exam 3-6 Flashcards
An 8-year-old boy has a recent history of an upper respiratory infection and comes to the clinic with a maculopapular rash on his lower extremities and swelling and tenderness in both ankles. The pediatric nurse practitioner performs a UA, which shows proteinuria and hematuria and diagnoses HSP. What ongoing evaluation will the nurse practitioner perform during the course of this disease? Select one: a. ANA titers b. Blood pressure measurement c. Chest radiographs d. Liver function studies
b. Blood pressure measurement
An 18-month-old child has horizontal, bright white lines along the upper gum line of the teeth. What is the most important question the primary care pediatric nurse practitioner will ask the child’s parents?
Select one:
a. If the child is still drinking milk from a bottle
b. If the child or the parents are brushing the teeth
c. If they are brushing the child’s teeth twice daily
d. If they have taken the child to a dentist
a. If the child is still drinking milk from a bottle
The primary care pediatric nurse practitioner notes a musty odor when examining a newborn at a 2-week checkup. What will the nurse practitioner suspect? Select one: a. Galactosemia b. Glucose-6-phosphatase deficiency c. Phenylketonuria d. Urea cycle disorder
c. Phenylketonuria
The primary care pediatric nurse practitioner observes a tender, swollen red furuncle on the upper lid margin of a child’s eye. What treatment will the nurse practitioner recommend?
Select one:
a. Culture of the lesion to determine causative organism
b. Referral to ophthalmology for incision and drainage
c. Topical steroid medication
d. Warm, moist compresses 3 to 4 times daily
d. Warm, moist compresses 3 to 4 times daily
A 3-year-old child with pressure-equalizing tubes (PET) in both ears has otalgia in one ear. The primary care pediatric nurse practitioner is able to visualize the tube and does not see exudate in the ear canal and obtains a type A tympanogram. What will the nurse practitioner do?
Select one:
a. Order ototopical antibiotic/corticosteroid drops.
b. Prescribe a prophylactic antibiotic medication.
c. Reassure the parent that this is a normal exam.
d. Refer the child to an otolaryngologist for follow-up
a. Order ototopical antibiotic/corticosteroid drops.
The parents of a formula-fed newborn report that they get their drinking water from a well. What will the primary care pediatric nurse practitioner recommend to provide adequate fluoride for this infant?
Select one:
a. Giving the infant a fluoride supplement
b. Testing the fluoride level of their water source
c. Using bottled water to prepare the infant’s formula
d. Using powdered formula with added fluoride
b. Testing the fluoride level of their water source
The primary care pediatric nurse practitioner is treating a toddler who has a lower respiratory tract illness with a low-grade fever. The child is eating and taking fluids well and has normal oxygen saturations in the clinic. The nurse practitioner suspects that the child has a viral pneumonia and will
Select one:
a. order an anti-viral medication and schedule a follow-up appointment.
b. prescribe a broad-spectrum antibiotic until the lab results are received.
c. teach the parents symptomatic care and order labs to help with the diagnosis.
d. write a prescription for an antibiotic to be given if the child’s condition worsens.
c. teach the parents symptomatic care and order labs to help with the diagnosis.
A 10-month-old infant has an erythematous, fluctuant, non-draining abscess on the right buttock after 10 days of treatment with amoxicillin for impetigo. What is the next step in managing this infant’s care?
Select one:
a. Consultation with a pediatric infectious disease specialist
b. Culture of any superficial open surface wounds
c. Empiric treatment with clindamycin
d. Incision and drainage of the abscess with culture
d. Incision and drainage of the abscess with culture
During a well child exam on a 4-year-old child, the primary care pediatric nurse practitioner notes that the clinic nurse recorded “20/50” for the child’s vision and noted that the child had difficulty cooperating with the exam. What will the nurse practitioner recommend?
Select one:
A. Follow up with a visual acuity screen in 6 months.
B. Refer to a pediatric ophthalmologist.
C. Re-test the child in 1 year.
D. Test the child’s vision in 1 month.
D. Test the child’s vision in 1 month.
A child who has psoriasis, who has been using a moderate-potency topical steroid on thick plaques on the extremities and a high-potency topical steroid on more severe plaques on the elbows and knees, continues to have worsening of plaques. In consultation with a dermatologist, which treatment will be added?
Select one:
a. Anthralin ointment in high strength applied for 10 to 30 minutes daily
b. Calcipotriol cream applied liberally each day to the entire body
c. Oral steroids and methotrexate therapy until plaques resolve
d. Wideband ultraviolet therapy for 15 minutes twice daily
a. Anthralin ointment in high strength applied for 10 to 30 minutes daily
The primary care pediatric nurse practitioner reviews hematology reports on a child with beta-thalassemia minor and notes an Hgb level of 8 g/dL. What will the nurse practitioner do? Select one: a. Evaluate serum ferritin. b. Order Hgb electrophoresis. c. Prescribe supplemental iron. d. Refer for RBC transfusions.
a. Evaluate serum ferritin.
Which characteristic is the key criterion that identifies a child has having special needs? Select one: a. Cognitive function b. Emotional health c. Health service requirements d. Medical diagnosis
c. Health service requirements
The mother of a female infant is concerned that her daughter is developing breasts. The primary care pediatric nurse practitioner notes mild breast development but no pubic or axillary hair. What is the likely diagnosis?
Select one:
a. Congenital adrenal hyperplasia causing breast development
b. Precocious puberty needing endocrinology management
c. Premature adrenarche which will lead to pubic hair onset
d. Premature thelarche which will resolve over time
d. Premature thelarche which will resolve over time
The primary care pediatric nurse practitioner is performing an initial well child exam on a 3-year-old child recently adopted from Africa. The adoptive parent has a record of immunizations indicating that the child is fully vaccinated. What will the nurse practitioner do?
Select one:
a. Administer a booster dose of each vaccine to ensure immunity.
b. Find out whether the vaccines were provided by reliable suppliers.
c. Perform antibody titers and reimmunize the child.
d. Record the vaccines in the child’s electronic medical record.
c. Perform antibody titers and reimmunize the child
The parent of a toddler who has special health care needs is resistant to a suggestion that her child needs a gastrostomy tube for nutrition. The toddler has fallen from the 10th percentile to the 5th percentile in the past few months and resists taking in appropriate amounts of food by mouth even with assistance from occupational therapy. What will the primary care pediatric nurse practitioner do?
Select one:
a. Inform the mother that, since other options have failed, the gastrostomy tube is the only option.
b. Refer the child to a dietician to teach the mother the importance of adequate nutrition.
c. Set weight gain and food intake goals with the mother and schedule regular visits to monitor weight.
d. Suggest that the gastrostomy tube may be tried temporarily and removed once the child gains weight.
c. Set weight gain and food intake goals with the mother and schedule regular visits to monitor weight
