Exam 3-5 Flashcards
An adolescent female who is sexually active and who has not had the HPV vaccine asks if she may have it. What will the primary care pediatric nurse practitioner tell her?
Select one:
a. Getting the vaccine now will still protect her from HPV oncogenic types even if already exposed
b. Receiving the HPV vaccine series will replace the need for regular cervical cancer screening
c. She will need to have Papanicolaou and pregnancy screening prior to receiving the vaccine
d. The vaccine will not protect her from any HPV oncogenic types acquired previously
d. The vaccine will not protect her from any HPV oncogenic types acquired previously
The primary care pediatric nurse practitioner is preparing to perform a painful procedure on a 4-month-old infant. Besides providing local anesthesia, what other pain control method provides analgesic effects? Select one: a. Providing toys b. Singing or music c. Sucrose solution d. Swaddling or cuddling
c. Sucrose solution
A child is brought to the clinic with a fever, headache, malaise, and a red, annular macule surrounded by an area of clearing and a larger, erythematous annular ring. The child complains of itching at the site. What will the primary care pediatric nurse practitioner do to determine the diagnosis? Select one: a. Ask about recent tick bites b. Obtain a skin culture c. Order blood cultures d. Perform serologic testing
a. Ask about recent tick bites
The primary care pediatric nurse practitioner uses a shared decision-making (SDM) model when working with families of children with chronic health conditions. When using this model, the nurse practitioner can expect
Select one:
a. considerably more time in each encounter.
b. improved patient health outcomes.
c. less PNP involvement in health care decisions.
d. lower provider and higher patient satisfaction.
b. improved patient health outcomes.
The primary care pediatric nurse practitioner examines a child who has had stiffness and warmth in the right knee and left ankle for 7 or 8 months but no back pain. The nurse practitioner will refer the child to a rheumatology specialist to evaluate for Select one: a. enthesitis-related JIA. b. oligoarticular JIA. c. polyarticular JIA. d. systemic JIA.
b. oligoarticular JIA.
An adolescent has localized bleeding of the gums when brushing the teeth. An exam of the mouth reveals the presence of plaque and calculus on the teeth, which are not loose. What will the primary care pediatric nurse practitioner recommend?
Select one:
a. Consistently brushing and flossing the teeth twice daily
b. Referral to an oral surgeon for treatment
c. Rinsing the mouth daily with chlorhexidine gluconate
d. Using a xylitol-containing gum after meals
a. Consistently brushing and flossing the teeth twice daily
The primary care pediatric nurse practitioner performs a physical examination on a 9-month-old infant with congenital hypothyroidism who takes daily levothyroxine sodium and notes a recent slowing of the infant’s growth rate. What will the nurse practitioner order? Select one: a. Free serum T4 and TSH levels b. Serum levothyroxine level c. Total T4 and free T4 levels d. TSH and total T4 levels
a. Free serum T4 and TSH levels
A child whose parents have refused vaccines has been exposed to chickenpox, and the parents ask whether the child may attend day care. What will the primary care pediatric nurse practitioner tell them?
Select one:
a. The child may attend day care as long as no rash is present even with mild fever or other symptoms.
b. The child should remain home and receive oral acyclovir for 5 days to prevent onset of symptoms.
c. The child should stay home until the 21-day incubation period has passed even if symptom free.
d. The child should stay home if any symptoms occur and may return in 1 week if no rash develops.
d. The child should stay home if any symptoms occur and may return in 1 week if no rash develops.
A child has an area of inflammation on the neck that began after wearing a hand-knot woolen sweater. On examination, the skin appears chafed with mild erythematous patches. The lesions are not pruritic. What is an appropriate initial treatment?
Select one:
a. Application of a lanolin-based emollient
b. Burow solution soaks and cool compresses
c. Oral antihistamines given 4 times daily
d. Topical corticosteroids applied 2 to 3 times daily
d. Topical corticosteroids applied 2 to 3 times daily
The pediatric nurse practitioner provides primary care for a 30-month-old child who has sickle cell anemia who has had one dose of 23-valent pneumococcal vaccine. Which is an appropriate action for health maintenance in this child?
Select one:
a. Administer an initial meningococcal vaccine.
b. Begin folic acid dietary supplementation.
c. Decrease the dose of penicillin V prophylaxis.
d. Give a second dose of 23-valent pneumococcal vaccine.
a. Administer an initial meningococcal vaccine.
The primary care pediatric nurse practitioner performs a well baby assessment of a 5-day-old infant and notes mild conjunctivitis, corneal opacity, and serosanguinous discharge in the right eye. Which course of action is correct?
Select one:
A. Administer intramuscular ceftriaxone 50 mg/kg.
B. Admit the infant to the hospital immediately.
C. Give oral erythromycin 30 to 50 mg/kg/day for 2 weeks.
D. Teach the parent how to perform tear duct massage.
B. Admit the infant to the hospital immediately.
A 12-year-old child has a recent history of increased thirst and frequent urination. The child’s weight has been in the 95th percentile for several years. A dipstick UA is positive for glucose, and random plasma glucose is 350 mg/dL. Which test will the primary care pediatric nurse practitioner order to determine the type of diabetes in this child? Select one: a. Fasting plasma glucose b. Hemoglobin A1C levels c. Pancreatic antibodies d. Thyroid function tests
c. Pancreatic antibodies
A school-age child has a rash without fever or preceding symptoms. Physical examination reveals a 3-cm ovoid, erythematous lesion on the trunk with a finely scaled elevated border, along with generalized macular, ovoid lesions appearing in a “Christmas tree” pattern on the child’s back. What is the initial action?
Select one:
a. Obtain a KOH preparation of a skin scraping to verify the diagnosis.
b. Prescribe topical steroid creams to shorten the course of the disease.
c. Reassure the child’s parents that the rash is benign and self-limited.
d. Recommend topical antihistamines and emollients to control the spread.
c. Reassure the child’s parents that the rash is benign and self-limited.
The primary care pediatric nurse practitioner is counseling an adolescent who was recently hospitalized for an asthma exacerbation and learns that the child usually forgets to use twice- daily inhaled corticosteroid medications that are supposed to be given at 0800 and 2000 each day. Which strategy may be useful in this case to improve adherence?
Select one:
a. Ask the adolescent to identify two times each day that may work better.
b. Consider having the school nurse supervise medication administration.
c. Prescribing a daily oral corticosteroid medication instead.
d. Suggest that the parent enforce the medication regimen each day.
a. Ask the adolescent to identify two times each day that may work better.
A parent brings a 4-month-old infant to the clinic who has had a low-grade fever for 24 hours. The primary care nurse practitioner notes that the infant has a weak cry, slightly dry oral mucosa, mottled skin, and a respiratory rate of 65 breaths per minute and sleeps unless stimulated by the examiner,. What will the nurse practitioner do?
Select one:
a. Administer oral fluids in the clinic.
b. Admit the infant to the hospital.
c. Order outpatient laboratory tests.
d. Send the infant home with close follow-up.
b. Admit the infant to the hospital.
