pedatrics PEDIATRIC PRIMARY 6TH EDITION, Exams of Pediatrics

Download pedatrics PEDIATRIC PRIMARY 6TH EDITION and more Exams Pediatrics in PDF only on Docsity!

TEST BANK

_PEDIATRIC

PRIMARY 6TH

EDITION

TEST BANK PEDIATRIC PRIMARY 6THEDITION cc Q&As

correctly answered grade A

+

Questions

1. A child who has attention•deficit/hyperactivity disorder (ADHD) has difficulty ID:^13348413834

stopping activities to begin other activities at school. The primary care pediatric nurse practitioner

understands that this is due to difficulty with the self•regulation component of

A. emotional control.

B. flexibility. Correct

C. inhibition.

D. problem•solving.

2. The primary care pediatric nurse practitioner cares for a preschool•age child ID:^13348413832

who was exposed to drugs prenatally. The child bites other children and has tantrums when asked to

stop but is able to state later why this behavior is wrong. This child most likely has adisorder of

A. executive function. Correct

B. information processing.

C. sensory processing.

D. social cognition.

3. The primary care pediatric nurse practitioner uses the Neurodevelopmental ID: 13348413842

Learning Framework to assess cognition and learning in an adolescent. When evaluatingsocial

cognition, the nurse practitioner will ask the adolescent

A. about friends and activities at school. Correct

B. if balancing sports and homework is difficult.

C. to interpret material from a pie chart.

D. to restate the content of something just read.

4. The primary care pediatric nurse practitioner is evaluating a school•age child ID:^13348413838

who has been diagnosed with ADHD. Which plan will the nurse practitioner recommend asking the child’s

school about to help with academic performance?

A. 504 Correct

B. FAPE

C. IDEA

D. IEP

• 5. The parent of a child diagnosed with ADHD tells the primary care pediatric ID:

nurse practitioner that the child gets overwhelmed by homework assignments, doesn’t seem toknow

which ones to do first, and then doesn’t do any assignments. The nurse practitioner

tells the parent that this represents impairment in which executive function? A.

Activation Correct

B. Effort

C. Emotion

D. Focus

6. The^ primary^ care^ pediatric^ nurse^ practitioner^ is^ considering^ medication^ ID:^13348413826

options for a school•age child recently diagnosed with ADHD who has a primarily hyperactive

presentation. Which medication will the nurse practitioner select initially?

A. Low•dose stimulant

B. Moderate•dose stimulant Correct

C. Low•dose non•stimulant

D. Moderate•dose non•stimulant

7. The parent of a 4 • year•old child reports that the child gets upset when the ID:^13348413824

hall light is left on at night and won’t leave the house unless both shoes are tied equally tight. Theprimary

care pediatric nurse practitioner recognizes that this child likely has which type of

sensory processing disorder?

A. Dyspraxia

B. Over•responder Correct

C. Sensory seeker

D. Under•responder

8. The^ parent^ of^ a^ preschool•age^ child^ who^ is^ diagnosed^ with^ a^ sensory^

ID: 13348413828

processing disorder (SPD) asks the primary care pediatric nurse practitioner how to help thechild

manage the symptoms. What will the nurse practitioner recommend?

A. Establishing a reward system for acceptable behaviors

B. Introducing the child to a variety of new experiences

C. Maintaining predictable routines as much as possible Correct D. Providing

frequent contact, such as hugs and cuddling

9. The primary care pediatric nurse practitioner is performing an examination on ID: 13348413846 a

5 • year•old child who exhibits ritualistic behaviors, avoids contact with other children, and has limited

speech. The parent reports having had concerns more than 2 years ago about autism, but was told that it

was too early to diagnose. What will the nurse practitioner do first?

A. Administer an M•CHAT screen to screen the child for communication and

Continue

socialization delays.

B. Ask the parent to describe the child’s earlier behaviors from infancy through

preschool. Correct

C. Reassure the parent that if symptoms weren’t present earlier, the likelihood ofautism is

low.

D. Refer the child to a pediatric behavioral specialist to develop a planof

treatment and management.

10. The primary care pediatric nurse practitioner is examining a 3 • year•old child ID:^13348413830

who speaks loudly, in a monotone, does not make eye contact, and prefers to sit on the examroom

floor moving a toy truck back and forth in a repetitive manner. Which disorder does the nurse

practitioner suspect?

A. Attention•deficit/hyperactivity disorder

B. Autism spectrum disorder Correct

C. Executive function disorder

D. Sensory processing disorder

11. The primary care pediatric nurse practitioner is selecting a medication for a ID:^13348413836

12 • year•old child who is newly diagnosed with ADHD. The child is overweight, has a history of anatrial

septal defect at birth, and reports mild shortness of breath during exercise. What will the nurse practitioner

prescribe?

A. A low•dose stimulant medication

B. A non•stimulant medication

C. Behavioral therapy only

D. Cardiovascular pre•screening Correct

12. The primary care pediatric nurse practitioner is conducting a follow•up ID:^13348413840

examination on a child who has recently begun taking a low•dose stimulant medication to treatADHD.

The child’s school performance and home behaviors have improved. The child’s parentreports noticing

a few tics, such a twitching of the eyelids, but the child is unaware of them andisn’t bothered by them.

What will the nurse practitioner recommend?

A. Adding an alpha•agonist medication

B. Changing to a non•stimulant medication

C. Continuing the medication as prescribed Correct

D. Stopping the medication immediately

Questions

1. The primary care pediatric nurse practitioner uses a shared decision•making ID:^13348425786

(SDM) model when working with families of children with chronic health conditions. When using this model,

the nurse practitioner can expect

A. considerably more time in each encounter.

B. improved patient health outcomes. Correct

C. less PNP involvement in health care decisions.

D. lower provider and higher patient satisfaction.

2. The primary care pediatric nurse practitioner diagnoses a 5 • year•old child with ID:^13348425782

asthma and prescribes an oral steroid and a short•acting beta•adrenergic medication via a

metered•dose inhaler to manage acute symptoms. Along with education about the prescribed

medications, what information is important to give the child’s family at this visit?

A. An asthma action plan

B. Effects and side effects of current medications

C. Information about spirometry testing

D. Instructions for medications at school

3. The parent of a child with complex health care needs tells the primary care

ID: 13348425764

pediatric nurse practitioner that the child has had difficulty breathing the past two nights but can’tarticulate

specific symptoms. The child has normal oxygen saturations and a normal respiratory rate with clear breath

sounds. What will the nurse practitioner do?

A. Admit the child to the hospital for close observation and monitoring of respiratory status.

B. Encourage the parent to call when concerned and schedule a follow•up appointmentthe next

day. Correct

C. Perform a complete blood count, blood cultures, and a chest radiograph to evaluatesymptoms.

D. Reassure the parent that the child has a normal exam and is most likely not ill.

4. Which characteristic is the key criterion that identifies a child has having special ID: 13348425780

needs?

A. Cognitive function

B. Emotional health

C. Health service requirements Correct

D. Medical diagnosis

Correct

5. The primary care pediatric nurse practitioner is performing a well baby ID:^13348425774

examination on a 2 • week•old infant who was recently discharged home from the neonatal intensive care unit.

The mother reports that the infant was born at 26 weeks’ gestation and states she was told that her baby will

probably have developmental delays. What is the most important aspect of long•termmanagement for this infant?

A. Careful monitoring of attainment of developmental milestones Correct

B. Familiarizing the parent with laws that mandate educational support

C. Providing genetic counseling to the infant’s parents

D. Referral to social services for assistance with resources

6. The primary care pediatric nurse practitioner is preparing to perform a well child ID:^13348425790

examination on a 5 year old child who has multiple developmental and cognitive delays. The child’s mother is

angry and tells the nurse practitioner that her friends’ children are all preparing for kindergarten. The nurse

practitioner will

A. allow the mother to express her feelings, understanding that she is experiencinggrief.

Correct

B. reassure the mother that special educational opportunities are available for her child.

C. suggest that the mother find a support group with other children with special needs.

D. tell her that most schools provide services for children with special health care needs.

7. The parent of a toddler who has special health care needs is resistant to a ID: 13348425766

suggestion that her child needs a gastrostomy tube for nutrition. The toddler has fallen from the 10th percentile

to the 5th percentile in the past few months and resists taking in appropriate amounts of food by mouth even

with assistance from occupational therapy. What will the primary care pediatric nurse practitioner do?

A. Inform the mother that, since other options have failed, the gastrostomy tube is the onlyoption.

B. Refer the child to a dietician to teach the mother the importance of adequate nutrition.

C. Set weight gain and food intake goals with the mother and schedule regular visits tomonitor

weight. Correct

D. Suggest that the gastrostomy tube may be tried temporarily andremoved once

the child gains weight.

8. What is the most important role of the primary care pediatric nurse practitioner ID: 13348425792

who provides care for a child with special health care needs who sees several specialists and receives

community and school•based services?

A. Assessing the parent’s ability to perform home care tasks

B. Coordinating services to ensure continuity of care Correct

C. Monitoring the family’s adherence to the health care plan

D. Ordering medications and other prescribed treatments

9. A toddler swallowed a coin several days prior. The child’s parent has not found ID:^13348425776

the coin in the child’s stool. Which imaging test will the primary care pediatric nurse practitioner employ to

evaluate this ingestion?

A. Abdominal ultrasound

B. Computed tomography

C. Conventional radiograph Correct

D. Magnetic resonance imaging

10. The primary care pediatric nurse practitioner is assessing an ill 2 • month•old infant ID:^13348425772

who is febrile and refusing most fluids. The preliminary blood work indicates a viral infection and shows that

the infant is hydrated. The infant is alert. The infant’s parents are attentive and live

close by. What will the nurse practitioner do?

A. Administer a parenteral antibiotic and antipyretic and send the infant home.

B. Admit the infant to an inpatient hospital unit for overnight monitoring.

C. Give the parents sick care instructions and follow up in the clinic in the

morning. Correct

D. Send the infant to the urgent care center for intravenous fluids.

11. A toddler is prescribed a liquid oral medication. The parent tells the primary care ID:^13348425784

pediatric nurse practitioner that the child refuses to take medications and usually spits them out.What will

the nurse practitioner do?

A. Demonstrate oral medication administration with the toddler in the office.

B. Instruct the parent to hide the medication in a favorite food or beverage.

C. Order the medication to be given via another route if possible.

D. Tell the parent to offer the child a reward each time the medication is taken.

12. The primary care pediatric nurse practitioner orders a pulmonology consult for a ID:^13348425788

child who has severe asthma. The nurse practitioner writes “child with asthma refractory to conventional

treatments needs suggestions for alternative treatments.” The nurse practitioner

expects the pulmonologist to

A. confirm the medical diagnosis for the child’s parents.

B. make recommendations for disease management. Correct

C. stress the importance of adherence to the medication regimen.

D. take over management of this child’s chronic illness.

rect

13. The primary care pediatric nurse practitioner cares for several families with K.^ L.^ ID:

chronically ill children who text status updates about their children to a mobile device that has an encryption•

protection platform installed. If the nurse practitioner misplaces the mobile device, it isimportant to

A. disconnect the user from the system to avoid a data breach. Correct

B. notify the families that their messages may be read by others.

C. obtain a new device as soon as possible to resume communication.

D. upload the messages from another remote device.

14. The parent of an 18 • month•old child calls the clinic to report that the child has a

I.

J. ID:

rectal temperature of 100.4°F (38°C). The child is playing normally, taking fluids well, and has aslightly

reduced appetite. What will the primary care pediatric nurse practitioner recommend?

G.

A. Administering an antipyretic medication

B. Bringing the child to the clinic for evaluation

C. Offering extra fluids and calling if symptoms change ct D.

Ordering outpatient lab work such as a CBC

15. The parent of a preschool•age child calls the clinic to report that the child has H.^ ID:

clear, watery drainage from both eyes, mild erythema of the conjunctiva, and no fever or other

symptoms. What will the primary care pediatric nurse practitioner recommend?

A. Allow the child to go to preschool. Correct

B. Bring the child to the clinic for a culture.

C. Keep the child home for 2 days.

D. Use antibiotic eyedrops for 3 days..

16. A parent brings a 4 • month•old infant to the clinic who has had a low•grade fever

E.

F. ID:

for 24 hours. The primary care nurse practitioner notes that the infant has a weak cry, slightly dryoral

mucosa, mottled skin, and a respiratory rate of 65 breaths per minute and sleeps unless stimulated by the

examiner,. What will the nurse practitioner do?

A. Administer oral fluids in the clinic.

B. Admit the infant to the hospital. Correct

C. Order outpatient laboratory tests.

D. Send the infant home with close follow•up.

Questions

1. A pharmaceutical company has developed a new drug that was tested only ID:^13348428705

on adults. The FDA has declared this drug to have potential benefits for ill children. According to the

Pediatric Research Equity Act (PREA), what may the pharmaceutical company be required todo?

A. Conduct pediatric drug studies to determine whether the drug is safe and effective inchildren.

Correct

B. Provide labeling stating that the safety and efficacy of the drug is not establishedfor

children.

C. Receive a patent extension for conducting pediatric studies to determine use inchildren.

D. Survey existing data about the drug to determine potential use in the

pediatric population.

2. The primary care pediatric nurse practitioner prescribes a new medication for ID:^13348428709 a

child who develops a previously unknown adverse reaction. To report this, the nurse practitioner will

A. access the BPCA website.

B. call the PREA hotline.

C. log onto the FDA Medwatch website. Correct

D. use the AAP online PediaLink program.

3. The primary care pediatric nurse practitioner is considering use of a relatively ID:^13348428701

new drug for a 15 • month•old child. The drug is metabolized by the liver, so the nursepractitioner will

consult a pharmacologist to discuss giving the drug:

A. less often or at a lower dose. Correct

B. more often or at a higher dose.

C. via a parenteral route.

D. via the oral route.

4. The primary care pediatric nurse practitioner is considering using a drug for ID:^13348428707

an “off label” use in a child. The nurse practitioner has used the drug in a similar situation previously, has

consulted a pharmacology resource and the FDA website, and has determined that there are no significant

contraindications and warnings for this child. What else must the nurse practitioner do when prescribing

this drug?

A. Discuss recommendations with the parents and document their consent. Correct

B. Document anecdotal reports of previous use of the drug by other providers.

C. Follow up daily with the parents to determine safe administration of the drug.

I.

D. Report this use to the FDA Medwatch website for tracking purposes.

5. The primary care pediatric nurse practitioner is counseling an adolescent J.^ ID :

who was recently hospitalized for an asthma exacerbation and learns that the child usually forgets to use

twice• daily inhaled corticosteroid medications that are supposed to be given at 0800 and 2000 each day.

Which strategy may be useful in this case to improve adherence?

A. Ask the adolescent to identify two times each day that may work better.

B. Consider having the school nurse supervise medication administration.

G.

C. Prescribing a daily oral corticosteroid medication instead.

D. Suggest that the parent enforce the medication regimen each day.

6. The primary care pediatric nurse practitioner is treating a toddler who has a H.^ ID :

lower respiratory tract illness with a low•grade fever. The child is eating and taking fluids well andhas

normal oxygen saturations in the clinic. The nurse practitioner suspects that the child has a viral

pneumonia and will

A. order an anti•viral medication and schedule a follow•up appointment.

B. prescribe a broad•spectrum antibiotic until the lab results are received.

C. teach the parents symptomatic care and order labs to help with thediagnosis.

Correct

D. write a prescription for an antibiotic to be given if the child’s condition worsens.

E.

7. The single mother of a 4 • year•old who attends day care tells the primary care F.^ ID:

pediatric nurse practitioner that she had difficulty giving her child a twice•daily amoxicillin for 10 days to

treat otitis media during a previous episode several months earlier because she workstwo jobs and is too

busy. The child has an ear infection in the clinic today. What will the nurse practitioner do?

C.

A. Administer an intramuscular antibiotic.

B. Order twice•daily amoxicillin for 5 days.

C. Prescribe azithromycin once daily for 5 days. Correct

D. Reinforce the need to adhere to the plan of care.

8. The parent of a school•age child who has asthma tells the primary care D. ID :

pediatric nurse practitioner that the child often comes home from school with severe wheezing after gym

class and needs to use his metered•dose inhaler right away. What will the nurse practitioner do?

A. Recommend that the child go to the school nurse when symptoms start.

B. Review the child’s asthma action plan and possibly increase his steroid dose.

rect

Continue

C. Suggest asking the school to excuse the child from gym class.

D. Write the prescription for two metered•dose inhalers with spacers. ect

Questions

1. The primary care pediatric nurse practitioner is evaluating a 10 • year•old child ID:^13348428717

who is describing shooting pain in both legs associated with aching, tingling, and burning. The child is

unable to pinpoint specific locations for this pain. Which type of pain does the nurse

practitioner suspect?

A. Chronic pain

B. Neuropathic pain Correct

C. Somatic pain

D. Visceral pain

2. A^3 • year•old^ child^ is^ recovering^ from^ injuries^ sustained^ in^ a^ motor^ vehicle^ ID:^13348428721

accident. How will the primary care pediatric nurse practitioner evaluate this child’s pain?

A. Ask the child to rate pain intensity on a 4 • to 5 • item pain discrimination scale.

B. Have the child describe any pain as “no pain, a little pain, or a lot of pain.” Correct

C. Question the child about the intensity and specific location of any pain.

D. Rely on nonverbal responses such as facial expressions and limb movements.

3. A 4 • year•old child has just been released from the hospital after orthopedic ID:^13348428725

surgery on one leg following a bicycle accident. The child is sitting quietly on the exam table. When asked

to rate pain, the child points to the “ 1 ” on a faces rating pain scale. What will the primary care pediatric

nurse practitioner do next?

A. Assess the child’s vital signs and ability to walk without pain. rrect

B. Refill the prescription for a narcotic analgesic medication.

C. Suggest that the parents give acetaminophen for mild pain.

D. Teach the parent to give analgesics based on the child’s report of pain.

4. A developmentally and cognitively disabled 10 • year•old child who is unable to ID:^13348428727

communicate must undergo a series of surgeries, and the child’s parent asks how to know if the child is

in pain and when to give pain medication. What will the primary care pediatric nursepractitioner teach

this parent to use to assess this child’s pain?

A. Comfort scale

B. FLACC scale

C. NCCPC•R Correct

D. Non•verbal observations

Correct

5. The primary care pediatric nurse practitioner is preparing to perform a painful ID:^13348428723

procedure on a 4 • month•old infant. Besides providing local anesthesia, what other pain control method

provides analgesic effects?

A. Providing toys

B. Singing or music

C. Sucrose solution Correct

D. Swaddling or cuddling

6. An adolescent female reports moderate dysmenorrhea with periods and tells theprimary

care pediatric nurse practitioner that 400 mg ibuprofen every 6 to 8 completely control

her pain. What will the nurse practitioner recommend?

A. Increasing the ibuprofen dose to 600 to 800 mg every 6 to 8 hours

B. Taking extra•strength acetaminophen 1000 mg every 4 to 6 hours

C. Taking naproxen 500 mg initially and then 250 mg every 6 to 8 hours D.

Using extended•release naproxen 500 mg every 12 hours

7. What is the most important dose•limiting factor when prescribing

acetaminophen with hydrocodone?

A. Acetaminophen dose Correct

B. Gastrointestinal side effects

C. Pruritis symptoms

D. Urinary retention

8. An adolescent takes ibuprofen, acetaminophen, and a tricyclic antidepressant

ID: 13348428733

hours doesn’t

ID: 13348428731

ID: 13348428719

(TCA) to treat phantom limb pain and reports that the medications are no longer effective.What will

the primary care pediatric nurse practitioner do?

A. Change the TCA to a selective serotonin reuptake inhibitor.

B. Evaluate the adolescent for drug•seeking behavior.

C. Increase the TCA dose and reevaluate in 2 to 3 weeks.

D. Refer the adolescent to a pain management specialist. Correct

9. The parent of a school•age child with a chronic pain condition tells the ID:^13348428729

primary care pediatric nurse practitioner that the child has requested to stay home from school more often

in the past few months. The child’s exam does not reveal any significant change in pathology, and a review

of the child’s medications indicates appropriate dosing of analgesic medications. What will the nurse

practitioner recommend?

A. Assessing the child’s pain every day to determine changes

Continue

B. Ensuring the child stays quiet in bed with videos when having pain

C.

Having the child do homework when staying home from school Correct

D. Requiring the child to go to school even during pain episodes

Questions

1. A 2 • month•old infant has a staccato cough and fever. Which aspect of the history ismost

important in determining the diagnosis?

A. Day care attendance

B. Immunization history Correct

C. Medication history

D. Past medical history

2. When reviewing a white blood cell (WBC) count, the primary care pediatric nurse

practitioner suspects a viral infection when which WBC element is elevated?

A. Bands

B. Leukocytes

C. Lymphocytes

D. Neutrophils

3. Which lab value is most concerning in an infant with fever and a suspected

bacterial infection?

A. C•reactive protein of 11.5 mg/L Correct

B. Lymphocyte count of 8.

C. Platelet count of 475

D. White blood cell count of 14

4. A toddler is receiving long•term antibiotics to treat osteomyelitis. Which laboratory

ID: 13348428747

ID: 13348428799

ID: 13348428751

ID: 13348428793

test will the primary care pediatric nurse practitioner order to monitor response to therapy in thischild?

A. Blood cultures

B. Erythrocyte sedimentation rate (ESR) Correct

C. Serum procalcitonin (Pro•CT)

D. White blood count (WBC)

5. According to recent research, which populations may have higher rates of under• ID: 13348428779

immunization than others?

A. Those with higher rates of Asians

B. Those with higher rates of graduate degrees Correct

C. Those with lower rates of poverty

Correct

D. Those with lower rates of primary providers

6. The parent of a 2 • month•old infant is reluctant to have the baby vaccinated. What ID: 13348428749 is aninitial

step in responding to these concerns?

A. Inform the parent that all vaccines may be given without thimerosol.

B. Providing Vaccine Information Statements for the parent to review.

C. Question the parent’s reasons for concern about immunizations.

D. Remind the parent that the infant is exposed to thousands of germs each day.

7. A parent is concerned about vaccine adverse reactions. Based on an Institute of Medicine

report, what will the primary care pediatric nurse practitioner tell the parent?

ID: 13348428755

A. Administering multiple vaccines may trigger the development of type 1 diabetes.

B. The MMR may be linked to febrile seizures in immunocompromised children. Correct

C. There is some risk of CNS disorders associated with the hepatitis B vaccine.

D. Vaccines containing thimerosol are linked to pervasive developmental disorders.

8. A^2 • month•old^ infant^ will^ receive^ initial^ immunizations,^ and^ the^ parent^ asks^ about^ giving^ ID:^13348428777

medications to increase the infant’s comfort and minimize fever. What will the pediatric

primary care nurse

practitioner recommend?

A. Administering ibuprofen or acetaminophen as needed Correct

B. Avoiding antipyretics if possible to attain better immunity

C. Giving ibuprofen and acetaminophen only after the vaccines

D. Pre•treating the infant with both ibuprofen and acetaminophen

9. The parent of an infant asks why some vaccines, such as MMR, are not given ID:^13348428787

along with the other series of immunizations at 2, 4, and 6 months of age. What will the primarycare

pediatric nurse practitioner tell this parent?

A. Febrile seizures are more likely in younger infants with some vaccines.

B. Maternal antibodies neutralize some vaccines and are delayed until 12 months.

Correct

C. The risk of adverse effects is lower for some vaccines after the first year.

D. Too many vaccines at once can overwhelm the infant’s immune system.

10. The primary care pediatric nurse practitioner is performing an initial well child ID: 13348428739

exam on a 3 • year•old child recently adopted from Africa. The adoptive parent has a record ofimmunizations

indicating that the child is fully vaccinated. What will the nurse practitioner do?

rrect

A. Administer a booster dose of each vaccine to ensure immunity.

B. Find out whether the vaccines were provided by reliable suppliers.

C. Perform antibody titers and reimmunize the child. Correct

D. Record the vaccines in the child’s electronic medical record.

11. The primary care pediatric nurse practitioner reviews the immunization records of ID:^13348428765

an 18 • month•old child and notes that the child received an MMR immunization 2 days prior to thefirst

birthday. What will the nurse practitioner do?

A. Administer a reduced dose of MMR to ensure adequate immunity.

B. Obtain mumps, measles, and rubella titers to determine immunity.

C. Recommend the next dose of MMR vaccine at 4 to 5 years of age. Correct

D. Repeat the MMR vaccine since the first dose was given too soon

12. A 5 • year•old child who has a history of pertussis infection as an infant is in theclinic

for immunizations prior to kindergarten. Which vaccine will be given?

A. DTaP

B. DTP

C. Td

D. Tdap

13. An adolescent female who is sexually active and who has not had the HPV

ID: 13348428791

ID: 13348428757

vaccine asks if she may have it. What will the primary care pediatric nurse practitioner tell her?

A. Getting the vaccine now will still protect her from HPV oncogenic types even if already

exposed

B. Receiving the HPV vaccine series will replace the need for regular cervical cancer

screening

C. She will need to have Papanicolaou and pregnancy screening prior to receiving thevaccine

D. The vaccine will not protect her from any HPV oncogenic types acquired

previously Correct

14. An 18 • month•old child has bronchopulmonary dysplasia. To help prevent ID: 13348428761

pneumococcal disease, which vaccine will be ordered?

A. PCV

B. PCV13 Correct

C. PCV

D. PCV

Correct

15. A 5 • year•old child who received VariZIG after exposure to varicella while M.^ N.^ ID:

immunocompromised during chemotherapy is in the clinic 5 months after stopping chemotherapy for

kindergarten vaccines. What will the primary care pediatric nurse practitioner order for this child?

K.

A. MMR and Tdap

B. MMR, Varivax, Tdap Correct

C. Tdap only

D. Varivax and Tdap

16. A 3 • year•old child who attends day care has had a fever, nausea, and vomiting L.^ ID:

several weeks prior and now has darkened urine and constipation along with hepatomegaly andright

upper quadrant tenderness. What treatment is warranted for this child?

I.

A. HAV vaccine

B. Immunoglobulin G

C. Interferon•alfa

D. Supportive care Correct

17. A 10 • month•old infant who is new to the clinic has chronic hepatitis B infection. J.^ ID:

What will the primary care pediatric nurse practitioner do to manage this infant’s disease?

G.

A. Consult a pediatric infectious disease specialist. Correct

B. Prescribe interferon•alfa.

C. Provide supportive care.

D. Consider use of lamivudine.

18. The primary care pediatric nurse practitioner performs a well child examination on H.^ ID:

a 1 • month•old. The infant was recently discharged from the neonatal intensive care unit after treatment

with parenteral acyclovir for a neonatal herpetic infection and is currently taking oralacyclovir. What will

the nurse practitioner do to manage this infant’s care?

A. Obtain regular absolute neutrophil counts. Correct

B. Perform routine skin cultures for herpes simplex virus.

C. Reinforce the need to give acyclovir indefinitely.

D. Stop the oral acyclovir at 2 months of age.

19. A 9 • month•old infant has had a fever of 103 °F for 2 days and now has a diffuse,

E.

F. ID:

maculopapular rash that blanches on pressure. The infant’s immunizations are up•to•date. What willthe

primary care pediatric nurse practitioner do?

A. Administer immunoglobulin G to prevent fulminant illness.

B. Perform serologic testing for human herpes virus • 6 and human herpes virus • 7.

C. Reassure the parent that this is a mild, self•limiting disease. Correct

D. Recommend avoiding contact with pregnant women.

20. A child who is immunocompromised has a fever and a rash consisting of macules,papules,

and pustules. What will the primary care pediatric nurse practitioner do?

A. Administer varicella immune globulin (VariZIG).

B. Hospitalize the child for intravenous acyclovir.

C. Order intravenous immunoglobulin as an outpatient.

D. Prescribe oral acyclovir for the duration of the illness.

21. A child whose parents have refused vaccines has been exposed to chickenpox,

ID: 13348428771

ID: 13348428763

and the parents ask whether the child may attend day care. What will the primary care pediatricnurse

practitioner tell them?

A. The child may attend day care as long as no rash is present even with mild fever orother

symptoms.

B. The child should remain home and receive oral acyclovir for 5 days to prevent onset of

symptoms.

C. The child should stay home until the 21 • day incubation period has passed even ifsymptom free.

D. The child should stay home if any symptoms occur and may return in 1 week if

no rash develops. Correct

22. An 18 • month•old child who developed upper respiratory symptoms 1 day prior is ID:^13348428797

brought to the clinic with a high fever, chills, muscle pains, and a dry, hacking cough. A rapid influenza

test is negative and a viral culture is pending. What will the primary care pediatric nursepractitioner do?

A. Consider therapy with rimantadine.

B. Hospitalize for supportive treatment.

C. Prescribe oseltamivir and follow closely Correct D.

Wait for cultures to determine treatment.

23. The primary care pediatric nurse practitioner is reviewing medical records for a ID: 13348428781

newborn that is new to the clinic. The toddler’s mother was found to be HIV positive during her pregnancy with

this child and received antiretroviral therapy during pregnancy. The child was born by cesarean section, begun

on anti•retroviral prophylaxis, and did not breastfeed. What is the correct management for this child?

rrect

A. Consult with a pediatric HIV specialist. Correct

B. Discontinue cART after 4 weeks of age.

C. Obtain a CD4+ cell count and HIV RNA levels.

D. Reinforce the need to give cART for life.

24. A 3 • year•old child whose immunizations are up•to•date has been exposed to ID:^13348428795

measles because of a localized outbreak among unvaccinated children. The parent reports thatcontact with

infected children occurred within the last 2 days at a birthday party. What is the best course of action?

A. Administer the MMR vaccine to help prevent disease. Correct

B. Give antiviral medications at the first sign of symptoms.

C. Give the child a dose of immune globulin to mitigate the response.

D. Reassure the parent that most exposed children will not get measles.

25. A preschool•age child is brought to clinic for evaluation of a rash. The primary ID: 13348428773

care pediatric nurse practitioner notes an intense red eruption on the child’s cheeks and circumoralpallor. What will

the nurse practitioner tell the parents about this rash?

A. This rash may be a prodromal sign of rubella or roseola.

B. The child will need immunization boosters to prevent serious disease.

C. This is a benign rash with no known serious complications.

D. Expect a lacy, maculopapular rash to develop on the trunk and extremities. Correct

26. An unimmunized school•age child whose mother is in her first trimester of ID: 13348428745

pregnancy is diagnosed with rubella after a local outbreak. What will the primary care pediatricnurse

practitioner recommend?

A. Assessment of maternal rubella titers Correct

B. Intravenous immunoglobulin for the child

C. MMR vaccine for the mother and child

D. Possible termination of the pregnancy

27. A child is brought to the clinic with a fever, headache, malaise, and a red, annular ID:^13348428783

macule surrounded by an area of clearing and a larger, erythematous annular ring. The child complains of

itching at the site. What will the primary care pediatric nurse practitioner do to

determine the diagnosis?

A. Ask about recent tick bites Correct

B. Obtain a skin culture

C. Order blood cultures

D. Perform serologic testing

28. A child whose family has been camping in a region with endemic Lyme disease suffered

several tick bites. The parents report removing the ticks but are not able to orthe length of

time the ticks were attached. The child is asymptomatic. What is the action?

A. Administer a prophylactic single dose of doxycycline.

B. Perform serologic testing for IgG or IgM antibodies.

C. Prescribe amoxicillin three times daily for 14 to 21 days.

D. Teach the parents which signs and symptoms to report.

29. A 10 • month•old infant has an erythematous, fluctuant, non•draining abscess on

HF...

I. ID:

13348428769

verify the type

G. ID:

the right buttock after 10 days of treatment with amoxicillin for impetigo. What is the next step in

managing this infant’s care?

A. Consultation with a pediatric infectious disease specialist

B. Culture of any superficial open surface wounds

C. Empiric treatment with clindamycin

D. Incision and drainage of the abscess with culture

30. A child with a history of a pustular rash at the site of a cat scratch on one arm now

D.

E. ID:

has warm, tender, swollen axillary lymph nodes on the affected side. The primary care pediatric nurse

practitioner notes induration and erythema of these nodes. What will the nurse practitionerdo?

A. Obtain a complete blood count and C•reactive protein.

B. Order an immunofluorescent assay (IFA) for serum antibodies.

C. Perform a needle aspiration of the affected lymph nodes.

D. Prescribe a 5 • day course of azithromycin.

31. A 7 • year•old child whose immunizations are up•to•date has a fever, headache, ID: 13348431603

stiff neck, and photophobia. What course of treatment is indicated?

A. Empiric treatment with oral antibiotics or intramuscular ceftriaxone

B. Hospitalization for diagnosis and treatment with antibiotics

C. Immediate vaccination with meningococcal vaccine

D. Outpatient lab work, including a CBC and blood and CSF cultures

32. A school•age child has fever of 104 °F, sore throat, vomiting and malaise. The ID: 13348428789

primary care pediatric nurse practitioner observes that the tonsils, oropharynx, and palate are

rect

rrect

Correct

Correct

erythematous and covered with exudate; the tongue is coated and red; and there is a red, sandpaper like rash

on the child’s neck, trunk, and extremities. A rapid strep test is positive. Whatwill the nurse practitioner do to

manage this child’s illness?

A. Administer intramuscular ceftriaxone.

B. Hospitalize for further diagnostic tests.

C. Prescribe oral amoxicillin. Correct

D. Refer to a pediatric infectious disease specialist.

33. An adolescent has a TB skin test prior to working as a volunteer in a hospital. The ID:^13348428753

adolescent is healthy and has not travelled to or from a TB•endemic area or had close contact with anyone who

has TB. The Mantoux skin test shows 10 mm of induration after 48 hours. What will the primary care pediatric

nurse practitioner do?

A. Ask the adolescent about exposure to homeless persons.

B. Order a chest radiograph to rule out active TB.

C. Reassure the adolescent that this is a negative screen. Correct

D. Refer the adolescent to an infectious disease specialist.

34. The primary care pediatric nurse practitioner is examining a 2 • month•old infant ID: 13348428775

with fever and cough. A WBC is 14,000/mm

3

and a chest radiograph is normal. The infant isnursing well

and having normal stools. What would be an appropriate next step?

A. Admitting the infant to the hospital for LP and IV antibiotics

B. Obtaining a blood culture, erythrocyte sedimentation rate, and C•reactive protein

C. Performing a catheterized urinalysis to screen for leukocytes and nitrites Correct D. Prescribing

empiric, broad•spectrum antibiotics with close follow•up

Questions

1. An 8 • year•old child is diagnosed with systemic lupus erythematosus (SLE), and ID:^13348419868

the child’s parent asks if there is a cure. What will the primary care pediatric nurse practitioner tellthe parent?

A. Complete remission occurs in some children at the age of puberty.

B. Periods of remission may occur but there is no permanent cure. Correct

C. SLE can be cured with effective medication and treatment.

D. The disease is always progressive with no cure and no remissions.

2. The primary care pediatric nurse practitioner examines a child who has had ID:^13348419872

stiffness and warmth in the right knee and left ankle for 7 or 8 months but no back pain. The nurse practitioner

will refer the child to a rheumatology specialist to evaluate for

A. enthesitis•related JIA.

B. oligoarticular JIA. Correct

C. polyarticular JIA.

D. systemic JIA.

3. The primary care pediatric nurse practitioner is managing care for a child who hasJIA

who has a positive ANA. Which specialty referral is critical for this child?

A. Cardiology

B. Ophthalmology Correct

C. Orthopedics

D. Pain management

4. The^ primary^ care^ pediatric^ nurse^ practitioner^ is^ prescribing^ ibuprofen^ for^ a^25 kg

ID: 13348419892

ID: 13348419860

child with JIA who has oligoarthitis. If the child will take 4 doses per day, what is the maximumamount

the child will receive per dose?

A. 200 mg

B. 250 mg Correct

C. 400 mg

D. 450 mg

5. The parent of a school•age child who is diagnosed with oligoarticular JIA asks the ID:^13348419894

primary care pediatric nurse practitioner what exercises the child may do to help reducesymptoms. What

will the nurse practitioner recommend?

A. Running