NUR 507: EXAM 5 QUESTIONS WITH 100% ACCURATE
SOLUTIONS.
1) The primary care pediatric nurse practitioner reviews hematology reports on a
child with beta thalassemia minor and notes an Hgb level of 8 g/dL. What will the
nurse practitioner do?
A) Evaluate serum ferritin.
B) Order Hgb electrophoresis.
C) Prescribe supplemental iron.
D) Refer for RBC transfusions. -- Correct Answer ✔✔ a. Evaluate
serum ferritin.
2) The primary care pediatric nurse practitioner sees a 12monthold infant who is
being fed goat's milk and a vegetarian diet. The child is pale and has a beefy red,
sore tongue and oral mucous membranes. Which tests will the nurse practitioner
order to evaluate this child's condition?
A) Hemoglobin electrophoresis
B) RBC folate, iron, and B12 levels
C) Reticulocyte levels
, D) Serum lead levels -- Correct Answer ✔✔ b. RBC folate, iron, and
B12 levels
3) A toddler who presents with anemia and reticulocytopenia has a history of a
gradual decrease in energy and increase in pallor beginning after a recent viral
infection. How will the primary care pediatric nurse practitioner treat this child?
A) Closely observe the child's symptoms and lab values.
B) Consult with a pediatric hematologist.
C) Prescribe supplemental iron for 4 to 6 months.
D) Refer for transfusions to correct the anemia -- Correct Answer
✔✔ a. Closely observe the child's symptoms and lab values.
4) The pediatric nurse practitioner provides primary care for a 30monthold child
who has sickle cell anemia who has had one dose of 23valent pneumococcal
vaccine. Which is an appropriate action for health maintenance in this child?
A) Administer an initial meningococcal vaccine.
B) Begin folic acid dietary supplementation.
C) Decrease the dose of penicillin V prophylaxis.
D) Give a second dose of 23valent pneumococcal vaccine. -- Correct
Answer ✔✔ a. Administer an initial meningococcal vaccine.
5) A 2yearold child who has SCA comes to the clinic with a cough and a fever of
101.5°C. The child currently takes penicillin V prophylaxis 125 mg orally twice
daily. What will the primary care pediatric nurse practitioner do?
A) Admit the child to the hospital to evaluate for sepsis
B) Give intravenous fluids and antibiotics in clinic.
C) Increase the penicillin V dose to 250 mg.
D) Order a chest radiograph to rule out pneumonia. -- Correct
Answer ✔✔ a. Admit the child to the hospital to evaluate for
sepsis
, 6) A school age child comes to the clinic for evaluation of excessive bruising. The
primary care pediatric nurse practitioner notes a history of an upper respiratory
infection 2 weeks prior. The physical exam is negative for hepatosplenomegaly
and lymphadenopathy. Blood work reveals a platelet count of 60,000/mm3 with
normal PT and aPTT. How will the nurse practitioner manage this child's
condition?
A) Admit to the hospital for IVIG therapy.
B) Begin a short course of corticosteroid therapy.
C) Refer to a pediatric hematologist.
D) Teach to avoid NSAIDs and contact sports. -- Correct Answer ✔✔
d. Teach to avoid NSAIDs and contact sports.
7) The primary care pediatric nurse practitioner is examining a 5yearold child who
has had recurrent fevers, bone pain, and a recent loss of weight. The physical
exam reveals scattered petechiae, lymphadenopathy, and bruising. A complete
blood count shows thrombocytopenia, anemia, and an elevated white cell blood
count. The nurse practitioner will refer this child to a specialist for
A) bone marrow biopsy.
B) corticosteroids and IVIG.
C) hemoglobin electrophoresis.
D) immunoglobulin testing. -- Correct Answer ✔✔ a. bone marrow
biopsy.
8) The primary care pediatric nurse practitioner is performing a well child
examination on a school age child who has a history of cancer treated with cranial
irradiation. What will the nurse practitioner monitor in this child?
A) Cardiomyopathy and arrhythmias
B) Leukoencephalopathy
C) Obesity and gonadal dysfunction
SOLUTIONS.
1) The primary care pediatric nurse practitioner reviews hematology reports on a
child with beta thalassemia minor and notes an Hgb level of 8 g/dL. What will the
nurse practitioner do?
A) Evaluate serum ferritin.
B) Order Hgb electrophoresis.
C) Prescribe supplemental iron.
D) Refer for RBC transfusions. -- Correct Answer ✔✔ a. Evaluate
serum ferritin.
2) The primary care pediatric nurse practitioner sees a 12monthold infant who is
being fed goat's milk and a vegetarian diet. The child is pale and has a beefy red,
sore tongue and oral mucous membranes. Which tests will the nurse practitioner
order to evaluate this child's condition?
A) Hemoglobin electrophoresis
B) RBC folate, iron, and B12 levels
C) Reticulocyte levels
, D) Serum lead levels -- Correct Answer ✔✔ b. RBC folate, iron, and
B12 levels
3) A toddler who presents with anemia and reticulocytopenia has a history of a
gradual decrease in energy and increase in pallor beginning after a recent viral
infection. How will the primary care pediatric nurse practitioner treat this child?
A) Closely observe the child's symptoms and lab values.
B) Consult with a pediatric hematologist.
C) Prescribe supplemental iron for 4 to 6 months.
D) Refer for transfusions to correct the anemia -- Correct Answer
✔✔ a. Closely observe the child's symptoms and lab values.
4) The pediatric nurse practitioner provides primary care for a 30monthold child
who has sickle cell anemia who has had one dose of 23valent pneumococcal
vaccine. Which is an appropriate action for health maintenance in this child?
A) Administer an initial meningococcal vaccine.
B) Begin folic acid dietary supplementation.
C) Decrease the dose of penicillin V prophylaxis.
D) Give a second dose of 23valent pneumococcal vaccine. -- Correct
Answer ✔✔ a. Administer an initial meningococcal vaccine.
5) A 2yearold child who has SCA comes to the clinic with a cough and a fever of
101.5°C. The child currently takes penicillin V prophylaxis 125 mg orally twice
daily. What will the primary care pediatric nurse practitioner do?
A) Admit the child to the hospital to evaluate for sepsis
B) Give intravenous fluids and antibiotics in clinic.
C) Increase the penicillin V dose to 250 mg.
D) Order a chest radiograph to rule out pneumonia. -- Correct
Answer ✔✔ a. Admit the child to the hospital to evaluate for
sepsis
, 6) A school age child comes to the clinic for evaluation of excessive bruising. The
primary care pediatric nurse practitioner notes a history of an upper respiratory
infection 2 weeks prior. The physical exam is negative for hepatosplenomegaly
and lymphadenopathy. Blood work reveals a platelet count of 60,000/mm3 with
normal PT and aPTT. How will the nurse practitioner manage this child's
condition?
A) Admit to the hospital for IVIG therapy.
B) Begin a short course of corticosteroid therapy.
C) Refer to a pediatric hematologist.
D) Teach to avoid NSAIDs and contact sports. -- Correct Answer ✔✔
d. Teach to avoid NSAIDs and contact sports.
7) The primary care pediatric nurse practitioner is examining a 5yearold child who
has had recurrent fevers, bone pain, and a recent loss of weight. The physical
exam reveals scattered petechiae, lymphadenopathy, and bruising. A complete
blood count shows thrombocytopenia, anemia, and an elevated white cell blood
count. The nurse practitioner will refer this child to a specialist for
A) bone marrow biopsy.
B) corticosteroids and IVIG.
C) hemoglobin electrophoresis.
D) immunoglobulin testing. -- Correct Answer ✔✔ a. bone marrow
biopsy.
8) The primary care pediatric nurse practitioner is performing a well child
examination on a school age child who has a history of cancer treated with cranial
irradiation. What will the nurse practitioner monitor in this child?
A) Cardiomyopathy and arrhythmias
B) Leukoencephalopathy
C) Obesity and gonadal dysfunction
