Exam 3-9 Flashcards
he primary care pediatric nurse practitioner is performing a well child examination on a 12-year-old child who was diagnosed with type 1 diabetes at age 9. The child had a lipid screen at age 10 with an LDL cholesterol <100 mg/dL. What will the nurse practitioner recommend as part of ongoing management for this child?
Select one:
a. Annual lipid profile evaluation
b. Annual screening for microalbuminuria
c. Comprehensive ophthalmologic exam
d. Hypothyroidism screening every 5 years
c. Comprehensive ophthalmologic exam
An 18-month-old child with no previous history of otitis media awoke during the night with right ear pain. The primary care pediatric nurse practitioner notes an axillary temperature of 100.5°F and an erythematous, bulging tympanic membrane. A tympanogram reveals of peak of +150 mm H2O. What is the recommended treatment for this child?
Select one:
a. Amoxicillin 80 to 90 mg/kg/day in two divided doses
b. An analgesic medication and watchful waiting
c. Ceftriaxone 50 to 75 mg/kg/dose IM given once
d. Ototopical antibiotic drops twice daily for 5 days
b. An analgesic medication and watchful waiting
A child has several circular, scaly lesions on the arms and abdomen, some of which have central clearing. The primary care pediatric nurse practitioner notes a smaller, scaly lesion on the child’s scalp. How will the nurse practitioner treat this child?
Select one:
a. Obtain scrapings of the lesions for fungal cultures.
b. Order prescription-strength antifungal creams.
c. Prescribe oral griseofulvin for 2 to 4 weeks.
d. Recommend OTC antifungal creams and shampoos.
c. Prescribe oral griseofulvin for 2 to 4 weeks.
The primary care pediatric nurse practitioner performs a well child examination on a 9-month-old infant who has a history of prematurity at 28 weeks’ gestation. The infant was treated for retinopathy of prematurity (ROP) and all symptoms have resolved. When will the infant need an ophthalmologic exam? Select one: A. At 12 months of age B. At 24 months of age C. At 48 months of age D. At 60 months of age
A. At 12 months of age
A 3-year-old child is recovering from injuries sustained in a motor vehicle accident. How will the primary care pediatric nurse practitioner evaluate this child’s pain?
Select one:
a. Ask the child to rate pain intensity on a 4- to 5-item pain discrimination scale.
b. Have the child describe any pain as “no pain, a little pain, or a lot of pain.”
c. Question the child about the intensity and specific location of any pain.
d. Rely on nonverbal responses such as facial expressions and limb movements.
a. Ask the child to rate pain intensity on a 4- to 5-item pain discrimination scale.
b. Have the child describe any pain as “no pain, a little pain, or a lot of pain.”
The primary care pediatric nurse practitioner is evaluating a child who has short stature. Although bone age studies reveal a delay in bone age, the child’s growth is consistent with bone age. Which diagnosis is most likely? Select one: a. Constitutional growth delay b. Growth hormone deficiency c. Idiopathic short stature d. Klinefelter syndrome
a. Constitutional growth delay
An adolescent female reports poor sleep, fatigue, muscle and joint paint, and anxiety lasting for several months. The primary care pediatric nurse practitioner notes point tenderness at several sites. What will the nurse practitioner do next?
Select one:
a. Evaluate the adolescent’s pain using a numeric pain scale.
b. Obtain ANA, CBC, liver function, and muscle enzymes tests.
c. Reassure the adolescent that this condition is not life-threatening.
d. Refer the adolescent to a rheumatologist for further evaluation.
d. Refer the adolescent to a rheumatologist for further evaluation.
The primary care pediatric nurse practitioner sees a 12-month-old infant who is being fed goat’s milk and a vegetarian diet. The child is pale and has a beefy-red, sore tongue and oral mucous membranes. Which tests will the nurse practitioner order to evaluate this child’s condition? Select one: a. Hemoglobin electrophoresis b. RBC folate, iron, and B12 levels c. Reticulocyte levels d. Serum lead levels
b. RBC folate, iron, and B12 levels
An 8-year-old child is diagnosed with systemic lupus erythematosus (SLE), and the child’s parent asks if there is a cure. What will the primary care pediatric nurse practitioner tell the parent?
Select one:
a. Complete remission occurs in some children at the age of puberty.
b. Periods of remission may occur but there is no permanent cure.
c. SLE can be cured with effective medication and treatment.
d. The disease is always progressive with no cure and no remissions.
b. Periods of remission may occur but there is no permanent cure.
An adolescent has a TB skin test prior to working as a volunteer in a hospital. The adolescent is healthy and has not travelled to or from a TB-endemic area or had close contact with anyone who has TB. The Mantoux skin test shows 10 mm of induration after 48 hours. What will the primary care pediatric nurse practitioner do?
Select one:
a. Ask the adolescent about exposure to homeless persons.
b. Order a chest radiograph to rule out active TB.
c. Reassure the adolescent that this is a negative screen.
d. Refer the adolescent to an infectious disease specialist.
c. Reassure the adolescent that this is a negative screen.
A toddler is receiving long-term antibiotics to treat osteomyelitis. Which laboratory test will the primary care pediatric nurse practitioner order to monitor response to therapy in this child? Select one: a. Blood cultures b. Erythrocyte sedimentation rate (ESR) c. Serum procalcitonin (Pro-CT) d. White blood count (WBC)
b. Erythrocyte sedimentation rate (ESR)
A 5-year-old child who has a history of pertussis infection as an infant is in the clinic for immunizations prior to kindergarten. Which vaccine will be given? Select one: a. DTaP b. DTP c. Td d. Tdap
a. DTaP
The primary care pediatric nurse practitioner notes velvety, brown thickening of skin in the axillae, groin, and neck folds of an adolescent Hispanic female who is overweight. What is the initial step in managing this condition?
Select one:
a. Consultation with a pediatric dermatologist
b. Performing metabolic laboratory tests
c. Prescribing topical retinoic acid cream
d. Referral to a pediatric endocrinologist
b. Performing metabolic laboratory tests
A school-age child is seen in the clinic after a fragment from a glass bottle flew into the eye. What will the primary care pediatric nurse practitioner do?
Select one:
a. Refer immediately to an ophthalmologist.
b. Attempt to visualize the glass fragment.
c. Irrigate the eye with sterile saline.
d. Instill a topical anesthetic.
a. Refer immediately to an ophthalmologist.
An adolescent has acne with lesions on the cheeks and under the chin. Which distribution is this? Select one: a. Athletic b. Frictional c. Hormonal d. Pomadal
c. Hormonal
