NR 602 FINAL EXAMPREP QUESTIONS AND
DETAILED SOLUTIONS
◉ An adolescent is dx with functional abdominal pain (FAP). The
child's sx worsen during stressful events, esp w/school anxiety.
What will be an important part of tx for this child?
A. informing the parents that the pain is most likely not real
B. instituting a lactose-free diet along w/lactobacillus supplements
C. teaching about the brain-gut interaction causing sx
D. using histamine2-blockers to help alleviate sx
Answer: C. teaching about the brain-gut interaction causing sx
◉ A school-age child has recurrent diarrhea w/foul-smelling stools,
excessive flatus, abd distention, and FTT. A 2-week lactose-free trial
failed to reduce sx. What is the next step in diagnosing this
condition?
A. lactose hydrogen breath test
B. serologic testing for celiac disease
C. stool for ova and parasites
D. Sweat chloride test for cystic fiborisis
Answer: B. serologic testing for celiac disease
,◉ A child is diagnosed w/Chron disease. What are the likely
complications for this child?
A. cancer of the colon and possible colectomy
B. intestinal obstruction w/scarring and strictures
C. intestinal perforation and hemorrhage
D. liver disease and sepsis
Answer: B. intestinal obstruction w/scarring and strictures
◉ A 12-month old infant exhibits poor wt. gain after previously
normal growth patterns. There is no hx of V/D, or irregular BM, and
the PE is normal. What is the next step in evaluating these findings?
A. CBC and electrolytes
B. Feeding and stooling hx and 3-day diet hx
C. Stool cx for ova and parasites
D. swallow study with videofluoroscopy
Answer: B. Feeding and stooling hx and 3-day diet hx
◉ A 2-year-old child has an acute diarrheal illness. The child is
afebrile and with oral rehydration measures, has remained well
hydrated. The parent asks what can be done to help shorten the
course of this illness. What will the primary care pediatric NP
recommend?
A. Clear liquids only
B. Lactobacillus
,C. Loperamide
D. Peppermint oil
Answer: B. Lactobacillus
◉ A 30-month-old girl who has been toilet trained for 6 mo has
daytime enuresis and dysuria and a low-grade fever. A dipstick
urinalysis is negative for leukocyte esterase and nitrates. What is the
next step?
a. begin empiric tx w/trimethoprim-sulfamethoxazole
b. discuss behavioral interventions for toilet training
c. reassure the child's parents that the child does not have a UTI
d. send the urine to the lab for cx
Answer: d. send the urine to the lab for cx
◉ The clean catch urine specimen of a child w/dysuria, frequency,
and fever has a colony count between 50,000 and 100,000 of E. coli.
What is the tx for this child?
a. obtain a CBC & CRP
b. perform sensitivity testing before treating w/antibiotics
c. repeat the culture if sx persist or worsen
d. tx w/antibiotics for UTI
Answer: d. tx w/antibiotics for UTI
, ◉ A dipstick urinalysis is positive for leukocyte esterase and nitrites
in a school-age child with dysuria and foul-smelling urine but no
fever who has not had previous UTI. A culture is pending. What will
the pediatric NP do to tx this child?
A. order cipro ER once daily x3 days if cx is positive
B. Prescribe trimethoprim-sulfamethoxazole (TMP) BID for 3-5 days
C. Reassure the child's parents that this is likely an asymptomatic
bacteriuria
D. Wait for urine cx results to determine the correct course of tx
Answer: B. Prescribe trimethoprim-sulfamethoxazole (TMP) BID for
3-5 days
◉ A preschool-age child with no previous hx has mild flank pain and
fever but no abd pain or vomiting. A UA is positive for leukocyte
esterase and nitrites. A cx is pending. What is the correct course of tx
of this child?
A. Hospitalize for IV antibiotics
B. Order amoxicillin clavulanate
C. Prescribe trimethoprim-sulfamethoxazole
D. Refer for a voiding cystourethrogram
Answer:
DETAILED SOLUTIONS
◉ An adolescent is dx with functional abdominal pain (FAP). The
child's sx worsen during stressful events, esp w/school anxiety.
What will be an important part of tx for this child?
A. informing the parents that the pain is most likely not real
B. instituting a lactose-free diet along w/lactobacillus supplements
C. teaching about the brain-gut interaction causing sx
D. using histamine2-blockers to help alleviate sx
Answer: C. teaching about the brain-gut interaction causing sx
◉ A school-age child has recurrent diarrhea w/foul-smelling stools,
excessive flatus, abd distention, and FTT. A 2-week lactose-free trial
failed to reduce sx. What is the next step in diagnosing this
condition?
A. lactose hydrogen breath test
B. serologic testing for celiac disease
C. stool for ova and parasites
D. Sweat chloride test for cystic fiborisis
Answer: B. serologic testing for celiac disease
,◉ A child is diagnosed w/Chron disease. What are the likely
complications for this child?
A. cancer of the colon and possible colectomy
B. intestinal obstruction w/scarring and strictures
C. intestinal perforation and hemorrhage
D. liver disease and sepsis
Answer: B. intestinal obstruction w/scarring and strictures
◉ A 12-month old infant exhibits poor wt. gain after previously
normal growth patterns. There is no hx of V/D, or irregular BM, and
the PE is normal. What is the next step in evaluating these findings?
A. CBC and electrolytes
B. Feeding and stooling hx and 3-day diet hx
C. Stool cx for ova and parasites
D. swallow study with videofluoroscopy
Answer: B. Feeding and stooling hx and 3-day diet hx
◉ A 2-year-old child has an acute diarrheal illness. The child is
afebrile and with oral rehydration measures, has remained well
hydrated. The parent asks what can be done to help shorten the
course of this illness. What will the primary care pediatric NP
recommend?
A. Clear liquids only
B. Lactobacillus
,C. Loperamide
D. Peppermint oil
Answer: B. Lactobacillus
◉ A 30-month-old girl who has been toilet trained for 6 mo has
daytime enuresis and dysuria and a low-grade fever. A dipstick
urinalysis is negative for leukocyte esterase and nitrates. What is the
next step?
a. begin empiric tx w/trimethoprim-sulfamethoxazole
b. discuss behavioral interventions for toilet training
c. reassure the child's parents that the child does not have a UTI
d. send the urine to the lab for cx
Answer: d. send the urine to the lab for cx
◉ The clean catch urine specimen of a child w/dysuria, frequency,
and fever has a colony count between 50,000 and 100,000 of E. coli.
What is the tx for this child?
a. obtain a CBC & CRP
b. perform sensitivity testing before treating w/antibiotics
c. repeat the culture if sx persist or worsen
d. tx w/antibiotics for UTI
Answer: d. tx w/antibiotics for UTI
, ◉ A dipstick urinalysis is positive for leukocyte esterase and nitrites
in a school-age child with dysuria and foul-smelling urine but no
fever who has not had previous UTI. A culture is pending. What will
the pediatric NP do to tx this child?
A. order cipro ER once daily x3 days if cx is positive
B. Prescribe trimethoprim-sulfamethoxazole (TMP) BID for 3-5 days
C. Reassure the child's parents that this is likely an asymptomatic
bacteriuria
D. Wait for urine cx results to determine the correct course of tx
Answer: B. Prescribe trimethoprim-sulfamethoxazole (TMP) BID for
3-5 days
◉ A preschool-age child with no previous hx has mild flank pain and
fever but no abd pain or vomiting. A UA is positive for leukocyte
esterase and nitrites. A cx is pending. What is the correct course of tx
of this child?
A. Hospitalize for IV antibiotics
B. Order amoxicillin clavulanate
C. Prescribe trimethoprim-sulfamethoxazole
D. Refer for a voiding cystourethrogram
Answer:
