2024 (ACTUAL EXAM )PEDIATRICS FINAL EXAM Practice Questions with SOLUTIONs GRADED A+, Exams of Nursing

Download 2024 (ACTUAL EXAM )PEDIATRICS FINAL EXAM Practice Questions with SOLUTIONs GRADED A+ and more Exams Nursing in PDF only on Docsity! 2024 (ACTUAL EXAM )PEDIATRICS FINAL EXAM Practice Questions with SOLUTIONs GRADED A+ -----------WEEK 9------ A client presents to clinic for the first time. The provider discovers that the client was diagnosed with prader-willi syndrome. What symptoms does the provider expect to find during this encounter? - SOLUTION >>Hyperphagia, obesity, and strabismus Lethargy and stridor and irritability Low-set ears, short stature, webbed neck Flat nasal bridge, epicanthal folds and heart murmur Prader-Willi Syndrome - SOLUTION 1) Caused by a lack of genetic material in the 15 pair of chromosomes. 2) Usually inherited from the father. The leading genetic cause of obesity. 3) Children with Prader-Willi syndrome can be rigid and oppositional. They do not respond well to sudden changes in their routine. 4) Mild MR, low muscle tone, short stature, incomplete sexual development, cognitive disabilities, problem behaviors, and a chronic feeling of hunger that can lead to excessive eating and life-threatening obesity. Turner Syndrome - SOLUTION A chromosomal disorder in females in which either an X chromosome is missing, making the person XO instead of XX, or part of one X chromosome is deleted. Affects females, short stature, infertility, short neck with a webbed appearance, a low hairline at the back of the head, low-set ears, and narrow fingernails and toenails that are turned upward. Down syndrome features - SOLUTION prominent tongue flat occiput slanting eyes (palpebral fissures) short hands ASD- epicanthal folds redundant nuchal skin fifth finger clinodactyly and brachydactyly single transverse palmar crease Brush field's spots on iris periphery low muscle tone s, respiratory problems, and digestive tract obstruction. A client with prader willi syndrome, well known to clinic, presents today for a well exam. The client is at higher risk and should be screened for what medical condition? - SOLUTION Depression Pyloric stenosis Celiac disease >>Type 2 diabetes - SOLUTION A new client presents to the clinic to establish care on exam, the provider notes the following: a long narrow face, high-arched palate and dental crowding, prominent ears, strabismus, macroorchidism, short stature, cognitive impairments and stereopathies. What would be the most likely diagnosis? - SOLUTION >>Fragile X Prader-Willi Angelman Beckwith-Weidemann If a client is positive for any of the following categorical clinical findings and developmental deficiencies: failuare to thrive, central obesity, enamel hypoplasia, scoliosis, motor delays, mild intellectual disability and compulsive hyperphagia; what would be the most likely diagnosis? - SOLUTION Fragile X >>Prader-Willi b) Abdominal pain, diarrhea, vomiting >>c) Irritability, fever, lethargy d) Vesicular rash, pruritus, fever A 11-year-old child presents with fever, sore throat, and swollen lymph nodes. The abdominal exam reveals a spleen tip that is palpable. A throat culture and monospot test results are negative. What would be the next step in the plan of care? - SOLUTION Question 2 options: a) Repeat throat culture b) Bone marrow biopsy c) Chest radiograph >>d) Epstein-Barr titer The nurse practitioner has a differential diagnosis of Lyme disease. Which of the following skin lesion would confirm the diagnosis? - SOLUTION >>a) Erythema migrans b) Koplik spots c) Pustules d) Scales Which of the following would best reflect the physical presentation in a newborn with Down's syndrome? - SOLUTION a) Pigeon-breasted chest, Brushfield spots, arachnodactyly >>b) Hypotonia, large-appearing tongue, small mouth, upward eye slant c) Microcephaly, flattened philtrum, downward eye slant d) Lymphadenopathy, coarctation of the aorta, webbed neck What is an expected finding in young infants with cerebral palsy (CP)? - SOLUTION Question 5 options: a) Weight gain and increased appetite b) Reactions to initial vaccines >>c) Hypotonia in the first weeks of life d) Hepatosplenomegaly ----------WEEK 8------ The Parents of an established patient call the pediatric clinic to ask what they should do for their child who tripped, fell, and hit head their head on the sidewalk Which of the following symptoms would require that the child goes to the emergency room? - SOLUTION a) History of febrile seizure b) Scalp laceration c) Uncontrollable crying >>d) Loss of consciousness Which of the following is the best measure of childhood intelligence? - SOLUTION >>a) Wechsler scale---It generates an IQ score, which represents a child's cognitive ability. b) Vineland scales-- measures the personal and social skills of individuals from birth through adulthood c) Bayley scales-- assess developmental functioning of infants and toddlers. d) Denver II-- widely used assessment for examining children 0-6 years of age as to their developmental progress. A nurse practitioner has a follow-up visit with a child who experienced a febrile seizure. Which of the following statements would be the most accurate when educating the parents on febrile seizures? - SOLUTION a) The child will be at an increased risk for epilepsy b) The child would benefit from phenytoin c) The child would benefit from phenobarbital >>d) The child may experience repeated seizures A child with Tourette syndrome presents to the pediatric clinic. Which of the following should the nurse practitioner be aware of? - SOLUTION >>a) Symptoms become more unpredictable during adolescence b) Sleep disturbance from tics increases with age c) Boys have an increased incidence of behavioral problems d) Medications are now available to control tics without a change in functioning A child who is enrolled in Head Start is suspected of having developmental delays based on Denver II results at two separate clinic visits. What would be the next step in the plan of care? - SOLUTION a) Request Head Start complete an independent evaluation b) Discuss interventions to foster development with the parents c) Repeat the Denver II again in 6 months A 16-year-old client presents to the clinic complaining of frequent headaches with bouts of nausea, vomiting, abdominal pain, photophobia and throbbing unilateral pain that is only relieved with sleep. What is the most likely diagnosis? - SOLUTION Cluster headache Vascular headache Tension headache >>Migraine headache A 15-year-old client presents to the clinic complaining of tension headaches. The provider understands that the client will experience pain to what region of the head? - SOLUTION At the back of the head >>On both sides of the head At the top of the head On one side of the head The parents of a 4-year-old client hysterically calls the office to seek assistance after their child hit his head on the brick walkway and lost consciousness for 10 minutes. What possible complications/conditions is the client at risk for? (select all that apply) - SOLUTION >>Concussions >>Intracranial lesions >>Cerebral contusions Febrile seizures Seventy-two hours after an emergency delivery, a newborn develops respiratory insufficiency, dysphagia, hypotonia, ptosis, weakness, weak cry, poor sucking, choking, expressionless face, and absent Moro reflex. Based on the symptomology the provider suspects that the newborn may be showing signs of Myasthenia Gravis. Which clinical test, when performed, may confirm this diagnosis? - SOLUTION >>Administering the short-acting cholinesterase inhibitor, edrophonium. Administering the long-acting cholinesterase inhibitor, neostigmine. Administering the short-acting cholinesterase inhibitor, pyridostigmine. Administering the long-acting cholinesterase inhibitor, Rivastigmate. A 16-year-old client, new to the clinic, presents with complaints of weakness and Landry ascending paralysis progressing over the last few weeks. The provider suspects Guillain-Barré syndrome based on the reported symptoms. However, as the collection of the client's health history continues, a past infection with which virus supports the providers suspicions? - SOLUTION Enterovirus >>Epstein-Barr virus Haemophilus influenzae Hantavirus Attention deficit hyper activity disorder maybe - SOLUTION >>Familiar Learned Acquired Triggered by a virus Symptoms of ADHD are present prior to ....years of age. - SOLUTION Ten >>Seven Nine Six .....are the first line choice for treatment of ADHD disordrs. - SOLUTION SSRIs >>Long acting stimulants Tricyclics Dopamine agonist inhibitors .....children are less likely to be diagnosed with attention deficit disorder than others - SOLUTION >>AA Non-hispanic white Asian Hispanic -----WEEK 7--------- A 5-year-old boy presents to the clinic with his mother who states the chief complaint of: "painful limping on the right leg for 2 days." Today he has a low-grade fever. Which of the following would be the most likely diagnosis? - SOLUTION Question 1 options: a) Osgood-Schlatter b) Slipped capital femoral epiphysis >>c) Transient synovitis of the hip d) Osteomyelitis Which of the following is a typical presentation of a dislocated hip of a child 6-months or older? - SOLUTION Question 2 options: a) Symmetry of skin folds b) Negative Trendelenburg sign >>c) Positive Galeazzi sign d) Atrophied leg muscle During the examination of a 3-week-old it is noted that the infant is irritable when lifted, has asymmetrical Moro reflex, and spasms along the right sternocleidomastoid. What does this suggest? - SOLUTION Question 3 options: a) Klippel-Feil syndrome in infants, obese children, and adolescents, and chronically ill/immunocompromised children. A 15 y/o client presents to the clinic c/o tenderness to the right side. The pain started gradually and radiates to the back. On the exam the client is positive for Tietze syndrome. The provider diagnosis the client with costochondritis. How should the provider treat this condition. - SOLUTION >>Recommend mild analgesics and NSAIDS >>Recommend avoiding strenuous activity >>Take cough suppressants Administer cortisone injections (not this) Costochondritis treatment includes NSAIDs, avoiding strenuous activity and cough suppressant may be beneficial is cough is an aggravating factor. Stretching and ice to the area can be useful.. parents should be reassured that the condition is benign and self limiting and is not cardiac related. A 6-year-old client presents to the clinic c/o intermittent limp and pain to the anterior thigh. Upon exam the following is noted: antalgic gait with limited hip movement, atrophy of the gluteus, quadriceps and hamstring. Decreased abduction, internal rotation, and extension of the hip and pain on the rolling the leg internally. - SOLUTION Legg-calve perthes disease Childhood hip disorder that results in infarction of the bony epiphysis of the femoral head. It presents as avascular necrosis of the femoral head. The basic underlying cause is insufficient blood supply to the femoral head. 9 y/o client in town for the summer presents for a rash. Multiple annular scaling nd discrete hypopigmentaed patches are located on the trunk. KOH scrapings of the lesions revealed short curved hyphae and circular spores that fluoresced yellow-orange under the woods lamp. What is the most likely diagnosis? - SOLUTION Tinea versicolor (not corporis, Tinea manuur, or Tina capitis) A 17 y/o presents with c/o small bumps on the face: very small, firm, flesh- colored discrete papule 1-6mm on face, axillae, and trunk. What is the most likely cause: - SOLUTION Molluscum contagiosum (Not condyloma acuminatum, small epidermal cysts, acne vulgaris) Benign common childhood viral skin infection with little health risk, molluscum often disappears on its own in a few weeks to months and is not easily treated. Common in children and adolescents. Infectivity is low but the child is contagious as long as the lesions are present. A 5 y/o with small white oval cases attached tightly to the hair shafts at the back of the head, nape of the neck, eyelashes. - SOLUTION Prescribe medication that follows local resistance patterns 4 y/o reports visile scratch marks on the arms. Throughout the day which intensifies at night. On exam, the following is noted: S-shaped burrows in the webs of the fingers, sides of hands and forearms. What is the most likely diagnosis? - SOLUTION Scabies; antiparasitics What are the key clinical signs of erythema multiform? - SOLUTION Lesions of the oral mucosa that are shallow Lesions are fixed, symmetric, and have a typical distribution Lesions initially appear dusky, as red macule or edematous papule Lesions evolve into target lesions with multiple concentric rings color change Erytema multiforme is an acute usually benign self-limited eruption characterized by target lesions and minor mucosal involvement (papule and varying bulae) it is rarely associated with complications. All above symptoms apply SKIN infections: CELLULITIS ABSCESS IMPETIGO - SOLUTION diffuse, acute infection of the skin marked by local heat, redness, pain, and swelling Collection of pus underneath the skin inflammatory skin disease with pustules that rupture and become crusted causes: Group A strep MRSA MSSA (methicillin susceptible S. aureus) CELLULITIS INFECTIONS - SOLUTION HERPETIC WHITLOW- An infection caused by herpes simplex virus infection that involves the distal phalanx of a finger from putting hands in mouth BITES - SOLUTION cats and dogs sometimes other kids Cats more likely to cause infection ANIMALS: pasteurella strep species capnocytophaga oral anaerobes HUMAN: strep species staph species Haemophilus species Oral anaerobes --RANDOM---- A congenital heart abnormality often discovered during the newborn period is coarctation of the aorta. How is this assessed? - SOLUTION By comparing upper and lower extremity blood pressures A child who can stack a maximum of 5 blocks is probably : - SOLUTION 2 years of age strep species fungal inflammation of the skin covering the glans penis Which suggestion below is the standard for treating iron and infants and children? - SOLUTION Iron supplements in divided doses between meals with orange juice A young child has developed a circumferential lesion on her inner forearm. It is raised, red, and pruritic. It is about 2.5cm in diameter. This is probably related to: - SOLUTION The child's new cat A 7-year odl entered the clinic 1 month ago. There was no evidence that he had any immunizations. He was given the vaccinations listed on his vaccination record at the time of his visit. If he returns today, which immunizations can he receive? - SOLUTION Hep B, DTap, IPV, MMR ------MID-TERM (W5)------ The provider knows that climate change will impact the main health outcome for children by its impact on cost of living cost of education food production smog - SOLUTION food production The parent of a 3-year-old girl is concerned that the child may have autism. The provider completes a modified checklist for autism in toddlers (M- CHAT) tool and the results indicate several areas of concern. what will the provider do? administer a childhood autism rating scale (CARS) in the clinic consult a specialist to determine early intervention strategies refer to behavioral specialist for further evaluation inform the parent that results from M-CHAT indicate that the child has autism - SOLUTION refer to behavioral specialist for further evaluation The provider learns the the mother of a 3-year-old child has been treated for depression for over 5 years. which aspect of this child's development may be impacted? fine motor gross motor social/emotional speech and language - SOLUTION speech and language a new client and family presents to the clinic to establish care. the provider collects info that identifies family members and other living in the household. relationships with others outside the home, and any significant medical, behavioral and emotional conditions. which tool to use to record this info? cRAFFT ecomap venogram pedigree - SOLUTION Ecomap The provider evaluates a school-age client whose body mass index is greater than the 97th percentile. the provider is concerned and orders several labs to evaluate this. which diagnosis will the provider document for this visit? precocious puberty prayer willi's syndrome obesity cushing-syndrome - SOLUTION obesity an established 2-year-old client presents for a well-child exam and it is noted that her BMI is below the 3rd percentile. the provider learns that the client does not have regular mealtimes and is allowed to carry a bottle of juice around at all times. which diagnosis will the provider use? failure to thrive home care resources inadequate nutrition alteration - less than required parenting alteration - SOLUTION parenting alteration a 10-week old premature infant, who was not immunized before d/c from the hospital is seen for the first time in your office. what immunizations should be given today? - SOLUTION H. influenzae type B Dtap Hep B IPV rotavirus pneumococcal an 8-month old has difficulty sleeping at night w/out being held by the parents. the provider understands that this is a result of: sleep apnea sleep terrors learned behavior insomnia - SOLUTION learned behavior A 6-year-old client cheats when playing video games. the parents are worried about this. How should the provider respond to the parents? - SOLUTION Explain that the child is appropriate for the age what is the best intervention for a 2-month-old client who on physical exam is found to have a rigid and immobile sagittal suture? - SOLUTION immediate referral to a neurologist/neurosurgeon A 2-year-old client presents today with a diffuse non-pruritic, discrete rose- colored maculopapular rash on the trunk. the lesions are 2-3 mm in diameter and fade on pressure. the provider learns that the last 3 days the client had a temperature of 101 and when the fever broke the rash appeared. what condition is this? - SOLUTION roseola infantum not: meningoencephalitis scarlet fever meningitis rash starts on the trunk and goes to the extremities Rash comes out when the fever breaks ophthalmoscope The parent of a 5-year old is diagnosed with asthma. 'unsure of what to do for the child during an asthma attack. what should the provider explain to the parent? - SOLUTION immediately administer albuterol NOT: immediately administer albuterol and an antihistamine immediately administer albuterol and call 911 immediately administer albuterol and steroid A healthy 7 -year-old suddenly develops a low-grade fever and cough. on exam, wheezes are auscultated throughout the lungs. what is the most likely diagnosis? - SOLUTION atypical pneumonia NOT: bacterial pneumonia bronchiolitis bronchitis A 7-year-old client is diagnosed with CAP. The provider decides to treat the condition outside of the hospital. what med is the best treatment for this condition? - SOLUTION amoxicillin NOT: azithromycin ceftriaxone oseltamivir A 3-year-old has been diagnosed with pertussis. the client lives in the home with a 6-week old sibling and a 4-week old cousin. what should the provider do to prevent disease transmission? - SOLUTION order azithromycin 10 mg/kg/day in a single dose daily for 5 days NOT: erythromycin 10mg/kg/dose QID for 14 days in home quarantine for 5 days to limit contact between children order immediate administration of diphtheria/pertussis/tetanus A 2-year-old client presents to the clinic and is immediately examined and found to have a 101.3 fever, 70 BPM, continuous stridor and intercostal retractions. what is the best treatment? - SOLUTION admit for inpatient hospitalization NOT: administer IM dexamethasone give racemic epinephrine in the office prescribe oral dexamethasone for 2 days Question 1 1 / 1 point What age do children usually begin receiving the human papillomavirus vaccine (HPV)? - SOLUTION 8 years >>11 years 13 years 15 years 11 years is the age most providers begin administering the HPV vaccine. When can a child stop using a booster seat in the car? - SOLUTION >>When the child is at least 4'9" tall. When the child is at least 5' tall. When the child is at least 4' tall. When the child is at least 3' tall. A child should be at least 4'9" before discontinuing the use of the booster seat. Question 3 1 / 1 point A 13-year-old client diagnosed with infectious mononucleosis 2 weeks ago is in your office today c/o abdominal pain to the upper left quadrant, is febrile and tired. Based on the client's recent history, what is the best intervention? - SOLUTION Prescribe Salicylates for the fever Refer to Gastroenterology Prescribe antibiotics >>>Refer to Emergency Services Splenic rupture may have occurred; refer to ER is best intervention to r/o active bleeding and need for surgical removal of spleen. Question 4 1 / 1 point An established 14-year-old client who recently returned from camp presents to the clinic c/o chills, severe headache, myalgias, malaise, GI upset/tenderness, diarrhea, cough, conjunctival injection, and a fever. On exam, the provider notes a rash of faint pink spots on the wrists, forearms, ankles, and the trunk. What is the most likely diagnosis? - SOLUTION >>Rocky Mountain Spotted Fever Leptospirosis Meningococcemia Thrombotic Thrombocytopenic Purpura Question 5 1 / 1 point A client with chickenpox who cannot stop itching presents to the clinic requesting relief. What can the provider do to help this client? (select all that apply) - SOLUTION >>Calamine >>Antihistamines Aspirin >>Oatmeal bath All choices are accurate except Salicylates are contraindicated because of Reye Syndrome. Question 6 1 / 1 point An infant can complete hand-to-hand transfers at what age? - SOLUTION 120 days 90 days >>7 months 11 months ?? KD is the second most common childhood vasculitis after Henoch- Schönlein purpura and the most common vasculitis affect- ing the coronary arteries What type of hemorrhage would be expected with severe factor VIII deficiency? - SOLUTION Severe hemorrhage following moderate trauma >>Gross bleeding following mild trauma ?? Gynecologic hemorrhage Spontaneous hemarthrosis The nurse practitioner suspects that a pediatric patient is exhibiting the signs and symptoms consistent with Leukemia. To confirm this diagnosis, which test/procedure should be ordered? - SOLUTION Bone marrow aspiration Chest radiograph >>CBC with differential Biopsy of an enlarged lymph node musculoskeletal infections - SOLUTION oteomyelitis septic arthritis septic arthritis: < 5 S. Aureus G.A. Strep S. Pneumoniae Kingella kingae neisseria gonorrhea >5 S. Aureus GAS streptococcus species Adolescent Neisseria gonorrhea -----WEEK 4----- A school-age client presents to the clinic to establish care. The child has autism, facial dysmorphia, and growth retardation. The provider suspects the child has what condition? - SOLUTION Down Syndrome >>Fetal alcohol syndrome Prader-Willi syndrome Turner syndrome Autism, facial dysmorphia, and growth retardation are differential diagnoses of fetal alcohol syndrome. A 8-year-old client was recently discharged from the hospital following an episode of meningitis. The client presented to the clinic for a follow-up appointment post discharge. The provider understands that the client's is at increased risk for which complication(s)? (check all that apply) - SOLUTION >>Hearing impairment >>Paralysis >>Loss of speech Infertility A client with history of bilateral tympanostomy tube insertion presents to the clinic c/o otorrhea. The provider confirms the complaint. What is the best treatment for this condition? - SOLUTION >>Combination antibiotic and corticosteroid otic drops Anaglesics and watchful waiting Oral antibiotics and antifungal cream corticosteroid otic drops Combination antibiotic and corticosteroid otic drops are the preferred treatment The gold standard in diagnosing acute otitis media is: - SOLUTION >>immobile Tympanic Membranes pearly gray Tympanic Membranes flat Tympanic Membranes perforated Tympanic Membranes OTITIS MEDIA is caused by what bacteria? - SOLUTION streptococcus pneumoniae Haemophilus influenzae B Moraxella-catarrhalis If the child has bacterial conjunctivitis and otitis media, it is usually caused by "non-typeable" H. influenzae B) OTITIS EXTERNA is caused by what bacteria? - SOLUTION pseudomonos aeruginosa Mass behind the ear is? Caused by? - SOLUTION Mastoiditis Streptococcus pneumoniae Non-typeable H-Influenza B Staphylococcus aureus Bacterial Conjunctivitis is caused by - SOLUTION N. gonorrhea Streptococcus pneumoniae H. Influenzae Moraxella catarrhalis Peri-orbital cellulitis is caused by what bacteria - SOLUTION Staph aureus Strep pyogenes (grp A) Pseudomonos aeruginosa Strep pneumoniae H. influenzae NASAL INFECTIONS may be due to - SOLUTION Foreign body Sinusitis An otolaryngology referral is indicated when appropriate therapy for otitis media has failed A 16 year-old-client presents to your clinic c/o sore throat and 101°F temperature. The provider learns that the client had a sore throat approximately 1 week ago. On exam, client is positive for cervical lymphadenopathy, enlarged left tonsil, edematous pharynx and uvula displacement. What condition does this client most likely have? - SOLUTION Acute uvulitis Infectious mononucleosis Mumps >>Peritonsillar abscess Classical presentation for peritonsillar abscess A 5-year-old client presents to the clinic for an annual physical. While performing the physical exam, the provider attempts to examine the client's ears. What does the provider do? - SOLUTION >>Gently pull outer ear down and back Gently pull outer ear up and back Gently pull outer ear down Gently pull outer ear back To correctly examine the ear of a child older than 12 months gently pull outer ear down and back What are the most common causes of bacterial pneumonia in neonates (select all that apply)? - SOLUTION Staphylococcus Aureus >>Group B Streptococcus Listeria Monocytogenes >>Escherichia Coli The most common organisms responsible for bacterial pneumonia in neonates are still group B streptococcus and Escherichia coli. The next most common causes are coagulase negative Staph and Listeria in the early neonatal period. After four days of age, the differential needs to be expanded to include S. aureus, Enterobacter, Pseudomonas, Serratia, Candida, Acinetobacter, and anaerobes. An ill appearing 3-month-old-infant is presented to your clinic. The parent reports that their child has a fever, persistent cough, rhinorrhea, wheezing, hypoxemia, and anorexia for 4 days. After the provider's exam and work- up, the child is diagnosed with Bronchiolitis. What is the most likely treatment option for this infant? - SOLUTION >>Refer patient for hospitalization Refer patient to Pulmonologist Refer patient for Bronchoscopy Refer patient for Chest-Xray Bronchiolitis is the term used for an infant seen with wheezing for the very first time and is the leading cause of hospitalizations for infants. It presents with cough, fever, coryza, tachypnea, expiratory wheezing, air trapping, and inspiratory crackles. In mild cases, symptoms can last for 1 to 3 days. In severe cases, cyanosis, air hunger, retractions, and nasal flaring with symptoms of severe respiratory distress within a few hours may be seen. Apnea can occur and may require mechanical ventilation. An ill-appearing child is presented to your clinic with a fever, sore throat, restless behavior, dysphagia, drooling, and inspiratory distress without stridor. The child tests positive for Haemophilus influenzae type b (Hib). What is the most likely diagnosis? - SOLUTION Tonsillitis >>Epiglottitis Laryngotracheobronchitis Retropharyngeal abscess Epiglottitis is characterized by inflammation of the epiglottis, the aryepiglottic folds, and the ventricular bands at the base of the epiglottis. The causative organism is Haemophilus influenzae type B (HIB). There is an abrupt onset of fever, severe sore throat, dyspnea, inspiratory distress without stridor, and drooling. The child looks acutely ill and toxic. If epiglottitis is suspected, do not examine the throat. Do not place the child in the supine position, and immediately transport the child to the hospital via emergency medical services. -----WEEK 3----- Which of the following is the correct order for introduction of solid foods to an infant? - SOLUTION Question 1 options: Fruits, cereal, meats, and vegetables Cereal, meats, vegetables, and fruits Fruits, cereal, vegetables and meat >>Cereal, vegetables, fruits, and meats Which of the following information is most important to ask about while performing a sports physical? - SOLUTION Question 2 options: Does the child have shortness of breath with exercise? >>Has the child ever fainted during exercise? Has the child ever undergone surgery? Has the child ever had a head injury? The mother of a 16-month-old child informs you that she feeds the baby skim milk. What is the best rationale for not using skim milk? - SOLUTION Question 3 options: Contains too little protein Contains an insufficient amount of calcium Is not as easily digested as whole milk • First dose: 12 through 15 months of age • Second dose: 4 through 6 years of age What should a cultural assessment of the family and child include? - SOLUTION An assessment of a patient's dominant culture including the accompanying health beliefs, and beliefs about birth, illness, and deaths. >>An assessment of potential biologic variations that occur in people of a particular race An assessment of whether the child and family have sought care from a traditional healer, and advise them to avoid such healers What question should the provider ask to elicit information about the internal structure of a family? - SOLUTION Question 2 options: Has any family member recently moved in or out of the home? If so, how has this move affected the family? >>Do both parents live in the home? If not, where do they live? How often do the children have contact with the parent or parents who do not live in the home? How often is there contact with the extended family (e.g. aunts, uncles)? "Culture is a social construction of the relationships within and among groups of human beings. . ." Which of the following is not a part of the products of culture? - SOLUTION Question 3 options: race >>religion class geography none of the above The provider understands that children who show signs of aggressive behavior, depression, anxiety, and poor school performance may have been exposed to which of the following during childhood? - SOLUTION Question 4 options: mumps second-hand smoke >>domestic violence immunizations Immigrants Which of the following best defines the role of the APN in Health Care? - SOLUTION Question 5 options: Codes all of the primary and differential diagnoses Orders lab tests and diagnostics for every patient >>Provides continuity of care for underserved populations Ensures that every medical chart has a growth chart Follow all doctors' orders Which of the following is considered a developmental red flag? (choose the best answer) - SOLUTION Question 1 options: Incorrect pronoun use Difficulty sharing Speech less than 75% unintelligible >>Loss of milestones What would be the most likely weight of a 1-year-old child whose weight at birth was 7 pounds? - SOLUTION Question 2 options: >>20-23 pounds 16-19 pounds 14-17 pounds weight triples by 1 year The pincer grasp is a fine motor skill that involves the ability to pick up a small object such as cold cereal, with the thumb and forefinger. When is this usually mastered? - SOLUTION Question 3 options: 16 months >>9 months 6 months 4 months The nurse practitioner is completing an examination of an 11-year-old female. It is noted during inspection that there is an appearance of breast buds. Which of the following would most likely occur in approximately 2 years? - SOLUTION Question 4 options: >>Onset of menses Axillary hair Growth of pubic hair Peak height velocity "The average time from breast buds to menarche is 1.5 to 2.5 years." When reviewing immunization protocols at your clinic, the nurse practitioner should be aware that the varicella vaccine can be administered at what age? - SOLUTION Question 5 options: 4 months 6 months >>12 months d) Sickle cell disease CONTRAINDICATIONS: Migraine with aura Past medical history of thromboembolism Untreated hypertension Lupus with vascular disease, nephritis or antiphospholipid Abs Less than 3 weeks post partum High triglycerides Catherine is a fourteen-year-old female who presents to your clinic with a chief complaint of angry acting out and nighttime sleeplessness. She is a new patient to your practice. She is accompanied by her aunt who is currently her legal guardian. You know this adult (the aunt) well since she brings her children to your practice for care. Catherine is in her aunt's custody because her parents are in prison for domestic violence. Catherine's physical examination is normal. You administer the Patient Health Questionnaire Modified for Adolescents (PHQ-A) to Catherine. The purpose of this test is to identify and differentiate if her acting aligns with five common mental disorders: somatoform, depressive, panic, anxiety, eating disorders, or alcohol abuse. On the PHQ-A, Catherine denies questions 1, 2, 4, 5, 6, and 9 but scores more than half the days (2) on questions 7 and 8; and nearly every day (3) on question 3. What w - SOLUTION PTSD Fred is a six-year-old male brought to your practice by his foster mother. Fred's mother reports that he is a very active boy and cannot seem to stay on task when given something to do. His teacher in his new school reports that he is disruptive in class. The foster mother has no past medical history or family history on this child. You are presented with an animated and distractible male child. He has no negative physical findings. Which tool do you believe would be most appropriate for initial assessment of this child? Pediatric symptom checklist Vanderbilt scale M-CHAT Child depression inventory - SOLUTION Vanderbilt scale - SOLUTION