A nurse observes the parent/child interaction during the ...

[Beheh]

A nurse observes the parent/child interaction during the 4-year-old well-child checkup and notes that the parent speaks harshly to the child and uses negative remarks when speaking with the nurse.
 
  Which statement by the nurse would be most beneficial?
  1. Perhaps you should leave the room so that I can speak with your child privately.
  2. I am going to refer you for counseling since your interactions with your child seem so negative.
  3. Let's talk privately. Let's discuss the way you speak with your child and possible ways to be more positive.
  4. Addressing the child, the nurse says, Are you unhappy when Mommy talks to you like this?

Question 2

At a routine healthcare visit, a nurse measures a toddler and plots the height and weight on the growth charts. The nurse documents that the toddler is above the 95th percentile for weight and is at the 5th percentile for height.
 
  How should the nurse interpret these data?
  1. The toddler is proportionate for the age.
  2. The toddler needs to eat more at each feeding.
  3. The height and weight are disproportionate, and the toddler needs further evaluation.
  4. The family is most likely short.

[coreycathey]

Answer to Question 1

Correct Answer: 3
Rationale: The best approach to this encounter would be for the nurse to discuss concerns with the parent privately, since the nurse wants to help the parent develop a good relationship with the child. The child should not be a part of this conversation. Since the child is only 6 years old, it would be difficult to ask the parent to leave the room. If the nurse also wants to speak alone with the child, the nurse perhaps would escort the child to another area and speak briefly with the child. Referring to counseling without a discussion with the parent is not appropriate. The nurse should not ask the child if she is unhappy with the parent.

Answer to Question 2

Correct Answer: 3
Rationale: Usually height and weight are at approximately the same percentile. When the weight of a child is found to be at the 95th percentile, the child's height is also greater than the 50th percentile. The height and weight for the child described in this question are a concern, and the child may need further endocrine testing.

[Beheh]

Excellent

[scottmt]

TYSM