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A series of questions and answers with rationales related to advanced nursing practice in pediatric primary care. It covers topics such as the role of advanced practice nurses, health promotion and disease prevention, management of pediatric patients with developmental delays, and the scope of practice for advanced practice nurses. Additionally, it includes case studies related to acute otitis media, vaccinations, asthma, ADHD, reproductive health services, pain management, tonsillectomy, diabetes, body image, and enuresis. useful for nursing students and healthcare professionals interested in pediatric primary care.
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Answer: a) Prescribing medication and providing treatment Rationale: Advanced practice nurses in pediatric primary care have the authority to prescribe medication and provide necessary treatment for children with chronic conditions, in collaboration with physicians.
skills Rationale: The primary objective of a pediatric primary care practicum is to enable nursing students to develop advanced clinical skills required to provide comprehensive care to children in a primary care setting.
A. MMR and varicella B. Hepatitis B and rotavirus C. Influenza and pneumococcal D. Meningococcal and diphtheria-tetanus-pertussis Answer: B. Hepatitis B and rotavirus Rationale: The CDC recommends initiating the hepatitis B and rotavirus vaccinations at the 2-month well-child visit to provide early protection against these diseases. Case Study Question 3: A 10-year-old child with asthma requires a long-term control medication. Which medication is considered a preferred option for this age group? A. Montelukast B. Fluticasone C. Albuterol D. Ipratropium Answer: B. Fluticasone Rationale: Fluticasone is a preferred long-term control medication for asthma in children due to its efficacy in reducing airway inflammation and its favorable safety profile. Case Study Question 4: A 6-year-old child presents with symptoms suggestive of attention-deficit/hyperactivity disorder (ADHD). What is the initial step in the assessment and management of ADHD in primary care?
A. Initiate stimulant medication B. Conduct a thorough physical examination C. Refer the child to a child psychologist D. Obtain a detailed developmental history Answer: D. Obtain a detailed developmental history Rationale: Obtaining a detailed developmental history is the initial step in the assessment and management of ADHD in primary care, as it helps in understanding the child's behavior across different settings and developmental stages. Case Study Question 5: A 14-year-old adolescent presents with symptoms of depression. What evidence-based screening tool should be used to assess the severity of the adolescent's depressive symptoms? A. Pediatric Symptom Checklist B. Patient Health Questionnaire-9 (PHQ-9) C. Vanderbilt Assessment Scale D. Revised Children's Manifest Anxiety Scale Answer: B. Patient Health Questionnaire-9 (PHQ-9) Rationale: The PHQ-9 is an evidence-based screening tool commonly used to assess the severity of depressive symptoms in adolescents, making it suitable for this scenario. Case Study Question 6: A 3-year-old child presents with a rash and fever. The
Case Study Question 8: A 16-year-old adolescent requests confidential care for contraception. What is the legal basis for providing confidential care to minors seeking reproductive health services? A. HIPAA regulations B. Title X funding C. Emancipation laws D. Mature minor doctrine Answer: D. Mature minor doctrine Rationale: The mature minor doctrine allows healthcare providers to provide confidential care to minors who demonstrate the maturity and understanding to make informed decisions about their reproductive health without parental consent. Case Study Question 9: A 7-year-old child presents with a laceration on the forearm that requires suturing. What is the most appropriate method for managing pain during the suturing procedure? A. Topical lidocaine cream B. Intranasal fentanyl spray C. Oral acetaminophen D. Subcutaneous injection of lidocaine Answer: A. Topical lidocaine cream Rationale: Topical lidocaine cream is a suitable method
for managing pain during suturing in children, as it provides local anesthesia without the need for injections. Case Study Question 10: A 5-year-old child is scheduled for a tonsillectomy due to recurrent tonsillitis. What postoperative complication should the nurse practitioner monitor for in the immediate postoperative period? A. Otitis media B. Hemorrhage C. Pneumonia D. Vocal cord paralysis Answer: B. Hemorrhage Rationale: Hemorrhage is a potential postoperative complication of tonsillectomy, and the nurse practitioner should closely monitor the child for signs of bleeding in the immediate postoperative period. Case Study Question 11: A 9-year-old child with type 1 diabetes presents for a follow-up visit. The nurse practitioner reviews the child's self-monitoring blood glucose records and notes frequent hypoglycemic episodes. What initial intervention should be implemented to address the hypoglycemia? A. Adjust insulin dosages B. Increase carbohydrate intake C. Initiate continuous glucose monitoring D. Educate the child on recognizing hypoglycemic symptoms
C. Fluid restriction in the evening D. Behavioral modification techniques Answer: D. Behavioral modification techniques Rationale: Behavioral modification techniques, such as bladder training and positive reinforcement, are recommended as the initial management approach for persistent nocturnal enuresis in young children. Case Study Question 14: A 8-year-old child with a history of frequent urinary tract infections (UTIs) presents for a follow-up visit. What preventive measure should the nurse practitioner recommend to reduce the risk of recurrent UTIs? A. Prophylactic antibiotic therapy B. Increased fluid intake C. Voiding after intercourse D. Cranberry juice supplementation Answer: B. Increased fluid intake Rationale: Increased fluid intake is a preventive measure that can help reduce the risk of recurrent UTIs in children by promoting frequent urination and flushing bacteria from the urinary tract. Case Study Question 15: A 11-year-old child is prescribed methylphenidate for attention-deficit/hyperactivity disorder (ADHD). What information should the nurse practitioner provide to the child and parents regarding medication administration?
A. Administer with food to enhance absorption B. Monitor for signs of tics and dyskinesias C. Discontinue medication during school holidays D. Avoid co-administration with vitamin C supplements Answer: B. Monitor for signs of tics and dyskinesias Rationale: Monitoring for signs of tics and dyskinesias is important when administering methylphenidate to children with ADHD, as these medication-related adverse effects should be promptly identified and managed. C:
therapy? a) Continue the same regimen b) Increase the dose of the inhaled corticosteroid c) Add a long-acting beta-agonist d) Step down the inhaled corticosteroid* Rationale: The goal of asthma therapy is to achieve and maintain good control of symptoms and lung function with the lowest possible dose of medication. According to the National Asthma Education and Prevention Program guidelines, if a patient has well-controlled asthma for at least three months, the therapy can be stepped down by reducing the dose of the inhaled corticosteroid by 25% to 50%. Increasing the dose of the inhaled corticosteroid or adding a long-acting beta-agonist are options for patients who have poorly controlled asthma.
of the mucosa that covers the anterior part of the nasal septum, which contains many fragile blood vessels. Foreign body, nasal polyps, and coagulopathy are less common causes of nosebleeds in children and would have other associated findings or symptoms.