NURG 604 FINAL EXAMINATION STUDY GUIDE. LATEST UPDATED EXAM GUIDE 2024/2025, Exams of Nursing

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STUDY GUIDE.

LATEST UPDATED EXAM GUIDE

2024/

what age do infants attain head control - ans6 months what age do infants sit without support - ans8 months when should an infant crawl - ans9 months when should an infant walk - ans12-18 months when does infant run - ans24 months how many words should a child at age 12 months say - ans"mama" and "dada" plus 3-5 other words words an 18 month old should say - ans15-20 words what should a 24 month old say - ans2 word combos and know about 200 other words what is the difference in caput succedaneum and a cephalohematoma - ansCaput - superficial soft tissue edema that CROSSES the suture line

Cephalohematoma- deep collection of blood and fluid that DOES NOT cross suture line lanugo - ansthin, fine hairs milia - anspearly white papuless mongolian spots - ansbruise colored spots harlequin sign - ans1/2 body red and 1/2 body pale what is the proper place for an infant to sleep - anssupine to decrease risk for SIDS what causes neonatal acne, when does it first appear and when should it resolve - ansunknown cause presents around 2-4 weeks resolves by 6-12 months when should the anterior fontanel close - ans9-18 months when should the posterior fontanel close - ans2-3 months what are some signs that a newborn may have a fractured clavicle - ansirritable when moved, decreased arm movement, pain, swelling

forceps used or shoulders got stuck how to care for a new circumcision - ansvasaline for 2-3 days clean area with water and cotton balls care for umbilical cord - anslet the cord air dry and fold diaper below it when should the 1st meconium still occur - answithin 24 hr what can cause a diaper rash and treatment for it - ansover hydration of the skin, prolong urine or feces on skin, soaps and/or allergy to diapers.

frequent diaper changes, let bottom air dry and breathe, use zinc oxide crea, when should there be no head lag - ans6 months when does visual acuity reach 20/20 - ans5-6 years

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when do primary teeth begin to come in - ans6 months what age should a child have all 20 primary teeth - ans3 years characteristics of pathologic murmur - ansgrade >III, thrill, loud, diastolic genu valGUM - ansknocked knees knees stuck together normal from 2yr-8yrs genu varum - ansbow legged normal fron infancy to toddler when does stranger anxiety begin - ans7 months the head circumference should be measured until what age - ans what age group engages in parallel play - anstoddlers 2-3yr should parents be concerned if their child stutters - ansyes if it is persistent for longer than 6 months REVIEW ROUTINE VACCINE SCHEDULE - ans REVIEW CONTRAINDICATIONS FOR ADMINISTRATION - ans what is normal newborn weight loss - ans7% how many ounces should a newborn gain per day - ans.5- infants should double their birth wt by - ans6 months infants should triple their birth wt by - ans1 year how is failure to thrive defined - answhen wt is below that of other kids with same age/sex

when wt is lower 3% OR 20% below ideal wt for height contraindications for breast feeding in US - ansgalactosemis, certain meds, chemo, HIV how many calories do both breast milk and formula have per ounce - ans20kcal what age do infants drink whole milk - ans12 months how do you know when an infant is ready for solid foods - ansthey drink 30oz of formula or more a day, decrease tongue reflex, have good head control, they reach for food recommended sequence for introducing solids - ans@ 5-7 months- rice cereal 6-9 mon - fruits and veggies 7-9 mon- eggs and mashed up foods 9-12 - meats, different textures categories of BMI for being obese and overweight - ans85th - 95th % on BMI chart is overweight

95th % is obese pityriasis rosea - ansstarts with Harold patch that is oval and scaly then breaks out on the back in a Christmas tree pattern

calamine lotion and no sun

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impetigo - anshoney colored crust; topical antibiotics or oral tinea - ansfungal infection so you use anti fungal creams psoriasis - ansthick silver scales. auspitz sign, emollient cream, no sun, mineral oil thrush - ansyeast; white plaques on the mouth, oral nystatin or gentian violet scabies - ansitch worse at night, s shaped burrows

scabicide - thin layer over body; repeat in 7 days permethrin- neck down and stay on for 8-14 hours before washing off greater than 6 cafe au lait spots is associated with what disease - ansneurofibromatosis first line treatment for mild acne in adolescences - anscombo of benzoin peroxide and clindamycin

oral antibiotics for moderate to severe heralds patch is associated with what diserase - anspityriasis rosea characteristics of the heralds patch - ans2.5cm solitary, oval patch with elevated borders what is an auspitz sign - ansbleeding after scales removed with psoriasis strabismus - anscrossed eyes nystagmus - ansInvoluntary rapid eye movements what do you suspect of the eye does not have a red reflex - ansretinoblastoma or congenital cataracts s/s of conjunctivitis, what causes it and how is it treated - ansred eyes, watery, discharge, itchy, matted eyes, burning

virus, bacterial, allergy

bacterial - antibiotics antivirals and remove triggers primary etiologies and treatment for otitis externa - ansbacterial infection antibiotic drops DOC for acute otitis media - ansamoxicillin 90 mg/kg/day 2nd DOC for otitis media - ansaugmentin how is asymptomatic otitis media with effusion treated - ans#1 is to wait and watch

or child gets tubes how is oral candidiasis in the newborn diagnosed and treated - ansclinically by seen of white plaques in mouth

nystatin for baby and cream for breastfeeding mom

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what might you see if you give ampicillin for GABS to someone with mono - ansit will cause a rash epiglottitis - ansdrooling, tripod position, hyperextended neck croup - ans- Barking cough

• Difficulty breathing, fast breathing, noisy breathing, SOB or wheezing
• Fatigue or fever
• Hoarseness or impaired voice most common etiology croup - ansParainfluenza virus Etiology of Epiglottitis - ansBacterial infection cause by HiB` how would you recognize respiratory distress in an infant or child - anstripod position, retractions, flaring, grunting, color change characteristics of bronchitis - ansblue bloaters due to hypoxia and cyanosis, lots of mucus that impairs ventilation and gas exchange, mucosa of lower respiratory passages becomes severely inflamed, pneumonia is common, risk of lung infection increases antihistamines and expectorants are not given with bronchitis because - ansthey dry up mucus and make them cough more what virus is most likely the cause of bronchiolitis in children - ansrsv antibiotic choice for a school age kid with mycoplasma pneumoniae - ansmacrolides initial symptoms of CF - anschronic or recurrent cough dyspnea wheezing recurrent respiratory infections decreased exercise tolerance hemoptysis how to diagnose CF - anssweat chloride test. Chloride greater than 60 for infants <3 mos or greater than 40 for others definition of asthma - anschronic inflammatory disorder of the airways what occurs during an asthma attack - ansbronchospasm mucosal edema increased secretions in order to control asthma, you must control - anstriggers key symptoms that would lead NP to suspect asthma - ansSOB, tight chest, cough, wheeze, trouble sleeping Step 1 Asthma Treatment

(Intermittent) - ansSABA PRN Step 2 asthma treatment (Mild Persistent) - ansDaily low dose ICS or

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low dose ICS + SABA Step 3 asthma treatment (Moderate Persistent) - ansLow dose ICS + LABA OR Medium dose of ICS Step 4 Asthma Treatment

(Severe Persistent) - ansMedium-dose ICS + LABA

(Alt: HD ICS, add on Tiotropium or LTRA) why should infants, children, and adolescents not be given aspirin during a febrile illness - ansreye syndrome Reye's Syndrome symptoms - ansVomiting, Alter mental status, absence fever, Rash on palms of hands and feet what virus causes hand foot mouth - ansCoxsackie virus hallmarks of hand foot mouth - ansfever, blisters on palms of hands and soles of feet, mouth varicella is caused by - ansherpes zoster virus how long should a child with chicken pox be kept home from school - ansuntil the rash completely crusts over (4-7 days) Mono is caused by - ansEpstein-Barr virus why is it important for a child with mono to avoid contact sports - ansto avoid rupturing spleen erythema infectious (5th disease) is caused by - anshuman Parvo virus what are the hallmark signs for 5th diseaase - ansLacey rash appearance, slapped cheeks Rubella - ansa viral infection characterized by a low-grade fever, swollen glands, inflamed eyes, and a fine, pink rash

German measles

3 day virus Rubeola - ansmeasles; can live in the air for 2 hours, it attacks the respiratory system, contagious 4 days before the rash shows and up to 14 days after complications of Strep throat untreated - anstoxic shock, rheumatic fever, glomerularnephritis, necrotizing fascitis DOC of strep - ansPCN management for cat scratch fever - ansself healing or azithromycin what is the classic sign of lyme disease - ansbulls eye what are the dangers of not treating lyme disease - ansspreads to the brain, heart, and joints

arthritis, cardiac arrhythmias, neuroborreliosis

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treatment for lyme disease - ansDoxycycline what should you suspect as a diagnosis in a child with a fever and nuchal rigidity - ansmeningitis what education should be provided to parents who has a child seize with a fever - ansto be careful and watch them because they can always have a seizure with a fever from now on cardiac murmurs in children are intensified by - ansfever, running, playing, crying, anemia what is the most frequent type of chest pain in children - ansmusculoskeletal what are the ref flags associated with chest pain in a child - anschest pain with exercise, palpitations, syncope, family hx, the pain does not go away Kawasaki disease - ans(inflammation of blood vessles, hence the strawberry tongue) causes coronary artery aneurysms. fever for 5 days with rash

IVIG and aspirin myocarditis - ansinflammation of the heart muscle

pale, cyanosis, mottled, increase RR and HR, galloping murmur, JVD

support care rheumatic fever - ansinfection caused by strep throat

poly arthritis, skin eruption, choria, carditis

Prevent it #1!! but PCN used to treat infective endocarditis - ansinflammation of endothelium that lines heart and cardiac valves. can also occur after an invasive medical or dental procedure.

symptoms: valvular dysfunction, may affect organ systems, chest pain, CHF, clubbing, meningitis, low back pain, arthralgia, arthritis

Hospitalization for antibiotics 4-6 weeks what OTC med should be avoided in children with a viral illness - ansaspirin what s/s might the NP see in a child with reye syndrome - anscoma, fixed pupils, servere vomit, posturing All women of child-bearing age are advised to take ____mg of folic acid per day to prevent _____ - ans.

neuro tube defects bell palsy - ansparalysis on one side of the face

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Bell Palsy Treatment - ansClosing and patching the affected eye Artificial tears used to prevent corneal dryness. Corticosteroids given if diagnosed early (ineffective if delayed more than 7 days) what are the dx criteria and s/s of scoliosis - ansunequal shoulders, scapulas, waist 10 degrees or more; spine xray at what degree curve should scoliosis be referred for possible treatment - ans20- different dx for a child with painless limp - anship dysplasia, cerebral palsy, short leg, neuromuscular disease appropriate treatment for sprain in first 48hr - ansRICE appropriate treatment for sprain after 48hr - ansheat, crutches, air cast exam findings and treatment for clavicle fracture in newborn - ansdecrease arm movement, crepitus, muscle spasms, pain, swelling, absent moro reflex

sling to immobilize what condition in children involves compromised blood flow to the femoral head - ansLegg Calve Perthes Disease Management of Osgood-Schlatter disease - ansRICE NSAIDs/tylenol Avoiding sports that involve heavy quadriceps loading or deep knee bending most common signs of Juvenile Idiopathic Arthritis - anspain, joint stiff, warmth, irritable, decrease appetite, myalgia, night pain, FTT GER - anscommon spit up that resolves by 12 months old

feeding changes, PPIs, surgery, rice cereal GERD - ansreflux that causes other s/s or complications passed 12 months old acute gastroenteritis - anssudden onset of inflammation of the stomach and intestines

N/V/D

stay hydrated pyloric stenosis - ansnarrowing of the pyloric sphincter

olive like mass intussusception - anstelescoping of the intestines

bowel obstruction, sausage shaped mass, air enema

very painful and children pull their knees to their chests

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most important thing to determine with hernia - ansif it is incarcerated, obstructed, or strangulated s/s, dx, tx of C Diff - ansdiarrhea, blood stool, black/sticky/tarry stools, abd pain, fever, N/V

stool culture

Flagyl or Vancomycin education to a parents who's child has had acute gastroenteritis for several days, what would the NP give on feeding - ansearly feedings, replace lost fluids, probiotics

emergent care if longer than 7 days celiac disease - ansdisease caused by sensitivity to gluten

pale stools, greasy stools, foul smelling

intestinal biopsy or antibody test

gluten free diet for life Crohn disease - anschronic inflammation of the intestinal tract usually affecting the ileum and colon

anywhere from mouth to anus ulcerative colitis - anschronic inflammation of the colon with presence of ulcers

only lower abdominal to rectum

bloody stools hepatitis a - ansspread by fecal-oral route

food/water contamination hepatitis b - ansblood to blood contact uti s/s and tx - anss/s depends on age but mostly urgency, frequency, burning, fever, abd pain, foul smelling, cloudy urine

UA and Culture

trimethoprim-Sulfa, amoxicillin, augmentin, cephalexin, cefixine what is the cause of primary VUR - ansshort ureter and ineffective valve

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why is it important to give antibiotics at night with VUR - ansurine stasis while sleeping cryptorchidism - ansundescended testicles hydrocele - anssac of clear fluid in the scrotum testicular torsion - anstwisting of the spermatic cord anisocytosis - anspresence of red blood cells of unequal size poikilocytosis - anscells are irregularly shaped hypochromic - anspale color RBC HCT - ansvolume of circulating RBC HGB - ansoxygen carrying RBC reticcount - ansimmature blood from bone marrow MCV - anssize of RBC MCH - ansamount of Hbg in RBC (color) MCHC - ansportion of RBC with Hgb RDW - ansmcv / RVC labs that obtained for an initial anemia work up - ansCBC, retic, peripheral smear a child has an elevated MCV along with diarrhea, anorexia, poor growth, and irritability. what is suspected - ansFolic Acid Deficiency child bruises frequently with minor injuries what anemia is suspectedq - ansthrombocytopenia hallmark sign for idiopathic thrombocytopenia purpur - anspetechiae with mucocutaneous bleeding what abnormal heart sound may be found in a child with IDA - anssystolic heart murmur what PE finding might lead the NP to suspect leukemia - ansplatelets less than 150,000 or 100, what gestational age is an infant premature - ans37 weeks and before why is intraventricular hemorrhage more common in premature babies - anstheir brain vessels are really small, thin, and fragile why are premies more susceptible to hypoglycemia - ansthey fight harder to eat, fight harder to maintain the right body temp, they fight harder to breathe rsp distress syndrome in premies is often due to the lack of - anssurfactant what dangerous neurological condition can result from high levels of bili in the brain - anskerniticous why do premies often have PDS - ansnot strong enough to let out a loud cry to help close it what med might be given to help a PDA close - ansindomethacin what age is an elective PDA ligation performed - ans4 months to 2 years when is a cardiology consult needed - answhen an undiagnosed murmur is heard signs and symptoms of NEC - ans1. Gastric residuals (>50%)

2. Signs of sepsis (lethargy, hypotension, apnea, bradycardia, temp instability, hypoperfusion).
3. Blood in stools: occult or frank blood

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4. Third spcaing of fluids is common, can lead to hypovolemia and hypotension

distended abdomen, tender, firm how many wet diapers should a newborn have in 24 hours - ans6- what is the only vaccine that should be delayed until the infant reaches 200 grams - anshep b what are some common causes of CP in premies - anshemorrhage or hypoxia to the brain during delivery what age does puberty occur in females - ans8- what age does puberty occur in males - ans9- mild transient depression - ansloss of interests, alone, worthless, no sleep moderate to severe depression - ansdecreased mood, crying spells, empty feels, isolation, decrease self esteem, insomnia NP MOST important role in a patient who is depressed - anssuicide risk questions what should you ask your patient who has suicidal ideations - ansdo you have a plan do you have the means to carry out your plan do you plan on hurting anyone else primary characteristics of anorexia - ansrefuse to be adequate body weight, intense fear of being fat, disturbance in image, amenorrhea

need therapy what are two forms of anorexia - ansself starvation and excessive weight loss clues that make NP think patient is anorexic - anscold, dry skin, brittle nails and hair, decreased heart rate, obsessions become worse with weight loss, they are just skin and bones, too skinny, look sick primary characteristics of bulimia - ansrecurring binge eating, recurrent purging, happens 2 times a week per months, they care about body shape and weight some clues that NP would think patient had bulimia - ansabdominal pain, reflux, dental caries, loss of enamel, dehydrated what is the cause of most adolescent deaths - ansmotor vehicle accidents what adolescent issues that cannot be confidential - ansabuse or suicide what could be the cause of an acute pancreatitis in a teen - anstrauma, alcohol How is autism diagnosed? - ansobservation of behavior by a professional Autism Treatment - ansapplied behaviour analysis; medications (risperidone, SSRIs, mood stabilizers, divalproex, and methylphenidate); gluten or casein free diet; various therapies and support groups when is childhood anxiety abnormal - ansongoing excessive worrying and nervousness that severely interferes with daily activities of childhood, inappropriate for developmental level

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what physiologic s/s accompany panic disorder - anschest pain, heart palpatations, SOB, dizzy, GI upset what is the rule of thumb when beginning SSRIs in children and what must parents be instructed to watch for - ansstart out on a low dose and slowly increase until desired dosage. parents should look for suicide ideations b/c pt can act it out when feeling better what is OCD - ansA condition characterised by obsessions and/or compulsive behaviour

excessive hand washing, repetitive counting, rechecking everything multiple times,

Family therapy and SSRIs definition of mania - ansextremely elevated and equitable mood usually with bipolar disorder, shifts in mood, energy, function, sweat, shaky, NVD what can be a dangerous side effect from stopping clonidine - ansrebound HTN S/S for suicide risks? - ansCues & Clues End centered Giving away valued possession Completion Will & testament Checking with friends, family, and enemies Sudden change in mood Role of Id Life instinct - More powerful instinct Death Instinct - Predominates during Suicidal thought Unconscious plea for help ADHD (Attention-Deficit Hyperactivity Disorder) - ansa psychological disorder marked by extreme inattention and/or hyperactivity and impulsivity ADHD diagnostic criteria - ans-Inattention -easily distracted -often forgetful HYPERACTIVITY -Unable to sit still -Doesn't pay attention to social cue -Runs and climbs in inappropriate situations -Talks excessively IMPULSIVITY -Blurts out answers before the question has been completed -Interrupts others -Difficulty waiting for their own turn

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ADHD treatment - ansbehavior therapy + methylphenidate or amphetamines (both phenethylamines), or atomoxetine (NeRI) expected benefits of stimulants - anspurpose, goal behavior met, more focused, decrease impulses, decreased motor activity disadvantages for stimulants - ansincrease heart rate, increase BP, loss of appetite, addictive Neglect - ansfailure to provide basic needs emotional abuse - ansconstant criticism, rejection, threats, withholding love physical abuse - ansinjuries resulting from beating, biting, burning, choking, kicking, shaking sexual abuse - ansany sexual act committed through coercion or physical force patient presentation of bipolar disorder - anssevere mood changes, increase self esteem, increase energy, decrease sleep, talk a lot, racing thoughts, risk takers, psychosis how does a parent describe a child with OCD - ansritual that has to be completed

a sense of fear of being contaminated, excessive washing, counting, checking everything, rearranging what does PANDAS mean - anspediatric autoimmune neuropsychiatric disorder associated with Strep recommended screening for autism - ansCHAT - 12-24 months MCHAT- toddlers CAST- > 3 years what visual acuity is partial blindness - ans20/ what visual acuity is legal blindness - ans20/ what might lead the NP or parent to believe the child has visual impairment - anslack of smiling, nystagmus, wondering eye movement, problem reaching for object what is the most common cause of mild to moderate hearing loss in a child - ansacute or chronic otitis media causing conduction abnormalities how is cerebral palsy defined - anschronic, non progressive motor disorder resulting from damage to the brain what is the most common type of CP and what are some features - ansspastic cerebral palsy- abnormal movement, increased tone, pathologic reflexes such as babinsky or hyper reflexia How many pairs of chromosomes do humans have? - ans23 pairs marfans syndrome - ansAn inherited disorder that affects connective tissue — most commonly affects the heart, eyes, blood vessels and skeleton.

People with this syndrome are usually tall and thin with disproportionately long arms, legs, fingers and toes. true or false

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in an autosomal dominant disorder, the child has 50% chance of having the disorder if one parent carries the gene - anstrue autosomal dominant inheritance - ansonly one gene of a pair must carry a genetic characteristic or mutation in order for it to be expressed

one parent ---- 50% of child getting it s/s of osteogenesis imperfecta - ans1. bone fx as babies (even during birth)

2. short, bowed, deformed limbs
3. short stature
4. spinal curves
5. blue sclera Autosomal Recessive Inheritance - anstwo recessive alleles must be present for trait to be displayed

both parents are carriers, 25% child with have the gene/disorder and 50% child will be a carrier explain. how an autosomal recessive disorder such as cystic fibrosis is expressed in offspring - ansboth parents are carriers of the gene. it is passed down to offspring by both parents.... making it a 25% chance of having CF and 50% of being a carrier for the CF gene neural tube defects have declined since the addition of folic acid. however, if parents have a child with a neuro tube defect, what is the likelihood that they will have a second child affected as well

• ans20-40 times rapid weight gain and extreme food seeking behavior is a characteristic in which genetic condition - ansprayer willi syndrome clinical features of down syndrome - ans-intellectual impairment (variable) -slanted eyes(almond shape) -congenital heart disease -intestinal defects -abnormal creases in palm hypotonia flat nasal bridge short stature broad neck protruding tongue prenatal screen that replaced the alpha fetal protein - ansCVS through the cervix or abdomen 10- 13 weeks if obtained trisomy 18 is Edwards syndrome, is essentially incompatible with life. what is the prognosis for these infants - ansonly 5% survive the 1st year of life

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what is the prognosis for trisomy 13 - ans50% die in the 1st month of life, 95% die by their 1st birthday 47, XXY (Klinefelter syndrome) causes incomplete development of sex characteristics in males. what age is it typically diagnosed - ansduring puberty (9-14) Turner syndrome is a monosomy and written 45,X... who does this affect - ansfemales characteristics of turner syndrome - ansshort stature, webbed neck, lack of ovarian development, broad chest, short neck, low hairline, high palate, wide space nipples, short fourth fingers what causes patients with turners syndrome to be infertile and is it treated - ansnon developed secondary sex characteristics , amenorrhea and no treatment which syndrome is considered the most common inherited form of mental retardation - ansfragile X