NR602 Pediatric Midterm Study Set.pdf file:///C:/Users/HP/Desktop/eewwww/NR602%20Pediatric%20Mid
NR602 Pediatric Midterm Study Set
1. The parent of a toddler is concerned that the child may have autism. The primary care
pediatric nurse practitioner completes a Modified Checklist for Autism in Toddlers (M-
CHAT) tool, which indicates several areas of concern. What will the nurse practitioner
do?
Administer a Childhood Autism Rating Scale (CARS) in the clinic.
Consult a specialist to determine appropriate early intervention strategies. Refer the child
to a behavioral specialist for further evaluation.
Tell the parent that this result indicates that the child has autism.:
ANS: C The M-CHAT is a screening tool and is useful for detecting behaviors that may indicate
autism. This instrument has been found to have acceptable sensitivity, specificity, and significant
positive predictive value. If these behaviors are detected, the PNP should refer the child to a
specialist for further assessment, using more diagnostic tools. The CARS may be used but
requires specialty training and proper credentials. Until the diagnosis is determined, strategies
for intervention are not discussed. The M-CHAT is a screening tool and is not diagnostic.
2. The mother of a newborn tells the primary care pediatric nurse practitioner that she is
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worried that her child will develop allergies and asthma. Which tool will the nurse
practitioner use to evaluate this risk?
Three-generation pedigree
Review of systems Genogram
Ecomap:
ANS: A
The three-generation pedigree is used to map out risks for genetic diseases in fami- lies, as well as
conditions with modifiable risk factors.The review of systems is used to evaluate the history of the
child's body systems.The genogram is an approach to developing a family database to provide a
graphic representation of family structure, roles, and problems of recurring significance in a
family. The ecomap is used to identify relationships in the family and community that are
supportive or harmful.
3. The primary care pediatric nurse practitioner is performing a well child check-up on a
20-month-old child. The child was 4 weeks premature and, according to a parent-
completed developmental questionnaire, has achieved milestones for a 15-month-old
infant. Which action is correct?
Perform an in-depth developmental assessment screen at this visit to evaluate this child.
Reassure the parent that the child will catch up to normal development by age 2 years.
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Re-evaluate this child's development and milestone achievements at the 2-year visit.
Refer the child to a specialty clinic for evaluation and treatment of develop-
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mental delay.:
ANS: A
This child should be at a 19-month adjusted age for prematurity so, according to the parent
screen, is 4 months behind. The PNP should perform a more in-depth screen to evaluate this
delay.Waiting to see if the child will "catch up" or assuring the parent that this will happen will
cause the delays to become more severe. A referral to a specialty clinic should not be made solely
on the basis of the parent-completed questionnaire but only after further evaluation of possible
delays.
4. When formulating developmental diagnoses for pediatric patients, the pri- mary care
pediatric nurse practitioner may use which resource?
DC: 0-3R
ICD-10-CM
ICSD-3
NANDA International:
ANS: A
The DC: 0-3R refers to the Diagnostic Classification of Mental Health and Devel- opmental
Disorders of Infancy and Early Childhood and is useful for developmen- tal problem diagnosis.
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