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- The parent of a newborn infant asks the primary care pediatric nurse practitioner
when to intervene to help the infant’s future intellectual growth. What will the nurse practitioner tell
- Cognitive learning begins during the toddler years.
- Intellectual growth begin when speech develops.
- Language and literacy skills begin at birth. Correct
- Preschool is an optimal time to begin general learning.
- The primary care pediatric nurse practitioner performs a well baby examination
on a 7dayold infant who is nursing well, according to the mother. The nurse practitioner notes that the infant weighed 3250 grams at birth and 2990 grams when discharged on the second day of life. The infant weighs 3080 grams at this visit. Which action is correct?
- Follow up at the 2month checkup.
- Refer to a lactation consultant.
- Schedule a weight check in 1 week. Correct
- Suggest supplementing with formula.
- During an assessment of a 4weekold infant, the primary care pediatric nurse
practitioner learns that a breastfed infant nurses every 2 hours during the day but is able to sleep for a 4hour period during the night. The infant has gained 20 grams per day in the interval since last seen in the clinic. What will the nurse practitioner recommend?
- Continuing to nurse the infant using the current pattern Correct
- Nursing the infant for longer periods every 4 hours
- Supplementing with formula at the last nighttime feeding
- Waking the infant every 2 hours to nurse during the night
- The primary care pediatric nurse practitioner is performing a well baby
examination on a 2monthold infant who has gained 25 grams per day in the last interval. The mother is nursing and tells the nurse practitioner that her infant seems fussy and wants to nurse more often. What will the nurse practitioner tell her?
- She may not be making as much breastmilk as before.
- She should keep a log of the frequency and duration of each feeding.
- The infant may be going through an expected growth spurt. Correct
- The infant should stay on the previously established nursing schedule.
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- The mother of a 6weekold breastfeeding infant tells the primary care pediatric
nurse practitioner that her baby, who previously had bowel movements with each feeding, now has
a bowel movement once every third day. What will the nurse practitioner tell her?
- Her baby is probably constipated.
- It may be related to her dietary intake.
- She should consume more water.
- This may be normal for breastfed babies. Correct
- The mother of a 3monthold child tells the primary care pediatric nurse
practitioner that it is “so much fun” now that her infant coos and smiles and wants to play. What is
important for the nurse practitioner to teach this mother?
- Appropriate ways to stimulate and entertain the infant
- How to read the infant’s cues for overstimulation
- The importance of scheduling “play dates” with other infants
- To provide musical toys to engage the infant
- The parent of a 5monthold is worried because the infant becomes fussy but
doesn’t always seem interested in nursing. What will the nurse practitioner tell this parent?
- The infant may be expressing a desire to play or to rest. Correct
- The parent should give ibuprofen for teething pain before nursing.
- This is an indication that the infant is ready for solid foods.
- This may indicate gastrointestinal discomfort such as constipation.
- The mother of a 6monthold infant is distressed because the infant can say
“dada” but not “mama” and asks the primary care pediatric nurse practitioner why this is when she is the one who spends more time with the infant. How will the nurse practitioner respond?
- “At this age, your baby does not understand the meaning of sounds.” Correct
- “Babies at this age cannot make the ‘ma’ sound.”
- “Most sounds made by babies at this age are accidental.”
- “This may mean that your baby doesn’t hear well.”
- The primary care pediatric nurse practitioner is performing a well child
examination on a 9monthold infant whose hearing is normal but who responds to verbal cues with only single syllable vocalizations. What will the nurse practitioner recommend to the parents to improve speech and language skills in this infant?
- Provide educational videos that focus on language.
- Read simple board books to the infant at bedtime. Correct
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- Sing to the child and play lullabies in the baby’s room.
- Turn the television to Sesame Streetduring the day.
- The primary care pediatric nurse practitioner is examining a 12monthold infant
who was 6 weeks premature and observes that the infant uses a raking motion to pick up small objects. The PEDS questionnaire completed by the parent did not show significant developmental delays. What will the nurse practitioner do first?
- Perform an indepth developmental assessment. Correct
- Reassure the parent that this is normal for a premature infant.
- Refer the infant to a developmental specialist.
- Suggest activities to improve fine motor skills.
- The primary care pediatric nurse is performing a well child examination on an
adolescent who was adopted as a toddler. The parent reports that the child had been removed from an abusive home at age 3 years. What will the nurse practitioner evaluate in light of possible longterm effects of this early situation?
- Cognitive and psychosocial development
- Mental health and suicide risk
- Moral development and conscience formation
- Spirituality, faith, and religious affiliation
- While the primary care pediatric nurse practitioner is discussing anticipatory
guidance with the mother of a 12 month old, the child repeatedly pulls objects out of the mother’s purse. Each time, the mother slaps the child’s hands as she takes the objects away. What will the nurse practitioner recommend to help the mother manage this child’s misbehavior in a developmentally appropriate manner?
- Keep her purse up high and out of the child’s reach. Correct
- Place acceptable objects in her purse for the child to find.
- Say “No!” instead of slapping the child’s hands.
- Use timeout each time the child gets into the purse.
- The mother of a 15yearold female expresses concerns that her daughter may
be sexually active because she’s had a steady boyfriend for over a year. The primary care pediatric nurse practitioner learns that the family is Catholic and that the mother had an abortion when she was 16 years old. What will the nurse practitioner do initially?
- Explore the mother’s feelings about her own past experience. Correct
- Offer to prescribe contraception to prevent pregnancy.
- Recommend that the mother discuss this with her daughter.
- Suggest that the mother talk to a priest about her daughter.
- During a well child examination of a schoolage child from a family who recently
immigrated from Africa, the primary care pediatric nurse practitioner learns that the child has been involved in many arguments at school. The parents are concerned that their child will never fit in with classmates. How will the nurse practitioner address this situation?
- Assess the conditions in the country of origin prior to immigration. Correct
- Recommend counseling to determine underlying causes of this behavior.
- Stress that this may be a normal response to feeling different at school.
- Suggest that the child may be responding to being bullied by others.
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- The primary care pediatric nurse practitioner sees a 6yearold child after a
hospitalization for injuries sustained in a motor vehicle accident (MVA) in which the child’s grandfather was killed. The parent states that it is difficult to get the child to stop talking about the accident and is worried that the child will have permanent emotional scars. What will the nurse practitioner suggest?
- Assure the child that he is safe and this won’t happen again.
- Encourage the child to express and examine feelings. Correct
- Reassure the child that his grandfather is in heaven.
- Redirect these conversations to happier topics.