NRNP 6541 FINAL EXAM (VERSION 1 LATEST 2022/2023, 100 QUESTIONS AND ANSWERS WEEK 11: WA, Exams of Nursing

Download NRNP 6541 FINAL EXAM (VERSION 1 LATEST 2022/2023, 100 QUESTIONS AND ANSWERS WEEK 11: WA and more Exams Nursing in PDF only on Docsity! NRNP 6541 FINAL EXAM (VERSION 1 LATEST 2022/2023, 100 QUESTIONS AND ANSWERS WEEK 11: WALDEN UNIVERSITY 100% VERFIED QUESTIONS AND ANSWERS Test Week 11 - Final Exam Status Completed • Question 1 0 out of 1 points Unilateral wheezing is a finding suggestive of Selected Answer: d. Cystic Fibrosis • Question 2 1 out of 1 points You are on call and receive a phone call from the parents of a 13-year-old known asthmatic. She has been having chest tightness and a worsening cough for 48 hours. She has significant nasal discharge that began 14 days ago and intermittent complaint of headache. She is now running a low-grade fever. Her peak flow the last 48 hours is 70–80% of personal best. Her temperature right now is 101.7°F. She is on salmeterol with corticosteroid (Advair) and PRN albuterol. Which of the following is most appropriate? Selected d. Answer: See her in the office in the morning and prescribe a 14-day course of amoxicillin plus the addition of a short course of oral steroids. • Question 3 1 out of 1 points You see a patient you believe has folliculitis. What medication would be the best to treat this patient? The patient has no allergies. Selected Answer: c. Dicloxacillin Question 4 1 out of 1 points The most common cause of primary amenorrhea is Selected Answer: a. Pregnancy Question 5 1 out of 1 points Kelly, your 11-year-old well visit patient, presents to the office with weight loss, polyuria, and polydipsia. Which of the following do you need to rule out? Selected Answer: d. Diabetes mellitus Question 6 1 out of 1 points Children in child care facilities are at greater risk of being exposed to which of the following infections? Selected Answer: b. HAV Question 7 1 out of 1 points A 6-year-old boy is left alone for 10 hours, now with hematemesis and pneumomediastinum on chest x-ray. Which of the following is the most likely etiology? Selected Answer: b. Esophageal foreign body • Question 17 1 out of 1 points An adolescent female presents with a 2-day history of increasing lower abdominal pain. She has mild vomiting and anorexia and fevers to 101F. She is unable to defecate but has an urge to do so. CBC reveals a slightly elevated WBC of 14,000, but is otherwise normal. Serum electrolytes are normal. The next step is Selected Answer: a. Refer to surgery for evaluation for appendicitis. Question 18 1 out of 1 points Vomiting in infancy has a long list of differential diagnoses. Which of the following other symptoms would mostly likely point to pyloric stenosis? Selected Answer: b. Sausage-shaped mass in abdomen Question 19 1 out of 1 points Which of the following is a characteristic physical sign of fragile X syndrome in adolescent males? Selected Answer: a. Macro-orchidism Question 20 1 out of 1 points A 3-week old presents to the office in January with a 1-week history of nasal congestion and occastional cough. On the night prior to the visit in infant developed a fever 102ºF rectally, was difficult to breastfeed, and had paroxysmal coughing and noisy, labored breathing. On exam, you note an ill-appearing infant who is lethergic with wheezing, tachypnea, and intercostal retractions. The infant is home with the mom at this time; however, has a sibling who is 4-years-old and is in daycare and recently had cold symptoms. If the patient has been diagnosed with RSV bronchiolitis, which of the following would be the treatment of choice? Selected Answer: b. Fluids and nutritional support and close monitoring Question 21 1 out of 1 points An adolescent who has tall stature, increased arm span, laxity of joints, pectus excavatum, and abnormal echocardiogram woudl be expected to have Selected Answer: d. Marfan syndrome Question 22 1 out of 1 points An 18-month-old African American girl is brought to your office because she has been crying and stopped walking today. She will crawl, however. Her mom denies any injury to the child. On examination, she is crying but consolable in her mother’s arms. She has bruising and swelling just proximal to the left ankle. An x-ray reveals a spiral fracture of the tibia. At this time, you advise the mother that: Selected Answer: a. This is a common fracture resulting from twisting on a planted foot. Question 23 1 out of 1 points A small-for-gestational-age, dysmorphic newborn infant has microcephaly and sloping forehead, cutis aplasia (missing portion of the skin and hair) of the scalp, polydactyly, microphthalmia, and omphalocele. Which of these is the most likely diagnosis? Selected Answer: c. Patau syndrome (trisomy 13) Question 24 1 out of 1 points A 16-year-old presents with pharyngitis, cough, and high fever. Her chest x-ray reveals bilateral pulmonary infiltrates. Her white blood cell count is normal and the neutrophil count is normal. The most likely etiology is Selected Answer: b. Chlamydia pneumonia Question 25 1 out of 1 points A common cause of in-toeing in childhood is Selected Answer: d. Internal tibial torsion Question 26 1 out of 1 points Individuals with chronic adrenal insufficiency often have Selected Answer: d. A craving for salt Question 27 1 out of 1 points Which of the following should be done annually after 1 year of age in a child with Down syndrome? Selected Answer: d. Thyroid screenings Question 28 1 out of 1 points Sarah, age 13, is markedly obese and has a poor self-image. How do you differentiate between compulsive eating and bulemia? Selected Answer: a. A compulsive eater does not induce vomiting. Question 29 1 out of 1 points The peak incidence of osteosarcoma is Selected Answer: a. 15-19 years of age Question 30 1 out of 1 points A 3-week-old male infant with 2 days of projectile, nonbilious vomiting and constant feeding. Which of the following is the most likely etiology? Selected Answer: e. Pyloric stenosis Question 40 1 out of 1 points Which fo the following foods would be most appropriate for a child with celiac disease? Selected Answer: a. Rice with butter Question 41 1 out of 1 points The most common cause of UTI (urinary tract infection) in the pediatric population is Selected Answer: d. E. coli Question 42 1 out of 1 points Which of the following is not found in an adolescent with untreated Graves' disease? Selected Answer: a. Tendency to gain weight easily Question 43 1 out of 1 points What does shift to the left mean in a white blood count? Selected Answer: d. A rise in neutrophils Question 44 1 out of 1 points Prophylactic penicillin should be started in children with sickle cell anemia by Selected Answer: d. 2 to 3 months of age Question 45 1 out of 1 points Six months after being diagnosed with what appears to be insulin-dependent diabetes, the 5-year-old in the case presentation has a significant decrease in his insulin requirement. Which of the following is the most likely explanation? Selected Answer: c. He has entered the "honeymoon phase" of his diabetes. Question 46 1 out of 1 points Tommy has bloody diarrhea. His family eats fast-food four to five times each week. Which organism may have caused the diarrhea? Selected Answer: b. E. Coli Question 47 1 out of 1 points Which chromosomal abnormality is associated with short stature in girls? Selected Answer: d. Turner syndrome Question 48 1 out of 1 points Maddie, age 2, had a complete blood count (CBC) drawn at her last visit. It indicates that she has a microcytic hypochromic anemia. What should you do now at this visit? Selected Answer: a. Obtain a lead level. Question 49 1 out of 1 points A 2-year-old boy is brought in with fever and poor feeding. He started getting sick yesterday and has worsened significantly today. He has had no recent illnesses or injuries, and no known ill contacts. On examination, his temperature is 101°F, he is tachycardic, and he appears ill. He is laying on his back with his left leg flexed and abducted at the hip. The HEENT examination is normal, heart is tachycardic but regular, and the lungs are clear. The abdomen is nontender and has normal bowel sounds. He screams in pain when you move his left leg from its resting position. Blood work reveals an elevated WBC count of 15,000 mm3 and an ERS or 45 mm/h. An x-ray of his left hip shows a widened joint space but no fractures. What is your next step at this point? Selected Answer: b. Hip joint aspiration Question 50 1 out of 1 points When a neonate is initially protected against measles, mumps, and rubella because the mother is immune, this is an example of which type of immunity? Selected Answer: d. Natural passive Question 51 1 out of 1 points You are examining Beth, age 9 months, and note a palpable right supraclavicular node. You know that this finding is suspicious for Selected Answer: b. Lymphoma of the mediastinum Question 52 1 out of 1 points A 4-year-old female with profuse vomiting, sweating, lacrimation, and diarrhea, who seizes in the emergency room. Which of the following is the most likely etiology? Selected Answer: a. Insecticide ingestion Question 53 1 out of 1 points Selected c. Answer: Greater reaction of hypersensitivity occurs most often with the initial exposure than with subsequent exposures. Question 63 1 out of 1 points Ben has been diagnosed with folliculitis, an inflammatory condition involving the pilosebaceous follicle. What is the most common cause of this condition? Selected Answer: c. Staphylococcus aureus Question 64 1 out of 1 points Which of the following therapeutic options is common for the treatment of both bee stings and bite wounds? Selected Answer: d. Tetanus vaccination Question 65 1 out of 1 points Pinworms can cause which of the following? Selected Answer: b. Anal itching Question 66 1 out of 1 points The classic radiographic finding of croup is Selected Answer: b. Steeple sign Question 67 1 out of 1 points An 8-month-old female infant with bilious vomiting, constant abdominal pain for 12 hours and upper GI study showing beaklike appearance of contrast. Which of the following is the most likely etiology? Selected Answer: d. Volvulus Question 68 1 out of 1 points Mrs. Bay is upset. She is convinced something is seriously wrong with her son. He is a 2-month-old and frequently vomits after feeding. Which of the following is most suggestive of GERD (gastroesophageal reflux disease)? Selected Answer: c. He drinks 7 to 8 ounces every 3 hours. Question 69 1 out of 1 points Lyme disease is most closely associated with which of the following skin lesions? Selected Answer: a. Erythema migrans Question 70 1 out of 1 points The following clinical description best matches which genetic disorder? A 15-year-old girl with primary amenorrhea is noted to be well below the 5th percentile for height. She has hypertension, a low posterior hairline, prominent and low-set ears, and excessive nuchal skin. Selected Answer: e. Turner syndrome (XO) Question 71 0 out of 1 points Jason, age 14, appears with tender discoid breast tissue enlargement (2-3 cm in diameter) beneath the areola. Your next action would be to Selected Answer: b. Order an ultrasound. • Question 72 1 out of 1 points Your patient has inflammatory bowel disease. Which of the following finding is most consistent with ulcerative colitis? Selected Answer: d. Left-sided abdominal pain • Question 73 1 out of 1 points Which of the following is not characteristic of an apparent life-threatening event (ALTE)? Selected Answer: d. Fever Question 74 1 out of 1 points Riley, a 12-year-old girl, has scaly, hyperpigmented lesions in a "Christmas tree" distribution. It is predominantly on her trunk. One lesion is on her buttock that is larger than the other, at about 4 cm in diameter. What is your diagnosis? Selected Answer: c. Pityriasis rosea Question 75 1 out of 1 points An 8-month-old baby arrives to the office with his mother with a complaint of decreased left arm movement. He is a product of a normal term pregnancy, has had no medical problems, and was in good health when his mother dropped him off at the daycare center. Upper arm radiographs show a left humerus spiral fracture. Which of the following is the most appropriate next step in management? Selected Answer: c. Send the child to the hospital for admission and call child protective services. Question 76 1 out of 1 points Antistreptolysin-O (ASO) titer Question 86 1 out of 1 points What does a low level of thyroid stimulating hormone (TSH) indicate? Selected Answer: d. Hyperthyroidism Question 87 1 out of 1 points When examining a child with abdominal pain, what symptom would lead to a likely organic etiology? Selected Answer: d. Night waking Question 88 1 out of 1 points John is 4 years old and in today for a well child visit. He is due for his 4-year-old immunizations. He was recently diagnosed with ALL and is being treated with chemotherapy and radiation. Which statement is true about immunizations during treatments during childhood cancer? Selected Answer: a. Immunizations are not given during active chemotherapy. Question 89 1 out of 1 points Which of the following is important to determine in the recent history of a child with suspected Clostridium difficile infection? Selected Answer: b. Antibiotic use Question 90 1 out of 1 points A healthy 8-month-old infant presents with diarrhea but no dehydration. What is the best advice to give to the parents? Selected Answer: b. Give bananas, cereal, vegetables, and full-strength formula as tolerated. Question 91 1 out of 1 points Which of the following is the primary diagnostic tool used in the evaluation of seizure disorders? Selected Answer: b. EEG Question 92 1 out of 1 points Screening infants for anemia should occur at what age? Selected Answer: d. 9 months Question 93 1 out of 1 points Absence seizures Selected Answer: b. Appear as altered awareness and blank stare for a brief period. Question 94 1 out of 1 points Antibiotic therapy is one of the mainstays of treatment for which of the following causes of wheezing? Selected Answer: c. Epiglottitis Question 95 1 out of 1 points Kawasaki disease is most common in Selected Answer: a. Children younger than 5 years of age Question 96 0 out of 1 points A small-for-gestational-age infant is born to a 35-year-old woman. He has low-set and malformed ears, microcephaly, rocker-bottom feet, inguinal hernias, cleft lip/palate, and micrognathia. Chromosomal analysis is likely to reveal which of the following? Selected Answer: b. Down syndrome (trisomy 21) Question 97 1 out of 1 points A 15-day-old infant has respiratory distress. A quick observation suggests she has slight cyanosis, hepatosplenomegaly, and features consistent with Down Syndrome. The cardiac examination demonstrates a loud first heart sound, a low-pitched, mid-diastolic murmur at the lower left sternal border, and a harsh apical holosystolic murmur in the mitral area. Which of the following cardiac conditions most likely explains her heart findings? Selected Answer: a. Complete atrioventricular canal (endocardial cushion defect) Question 98 1 out of 1 points Grace, age 15, has been diagnosed with acne. Which of the following is not true with this condition? Selected Answer: c. Poor hygiene is the primary cause of acne. Question 99 1 out of 1 points A 7-year-old presents with abrupt fever, stridor, drooling, and hyperextension of the neck. You examine the nose and throat and notice one tonsil is enlarged and there is marked erythema of the pharynx with uvular deviation. Which is most appropriate? Selected b. Answer: Refer to otolaryngology for management of a peritonsillar abscess and possible hospital admission