13.6 Learning Activities
Learning Activities
Well Child Visit Case Study[1]
Please use the following information to answer questions 1-6.
Handoff Report:
1405: This is a 12-year-old female, Mai Nguyen, a new client that is here for a well-child visit. She is experiencing a significant growth spurt and reports no concerns. The client’s family adheres to cultural norms where menstruation and puberty are not openly discussed. She displays limited knowledge about these topics and has a lot of questions about her changing body. Her vaccination records are incomplete, but her mother states she has always received recommended vaccines from her previous healthcare provider. Vitals: T 98.4 F (oral), P 80 bpm, RR 18 breaths/min, BP 110/70 mmHg, weight 48 kg (50th percentile), height 155 cm (60th percentile).
History & Physical:
History
- Reports no significant past medical history.
- Family history is unknown.
- Client reports she has not had her menstrual cycle yet.
Physical Findings
- Appears well-nourished and hydrated.
- No abnormal findings on physical exam.
Progress Notes:
- 13:00: Client arrived for a scheduled well-child visit. Vitals obtained. Client and mother placed in exam room.
- 13:15: Nursing assessment completed. Awaiting provider.
- 13:30: Provider assessment complete. Orders placed for immunizations. Client has questions regarding puberty, client’s mother is visibly uncomfortable.
- 13:45: Client’s mother asked to leave the room. Puberty and menstruation education provided. Client verbalizes understanding.
- 14:00: Client’s mother brought back into the room.
Provider Orders:
| Tdap Vaccine |
| Meningococcal Vaccine |
| HPV Vaccine |
| Influenza Vaccine |
| Provide age-appropriate education about puberty and menstruation |
- Based on Mai Nguyen’s history and physical assessment, what is the priority nursing diagnosis?
a. Knowledge Deficit related to puberty and menstruation
b. Risk for Infection related to incomplete immunization status
c. Impaired Social Interaction related to cultural norms and lack of knowledge about puberty.
d. Anxiety related to upcoming vaccinations
2. When teaching Mai Nguyen about menstruation, which approach is most appropriate for the nurse to use?
a. A detailed anatomical diagram of the female reproductive system.
b. A pamphlet with comprehensive information about puberty and menstruation.
c. A conversation using simple terms and addressing Mai Nguyen’s specific questions and concerns.
d. A video presentation with animations and real-life testimonials about puberty.
3. Mai’s growth spurt places her height at the 60th percentile and weight at the 50th percentile. What does this indicate about her development?
a. She is overweight for her height.
b. She is experiencing normal growth for her age.
c. She has delayed physical development.
d. She requires a specialized diet to increase her weight.
- Mai’s vaccination records are incomplete. What is the most appropriate action for the nurse to take at this time?
a. Administer all vaccines that have been ordered by the provider.
b. Contact Mai’s previous healthcare provider for vaccination records.
c. Defer vaccinations until records are obtained.
d. Administer only the flu vaccine today to avoid overloading her system.
5. Mai Nguyen is starting middle school and mentions an interest in joining the school drama club. However, she also mentions feeling unsure about whether her peers will accept her. Based on Erikson’s theory of psychosocial development, which nursing intervention would best support Mai’s developmental stage?
a. Encourage her to focus on academic achievements rather than extracurricular activities.
b. Validate her feelings and encourage her to explore her interests to help build her identity.
c. Advise her to wait until she feels more confident before joining new activities.
d. Reassure her that she will eventually grow out of these feelings as she matures.
6. Which dietary recommendation is most appropriate for Mai at this time?
a. Increase her protein and calcium intake.
b. Reduce her carbohydrate consumption.
c. Eliminate all sugary snacks and drinks.
d. Encourage fasting once a week.
Stages of Development Question Set[2]
- A nurse is teaching a parent how to properly use a car seat to safeguard their child while in the car. Which of the following statements are accurate about car seat safety?
a. An infant should be facing the rear of the car.
b. A preschooler can stop using a car seat and use a lap belt.
c. Any child can sit in the front if they have a car seat.
d. Infants and toddlers can wear jackets under the shoulder harness of a car seat.
2. Explain why a toddler uses the word “No” often, using Eriksson’s psychosocial stage in your explanation.
- A parent is at the public health department vaccine clinic with their five year old and would like information about the safety of vaccines. The child has not had all immunizations on schedule as recommended by the CDC because the parents have questions about vaccines. Which of the following answers by the nurse can help the parents understand accurate information about the safety of vaccines?
a. We have eradicated some diseases like polio so the vaccine is not necessary.
b. The scheduled vaccines are too much for a small baby, so it’s alright to delay your child’s immunizations.
c. Vaccines cause autism.
d. The risk of injury from the diseases vaccines prevent is higher than the risk of injury from the vaccines.
Test your knowledge on teaching and learning using this NCLEX Next Generation-style case study. You may reset and resubmit your answers to this question an unlimited number of times.[3]
- “Well Child Visit" by Angela Landry for OpenRN is licensed under CC BY-NC 4.0 ↵
- “Stages of Development Question Set" by OpenRN is licensed under CC BY-NC 4.0 ↵
- “HP Chapter 13 Case Study A" by Kellea Ewen for OpenRN is licensed under CC BY-NC 4.0 ↵
