Social and Environmental Influences on the Child Flashcards

1
Q

Which adolescent behavior, reported by a parent, would cause the nurse to suspect possible
substance abuse?
1. Becoming very involved with friends and in activities related to basketball
2. Becoming moody, crying, and weeping one minute and then cheerful and excited the
next
3. Receiving numerous detentions for sleeping in class
4. Wearing baggy, oversized clothing and dyeing hair black

A

Answer: 3

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2
Q

During a well-child examination, the parents of a 4-year-old client 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. Which response by the nurse is most appropriate?
1. “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 2 hours per day.”
2. “Research has shown that watching educational television shows improves a child’s
performance in school.”
3. “Don’t buy a television for your child’s room; he is much too young for that.”
4. “Research has shown that children with a television in their bedroom spend significantly
less time playing outside than other children.”

A

Answer: 4

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3
Q

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. Which
suggestion by the nurse to the mother is most appropriate?
1. “Spend time with your children, and take cues from them about how much they want to
discuss.”
2. “Allow the children to watch as much television as they want. This is how they are
coping with their father’s absence.”
3. “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.”
4. “It will just take some time to adjust to their father’s absence and then everything will
return to normal.”

A

Answer: 1

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4
Q

A 7-year-old child is seen in the pediatric clinic 3 times in the last 2 months for complaints
of abdominal pain. On each occasion, the physical examination and all ordered laboratory
work have been normal. Which is the priority nursing assessment at this time?
1. The child’s normal eating habits
2. Recent viral illnesses or other infectious symptoms
3. Review of the child’s immunization history
4. Changes in school or home life

A

Answer: 4

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5
Q

The nurse is providing care to homeless adolescents at an outreach clinic. Which concept is
important for the nurse to consider when providing care to this population?
1. Teens who are homeless will get a job and somewhere to live.
2. Teens who are homeless will seek help when needed.
3. Teens who are homeless will not be fearful of authority figures.
4. Teens who are homeless are most likely to have unprotected sex.

A

Answer: 4

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6
Q

A parent is concerned about her 8-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, has withdrawn from activities, and does not want to attend school. Which should the nurse
explore in more detail with the parent?
1. Bullying
2. Sexual abuse
3. Lead poisoning
4. Drug abuse

A

Answer: 1

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7
Q

A high school student calls to ask the nurse for advice on how to care for a new navel
piercing. Which response by the nurse is appropriate?
1. “Avoid contact with another person’s bodily fluids until the area is well healed.”
2. “Do not move or turn the jewelry for the first 3 days.”
3. “Apply lotion to the area, rubbing gently, to prevent skin from becoming dry and
irritated.”
4. “Apply warm soaks to the area for the first 2 days to minimize swelling.”

A

Answer: 1

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8
Q

The school nurse is planning a smoking prevention program for middle school students.
Which is most likely to be effective in preventing this population from smoking?
1. A demonstration of the pathophysiology of the effects of smoking tobacco on the body
given by the school’s biology teacher
2. A talk on the importance of not smoking given by a local high school basketball star
3. Colorful posters with catchy slogans displayed throughout the school
4. A pledge campaign during which students sign contracts saying that they will not use
tobacco products

A

Answer: 2

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9
Q

Which is the priority nursing action when working with a parent who is suspected of Munchausen syndrome by proxy?
1. Try to keep the parent separated from the child as much as possible.
2. Explain to the child that the parent is causing the illness and that the healthcare team
will prevent the child from being harmed.
3. Carefully document parent–child interactions.
4. Confront the parent with concerns of possible abuse.

A

Answer: 3

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10
Q

An infant presents to the emergency department (ED) with physical injuries. The nurse is
taking the child’s history. Which parental statement would cause the nurse to be suspicious of
abuse?
1. “I was walking up the steps and slipped on the ice and fell while carrying my baby.”
2. “The baby’s 18-month-old brother was trying to pull the baby out of the crib and dropped the baby on the floor.”
3. “I placed the baby in the infant swing. His 6-year-old brother was running through the
house and tripped over the swing, causing it to fall.”
4. “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.”

A

Answer: 2

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11
Q

While taking the history of a 10-year-old child, the parents admit to owning firearms. Which should the nurse suggest to enhance the child’s safety based on this information?
1. Keeping all the guns put away and out of the child’s reach
2. Taking the child to a shooting range for lessons on how to use a gun properly
3. Storing the guns and ammunition in the same place
4. Using a gun lock on all firearms in the house

A

Answer: 4

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12
Q

The nurse is providing care to a 3-year-old client whose mother states, “I am not sure that I have enough money to buy both food for the rest of the month and the antibiotic for my
child’s ear infection.” Which nursing intervention would be beneficial for the child and this family?
1. Talking with the mother about keeping the child’s ear clean by using a Q-tip
2. 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
3. Providing the mother with samples of food and food stamps for the child
4. Giving the mother free samples of an antibiotic

A

Answer: 2

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13
Q

The mother of an infant tells the nurse that her maternity leave is almost over and she will be returning to work soon. The mother states that she will need to place her infant in a day
care facility, and she asks the nurse how to know which day care facility is best. Which topics will the nurse include in the response to the mother? Select all that apply.
1. A day care facility that is close to her work in the event of an emergency
2. A day care facility that requires all staff have criminal background checks
3. A day care facility that is attractive in appearance, with bright colors and interesting
visual stimulation
4. A day care facility that provides regular training of the staff and administration
5. A day care facility that has policies regarding child health and emergencies, such as
immunization requirements and emergency medical forms

A

Answer: 2,4,5

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14
Q

The pediatric public health nurse visits a facility for the homeless. Which types of medical issues will the nurse assess these children for based on the current data? Select all that
apply.
1. Dental caries
2. Infections secondary to tattoos
3. Lack of immunizations
4. Nutritional deficits
5. Munchausen syndrome by proxy

A

Answer: 1,3,4

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15
Q

A child is brought to the emergency department in a coma. The mother thinks the child may have ingested a poison. Which will the nurse assess based on this information? Select all that apply.
1. For oral burns
2. The child’s breath
3. The child’s vomitus
4. Hair samples
5. Blood and urine toxicology screens

A

Answer: 1,2,3,5

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16
Q

A child is admitted to the hospital with a diagnosis of lead poisoning. Which should be included in the home assessment to determine the probable source of the lead poisoning?
1. The home’s foundation for a possible radon leak
2. The home’s water pipes
3. The dirt surrounding the house
4. The presence of imported toys or antique baby furniture
5. Gas stored in cans in the garage.

A

Answer: 2,3,4

17
Q

A child is admitted to the hospital unit for physical injuries. The mother’s boyfriend is suspected of child abuse. Which is the primary role of the nurse in addition to reporting the information to the proper authorities?
1. Gathering information about how the injuries occurred.
2. Collecting evidence against the suspected abuser.
3. Encouraging the child to talk about his experience.
4. Protecting the child from further injury.

A

Answer: 4

18
Q

The school nurse recognizes that many adolescents who are currently pregnant are hiding their pregnancies from adults, both at school and at home. Which should the nurse educate
the adolescents about based on the current data?
1. Safe haven laws
2. Birth control available to all teenagers
3. Domestic abuse protection
4. The father’s financial responsibility for the infant

A

Answer: 1

19
Q

A child is admitted to the emergency department (ED) for scald burns to the 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. Which would cause the nurse to suspect abuse?
1. The burns are uneven, with some burns deeper than others.
2. The child’s hands and feet are free of burns.
3. In addition to the main burn site, there are splash burns surrounding the area.
4. The mother was home alone with the child.

A

Answer: 2

20
Q

Which characteristics of abusers should the nurse include in the teaching session for elementary school teachers regarding child abuse? Select all that apply.
1. Physical illness
2. Alcoholism
3. Many friends and families nearby
4. Unrealistic expectations for their child
5. The abuser has no relationship to the child.

A

Answer: 2,4

21
Q

A recently divorced mother who must return to work is concerned about the effects of placing her child in day care full-time. In counseling the mother, the nurse knows that which factor is most influential in determining whether day care has a positive or negative effect on the child?
1. The amount of time that the children spend playing outside
2. The closeness of the parent–child relationship
3. The ratio of day care workers to children
4. The cleanliness of the day care facility

A

Answer: 2

22
Q

Which clinical manifestations should the nurse anticipate when providing care to a pediatric client who huffing glue? Select all that apply.
1. Impaired coordination
2. Elevated liver enzymes
3. Delirium
4. Dementia
5. Giddiness

A

Answer: 1,2,3

23
Q

Which nursing interventions should the nurse implement for a school-age child who is the victim of physical abuse by a parent? Select all that apply.
1. Referring members of the family for appropriate counseling
2. Protecting the child from further injury
3. Allowing the child to wear clothing during the examination process
4. Discouraging parental participation in the plan of care
5. Documenting the child’s response to parental interaction

A

Answer: 1,2,3,5

24
Q

The nurse is providing care to a child who is admitted to the hospital due to environmental exposure to a toxic agent. Which questions should the nurse ask the child and the parent during
the assessment process?
1. “Do you work around harmful substances that could have been brought to the home
environment?”
2. “What year was your home built?”
3. “Does your child have a hobby that includes working with glue?”
4. “Does your home have a smoke detector?”
5. “Does your home have a carbon monoxide detector?”

A

Answer: 1,2,3,5

25
Q

The nurse is providing care to a pediatric client who is homeless. Which nursing actions will decrease the risk for the child developing an infectious disease? Select all that apply.
1. Teaching hygienic methods
2. Arranging for medications, as needed
3. Evaluating the family for food security
4. Performing a nutritional assessment
5. Teaching oral hygiene

A

Answer: 1,2

26
Q

The nurse is assessing a child and suspects the child’s mother is abusing an opiate. Which clinical manifestations exhibited by the child’s mother lead the nurse to this conclusion?
1. Constricted pupils
2. Mood swings
3. Impaired memory
4. Tremors
5. Psychosis

A

Answer: 1,2,3