Final Exam: Quizzes/Test Banks Flashcards
Which of the following statements is TRUE?
1. Women who are depressed during pregnancy are more likely to have OB complications
2. Paroxetine (Category D) should always be stopped in first trimester
2. The combination of antidepressant medication and CBT has not been shown beneficial
4. Venlafaxine crosses the…
Women who are depressed during pregnancy are more likely to have OB complications
Postpartum depression affects _______ women
1 in 8
Lisa is a 32 y/o white woman who visits the NP at her OB/GYNs office for a routine checkup during their first pregnancy. On her pt history form, she checks “yes” for asthma and psychiatric disorder but “no” for all others. She notes that her psychiatric condition was a brief episode of mild depression about 6 years ago. Lisa takes a daily prenatal, no other routine medications or supplements. She does not drink or smoke. She was using BC pills but stopped to start a family. After reviewing Lisa’s history, the NP decides Lisa has an increased risk of perinatal depression. Which of the following represents Lisa’s greatest risk factor for perinatal depression and/or anxiety?
History of depression
At later routine pregnancy appointments, the NP checks with Lisa about symptoms of depression and anxiety. At the end of Lisa’s second trimester, the OB/GYN in the practice asks Lisa how she is sleeping and eating. Lisa says fine except for adding an ice cream snack before bedtime. She says she only sleeps a few hours each night because of belly. The physician asks about Lisa’s mood. Lisa’s husband mentions she’s been tearful for the past few weeks. Lisa admits this is true lately. Lisa’s husband adds “you used to have lunch every Saturday with your friends. I can’t remember the last time you went to lunch with them. Lisa says “sometimes I feel like I’m in a fog. I forget what I going to say and can’t make decisions about somethings”. All of the following symptoms suggest that Lisa might be experiencing anxiety/depression EXCEPT:
1. Irritability
2. Change in eating habits
3. Racing thoughts
4. Diminished ability to think or concentrate
Change in eating habits
Which of the following is the immediate next step that Lisa’s OB/GYN should take?
Screen Lisa for prinatal dpression
Tonya is a 26 y/o single mother who brings her son Ryan to the pediatricians office for his 2-month vaccinations. He is healthy and his growth is on target. “Are you sure he’s OK?” Tonya says “Because I feel like I’m doing everything wrong”. The NP assures her Ryan is fine and asks how she is feeling. “Sometimes I feel overwhelmed, like I can’t handle everything”. The NP patiently listens to her explain more about her feelings and reassures her that she is not a bad mother and that there are things that can help if she does have perinatal depression and/or anxiety. Which of the following would be the most appropriate next step for the NP to take?
Screen Tonya and refer her to an OB/GYN or a PCP if results show she is at risk for PPD
The DSM-V currently defines PPD as depression beginning ______ after childbirth?
4 weeks
What can you accurately tell this patient when discussing whether to continue her current antidepressant medication in pregnancy?
In most situations, switching to a different antidepressant medication during pregnancy is not recommended
Which of the following is most commonly used for PPD?
EPDS (Edinburgh Postnatal Depression Scale)
Lifetime prevalence for depression in women compared to men is:
2:1
A 27 y/o F with a diagnosis of depression comes to your office in the 5th week of her 1st pregnancy. She wants to know if her antidepressant medication, sertraline, is safe for her baby. Which is the BEST answer you can provide to her?
While no medication is “safe” during pregnancy, it may be safer to continue the medication than to switch it
A child born with Dandy Walker malformation is receiving palliative care in the pediatric unit. A nurse should:
Provide the parents, patient, and family members with supportive care
Ask the parents to be part of the plan of care as much as possible
Attempt to provide a primary nurse for this particular patient on each shift
A head circumference is being measured at a 4 month well-baby checkup. It is noted that the head circumference has not grown since the prior assessment. The NP should:
Re-measure the head circumference, check developmental milestones, assess the nutritional status and discuss with the doctor
A child with a diagnosis of schizencephaly is assign to a new nurse on the pediatric floor. The new nurse has not worked with a child with this diagnosis before. A career nurse discusses the POC needed for this child with the new nurse. It will be important to:
Assess the side of the body that has paralysis for any lesions or sores
A nurse is assessing a 6 month-old M suture lines. They note that the baby has craniosynostosis. The NP should be concerned because:
The suture line closure will not allow the brain to grow
A child that had a shunt placed 4 years ago for hydrocephalus is brought to the ED c/o rapid onset vomiting and increased lethargy. The NP knows that this child will need:
This to be considered a medical emergency, check the head circumference, get neuro
Night terrors can occur in adolescents because of:
Emotional stress, alcohol use, bullying
When speaking with a family about their 9 year old daughters nightmares, it is important to ask:
If the child has a history of daytime napping
What medications the child takes during the day
How often the child consumes caffeine
A quality of a partial seizure is:
Clonic movements
A mother is asking the nurse why her daughter continues to have temporal lobe seizures even though she is on medication. The NP knows this is occurring because:
Temporal lobe seizures do not respond well to medications
Which of the following types of epilepsy are photosensitive?
Juvenile myoclonic epilepsy
A child who had a seizure one hour ago is exhibiting signs of paralysis on the L side of the body. The NP understand the child is exhibiting signs of:
Postictal paralysis
A child with a known history of Benign Rolandic Epilepsy is having a seizure during lunch at the middle school. The school nurse is called to the cafe. What is the priority at this time?
Prevent a possible choking incident by checking the mouth for food
An 18 month old is having a seizure when the NP is assessing him. The NP notes the child is fluttering his eyes and smacking his lips. The NP should document this seizure as:
An absence seizure
A 9 month old is admitted to the pediatric unit for seizures of unknown origin. The child has an EEG performed for several hours. The EEG notes several seizures occurring at different intervals. The NP knows this child:
May have severe mental and physical challenges due to the frequent seizure activity
A child has been status epileptics for the last 20 minutes. The child has Depakote, Valproic Acid, and Diazepam ordered. The nurse should prep which medication?
Diazepam
Care for a child during status epilepticus should include all of the following except:
Turn the patient to the R side
The NP is identifying the difference between primary headaches to secondary headaches. Secondary headaches can occur:
Because of concussions
Cyclic vomiting may:
Not be associated with a headache
A child that has rhythmic, repetitive, involuntary movements is exhibiting:
Dystonia
Identify a therapeutic management technique for a child with a tic disorder.
Education and support for the child and the family
Identify a true statement about Tourettes Syndrome it that:
The tics are involuntary, and the person cannot control the behavior
The assessment an NP preformed on a 12 y/o M demonstrated a positive Kernig’s sign and a positive Brudzinski’s sign. Identify the priority for the NP’s next action:
Further assess the neurological function of the child and call ED with report if needed
Results from CSF that was tested for meningitis have been received. They results indicate bacterial meningitis. The NP knows this because the results show:
An elevated protein count and a low glucose level
A child who as ADHD has difficulty stopping activities to begin other activities at school. The PCP understands that this is due to the difficulty with the self-regulation component of
Flexibility
The PCP cares for a preschoolage child who was exposed to drugs prenatally. The child bites other children and has tantrums when asked to stop but is able to state later why this behavior is wrong. The child most likely has a disorder of:
Executive functioning
The PCP uses the Neurodevelopmental Learning Framework to assess cognition and learning in adolescents. When evaluating social cognition, the NP will ask the adolescent:
About friend and activities at school
The PCP is evaluating a school-age child who has been diagnosed with ADHD. Which plan will the NP recommend asking the child’s school about to help with academic performance?
504 plan
The parent of a child diagnosed with ADHD tells the PCP that the child gets overwhelmed by homework assignments, doesn’t seem to know which ones to do first, and the doesn’t do any assignments. The NP tells the parent that this represents impairment in which executive function?
Activation
The PCP is considering medication options for a school-age child recently diagnosed with ADHD who has a primarily hyperactive presentation. Which medication will the NP select?
Moderate dose stimulant
The parent of a 4 y/o reports that the child gets upset when the hall light is on at night and won’t leave the house unless both shoes are tied equally tight. The PCP recognizes this child likely has which type of sensory processing disorder?
Over-responder
The parent of a preschool-age child who is diagnosed with sensory processing disorder ask the PCP how to help the child manage the symptoms. The NP will recommend:
Maintaining predictable routines as much as possible
The PCP is performing an examination on a 5 y/o who exhibits ritualistic behaviors, avoids contact with other children, and has limited speech. The parent reports having had concerns more than 2 years ago about autism, but was told that it was too early to diagnose. What will the NP do first?
Ask the parent to describe the child’s earlier behaviors from infancy through preschool
The PCP is examining a 3 y/o who speaks loudly, in a monotone voice, does not make eye contact, and prefers to sit on the exam room floor moving a truck back and forth in a repetitive manner. Which disorder does the NP suspect?
Autism spectrum disorder
