NU664A FINAL EXAM QUESTIONS &
ANSWERS WITH COMPLETE SOLUTIONS
GRADED A+
QUESTIONS AND ANSWERS
In the United States, the most common cause of myocarditis in children is: ANSWER
-Viruses
The characteristic that is most concerning in the school-aged child with a cardiac
murmur. ANSWER -Progressive exercise intolerance
A parent of a child with a history of a benign cardiac murmur states she read that
children with heart disease need to have an antibiotic before dental procedures. How
would you answer the mother as the PNP? ANSWER -Certain children do need an
antibiotic to prevent something called bacterial endocarditis, but these are children
who have had a surgical repair done.
Your next patient is a 12-year-old male here for his well-child exam. When reviewing
his height, weight, and BMI, it is noted that his BMI is in the 90th percentile. The
mother states that her child is "big-boned" and is not concerned of any cardiovascular
disease risk. What would you discuss with the mother? ANSWER -Although a risk
of cardiovascular disease exists, with a healthy diet and regular exercise, your son
likely will be able to reduce his BMI and reduce his risk.
Your next patient is a 5-year-old child with a history of moderate persistent asthma.
He has been wheezing and coughing for the past two days, and his mother brings him
in today for evaluation. He has been using albuterol every four hours. His respiratory
rate is 13 breaths per minute; his lungs are clear to auscultation; and no retractions
are noted. What may be your assessment and intervention based on this information?
ANSWER -Your child is breathing slower than normal for his age. We need to send
him to the ER for further intervention.
, Your next patient is a 6-year-old male here for his annual influenza vaccine. He has a
history of mild persistent asthma. What would you discuss for medications when
reviewing his asthma action plan? ANSWER -Your child should continue his low-
dose inhaled corticosteroid daily and add albuterol as needed for an exacerbation.
Which of the following is a common cause of acquired coronary artery disease in
children? ANSWER -Kawasaki disease
Your next patient is a 14-year-old female who presents to your office with a complaint
of syncope at school. She had just stood up from her chair at the end of the day, felt
dizzy and nauseous, and then woke up on the floor. She did not hit her head and woke
up within 30 seconds. What is your impression, and what would you do next?
ANSWER -At this age, children may have these episodes called neurally mediated
syncope. We will schedule an EKG.
A child is brought to the clinic immediately after being stung by a wasp while playing
in the yard. The PE reveals localized redness and edema at the site along with
abdominal tenderness, watery eyes and generalized hives. What is the initial
treatment? ANSWER -Administer IM epinephrine
A child is brought to the clinic with a generalized annular rash characterized by raised
wheals with pale centers. On PE, the child's lungs are clear and there is no peripheral
edema. A history reveals ingestion of strawberries earlier in the day. What is the
initial treatment? ANSWER -Diphenhydramine .05-1 mg/kg/dose every 4-6 hours
A child who has been diagnosed with asthma for several years has been using a short-
acting Beta-agonist (SABA) to control symptoms. The PNP learns that the child has
recently begun using the SABA 2-3 times each week to prevent wheezing and
shortness of breath. The child currently has clear breath sounds and an FEV1 of 75%
of personal best. What will the NP do? ANSWER -Add an inhaled corticosteroid.
ANSWERS WITH COMPLETE SOLUTIONS
GRADED A+
QUESTIONS AND ANSWERS
In the United States, the most common cause of myocarditis in children is: ANSWER
-Viruses
The characteristic that is most concerning in the school-aged child with a cardiac
murmur. ANSWER -Progressive exercise intolerance
A parent of a child with a history of a benign cardiac murmur states she read that
children with heart disease need to have an antibiotic before dental procedures. How
would you answer the mother as the PNP? ANSWER -Certain children do need an
antibiotic to prevent something called bacterial endocarditis, but these are children
who have had a surgical repair done.
Your next patient is a 12-year-old male here for his well-child exam. When reviewing
his height, weight, and BMI, it is noted that his BMI is in the 90th percentile. The
mother states that her child is "big-boned" and is not concerned of any cardiovascular
disease risk. What would you discuss with the mother? ANSWER -Although a risk
of cardiovascular disease exists, with a healthy diet and regular exercise, your son
likely will be able to reduce his BMI and reduce his risk.
Your next patient is a 5-year-old child with a history of moderate persistent asthma.
He has been wheezing and coughing for the past two days, and his mother brings him
in today for evaluation. He has been using albuterol every four hours. His respiratory
rate is 13 breaths per minute; his lungs are clear to auscultation; and no retractions
are noted. What may be your assessment and intervention based on this information?
ANSWER -Your child is breathing slower than normal for his age. We need to send
him to the ER for further intervention.
, Your next patient is a 6-year-old male here for his annual influenza vaccine. He has a
history of mild persistent asthma. What would you discuss for medications when
reviewing his asthma action plan? ANSWER -Your child should continue his low-
dose inhaled corticosteroid daily and add albuterol as needed for an exacerbation.
Which of the following is a common cause of acquired coronary artery disease in
children? ANSWER -Kawasaki disease
Your next patient is a 14-year-old female who presents to your office with a complaint
of syncope at school. She had just stood up from her chair at the end of the day, felt
dizzy and nauseous, and then woke up on the floor. She did not hit her head and woke
up within 30 seconds. What is your impression, and what would you do next?
ANSWER -At this age, children may have these episodes called neurally mediated
syncope. We will schedule an EKG.
A child is brought to the clinic immediately after being stung by a wasp while playing
in the yard. The PE reveals localized redness and edema at the site along with
abdominal tenderness, watery eyes and generalized hives. What is the initial
treatment? ANSWER -Administer IM epinephrine
A child is brought to the clinic with a generalized annular rash characterized by raised
wheals with pale centers. On PE, the child's lungs are clear and there is no peripheral
edema. A history reveals ingestion of strawberries earlier in the day. What is the
initial treatment? ANSWER -Diphenhydramine .05-1 mg/kg/dose every 4-6 hours
A child who has been diagnosed with asthma for several years has been using a short-
acting Beta-agonist (SABA) to control symptoms. The PNP learns that the child has
recently begun using the SABA 2-3 times each week to prevent wheezing and
shortness of breath. The child currently has clear breath sounds and an FEV1 of 75%
of personal best. What will the NP do? ANSWER -Add an inhaled corticosteroid.
