Pediatric Nurse Practitioner Exam Questions, Exams of Nursing

Download Pediatric Nurse Practitioner Exam Questions and more Exams Nursing in PDF only on Docsity! NSG 6435 FINAL EXAM 2 VERSIONS 2023/2024 Which of the following is not found in an adolescent with untreated Graves' disease? Question 1 options: a) Behavioral problems b) Sleep disturbances d) Tachycardia Save Question 2 (2 points) A fifteen-year-old male patient reports a three-day history of sore throat, fever, and malaise. Physical examination reveals pharyngitis, anterior cervical adenopathy, and an oral temperature of 101.6 degree Fahrenheit (38.7 degree Celsius). Which diagnostic test does a pediatric primary care nurse practitioner order next? Question 2 options: a) Antistreptolysin O titer c) Tendency to gain weight easily Save Question 6 (2 points) The nurse practitioner recognizes which of the following signs as indicators that baby is not receiving sufficient breastmilk from the mother? Question 6 options: b) Diarrhea, nausea, and vomiting c) Bulging fontanel and irritability d) Sleeplessness and excitability Save Question 7 (2 points) The sexual development of a fourteen-year-old girl is notably delayed. She is very short, slightly obese, and complains of constipation and fatigue. Her skin is sallow and coarse in texture, and her hair is brittle. Which of the following tests should be obtained? Question 7 options: a) Chromosome analysis and serum thyroxine a) Sleepiness, jaundice, decreased urine, and stool c) Serum luteinizing hormone and chromosome analysis d) Serum luteinizing hormone and thyroid-stimulating hormone Save Question 8 (2 points) children are less likely to be diagnosed with attention deficit disorder than others. Question 8 options: a) African American b) Non-Hispanic White c) Asian Save Question 9 (2 points) b) Serum thyroxine and thyroid-stimulating hormone d) Hispanic The most common form of juvenile rheumatoid arthritis is _. Question 9 options: a) systemic c) osteoarticular d) polyarticular Save Question 10 (2 points) Indications for immediate dialysis in the pediatric patient is Question 10 options: a) hypotension b) hyperkalemia d) dehydration b) pauciarticular c) hypercalcemia An immunocompromised four-year-old patient presents for his vaccinations. Which vaccination would you hold on this patient? Question 15 options: b) Hib c) Pneumococcal conjugate vaccine (PCV) 13 d) DtaP Save Question 16 (2 points) Bipolar disease is often diagnosed in _. Question 16 options: a) childhood years b) the fifth or sixth decade c) mid puberty a) MMR d) post puberty to early adulthood Save Question 17 (2 points) Biomedical issues that may create academic performance issues include . Question 17 options: a) substance abuse b) familial stressors c) cultural differences Save Question 18 (2 points) increases a child’s risk of being diagnosed with attention deficit hyperactivity disorder. Question 18 options: a) Exposure to paternal tobacco use d) fetal alcohol syndrome b) Exposure to maternal antidepressant use c) Exposure to paternal antidepressant use Save Question 19 (2 points) Question 19 options: The best way to screen for human papilloma virus in an adolescent female is Save Question 20 (2 points) Attention deficit hyperactivity disorder may be _. Question 20 options: b) learned c) acquired d) triggered by a virus d) Exposure to maternal tobacco use a) familial Save Question 25 (2 points) It is important to monitor in an adolescent with inflammatory bowel disease? Question 25 options: a) linear growth b) skeletal development c) pubertal changes Save Question 26 (2 points) Which of the following medications should be avoided in a patient with idiopathic thrombocytopenic purpura (ITP Question 26 options: a) Decongestants d) the Americans with Disabilities Act d) all of the above b) Sulfa drugs c) Acetaminophen Save Question 27 (2 points) The two primary sources of inflammatory bowel disease are and . Question 27 options: a) Helicobacter pylori; Crohn’s disease b) diverticulosis; ulcerative colitis c) Crohn’s disease; diverticulosis Save Question 28 (2 points) An otherwise healthy two-year-old boy is brought to the emergency room with a four-week history of wheezing and persistent cough. Prior to the start of these d) Aspirin d) Crohn’s disease; ulcerative colitis symptoms, the parent recalls a coughing event that resolved spontaneously. Of the following the most likely diagnosis is: Question 28 options: a) acute laryngotracheobronchitis b) bronchiolitis c) viral pneumonia Save Question 29 (2 points) Which of the following is not a sign or symptoms of congenital hypothyroidism? Question 29 options: a) Hoarse cry c) Coarse features d) Lethargy d) foreign body aspiration b) Frequent stooling Question 33 options: a) HPV2 (Cervarix) c) Meningococcal vaccine (MPSV) 4 (Menomune) d) Pneumococcal polysaccharide vaccine (PPSV) 23 (Pneumovax) Save Question 34 (2 points) The nurse practitioner sees a three-week-old infant in the clinic. Initial assessment findings show an infant with a 100.5 degree Fahrenheit rectal temperature, heart rate 120, respiratory rate 50. Upon physical exam no noted abnormalities are found. What would be the appropriate response of the primary care, clinic nurse practitioner? Question 34 options: b) Obtain CBC with diff, urinalysis, urine culture, blood culture c) Obtain CBC, urinalysis, urine culture and stool culture d) Observe since this is not considered a b) Tdap (Adacel) a) Transport immediately to the ER Save Question 35 (2 points) Genu Varum is considered an abnormal condition when extreme knock knees continues Question 35 options: a) after seven years of age c) parents are concerned about their child's appearance d) evident before two years of age Save Question 36 (2 points) The reliving of a very personal, negative, or traumatic event, over and over again is known as _. Question 36 options: a) anxiety disorders b) extreme bowing continues after two years of age b) flashbacks c) story telling Save Question 37 (2 points) The parents of a twelve-year old are concerned about their daughter’s fear of school. She is reluctant to go and will “come home early because she is sick.” You suspect the patient suffers from _. Question 37 options: a) attention deficit hyperactivity disorder b) truancy c) learning disabilities Save Question 38 (2 points) d) post-traumatic stress disorder d) school phobia d) Dopamine agonist inhibitors Save Question 42 (2 points) Type 1 diabetes begins when _. Question 42 options: a) the adolescent is overweight c) insulin resistance is present d) poor nutrition is present Save Question 43 (2 points) Which of the following results would you most likely see in a child with a viral infection? Question 43 options: a) Leukocytosis b) beta cell production fails b) Leukopenia c) Elevated band count d) Increased neutrophils Save Question 44 (2 points) A fifteen-year-old male patient with cerebral palsy has been experiencing alteration in mood for the past two days, complains of an unusual odor, and then begins to have forceful muscle contractions followed by flaccidity then lethargy. You would describe this as a _. Question 44 options: a) prodrome b) postictal state d) petit mal seizure Save Question 45 (2 points) The feeling of loss of control over eating is known as _. Question 45 options: c) tonic-clonic seizure a) bulimia c) fad diets d) anorexia Save Question 46 (2 points) A sixteen-year-old male presents to your office accompanied by his parents. They are concerned about his absenteeism from school. You suspect the patient has . Question 46 options: b) suffers from attention deficit disorder c) social anxiety disorder d) panic attacks Save Question 47 (2 points) b) binge eating disorder a) made a conscious decision to miss school (truancy) Pauciarticular arthritis is identified by pain in joints. Question 51 options: a) multiple b) single c) zero Save Question 52 (2 points) Type 2 diabetes is found Question 52 options: a) in overweight adolescents b) when insulin resistance is present c) adequate endogenous insulin is present Save Question 53 (2 points) d) few d) All of the above Which group of adolescents is more likely to develop Type 1 diabetes? Question 53 options: b) American-Indian adolescents c) African-American adolescents d) Pacific Islander adolescents Save Question 54 (2 points) Which of the following is most accurate regarding pain assessment in the pediatric patient? Question 54 options: b) Most pediatric patients can use self-report pain scales (e.g., Faces scale, 0–10 scales) by two years of age c) Premature neonates are neurologically less capable of feeling pain d) Parents are an unreliable source of pain assessment in the cognitively impaired pediatric patient a) Non-Hispanic white adolescents a) Behavioral pain assessment measures are useful for measuring pain in infants or children with impaired communication skills Save Question 55 (2 points) Question 55 options: The best way to screen for gonorrhea in an adolescent female is Save Question 56 (2 points) The primary age of onset for inflammatory bowel disease is between ages of and _. Question 56 options: a) ten; fifteen years b) fifteen; eighteen years c) twenty; twenty-five years Save Question 57 (2 points) creates higher costs than all other medical problems. d) fifteen; twenty-five years Symptoms of attention deficit hyperactivity disorder are present prior to years of age. Question 61 options: a) ten c) nine d) six Save Question 62 (2 points) Secondary hypothyroidism results from Question 62 options: a) excessive release of thyroid hormone beyond the newborn period b) intrauterine exposure to thyrotoxic drugs c) disease or disorder of the thyroid gland itself b) seven d) disease or disorder of the hypothalamus or pituitary gland compromising thyroid function Save Question 63 (2 points) During a well-child visit, a mother expresses concern that her three-year-old child has recently started to stutter when excited. The pediatric primary care nurse practitioner informs the mother that stuttering in a preschool-aged child Question 63 options: b) is a sign of abnormal speech pattern development. c) occurs because the child does not know what to say. d) signals the presence of stress in the child's environment Save Question 64 (2 points) Symptoms of the attention deficit hyperactivity disorder must have been present at least before a diagnosis can be made. Question 64 options: a) is a normal characteristic of language development. a) six weeks b) two weeks c) two months Save Question 65 (2 points) ADHDs are likely to affect _. . Question 65 options: b) females more than males c) adults more than adolescents d) both males and females the same Save Question 66 (2 points) d) six months a) males more than females Save Question 70 (2 points) Maturity onset diabetes of youth (MODY) is usually found before the age of . Question 70 options: b) twenty years c) fifteen years d) twelve years Save Question 71 (2 points) The Board of Nursing for each state _. Question 71 options: a) is responsible for its own rules and regulations b) may differ from other states c) is one of the agencies that assist in ensuring the health and welfare of the public a) twenty-five years d) all of the above Save Question 72 (2 points) The insulin requirement for a Type 1 diabetic is determined by: Question 72 options: a) The HgbA1C c) The quantity of glucose in the urine d) The fasting blood sugar average0 Save Question 73 (2 points) In a newborn, a diagnosis of hip dislocation is suspected when Question 73 options: b) wide hip abduction that is symmetric c) flaccidity of the left leg following extension of both legs with return to flexion b) The quantity of ketones in the urine a) positive Galeazzi, Barlow and Ortolani d) tonic neck reflex in which the left leg is flexed Save Question 74 (2 points) Thoughts that are false but persistent are known as ideations. Question 74 options: a) anxiety b) obsessive c) schizophrenic Save Question 75 (2 points) Age related or primary epilepsy usually presents _. Question 75 options: a) middle adolescence to high school years d) compulsive b) early school years to adolescence • When the nurse interviews an adolescent, it is especially important to: Allow an opportunity to express feelings. • The nurse is having difficulty communicating with a hospitalized 6-year-old child. What technique might be most helpful? Ask the child to draw a picture. • The nurse is taking a health history on an adolescent. What best describes how the chief complaint should be determined? Ask adolescent, “Why did you come here today?” • Where in the health history should the nurse describe all details related to the chief complaint? Present illness • The nurse is interviewing the mother of an infant. She reports, “I had a difficult delivery, and my baby was born prematurely.” This information should be recorded under which heading? Birth history • When interviewing the mother of a 3-year-old child, the nurse asks about developmental milestones such as the age of walking without assistance. This should be considered because these milestones are: An important part of the child’s past growth and development. • The nurse is taking a sexual history on an adolescent girl. The best way to determine whether she is sexually active is to: Ask her, “Are you having sex with anyone?” • When doing a nutritional assessment on an Hispanic family, the nurse learns that their diet consists mainly of vegetables, legumes, and starches. The nurse should recognize that this diet: May provide sufficient amino acids. • Which parameter correlates best with measurements of the body’s total protein stores? Upper arm circumference • An appropriate approach to performing a physical assessment on a toddler is to: Use minimal physical contact initially. • With the National Center for Health Statistics (NCHS) criteria, which body mass index (BMI)–for-age percentile indicates a risk for being overweight? 85th percentile • The nurse is using the NCHS growth chart for an African-American child. The nurse should consider that: The NCHS charts are accurate for U.S. African-American children. • Which tool measures body fat most accurately? Calipers • By what age do the head and chest circumferences generally become equal? 1 to 2 years • The earliest age at which a satisfactory radial pulse can be taken in children is: 2 years • Where is the best place to observe for the presence of petechiae in dark-skinned individuals? Oral mucosa • When palpating the child’s cervical lymph nodes, the nurse notes that they are tender, enlarged, and warm. The best explanation for this is: Infection or inflammation close to the site. • The nurse has just started assessing a young child who is febrile and appears very ill. There is hyperextension of the child’s head (opisthotonos) with pain on flexion. The most appropriate action is to: Refer for immediate medical evaluation. • The nurse should expect the anterior fontanel to close at age: 12 to 18 months • During a funduscopic examination of a school-age child, the nurse notes a brilliant, uniform red reflex in both eyes. The nurse should recognize that this is: A normal finding. • Binocularity, the ability to fixate on one visual field with both eyes simultaneously, is normally present by what age? 3 to 4 months • The most frequently used test for measuring visual acuity is the: Snellen letter chart. • The nurse is testing an infant’s visual acuity. By what age should the infant be able to fix on and follow a target? Because the anterior fontanel normally closes between ages 12 and 18 months, • By what age does the posterior fontanel usually close? 6 to 8 weeks • The parents of a 9-month-old infant tell the nurse that they have noticed foods such as peas and corn are not completely digested and can be seen in their infant’s stool. The nurse bases her explanation on knowing that: This is normal because of the immaturity of digestive processes at this age. • A 3-month-old infant, born at 38 weeks of gestation, will hold a rattle if it is put in her hands, but she will not voluntarily grasp it. The nurse should interpret this as: Normal development. • In terms of fine motor development, the infant of 7 months should be able to: Transfer objects from one hand to the other. • In terms of gross motor development, what would the nurse expect a 5-month-old infant to do? Roll from abdomen to back • At which age can most infants sit steadily unsupported? 8 months • By what age should the nurse expect that an infant will be able to pull to a standing position? 11 to 12 months they can pull themselves up by 9 months • According to Piaget, the 6-month-old infant would be in what stage of the sensorimotor phase Secondary circular reactions • What behavior indicates that an infant has developed object permanence? Actively searches for a hidden object • Most infants begin to fear strangers at age: 6 months • The nurse is interviewing the father of 10-month-old Megan. She is playing on the floor when she notices an electrical outlet and reaches up to touch it. Her father says “No” firmly and removes her from near the outlet. The nurse should use this opportunity to teach the father that Megan: Is old enough to understand the word “No.” • Sara, age 4 months, was born at 35 weeks’ gestation. She seems to be developing normally, but her parents are concerned because she is a “more difficult” baby than their other child, who was term. The nurse should explain that: Infants’ temperaments are part of their unique characteristics. • What information could be given to the parents of a 12-month-old child regarding appropriate play activities for this age? Give large push-pull toys for kinetic stimulation. • An appropriate play activity for a 7-month-old infant to encourage visual stimulation is: Playing peek-a-boo. • The best play activity for a 6-month-old infant to provide tactile stimulation is to: Allow to splash in bath. • At what age should the nurse expect an infant to begin smiling in response to pleasurable stimuli? 2 months • Latasha is a breastfed infant being seen in the clinic for her 6-month checkup. Her mother tells the nurse that she recently began to suck her thumb. The best nursing intervention is to: Reassure the mother that this is very normal at this age. • Austin, age 6 months, has six teeth. The nurse should recognize that this is: Earlier-than-normal tooth eruption. • The nurse notices that a 10-month-old infant being seen in the clinic is wearing expensive, inflexible, high-top shoes. The nurse should explain that: Soft and flexible shoes are generally better. • A mother tells the nurse that she is discontinuing breastfeeding her 5-month-old infant. The nurse should recommend that the infant be given: Commercial iron-fortified formula. • When is the best age for solid food to be introduced into the infant’s diet? 4 to 6 months • The parents of a 4-month-old infant tell the nurse that they are getting a microwave oven and will be able to heat the baby’s formula faster. The nurse should recommend to: Always leave bottle top uncovered to allow heat to escape. • A clinical manifestation of the systemic venous congestion that can occur with congestive heart failure is: Peripheral edema. • A beneficial effect of administering digoxin (Lanoxin) is that it: Decreases edema. • Which drug is an angiotensin-converting enzyme (ACE) inhibitor? Captopril (Capoten) • A common sign of digoxin toxicity is: Vomiting. • The parents of a young child with congestive heart failure tell the nurse that they are “nervous” about giving digoxin. The nurse’s response should be based on knowing that: Parents must learn specific, important guidelines for administration of digoxin. • As part of the treatment for congestive heart failure, the child takes the diuretic furosemide. As part of teaching home care, the nurse encourages the family to give the child foods such as bananas, oranges, and leafy vegetables. These foods are recommended because they are high in: Potassium. • An 8-month-old infant has a hypercyanotic spell while blood is being drawn. The nurse’s firstaction should be to Place the child in the knee-chest position • The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk of cerebrovascular accidents (strokes) exists. An important objective to decrease this risk is to: Prevent dehydration. • Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse’s reply should be based on knowing that: The child needs opportunities to play with peers. • When preparing a school-age child and the family for heart surgery, the nurse should consider: Letting child hear the sounds of an electrocardiograph monitor. • Seventy-two hours after cardiac surgery, a young child has a temperature of 37.7°C (101°F). The nurse should: Report findings to physician. • An important nursing consideration when suctioning a young child who has had heart surgery is to: Administer supplemental oxygen before and after suctioning • The nurse is caring for a child after heart surgery. What should he or she do if evidence is found of cardiac tamponade? Immediately report this to the physician. • An important nursing consideration when chest tubes will be removed from a child is to: Administer analgesics before procedure. • The most common causative agent of bacterial endocarditis is: Streptococcus viridans. • What painful, tender, pea-sized nodules may appear on the pads of the fingers or toes in bacterial endocarditis? Osler nodes • The primary nursing intervention to prevent bacterial endocarditis is to: Counsel parents of high-risk children about prophylactic antibiotics. • A common, serious complication of rheumatic fever is: Cardiac valve damage. • A major clinical manifestation of rheumatic fever is: Polyarthritis, is swollen, hot, red, and painful joints. The affected joints will change every 1 to 2 days. Primarily the large joints are affected • When discussing hyperlipidemia with a group of adolescents, the nurse should explain that high levels of what substance are thought to protect against cardiovascular disease? High-density lipoproteins (HDLs). • The leading cause of death after heart transplantation is: Rejection. • When caring for the child with Kawasaki disease, the nurse should know that: Therapeutic management includes administration of gamma globulin and aspirin. This is typical behavior because of inability to transfer knowledge to new situations. • Two toddlers are playing in a sandbox when one child suddenly grabs a toy from the other child. The best interpretation of this behavior is that: This is typical behavior because toddlers are egocentric. • Which statement is correct about toilet training? Wanting to please the parent helps motivate the child to use the toilet. • Which characteristic best describes the gross motor skills of a 24-month-old child? Walks up and down stairs • In the clinic waiting room a nurse observes a parent showing an 18-month-old child how to make a tower out of blocks. In this situation the nurse should recognize that: Toddlers are capable of building a tower of blocks. • The parents of a newborn say that their toddler “hates the baby . . . he suggested that we put him in the trash can so the trash truck could take him away.” The nurse’s best reply is: That is a normal response to the birth of a sibling. Let’s look at ways to deal with this.” • A toddler’s parent asks the nurse for suggestions on dealing with temper tantrums. The most appropriate recommendation is to: Ignore the behavior, provided that it is not injurious. • A parent asks the nurse about negativism in toddlers. The most appropriate recommendation is to: Reduce the opportunities for a “no” answer. • The parents of a 2-year-old tell the nurse that they are concerned because the toddler has started to use “baby talk” since the arrival of their new baby. The nurse should recommend that the parents: Ignore the “baby talk.” • Parents tell the nurse that their toddler daughter eats little at mealtime, only sits at the table with the family briefly, and wants snacks “all the time.” The nurse should recommend that the parents: Give her planned, frequent, and nutritious snacks. • A father tells the nurse that his daughter wants the same plate and cup used at every meal, even if they go to a restaurant. The nurse should explain that this is: Ritualism, common at this age. • Developmentally most children at age 12 months: Eat the same food as the rest of the family. • The most effective way to clean a toddler’s teeth is for the: Parent to stabilize the chin with one hand and brush with the other • The nurse is discussing with a parent group the importance of fluoride for healthy teeth. The nurse should recommend that the parents: Determine whether water supply is fluoridated. • An appropriate recommendation in preventing tooth decay in young children is to: Serve sweets after a meal. • The leading cause of death during the toddler period is: Injuries. • Kimberly’s parents have been using a rearward-facing convertible car seat since she was born. Most car seats can be safely switched to the forward-facing position when the child weighs: 20 pounds • The nurse recommends to parents that peanuts are not a good snack food for toddlers. They can be easily aspirated. • The parent of 16-month-old Chris asks, “What is the best way to keep Chris from getting into our medicines at home?” The nurse should advise that: All medicines should be locked securely away.” • The most fatal type of burn in the toddler age group is: Flame burn from playing with matches. • Which is characteristic of physical development of a 30-month-old child? Choose all that apply. Primary dentition is complete. Sphincter control is achieved. • What best describes why children have fewer respiratory tract infections as they grow older? Repeated exposure to organisms causes increased immunity. • Cool-mist vaporizers rather than steam vaporizers are recommended in home treatment of respiratory tract infections because: They are safer. • Asthma in infants is usually triggered by: A viral infection • A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests: Asthma. • It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because they may develop: Slowed growth. • b-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. What is their action? Dilate the bronchioles. • A parent whose two school-age children have asthma asks the nurse in what sports, if any, they can participate. The nurse should recommend: Swimming. • Which statement expresses accurately the genetic implications of cystic fibrosis (CF)? If it is present in a child, both parents are carriers of this defective gene. • The earliest recognizable clinical manifestation(s) of cystic fibrosis (CF) is: Meconium ileus. • Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis? Sweat chloride test • A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (rhDNase). This drug: May cause voice alterations. • Pancreatic enzymes are administered to the child with cystic fibrosis. Nursing considerations should include: Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal. • Cardiopulmonary resuscitation is begun on a toddler. Which pulse is usually palpated because it is the most central and accessible? Carotid • Which drug is considered the most useful in treating cardiac arrest? Epinephrine hydrochloride • The Heimlich maneuver is recommended for airway obstruction in children older than: 1 year • An appropriate nursing intervention when caring for a child with pneumonia is to: Encourage rest. • An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes (choose all that apply): Cluster care to conserve energy Administration of antibiotics. Encourage infant to drink 8 ounces of formula every 4 hours. Cluster care to encourage adequate rest. Place on noninvasive oxygen monitoring. • The nurse is caring for a 5-year-old child who is scheduled for a tonsillectomy in 2 hours. Which actions should the nurse include in the child’s postoperative care plan? (Choose all that apply.) Notify the surgeon if the child swallows frequently. Place the child on the abdomen until fully awake. Allow the child to have diluted juice after the procedure. • What would the nurse expect of a healthy 3-year-old child? Balance on one foot for a few seconds • In terms of fine motor development, what could the 3-year-old child be expected to do? Copy (draw) a circle. • In terms of cognitive development the 5-year-old child would be expected to: Use magical thinking. • What is descriptive of the preschooler’s understanding of time? Associates time with events • The nurse is caring for a hospitalized 4-year-old boy, Ryan. His parents tell the nurse that they will be back to visit at 6 PM. When Ryan asks the nurse when his parents are coming, the nurse’s best response is: They will come after dinner.” • The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which interventions should be included in the child’s care? Choose all that apply.