BURNS PEDIATRIC QUESTIONS AND ANSWERS SURE
A+
✔✔10. The primary care pediatric nurse practitioner is performing a well child
examination on a high school
age adolescent who plays football who has hypercalciuria. Which dietary supplement
will the nurse
practitioner question the adolescent about?
a. Protein supplements
b. Salt tablets
c. Sports drinks
d. Vitamin C - ✔✔ANS: A
Protein supplements can cause hypercalciuria with calcium loss and dehydration if
protein intake is too
high. Salt tablets can cause hypernatremia and delayed gastric emptying. Sports drinks
are high in sugar
and electrolytes, which will not affect the calcium content of the urine. It is not necessary
to take vitamin
C.
✔✔11. The primary care pediatric nurse practitioner is evaluating a heart murmur during
a pre-participation
examination of a high school athlete. Which finding would be a concern requiring
referral to a
cardiologist?
a. A murmur that is louder when squatting and softer when standing
b. A murmur that is quieter when squatting and louder with a Valsalva maneuver
c. A murmur with narrow and variable splitting of S2
d. A systolic murmur that is grade 1 or 2 - ✔✔ANS: B
Normally, squatting will increase venous return to the heart and cause murmurs to be
louder, while
standing or performing a Valsalva maneuver will cause murmurs to be quieter. If the
reverse is true, then
,hypertrophic cardiomyopathy or mitral valve prolapse must be ruled out. A murmur with
a wide or fixed
splitting of S2 must be evaluated. A split S2 that is variable, particularly in synchrony
with respirations, is
common, and a narrow S2 split is of less concern but should be monitored over time.
Systolic murmurs of
grade 3 or greater must be evaluated by specialists
✔✔however, murmurs of grades 1 and 2 do not need to be
evaluated by a cardiologist. - ✔✔
✔✔12. The primary care pediatric nurse practitioner is discussing lifestyle changes with
an adolescent who
has hypertension. What will the nurse practitioner recommend about exercise for this
client?
a. Regular to vigorous activity initially with a combination of resistance and aerobic
exercise to
maintain lower blood pressure
b. Moderate daily exercise such as walking for 20 minutes daily with increasing intensity
as blood
pressure drops
c. Vigorous aerobic exercise combined with maximal strength training to lower blood
pressure
d. Vigorous aerobic exercise only to reduce blood pressure and then to maintain
lowered blood
pressure - ✔✔ANS: A
Regular to vigorous physical activity for 30 minute 3 days per week helps to lower blood
pressure.
Resistance training may be combined with aerobic exercise after blood pressure is
lowered to help
maintain lowered blood pressure. Strength training is contraindicated in children with
hypertension.
✔✔13. The primary care pediatric nurse practitioner is discussing fitness and exercise
with the parents of a 5-
year-old child who ask what kinds of activities are developmentally appropriate for their
child. What
will the nurse practitioner recommend?
a. Bike riding
b. Interactive play
c. Martial arts
d. Organized sports - ✔✔ANS: A
Bike riding away from traffic or with parents is a good activity for the preschool to early
school-age child.
Interactive play is recommended for toddlers. Martial arts and organized sports are
recommended for
, school-age children.
✔✔14. The parent of a child newly diagnosed with epilepsy asks the primary care
pediatric nurse practitioner
if the child will ever be able to participate in gym or sports. What will the nurse
practitioner
recommend?
a. Bicycle riding is not safe for children with seizures.
b. Contact sports should be avoided.
c. Direct supervision of some activities is necessary.
d. Underwater sports are not recommended. - ✔✔ANS: C
Children with epilepsy may participate in most sports but may require direct supervision
in some cases to
reduce the risk of injury to self or others if a seizure should occur during sports. Bicycle
riding, contact
sports, and underwater sports may be engaged in, but certain precautions must be
taken (e.g.,
supervision).
✔✔15. The primary care pediatric nurse practitioner is examining a 17-year-old male
who is on his high
school swim team. The adolescent is concerned about "lumps" on his chest. The nurse
practitioner
notes a marked increase in weight since the last visit along with worsening of the
adolescent's acne.
Given this set of symptoms, which performance-enhancing substance will the nurse
practitioner be
most concerned about and ask about?
a. Creatine
b. Dehydroepiandrosterone (DHEA)
c. Ephedra
d. Growth hormone - ✔✔ANS: B
DHEA is a prohormone that is converted to either testosterone or estrone and will cause
adverse changes
similar to anabolic steroids, such as increased weight, gynecomastia, and acne.
Creatine is taken because
athletes believe it enhances endurance. Side effects include weight gain but not
androgenic effects such as
gynecomastia or acne. Ephedra is similar to amphetamine, with most side effects
related to the heart, such
as tachycardia and arrhythmias. Growth hormone will cause increased weight and has
side effects
associated with diabetes, cardiomyopathy, hepatitis, and renal failure.
✔✔16. The parent of a 12-year-old child who has sickle cell trait (SCT) asks the primary
care pediatric nurse
A+
✔✔10. The primary care pediatric nurse practitioner is performing a well child
examination on a high school
age adolescent who plays football who has hypercalciuria. Which dietary supplement
will the nurse
practitioner question the adolescent about?
a. Protein supplements
b. Salt tablets
c. Sports drinks
d. Vitamin C - ✔✔ANS: A
Protein supplements can cause hypercalciuria with calcium loss and dehydration if
protein intake is too
high. Salt tablets can cause hypernatremia and delayed gastric emptying. Sports drinks
are high in sugar
and electrolytes, which will not affect the calcium content of the urine. It is not necessary
to take vitamin
C.
✔✔11. The primary care pediatric nurse practitioner is evaluating a heart murmur during
a pre-participation
examination of a high school athlete. Which finding would be a concern requiring
referral to a
cardiologist?
a. A murmur that is louder when squatting and softer when standing
b. A murmur that is quieter when squatting and louder with a Valsalva maneuver
c. A murmur with narrow and variable splitting of S2
d. A systolic murmur that is grade 1 or 2 - ✔✔ANS: B
Normally, squatting will increase venous return to the heart and cause murmurs to be
louder, while
standing or performing a Valsalva maneuver will cause murmurs to be quieter. If the
reverse is true, then
,hypertrophic cardiomyopathy or mitral valve prolapse must be ruled out. A murmur with
a wide or fixed
splitting of S2 must be evaluated. A split S2 that is variable, particularly in synchrony
with respirations, is
common, and a narrow S2 split is of less concern but should be monitored over time.
Systolic murmurs of
grade 3 or greater must be evaluated by specialists
✔✔however, murmurs of grades 1 and 2 do not need to be
evaluated by a cardiologist. - ✔✔
✔✔12. The primary care pediatric nurse practitioner is discussing lifestyle changes with
an adolescent who
has hypertension. What will the nurse practitioner recommend about exercise for this
client?
a. Regular to vigorous activity initially with a combination of resistance and aerobic
exercise to
maintain lower blood pressure
b. Moderate daily exercise such as walking for 20 minutes daily with increasing intensity
as blood
pressure drops
c. Vigorous aerobic exercise combined with maximal strength training to lower blood
pressure
d. Vigorous aerobic exercise only to reduce blood pressure and then to maintain
lowered blood
pressure - ✔✔ANS: A
Regular to vigorous physical activity for 30 minute 3 days per week helps to lower blood
pressure.
Resistance training may be combined with aerobic exercise after blood pressure is
lowered to help
maintain lowered blood pressure. Strength training is contraindicated in children with
hypertension.
✔✔13. The primary care pediatric nurse practitioner is discussing fitness and exercise
with the parents of a 5-
year-old child who ask what kinds of activities are developmentally appropriate for their
child. What
will the nurse practitioner recommend?
a. Bike riding
b. Interactive play
c. Martial arts
d. Organized sports - ✔✔ANS: A
Bike riding away from traffic or with parents is a good activity for the preschool to early
school-age child.
Interactive play is recommended for toddlers. Martial arts and organized sports are
recommended for
, school-age children.
✔✔14. The parent of a child newly diagnosed with epilepsy asks the primary care
pediatric nurse practitioner
if the child will ever be able to participate in gym or sports. What will the nurse
practitioner
recommend?
a. Bicycle riding is not safe for children with seizures.
b. Contact sports should be avoided.
c. Direct supervision of some activities is necessary.
d. Underwater sports are not recommended. - ✔✔ANS: C
Children with epilepsy may participate in most sports but may require direct supervision
in some cases to
reduce the risk of injury to self or others if a seizure should occur during sports. Bicycle
riding, contact
sports, and underwater sports may be engaged in, but certain precautions must be
taken (e.g.,
supervision).
✔✔15. The primary care pediatric nurse practitioner is examining a 17-year-old male
who is on his high
school swim team. The adolescent is concerned about "lumps" on his chest. The nurse
practitioner
notes a marked increase in weight since the last visit along with worsening of the
adolescent's acne.
Given this set of symptoms, which performance-enhancing substance will the nurse
practitioner be
most concerned about and ask about?
a. Creatine
b. Dehydroepiandrosterone (DHEA)
c. Ephedra
d. Growth hormone - ✔✔ANS: B
DHEA is a prohormone that is converted to either testosterone or estrone and will cause
adverse changes
similar to anabolic steroids, such as increased weight, gynecomastia, and acne.
Creatine is taken because
athletes believe it enhances endurance. Side effects include weight gain but not
androgenic effects such as
gynecomastia or acne. Ephedra is similar to amphetamine, with most side effects
related to the heart, such
as tachycardia and arrhythmias. Growth hormone will cause increased weight and has
side effects
associated with diabetes, cardiomyopathy, hepatitis, and renal failure.
✔✔16. The parent of a 12-year-old child who has sickle cell trait (SCT) asks the primary
care pediatric nurse
