NR 602/ NR602 MIDTERM EXAM: (NEW 2025/ 2026 UPDATE) PRIMARY CARE OF THE CHILDBEARING & CH, Exams of Nursing

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NR 602/ NR602 MIDTERM EXAM: (NEW 2025/

2026 UPDATE) PRIMARY CARE OF THE

CHILDBEARING & CHILDREARING FAMILY GUIDE|

QUESTIONS & ANSWERS| GRADE A| 100%

CORRECT (VERIFIED SOLUTIONS)- CHAMBERLAIN

1. What is conjunctivitis? - ANS ✓Inflammation or irritation of conjunctiva
2. What is the most common cause of conjunctivitis in peds? - ANS ✓Bacteria
3. What are some common causes of bacterial conjunctivitis? - ANS ✓Contact lenses Rubbing eyes Trauma
4. What are s/s of bacterial conjunctivitis? - ANS ✓Purulent (green/yellow) drainage, initially unilateral, then bilat Sensation of FB is common Redness Crust/matted eyelids in AM

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5. How long does bacterial conjunctivitis usually last? - ANS ✓ 5 - 7 days (self- limiting)
6. What is the treatment for bacterial conjunctivitis? - ANS ✓Eye drops: polytrim, erythromycin, tobramycin, cipro
7. What is the most common organism causing bacterial conjunctivitis? - ANS ✓H. influenza
8. What are common causative organisms of viral conjunctivitis? - ANS ✓Adenovirus Coxsackie Herpes Molluscum
9. What are s/s of viral conjunctivitis? - ANS ✓Profuse tearing Mucus drainage Burning Concurrent URI Enlarged/tender preauricular nodes
10. What is treatment for viral conjunctivitis? - ANS ✓Antihistamine Decongestant

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Tearing Sneezing

20. How is allergic conjunctivitis treated? - ANS ✓Topical antihistamine or topical steroids
21. When is improvement usually seen in allergic conjunctivitis? - ANS ✓ 2 - 3 days
22. How is chemical conjunctivitis treated? - ANS ✓Thimerosal Erythromycin Silver nitrate
23. What are s/s of chemical conjunctivitis? - ANS ✓Conjunctival erythema
24. Conjunctivitis never accompanies _______________ ________________. - ANS ✓Vision changes
25. When is ophthalmology referral necessary for conjunctivitis? - ANS ✓Herpes Hemorrhagic Ulcerations
26. When can a pt return to work/school with conjunctivitis? - ANS ✓24h after topical abx

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27. What is hand foot mouth? - ANS ✓Highly contagious viral illness, most common in kids <
28. What is the most common cause of HFM? - ANS ✓Coxsackie A 16
29. What are s/s of HFM? - ANS ✓Fever Vesicular eruptions in oropharynx that may ulcerate Maculopapular rash involving hands & feet Rash evolves into vesicles, esp. on dorsa of hands/feet Lesions on buccal mucosa, palate, palms/soles, buttocks Malaise Abd pain Enlarged anterior cervical/submandibular nodes
30. How long does HFM usually last? - ANS ✓ 1 - 2wks
31. When does the exanthem of HFM occur? - ANS ✓Usually 1-2 days after oral lesions

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Red/swollen throat Gray, furry tongue

37. What commonly causes viral pharyngitis? - ANS ✓Rhinovirus Adenovirus Parainfluenza Epstein-barr virus
38. What commonly causes bacterial pharyngitis? - ANS ✓Group A strep
39. What increases the risk of getting pharyngitis? - ANS ✓Fam h/o rheumatic fever Day care
40. What are s/s of strep throat? - ANS ✓Cervical adenopathy Fever > No cough/nasal congestion Petechiae on soft palate Beefy red tonsils Sandpaper rash (nose, neck, torso) Abd pain HA
41. What are some diagnostic tests for pharyngitis? - ANS ✓Rapid strep CBC (WBC shift to the left) Monospot if mono suspected

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42. What are some treatments for pharyngitis? - ANS ✓Gargle with salt water Change toothbrush PCN x1 IM or x10d PO 1st gen cephs x10d Azithro (if PCN)
43. What is the incubation period for pharyngitis? - ANS ✓ 2 - 5d
44. When is a consult/referral needed for pharyngitis? - ANS ✓Evidence of acute renal failure Reddish, tea colored urine (2-3w post-infection)
45. When is a pt no longer contagious with pharyngitis? - ANS ✓After 24h on abx
46. What is kawasaki dz? - ANS ✓Acute, febrile, immune-mediated, self-limited dz characterized by vasculitis. Leading cause of acquired heart dz in kids. 85% <5yo Most prevalent in Japan

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• Hepatosplenomegaly
• Plt count >10,000,000/mm

50. What is stage 3 of Kawasaki dz? - ANS ✓Convalescent:

• Clinical signs resolved
• Completed when all labs return to normal
• Nail changes (Beau lines: deep transverse grooves across nails)

51. What are some differentials for Kawasaki dz? - ANS ✓Group A strep Scarlet fever Measles Epstein barr Toxic shock Rocky mountain spotted fever Stevens-Johnson syndrome Juvenile RA
52. What are some tests for Kawasaki dz? - ANS ✓CBC (anemia, plt 50% >450K) ESR > CRP EKG (prolonged PR, decreased QRS) CXR (dilated heart, pleural effusion) Pyuria/mild proteinuria

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53. What is the pharm treatment for Kawasaki dz? - ANS ✓IVIG single dose 2g/kg over 12h in first 10d ASA 80-100mg/kg/d in 4 doses
54. What are some complications of Kawasaki? - ANS ✓MI Development/rupture of coronary artery aneurysm (may cause emboli, HF, heart valve probs, dysrhythmia, myocarditis)
55. What is rheumatic fever? - ANS ✓Inflammatory dz that develops in 1-3% of kids who have untreated group A strep.
56. What all can rheumatic fever affect? - ANS ✓Heart Blood vessels Joints Skin CNS Connective tissues
57. What are s/s of rheumatic fever? - ANS ✓h/o pharyngitis 2-4 prior to symptom onset Modified Jones criteria to dx: J: joints (polyarthritis) O: carditis N: nodules E: erythema marginatum

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61. What is a port-wine stain? - ANS ✓AKA nevus flammeus Permanent defect that grows w/child If forehead and eyelids are involved, potential for multiple symptoms (Sturge-Weber, Klippel-Trenaunay-Weber and Parkes Weber)
62. What is a salmon patch? - ANS ✓AKA stork bite at base of neck, angel kiss between eyes Simple nests of blood vessels that fade after a few weeks or months. Occasionally stork bites don't fade No treatment needed
63. What are cafe au lait spots? - ANS ✓Smooth, regular borders of darkened patch
64. If a child has >5 cafe au lait spots that are >1.5cm, what should be suspected? - ANS ✓Possible Von Recklinghausen's dz (90-100%) LEOPARD syndrome: - Lentigines

• Electrographic abnormalities
• Ocular hypertelorism

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• Pulmonary stenosis
• Abnormalities of genitalia
• Retardation of growth
• Deafness

65. In kids <5yo with 5 or more cafe au lait spots of at least 0.5cm, what should be suspected? - ANS ✓Neurofibromatosis
66. What is a rare but diagnostic sign of neurofibromatosis? - ANS ✓Smaller 1-4cm diameter cafe au lait spots in axillae (axillary freckling or Crow's sign)
67. What is a hemangioma? - ANS ✓Dilation of capillaries Raised Cavernous Appear bluish Located deep beneath skin NOT present at birth, appear w/in few months, disappear before 10yo)
68. What is a strawberry hemangioma? - ANS ✓Bright red vascular overgrowth Elevated Vary in size
69. What is a possible treatment for strawberry hemangioma? - ANS ✓Steroids

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76. What is molluscum contagiosum? - ANS ✓Infection caused by poxvirus, resulting in benign, mild skin dz characterized by lesions (growths), can appear anywhere on body.
77. How long does it take molluscum to resolve? - ANS ✓Usually 6-12mo, but can take as long as 4yrs
78. What do molluscum lesions looks like? - ANS ✓Small, raised, usually white, pink, or flesh-colored w/dimple or pit in center. Often have pearly appearance. Usually smooth, firm. Usually about size of a pinhead to as large as a pencil eraser. May bit itchy, sore, red, or swollen.
79. Where is molluscum usually NOT found? - ANS ✓Rarely on palms/soles
80. How is molluscum spread? - ANS ✓Direct person-to-person physical contact and through contaminated fomites
81. What are fomites? - ANS ✓Inanimate objects that can become contaminated w/virus

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82. What is the treatment for molluscum? - ANS ✓Because it is self-limited in healthy people, tx may be unneccessary. Tx options: iodine & salicylic acid, potassium hydroxide, tretinoin, cantharidin
83. What is verruca vulgaris? - ANS ✓Wart: painless, benign skin tumor, viral (HPV 6 or ll)
84. What are the characteristics of the common wart? - ANS ✓Rough surface Elevated Flesh-colored
85. What is the treatment for warts? - ANS ✓Paring & debridement of wart prior to any treatment. Soak in warm water, occlude w/waterproof tape x1wk, leave open to air 8-12hrs, then reocclude x1wk Cryotherapy w/liquid nitrogen (5sec freeze until ice ball forms)
86. When should a biopsy be done on a wart? - ANS ✓When it is resistant to therapy.

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93. What is a chalazion? - ANS ✓Benign, chronic lipogranulomatous inflammation of the eyelid
94. What causes a chalazion? - ANS ✓Blockage of the meibomian gland
95. What puts a person at risk for a chalazion? - ANS ✓Hordeolum or any condition which may impede flow through the meibomian gland. Mite species that reside in lash follicles.
96. What are physical exam findings for a chalazion? - ANS ✓Painless Does NOT involve lashes Lid edema or palpable mass Red or grey mass on inner aspect of lid margin
97. What is prevention for chalazion? - ANS ✓Good eye hygiene
98. What is treatment for chalazion? - ANS ✓Warm, moist compresses 3x a day If secondarily infected: sulfacetamide or erythromycin
99. What is the follow-up for chalazion? - ANS ✓In 2-4 weeks If still present after 6wks, follow up w/ophthalmologist

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100. What is blepharitis? - ANS ✓Inflammation/infection of the lid margins (chronic problem)
101. What are the two types of blepharitis? - ANS ✓Seborrheic (non-ulcerative) Ulcerative
102. What can cause seborrheic blepharitis? - ANS ✓Irritants (smoke, makeup, chemicals)
103. What are s/s of seborrheic blepharitis? - ANS ✓Chronic inflammation of eyelid Erythema Greasy scaling of anterior eyelid Loss of eyelashes Seborrheic dermatitis of eyebrows/scalp
104. What usually causes ulcerative blepharitis? - ANS ✓Infection w/staph or strep
105. What are s/s of ulcerative blepharitis? - ANS ✓Itching Tearing Recurrent styes Chalazia Photophobia