CPN Assessment Flashcards: 180 Practice Questions & Answers

For a preschooler, the nurse should use age-appropriate language and involve the child by asking simple questions about their body (e.g., Where is your boo-boo?). However, the bulk of the clinical history (HPI) should be obtained from the parent. Observe the child's play and interaction with the parent to assess developmental milestones and parent-child bonding. **Exam Strategy:** PNCB emphasizes developmental staging. For toddlers/preschoolers, the parent is the primary historian, but the child should not be ignored. Avoid medicalese and use play-based assessment techniques.

The nurse must establish conditional confidentiality before the interview begins. Inform the adolescent that information is private UNLESS there is a risk of harm to self (suicide), harm to others (homicide), or suspected physical/sexual abuse. **Clinical Pearl:** In most states, minors can consent to STI testing and contraception without parental notification. However, mandatory reporting laws for abuse supersede confidentiality. **PNCB Focus:** Knowing the specific triggers that require breaking confidentiality (safety/abuse).

Tell me more about the fever from when you first noticed it. This allows the parent to provide a chronological narrative without being biased by leading questions. Follow up with the OLD CARTS mnemonic (Onset, Location, Duration, Characteristics, Aggravating/Alleviating, Radiation, Timing, Severity). **Common Distractor:** Avoid Is the fever worse at night? or Did you give Tylenol? as initial questions, as these are closed-ended and focus only on specific details rather than the whole picture.

The S categories: Suicide/Depression and Safety (violence/injury). The HEEADSSS acronym (Home, Education/Employment, Eating, Activities, Drugs, Sexuality, Suicide/Depression, Safety) is structured to move from least sensitive to most sensitive topics. **Rationale:** Building rapport through less threatening topics (Home/School) increases the likelihood of honest disclosure regarding high-risk behaviors and mental health. **Exam Tip:** Always screen for safety/suicide if any red flags appear in the earlier sections of the interview.

Consumption of more than 24 ounces of cow's milk per day. **Rationale:** Excessive milk intake is the leading risk factor for Iron Deficiency Anemia (IDA) in toddlers. Milk is poor in iron and its high volume often displaces iron-rich solid foods. It can also cause microscopic intestinal bleeding due to protein sensitivity. **PNCB Focus:** Linking historical data (diet) to common pediatric pathologies (Anemia). Ensure the history includes specific volumes of milk and juice.