Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023, Exams of Law

Download Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 and more Exams Law in PDF only on Docsity! Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 Burns' Pediatric Primary Care 7th Edition Test Bank Chapter 1: Health Status of Children: Global and National Perspectives 1. Which region globally has the highest infant mortality rate? A. Indonesia B. Southern Asia C. SubSaharan Africa Correct D. Syria 2. The primary care pediatric nurse practitioner understands that, to achieve the greatest worldwide reduction in child mortality from pneumonia and diarrhea, which interventionis most effective? A. Antibiotics B. Optimal nutrition C. Vaccinations Correct D. Water purification 3. Which is true about the health status of children in the United States? . 13348413856 A. Globalism has relatively little impact on child health measures in the U.S. B. Obesity rates among 2to5yearolds have shown a recent significant decrease. Correct . C. The rate of household poverty is lower than in other economically developed nations. D. Young children who attend preschool or day care have higher food insecurity. 4. The primary care pediatric nurse practitioner understands that a major child health outcome associated with worldwide climate change is A. cost of living. B. education. C. nutrition. Correct D. pollution. 5. When providing well child care for an infant in the first year of life, the primary care pediatric nurse practitioner is adhering to the most recent American Academy of PediatricsRecommendations for Preventive Pediatric Health Care guidelines by A. focusing less on development and more on illness prevention and nutrition. B. following guidelines established by theBright Futures publication. C. scheduling wellbaby visits to coincide with key developmental milestones. Correct D. seeing the infant at ages 2, 4, 6, and 12 months when immunizations are due. Chapter 2. Unique Issues in Pediatrics 1. A nurse is explaining the therapeutic milieu to a new nurse. The best explanation of this term would be: 1. The place where the child is receiving care. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 2. Group therapy. 3. Personal interactions between patients and staff. 4. All of the above are correct. ANS: 4 2. A 16-year-old male has received a pink-slip from the police for inpatient psychiatric treatment. The teen has been expressing thoughts of hanging himself because Life sucks. Thenursing staff should consider placing the child: 1. With peers. 2. In an area where he can be watched one-on-one. 3. With aroommate thatisexpressing the sameconcerns. 4. In an area close to an external door. ANS: 2 3. Learning disabilities in children have scientifically been linked to: 1. Poornutrition. 2. The environment in which the child lives. 3. Genetics. 4. Watching more than four hours of television a day. ANS: 3 4. A mental health nurse has assessed a child and determined that the child exhibits behavioral challenges. When the school nurse explains this to a teacher, the best description wouldbe: . 1. The child may exhibit physical outbursts. 2. The child may exhibit violence toward others. 3. The child may be defiant or have tantrums. 4. The child will need special interventions for learning. ANS: 3 5. A child that has not exhibited enuresis in four years has exhibited this behavior pattern for the last week. The reason a child may revert back to this behavior pattern is because of: 1. Hallucinations. 2. Behavioral challenges. 3. Delusions. 4. Stress. ANS: 4 6. An 18-year-old male has called the crisis line for help. The crisis nurse recognizes the intervention needs may consist of all of the following except: 1. Discussing the individuals everyday activities. 2. Recognizing that the patient may be in a catharsis state. 3. Expressing empathy toward the caller. 4. Avoiding entropy. ANS: 1 7. An 8-year-old boy with a history of hallucinations and violent behavior has been place in a seclusion room at the hospital because he has been hurting others. The nurse checks on the patient and realizes she must take him out of the seclusion room when: 1. He is crying to be released. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 F. They replicate via the process of mitosis. 2. What does the following genetic notation symbol mean 47,XX,6q? . 13348407650 A. Male with deletion of chromosome 6 B. Female with deletion of chromosome 6 C. Male with deletion onthelongarmofchromosome 6 D. Female with deletion on the long arm of chromosome 6 Correct 3. A child has a recessive genetic disorder that is homozygous for that mutation. . 13348407646 What is most likely about this child‟s parents? A. Neither parent has a copy of that gene mutation. B. Only the mother has a copy of that gene mutation. C. Only the father has a copy of that gene mutation. D. Each parent has one copy of that gene mutation. Correct 4. Which type of mutation isresponsible formany singlegene genetic disorders? . 13348407636 A. Copy numbervariations B. Nucleotide repeat expansions C. Point mutations Correct D. Single nucleotide polymorphisms (SNP) . 5. Cystic fibrosis isarecessive disease requiring the presence ofagene mutation . 13348407638 on both alleles inherited from the parents. Which type of genetic disorder isthis? A. Chromosome B. Mitochondrial C. Monogenetic Correct D. Multifactorial . 6. The primary care pediatric nurse practitioner is counseling a couple about genetic risks and learns that one parent has neurofibromatosis, an autosomal dominant disorder, and the other parent does not. What will the nurse practitioner include when discussingthis disorder and its transmission? C. Children must inherit a gene from both parents to develop the disease. D. Each child born to this couple will have a 50% risk of having the disease. Correct E. This type of disorder characteristically skips generations. F. Unaffected offspring may still pass on the disease to their offspring. 7. A family medical history conducted during a well baby exam for a newborn girl reveals that hemophilia A, an Xlinked Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 recessive disorder, is present in males in three previous generations in the mother‟s family, whose father had the disease. What will the primary care pediatric nurse practitioner tell the parents about the risk of this disease intheir children? E. All of their sons will be affected by the disease. F. Any sons they have will not be affected by the disease. G. Daughters have a 50% chanceofbeing carriers ofthedisease. Correct H. Their daughter has a 25% chance of having the disease. 8. What is an important responsibility of the primary care pediatric nurse practitioner . to help determine genetic risk factors in families? E. Assessing physical characteristics of genetic disorders F. Knowing which genetic screening tests to perform G. Making appropriate referrals to pediatric geneticists D. Obtaining a threegeneration pedigree for each family Correct 9. Which diagnostic study may be ordered when the provider wishes to detect the . presence ofadditional genetic material ona chromosome? A. Chromosomal microarray B. FISH Correct D. Karyotype E. Molecular testing 10. Which type of testing will the primary care pediatric nurse practitioner recommend . for a couple concerned about the potential for having children with cystic fibrosis? A. Biochemical testing B. Carrier testing Correct C. FISH testing D. Karyotype testing Chapter 4. Environmental Issues Questions 1. What has been the result of passage of the Toxic Substances Control Act. (TSCA) of 1976? G. A mandate for corporations to disclose known toxic chemicals H. A requirement that all manufactured chemicals undergo toxicity testing I. Authorization of the EPA to require testing and reporting of some chemicals Correct J. Development of a mechanism to report reactions to toxic chemicals 2. Many European nations use the “precautionary principle” to help regulate potentially toxic chemicals. What does this mean? G. Chemicals must be proven to be safe before being introduced into the Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 environment. Correct H. Corporations may be exempt from testing if their costs in doing so are too high. I. Regulators must demonstrate risk to the public before banning a chemical. J. Without a strong risk, corporations need not release data about their products. 3. During a clinic visit, a child‟s rapid capillary screening test for lead revealsa level of 11 mcg/dL. What will the primary care pediatric nurse practitioner do next? I. Institute lead abatement measures in the child‟s home. J. Monitor lead levels monthly until decreased. K. Order a venous sample to test for lead levels. Correct L. Test the child‟s siblings and parents for lead. 4. A child has a lead level of 25 mcg/dL. Once lead abatement measures are instituted, what is an important intervention to help prevent permanent damage H. Chelation therapy I. Dietary changes C. Followup testing Correct . D. Testing family members 5. A child whose parent works in a factory pr esents with swelling of the extremities, pain and weakness in the pelvis, and an erythematous maculopapular rash. Which industrial toxin will the primary care pediatric nurse practitioner suspect in this child? A. Lead B. Mercury C. Organophosphates Correct D. Phthalates 6. Whencounseling amother whosmokes about preventing exposureto smokingrelated risks to her nursing newborn, what will the primary care pediatric nurse practitioner tell her? F. If she quits now, her child will not have longterm effects from exposure. G. Prenatal smoke exposure does not cause respiratory effects after the infant is born. H. Smoking outdoors or near anopen windowprevents exposuretotobacco smoke. I. Thirdhandsmoke exposure risks may last for years even if the mother quits now. Correct 7. A child who has been playing in a public park is brought to the clinic with wheezing, vomiting, diarrhea, and drooling. A physical exam reveals a low heart rate and diaphoresis. What will the primary care pediatric nurse practitioner suspect as a cause for these symptoms? B. Arsenic consumption C. Lead poisoning C. Organophosphate exposure Correct D. Phthalate ingestion 8. A parent asks about ways tolimit exposure torisksassociated with plastics. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 D. Fine motor E. Gross motor F. Social/emotional D. Speech and language Correct . 9. When meeting with a new family, the primary care pediatric nurse practitioner develops a database that identifies family members and others living in the household, relationships with others outside the household, and significant behavioral and emotional problems. Which tool will the nurse practitioner use to record this information? C. CRAFFT D. Ecomap C. Genogram Correct D. Pedigree 10. A child is in the clinic for evaluation of an asthma action plan. The primary care pediatric nurse practitioner notes that the child‟s last visit was for a prekindergarten physical and observes that the child is extremely anxious. What will the nurse practitioner do initially? A. Ask the child‟s parent why the child is so anxious. B. Performaphysical assessment toruleoutshortness of breath. C. Reassure the child that there is nothing to be afraid of. D. Review the purpose of this visit and any anticipated procedures. Correct 11. The primary care pediatric nurse practitioner is evaluating health literacy in the mother of a new preschoolage child. How will the nurse practitioner assess C. Ask the child how many books he has at home. Correct D. Ask the mother about her highest grade in school. E. Ask the mother to determine the correct dose of a drug from a label. F. Ask the mother to read a health information handout aloud. 12. The mother of a newborn tells the primary care pediatric nurse practitioner that she is worried that her child will develop allergies and asthma. Which tool will the nurse practitioner use to evaluate this risk? A. Threegeneration pedigree Correct A. Review of systems B. Genogram C. Ecomap 1 3. The primary care pediatric nurse practitioner is performing a well child assessment on an adolescent and is concerned about possible alcohol and tobacco use. Which assessment tool will the nurse practitioner use? A. CRAFFT Correct A. HEEADSSS B. PHQ2 C. RAAPS Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 14. The primary care pediatric nurse practitioner evaluates a schoolage child whose body mass index (BMI) is greater than the 97th percentile. The nurse practitioner is concerned about possible metabolic syndrome and orders laboratory tests to evaluate this. Which diagnosis will the nurse practitioner document for this visit? A. Metabolic syndrome B. Nutritional alteration: more than required C. Obesity Correct A. Rule out type 2 diabetes mellitus Chapter 6. Cultural Considerations for Pediatric Primary Care Questions 1. The primary care pediatric nurse practitioner provides well child care for a community of immigrant children from Central America. The pediatric nurse practitioner is surprised to learn that some of the families are Jewish and not Catholic. This response is an example of cultural O. collectivism. P. constructivism. Q. essentialism. Correct R. individualism. 2. The primary care pediatric nurse practitioner learns that an AfricanAmerican family lives inaneighborhood witha high crimerateand suggests thattheytry moving to another neighborhood for the safety of their children. This is an example of N. cultural sensitivity. O. group bias. P. individual privilege. Correct Q. racial awareness. 3. The primary care pediatric nurse practitioner cares f or children from a Native American family and learns that they used many herbs to treat and prevent illness. Which approach will the pediatric nurse practitioner use to promote optimum healthin the children? O. Ask about the types of practices used and when they are applied. Correct P. Provide a list of harmful herbs and ask the family to avoid those. Q. Suggest that the family avoid using these remedies in their children. R. Tell the parents to use the herbs in conjunction with modern medications. 4. The primary care pediatric nurse practitioner works with families from a variety of cultures and socioeconomic classes. Which is an example of cultural humility in practice? M. Giving health care advice that takes cultural differences into account N. Identification of other cultures that may be superior to one‟s own culture C. Receptivity to learning about the perspectives of other cultures Correct D. Respecting other cultures while maintaining the views of one‟s own 5. A Somalian immigrant mother is concerned that her 8yearold Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 child is underweight. The primary care pediatric nurse practitioner notes that the child‟s weight is at the 25th percentile. After realizing that the mother is comparing her child to a group of Americanborn children who are overweight, the pediatric nurse practitioner is able to convince the mother that this is a normal weight. Which domain of culturalcompetence does this represent? A. Global B. Interpersonal Correct N. Intrapersonal O. Organizational 6. The primary care pediatric nurse practitioner in a community health center meets a family who has recently immigrated to the United States who speak only Karon. They arrive in the clinic with a church sponsor, who translates for them. Thepediatric nurse practitioner notices that the sponsor answers for the family without giving them time to speak. The pediatric nurse practitioner will H. ask the sponsor to allow the family to respond. I. develop the plan of care and ask the sponsor to make sure it is followed. J. request that the sponsor translate written instructions for the family. K. use the telephone interpreter service to communicate with the family. Correct 7. The primary care pediatric nurse practitioner prescribes a twice daily inhaled corticosteroid for a 12yearold child. At a well child visit, the child reports not using the medication on a regular basis. Which response by the pediatric nurse practitioner demonstrates an understanding of clientcentered care? A. Asking the child to describe usual daily routines and schedules Correct I. Referring the family to a social worker to help with medication compliance J. Reviewing the asthma action plan with the parent and the child K. Teaching the child how the medication will help to control asthma Symptoms 8. A primary care pediatric nurse practitioner working in a community health center wishes to develop a program to assist impoverished children and families to have access to healthy foods. Which strategy will the pediatric nurse practitioner employto ensure the success of such a program? G. Asking community members to assist in researching and implementing a program Correct H. Designing acommunity garden approach that involveschildren andtheir parents I. Gaining support from the corporate community to provide needed resources J. Providing evidencebased information about the importance of a healthy diet 9. The parents of a special needs child tell the primary care pediatric nurse practitioner that they are planning a 3month Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 ANS: 2 12. 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 cafeteria. What is the school nurses priority at this time? 1. Prevent a possible choking incident by checking the students mouth for food. 2. Lay the child down on the floor and make sure the area is safe. 3. Call the EMTs for help. 4. Notify the parents that their daughter is having a seizure. ANS: 1 . 13. An 18 month old is having a seizure when the nurse is assessing him. The nurse notes that the child isfluttering his eyes andsmacking his lips. Thenurseshould document this seizure as: 1. Anabsence seizure. 2. A tonic-clonic seizure. 3. A myoclonic seizure. 4. Afebrile seizure. ANS: 1 14. 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 nurse knows this child: 1. Will develop at the same rate as his peers. 2. May have severe mental andphysical challenges duetothefrequent seizure activity. 3. May exhibit a slight cognitive delay as he grows. 4. Will grow out of having seizures. ANS: 2 15. A child has been status epileptics for the last 20 minutes. The child has Depakote, Valporic Acid, and Diazepam gel ordered. The nurse should prepare which medication for administration at this time? 1. Depakote 2. Valporic acid 3. Diazepam 4. None of the medications. The child will stop on his own. ANS: 3 16. Care for a child during status epilepticus should include all of thefollowing except: 1. Turn the patient to the right side. 2. Loosen tight clothes. 3. Move toys out of the area to prevent injury. 4. Stay with the patient until the seizure has stopped. ANS: 1 17. The nurse is identifying the difference between primary headaches to secondary headaches. Secondary headaches canoccur: 1. Because of stress. 2. In relation to low blood pressure. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 3. Because of concussions. 4. Because of migraines.ANS: 3 18. Cyclic vomiting may: 1. Last for days. 2. Require SSRIs tostop hurting. 3. Not be associated with a headache. 4. Requires pain medication and Zofran. ANS: 3 19. A child that has rhythmic, repetitive, involuntary movements isIexhibiting: 1. Tremors. 2. Dystonia. 3. Contractures. 4. Tics. ANS: 2 20. Identify a therapeutic management technique for a child with a ticdisorder. 1. Behavioral modification to suppress the tics 2. Administer anti-psychotic medications to reduce the tics 3. Education and support for the child and the family 4. Genetic counseling for the family ANS: 3 21. Identify a true statement about Tourettes Syndrome (TS) is that: 1. Manifestations rarely change once developed. 2. Children with TS do not have obsessive compulsive disorders. 3. The tics of TS can lead to mental deterioration. 4. The tics are involuntary, and the person cannot control the behavior. ANS: 4 22. The assessment anurse performed ona 12-year-old boy demonstrated a positive Kernigs sign and a Brudzinskis sign. Identify the priority for the nurses next action. 1. Document the findings andnote asnormal. 2. Further assess the neurological function of the child and call the doctor with a report. 3. Explain to the patient that the assessment was abnormal and there is no a cause for concern. 4. Prepare the child for a lumbar puncture. ANS: 2 23. Results from cerebrospinal fluid that was tested for meningitis have been received by the nurse. The results indicate bacterial meningitis. The nurse knows this because theresults show: 1. A low protein count and a low glucose count. 2. A low red blood cell count. 3. An elevated protein count and a low glucose level. 4. A normal proteincount and a high glucose count. ANS: 3 . Chapter 8. Developmental Management in Pediatric PrimaryCare Questions Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 1. 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 S. developing consistent daily routines for the child. Correct T. exposing her child to extended family members when possible. U. not working outside the home during the first few years. V. taking her child to regular play date activities with other children. 2. 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? R. Reassure them that the child is too young to understand. S. Recommend that they continue to not argue in front of the child. T. Suggest counseling tolearn waystohandlestress. Correct U. Tell them that the conflict will resolve when the situation changes. 3. 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? S. Allow the parent to put the child in a “timeout.” T. Ask the parent about usual discipline practices. U. Offer the child a book or a toy to look at. Correct V. Stop the exam since the child has reached a “meltdown.” 4. Which recommendation will a primary care pediatric nurse practitioner make when parents ask about ways to discipline their 3yearoldchild who draws on the walls with crayons? O. Give thechild washable markers sothe drawings can be removed easily. P. Provide a roll of paper for drawing and teach the child to use this. Correct Q. Put the child in “timeout” each time the child draws on the walls. R. Take the crayons away from the child to prevent the behavior. 5. The primary care pediatric nurse practitioner conducts a well baby exam on . aninfant andnotes mild gross motor delays but nodelays inother areas. Which initial course of action will the nurse practitioner recommend? P. Consult a developmental specialist for a more complete evaluation. Q. Prepare the parents for a potentially serious developmental disorder. R. Refer the infant to an early intervention program for physical therapy. S. Teach the parents to provide exercises to encourage motor development. Correct 6. 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? Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 decreased diapers for 2 days. The baby has been sleeping more and hasbeen hard to wake up. On assessment, you find that the baby is difficult to arouse, is hypotonic and temperature is 35.4 rectally. What is an important lab value to check? Choose the best answer. 1. Complete metabolic panel 2. Liver panel 3. Blood glucose 4. PTT ANS: 3 8. A pregnant woman with a history of a clotting disorder is required to self- administer heparin during her pregnancy. After delivery, the infant will be at greater risk for: 1. Low blood sugar 2. Decrease Vitamin K 3. Increased Vitamin K 4. High blood sugar ANS: 2 . 9. A part of injury prevention is making and keeping infant appointments. The required checkups and vaccinations are at: 1. 3 months, 6 months, 9 months 2. 2 months, 4 months, 6 months and 1 year 3. 2 months, 4 months, 6 month, 9 months and 1 year 4. 2 months, 4 months, 9 months and 1 year ANS: 3 10. You are taking care of an infant who was admitted with dehydration. His weight is 6kg. You have been watching his I & Os. What would you expect the infants urinary output to bein order to maintain adequate hydration? 1. 0.52 ml/kg/hr 2. 0.52.5 ml/kg/hr 3. 13 ml/kg/hr 4. As long as heis having wet diapers it doesnt matter ANS: 3 11. A mother brings her newborn daughter tothe ER with concerns that sheis having vaginal bleeding. You know this is normal and called what? 1. Pseudomenstruation 2. Milia 3. Vernix caseosa 4. Toxicum ANS: 1 12. While interviewing the mother of an infant, you note that the mother gets frustrated as she explains that her baby has been upall night crying at least 3 times a week for the last 2weeks. She states that she has tried everything andfeels hopeless. What would bethe BEST response fromyou as the nurse? 1. Believe me, I know. I have a newborn too. 2. Haveyou tried warm milk? 3. Its ok to be frustrated and feel overwhelmed. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 4. You are doing nothing wrong. This can be a common occurrence in infants and you should not feel guilty. ANS: 4 Chapter 10. Developmental Management of Infants Questions 1. 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? W. Cognitive learning begins during the toddler years. X. Intellectual growth begin when speech develops. Y. Language and literacy skills begin at birth. Correct Z. Preschool is an optimal time to begin general learning. 2. 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 2990grams when discharged on the second day oflife. Theinfantweighs 3080 gramsatthis visit. Which action is correct? V. Follow up at the 2month checkup. W. Refer to a lactation consultant. X. Schedule a weight check in 1 week. Correct Y. Suggest supplementing with formula. 3. During an assessment of a 4weekold infant, the primary care pediatric nurse practitioner learns that a breastfed infant nurses every 2 hours during theday but is able to sleep for a 4hour period during the night. The infant has gained 20 grams perday intheiI nterval since last seen in the clinic. What will the nurse practitioner recommend? A. Continuing to nurse the infant using the current pattern Correct W. Nursingtheinfant forlongerperiodsevery 4 hours X. Supplementing with formula at the last nighttime feeding Y. Waking theinfant every 2 hourstonurseduring the night 4. 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? S. She may not be making as much breastmilk as before. T. She should keep a log of the frequency and duration of each feeding. U. The infant may be going through an expected growth spurt. Correct V. The infant should stay on the previously established nursing schedule. . 5. The mother of a 6weekold breastfeeding infant tells the primary care pediatric Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 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? T. Her baby is probably constipated. U. It may be related to her dietary intake. V. Sheshould consume more water. W. This may be normal for breastfed babies. Correct 6 . 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? A. Appropriate ways to stimulate and entertain the infant B. How to read the infant’s cues for overstimulation Correct O. The importance of scheduling “play dates” with other infants P. To provide musical toys to engage the infant 7. The parent of a 5monthold is worried because the infant becomes fussybut doesn‟t always seem interested in nursing. What will the nurse practitioner tell this parent? P. The infant may be expressing a desire to play or to rest. Correct Q. The parent should give ibuprofen for teething pain before nursing. R. This is an indication that the infant is ready for solid foods. S. This may indicate gastrointestinal discomfort such as constipation. 8. 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 whenshe istheonewhospendsmore time with the infant. How will the nurse practitioner respond? R. “At this age, your baby does not understand the meaning of sounds.” Correct S. “Babies at this age cannot make the „ma‟ sound.” T. “Most sounds made by babies at this age are accidental.” U. “This may mean that your baby doesn‟t hear well.” 9. 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? L. Provide educational videos that focus on language. M. Read simple board books to the infant at bedtime. Correct L. Sing to the child and play lullabies in the baby‟s room. M. Turn the television to Sesame Streetduring the day. 10. 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? G. Perform an indepth developmental assessment. Correct H. Reassure the parent that this is normal for a premature infant. I. Refer the infant to a developmental specialist. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 occasionally takes water from a cup. What will the pediatric nursepractitioner counsel the parent to promote optimum dental health? D. To begin brushing the infant‟s teeth with toothpaste E. To consider weaning the infant from breastfeeding F. To discontinue giving fluoride supplements D. To make an appointment for an initial dental examination Correct 10. The parents of a 3yearold child are concerned that the child has begun refusing usual foods and wants to eat mashed potatoes and chicken strips at every meal and snack.The child‟s rate of weight has slowed, but the child remains at the same percentile for weight on a growth chart. What will the primary care pediatric nurse practitioner tell the parents to do? D. Allow the child to choose foods for meals to improve caloric intake. E. Place a variety of nutritious foods on the child’s plate at each meal. Correct F. Prepare mashed potatoes and chicken strips for the child at mealtimes. G. Suggest cutting out snacks to improve the child‟s appetite at mealtimes. Chapter 12. Developmental Management of Middle Childhood Questions 1. The primary care pediatric nurse practitioner is examining a 6yearold Child who attends first grade. The child reports “hating” school. The parent states that the child pretends to be sick frequently in order to stay home from school. To further assess this situation, the nurse practitioner will first ask the child EE. about school performance and grades. FF. why school is so distressing. GG. to name one or two friends. Correct HH. whether bullying is taking place. 2. The parent of a 10yearold boy tells the primary care pediatric nurse practitioner that the child doesn‟t appear to have any interest in girls and spends most of his time with a couple of other boys. The parent is worried about the child‟s sexual identity.The nurse practitioner will tell the parent DD. children at this age who prefer interactions with samegender peers usually have a homosexual orientation. EE. children experiment with sexuality at this age as a means of decidinglater sexual orientation. FF. this attachment to other samegender children is how the child learns to interact with others. Correct GG. to encourage mixed gender interactions in order to promote development of sexual values. 3. The parents ofa 12yearold child are concerned that some of the child‟s older classmates may be a bad influence ontheir child, who, they say, hasbeenraised to believe in right and wrong. What will the primary care pediatric nurse practitioner tellIthe parent? DD. Allowing thechild to make poorchoices andaccept consequences is important for learning values Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 EE. Children at this age have a high regard for authority and social norms, so this is not likely to happen FF. Moral values instilled in the early schoolageperiod will persist throughout childhood GG. The pressures from outside influences may supersede parental teachings and should be confronted Correct 4. During awell child examofaschoolage child, the primary care pediatric nurse practitioner learns that the child has been having angry episodes at school. The nurse practitioner observes the child to appear withdrawn and sad. Which action is appropriate? A. Ask the child and the parent about stressors at home Correct PP. Make a referral to a child behavioral specialist QQ. Provide information about anger management D. Suggest consideration of a different classroom 5. The primary care pediatric nurse practitioner is preparing to conduct a well child . assessment of an 8yearold child. How will the nurse practitioner begin the exam? A. Ask the child about school, friends, home activities, a nd sports Correct Y. Discuss the purpose of the visit and explain the procedures that will be performed Z. Offer ageappropriate information about usual developmental tasks AA. Provide information about healthy nutrition and physical activities 6. The parent of a 6yearold child expressesconcern that thechild may have ADHD. Which screening tool will the primary care pediatric nurse practitioner use to evaluate this possibility? Q. Behavioral and Emotional Screening System for Children (BESS2) R. Behavioral Assessment for Children – 2nd ed. (BASC2) C. Conner’s 3 Parent and Teacher Rating Scale Correct D. Pediatric Symptom Checklist (PSC) 7. The parent of a 5yearold child who has just begun kindergarten expresses concern that the child will have difficulty adjusting to the birth of a sibling. What willthe primary care pediatric nurse practitioner recommend? U. Allowing the child opportunities to discuss feelings about the baby V. Giving the child specific baby care tasks to promote sibling bonding C.Having snack time with the child each day to discuss the school day Correct D. Providing reassurance that the sibling will not replace the child 8. A schoolage child has begun refusing all cooked vegetables. What will the primary care pediatric nurse practitioner recommend to the parent? Y. Allow the child to make food choices since this is usually a phase Z. Ensure that the child has three nutritious meals and twonutritious snacks each Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 day Correct AA. Prepare vegetables separately for the child to encourage adequate intake BB. Teach the child how important it is to eat h ealthy fruits and vegetables 9. The primary care pediatric nurse practitioner performs a physical examination on a 12yearold child and notes poor hygiene and inappropriate clothes for the weather. The child‟s mother appears clean and well dressed. The child reports getting 6 to 7 hours of sleep each night because of texting with friends late each evening. What action by the nurse practitioner will help promote healthy practices? A. Discuss setting clear expectations about selfcare with the mother Correct B. Give the child information about sleep and selfcare S. Reassure the mother that this “noncompliance” is temporary T. Tell the mother that experimenting with selfcare behaviors is normal 10. During a well child exam on a 5yearold child, the primary care pediatric nurse practitioner assesses the child for school readiness. Which finding may be a factor in limiting school readiness for this child? T. Adherence to daily family routines and regular activities U. Having two older siblings who attend the same school C. Parental concerns about bullying in the school Correct D. The child‟s ability to recognize four different colors 11. The primary care pediatric nurse practitioner is examining a schoolage child who complains of frequent stomach pain and headaches. The parent reports that the child misses several days of school each month. The child has a normal exam. Before proceeding with further diagnostic tests, what will the nurse practitioner initially ask the parent? A. About the timing of the symptoms each day and during the week Correct M. How well the child performs in school and in extracurricular activities N. If the parent feels a strong need to protect the child from problems O. Whether there areany unusual stressors orcircumstances at home 12. The primary care pediatric nurse practitioner is evaluating recurrent stomach pain in a schoolage child. The child‟s exam is normal. The nurse practitioner learns that the child reports pain most evenings after school and refuses to participate in sports but does not have nausea or vomiting. The child‟s grandmother recently had gallbladder surgery. Which action is correct? A. Encourage the child to keep a log of pain, stool patterns, anddietary intake Correct G. Order radiologic studies and laboratory tests to rule out systemic causes H. Reassure the child and encourage resuming sports when symptoms subside I. Refer the child to a counselor to discuss anxiety about health problems Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 U. Do not allow a vegetarian diet in order to maintain appropriate limits for the adolescent. V. Provide vegetarian options for the adolescent that preserve adequate nutrition and protein intake. W. Suggest that the adolescent prepare appropriate vegetarian dishes to complement family meals. Correct X. Tell the adolescent that a vegetarian diet may be considered in adulthood but not while living at home. 1 0. The primary care pediatric nurse practitioner is performing a well childexam on a 17yearold female whose mother is present during the history. The mother expresses concern that her daughter wishes tohavean eyebrow piercing andstates that sheis opposed to the idea. What will the nurse practitioner do? V. Provide information about piercings and encourage continued discussion. Correct W. Remind the adolescent that her mother is responsible for her health. X. State that piercings are relatively harmless and are an expression of individuality. Y. Suggest that she wait until she is 18 years old and can make her own decisions. 11. The parent of a 16yearold tells the primary care pediatric nurse practitioner that the teen was recently caught smoking an electronic cigarette (ecigarette). What will the nurse practitioner tell this parent? P. Ecigarette use may be a risk factor for later substance abuse. Correct Q. Experimentation with ecigarettes does not lead to future tobacco use. R. Most teens who experiment with tobacco usually do not become addicted. S. This form of nicotine ingestion is safer than regular cigarettes. 12. The parent of an adolescent reports noting cutting marks on the teen‟s arms and asks the primary care pediatric nurse practitioner what it means. What will the nurse practitioner tell this parent? J. Cutting is a way of dealing with emotional distress. Correct K. It is a method of fitting in with other adolescents. L. The behavior iscommon and will usually stop. H. This type of behavior is a type of suicide attempt. Chapter 14. Introduction to Health Promotion Health Protection for Children & Families Questions 1. The primary care pediatric nurse practitioner is performing a focused problem assessment onachild who has asthma andlearns that one ofthe child‟sparents smokes around the child in spite of being advised against this. The nurse practitioner recognizes this as a possible Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 alteration in which functional health pattern? A. Cognitiveperceptual B. Health perception Correct KK. Rolerelationship LL. Valuesbeliefs 2. The primary care pediatric nurse practitioner examines an infant whose weight is below the 3rd percentile and whose mother does not comply with the feeding regimen. When attempting to enlist the help of the infant‟s grandmother, the grandmother says, “My daughter was like this when she was a baby and she turned out all right.” Which approach will the nurse practitioner take to improve the outcome for this infant? LL. Ask the grandmother about her daughter’s health during childhood. Correct MM. Explain that the condition is potentially serious if not treated. NN. Give the grandmother and mother information about normal growth. OO. Refer the family to a social worker to investigate possible neglect. 3. The primary care pediatric nurse practitioner provides patient teaching for children newly diagnosed with irritable bowel syndrome (IBS). At which stage of development will children be able to understand the link between stress and the symptoms of the disease? A. Concreteoperational stage B. Formaloperational stage Correct LL. Preconceptual stage MM. Sensorimotor stage 4. The primary care pediatric nurse practitioner is counseling an obese adolescent whose parents both have type 2 diabetes mellitus. Which health behavior prediction model is useful when the nurse practitioner discusses lifestyle changes with this client? A. Behavioral change model B. Health belief model Correct JJJ. Health promotion model KKK. Transtheoretical model 5. The primary care pediatric nurse practitioner is counseling a schoolage Child about asthma management strategies. The child states that it is “too much trouble” to remember to use an inhaled corticosteroid medication twice daily and reports feeling fine, in spite of exhibiting expiratory wheezes. Which action uses the health belief and selfefficacy model to teach this child about asthma management? FF. Asking the child to try to use the inhaler at least once daily GG. Discussing whether the child wants to participate in athletics C. Obtaining preand posttreatment spirometry testing Correct D. Providing written information about inhaled corticosteroids 6. An adolescent who is overweight expresses a desire to lose weight in order to participate in sports but tells the primary care pediatric nurse practitioner that he doesn‟t want to give upsweets andsoftdrinks because heenjoys them toomuch. Whichstage of change does Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 this represent? A. Action B. Contemplation Correct V. Precontemplation W. Preparation 7. The primary care pediatric nurse practitioner sees a 17yearold client who quit smoking almost a year prior but who reports having renewed cravings when around friends who smoke. Using knowledge of the maintenance stage of change, the primary care pediatric nurse practitioner will AA. go over with the adolescent about the health risks associated withsmoking. BB. recommend avoiding friends whosmokeandmaking new friends. CC. remind the adolescent about the struggles associated with quitting smoking. DD. suggest that the teen consider taking up a sport or other physical activity.Correct 8. The primary care pediatric nurse practitioner is working with a 12yearold Female who has poor diabetes control. The child tells the nurse practitioner that the parent forgets to remind her to check her blood sugars. Which action is correct? EE. Assessthe parent‟s knowledge about diabetes management. FF. Help the child develop a strategy to remember without parental prompts. Correct GG. Refer to a social worker to help the family overcome obstacles to care. HH. Remind the child‟s parent about the importance of good diabetes control. 9. The primary care pediatric nurse practitioner is counseling an obese 16yearold client about weight management. The adolescent says, “I know I need to lose weight, but I don‟t want to give up all my favorite foods.” When using motivational interviewing techniques, how will the nurse practitioner respond? Y. “Do you think there are any foods you could limit or do withoutfor a while?” Correct Z. “I hear you telling me that you really don‟t have a desire to lose weight.”AA. “If you can‟t give up these foods, you won‟t see the benefits of weight loss.” BB. “In the long run, the sacrifices you make today will improve your health.” 10. The parent of a newborn has quit smoking cigarettes within the past month and reports feeling fidgety. Using a “reframing” technique, how will the primarycare pediatric nurse practitioner respond? Z. Explore ways that the parent can use this extra energy to dothings for the baby. Correct AA. Remind the parent that this is a normal, temporary part of nicotine withdrawal. BB. Suggest that the parent take up exercise to enjoy the benefits of not smoking. CC. Tell the parent that, over time, these symptoms of withdrawal willsubside. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 limited speech. The parent reports having had concerns more than 2 yearsago about autism, but was told that it was too early to diagnose. What will the nurse practitioner do first? A. Administer an MCHAT screen to screen the child for communication and socialization delays. CC. Ask the parent to describe the child’s earlier behaviors from infancy through preschool. Correct DD. Reassure the parent that if symptoms weren‟t present earlier, thelikelihood of autism is low. EE. Refer the child to a pediatric behavioral specialist to develop a plan of treatment and management. 10. The primary care pediatric nurse practitioner is examining a 3yearold child who speaks loudly, in a monotone, does not make eye contact, and prefers to sit on the exam room floor moving a toy truck back and forth in a repetitive manner. Which disorder does the nurse practitioner suspect? A. Attentiondeficit/hyperactivity disorder B. Autism spectrum disorder Correct DD. Executive function disorder EE. Sensory processing disorder 11. The primary care pediatric nurse practitioner is selecting a medication fora 12yearold child who is newly diagnosed with ADHD. The child is overweight, has a history of an atrial septal defect at birth, and reports mild shortness of breath during exercise. What will the nurse practitioner prescribe? W. A lowdose stimulant medication X. A nonstimulant medication Y. Behavioral therapy only D. Cardiovascular prescreening Correct 12. The primary care pediatric nurse practitioner is conducting a followup examination on a child who has recently begun taking a lowdose stimulant medication to treat ADHD. The child‟s school performance and home behaviors have improved. The child‟s parent reports noticing a few tics, such a twitching of the eyelids, but the child is unaware of them and isn‟t bothered by them. What will the nurse practitioner recommend? Q. Adding analphaagonist medication R. Changing to a nonstimulant medication C. Continuing the medication as prescribed Correct I. Stopping the medication immediately . . . . Continue Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 . Chapter 16. Breastfeeding Questions 1. 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? QQ. Begin supplementing with iron. RR. Continue to nurse as long as desired. Correct SS. Discontinue the vitamin D supplement. TT. Stop breastfeeding at 1 year of age. 2. 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 TT. calcium deficiency. UU. excess caloric intake. VV. excess fat intake. WW. protein deficiency. Correct 3. 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? RR. Whole milk is usually not fortified with vitamin D. SS. 2% milk is higher in essential proteins and minerals. TT. Young children don‟t need the extra calories found in whole milk. UU. Younger children need a limited amount of fats. Correct 4. 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? WWW. Ask the parents to provide a 3day food diary. Correct XXX. Prescribe a daily multivitamin with iron. YYY. Reinforce the need to meet DRIs each day. ZZZ. Tell them that supplements are unnecessary 5. 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? KK. Evaluate the child’s feeding and elimination behaviors and ask the family to describe mealtime routines. Correct LL. Recommend giving a multivitamin and offering highcalorie foods, such as ice cream. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 MM. Refer the child to a feeding evaluation clinic for a swallow study and evaluation of possible GERD. NN. Suggest that the parents supplement the child‟s food intake with a Highcalorie formula. 6. 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 refusesmI vegetables. What will the nurse practitioner recommend? Z. Giving the child a multivitamin since this is a phase AA. Having the child eat vegetables before getting the hamburger C. Providing a variety of healthy foods at each meal Correct D.Putting extra lettuce and tomatoes on hamburgers ost 7 . The parents of a toddler tell the primary care pediatric nurse practitionerthat they get frustrated trying to get the child to eat any vegetables other than squash and carrots. What will the nurse practitioner recommend? GG. Continue to offer a variety of foods without forcing the child toIeat them. Correct HH. Offer snacks to make up for calories the child misses by not eating the vegetables. II. Prepare dishes the child likes to ensure that a vegetable is eaten at each meal. JJ. Require the child to take 1 to 2 bites of each food at each meal. 8. 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? KK. “Foods given for this purpose do not meet all the child‟s nutritional needs.” LL. “Giving infants control of the feeding process will help prevent obesity.”MM. “Infants are given soft, mashable table foods when able toselffeed.” Correct NN.“Infants must beable tograsp andfeed themselves froma spoon todothis.” . 9. 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, whichnutrients may this adolescent need to supplement? A. Calcium, vitamin C, and vitamin A B. Iron, folic acid, and B12 Correct FF. Magnesium, vitamin E, and zinc GG. Vitamin D, vitamin C, and phosphorus 10. The primary care pediatric nurse practitioner is evaluating a schoolage child who, after removal of a pituitary tumor, has altered hypothalamic control overhunger and satiety. The child is morbidly obese and expresses feeling depressed because of the obesity. What will the nurse practitioner recommend? Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 OO. Consultation with a lactation specialist to assess intake PP. Pumping her breast during the night to maintain milk supply QQ. Supplementing the last feeding of the day with formula D. Waking the infant up at least every 3 hours to nurse Correct 9. 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 willIthe nurse practitioner include in teaching this mother? A. Frozen breast milk may be stored up to 3 months in a 0° F freezer. Correct HH. Once shebeginspumping theinfant should drinkonly pumpedbreast milk. II. Pumped breast milk must be discarded after 3 days when storedin the refrigerator. JJ. Unused defrosted breast milk may be stored in the refrigerator for 48 hours. 10. The mother of a 2monthold infant tells the primary c are 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? HH. Recommend pumping her breasts after feedings. II. Refer the mother to a lactation consultant. JJ. Suggest supplementation with formula. KK. Weigh the infant to assess for a growth spurt. Correct 11. 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? DD. Breastfeed only at bedtime to establish meal patterns. EE. Clean the toddler’s teeth each time after breastfeeding. Correct FF. Offer the breast just prior to meals to maintain milk supply.GG. The toddler should continue to be breastfed “on demand.” 12. The primary care pediatric nurse practitioner is performing an assessment on a 1weekold 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? W. Order home phototherapy and closely monitor bilirubin levels. X. Reassure the mother that the bilirubin level will drop in a few days. Y. Recheck the serum bilirubin and infant’s weight in 24 hours. Correct Z. Recommend that the mother pump her breast milk for a couple of days. Chapter 18. Elimination Questions 1. The primary care pediatric nurse practitioner is performing a well child exam on a 4monthold infant who is nursing exclusively. The mother reports that the infant has hada marked decrease inthe numberofstools each day, from 3 to 5 stoolseachday to only one stool every other day. How will the nurse practitioner respond? Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 YY. Ask the mother to describe the color and consistency of theIstools. Correct ZZ. Explain to the mother that breastfed infants should have daily stools.AAA. Recommend using a glycerin suppository as needed. BBB. Suggest to the mother that she increase her intake of fluids. 2. The primary care pediatric nurse practitioner is performing a well child exam on a 12monthold infant. The parent tells the nurse practitioner that the infant has predictable bowel and bladder habits and asks about toilet training. What will the nurse practitioner tell this parent? BBB. It is too early to begin introducing the child to the toilet, and the parent should wait until the child is at least 2 years old. CCC. Placing the child on a “potty” chair helps the child associate elimination cues with the toilet. Correct DDD. Predictability of elimination patterns indicates readiness for toilet training, and the parent can begin this process. EEE. The parent should wait until other signs of toilet training readiness occur before introducing the child to the toilet. 3. The primary care pediatric nurse practitioner is performing a well child exam on a 24monthold child. The parent tells the nurse practitioner that the child is being toiletItrained and expresses frustration that on some days the child uses the toilet every time and on other days not at all. What will the nurse practitioner do? XX. Advise the parent to make the child get clean clothes after an accident. YY. Ask the parent about the child’s toilet habits and understandingof toilet training. Correct ZZ. Recommend using anawards system to encourage toilet use. AAA. Suggest that the parent place the child on the toilet at predictable intervals. 4. The primary care pediatric nurse practitioner is discussing toileting issues with the parent of a 3yearold toddler who reports that the child has been toilet trained for several months buthasrecently been refusing tohavebowel movementsand is becoming constipated. What will the nurse practitioner do? OOOO. Ask the parent about bathroom facilities in the child’s day care. Correct PPPP. Refer the child to a gastroenterologist for evaluation of pathology. QQQQ. Suggest putting the child in diapers and resuming toilet training in a few weeks. RRRR. Tell the parent that this represents a developmental delay. 5 . The primary care pediatric nurse practitioner is evaluating a 5yearoldchild who has frequent soiling ofstoolassociated with stomach aches anddecreased appetite for the past 2 months. The parent states that the child has two or fewer formed bowel movements each week Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 and has been toilet trained for about 2 years. Which initial assessment willthe nurse practitioner make? SS. History of neurogenic conditions TT. Recent adjustments in the family C. Recent illnesses, fluid intake, changes in diet Correct D. Toilet training history 6. The primary care pediatric nurse practitioner is managing a 6yearold child who has chronic constipation and encopresis. The nurse practitioner hasruled out neurogenic etiology. The parents report that the child was difficult to toilet train as atoddler. What is key to managing this child‟s condition? A. Encouraging use of maintenance medications for at least 2months after resolution of constipation Correct EE. Referral to a mental health consultant to manage problems in the parentchild dyad FF. Spending time with the parents to uncover their feelings about theirchild‟s condition GG. Teaching the parents that the symptom of stool retention is often voluntary for the child 7. The parent of a 5yearold child tells the primary care pediatric nurse practitioner that the child has been using the toilet to urinate for since age 3but continues to defecate in “pullups.” The nurse practitioner learns that the child has predictable bowel movements and a physical examination is normal. What will the nurse practitioner recommend? OO. Providing a reward system to offer incentives when the child uses thetoilet PP. Put the child back in diapers and resume toilet training in a few months.QQ. Putting the child on the toilet for 5 to 10 minutes at the usual time of defecation Correct RR. Use of polyethylene glycol until the child is able to use the toilet regularly . . . . 8. The primary care pediatric nurse practitioner evaluates a 4yearold girl . whose parent reports frequent urination in the evenings on weekdays, incontinence after voiding. The parent reports that the child has soft formed stools 5 or 6 times weekly. Which assessment will the nurse practitioner make initially? A. Examination for labial adhesions Correct RR. Palpation for abdominal masses SS. Screening for potential child abuse TT. Urine culture and sensitivity 9. The primary care pediatric nurse practitioner is co ncerned that a toddler may Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 HH. Avoiding strength training programs until after puberty to minimize the risk for injury II. Enrolling their daughter in a program that uses fixed weight machines or resistance bands Correct JJ. Having their daughter participate in weight training 4 or 5 times each week for maximum effect KK. Making sure that their daughter begins with the greatest weight tolerable using lower repetitions 7. The parent of a 14yearold child asks the primary care pediatric nurse practitioner how to help the child prevent injuries when basketball tryouts begin later in the school year. Which recommendation will be of most benefit? A. Preseason conditioning Correct SS. Proper footwear TT. Protective knee braces UU. Stretching before practices 8. The primary care pediatric nurse practitioner is counseling a parent about bicycle helmet use. The parent reports having a helmet used a year previously by an older child and wonders about using it for a younger child since they are so expensive. What will the nurse practitioner tell the parent? UU. “As long as the helmet does not have cracks, you may use it.” VV. “If the helmet is free from marks, you may use it.” Correct MM. “You may continue to use a helmet up to 10 years.” NN. “You should always purchase a new helmet for each child.” 9. The primary care pediatric nurse practitioner is performing a well child examination on a high school age adolescent who plays football who has hypercalciuria. Which dietary supplement will the nurse practitioner question the adolescent about? A. Protein supplements Correct PP. Salt tablets QQ. Sports drinks RR. Vitamin C 1 0. The primary care pediatric nurse practitioner is performing a preparticipation sports physical examination on a 14yearold male who will be on the wrestling team at school. What will the nurse practitioner include when discussing healthy practices with this adolescent? A. Risks associated with repeatedly losing and gaining weight Correct LL. The need for an electrocardiogram or echocardiogram prior toparticipation MM. The need to consume 20 to 30 grams of protein after exercise NN. To consume water with CHO prior to activity lasting up to an hour 11. The primary care pediatric nurse practitioner is evaluating a heart murmur during a preparticipation examination of a high school athlete. Which finding would be a concern requiring referral to a cardiologist? AA. A murmur that islouderwhen squatting and softer whenstanding BB. A murmur that is quieter when squatting and louder with a Valsalva maneuver Correct CC. A murmur with narrow and variable splitting of S2 DD. A systolic murmur that is grade 1 or 2 Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 12. The parent of a 12yearold child who has sickle cell trait (SCT) asks the primary care pediatric nurse practitioner whether the child may play football. What will the nurse practitioner tell this parent? J. Children with SCT should not play any contact sports. K. Children with SCT may not play for NCAA schools in college. L. Children with SCT should follow heat acclimatization guidelines. Correct M. Children with SCT should not participate in organized sports. 13. The parent of a child newly diagnosed with epilepsy asks the primary care pediatric nurse practitioner if the child will ever be able to participate in gymor sports. What will the nurse practitioner recommend? C. Bicycle riding is not safe for children with seizures. D. Contact sports should be avoided. E. Direct supervision of some activities is necessary. Correct F. Underwater sports are not recommended. 14. The primary care pediatric nurse practitioner diagnoses a high school basketball player with mononucleosis. The adolescent asks when she may resume play. What will the nurse practitioner tell her? B. After 3 weeks, she may begin lifting weights but not full sports. C. After 4 weeks, she may return to full play and practice. D. At 4 weeks, she must have an exam to determine fitness for play. Correct E. She may engage in moderate exertion and practice after 3 weeks. 15. A 12yearold child who plays soccer is diagnosed with vocal cord dysfunction. What will the primary care nurse practitioner say when the child‟s parents ask about continued sports participation? A. The child may continue to participate in soccer. Correct B. The child should limit activity to nonaerobic sports. C. This condition is a contraindication for all sports. D . This condition predisposes the child to sudden cardiac death. 16. The parent of a high school basketball player tells the primary care pediatric nurse practitioner that the adolescent becomes short of breath only when exercising. What will the nurse practitioner recommend? A. Permanent discontinuation of all strenuous and aerobic activities B. Enrollment in a conditioning program to improve performance C. Evaluation for underlying cardiac causes of this symptom Correct D. Treatment for exerciseinduced asthma with a bronchodilator 17. A 10yearold is hit in the head with a baseball during practice and is diagnosed with concussion, even though no loss of consciousness occurred. The primary care pediatric nurse practitioner is evaluating the child 2 weeks after the injury and learns that the child is still experiencing some sleepiness every day. The neurological exam is normal. The child and the parent are adamant that the child be allowed to return to play baseball. What will the nurse practitioner recommend? A. Continuation of cognitive rest only B. Continuation of physical and cognitive rest Correct A. Continuation of physical rest only B. Returning to play Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 18. A 15yearold female basketball player who has secondary amenorrhea is evaluated by the primary care pediatric nurse practitioner who notes a BMI in the 3rd percentile. What will the nurse practitioner counsel this patient? A. That amenorrhea in female athletes is not concerning B. That she should begin a program of plyometrics and strength training C. To consider a different sport, such as volleyball D. To work with a dietician to improve healthy weight gain Correct 19. The primary care pediatric nurse practitioner is examining a 17yearold male who is on his high school swim team. The adolescent is concerned about “lumps” on his chest. The nurse practitioner notes a marked increase in weight since the last visit along with worsening of the adolescent‟s acne. Given this set of symptoms, which performance enhancing substance will the nurse practitioner be most concerned about and askIa A. Creatine B. Dehydroepiandrosterone (DHEA) Correct A. Ephedra B. Growth hormone Chapter 20. Sleep Questions bout? 1. The primary care pediatric nurse practitioner is performing a well child examination on a 4yearold child. The parent reports that the child snores frequently, often awakens during the night, and seems cranky during the day. What will thenI practitioner tell this parent? GGG. Most sleep disorders are benign and will be outgrown. HHH. Sleep disorders are symptomatic of underlying behavior problems. urse III. Sleep disordersat this agecanhave longterm impactsonlearning. Correct JJJ. The child will need longer daytime naps to compensate for lost sleep. 2. The parent ofaschoolage child who is overweight tells the primary care pediatric nurse practitioner that the child seems to crave highcalorie, highcarbohydrate foods, even when full. The nurse practitioner learns that the child is often irritableand sleepy at school in spite of sleeping 9 or 10 hours each night. What will the nurse practitioner recommend? JJJ. Assessment of leptin and ghrelin hormone levels KKK. Consultation with a dietician to develop an appropriate diet C. Referral to a sleep disorder clinic for a sleep study Correct D. Taking one or two naps each day to increase the amount of sleep 3. The primary care pediatric nurse practitioner is performing a well baby examination on a 2weekold infant. The parent is concerned that the infant sleeps too much. The nurse practitioner asks the parent to keep a sleep log and will teach theparent that which amount of sleep per day is optimal for this infant? EEE. 10 to 12 hours FFF. 12 to 15 hours C. 15 to 18 hours Correct D. 18 to 20 hours Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 EE. Craniofacial surgery FF. Oral appliances C. Positive airway pressure therapy Correct D. Supplemental oxygen . Chapter 21. Sexuality Section Questions 1. The mother of a 3monthold male infant tells the primary care pediatric nurse practitioner that she occasionally notices he has a penile erection just after nursing. What will the nurse practitioner tell the mother? KKK. Infants should be prevented from masturbating. LLL. The infant is conscious of the pleasure associated with nursing.MMM. This is a form of infantile priapism. NNN. This is a normal, reflexive behavior at this age. Correct 2. The primary care pediatric nurse practitioner is performing a well child examination on a 3yearold. The child‟s parent reports that the child has recently begun masturbating. What will the nurse practitioner counsel this parent? LLL. To allow the behavior whenever it occurs, since it is normal MMM. To discuss sexuality with the child NNN. To explore whether the child is being abused D. To teach the child about privacy and hand hygiene Correct 3. The parent of an 8yearold child tells the primary care pediatric nurse practitioner that the child has begun toaskquestions about why aschoolmate has “2 daddies” and wonders how to talk to the child about this. What will the nurse practitioner recommend? GGG. Beginning a discussion about different types of sexual relationships and samesex partners HHH. Discussing the issue with the child in terms of the parent‟s religiousvalues and norms III. Explaining that not all families are the same and what is most important is that they love and care for their children Correct GGGGG. Telling the child that some adult relationships are complicated and will be understood when the child is older 4. The primary care pediatric nurse practitioner is performing a well child exam on an 8yearold girl and notes the presence of breast buds. What will the nurse practitioner include when initiating anticipatory guidance for this patient? A. A discussion about the risks of pregnancy and sexually transmitted diseases B. Information about sexual maturity and menstrual periods Correct AAA. Material about the human papillomavirus vaccine BBB. Sexual orientation and the nature of sexual relationships Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 . 5. The primary care pediatric nurse practitioner is co unseling the parents ofa 13yearold female who has Down syndrome about sexual maturation. What will the nurse practitioner tell these parents? OO. It is important to discuss and support healthy sexuality. CorrectPP. Providing too much information about sexuality may be confusing given the child‟s cognitive level of understanding. QQ. Suppressing periods with contraceptives will lessen their daughter‟s distress. RR. They should give her information about periods but not about sexuality. 6 . During a well child exam on a 13yearold female, the primary care pediatric nurse practitioner notes that the child is at Tanner Stage 3. During the exam, when the nurse practitioner initiates a conversation about healthy sexuality education, the parent states that this topic is “off limits.” What will the nurse practitioner do? XX. Askthe adolescent whether shewishes to discuss these matters sinceshe is becoming an adult. YY. Separate the parent from the adolescent to discuss the adolescent‟s concerns in private. ZZ. Spend private time with the parent to discuss how sexuality education reduces the risk of early sexual intercourse and risky sexual behaviors. CorrectAAA. Tell the parent that this information is a routine part of adolescent well child examinations and must be included. 7. During a well child examination, a 15yearold female tells the primary care pediatric nurse practitioner that some of her friends have begun having sex. She has a boyfriend but denies engaging in sex with him. What will the nurse practitioner do initially? HHH. Ask her for her definitions of “sex.” Correct III. Discuss the risks of sexually transmitted diseases. JJJ. Find out if she is considering sexual relations. KKK. Give her information about contraception. 8. During a well child examination of a 6yearold girl, the primary care pediatric nurse practitioner notes that the child becomes embarrassed and resists taking off her underwear for the exam. What should the nurse practitioner infer from this observation? QQ. The child has been sexually molested. RR. The child is feeling violated by the examiner.SS. The parent is exhibiting regressive behavior. TT. This is a normal reaction in a child of this age. Correct Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 . 9. The primary care pediatric nurse practitioner is providing anticipatory guidance to the parent of a schoolage boy. The parent expresses concerns that the child prefers to play with dolls, is worried that the child will be a homosexual,and asks what can be done to prevent this from happening. What will the nurse practitioner tell this parent? WW. Homosexual identity formation cannot be predicted by early childhood behavior. XX. Masculinizing boys from an early age helps to determine heterosexual orientation. YY. Sexual orientation identification begins late in adolescence and not in childhood. ZZ. The development of sexual orientation is generally amultifaceted process. Correct Chapter 22. Immunizations Questions 1. A 2monthold infant has a staccato cough and fever. Which aspect of the history is most important in determining the diagnosis? A. Daycareattendance B. Immunization history Correct OOO. Medication history PPP. Past medical history 2. When reviewing a white blood cell (WBC) count, the primary care pediatric nurse practitioner suspects a viral infection when which WBC element is elevated? OOO. Bands PPP. Leukocytes C. Lymphocytes Correct D. Neutrophils 3. 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 JJJ. Lymphocyte count of 8.7 KKK. Platelet count of 475 LLL. White blood cell count of 14 4. A toddler is receiving longterm antibiotics to treat osteomyelitis. Which laboratory test will the primary care pediatric nurse practitioner order to monitorresponse to therapy in this child? A. Blood cultures B. Erythrocyte sedimentation rate (ESR) Correct c. Serum procalcitonin (ProCT) d. White blood count (WBC) Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 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? F. HAV vaccine G. Immunoglobulin G H. Interferonalfa D. Supportive care Correct 17. 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? E. Consult a pediatric infectious disease specialist. Correct F. Prescribe interferonalfa. G. Provide supportive care. H. Consider use of lamivudine. 18. 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? C. Obtain regular absolute neutrophil counts. Correct D. Perform routine skin cultures for herpes simplex virus. E. Reinforce the need to give acyclovir indefinitely. F. Stop the oral acyclovir at 2 months of age. 19. 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? C. Administer immunoglobulin G to prevent fulminant illness. D. Perform serologic testing for human herpes virus 6 and human herpes virus 7. E. Reassure the parent that this is a mild, selflimiting disease. Correct F. Recommend avoiding contact with pregnant women. 20. A child whois immunocompromised has a fever and a rash consisting of macules, papules, and pustules. What will the primary care pediatric nurse practitioner do? D. Administer varicella immune globulin (VariZIG). E. Hospitalize the child for intravenous acyclovir. Correct F. Order intravenous immunoglobulin as an outpatient. G. Prescribe oral acyclovir for the duration of the illness. 21. 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? C. The child may attend day care aslong as no rash is present even with mild fever or other symptoms. D. The child should remain home and receive oral acyclovir for 5 days to prevent onset of symptoms. E. The child should stay home until the 21day incubation period has passed even if symptom free. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 F. The child should stay home if any symptoms occur and may return in 1 week if no rash develops. Correct 22. 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? B. Consider therapy with rimantadine. C. Hospitalize for supportive treatment. C. Prescribe oseltamivir and follow closely Correct D.Wait for cultures to determine treatment. 23. The 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 thischild? A. Consult with a pediatric HIV specialist. Correct B. Discontinue cART after 4 weeks of age. C. Obtain a CD4+ cell count and HIV RNA levels. D. Reinforce the need to give cART for life. 24. 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? A. Administer the MMR vaccine to help prevent disease. Correct B. Give antiviral medications at the first sign of symptoms. C. Give the child a dose of immune globulin to mitigate the response. D. Reassure the parent that most exposed children will not get measles. 25. A preschool age child is brought to clinic for evaluation of a rash. The primary 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? A. This rash may be a prodromal sign of rubella or roseola. B. The child will need immunization boosters to prevent serious disease. C. This is a benign rash with no known serious complications. D. Expect a lacy, maculopapular rash to develop on the trunk and extremities. Correct 26. 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? A. Assessment of maternal rubella titers Correct B. Intravenous immunoglobulin for the child C. MMR vaccine for the mother and child D. Possible termination of the pregnancy 27. A child is brought to the clinic with a fever, headache, malaise, and a red, annular macule surrounded by anareaofclearing andalarger, erythematousIannular ring. The child complains of itching at the site. What will the primary care pediatric nurse practitioner do to Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 determine the diagnosis? A. Ask about recent tick bites Correct A. Obtain a skin culture B. Order blood cultures D. Perform serologic testing 28. Achild whose family has been camping in aregion 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. Whatis the action? C. Administer a prophylactic single dose of doxycycline. D. Perform serologic testing for IgG or IgM antibodies. E. Prescribe amoxicillin three times daily for 14 to 21 days. F. Teach the parents which signs and symptoms to report. Correct 29. A 10monthold nfant has an erythematous, fluctuant, nondraining abscess on the right buttock after 10 days of treatment with amoxicillin for impetigo. What is the next stepinmanaging this infant‟s care? A. Consultation with a pediatric infectious disease specialist B. Culture of any superficial open surface wounds C. Empiric treatment with clindamycin D. Incision and drainage of the abscess with culture Correct 30. 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? A. Obtain a complete blood count and Creactive protein. B. Order an immunofluorescent assay (IFA) for serum antibodies. Correct C. Perform a needle aspiration of the affected lymph nodes. D . Prescribe a 5daycourse of azithromycin. 31. A 7yearold bchild whose immunizations are uptodate has a fever, headache, stiff neck, and photophobia. What course of treatment is indicated? A. Empiric treatment with oral antibiotics or intramuscular ceftriaxone B. Hospitalization for diagnosis and treatment with antibiotics Correct C. Immediate vaccination with meningococcal vaccine D. Outpatient lab work, including a CBC and blood and CSF cultures C. 32. 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 streptest is positive. What will the nurse practitioner do to manage this child‟s illness? A. Administer intramuscular ceftriaxone. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 . 10. A child has several shallow mucosal lesions on the buccal mucosa and tongue that are surrounded with an erythematous halo and covered by yellowplaques. What will the primary care pediatric nurse practitioner recommend? A. Chlorhexidine gluconate Correct EEE. Diphenhydramine and Maalox FFF. Oral acyclovir GGG. Topical antiviral medication 11. During a well child exam, the primary care pediatric nurse practitioner notes yellowishwhite serpentinebordered lesions on the anterior portion of a child‟s tongue. What will the nurse practitioner do? UU. Order chlorhexidine gluconate rinses to treat the lesions. VV. Prescribe oral acyclovir to shorten the course of the disease. WW. Reassure the parent that these are benign lesions. Correct XX. Refer the child to a pediatric dentist for evaluation. 12. A 4yearold child who has asthma has teeth with smooth, cuppedout teeth on the chewing surfaces. Which is the most likely explanation for this finding? KK. Bruxism LL. Bulimia MM. Decreased saliva D. Gastroesophageal reflux Correct 13. An adolescent female reports facial pain and frequent popping of her jaw. An exam reveals unilateral tender facial muscles and a deviation of the mandible to the affected side with opening of the mouth. What will the primary care pediatric nurse practitioner do? JJ. Recommend ice packs, NSAIDs, and a soft diet. Correct KK. Refer to a pediatric mental health specialist. LL. Refer to an orthodontist for a surgical intervention. MM. Suggest obtaining Botox injection treatments. 14. A 5yearold child is hit in the face with a baseball bat and is brought to the clinic by a parent. An exam reveals three avulsed front teeth. Radiologic studiesIare negative for facial fractures. What is the recommended treatment? I. Prescribe tetracycline 4.4 mg/kg twice daily for 7 to 10 days. J. Refer the child to a dentist for reimplantation of the avulsed teeth. K. Refer the child to a dentist immediately for further examination. Correct L. Remove the teeth, place them in saline, and refer the child to a dentist. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 . 15. A child with cerebral palsy receives all nutrition via gastrostomy t ube. What will the primary care pediatric nurse practitioner recommend to promote dentalhealth in this child? A. Applying topical iodine every month B. Daily chlorhexidine gluconate rinses Correct I. Ordering medications to prevent drooling J. Prescribing prophylactic antibiotics Chapter 24. Intentional and Unintentional Injuries: Injury Prevention Child Maltreatment 1. Which of the following statements best defines the term child maltreatment? a. intentional injury of a child c. failure to provide what a child needs b. not giving achild what he orshewants d. accidental harm to a child by someone ANS: A 2. Which of the following statements best defines the term physical abuse? a. bodily injury to a person that seems to have been inflicted by other than accidental means b. purposefully beating a child so that there are highly visible marks on the childs body c. useof the hands applied toachild inan excessively forceful manner d. any damage to a child that involves the use of muscle-applied force ANS: A 3. The school nurse observes parents interacting with a school-aged child and notices that they do not show any affection toward the child and there is no evidence of emotional support or supervision. Later the nurse learns from the child that he must take care of all his own hygiene tasks, has to find something to eat on his own, and his parents never say anything nice about him. The nurse at this point believes that the parents are engaging in: a. physical abuse c. poor parenting b. psychological abuse d. withholding of love ANS: B 4. The majority of perpetrators of abuse to children reported to state Child Protective Service agencies as suspected victims of abuse and neglect are: a. neighbors within one block c. parents b. strangers d. relatives other than parents ANS: C 5. The majority of child abuse victims fall into which of the following age ranges? a. over 10 years c. 6 to 8 years b. 8 to 10 years d. under 6 years ANS: D 6. Which of the following is the most common type of mistreatment of children? a. physical abuse c. sexual abuse b. neglect d. emotional maltreatment ANS: B Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 7. In the sociological model of family violence, family violence is viewed as: a. a pattern of behavior that is passed from generation to generation b. a pattern of harm within the nuclear family with no outside persons involved c. any harmful action(s) between related persons no matter how distant the relationship is d. harmful activities within a group designated as family no matter what the relationship ANS: A 8. When family violence is passed from generation to generation, this type of abuse has which of the following characteristics? a. It continues without changing to another type. b. The form of abuse may change. c. It usually gets more violent. d. It is more detrimental to the child from generation to generation. ANS: B 9. Which of the following children is in a high-risk family for less nurturing and more hurtful behavior? a. achild being raisedby grandparents b. a child who is forbidden from playing with other children c. a child being raised by two men d. a child in a nuclear family there both parents have full-time jobs ANS: B 10. The social-interactional systemic perspective of child abuse and neglect says that the legitimization of violence in the family is due to which of the following factors? a. family pathology of a genetic nature b. increased availability of pornography c. emphasis on hiding sexuality and not being open d. societys attitudes, beliefs, and values ANS: D 11. According to the social-interactional systemic perspective of child abuse and neglect, four factors place the family members at risk for abuse. These risk factors are the family itself,the caregiver, the child, and: a. chronic poverty c. the presence of a family crisis b. genetics d. the national emphasisonsex ANS: C 12. When caregivers lack knowledge about parenting, lack parenting skills, and are emotionally immature, the child often assumes which of the following roles? a. victim b. caregiver role toward the caregiver c. regressedchild ofregressedcaregivers d. scapegoat ANS: B 13. Which of the following examples best defines the term role reversal? a. The child assumes a caregiver role toward the caregiver. b. The good child takes on a bad child role. c. A person who has been a good provider quits his or her job. d. A lazy person becomes very productive in the family. ANS: A Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 UUU. considerably more time in each encounter. VVV. improved patient health outcomes. Correct WWW. less PNP involvement in health care decisions. XXX. lower provider and higher patient satisfaction. 2. The primary care pediatric nurse practitioner diagnoses a 5yearold child with asthma and prescribes an oral steroid and a shortacting betaadrenergicmedication via a metereddose inhaler to manage acute symptoms. Along with education about the prescribed medications, what information is important to give the child‟s family at thisvisit? A. Anasthmaaction plan B. Effects and side effects of current medications Correct UUU. Information about spirometry testing VVV. Instructions for medications at school 3. 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? PPP. Admit the child to the hospital for close observation and monitoring of respiratory status. QQQ. Encourage the parent to call when concerned and schedule a followup appointment the next day. Correct RRR. Perform a complete blood count, blood cultures, and a chest radiographto evaluate symptoms. SSS. Reassure the parent that the child has a normal exam and is most likely not ill. 4. Which characteristic is the key criterion that identifies a child has having special needs? A. Cognitive function B. Emotional health C. Health service requirements Correct D. Medical diagnosis . 5. The primary care pediatric nurse practitioner is performing a well baby examination on a 2weekold infant who was recently discharged home from the neonatal intensive care unit. The mother reports that the infant was born at 26 weeks‟ gestation and states she was told that her baby will probably have developmental delays. What is the most important aspect of longterm management forthis infant? A. Careful monitoring of attainment of developmental milestones Correct LLLLL. Familiarizing the parent with laws that mandate educational support MMMMM. Providing genetic counseling to the infant‟s parents NNNNN. Referral to social services for assistance with resources Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 6. The primary care pediatric nurse practitioner is preparing to perform a well child examination ona 5yearold child who has multiple developmental and cognitive delays. The child‟s mother is angry and tells the nurse practitioner that her friends‟ children areall preparing for kindergarten. The nurse practitioner will QQQ. allow the mother to express her feelings, understanding thatshe is experiencing grief. Correct RRR. reassure the mother that special educational opportunities are available for her child. SSS. suggest that the mother find a support group with other children with special needs. TTT. tell her that most schools provide services for children with specialhealth care needs. 7. The parent of a toddler who has special health care needs is resistant to a suggestion that her child needs a gastrostomy tube for nutrition. The toddler has fallen from the 10th percentile to the 5th percentile in the past few months and resists taking in appropriate amounts of food by mouth even with assistance from occupational therapy. What will the primary care pediatric nurse practitioner do? YY. Inform the mother that, since other options have failed, the gastrostomy tube is the only option. ZZ. Refer the child to a dietician to teach the mother the importance ofadequate nutrition. AAA. Set weight gain and food intake goals with the mother and schedule regular visits to monitor weight. Correct BBB. Suggest that thegastrostomytube may be triedtemporarily andremoved once the child gains weight. 8 . 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 andschoolbased services? A. Assessing the parent‟s ability to perform home care tasks B. Coordinating services to ensure continuity of care Correct C. Monitoring the family‟s adherence to the health care plan D. Ordering medications and other prescribed treatments 9. A toddler swallowed a coin several days prior. T he child‟s parent has not found the coin in the child‟s stool. Which imaging test will the primary care pediatric nurse practitioner employ to evaluate this ingestion? HHH. Abdominal ultrasound III. Computed tomography C. Conventional radiograph Correct D. Magnetic resonance imaging 10. The primary care pediatric nurse practitioner is assessing an ill 2monthold Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 infant who is febrile and refusing most fluids. The preliminary blood work indicatesa viral infection and shows that the infant is hydrated. The infant is alert. The infant‟s parents are attentive and live close by. What will the nurse practitioner do? SSS. Administer a parenteral antibiotic and antipyretic and send the infant home. TTT. Admit the infant to an inpatient hospital unit for overnight monitoring. UUU. Give the parents sick care instructions and follow up in the clinic in the morning. Correct VVV. Send the infant to the urgent care center for intravenous fluids. 11. A toddler is prescribed a liquid oral medication. The parent tells the primary care pediatric nurse practitioner that the child refuses to take medications and usually spits them out. What will the nurse practitioner do? CCC. Demonstrate oral medication administration with the toddler in the office. Correct DDD. Instruct the parent to hide the medication in a favorite food orbeverage. EEE. Order the medication to be given via another route if possible. FFF. Tell the parent to offer the child a reward each time the medication istaken. 12. The primary care pediatric nurse practitioner orders a pulmonology consult for a child who has severe asthma. The nurse practitioner writes “child withasthma refractory to conventional treatments needs suggestions for alternative treatments.” The nurse practitioner expects the pulmonologist to HHH. confirm the medical diagnosis for the child‟s parents. III. make recommendations for disease management. Correct JJJ. stress the importance of adherence to the medication regimen. KKK. take over management of this child‟s chronic illness. . 13. The primary care pediatric nurse practitioner c ares for several families with chronically ill children who text status updates about their children to a mobile device that has an encryptionprotection platform installed. If the nurse practitioner misplaces the mobile device, it is important to YY. disconnect the user from the system to avoid a data breach.Correct ZZ. notify the families that their messages may be read by others. AAA. obtain a new device as soon as possible to resume communication. BBB. upload the messages from another remote device. 14. The parent of an 18monthold child calls the clinic to report that the child has a rectal temperature of 100.4°F (38°C). The child is playing normally, taking fluids well, and has a slightly reduced appetite. What will the primary care pediatric nurse practitioner recommend? NN. Administering an antipyretic medication Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 LLL. teach the parents symptomatic care and order labs to help with the diagnosis. Correct MMM. write a prescription for an antibiotic to be given if the child‟scondition worsens. 7. The single mother of a 4yearold who attends day care tells the primary care pediatric nurse practitioner that she had difficulty giving her child atwicedaily amoxicillin for 10 days to treat otitis media during a previous episode several months earlier because she works two jobs and is too busy.The child has an ear infection in the clinic today. What will the nurse practitioner do? WWW. Administer an intramuscular antibiotic. XXX. Order twicedaily amoxicillin for 5 days. YYY. Prescribe azithromycin once daily for 5 days. Correct ZZZ. Reinforce the need to adhere to the plan of care. 8. The parent ofaschoolage 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 metereddose inhaler right away. What will the nurse practitioner do? GGG. Recommend that thechild gototheschool nurse when symptomsstart. HHH. Review the child‟s asthma action plan and possibly increase his steroid dose. TTT. Suggest asking the school to excuse the child from gym class. UUU. Write the prescription for two metereddose inhalers with spacers.Correct Chapter 27. Complementary and Integrative Health inPediatrics Questions 1. The primary care pediatric nurse practitioner is performing a medication history on a child and learns that the child‟s parents use various complementary treatments and remedies for the child. According to the American Academy of Pediatrics standard for providers, what will the nurse practitioner do? CCCC. Evaluate the safety and efficacy of each product and monitor use. Correct DDDD. Incorporate these therapies into standard care practices. EEEE. Recommend not using the products until the child is older. FFFF. Suggest that most of these treatments are not safe for children. 2. According to the 2007 NHIS analysis of the use of CAM therapy, use was higher among AAAA. families whose parent or parents had a college education. Correct BBBB. Hispanic and AfricanAmerican populations. CCCC. persons who had not recently taken prescription medications. DDDD. those living in households earning less than $65,000. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 3. The parent ofachild who has numerous allergies reports using herbal remedies to help treat the child because they are “natural” products. What will theprimary care pediatric nurse practitioner suggesttothis parent about usingthese products? XXX. Brandname herbal products have been tested for efficacy. YYY. Natural ingredients are usually safe for use in children. ZZZ. There are few interactions between drugs and supplements. AAAA. Use singleherb supplements whenever possible. Correct 4. Which label on a CAM therapy product verifies that a product meets standards for contamination, adulteration, manufacturing processes, and pharmacologic properties? . YYYYY. Generally Recognized as Safe (GRAS) ZZZZZ. National Sanitation Foundation International (NSF) AAAAAA. Natural Products Association (NPA) D. United States Pharmacopeia (USP) Correct 5. The parent of a newborn reports using echinacea for family members to help treat viral illnesses and feels that it is usually effective. What will the primary care pediatric nurse practitioner tell this parent? A. That echinacea has no known therapeutic effects and should not be given . B. That thesupplement shouldnotbegiven tochildren under 2 years ofage WWW. To give half the recommended adult dose until the child is 5 years old XXX. To wait until the infant is at least 1 month old before giving this product 6. Achild has wheat allergies and continues to have problems inspite of consuming a diet without breads and cereals. What will the primary care pediatric nurse practitioner caution the parents to look for on product labels that may indicate wheat products are present infoods? A. Casein B. Malt Correct GGG. Miso HHH. Whey 7. An adolescent will begin taking the combination oral contraceptive pill (OCP). Which supplement will the primary care pediatric nurse practitioner caution the adolescent to avoid while taking OCPs? NNN. Ginkgo OOO. Kava C. St. John‟s wort Correct D. Valerian Chapter 28. Pediatric Pain and Fever Management Questions Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 1. The primary care pediatric nurse practitioner is evaluating a 10yearold child who is describing shooting pain in both legs associated with aching, tingling,and burning. The child is unable to pinpoint specific locations for this pain. Which type of pain does the nurse practitioner suspect? A. Chronic pain B. Neuropathic pain Correct GGGG. Somatic pain HHHH. Visceral pain 2. A 3yearold child is recovering from injuries sustained in a motor vehicle . accident. How will the primary care pediatric nurse practitioner evaluate this child‟s pain? EEEE. Ask the child to rate pain intensity on a 4to 5item pain discrimination scale. FFFF. Have the child describe any pain as “no pain, a little pain, or alot of pain.” Correct GGGG. Question the child about the intensity and specific location of anypain. HHHH. Rely onnonverbal responses such asfacial expressions andlimb movements. 3. A 4yearold child has just been released from the hospital after orthopedic surgery on one leg following a bicycle accident. The child is sitting quietly onthe exam table. When asked to rate pain, the child points to the “1” on a faces rating painscale. What will the primary care pediatric nurse practitioner do next? BBBB. Assess the child’s vital signs and ability to walk without pain. Correct CCCC. Refill the prescription for a narcotic analgesic medication. DDDD. Suggest that the parents give acetaminophen for mild pain. E EEE. Teach the parent to give analgesics based on the child‟s report ofpain. 4. A developmentally and cognitively disabled 10yearold child who is unable to communicate must undergo a series of surgeries, and the child‟s parent asks how to know if the child is in pain and when to give pain medication. What will the primary care pediatric nurse practitioner teach this parent to use to assess this child‟s pain? BBBBBB. Comfort scale CCCCCC. FLACCscale C. NCCPCR Correct D. Nonverbal observations . 5. The primary care pediatric nurse practitioner is preparing to perform a painful procedure ona 4monthold infant. Besides providing local anesthesia, what other Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 AAAA. Encourage the mother to nurse the infant more frequently for shorter duration. BBBB. Obtain serum electrolytes and hospitalize for surgical intervention. Correct CCCC. Recommend oral rehydration fluids for 24 to 48 hours to correct dehydration. DDDD. Suggest trying a soybased or hydrolyzed protein formula until vomiting resolves. 6. A 5dayold infant who was delivered at home has abdominal distension and poor feeding. The mother is worried that the infant is constipated because he didn‟t have a first stool until yesterday and has only passed a small amount of meconium. What will the primary care pediatric nurse practitioner do? KKK. Obtain a sweat chloride skin test to evaluate for possible cystic fibrosis. LLL. Order an abdominal radiograph and refer the infant to a pediatric surgeon. Correct MMM. Prescribe glycerin suppositories to use as needed until bowel function is normal. NNN. Suggest that the mother increase her fluid intake to help with constipation. 7. The parent of a 4dayold infant tells the primary care pediatric nurse practitioner that the infant was diagnosed with hydronephrosis while in utero and asks what will be done. What will the nurse practitioner tell this parent? SSS. Renal function will be abnormal and will require lifetime treatment. TTT. Spontaneous resolution often occurs within 6 months to a yearof age. Correct UUU. The affected kidney will be nonfunctionalbut the other kidney will compensate. VVV. The infant will eventually require renal transplantation for thatIkidney. 8. A 2monthold infant has increased head circumference from the 10th percentile at the 2week exam to the 30th percentile today. What will the primary care pediatric nurse practitioner do? EEEE. Order a magnetic resonance imaging exam of the infant‟s head. FFFF. Refer the infant immediately to a pediatric neurosurgeon. Correct GGGG. Schedule frequent clinic visits to monitor head growth. HHHH. Watch the infant closely over time if the rest of the exam is normal. 9. A 3dayold infant has a total serum bilirubin (TSB) level of 15.7 mg/dL after having a TSB of 10.8 mg/dL 24 hours prior. The infant nursed 8 times, had 7wet diapers, and passed 4 stools in the past 24 hours. What is the indicated treatment for this infant? JJJ. Admit to an inpatient setting for phototherapy and every12hour bilirubin monitoring. VVV. Have the mother supplement with extra fluids and return to the clinic in 24 hours for a repeat TSB. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 WWW. Recommend nursing every 2 hours, order a biliblanket, and recheck TSB in 24 hours. Correct XXX. Suspend breastfeeding for 24 to 72 hours and have the mother save pumped breast milk. 10. The primary care pediatric nurse practitioner is performing a wellbaby examination on a 7dayold infant born to a Chlamydiapositive mother. The infant‟s eyes are clear without exudate. The infant is free from cough and lungs are clear. What willIthe primary care pediatric nurse practitioner do to prevent illness in this infant? CCC. Administer a single dose of intramuscular ceftriaxone. DDD. Obtain bacterial cultures of both conjunctivae. EEE. Prescribe prophylactic erythromycin suspension. FFF. Schedule a followup appointment in 1 week. Correct Chapter 30. Mental Health Disorders Questions 1. During a well child examination on a 4monthold infant, the primary care pediatric nurse practitioner evaluates mental health issues. Which statement by the parent indicates a potential problem with the parentinfant relationship? MMMM. “I cansensea difference inmy baby‟s cries.” NNNN. “I let my baby cry a while to learn to be patient.” Correct OOOO. “My baby prefers to nurse in a darkened room.” PPPP. “My baby seems very sensitive to loud noises.” 2. A child has a difficult temperament. What will the primary care pediatric nurse practitioner tell the parent about managing this child‟s behavior? MMMM. A difficult temperament is its own risk factor for maladjustment disorders. KKK. LLL. . NNNN. Children with difficult temperaments need strict adherence to rules. OOOO. Having a difficult temperament limits intelligence and emotional maturity PPPP. It is important for the parent to learn to manage criticism and power struggles. Correct 3. During a well child assessment of a preschoolage ch ild, the parent voices concerns that, because the child has behavior problems at school, the childmay have a mental health disorder. Which initial approach will provide the best information? JJJJ. Ask the parent whether other caregivers have voiced similar concerns. KKKK. Interview the child separately from the parent to encourage sharing of feelings. LLLL. Take time to actively listen to the parent’s and child’sperceptions of the problem. Correct MMMM. Use a validated screening tool to ensure that all aspects of behaviors are evaluated. 4. The primary care pediatric nurse practitioner attempts to learn more about the emotional health of an 18monthold Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 child through which assessment strategy? HHHHHH. Asking the child to tell a story using dolls and other props IIIIII. Asking the child to draw a picture of himor herself and other family members JJJJJJ. Interviewing the child separately from caretakers and parents KKKKKK. Observation of the child with caretakers in structured and unstructured situations Correct 5. A middleschoolage child is skipping school frequently and getting poor grades since the child‟s father was killed while deployed in the military. How will the primary care pediatric nurse practitioner manage this situation? EEEE. Prescribe shortterm antidepressants for this situational depression. FFFF. Refer the child to a mental health specialist for evaluation and treatment. Correct GGGG. Schedule extended appointments for counseling and mental health interventio. HHHH. Suggest that the child have close followup by a school counselor. 6. The parent of a 4yearold child reports that the child seems to be having trouble adjusting to a new day care and reportedly is always engaging in solitary play when the parent arrives to pick up the child. What will the primary care pediatric nurse practitioner do? OOO. Ask the parent if the child is slow to warm up to other new situations. Correct PPP. Reassure the parent that parallel play is common among preschoolage children. QQQ. Recommend that the parent spend time encouraging the child to play with others. RRR. Suggest that the day care center may be neglecting the child. 7. The parent ofaschoolage child is concerned because the child has started to express angerabout agrandparent‟s death even though this occurred whenthe child was a toddler. What will the primary care pediatric nurse practitioner tell theparent? WWW. Anger is an abnormal reaction to bereavement and loss in this age child. XXX. Counseling is needed since thechild has had sufficient time toresolvethis issue. YYY. Grief and bereavement lasting longer than a year may requiremedication. ZZZ. The significance of this loss must be reworked at each developmental level. Correct 8. The parent ofaschoolage child reports that the child doesn‟t like being alone in rooms because of a fear of aliens hiding in closets. What will the primary care pediatric nurse practitioner tell the parent? IIII. “Fear of imaginary creatures does not usually occur at this age.” Correct Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 • Consult with a child psychiatrist to prescribe an antidepressant medication. • Reassure the parent that this behavior is common after mild depressive symptoms. • Refer the child to a child psychiatrist for evaluation of bipolar disorder. Correct 18. A toddler has begun hitting and biting other children at a day care center and is exhibiting temper tantrums and bad language at home. The parent reports that these behaviors began shortly after a sibling was born. What will the primary care pediatric nurse practitioner do? A. Advise the parent that the child is exhibiting early symptoms of ADHD. G. Engage the parent in positive parenting strategies to facilitate appropriate child coping. Correct H. Recommend evaluating the child for conduct or oppositional defiant disorder. I. Suggest putting the child in another day care center to ameliorate the problems. 19. A 14yearold female comes to the clinic with amenorrhea for 3 months. A pregnancy test is negative. The adolescent‟s body weight is at 82% of expected for height and age. The mother reports that her daughter often throws up and refuses to eat most foods. Which condition does the primary care pediatric nurse practitioner suspect? A. Anorexia nervosa Correct H. Bulimia nervosa I. Depression J. Substance abuse Chapter 31. Infectious Diseases 1. Which of the following is a consideration in the administration of immunizations? 1. Immunizations can only be administered if a child is free from any illnesses. 2. Caregivers should administer aspirin prior to the injection to prevent any side effects. 3. Children should be isolated from other children for 24 hours after receiving immunizations. 4. Caregivers should be advised that immunizations maycause a mild feveror soreness and redness at the injection site. ANS: 4 2. A vaccine that contains fragments of cells that stimulate an immune response, but does not contain the whole cell is known asa: 1. Toxoid. 2. Subunit. 3. Acellular. 4. Attenuated. ANS: 3 3. Which of the following is true about immunizations containing thimersaland autism? 1. Thimersal has been removed from all vaccines. 2. Only the MMRvaccineisassociated withautism. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 3. Thimersal has been linked to learning disabilities, but not autism. 4. Researchers have found no evidence that thimersal is linked to autism. ANS: 4 4. A 27-year-old mother has just delivered a healthy 7 lb. 3 oz. baby boy. Which of the following is true regarding the babys immunization schedule for Hepatitis B? 1. The infant will need two doses administered at least 6 months apart. 2. The infant should not receive the vaccine until at least 12 months of age. 3. The infant will not need any vaccines at this time because of passive immunity from the mother. 4. If the mother is Hepatitis B surface antigen positive, the baby will need 0.5ml of Hepatitis B Immune Globulin. ANS: 4 . . 5. A mother is bringing her 2-month-old son in for his well-child visit. He is due to receive his Diphtheria, Tetanus, and Pertussis vaccine. The nurse is educating the mother on the possible side effects of the vaccine, which include: 1. Pain and swelling in the joints. 2. Irritability, loss of appetite, and seizures. 3. Nausea, vomiting, and abdominal pain. 4. Fever and decreased white blood cell count. ANS: 2 6. When a fetus receives antibodies from the mother by way of the placenta, this is known as: 1. Activeimmunity. 2. Natural Passive immunity. 3. Transmission immunity. 4. Attenuated immunity. ANS: 2 7. Which ofthe following isa high riskgroup among children and adolescentsfor contracting Hepatitis B? 1. Those living in institutions 2. Individuals infected by sexual partners 3. Children who are hemophiliacs or are receiving frequent blood transfusions 4. All of the above ANS: 4 8. A 15-year-old girl has been diagnosed with Hepatitis B and will be starting treatment with Interferonalpha (IFN). The nurse needs to educate the patient on this medication. Which ofthe following should be included in this education? 1. The medication reduces the replication of the Hepatitis B virus. 2. The patient needs to remain on treatment for one year. 3. Patients may develop resistance to Interferon-alpha over time. 4. Interferon-alpha has fewer side effects than Lamivudine, which is also used to treat Hepatitis B. ANS: 1 9. A 6-year-old boy with Varicella-zoster (chickenpox) and a visible rash is being admitted to the hospital Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 for treatment of dehydration. Which of the following isolation precautions needs to be taken? 1. Contact 2. Airborne 3. Contact and droplet 4. Contact and airborne ANS: 4 10. The mother of a 4-year-old girl brings her daughter in to be evaluated fora fever of 101 degrees and a headache that has lasted for the past three days. The mother was concerned this morning when the child woke upand had reddened cheeks that lookedlikeshe had been slapped.The nurse suspects the child has: 1. Impetigo. 2. Fifths disease. 3. Germanmeasles. 4. Hand-Foot-Mouth Disease ANS: 2 11. Which of the following should be considered in the administration of the influenza vaccine? 1. The vaccine is contraindicated for individuals who are allergic to eggs or egg products. 2. The Live Attenuated Influenza Virus (LAIV) is a safe alternative for children of any age. 3. The influenza vaccine is contraindicated in children with asthma and wheezing within the past 12 months. 4. Since influenza has a bimodal seasonal pattern, children under 18 years of age should receive two doses of the vaccine. ANS: 1 . 12. The period of time when a child begins to have mild signs and symptoms until the main illness appears, and which is associated with increased communicability, is referred to as: 1. Transmission. 2. Susceptibility. 3. Prodromal period. 4. Incubation period. ANS: 3 13. Reyes Syndrome can be a life-threatening disease affecting the brain and liver of children. The cause of this disease comes from the ingestion of: 1. Ibuprofen during a viral illness. 2. Ibuprofen during a bacterial illness. 3. Aspirin or other salicylates during a viral illness. 4. Aspirin or other salicylates during a bacterial illness. ANS: 3 14. A mother brings in her 4-year-old daughter to be evaluated for a rash all over her torso. The mother states that the 4 year old was recently around her grandmother, who is presently recovering from shingles. The mother is now concerned that the child has contracted shingles. Which of the following would be an Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 4. All of the above ANS: 2 . 12. Fetal Alcohol Syndrome Disorder (FASD) is divided into foursubtypes. Asa nurse, you knowthat themostsevere typeis: 1. Alcohol-Related Birth Defects. 2. Alcohol-Related Neurodevelopmental Disorder. 3. Partial Fetal Alcohol Syndrome. 4. Fetal Alcohol Syndrome ANS: 4 13. Angelman syndrome isthe deletion ofwhichchromosome? 1. Maternal chromosome 12 2. Maternal chromosome 15 3. Paternal chromosome 17 4. Paternal chromosome 19 ANS: 2 Chapter 33. Atopic, Rheumatic, and Immunodeficiency Disorders Questions 1. An 8yearold 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? QQQQ. Complete remission occurs in some children at the age of puberty. RRRR. Periods of remission may occur but there is no permanent cure. Correct SSSS. SLE can be cured with effective medication and treatment. TTTT. The disease is always progressive with no cure and no remissions. 2. The primary care pediatric nurse practitioner examines a child who has had stiffness and warmth in the right knee and left ankle for 7 or 8 months but no back pain. The nurse practitioner will refer the child to a rheumatology specialist to evaluate for QQQQ. enthesitisrelated JIA. RRRR. oligoarticular JIA. Correct SSSS. polyarticular JIA. TTTT. systemic JIA. 3. The primary care pediatric nurse practitioner is managing care for a child who has JIA who has a positive ANA. Which specialty referral is critical for this child? A. Cardiology B. Ophthalmology Correct NNNN. Orthopedics OOOO. Pain management Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 . 4. The primary care pediatric nurse practitioner is prescribing ibuprofen for a 25 kg child with JIA who has oligoarthitis. If the child will take 4 doses per day, whatis the maximum amount the child will receive per dose? A. 200 mg B. 250 mg CorrectLLLLLL. 400 mg MMMMMM. 450 mg 5. The parent ofaschoolage 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? A. Running B. Swimming Correct IV. Weights JJJJ. Yoga 6. A 12yearold child is brought to the clinic with joint pain, a 3week history of lowgrade fever, and a facial rash. The primary care pediatric nurse practitioner palpates an enlarged liver 2 cm below the subcostal margin along with diffuse lymphadenopathy. An ANA test is positive. Which test may be ordered to confirm a diagnosis of SLE? A. Antidoublestrand DNA antibodies Correct SSS. AntiLa antibodies TTT. AntiRo antibodies UUU. AntiSm antibodies 7. The primary care pediatric nurse practitioner is reviewing the rheumatology plan of care for a child who is diagnosed with SLE. Besides reinforcing information about prescribed medications, what will the nurse practitioner teach the family to help minimize flaring of episodes? AAAA. Have the child rest between activities.BBBB. Obtain regular ophthalmology exams. CCCC. Participate in lowimpact exercises. DDDD. Use UVA and UVB sunscreen daily. Correct 8. 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?MMMM. Evaluate the adolescent‟s pain using a numeric pain scale. NNNN. Obtain ANA, CBC, liver function, and muscle enzymes tests. OOOO. Reassure the adolescent that this condition is not lifethreatening. PPPP. Refer the adolescent to a rheumatologist for further evaluation. Correct Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 9. A child has a fever and arthralgia. The primary care pediatric nurse practitioner learns that the child had asore throat 3 weeks prior andauscultates amurmur in the clinic. Which test will the nurse practitioner order? A. AntiDNase B test B. ASO titer Correct PPP. Rapid strep test QQQ. Throat culture . 10. The primary care pediatric nurse practitioner sees a child for followup care after hospitalization for ARF. The child has polyarthritis but no cardiac involvement. What will the nurse practitioner teach the family about ongoing care for this child? CCCC. Aspirin is given for 2 weeks and then tapered to discontinuethe medication. Correct DDDD. Prophylactic amoxicillin will need to be given for 5 years. EEEE. Steroids will be necessary to prevent development of heart disease. FFFF. The child will need complete bedrest until all symptoms subside. 11. An 8yearold boy has a recent history of an upper respiratory infection and comes to the clinic with a maculopapular rash on his lower extremities and swelling and tenderness in both ankles. The pediatric nurse practitioner performs a UA, which shows proteinuria and hematuria and diagnoses HSP. What ongoing evaluation will the nurse practitioner perform during the course of this disease? A. ANA titers B. Blood pressure measurement Correct JJJ. Chest radiographs KKK. Liver function studies 12. A 10yearold child has a 1week history of fever of 104°C that is unresponsive to antipyretics. The primary care pediatric nurse practitioner examines the child and notes bilateral conjunctival injection and a polymorphous exanthema, with no other symptoms. Lab tests show elevated ESR, CRP, and platelets. Cultures are all negative. What will the nurse practitioner do? SS. Begin treatment with intravenous methyl prednisone. TT. Consider IVIG therapy if symptoms persist one more week. UU. Order a baseline echocardiogram today and another in 2 weeks. Correct VV. Reassure the child‟s parents that this is a selflimiting disorder. 13. The primary care pediatric nurse practitioner is evaluating an 11monthold infant who has had three viral respiratory illnesses causing bronchiolitis. The child‟s parents both have Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 especially for nasal obstruction symptoms. What will the primary care pediatric nurse practitioner do? G. Order an intranasal corticosteroid to begin 1 to 2 weeks prior to pollen season. Correct H. Prescribe a decongestant medication as adjunct therapy during pollen season. I. Recommend adding diphenhydramine to the child‟s regimen for additional relief. J. Suggest using anoverthecounter intranasal decongestant. 21. A 4monthold infant has a history of reddened, dry, itchy skin. The primary care pediatric nurse practitioner notes fine papules on the extensor aspect of the infant‟s arms, anterior thighs, and lateral aspects of the cheeks. What is the initial treatment? A. Moisturizers Correct D. Oral antihistamines E. Topical corticosteroids F. Wet wrap therapy 22. The primary care pediatric nurse practitioner is performing a wellbaby Check upon a 6montholdinfant and notes a candida diaper rash and oral thrush. The infant has had two ear infections in the past 2 months and is in the 3rd percentile for weight. What will the nurse practitioner do? E. Order a CBC with differential and platelets and quantitative immunoglobulins. Correct F. Order candida andpneumococcal skin tests and lymphocyte surfacemarkers. G. Refer the infant to an immunologist for evaluation of immunodeficiency. H. Refer the infant to an otolaryngologist to evaluate recurrent otitis media. Chapter 34. Dermatologic Disorders Questions 1. The primary care pediatric nurse practitioner is teaching a parent of a child with dry skin about hydrating the skin with bathing. What will the nurse practitioner include in teaching? UUUU. Apply lubricating agents at least 1 hour after the bath. VVVV. Have the child soak in a lukewarm water bath. Correct WWWW. Keep the child in the bath until the skin begins to “prune.” XXXX. Soaping should be done at the beginning of the bath. 2. A child will need an occlusive dressing to treat lichen simplex chronicus. What will the primary care pediatric nurse practitioner tell the parents aboutapplying this treatment? UUUU. Apply ointment before the dressing. Correct VVVV. Plastic wrap should not be used. WWWW. The dressing should be applied to dry skin. XXXX. Change the dressing twice daily. 3. When prescribing topical glucocorticoids to treat inflammatory skin conditions, the primary care pediatric nurse practitioner will PPPP. initiate therapy with a highpotency glucocorticoid. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 QQQQ. order lotions when higher potency is necessary. RRRR. prescribe brandname preparations for consistent effects. Correct S SSS. use fluorinated steroids to minimize adverse effects. 4. A preschool age child has honeycrusted lesions on erythematous, eroded skinaround the nose and mouth, with satellite lesions onthearmsandlegs. The child‟s parent has several similar lesions and reports that other children in the day care have a similar rash. How will this be treated? A. Amoxicillin 40 to 5 mg/kg/day for 7 to 10 days B. Amoxicillinclavulanate 90 mg/kg/day for 10 days CorrectNI NNNNN. Bacitracin cream applied to lesions for 10 to 14 days OOOOOO. Mupirocin ointment applied tolesions until clear 5. A child is brought to clinic with several bright red lesions on the buttocks. The primary care pediatric nurse practitioner examines the lesions and notes sharp margins and an “orange peel” look and feel. The child is afebrile and does not appear toxic. What is the . course of treatment for these lesions? KKKK. Hospitalize the child for intravenous antibiotics and possible I&D of the lesions. LLLL. Initiate empiric antibiotic therapy and follow up in 24 hours to assess response. Correct MMMM. Obtain blood cultures prior to beginning antibiotic treatment. NNNN. Perform gram stain and culture of the lesions before initiating antibiotics. 6. Anadolescent who recently spent time inahot tub while onvacation has discrete, erythematous 1to 2mm papules that are centered around hair follicles on the thighs, upper arms, and buttocks. How will the primary care pediatric nurse practitioner manage this condition? VVV. Culture the lesions and treat with appropriate IM antibiotics. WWW. Hospitalize for incision and drainage and intravenous antibiotics. XXX. Order an antistaphylococcal betalactamaseresistant antibiotic. YYY. Prescribe topical keratolytics and topical antibiotics. Correct 7. An infant is brought to clinic with bright erythema in the neck and flexural folds after recent treatment with antibiotics for otitis media. What is the treatment for this condition? EEEE. 1% hydrocortisone cream to affected areas for 1 to 2 days FFFF. Oral fluconazole 6 mg/kg on day 1, then 3 mg/kg/dose for 14 days GGGG. Topical keratolytics and topical antibiotics for 7 to 10 days D. Topical nystatin cream applied several times daily Correct 8. A schoolage child has severalannular lesions on the abdomen Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 characterized by central clearing with scaly, red borders. What is the first step in managing this condition? QQQQ. Fluoresce the lesions with a Wood‟s lamp. RRRR. Obtain fungal cultures of the lesions. SSSS. Perform KOHtreated scrapings of the lesion borders. TTTT. Treatempirically withantifungal cream. Correct 9. Achild has several circular, scalylesions onthe armsandabdomen, someof which have central clearing. The primary care pediatric nurse practitionernotes a smaller, scaly lesion on the child‟s scalp. How will the nurse practitioner treat thiscI hild? ZZZ. Obtain scrapings of the lesions for fungal cultures. AAAA. Order prescriptionstrength antifungal creams. GGGG. Prescribe oral griseofulvin for 2 to 4 weeks. Correct HHHH. Recommend OTCantifungal creams and shampoos. 10. A child is diagnosed with tinea versicolor. What is the correct management of . 13348425718 this disorder? A. Application of selenium sulfide 2.5% lotion twice weekly for 2 to 4 weeks Correct LLL. Oral antifungal treatment with fluconazole once weekly for 2 to 3 weeks MMM. Sun exposure for up to an hour every day for 2 to 4 weeks NNN. Using ketoconazole 2% shampoo on lesions twice daily for 2 to 4 weeks 11. Anadolescent female has grouped vesicles on her oralmucosa. To determine whether these are caused by HSV1 or HSV2, the primary care pediatric nurse practitioner will order which test? WW. Direct fluorescent antibody test XX. Enzymelinked immunosorbent assay YY. Tzanck smear D. Viral culture Correct 12. A 4yearold child has clusters of small, clear, tense vesicles with an erythematous base on one side of the mouth along the vermillion border, which are causing discomfort and difficulty eating. What will the primary care pediatric nurse practitioner recommend as treatment? XX. Mupirocin ointment applied to lesions 3 times daily YY. Oral acyclovir 20 to 40 mg/kg/dose for 7 to 10 days ZZ. Topical acyclovir applied to lesions 4 times daily D. Topical diphenhydramine and magnesium hydroxide Correct 13. A previously healthy schoolage child develops herpes zoster on the lower back. What will the primary care pediatric nurse practitioner do to managethis condition? Y. Order Burow solution and warm soothing baths as comfort measures. Correct Z. Prescribe oral acyclovir 30 mg/kg/day in 4 doses/day for 5 days. AA. Recommend topical antihistamines to control itching. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 The parent reports that the child had a fever associated with what looked like sunburn and now has “blisters” all over. A physical examination shows coalescent target lesions and widespread bullae and areas of peeled skin revealing moist, red surfaces. What will the primary care pediatric nurse practitioner do? E. Consult with a pediatric intensivist for admission to a pediatric intensive care unit. Correct F. Order oral acyclovir 20 mg/kg/day in two doses for 6 to 12 months. G. Prescribe systemic antihistamines and antimicrobial medications as prophylaxis. H. Recommend analgesics, cool compresses, and oral antihistamines for comfort. 24. A schoolage child has arash without fever or preceding symptoms. Physicalexamination reveals a 3cm ovoid, erythematous lesion on the trunk with a finely scaled elevated border, along with generalized macular, ovoid lesions appearing in a “Christmas tree” pattern on the child‟s back. What is the initial action? E. Obtain a KOH preparation of a skin scraping to verify the diagnosis. F. Prescribe topical steroid creams to shorten the course of the disease. G. Reassure the child’s parents that the rash is benign and selflimited. Correct H. Recommend topical antihistamines and emollients to control the spread. 25. A child who has psoriasis, whohas been using a moderatepotency topical steroid on thick plaques on the extremities and a highpotency topical steroid on more severe plaques on the elbows and knees, continues to have worsening of plaques. In consultation with a dermatologist, which treatment will be added? A. Anthralin ointment in high strength applied for 10 to 30 minutes daily E. Calcipotriol cream applied liberally each day to the entire body F. Oral steroids and methotrexate therapy until plaques resolve G. Wideband ultraviolet therapy for 15 minutes twice daily 26. 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? I. Endocrine disorders J. Malignancy C. Neurofibromatosis Correct D. SturgeWeber syndrome 27. The primary care pediatric nurse practitioner notes velvety, brown thickening . of skin in the axillae, groin, and neck folds of an adolescent Hispanic femaleIwho is overweight. What is the initial step in managing this condition? A.Consultation with a pediatric dermatologist Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 B. Performing metabolic laboratory tests Correct G. Prescribing topical retinoic acid cream H. Referral to a pediatric endocrinologist 28. An AfricanAmerican child has recurrent tinea capitis and has just developed a new area of alopecia after successful treatment several months prior. When prescribing treatment with griseofulvin and selenium shampoo, what else will the primary care pediatric nurse practitioner do? D. Monitor CBC, LFT, and renal function during therapy. E. Order oral prednisone daily for 5 to 14 days. F. Perform fungal cultures on family members and pets. Correct G . Prescribe oral itraconazole or terbinafine. Chapter 35. Eye and Vision Disorders Questions 1. The primary care pediatric nurse practitioner performs a vision screen on a 4monthold infant and notes the presence of convergence and accommodation with mild esotropia of the left eye. What will the nurse practitioner do? YYYY. Patch the right eye to improve coordination of the left eye. ZZZZ. Reassure the parents that the infant will outgrow this. AAAAA. Recheck the infant‟s eyes in 2 to 4 weeks. BBBBB. Refer the infant to a pediatric ophthalmologist. Correct 2. During a well child exam on a 4yearold child, the primary care pediatric nurse practitioner notes that the clinic nurse recorded “20/50” for the child‟s visionand noted that the child had difficulty cooperating with the exam. What will the nurse practitioner recommend? YYYY. Follow up with a visual acuity screen in 6 months. ZZZZ. Refer to a pediatric ophthalmologist. AAAAA. Retest the child in 1 year. BBBBB. Test the child’s vision in 1 month. Correct 3. During a well child assessment of an AfricanAmerican infant, the primary care pediatric nurse practitioner notes a dark redbrown light reflex in the left eye and a slightly brighter, redorange light reflex in the right eye. The nurse practitioner will TTTT. dilate the pupils and reassess the red reflex. UUUU. order autorefractor screening of the eyes. VVVV. recheck the red reflex in 1 month. WWWW. refer the infant to an ophthalmologist. Correct 4. The primary care pediatric nurse practitioner performs a Hirschberg test to evaluate PPPPPP. colorvision. QQQQQQ. ocular alignment. Correct RRRRRR. peripheral vision. SSSSSS. visual acuity. Burns' Pediatric Primary Care 7th Edition Test Bank latest updated 2023 5. The primary care pediatric nurse practitioner applies fluorescein stain to a child‟s eye. When examining the eye with a cobalt blue filter light, the entire cornea appears cloudy. What doesthis indicate? A. The cornea has not been damaged. OOOO. There is too little stain on the cornea. PPPP. There is damage to the cornea. QQQQ. There is too much stain on the cornea. Correct 6. A toddler exhibits exotropia of the right eye during a coveruncover screen. The primary care pediatric nurse practitioner will refer to a pediatricophthalmologist to initiate which treatment? ZZZ. Botulinum toxin injection AAAA. Corrective lenses BBBB. Occluding the affected eye for 6 hours per day D. Patching of the unaffected eye for 2 hours each day Correct 7. The primary care pediatric nurse practitioner performs a well child examination on a 9monthold 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? A. At 12 months of age Correct HHHH. At 24 months of age IIII. At 48 months of age JJJJ. At 60 months of age 8. During a wellbaby assessment on a 1weekold infant who had a normal exam when discharged fromthe newborn nursery 2 days prior, the primary care pediatric nurse practitioner notes moderate eyelid swelling, bulbar conjunctival injections, and moderate amounts of thick, purulent discharge. What is the likely diagnosis? A. Chemicalinduced conjunctivitis B. Chlamydia trachomatis conjunctivitis Correct UUUU. Herpes simplex virus (HSV) conjunctivitis VVVV. Neisseria gonorrhea conjunctivitis 9. The primary care pediatric nurse practitioner performs a well baby assessment of a 5dayold infant and notes mild conjunctivitis, corneal opacity, and serosanguinous discharge in the right eye. Which course of action is correct? HHHH. Administer intramuscular ceftriaxone 50 mg/kg. IIII. Admit the infant to the hospital immediately. Correct JJJJ. Give oral erythromycin 30 to 50 mg/kg/day for 2 weeks. KKKK. Teach the parent how to perform tear duct massage.