nurse is planning a smoking prevention program for middle school students. All of the following activities will be utilized. Which is likely to be the most effective in preventing middle school children from smoking?

A)A demonstration of the pathophysiology of the effects of smoking tobacco on the body given by the school's biology teacher
B)A talk on the importance of not smoking given by a local high school basketball star
C)Colorful posters with catchy slogans displayed throughout the school
D)A pledge campaign during which students sign contracts saying that they will not use tobacco products

Question 18

The nurse works in a pediatric unit. In working with a parent who is suspected of Munchausen syndrome by proxy, it is very important for the nurse to:

A)Try to keep the parent separated from the child as much as possible.
B)Explain to the child that the parent is causing the illness and that the health care team will prevent the child from being harmed
C)Carefully document parent-child interactions.
D)Confront the parent with concerns of possible abuse.

Question 19

While the nurse is taking the history of a 10-year-old child, the parents admit to owning firearms. An appropriate safety measure for the nurse to suggest would be which of the following?

A)Keeping all the guns put away and out of the child's reach
B)Taking the child to a shooting range for lessons on how to use a gun properly
C)Storing the guns and ammunition in the same place
D)Using a gun lock on all firearms in the house

Question 20

A child is admitted to the hospital with a diagnosis of lead poisoning. The health department nurse is investigating the child's home to locate the source of the lead that the child has ingested. Which possibilities will the nurse investigate? Standard Text: Select all that apply.

A)The home's foundation for a possible radon leak
B)The home's water pipes
C)The dirt surrounding the house
D)The presence of imported toys or antique baby furniture
E)Gas stored in cans