NU664A FINAL EXAM 2026 STUDY GUIDE
COMPLETE ADVANCED NURSING PRACTICE
CONCEPTS AND PRACTICE QUESTIONS
◉ 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.
◉ A child has fever and arthralgia. The PNP learns that the child had
a sore throat 3 weeks prior and auscultates a murmur in the clinic.
§What test will the PNP order? Answer: ASO titer
COMPLETE ADVANCED NURSING PRACTICE
CONCEPTS AND PRACTICE QUESTIONS
◉ 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.
◉ A child has fever and arthralgia. The PNP learns that the child had
a sore throat 3 weeks prior and auscultates a murmur in the clinic.
§What test will the PNP order? Answer: ASO titer
