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NURS 6541
MIDTERM EXAM
• What Question is the most common 1 form of child abuse seen in pediatric primary care?
Selecte
d
Answer:
c.
Shaken baby syndrome
• Question 2
1 out of 1 points
Which of the following conditions requires urgent inpatient admission?
Selecte
d
Answer:
b.
Cervic al adeniti s
• Question 3
1 out of 1 points
An eye that deviates in when covered but that returns to midline when uncovered is an
Selecte
d
Answer:
b.
esopho r ia
• Question 4
1 out of 1 points
All of the following are consistent with peritonsillar abscess except:
Selecte
d
Answer:
c.
Trism u s
• Question 5
1 out of 1 points
Which adolescent would be at greatest risk for developing anorexia nervosa?
Selecte
d
Answer:
d.
14-year-old female gymnast
• Question 6
1 out of 1 points
A mother states that her 4-year-old son constantly grinds his teeth at night. You document this as:
Selecte
d
Answer:
b.
Bruxi s m
- Question 7
1 out of 1 points
FIRST-LINE therapy for preschoolers (4-5 years of age) diagnosed with attention-deficit hyperactive disorder is:
Selecte
d
Answer:
c.
Behavior therapy
- Question 8
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:
Selecte
d
Answer:
c.
"Use a consistent approach with behavioral cues both at home and at school."
- Question 9
1 out of 1 points
The most common substance used in middle school is
Selecte
d
Answer:
b.
Alcoh ol
- Question 10
1 out of 1 points
The most likely weight of a 1-year-old whose birth weight was 6-1/2 pounds would be:
Selecte
d
Answer:
b.
19 to 20 pounds
- Question 11
0 out of 1 points
Which of the following characterizes middle adolescence (14 to 16 years old)?
Selecte
d
Answer:
c.
Concrete thinking, present orientation, intense preoccupation with body image
- Question 12
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
Selecte
d
Answer:
b.
Speech is 50% understandable at 36 months of age
- Question 19
1 out of 1 points
Appropriate advice for a mother of a 2-week-old child here for a “well
child” visit includes which of the following?
Selecte
d
Answer:
b.
Sleep in the supine position is recommended
- Question 20
0 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:
Selecte
d
Answer:
d.
Obtaining a psychiatric consultation.
- Question 21
1 out of 1 points
Miguel, age 14, was hit in the eye with a baseball and developed eye pain,
decreased visual acuity, and injection of the globe. Upon exam you note
blood in the anterior chamber and confirm diagnosis of hyphema. What
treatment do you recommend while Miguel is waiting to see the
ophthalmologist
Selecte
d
Answer:
b.
Apply bilateral eye patches.
- Question 22
1 out of 1 points
A 4-month-old presents with both eyes turning inward. What is this called?
Selecte
d
Answer:
c.
Esotro pi a
- Question 23
1 out of 1 points
Sarah, age 15, presents with pain and pressure over her cheeks and discolored nasal discharge. You cannot transilluminate the sinuses. You suspect which common sinus to be affected?
Selecte
d
Answer:
d.
Maxillary sinus
- Question 24
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 child’s development will not be normal
because she mixes up the two languages. You respond:
Selecte
d
Answer
a.
"Your child's speech is normal and bilingual children commonly intermix the words from both languages until about 3 years of age."
- Question 25
1 out of 1 points
Sarah, 7 years old, is in the office today. All of the following are acceptable management options for allergic rhinitis, except
Selecte
d
Answer:
d.
Nasal neosynephri ne
- Question 26
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
Selecte
d
Answer:
d.
Explain to the child that masturbation is something that should be done in private.
- Question 27
1 out of 1 points
Which of the following would not suggest an eating disorder with a purging
component?
Selecte
d
Answer:
d.
Diarrh e a
- Question 28
1 out of 1 points
I can roll over, grasp a rattle, and reach for things and have begun feeding
myself finger foods, but I can’t wave bye-bye yet. How old am I?
Selecte
d
Answer:
b.
months
- Question 29
1 out of 1 points
You see a 13-year-old who reports she is learning some basic geometry
(areas, volume etc.). The ability to successfully master these concepts
occurs during which Piaget developmental stage?
Which of the following eye findings would be considered an ophthalmic emergency?
Selecte
d
Answer:
a.
Unilateral vesicular lesions on the upper eyelid in a 3-week old.
- Question 36
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
Selecte
d
Answer:
c.
Fluid restriction and voiding prior to the night may be effective.
- Question 37
1 out of 1 points
During a domestic health assessment, the CDC recommends screening every refugee child for which of the following diseases?
Selecte
d
Answer:
b.
tuberculo s is
- Question 38
1 out of 1 points
The diagnostic criteria for autism spectrum disorder include all of the following except
Selecte
d
Answer:
c.
Tolerance of flexibility with routines
- Question 39
0 out of 1 points
A 19-month-old says “mama” and “dada,” points and gestures if he wants
things, and follows simple one-step commands. Your best response is
which of the following?
Selecte
d
Answer:
c.
Encourage early intervention services for speech.
- Question 40
1 out of 1 points
While assessing the skin of an infant, you note cafe-au-lait spots. Which disease should be ruled out?
Selecte
d
Answer:
a.
Neurofibroma to sis
- Question 41
1 out of 1 points
A differential diagnosis for child abuse would include all of the following except.
Selecte
d
Answer:
c.
Prader- Wlli syndrom e
- Question 42
1 out of 1 points
Which of the following screenings should adolescents have done annually?
Selecte
d
Answer:
d.
Psychosocial screening, blood pressure, body mass index
- Question 43
1 out of 1 points
The nurse practitioner role was initially established to
Selecte
d
Answer:
c.
Improve access to care and partially solve physician shortage.
- Question 44
0 out of 1 points
An 8-year-old female is brought into the office by her mother. She has
complaints of fever and sore throat for the past 2 days. She denies
difficulty swallowing but has loss of appetite and mild diarrhea. A few
classmates have similar symptoms. A review of systems reveals clear
nasal drainage, dry cough, and hoarseness. On exam she has a 101.
temperature, 3+ erythematous tonsils, and anterior cervical
lymphadenopathy. What is the likely diagnosis?
Selecte
d
Answer:
b.
Strep pharyngit is
- Question 45
1 out of 1 points
Josh, age 13, has some enlargement of the scrotum and testes, a reddened scrotal sac, and some hair texture alteration. His penis is not enlarged. He is in Tanner stage
Selected d.
Answer: II
Mark is in the exam room. You are concerned he may have epiglottitis. In what position do these patients prefer to sit?
- Question 46
1 out of 1 points
- Question 52
1 out of 1 points
A mother of a 6-month-old asks you about normal sleep patterns for an infant this age. The best response is:
Selecte
d
Answer:
a.
10 hours at night and 3-4 hours during the day
- Question 53
1 out of 1 points
A Mantoux test in a child with no risk factors is considered positive with a reaction of:
Selecte
d
Answer:
a.
at least 15 mm induration
- Question 54
1 out of 1 points
Which is the correct order for introduction of solid foods to an infant?
Selecte
d
Answer:
c.
Cereal, vegetables, fruits, and meats
- Question 55
0 out of 1 points
Initial screening tests for an 11-year-old with a family history of hyperlipidemia and weight at the 97th percentile include:
Selecte
d
Answer:
a.
fasting glucose, postprandial glucose, fasting lipid profile
- Question 56
0 out of 1 points
Luke, a 17-month-old, failed treatment with amoxicillin for otitis media. At
the two- week recheck, his TM was still erythematous and you cannot see
the landmarks. He has persistent nasal congestion, he is not sleeping at
night, and he has a 101°F fever. What is the next best step for Luke?
Selecte
d
Answer:
c.
Ceftriaxone and an antihistamine
- Question 57
0 out of 1 points
A 2-year-old boy has been slightly less than the 50th percentile for weight,
height and head circumference, but in the last 6 months he has fallen to
slightly less than the 25th percentile for weight. The pregnancy was
normal, his development is as expected, and the family reports no
psychosocial problems. The mother says that he is now a finicky eater
(wants only macaroni and cheese at all meals), but she insists
- Question 63
1 out of 1 points
Answer: Anyone^ whose^ personal^ income^ falls^ below
federal poverty level.
Which of the following vaccines is routinely recommended at 4 months of age?
Selecte
d
Answer:
b.
Diphtheria, tetanus, acellular pertussis (DTaP)
- Question 64
1 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 5 th^ 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?
Selecte
d
Answer:
a.
Congenital cytomegalovirus infection
- Question 65
1 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:
Selecte
d
Answer:
a.
Toilet refusal in 3-year-olds is largely due to caregivers overemphasizing toilet training.
- Question 66
0 out of 1 points
Which of the following children should be referred for a comprehensive developmental evaluation?
Selecte
d
Answer:
d.
A 3-year-old who consistently tracks at the 5th percentile for height and weight since birth.
- Question 67
0 out of 1 points
Which of the following injuries is most likely to be caused by abuse of a toddler?
Selecte
d
Answer:
b.
Spiral fracture of the tibia.
- Question 68
0 out of 1 points
You would be concerned about the language development of a child who:
Selecte
d
Answer:
b.
Pronounces words that are not understandable at 2 years of age
- Question 69
1 out of 1 points
A 7-month-old male is found to have a spiral fracture of the femur that his father says he got
by climbing onto a chair and then jumping off. Which of the following statements is true
regarding this situation?
Selecte
d
Answer:
c.
You can be held legally liable for failing to report child abuse.
- Question 70
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?
Selecte
d
Answer:
c.
"This is a very healthy breastfeeding pattern. Be sure to rest when you can. You are doing a great job."
- Question 71
1 out of 1 points
Upon eye examination of a newborn, you note inner canthal folds and Brushfield spots. What do you suspect?
Selecte
d
Answer:
d.
Down syndrom e
- Question 72
0 out of 1 points
Acute otitis media can be diagnosed when there is
Selecte
d
Answer:
c.
Fluid in the middle ear without signs or symptoms of an ear infection.
- Question 73
0 out of 1 points
Which of the following are important considerations when screening child
refugees for tuberculosis? SELECT TWO (2)
Selecte
d
Answers
b.
Mantoux TST should not be used in a child who has received a Bacille Calmette-Guerin vaccination.
Which of the following signs may indicate a baby is not receiving sufficient breastmilk?
Selecte
d
Answer:
b.
Sleepiness and excitability
- Question 80
1 out of 1 points
Which of the following strategies would not be appropriate to include as part of your treatment plan of an 8-year-old boy who is obese?
Selecte
d
Answer:
b.
Referral to nutritionist for weight reduction plan.
- Question 81
1 out of 1 points
Which of the following complication of strep pharyngitis cannot be prevented with antibiotics?
Selecte
d
Answer:
d.
Glomerulonephri tis
- Question 82
0 out of 1 points
You see a 4-year-old for a well-child visit. He has received four
diphtheria, tetanus, and acellular pertussis vaccines (DTaP); three
injected polio vaccines (IPV); one measles, mumps, and rubella vaccine
(MMR); one varicella vaccine; and two hepatitis B (Hep B) vaccines. What
do you order today?
Selecte
d
Answer:
b.
PVC 13, DTaP, IPV, MMR, and Varivax
- Question 83
1 out of 1 points
You see a 6-month-old for a well-child visit and the mother tells you the
child’s grandmother recommends that she give the infant whole milk and
eggs when he starts solids. What should you tell the mother?
Selecte
d
Answer:
b.
The baby should remain on infant formula and stage 2 and 3 baby foods for now.
- Question 84
1 out of 1 points
Which of the following substances is associated with pupillary constriction?
Selecte
d
Answer:
c.
Hero i n
- Question 85
0 out of 1 points
A breastfed infant is expected to have a lower incidence of which of the following?
Selecte
d
Answer:
b.
Asth m a
- Question 86
1 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)
Selecte
d
Answers
d.
Sickle Cell Disease
e.
Cystic Fibrosis
- Question 87
1 out of 1 points
Which of the following statements about bullying is true?
Selecte
d
Answer:
b.
It occurs most commonly during unstructured times (lunch, recess, etc.).
- Question 88
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?
Selecte
d
Answer:
a.
Ocular mobilit y
- Question 89
1 out of 1 points
What method can be safely used to remove cerumen in a 15-month-old child's ear?
Selecte
d
Answer:
d.
Irrigation using warm water from a soft bulb syringe
- Question 90
1 out of 1 points
You see a 5-month-old who is fussy, has interrupted sleep, and is drooling.
You note large lower lateral incisor bulges. You recommend:
Selected e.
- Question 96
1 out of 1 points
Answer: tolerance
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?
Selecte
d
Answer:
d.
Rhythmic i ty
- Question 97
0 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?
Selecte
d
Answer:
a.
Sweat chloride analysis
- Question 98
0 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. What is the proper management for his patient?
Selecte
d
Answer:
a.
Oral Amoxicillin and topical anesthetic
- Question 99
1 out of 1 points
A mother brings her 4-week-old infant into the office because she noticed small yellow- white glistening bumps on her infant's gums. She says they look like teeth but is concerned that they may be cancer. You diagnose these bumps as
Selecte
d
Answer:
a.
Epstein's pearls
- Question 100
0 out of 1 points
A 2-day-old newbornwith conjunctivitis is likely due to
Selecte
d
Answer:
c.
Gonorr h ea NURS 6541 Midterm Exam (Latest): Walden University
(FOR 100% CORRECT ANSWER CHECK THE LAST PAGE)
· Question 1
1 out of 1 points
Medicaid provides health insurance coverage to
Select
ed
Answe
r:
b.
Certain categories of people whose personal income falls below a
certain percentage of 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
