Chapter 13

Well Child Visit Case Study

Answers

1. Correct Answer: A) Knowledge Deficit related to puberty and menstruation. This should be addressed as the priority nursing diagnosis because it directly impacts the client’s current understanding of her rapid growth and development.  While B is a potential nursing diagnosis based on the incomplete vaccination record, more investigation would have to be done before this nursing diagnosis could be supported.  Options C and D are not supported by the information provided in the case study.
2. Correct Answer: C) A conversation using simple terms and addressing Mai Nguyen’s specific questions and concerns. This approach allows for individualized education, ensures clarity and understanding, and creates a safe space for Mai Nguyen to ask questions. While options A, B, and D can be helpful supplemental materials, they lack the personalized touch necessary for addressing cultural sensitivities and individual needs.
3. Correct Answer: B. She is experiencing normal growth for her age. Percentiles within 5–85% are typically considered normal. Her height and weight percentiles are well-proportioned, and she is not overweight for her height. Delayed development would involve percentiles significantly below average or lack of expected milestones. Her weight does not indicate the need for dietary adjustments.
4. Correct Answer: B. Contact Mai’s previous healthcare provider for vaccination records. This ensures accurate records and avoids duplicate immunizations. Without confirming prior vaccinations, unnecessary duplication could occur. Deferring vaccinations delays necessary protection. Only administering the flu vaccine is insufficient if other vaccinations are due.
5. Correct Answer: B. Validate her feelings and encourage her to explore her interests to help build her identity. Adolescents in the “Identity vs. Role Confusion” stage benefit from support in exploring interests to develop a sense of self.  While academics are important, a focus on only academics dismisses the role of extracurricular activities in identity formation. Answer choice “C” delays opportunities for personal growth and may reinforce uncertainty. Option choice “D”, while true to an extent, overlooks the need for active support during this critical developmental period.

6. Correct Answer: A. Increase her protein and calcium intake. Protein and calcium are essential for muscle and bone development during growth spurts. Carbohydrates should not be reduced as they are needed for energy. With sugary snacks and drinks, the focus should be on moderation, not elimination. Fasting is not recommended for adolescents without medical need.

Stages of Development Question Set

1. Correct answer: A An infant should face the rear of the car to prevent neck injury in a crash. A child should use either a car seat or booster seat until they are too large for a booster seat. Children are safest in the center back seat until age 13. Infants and toddlers should not have anything between their body and the shoulder harness to assure a snug fit of the shoulder harness.
2. A toddler is in the psychosocial stage of Autonomy vs. Shame and Doubt, according to Erik Erikson. In this stage, they start to develop their sense of a person independent from their main caregiver. If parents allow them to make their own decisions, they will develop a sense of autonomy and independence. If parents do not allow this or criticize their decisions, they will develop shame and doubt. Therefore, saying “no” is a wat for a toddler to exert their independence.
3. Correct:  D. Vaccines are very safe, the safest in US history. Millions of children receive vaccines yearly.
   The risks of the diseases (severe pain, disability, and death) are greater than the risks of vaccines for almost all children. The main risks are mild reactions of mild pain and redness at the site, which go away after a few days. Serious side effects of vaccines are rare, and staff are trained to deal with them.

Please find answers to the Learning Activity interactive elements within the element.