Module 1 (Ch. 4,5,10,11, 24, 33, 27) Flashcards
The mother of a 6monthold infant is distressed because the infant can say
“dada” but not “mama” and asks the primary care pediatric nurse practitioner why this is when she is the one who spends more time with the infant. How will the nurse practitioner respond
“At this age, your baby does not understand the meaning of sounds.”
A 5yearold 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
DTaP
The primary care pediatric nurse practitioner is examining a newborn infant
recently discharged from the neonatal intensive care unit after a premature birth. The parent is upset and expresses worry about whether the infant will be normal. What will the nurse practitioner do in this situation?
A. Point out the tasks that the infant can perform while conducting the
assessment.
An 18monthold child who developed upper respiratory symptoms 1 day prior is
brought to the clinic with a high fever, chills, muscle pains, and a dry, hacking cough. A rapid influenza test is negative and a viral culture is pending. What will the primary care pediatric nurse practitioner do?
Prescribe oseltamivir and follow closely
A single mother of an infant worries that living in a household with only one
parent will cause her child to be maladjusted. To help address the mother’s concerns, the
primary care pediatric nurse practitioner will suggest
developing consistent daily routines for the child
The primary care pediatric nurse practitioner is examining a toddler who is below the 3rd percentile for weight even though the parents claim that the child eats “constantly.” What
will the nurse practitioner do initially?
Evaluate the child’s feeding and elimination behaviors and ask the family to describe mealtime routines.
The primary care pediatric nurse practitioner is performing a well child
examination on a schoolage child who has a history of cancer treated with cranial irradiation. What will the nurse practitioner monitor in this child?
Leukoencephalopathy
The primary care pediatric nurse practitioner sees a 12monthold infant who is
being fed goat’s milk and a vegetarian diet. The child is pale and has a beefyred, sore tongue and oral mucous membranes. Which tests will the nurse practitioner order to evaluate this child’s condition?
RBC folate, iron, and B12 levels
The mother of a 6weekold breastfeeding infant tells the primary care pediatric
nurse practitioner that her baby, who previously had bowel movements with each feeding, now has
a bowel movement once every third day. What will the nurse practitioner tell her
This may be normal for breastfed babies
During a well child exam, the primary care pediatric nurse practitioner learns
that the parents of a young child fight frequently about finances. The parents state that they do not fight in front of the child and feel that the situation is temporary and related to the father’s job layoff. What will the nurse practitioner do?
Suggest counseling to learn ways to handle stress
A toddler is seen in the clinic after a 2day history of intermittent vomiting and
diarrhea. An assessment reveals an irritable child with dry mucous membranes, 3second capillary refill, 2 second recoil of skin, mild tachycardia and tachypnea, and cool hands and feet. The child has had two wet diapers in the past 24 hours. What will the primary care pediatric nurse practitioner recommend
Oral rehydration solution with followup in 24 hours
A 2monthold infant has a staccato cough and fever. Which aspect of the history is most important in determining the diagnosis
Immunization history (Chlamydia Pneumonia with staccato cough)
During an assessment of a 4weekold infant, the primary care pediatric nurse
practitioner learns that a breastfed infant nurses every 2 hours during the day but is able to sleep for a 4hour period during the night. The infant has gained 20 grams per day in the interval since last seen in the clinic. What will the nurse practitioner recommend
Continuing to nurse the infant using the current pattern
The primary care pediatric nurse practitioner is performing a well baby
examination on a 2monthold infant who has gained 25 grams per day in the last interval. The mother is nursing and tells the nurse practitioner that her infant seems fussy and wants to nurse more often. What will the nurse practitioner tell her
The infant may be going through an expected growth spurt.
- A schoolage child has fever of 104°F, sore throat, vomiting and malaise. The
primary care pediatric nurse practitioner observes that the tonsils, oropharynx, and palate are
erythematous and covered with exudate; the tongue is coated and red; and there is a red, sandpaperlike rash on the child’s neck, trunk, and extremities. A rapid strep test is positive. What will the nurse practitioner do to manage this child’s illness?
Prescribe oral amoxicillin
- A 7yearold child whose immunizations are uptodate has a fever, headache,
stiff neck, and photophobia. What course of treatment is indicated?
Hospitalization for diagnosis and treatment with antibiotics
The primary care pediatric nurse practitioner is performing an initial well child
exam on a 3yearold 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?
Perform antibody titers and reimmunize the child.
The parent of a toddler tells the primary care pediatric nurse practitioner that the
family has adopted a plantbased diet and the child is receiving rice and almond milk instead of
cow’s milk. The nurse practitioner will counsel the parents about
protein deficiency.
During a well child assessment of an 18monthold child, the primary care
pediatric nurse practitioner observes the child becoming irritable and uncooperative. The
parent tells the child to stop fussing. What will the nurse practitioner do
Offer the child a book or a toy to look at.
An 18monthold child has a 1day history of intermittent, cramping abdominal
pain with nonbilious vomiting. The child is observed to scream and draw up his legs during pain episodes and becomes lethargic in between. The primary care pediatric nurse practitioner notes a small amount of bloody, mucous stool in the diaper. What is the most likely diagnosis
Intussusception
Which lab value is most concerning in an infant with fever and a suspected bacterial infection?
A. Creactive protein of 11.5 mg/L (Correct)
B. Lymphocyte count of 8.7
C. Platelet count of 475
D. White blood cell count of 14
The parent of a schoolage child reports that the child is on a glutenfree diet.
When questioned about the reason for this diet, the parent states that the child has fewer stomach aches since beginning the diet but has never been diagnosed with celiac disease. The parent reports using glutenfree grain products for all family members. The nurse practitioner will tell this parent that glutenfree diets
may be deficient in essential nutrients.
A 3yearold child whose immunizations are uptodate has been exposed to
measles because of a localized outbreak among unvaccinated children. The parent reports that contact with infected children occurred within the last 2 days at a birthday party. What is the best course of action
Administer the MMR vaccine to help prevent disease.
A 12monthold infant exhibits poor weight gain after previously normal growth
patterns. There is no history of vomiting, diarrhea, or irregular bowel movements, and the physical
exam is normal. What is the next step in evaluating these findings
Feeding and stooling history and 3day diet history
A schoolage child has recurrent diarrhea with foulsmelling stools, excessive
flatus, abdominal distension, and failuretothrive. A 2week lactosefree trial failed to reduce symptoms. What is the next step in diagnosing this condition
Serologic testing for celiac disease
The primary care pediatric nurse practitioner has a cohort of patients who
have special health care needs. Which is an important role of the nurse practitioner when
caring for these children
Care coordination and collaboration
The parent of a 2monthold infant is reluctant to have the baby vaccinated. What is an initial step in responding to these concerns
Question the parent’s reasons for concern about immunizations.
The primary care pediatric nurse practitioner evaluates a 5yearold child who
presents with pallor and obtains labs revealing a hemoglobin of 8.5 g/dL and a hematocrit of 31%.
How will the nurse practitioner manage this patient?
Prescribe elemental iron and recheck labs in 1 month
The primary care pediatric nurse practitioner is examining a newborn who is
breastfeeding and notes the presence of an ankyloglossia. What will the nurse practitioner do
next
Ask the mother if the infant has any feeding difficulties.
The primary care pediatric nurse practitioner is providing anticipatory guidance to
the mother of a breastfed 6monthold infant who asks about “babyled weaning.” What will the nurse practitioner tell her about this practice
“Infants are given soft, mashable table foods when able to selffeed.”
A schoolage child has a 3month history of dull, aching epigastric pain that
worsens with eating and awakens the child from sleep. A complete blood count shows a
hemoglobin of 8 mg/dL. What is the next step in management?
Referral for esophagogastroduodenoscopy (EGD)
The primary care pediatric nurse practitioner sees a 3yearold child whose
parents report is a picky eater in spite of their continued efforts to provide nutritious meals. The parents ask whether a multivitamin is necessary. How will the nurse practitioner respond
Ask the parents to provide a 3day food diary.
The primary care pediatric nurse practitioner is managing care for a child
diagnosed with irondeficiency anemia who had an initial hemoglobin of 8.8 g/dL and hematocrit of 32% who has been receiving ferrous sulfate as 3 mg/kg/day of elemental iron for 4 weeks. The child’s current lab work reveals elevations in Hgb/Hct and reticulocytes with a hemoglobin of 10.5 g/dL and a hematocrit of 36%. What is the next step in management of this patient?
Continue the current dose of ferrous sulfate and recheck labs in 1 to 2 months
The primary care pediatric nurse practitioner is examining a 5yearold child who
has had recurrent fevers, bone pain, and a recent loss of weight. The physical exam reveals scattered petechiae, lymphadenopathy, and bruising. A complete blood count shows thrombocytopenia, anemia, and an elevated white cell blood count. The nurse practitioner will refer this child to a specialist for
bone marrow biopsy.
A 3yearold child who attends day care has had a fever, nausea, and vomiting
several weeks prior and now has darkened urine and constipation along with hepatomegaly and
right upper quadrant tenderness. What treatment is warranted for this child?
Supportive care
The primary care pediatric nurse practitioner is performing a well child
examination on a 9monthold infant whose hearing is normal but who responds to verbal cues with only single syllable vocalizations. What will the nurse practitioner recommend to the parents to improve speech and language skills in this infant
Read simple board books to the infant at bedtime.
A 2monthold infant will receive initial immunizations, and the parent asks about giving medications to increase the infant’s comfort and minimize fever. What will the pediatric nurse practitioner recommend
Administering ibuprofen or acetaminophen as needed
A toddler who presents with anemia and reticulocytopenia has a history of a
gradual decrease in energy and increase in pallor beginning after a recent viral infection. How will
the primary care pediatric nurse practitioner treat this child?
Closely observe the child’s symptoms and lab values.
The mother of a nursing infant expresses concern about whether highcholesterol
foods will increase her infant’s risk of hyperlipidemia. What will the primary care pediatric nurse practitioner tell her?
Maternal dietary cholesterol intake does not affect the infant’s serum cholesterol values.
A child whose family has been camping in a region with endemic Lyme disease suffered several tick bites. The parents report removing the ticks but are not able to or the length of time the ticks were attached. The child is asymptomatic. What is the action
Teach the parents which signs and symptoms to report.
The primary care pediatric nurse practitioner performs a physical examination
on a 9monthold infant and notes two central incisors on the lower gums. The parent states that the infant nurses, takes solid foods three times daily, and occasionally takes water from a cup. What will the pediatric nurse practitioner counsel the parent to promote optimum dental
health
To make an appointment for an initial dental examination
The primary care pediatric nurse practitioner conducts a well baby exam on
an infant and notes mild gross motor delays but no delays in other areas. Which initial course of action will the nurse practitioner recommend?
Teach the parents to provide exercises to encourage motor development
he primary care pediatric nurse practitioner is reviewing medical records for a
newborn that is new to the clinic. The toddler’s mother was found to be HIV positive during her pregnancy with this child and received antiretroviral therapy during pregnancy. The child was born by cesarean section, begun on antiretroviral prophylaxis, and did not breastfeed. What is the correct management for this child
Consult with a pediatric HIV specialist
The mother of a 6yearold child tells the primary care pediatric nurse practitioner
that the child only wants to eat French fries and hamburgers and refuses most vegetables. What
will the nurse practitioner recommend?
Providing a variety of healthy foods at each meal
A 9monthold infant has had a fever of 103°F for 2 days and now has a diffuse,
maculopapular rash that blanches on pressure. The infant’s immunizations are uptodate. What will the primary care pediatric nurse practitioner do?
Reassure the parent that this is a mild, selflimiting disease.
The parent of a 5monthold is worried because the infant becomes fussy but
doesn’t always seem interested in nursing. What will the nurse practitioner tell this parent
The infant may be expressing a desire to play or to rest
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?
Ask about recent tick bites
- An 18monthold child has bronchopulmonary dysplasia. To help prevent
pneumococcal disease, which vaccine will be ordered?
PCV13
The primary care pediatric nurse practitioner is examining a 2monthold infant with fever and cough. A WBC is 14,000/mm3 and a chest radiograph is normal. The infant is nursing well and having normal stools. What would be an appropriate next step
Performing a catheterized urinalysis to screen for leukocytes and nitrites
A 2yearold child who has SCA comes to the clinic with a cough and a fever of
101.5°C. The child currently takes penicillin V prophylaxis 125 mg orally twice daily. What will the
primary care pediatric nurse practitioner do?
Admit the child to the hospital to evaluate for sepsis.
The mother of a newborn asks the primary care pediatric nurse practitioner about the benefits of breastfeeding. What will the nurse practitioner tell her
Nursing her baby exclusively for at least 4 months will help her infant to resist infections.
The parents of a toddler tell the primary care pediatric nurse practitioner that they
get frustrated trying to get the child to eat any vegetables other than squash and carrots. What will the nurse practitioner recommend
Continue to offer a variety of foods without forcing the child to eat them.
The primary care pediatric nurse practitioner is counseling the mother of a
newborn about breastfeeding her infant. Which supplements will the nurse practitioner
recommend
Vitamin D
The mother of a 2monthold infant tells the primary care pediatric nurse
practitioner that she is afraid her breast milk is “drying up” because her baby never seems satisfied
and wants to nurse all the time. Which action is correct?
Weigh the infant to assess for a growth spurt.
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
an elevated neutrophil count.
Which recommendation will a primary care pediatric nurse practitioner make
when parents ask about ways to discipline their 3yearold child who draws on the walls with crayons?
Provide a roll of paper for drawing and teach the child to use this
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
A. The vaccine will not protect her from any HPV oncogenic types acquired
previously
The primary care pediatric nurse practitioner is examining a 12monthold infant
who was 6 weeks premature and observes that the infant uses a raking motion to pick up small objects. The PEDS questionnaire completed by the parent did not show significant developmental delays. What will the nurse practitioner do first?
Perform an indepth developmental assessment.
The primary care pediatric nurse practitioner sees a developmentally delayed
toddler for an initial visit. The family has just moved to the area and asks the nurse practitioner about community services and resources for their child. What should the nurse practitioner do initially?
Ask the parents if they have an individualized family service plan (IFSP).
The parent of a 12monthold infant asks the primary care pediatric nurse
practitioner why 2% cow’s milk is recommended instead of whole milk. What will the nurse
practitioner tell this parent
Younger children need a limited amount of fats.
The primary care pediatric nurse practitioner provides anticipatory guidance for a
6monthold infant who is breastfed who takes 400 IU of vitamin D daily. The parent reports that the infant has begun taking cereals, fruits, and vegetables in addition to nursing. What will the nurse practitioner recommend to promote healthy nutrition
Continue to nurse as long as desired.
A 9yearold girl has a history of frequent vomiting and her mother has frequent
migraine headaches. The child has recently begun having more frequent and prolonged episodes accompanied by headaches. An exam reveals abnormal eye movements and mild ataxia. What is the correct action
Refer to a pediatric gastroenterologist for further workup
The primary care pediatric nurse practitioner is performing an assessment on a 1
weekold newborn with a slightly elevated bilirubin who is breastfeeding well and who has gained 30 grams in the past 24 hours. The infant is stooling and voiding well. The nurse practitioner suspects breast milk jaundice. Which action is correct
recheck the serum bilirubin and infant’s weight in 24 hours.
A toddler is receiving longterm antibiotics to treat osteomyelitis. Which laboratory
test will the primary care pediatric nurse practitioner order to monitor response to therapy in this child?
Erythrocyte sedimentation rate (ESR)
An unimmunized schoolage child whose mother is in her first trimester of
pregnancy is diagnosed with rubella after a local outbreak. What will the primary care pediatric
nurse practitioner recommend?
Assessment of maternal rubella titers
The primary care pediatric nurse practitioner reviews hematology reports on a
child with betathalassemia minor and notes an Hgb level of 8 g/dL. What will the nurse practitioner
do?
Evaluate serum ferritin.
The primary care pediatric nurse practitioner sees a 3dayold nursing infant
whose newborn metabolic screen is positive for galactosemia. The nurse practitioner refers the newborn to a specialist for immediate evaluation and will tell the mother
to stop breastfeeding immediately.
A 10yearold child has had abdominal pain for 2 days, which began in the
periumbilical area and then localized to the right lower quadrant. The child vomited once today and then experienced relief from pain followed by an increased fever. What is the likely diagnosis
Appendicitis with perforation
The mother of a newborn infant asks the primary care pediatric nurse practitioner
about pumping her breasts when she returns to work in 2 months. What will the nurse practitioner include in teaching this mother
Frozen breast milk may be stored up to 3 months in a 0° F freezer.
The primary care pediatric nurse practitioner is evaluating a schoolage child who,
after removal of a pituitary tumor, has altered hypothalamic control over hunger and satiety. The child is morbidly obese and expresses feeling depressed because of the obesity. What will the nurse practitioner recommend?
Restricting all access to food in the house and at school
The parent of an infant asks about using a probiotic medication. What will the
primary care pediatric nurse practitioner tell this parent?
There is no conclusive evidence about using probiotics to treat colic.
A child is diagnosed with Crohn disease. What are likely complications for this child
Intestinal obstruction with scarring and strictures
A complete blood count on a 12monthold infant reveals microcytic, hypochromic
anemia with a hemoglobin of 9.5 g/dL. The infant has mild pallor with no hepatosplenomegaly. The
primary care pediatric nurse practitioner suspects
irondeficiency anemia.
According to recent research, which populations may have higher rates of under immunization than others
Those with higher rates of graduate degrees
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
The child should stay home if any symptoms occur and may return in 1 week if no rash develops.
The mother of a 3monthold child tells the primary care pediatric nurse
practitioner that it is “so much fun” now that her infant coos and smiles and wants to play. What is
important for the nurse practitioner to teach this mother?
How to read the infant’s cues for overstimulation
A 2monthold infant cries up to 4 hours each day and, according to the parents,
is inconsolable during crying episodes with fists and legs noted to be tense and stiff. The infant is breastfeeding frequently but is often fussy during feedings. The physical exam is normal and the infant is gaining weight normally. What will the primary care pediatric nurse practitioner recommend
Eliminating certain foods from the mother’s diet
A 5yearold child who received VariZIG after exposure to varicella while
immunocompromised during chemotherapy is in the clinic 5 months after stopping chemotherapy for kindergarten vaccines. What will the primary care pediatric nurse practitioner order for this child?
MMR, Varivax, Tdap
A schoolage child comes to the clinic for evaluation of excessive bruising. The primary care pediatric nurse practitioner notes a history of an upper respiratory infection 2 weeks prior. The physical exam is negative for hepatosplenomegaly and lymphadenopathy. Blood work reveals a platelet count of 60,000/mm3 with normal PT and aPTT. How will the nurse practitioner manage this child’s condition?
Teach to avoid NSAIDs and contact sports
- A preschoolage child is brought to clinic for evaluation of a rash. The primary
ID: 13348428773
care pediatric nurse practitioner notes an intense red eruption on the child’s cheeks and circumoral pallor. What will the nurse practitioner tell the parents about this rash
Expect a lacy, maculopapular rash to develop on the trunk and extremities.
When reviewing a white blood cell (WBC) count, the primary care pediatric nurse practitioner suspects a viral infection when which WBC element is elevated
Lymphocytes
A 10monthold infant who is new to the clinic has chronic hepatitis B infection.
What will the primary care pediatric nurse practitioner do to manage this infant’s disease?
Consult a pediatric infectious disease specialist
The primary care pediatric nurse practitioner performs a well child examination on
a 1monthold. The infant was recently discharged from the neonatal intensive care unit after treatment with parenteral acyclovir for a neonatal herpetic infection and is currently taking oral acyclovir. What will the nurse practitioner do to manage this infant’s care?
Obtain regular absolute neutrophil counts.
A schoolage child has had abdominal pain for 3 months that occurs once or twice
weekly and is associated with a headache and occasional difficulty sleeping, often causing the child to stay home from school. The child does not have vomiting or diarrhea and is gaining weight normally. The physical exam is normal. According to Bishop, what is included in the initial diagnostic workup for this child
CBC, ESR, amylase, lipase, UA, and abdominal ultrasound
The pediatric nurse practitioner provides primary care for a 30monthold child
who has sickle cell anemia who has had one dose of 23valent pneumococcal vaccine. Which is an appropriate action for health maintenance in this child?
Administer an initial meningococcal vaccine.
The primary care pediatric nurse practitioner learns that the mother of a newborn
infant is being tested for tuberculosis after a positive TB skin test. What will the nurse practitioner
tell the mother who states a desire to breastfeed her baby
That she can express breast milk and feed that to her infant
The mother of a 15monthold infant tells the primary care pediatric nurse
practitioner that she wishes to continue nursing her child for another year, if possible. What will the
nurse practitioner recommend
Clean the toddler’s teeth each time after breastfeeding.
When counseling an adolescent with a family history of hyperinsulinemia and type
2 diabetes, the primary care pediatric nurse practitioner will recommend avoiding
processed breads
The primary care pediatric nurse practitioner performs a well baby examination
on a 7dayold infant who is nursing well, according to the mother. The nurse practitioner notes that the infant weighed 3250 grams at birth and 2990 grams when discharged on the second day of life. The infant weighs 3080 grams at this visit. Which action is correct
Schedule a weight check in 1 week.
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 TBendemic 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
Reassure the adolescent that this is a negative screen.
A 2yearold child has an acute diarrheal illness. The child is afebrile and, with
oral rehydration measures, has remained well hydrated. The parent asks what can be done to help shorten the course of this illness. What will the primary care pediatric nurse practitioner recommend
Lactobacillus
The primary care pediatric nurse practitioner reviews the immunization records of
an 18monthold child and notes that the child received an MMR immunization 2 days prior to the first birthday. What will the nurse practitioner do
Recommend the next dose of MMR vaccine at 4 to 5 years of age.
The parent of an infant asks why some vaccines, such as MMR, are not given
along with the other series of immunizations at 2, 4, and 6 months of age. What will the primary
care pediatric nurse practitioner tell this parent
Maternal antibodies neutralize some vaccines and are delayed until 12 months
A child with a history of a pustular rash at the site of a cat scratch on one arm now
has warm, tender, swollen axillary lymph nodes on the affected side. The primary care pediatric nurse practitioner notes induration and erythema of these nodes. What will the nurse practitioner do
Order an immunofluorescent assay (IFA) for serum antibodies
A parent is concerned about vaccine adverse reactions. Based on an Institute of Medicine report, what will the primary care pediatric nurse practitioner tell the parent?
The MMR may be linked to febrile seizures in immunocompromised children
The parent of a 3monthold reports that the infant arches and gags while feeding and spits up undigested formula frequently. The infant’s weight gain has dropped to the 5th percentile from the 12th percentile. What is the best course of treatment for this infant
Begin a trial of extensively hydrolyzed protein formula for 2 to 4 weeks
The primary care pediatric nurse practitioner is performing a well child
examination on a 15yearold girl who consumes a vegan diet. Based on this assessment, which nutrients may this adolescent need to supplement?
Iron, folic acid, and B12
The primary care pediatric nurse practitioner enters an exam room and finds
a 2monthold infant in a car seat on the exam table. The infant’s mother is playing a game on her smart phone. The nurse practitioner interprets this behavior as
of moderate concern for parenting problems
A 10monthold infant has an erythematous, fluctuant, nondraining 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
Incision and drainage of the abscess with culture
A toddler who was born prematurely refuses most solid foods and has poor
weight gain. A barium swallow study reveals a normal esophagus. What will the primary care
pediatric nurse practitioner consider next to manage this child’s nutritional needs
Videofluoroscopy swallowing study
An adolescent is diagnosed with functional abdominal pain (FAP). The child’s
symptoms worsen during stressful events, especially with school anxiety. What will be an important
part of treatment for this child
Teaching about the braingut interaction causing symptoms
A child is in the clinic after swallowing a metal bead. A radiograph of the GI tract
shows a 6 mm cylindrical object in the child’s stomach. The child is able to swallow without difficulty
and is not experiencing pain. What is the correct course of treatment?
Have the parents watch for the object in the child’s stool
The primary care pediatric nurse practitioner performs a well child assessment on
a 6monthold infant whose mother reports having less breast milk because of stressors associated with pumping and returning to work. The nurse practitioner will provide resources to promote pumping and
discuss adding other foods to the baby’s diet
The primary care pediatric nurse practitioner performs an initial well baby exam
on a 1weekold infant who is breastfeeding and who is at birth weight. The mother tells the nurse practitioner that her baby is already sleeping 5 or 6 hours at night. What will the nurse practitioner recommend?
Waking the infant up at least every 3 hours to nurse
The parent of a newborn infant asks the primary care pediatric nurse practitioner
when to intervene to help the infant’s future intellectual growth. What will the nurse practitioner tell
the parent
Language and literacy skills begin at birth
A child who is immunocompromised has a fever and a rash consisting of macules, papules, and pustules. What will the primary care pediatric nurse practitioner do?
Hospitalize the child for intravenous acyclovir.
- The primary care pediatric nurse practitioner performs a well baby examination on a 4monthold infant who is exclusively breastfed and whose mother plans to introduce only small amounts of fruits and vegetables in addition to breastfeeding. To ensure that the infant gets adequate amounts of iron, what will the nurse practitioner recommend
Elemental iron supplementation of 1 mg/kg/day until cereals are added
