NRNP 6541 Midterm Exam (Version-1,Latest-2022-2023, 100 Q & A)Walden University, Exams of Pharmacology

Download NRNP 6541 Midterm Exam (Version-1,Latest-2022-2023, 100 Q & A)Walden University and more Exams Pharmacology in PDF only on Docsity! NRNP 6541 Midterm Exam (Version-1,Latest-2022-2023, 100 Q & A) NRNP6541 Week 6 Mdterm Exam: Walden University 100% Verified Q & A Question 1 0 out of 1 points Medicaid provides health insurance coverage to Selected b. Answer: Newborn, pregnant women, and those older than 65 whose personal income falls below the federal poverty level. Question 2 1 out of 1 points A differential diagnosis for child abuse would include all of the following except. Selected Answer: c. Prader-Wlli syndrome Question 3 1 out of 1 points Which of the following injuries is most likely to be caused by abuse of a toddler? Selected Answer: d. A displaced posterior rib fracture. Question 4 1 out of 1 points You are doing a kindergarten physical on a 5-year-old girl. Which of the following scenarios would suggest the child is not ready to start kindergarten in the fall? Selected Answer: a. Counts to 4 and draws a person with three parts. Question 5 1 out of 1 points The first sign of the onset of female puberty is usually: Selected Answer: b. Breast buds Question 6 1 out of 1 points You see a 7-year-old with complaints of "having accidents at night." Physical exam and history are unremarkable. Urinalysis, urine culture, and specific gravity are normal. His parents ask about the best treatment for this problem. The best response is Selected Answer: b. Fluid restriction and voiding prior to the night may be effective. Question 7 1 out of 1 points Which of the following statements about bullying is true? Which of the following children has abnormal language development? Selected Answer: c. Speech is 50% understandable at 36 months of age Question 15 1 out of 1 points Please interpret the following labs for an adolescent. The adolescent has a history of obesity and acanthosis nigricans. Test Results Fasting blood glucose 112 mg/dL 2 hour postprandial glucose 138 mg/dL Selected Answer: d. Impaired fasting glucose, postprandial glucose within normal limits Question 16 1 out of 1 points Which of the following issues or concepts is relevant to the school-age child? Selected Answer: c. Erikson's initiative versus guilt Question 17 1 out of 1 points The diagnostic criteria for autism spectrum disorder include all of the following except Selected Answer: d. Tolerance of flexibility with routines Question 18 1 out of 1 points Conductive hearing loss can be caused by Selected Answer: d. Serous otitis Question 19 1 out of 1 points The most common substance used in middle school is Selected Answer: a. Alcohol Question 20 0 out of 1 points The results of the hemoglobin A1c test are LESS reliable in children with which of the following conditions? (Hint: select two) Selected Answers: a. Crohn's Disease b. Celiac Disease Question 21 1 out of 1 points A teenage female who is overweight has moderate acne on the face and chest, and irregular menses. Elevation of which laboratory test provides the test evidence of polycystic ovarian syndrome? Selected Answer: d. free testosterone Question 22 1 out of 1 points Mark is in the exam room. You are concerned he may have epiglottitis. In what position do these patients prefer to sit? Selected Answer: a. Sitting up and leaning forward Question 23 1 out of 1 points You see a 30-month-old who speaks in mixed Spanish and English. The child’s vocabulary is normal but at the low end of the normal language spectrum. The parent is worried the Question 29 1 out of 1 points Most children can independently get dressed by themselves by age: Selected Answer: b. 5 years Question 30 0 out of 1 points A 13-month-old child is noted to be at the 25th percentile for weight, the 10th percentile for height, and less than the 5th percentile for head circumference. She was born at term. She was noted to have a small head at birth, to be developmentally delayed throughout her life, and to have required cataract surgery shortly after birth. She currently takes phenobarbital for seizures. Which of the following would most likely explain this child’s small size? Selected Answer: b. Down syndrome Question 31 1 out of 1 points A 4-month-old child has poor weight gain. Her current weight is less than the 5th percentile, height about the 10th percentile, and head circumference at the 50th percentile. The planned pregnancy resulted in a normal, spontaneous, vaginal delivery; mother and child were discharged after a 48- hour hospitalization. Feeding is via breast and bottle; the quantity seems sufficient. The child has had no illness. The examination is unremarkable except for the child’s small size. Screening laboratory shows the hemoglobin and hematocrit are 11 mg/dL and 33% respectively, with a platelet count of 198,000/mm3. Serum electrolyte levels are sodium 140, chloride 105, potassium 3.5, bicarbonate 17, blood urea nitrogen 15, and creatinine 0.3. Liver function tests are normal. Urinalysis reveals a pH of 8 with occasional epithelial cells but no white blood cells, bacteria, protein, ketones, or reducing substances. Which of the following is the most appropriate therapy for this child? Selected Answer: d. Oral supplementation with bicarbonate Question 32 1 out of 1 points Chelsea, age 8, complains that she feels as if something is stuck in her ear. What action is contraindicated? Selected Answer: b. Flushing the ear with water. Question 33 1 out of 1 points Which of the following substances is associated with pupillary constriction? Selected Answer: c. Heroin Question 34 0 out of 1 points Which of the following children should be referred for a comprehensive developmental evaluation? Selected Answer: a. A 12-month-old who does not speak. Question 35 0 out of 1 points John is diagnosed with allergic conjunctivitis. What type of discharge do you expect to see upon exam? Selected Answer: a. Purulent Question 36 1 out of 1 points You diagnose a 16-year-old with acute otitis media and need to prescribe an antibiotic with beta-lactamase coverage. What do you choose? Selected Answer: d. amoxicillin and potassium clavulanate (Augmentin) Question 37 1 out of 1 points A new mom calls the NP on postpartum day 5. She reports her newborn wants to nurse for 30 minutes every 1-1/2 to 2 hours. Which of these is the best response? Selected d. Answer: "This is a very healthy breastfeeding pattern. Be sure to rest when you can. You are doing a great job." Sarah, 7 years old, is in the office today. All of the following are acceptable management options for allergic rhinitis, except Selected Answer: a. Nasal neosynephrine Question 45 0 out of 1 points During a “well-child” visit, the parents of a healthy 5-month-old offer a great amount of information. Which of the following bits of information is of most concern? Selected Answer: e. Intermittent tugging on the ears. Question 46 0 out of 1 points At what age would a child be expected to remember a string of numbers and repeat them backwards? Selected Answer: a. 6 years Question 47 1 out of 1 points During a domestic health assessment, the CDC recommends screening every refugee child for which of the following diseases? Selected Answer: b. tuberculosis Question 48 1 out of 1 points Which of the following signs may indicate a baby is not receiving sufficient breastmilk? Selected Answer: a. Sleepiness, jaundice, and vomiting Question 49 1 out of 1 points Which of the following eye findings would be considered an ophthalmic emergency? Selected Answer: d. Unilateral vesicular lesions on the upper eyelid in a 3-week old. Question 50 1 out of 1 points Which of the following statements regarding adolescent substance use is true? Selected Answer: c. Tobacco is the most commonly abused substance during adolescence. Question 51 1 out of 1 points Which of the following vaccines is routinely recommended at 4 months of age? Selected Answer: a. Diphtheria, tetanus, acellular pertussis (DTaP) Question 52 1 out of 1 points The nurse practitioner role was initially established to Selected Answer: c. Improve access to care and partially solve physician shortage. Question 53 1 out of 1 points Mark, a 10-year-old, has a lot of ear pain. He does not want anyone to touch it and is crying in pain. The ear canal is swollen and exudate is present. The TM is normal. Mark should be instructed to do which of the following? Selected Answer: b. Keep ear dry until symptoms improve. Question 54 0 out of 1 points Concrete operational Question 61 1 out of 1 points An 8-year-old female has an edematous, mildly erythematous right upper eyelid for 2 days with a fever of 102.9 (F). Which important eye assessment do you need to consider? Selected Answer: a. Ocular mobility Question 62 1 out of 1 points Tammy, age 3, is at the office for her well-child visit. She has trouble removing her own shirt as requested. Her mother yanks off her shirt after smacking her wrist and saying, "you must do as you're told quickly." Which action is indicated? Selected Answer: a. Observe Tammy for signs of child abuse. Question 63 1 out of 1 points Which of the following is a true contraindication of vaccinating a child? Selected Answer: a. Previous vaccination reaction that consisted of wheezing and hypotension Question 64 1 out of 1 points The parent of a 2-year-old tells you her daughter recently started having breathholding spells. She tells you the older sibling “did the same thing” and asks you for help. You advise her that after a breath-holding event: Selected Answer: c. Act as if nothing abnormal happened. Question 65 1 out of 1 points You see a healthy 18-month-old for a well-child visit. At the 12-month visit he received the diphtheria, tetanus, and acellular pertussis (DTaP) third dose; hepatitis B second dose; measles, mumps, and rubella (MMR) first dose; injected poliovirus (IPV) second dose; pneumococcal conjugate (PCV13) fourth dose; and Haemophilus influenzae type B (Hib) fourth dose. Which of the following do you order today? Selected Answer: c. DTaP, varicella, hepatitis A, and hepatitis B Question 66 1 out of 1 points A 7-year-old boy with mental retardation was born at home at 26 weeks gestation to a 28year-old mother who had received no prenatal care. An evaluation is likely to suggest his MR is related to which of the following? Selected Answer: a. Complications of prematurity Question 67 1 out of 1 points Which is the correct order for introduction of solid foods to an infant? Selected Answer: d. Cereal, vegetables, fruits, and meats Question 68 1 out of 1 points Which of the following foreign body in the nose requires immediate removal? Selected Answer: c. battery Question 69 1 out of 1 points A Mantoux test in a child with no risk factors is considered positive with a reaction of: Selected Answer: c. at least 15 mm induration Question 70 1 out of 1 points Which of the following screenings should adolescents have done annually? Selected Answer: d. Psychosocial screening, blood pressure, body mass index Question 77 0 out of 1 points A 6-month-old infant has been growing poorly. His parents have changed his formula three times without success. His examination is remarkable for a pale, emaciated child with little subcutaneous fat and anterior fontanelle fullness. His laboratory test results are notable for a hemolytic anemia and prolonged bleeding times. Which of the following is the most appropriate next step? Selected Answer: e. Measure serum immunoglobulins Question 78 1 out of 1 points You see a 3-year-old for a well-child visit. His mother informs you that potty training has been very easy because he “has an amazing internal clock. He falls asleep, gets hungry, and has bowel movements at the same time every day.” This describes which aspect of temperament? Selected Answer: a. Rhythmicity Question 79 1 out of 1 points A 12-year-old male states he noticed an enlargement of his testes and scrotum. When counseling him about the next step in pubertal development, you state: Selected Answer: c. The penis will grow in length and width. Question 80 1 out of 1 points A 14-year-old female comes into the office for an urgent visit after taking 10 valium tablets. Following the initial emergent care and stailization, the most important part of the management is: Selected Answer: c. Assessing the family supports available to the child. Question 81 0 out of 1 points A 2-year-old child weighs 34 lb. What type of car seat should the child use? Selected Answer: a. A rear facing car seat in the back seat of the vehicle. Question 82 1 out of 1 points Which of the following is a priority nurse practitioner role to help children and adolescents to have healthy sexual development? Selected b. Answer: Begin anticipatory guidance related to sexuality and normal pubertal development in the early school-age visits. Question 83 1 out of 1 points Epiglottitis has decreased due to which immunization? Selected Answer: c. Hib Question 84 1 out of 1 points Role-play with equipment during the course of the physical exam would be the most beneficial with which age group? Selected Answer: a. Preschoolers Question 85 0 out of 1 points A 2-day-old newbornwith conjunctivitis is likely due to Selected Answer: a. Gonorrhea Question 92 0 out of 1 points Head and chest circumferences should be equal at: Selected Answer: d. 2 years of age Question 93 1 out of 1 points An 11-year-old girl has dizziness, pupillary dilation, nausea, fever, techycardia, and facial flushing. She says she can "see" sound and "hear" colors. The agent likely to be responsible is which of the following? Selected Answer: a. Lysergic acid diethylamide (LSD) Question 94 1 out of 1 points FIRST-LINE therapy for preschoolers (4-5 years of age) diagnosed with attention-deficit hyperactive disorder is: Selected Answer: c. Behavior therapy Question 95 1 out of 1 points Max, a 9-year-old boy, is a very active child with limited self-control. He is easily distracted and has difficulty staying on task. You determine that he should have a neurodevelopmental evaluation because he is showing signs of Selected Answer: a. ADHD Question 96 0 out of 1 points A 3-year-old (37 months) refuses to have bowel movements on the toilet. He is bladder trained. He goes and hides and squats when having bowel movements. Positive encouragement and praise is not working. You advise: Selected b. Answer: Tell the parent this is normal; the child will eventually train himself, but it is difficult to wait. Question 97 1 out of 1 points A typically developing 8-year-old girl will have which of the following genital development? Selected Answer: c. No pubic hair at all Question 98 0 out of 1 points Which of the following are important considerations when screening child refugees for tuberculosis? SELECT TWO (2) Selected Answers: c. IGRA may be falsely positive in children who have autoimmune disorders. d. Mantoux TST should not be used in a child who has received a Bacille Calmette-Guerin vaccination. Question 99 1 out of 1 points The mother of a 4-year-old tells you he likes to "play with himself" while playing and watching television. You advise the mother to Selected b. Answer: Explain to the child that masturbation is something that should be done in private. Question 100 1 out of 1 points A 7-year-old has just been diagnosed with attention deficit hyperactivity disorder (ADHD). Her parents report that she is doing poorly in school and is disruptive in the classroom. They ask you what they can do. Your best response is: Selected a.