Exam 3-8 Flashcards
During a well child exam, the primary care pediatric nurse practitioner notes yellowish-white serpentine-bordered lesions on the anterior portion of a child’s tongue. What will the nurse practitioner do?
Select one:
a. Order chlorhexidine gluconate rinses to treat the lesions.
b. Prescribe oral acyclovir to shorten the course of the disease.
c. Reassure the parent that these are benign lesions.
d. Refer the child to a pediatric dentist for evaluation.
c. Reassure the parent that these are benign lesions.
The parent of a school-age child with a chronic pain condition tells the primary care pediatric nurse practitioner that the child has requested to stay home from school more often in the past few months. The child’s exam does not reveal any significant change in pathology, and a review of the child’s medications indicates appropriate dosing of analgesic medications. What will the nurse practitioner recommend?
Select one:
a. Assessing the child’s pain every day to determine changes
b. Ensuring the child stays quiet in bed with videos when having pain
c. Having the child do homework when staying home from school
d. Requiring the child to go to school even during pain episodes
c. Having the child do homework when staying home from school
An adolescent female has grouped vesicles on her oral mucosa. To determine whether these are caused by HSV-1 or HSV-2, the primary care pediatric nurse practitioner will order which test? Select one: a. Direct fluorescent antibody test b. Enzyme-linked immunosorbent assay c. Tzanck smear d. Viral culture
d. Viral culture
According to recent research, which populations may have higher rates of under-immunization than others?
Select one:
a. Those with higher rates of Asians
b. Those with higher rates of graduate degrees
c. Those with lower rates of poverty
d. Those with lower rates of primary providers
b. Those with higher rates of graduate degrees
The parent of a school-age child who has asthma tells the primary care pediatric nurse practitioner that the child often comes home from school with severe wheezing after gym class and needs to use his metered-dose inhaler right away. What will the nurse practitioner do?
Select one:
a. Recommend that the child go to the school nurse when symptoms start.
b. Review the child’s asthma action plan and possibly increase his steroid dose.
c. Suggest asking the school to excuse the child from gym class.
d. Write the prescription for two metered-dose inhalers with spacers.
d. Write the prescription for two metered-dose inhalers with spacers.
The parent of a child with complex health care needs tells the primary care pediatric nurse practitioner that the child has had difficulty breathing the past two nights but can’t articulate specific symptoms. The child has normal oxygen saturations and a normal respiratory rate with clear breath sounds. What will the nurse practitioner do?
Select one:
a. Admit the child to the hospital for close observation and monitoring of respiratory status.
b. Encourage the parent to call when concerned and schedule a follow-up appointment the next day.
c. Perform a complete blood count, blood cultures, and a chest radiograph to evaluate symptoms.
d. Reassure the parent that the child has a normal exam and is most likely not ill.
b. Encourage the parent to call when concerned and schedule a follow-up appointment the next day.
The parent of a child with complex health care needs tells the primary care pediatric nurse practitioner that the child has had difficulty breathing the past two nights but can’t articulate specific symptoms. The child has normal oxygen saturations and a normal respiratory rate with clear breath sounds. What will the nurse practitioner do?
Select one:
a. Admit the child to the hospital for close observation and monitoring of respiratory status.
b. Encourage the parent to call when concerned and schedule a follow-up appointment the next day.
c. Perform a complete blood count, blood cultures, and a chest radiograph to evaluate symptoms.
d. Reassure the parent that the child has a normal exam and is most likely not ill.
b. Encourage the parent to call when concerned and schedule a follow-up appointment the next day.
During a well child examination of an infant, the primary care pediatric nurse practitioner notes 10 café au lait spots on the infant’s trunk. What is the potential concern associated with this finding? Select one: a. Endocrine disorders b. Malignancy c. Neurofibromatosis d. Sturge-Weber syndrome
c. Neurofibromatosis
The parent of a school-age child who is diagnosed with oligoarticular JIA asks the primary care pediatric nurse practitioner what exercises the child may do to help reduce symptoms. What will the nurse practitioner recommend? Select one: a. Running b. Swimming c. Weights d. Yoga
b. Swimming
A child who has been diagnosed with asthma for several years has been using a short-acting B2-agonist (SABA) to control symptoms. The primary care pediatric nurse practitioner learns that the child has recently begun using the SABA two or three times each week to treat wheezing and shortness of breath. The child currently has clear breath sounds and an FEV1 of 75% of personal best. What will the nurse practitioner do next? Select one: a. Add a daily inhaled corticosteroid. b. Administer 3 SABA treatments. c. Continue the current treatment. d. Order an oral corticosteroid.
a. Add a daily inhaled corticosteroid.
A child with a history of otitis externa asks about ways to prevent this condition. What will the primary care pediatric nurse practitioner recommend?
Select one:
a. Cleaning ear canals well after swimming
b. Drying the ear canal with a hair dryer
c. Swimming only in chlorinated pools
d. Using cerumenolytic agents daily
b. Drying the ear canal with a hair dryer
What is the most important role of the primary care pediatric nurse practitioner who provides care for a child with special health care needs who sees several specialists and receives community and school-based services?
Select one:
a. Assessing the parent’s ability to perform home care tasks
b. Coordinating services to ensure continuity of care
c. Monitoring the family’s adherence to the health care plan
d. Ordering medications and other prescribed treatments
b. Coordinating services to ensure continuity of care
A preschool-age child who attends day care has a 2-day history of matted eyelids in the morning and burning and itching of the eyes. The primary care pediatric nurse practitioner notes yellow-green purulent discharge from both eyes, conjunctival erythema, and mild URI symptoms. Which action is correct? Select one: A. Culture the conjunctival discharge. B. Observe the child for several days. C. Order an oral antibiotic medication. D. Prescribe topical antibiotic drops.
D. Prescribe topical antibiotic drops.
An infant has congenital adrenal hyperplasia. At a routine well baby checkup, the primary care pediatric nurse practitioner notes vomiting, poor feeding, lethargy, and mild dehydration. Which action is correct?
Select one:
a. Administer an intramuscular stress dose of hydrocortisone succinate.
b. Administer intravenous fluids in the clinic and reassess hydration status.
c. Prescribe an oral hydrocortisone in a replacement dose of 8 to 10 mg/M2.
d. Refer the infant to the emergency department for fluids, dextrose, and steroids.
d. Refer the infant to the emergency department for fluids, dextrose, and steroids.
The primary care pediatric nurse practitioner reviews a child’s complete blood count with differential white blood cell values and recognizes a “left shift” because of Select one: a. a decreased eosinophil count. b. a decreased lymphocyte count. c. an elevated monocyte count. d. an elevated neutrophil count.
d. an elevated neutrophil count.
