Download Pediatric Infectious Diseases and Immunizations and more Exams Pediatrics in PDF only on Docsity!
PNP Pediatric Nurse Practitioner 2024
Summer Semester Final Exam
Review Questions and Answers 100%
Pass
The PNP is examining an infant in the newborn nursery whose mother had no prenatal care. What mode of disease transmission must the PNP consider in this scenario? a. Passive b. Airborne c. Vertical d. Vector - Answer>> C. Vertical Which of the following pathogens are concerning for vertical transmission? Select all that apply. a. Rubella b. Chicken pox c. Chlamydia d. Cytomegalovirus e. Herpes virus - Answer>> All of them
- A 3-year-old child who attends daycare has had a fever, nausea, and vomiting several weeks prior and now has darkened urine and right upper quadrant tenderness. What treatment is warranted for this child? a. Immunoglobulin G b. Supportive care c. HAV Vaccine d. Interferon-alfa - Answer>> B. Supportive Care The PNP is examining a 2-day-old infant. The mother states she refused the Hepatitis B vaccine in the newborn nursery because
she is breastfeeding and "this provides immunity". The PNP explains immunity to Hepatitis B can only occur through: a. Naturally acquired passive immunity b. Artificially acquired passive immunity via IVIG c. Acquired immunity d. Artificially acquired active immunity - Answer>> d. Artificially acquired active immunity Which of the following should the PNP elicit when obtaining a history from a patient suggestive of an infectious disease? Select all that apply. (1.67/5) a. Local outbreaks b. Travel history c. Immunizations status d. Diet history - Answer>> b. Travel history c. Immunizations status d. Diet history A 9 month-old infant has had a fever of 103°F for 2 days. On exam, the infant is afebrile non toxic appearing and now has a diffuse, maculopapular rash that blanches on pressure. The infants immunizations are up to date What will the PNP do? a. Reassure the parent that this is a mild, self-limiting disease b. Recommend avoiding contact with pregnant women c. Prescribe a 10-day course of amoxicillin d. Perform serologic testing for human herpes virus-6 and human herpes virus -7 - Answer>> a. Reassure the parent that this is a mild, self-limiting disease A child who is immunocompromised has a fever and a rash consisting of macules, papules, and pustules. What will the PNP do? a. Recommend symptomatic care b. Prescribe oral acyclovir for the duration of the illness c. Administer varicella immune globulin (VarIZIG)
A 10-year-old presents to the clinic with a Mantoux skin test showing 20 mm of induration after 48 hours. The PNP reviews the child's immunization record and finds the child received the BCG vaccine while living in Mexico What will the primary care pediatric nurse practitioner do? a. Obtain an IGRA assay b. Treat the child with INH c. Order a chest radiograph to rule out active TB d. Refer the child to an infectious disease specialist - Answer>> a. Obtain an IGRA assay A 5-year-old female presents with a low-grade fever, sore throat, rhinorhea, and a grayish-white pseudomembrane on her throat. What is the most likely diagnosis? a. Adenovirus b. Diphtheria c. Mononucleosis d. Streptococcal Pharyngitis - Answer>> b. Diphtheria A 9-year-old male presents with a fever of 103, cough, congestion, chills, and body aches. Which of the following should the PNP include in the differential diagnosis? Select all that apply. a. Influenza B b. COVID- c. Influenza A d. Tuberculosis - Answer>> a. Influenza B b. COVID- c. Influenza A What recommendation will the PN make to a parent whose son has been diagnosed with mumps and who wants to know when the child can return to school? a. He can return after 72 hours of antibiotic therapy b. He can return when the swelling has resolved c. He can return 9 days after onset of symptoms
d. He can return once he is febrile and eating well - Answer>> c. He can return 9 days after onset of symptoms A 11-year-old male presents with a fever and rash. The rash was initially erythematous and macular then became maculopapular and petechial. The rash began on the wrists and ankles and spread to the palms, soles, and trunk. What is the most likely diagnosis? a. Lyme disease b. Measles c. Roseola d. Rocky mountain spotted fever - Answer>> d. Rocky mountain spotted fever Which of the following factors is not associated with increased risk for infantile botulism? a. Honey ingestion b. Living on a farm c. Rural Environment d. Corn syrup ingestion - Answer>> Corn syrup ingestion Patrick, a 19-year-old college student, is planning a college course trip to Nigeria. Which of the following will the PNP recommend? Select all that apply. Note: https://wwwnc.cdc.gov/travel/destinations/list B may be helpful a. Amoxicillin for travelers' diarrhea b. Hepatitis A vaccine c. Yellow fever vaccine d. Antimalarial medication - Answer>> b. Hepatitis A vaccine c. Yellow fever vaccine d. Antimalarial medication What will the PNP include as part of Alex's care? Select all that apply
Sam, a 7-year-old presents with the following pruritic rash. The lesions started today and come and go. What is the most likely diagnosis for Sam's rash? a. Insect bites b. Urticaria c. Contact dermatitis d. Bullous impetigo - Answer>> b. Urticaria
- Which of the following should be included in the differential diagnosis of scabies? Select all that apply.
- Atopic dermatitis
- Insect bites
- Acne
- Seborrhea dermatitis
- Viral Exanthem - Answer>> 1. Atopic dermatitis
- Insect bites
- Seborrhea dermatitis
- Viral Exanthem 1.Which of the following should be included in the differential diagnosis of atopic dermatitis? Select all that apply. a. Varicella b. Psoriasis c. Scabies d. Measles e. Seborrheic dermatitis - Answer>> b. Psoriasis c. Scabies e. Seborrheic dermatitis 1.A 5-year-old presents with the following rash in the extensor surfaces of her elbows. What is the appropriate treatment? Select all that apply. a. Amoxicillin PO bid for 10 days
b. Keflex PO bid for 10 days c. 5% permethrin d. Topical moisturizer e. Topical triamcinolone - Answer>> b. Keflex PO bid for 10 days d. Topical moisturizer e. Topical triamcinolone A 30-month-old girl who has been toilet trained for 6 months has daytime enuresis and dysuria and low-grade fever. A dipstick urinalysis is negative for leukocytes and esterase and nitrates. What is the next step? a. Begin empiric treatment with trimethoprim-sulfamethaxazole b. Discuss behavioral interventions for toilet training c. Send the urine to the lab for culture d. Reassure the child's parents that the child does not have a UTI
- Answer>> c. Send the urine to the lab for culture
- The clean catch urine specimen of a child with dysuria, frequency and fever has a colony count between 50,000 and 100,000 of coli. What is the most appropriate treatment for this child? a. Repeat the culture if symptoms persist or worsen b. Obtain a complete blood count and C-reactive protein c. Treat with antibiotics for urinary tract infection d. Perform sensitivity testing before treating with antibiotics - Answer>> c. Treat with antibiotics for urinary tract infection An adolescent has 2+ proteinuria in a random dipstick urinalysis. What is the most appropriate next step? a. Refer to pediatric nephrology b. Send a urine culture c. Order a 24-hour timed urine collection for creatinine and protein excretion
- An adolescent male comes to the clinic reporting unilateral scrotal pain, nausea, and vomiting that began that morning. The primary care pediatric nurse practitioner palpates a painful, swollen, testis and elicits increased pain with slight elevation of the testis (a negative Phren's sign). What will the nurse practitioner do? a. Encourage bed rest, scrotal support, and ice packs to the scrotum as tolerated b. Refer the adolescent immediately to a pediatric urologist or surgeon c. Prescribe NSAIDs, limited activities, and warm compresses to the scrotum d. Administer IM ceftriaxone and prescribe doxycycline twice daily for 10 days - Answer>> b. Refer the adolescent immediately to a pediatric urologist or surgeon
- While examining a 4-month-old boy, you are unable to palpate one of the testes. The next most appropriate step is to: a. Consult with a pediatrician b. Refer the child to a urologist c. Reexamine the baby in 2 months d. Reassure the parents this is a normal finding - Answer>> b. Refer the child to a urologist
- Peter, a 15-year-old adolescent, presents to the clinic with complaints of a painless "swelling" in the left side of his scrotum. The most likely diagnosis is: a. Testicular torsion b. Hydrocele c. Epididymitis d. Incarcerated hernia - Answer>> b. Hydrocele
- An adolescent has sudden onset of right-sided flank pain without fever. A dipstick urinalysis reveals gross hematuria
without signs of infection or bacteriuria. What is the initial treatment for this condition? a. Increasing fluid intake up to 2L daily b. Percutaneous removal of renal calculi c. Referral to a pediatric nephrologist d. Extracorporeal shockwave lithotripsy (ESWL) - Answer>> a. Increasing fluid intake up to 2L daily
- Urinary tract infections are the most common pediatric urinary tract problems seen in primary care. Which of the following is not true regarding's UTIs? a. Symptoms are often nonspecific, especially in infants b. Trimethoprim-sulfamethoxazole is the drug of choice for most children c. Urine culture is required for definitive diagnosis d. Radiologic studies are rarely indicated with the first infection - Answer>> d. Radiologic studies are rarely indicated with the first infection
- A 22-month-old female presents to your office with painful urination, frequency, and occasional incontinence over the past week. When seen in your office, she has a fever of 102 F. which of the following would be your approach in establishing a definitive diagnosis? a. Straight catheterization collection for urine culture b. Straight catheterization collection for urine analysis c. Clean-catch midstream urine for urine culture d. Clean-catch midstream urine for urine analysis - Answer>> a. Straight catheterization collection for urine culture Luke, an 8 year old body with fever of 102 F, presents to your clinic for evaluation of a suspected urinary tract infection. Which of the following signs would lead you to include diagnoses other than UTI in the differential? a. Incontinence
- Which of the following antibiotics are appropriate for initial management of Lucy's suspected UTI while a culture is pending? Select all that apply a. Amoxicillin b. Cephalexin c. Aazithromycin d. Clindamycin e. Trimethoprim-sulfamethoxazole - Answer>> a. Amoxicillin b. Cephalexin e. Trimethoprim-sulfamethoxazole
- The mother of an uncircumcised 11 mo male infant reports that the child seems to have pain associated with voiding. A physical examination reveals a tight, pinpoint opening of the foreskin, which thickened and inflamed. What will the primary care pediatric nurse practitioner do? a. Attempt to retract the foreskin to visualize the penis b. Teach the mother to gently stretch the foreskin with cleaning c. Refer the child to a pediatric urologist d. Order corticosteroid cream 3 times daily for 4 weeks - Answer>> c. Refer the child to a pediatric urologist A 9-month-old infant is brought to the clinic with scrotal swelling and fussiness. The primary care pediatric nurse practitioner notes a tender mass in the affected scrotum that is difficult to reduce. What is the correct action? a. Teach the parents signs of incarceration b. Schedule an appointment with a pediatric urologist c. Obtain an abdominal radiograph d. Refer immediately to a pediatric surgeon - Answer>> d. Refer immediately to a pediatric surgeon
- A child has gross hematuria, abdominal pain, and arthralgia as well as a rash. What diagnosis is most likely? a. Systemic lupus erythematosus
b. Henoch-schonlein purpura c. Rhabdomyosarcoma d. pyelonephritis - Answer>> b. Henoch-schonlein purpura
- What intervention does the primary provide for a child diagnosed with several complex health conditions? (select all that apply.) a. Maintaining the child's routine vaccinations as well as a yearly flu shot b. Providing diagnosis and treatment for the child's acute onset of ear fullness and pain c. Providing an explanation regarding the use and care of the clients respiratory support equiptment d. Referring the child to a respiratory specialist to deal with exacerbation of asthma symptomology e. Discussing the expected physical implications of puberty with the patient's parents - Answer>> All but C
- Support for a child with complex health issues may require the use of what high level tech equipment a. Urinary catheter b. Enteral feeding pump c. A handheld magnifier d. Crutches - Answer>> b. Enteral feeding pump
- Which complex health condition is the result of a chromosomal defect causing varied physical and emotional symptoms? a. Cerebral palsy b. Prader-willi syndrome c. Cystic fibrosis d. Diabetes - Answer>> b. Prader-willi syndrome
- What is the greatest barrier to securing adequate home health care for the child with complex medical needs? a. Shortage of trained service providers
A child with a diagnosis of schizencephaly is assigned to a new nurse on the pediatric floor. The new nurse has not worked with a child with this diagnosis before. A career nurse discusses the plan of care needed for the child with the new nurse. It will be important to: a. Assess the side of the body that has paralysis for any lesions or sores b. Let the patient do as much as possible for activities of daily c. Discourage the patient to move the paralyzed side of the body d. Provide full care for this patient - Answer>> a. Assess the side of the body that has paralysis for any lesions or sores
- A nurse is assessing a 6-month-old boys suture lines. The nurse notes that the baby has craniosynostosis the nurse should be concerned because: a. The suture line closure will not allow the brain to grow b. This can lead to hydrocephalus c. The child will have immediate developmental delays because of the lack of space for the brain to grow d. The child will not require surgery - Answer>> a. The suture line closure will not allow the brain to grow
- A child that had a shunt placed four years ago for hydrocephalus is in the emergency room complaining of a rapid onset of vomiting and increased lethargy. The nurse knows that the child will need: a. Nothing, as this is a normal complication and not an emergency b. To be placed on IV fluids to help maintain an electrolyte balance c. Small amounts of fluids until the vomiting has subsided d. To consider this a neurological medical emergency and check the childs head circumference - Answer>> d. To consider this a neurological medical emergency and check the childs head circumference
- Night terrors can occur in adolescents because of: a. Emotional stress b. Alcohol use c. Bullying d. All of the above can trigger night terrors in adolescents - Answer>> d. All of the above can trigger night terrors in adolescents
- When speaking with family about their 9-year-old daughters nightmares it is important to ask a. If the child has a history of daytime napping b. What medications the child takes during the day c. How often the child consumes caffeine d. All of the above should be part of the assessment - Answer>> d. All of the above should be part of the assessment A mother is asking the nurse why her daughter continues to have temporal lobe seizures even though she is on medication. The nurse knows this is occurring because: a. The medication may not be in the therapeutic range b. Temporal lobe seizures do not respond well to medications c. The daughter may be missing doses of her medication d. The food her daughter eats may have a negative reaction with the medication, causing more seizures - Answer>> b. Temporal lobe seizures do not respond well to medications Which of the following types of epilepsy are photosensitive?. a. Juvenile myoclonic epilepsy b. Temporal lobe epilepsy c. Febrile seizures d. Childhood absence epilepsy - Answer>> a. Juvenile myoclonic epilepsy
b. May have severe mental and physical challenges due to the frequent seizure activity c. May exhibit a slight cognitive delay as he grows d. Will grow out of having seizures - Answer>> b. May have severe mental and physical challenges due to the frequent seizure activity
- A child has been status epileptics for the last 20 minutes. The child has Depakote, Valproic Acid, and Diazepam gel ordered. The nurse should prepare which medication for administration at this time? a. Depakote b. Valproic acid c. Diazepam d. None of the medications. The child will stop on his own. - Answer>> c. Diazepam
- Care for a child during status epilepticus should include all of the following except: a. Turn the patient to the right side b. Loosen tight clothes c. Move toys out of the area to prevent injury d. Stay with the patient until the seizure has stopped - Answer>> a. Turn the patient to the right side
- The nurse is identifying the difference between primary headaches to secondary headaches. Secondary headaches can occur: a. Because of stress b. In relation to low blood pressure c. Because of concussions d. Because of migraines - Answer>> c. Because of concussions
- Cyclic vomiting may a. Last for days b. Require SSRIs to stop hurting c. Not be associated with a headache d. Requires pain medication and Zofran - Answer>> c. Not be associated with a headache
- A child that has rhythmic, repetive, involuntary movements is exhibiting: a. Tremors b. Dystonia c. Contractures d. Tics - Answer>> b. Dystonia
- Identify a therapeutic management technique for a child with a tic disorder a. Behavioral modification to suppress the tics b. Administer anti-psychotic medications to reduce the tics c. Education and support for the child and the family d. Genetic counseling for the family - Answer>> c. Education and support for the child and the family The assessment of a nurse performed on a 12-year-old boy demonstrated a positive Kernigs sign and a Brudzinskis sign. Identify the priority for the nurses next action. a. Document the findings and note as normal b. Further assess the neurological function of the child and call the doctor with a report c. Explain to the patient that the assessment was abnormal and there is no a cause for concern d. Prepare the child for lumbar puncture - Answer>> b. Further assess the neurological function of the child and call the doctor with a report
