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What is the most common form of child abuse seen in pediatric primary care? Selecte d Answer: c. Shaken baby syndrom e Which of the following conditions requires urgent inpatient admission? Selecte d Answer: b. Cervi cal adeni tis An eye that deviates in when covered but that returns to midline when uncovered is an Selecte d Answer: b. esoph or ia All of the following are consistent with peritonsillar abscess except: Selecte d Answer: c. Tris mu s Which adolescent would be at greatest risk for developing anorexia nervosa?
NURS 6541 MIDTERM
EXAMination
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Selecte d Answer: d. 14-year-old female gymnast A mother states that her 4-year-old son constantly grinds his teeth at night. You document this as:
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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 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
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should be instructed to do which of the following? Selecte d Answer: a. Keep ear dry until symptoms improve. A 2-year-old child weighs 34 lb. What type of car seat should the child use? Selecte d Answer: d. A forward-facing car seat in the back of the vehicle. An expected milestone of a 4-year-old is the ability to Selecte d Answer: b. Copy a cros s A child's central visual acuity is 20/30 by age Selecte d Answer: b. 4 years Early reflexive responses that are not related to survival include all but: Selecte d Answer: c. Swim mi ng Sam has an otitis media. He also presents with conjunctivitis. This is due to which organism? Selecte d Answer:
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Selecte d Answer: b. Speech is 50% understandable at 36 months of age 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 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. 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. A 4-month-old presents with both eyes turning inward. What is this called? Selecte d Answer: c. Esotr opi a
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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. Maxillar y sinus
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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?
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Selecte d Answer: d. Formal operatio nal A 7-year-old boy with mental retardation was born at home at 26 weeks gestation to a 28- year-old mother who had received no prenatal care. An evaluation is likely to suggest his MR is related to which of the following? Selecte d Answer: b. Congenital infection with cytomegalovirus 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? Selecte d Answer: c. Counts to 4 and draws a person with three parts. A healthy, well-developed 6-year-old child arrives as a new patient to your clinic. His immunization card reveals that he received an immunization at birth and some when he was 2 months old, but none sense. Which of the following statements about him is correct? Selecte d Answer: a. He is too old to receive the Haemophilus influenzae Type B vaccine. Conductive hearing loss can be caused by Selecte d Answer: a. Serou s otitis
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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. 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. During a domestic health assessment, the CDC recommends screening every refugee child for which of the following diseases? Selecte d Answer: b. tubercu los is The diagnostic criteria for autism spectrum disorder include all of the following except Selecte d Answer: c. Tolerance of flexibility with routines 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.
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While assessing the skin of an infant, you note cafe-au-lait spots. Which disease should be ruled out? Selecte d Answer: a. Neurofibro mato sis
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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?
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Selecte d Answer: c. Sitting up and leaning forward Hannah, age 4, is brought into the office by her father. She complains of a sore throat, difficulty swallowing, copious oral secretions, stridor, and a temperature of 102F. She does not have pharyngeal erythema or cough. What do you suspect? Selecte d Answer: c. Epiglott it is John is diagnosed with allergic conjunctivitis. What type of discharge do you expect to see upon exam? Selecte d Answer: a. Stringy and white The first sign of the onset of female puberty is usually: Selecte d Answer: c. Brea st bud s 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? Selecte d Answer: d. Obtain a sweat chloride concentration
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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- hours during the day 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 Which is the correct order for introduction of solid foods to an infant? Selecte d Answer: c. Cereal, vegetables, fruits, and meats 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 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
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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
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