NURS 6541 Final Exam Questions With Answers | Latest Update 2023/2024 | Graded A+

Kelly, your 11-year-old well visit patient, presents to the office with weight loss, polyuria, and polydipsia. Which of the following do you need to rule out? Selected Answer: d. Diabetes mellitus  Question 6 1 out of 1 points Children in child care facilities are at greater risk of being exposed to which of the following infections? Selected Answer: b. HAV  Question 7 1 out of 1 points A 6-year-old boy is left alone for 10 hours, now with hematemesis and pneumomediastinum on chest x-ray. Which of the following is the most likely etiology? Selected Answer: b. Esophageal foreign body  Question 8 1 out of 1 points A 14-month-old child has lower extremity bowing, a waddling gait, genu varum, and is at the 5 th percentile for height. Laboratory data include low-normal serum calcium, moderately low serum phosphate, and elevated serum alkaline phosphatase levels, hyperphosphaturia, and normal parathyroid levels. Which of the following is the most likely diagnosis? Selected Answer: e. Genetic primary hypophosphatemia  Question 9 1 out of 1 points The most common trigger for an acute asthma episode in the very young child is Selected Answer: d. Respiratory infections  Question 10 1 out of 1 points What is the primary treatment for testicular torsion? Selected Answer: c. Immediate surgical referral  Question 11 1 out of 1 points When Jason, age 12, slid into homeplate while playing baseball, he injured his ankle. You are trying to differentiate between a strain and a sprain. You know that a sprain Selected Answer: b. Is an injury to the ligaments that attach to the bones in a joint.  Question 12 1 out of 1 points The most common presentation of Hirschprung disease is which of the following? Selected Answer: b. Infrequent bowel movements  Question 13 0 out of 1 points Jennifer, age 16, is an active cheerleader who just developed type 1 diabetes. She is worried that she will not fit in with her friends anymore because she does not think she can have all the same snacks they have. How do you respond? Selected Answer: c. Be sure to stick to snacks that are high in simple carbohydrates.  Question 14 1 out of 1 points Which of the following is not a sign or symptom of congenital hypothyroidism? Selected Answer: a. Frequent stooling  Question 15 0 out of 1 points You see a 7-year-old boy a day after he was bitten by his pet dog. According to the mother, the dog bit the child after he snuck up on the dog and grabbed his tail. The dog has had all its vaccinations, including rabies. The child has had no fever, has full movement of the injured limb, and has no sign of neurologic or vascular injury. The wound is on the child’s forearm, is not deep, and is not bleeding, but has developed about 2 cm of erythema surrounding the site. Which of the following is the most appropriate treatment? Selected Answer: d. Oral amoxicillin-clavulanate for 3-5 days  Question 16 1 out of 1 points Robert, your 15-year-old male patient, is here today for a well visit. He is tall in stature and has increased arm span, laxity of joints, pectus excavatum, and an abnormal echocardiogram. Which of the following diagnosis would you suspect Robert as having? Selected Answer: b. Marfan syndrome  Question 17 1 out of 1 points An adolescent female presents with a 2-day history of increasing lower abdominal pain. She has mild vomiting and anorexia and fevers to 101F. She is unable to defecate but has an urge to do so. CBC reveals a slightly elevated WBC of 14,000, but is otherwise normal. Serum electrolytes are normal. The next step is Selected Answer: a. Refer to surgery for evaluation for appendicitis.  Question 18 1 out of 1 points Vomiting in infancy has a long list of differential diagnoses. Which of the following other symptoms would mostly likely point to pyloric stenosis? Selected Answer: b. Sausage-shaped mass in abdomen  Question 19 1 out of 1 points Which of the following is a characteristic physical sign of fragile X syndrome in adolescent males? Selected Answer: a. Macro-orchidism  Question 20 1 out of 1 points A 3-week old presents to the office in January with a 1-week history of nasal congestion and occastional cough. On the night prior to the visit in infant developed a fever 102ºF rectally, was difficult to breastfeed, and had paroxysmal coughing and noisy, labored breathing. On exam, you note an ill-appearing infant who is lethergic with wheezing, tachypnea, and intercostal retractions. The infant is home with the mom at this time; however, has a sibling who is 4-years-old and is in daycare and recently had cold symptoms. If the patient has been diagnosed with RSV bronchiolitis, which of the following would be the treatment of choice? Selected Answer: b. Fluids and nutritional support and close monitoring  Question 21 1 out of 1 points An adolescent who has tall stature, increased arm span, laxity of joints, pectus excavatum, and abnormal echocardiogram woudl be expected to have Selected Answer: d. Marfan syndrome  Question 22 1 out of 1 points An 18-month-old African American girl is brought to your office because she has been crying and stopped walking today. She will crawl, however. Her mom denies any injury to the child. On examination, she is crying but consolable in her mother’s arms. She has bruising and swelling just proximal to the left ankle. An x-ray reveals a spiral fracture of the tibia. At this time, you advise the mother that: Selected Answer: a. This is a common fracture resulting from twisting on a planted foot.  Question 23 1 out of 1 points A small-for-gestational-age, dysmorphic newborn infant has microcephaly and sloping forehead, cutis aplasia (missing portion of the skin and hair) of the scalp, polydactyly, microphthalmia, and omphalocele. Which of these is the most likely diagnosis? Selected Answer: c. Patau syndrome (trisomy 13)  Question 24 1 out of 1 points A 16-year-old presents with pharyngitis, cough, and high fever. Her chest x-ray reveals bilateral pulmonary infiltrates. Her white blood cell count is normal and the neutrophil count is normal. The most likely etiology is Selected Answer: b. Chlamydia pneumonia  Question 25 1 out of 1 points A common cause of in-toeing in childhood is Selected Answer: d. Internal tibial torsion  Question 26 1 out of 1 points Individuals with chronic adrenal insufficiency often have Selected Answer: d. A craving for salt  Question 27 1 out of 1 points Which of the following should be done annually after 1 year of age in a child with Down syndrome? Selected Answer: d. Thyroid screenings  Question 28 1 out of 1 points Sarah, age 13, is markedly obese and has a poor self-image. How do you differentiate between compulsive eating and bulemia? Selected Answer: a. A compulsive eater does not induce vomiting.  Question 29 1 out of 1 points The peak incidence of osteosarcoma is Selected Answer: a. 15-19 years of age  Question 30 1 out of 1 points A 10-year-old boy jumps off a 2-foot wall, twisting his foot and ankle upon landing. His ankle x-ray reveals a fracture of the distal tibia over the articular surface into the epiphysis and physis. Based on the Salter-Harris classification for growth plate injuries, you know this as a Selected Answer: a. Salter-Harris III  Question 31 1 out of 1 points One of the most appropriate agents used to treat influenza A is Selected Answer: a. Oseltamivir  Question 32 1 out of 1 points An essential test in the evaluation of a 2-year-old being managed for Kawasaki disease is Selected Answer: d. an echocardiogram  Question 33 1 out of 1 points You have a patient with pityriasis rosea. You will recommend all of these treatments, except Selected Answer: c. Oral antibiotics.  Question 34 1 out of 1 points A 14-year-old girl from another state was followed for 7 years for a history of insulin-dependent diabetes mellitus. Her hemoglobin A1C is 14.9%. This laboratory test indicates which of the following? Selected Answer: d. Her glucose control is poor.  Question 35 1 out of 1 points A 7-month-old female was brought by her mother to an outpatient clinical because of a 2-day history of fever, copious nasal secretions, and wheezing. The mother volunteered that the baby has been healthy and has not had these symptoms in the past. The infant’s temperature is noted to be 100.7°F, her respiratory rate is 50 breaths/min, and her pulse oximetry is 95% on room air. Physical examination reveals no signs of dehydration, but wheezing is hear on lung auscultation. The infant shows no improvement after three treatments with nebulized albuterol. Which of the following is recommended treatment? Selected Answer: c. Supportive care with hydration and humidified oxygen  Question 36 1 out of 1 points A child has developed her second perirectal abscess in 6 months. She should be evaluated for which of the following conditions? Selected Answer: d. Crohn's disease  Question 37 1 out of 1 points A 9-month-old has been diagnosed with gastroenteritis. He attends a daycare facility. What is the likely cause of the illness? Selected Answer: d. Rotavirus  Question 38 1 out of 1 points Hypercholesterolemia in children older than 2 is defined as a total cholesterol at or above Selected Answer: d. 200 mg/dL  Question 39 1 out of 1 points A 3-week-old male infant with 2 days of projectile, nonbilious vomiting and constant feeding. Which of the following is the most likely etiology? Selected Answer: e. Pyloric stenosis  Question 40 1 out of 1 points Which fo the following foods would be most appropriate for a child with celiac disease? Selected Answer: a. Rice with butter  Question 41 1 out of 1 points The most common cause of UTI (urinary tract infection) in the pediatric population is Selected Answer: d. E. coli  Question 42 1 out of 1 points Which of the following is not found in an adolescent with untreated Graves' disease? Selected Answer: a. Tendency to gain weight easily  Question 43 1 out of 1 points What does shift to the left mean in a white blood count? Selected Answer: d. A rise in neutrophils  Question 44 1 out of 1 points Prophylactic penicillin should be started in children with sickle cell anemia by Selected Answer: d. 2 to 3 months of age  Question 45 1 out of 1 points Six months after being diagnosed with what appears to be insulin-dependent diabetes, the 5-year-old in the case presentation has a significant decrease in his insulin requirement. Which of the following is the most likely explanation? Selected Answer: c. He has entered the "honeymoon phase" of his diabetes.  Question 46 1 out of 1 points Tommy has bloody diarrhea. His family eats fast-food four to five times each week. Which organism may have caused the diarrhea? Selected Answer: b. E. Coli  Question 47 1 out of 1 points Which chromosomal abnormality is associated with short stature in girls? Selected Answer: d. Turner syndrome  Question 48 1 out of 1 points Maddie, age 2, had a complete blood count (CBC) drawn at her last visit. It indicates that she has a microcytic hypochromic anemia. What should you do now at this visit? Selected Answer: a. Obtain a lead level.  Question 49 1 out of 1 points A 2-year-old boy is brought in with fever and poor feeding. He started getting sick yesterday and has worsened significantly today. He has had no recent illnesses or injuries, and no known ill contacts. On examination, his temperature is 101°F, he is tachycardic, and he appears ill. He is laying on his back with his left leg flexed and abducted at the hip. The HEENT examination is normal, heart is tachycardic but regular, and the lungs are clear. The abdomen is nontender and has normal bowel sounds. He screams in pain when you move his left leg from its resting position. Blood work reveals an elevated WBC count of 15,000 mm3 and an ERS or 45 mm/h. An x-ray of his left hip shows a widened joint space but no fractures. What is your next step at this point? Selected Answer: b. Hip joint aspiration  Question 50 1 out of 1 points When a neonate is initially protected against measles, mumps, and rubella because the mother is immune, this is an example of which type of immunity? Selected Answer: d. Natural passive  Question 51 1 out of 1 points You are examining Beth, age 9 months, and note a palpable right supraclavicular node. You know that this finding is suspicious for Selected Answer: b. Lymphoma of the mediastinum  Question 52 1 out of 1 points A 4-year-old female with profuse vomiting, sweating, lacrimation, and diarrhea, who seizes in the emergency room. Which of the following is the most likely etiology? Selected Answer: a. Insecticide ingestion  Question 53 1 out of 1 points A 6-year-old male is brought in for evaluation of a painful hip. He has been limping and not wanting to walk for the past 2 days. He has no obvious injury. He feels a little better if he is given ibuprofen. He has not had a fever and does not have any other current symptoms, although he had "the flu" last week. On examination, his vital signs are normal. His right hip has some pain with internal rotation. He walks with a pronounced limp. Which of the following statements is most accurate? Selected Answer: a. He should have a complete blood count (CBC) and ESR.  Question 54 1 out of 1 points You see a 7-year-old with a positive stool culture for Salmonella enteriditis. The appropriate therapy for a non-dehydrated child is Selected Answer: b. Bland diet with focus on maintaining hydration  Question 55 1 out of 1 points A common presenting symptom of inflammatory bowel disease is Selected Answer: a. Unexplained fever  Question 56 0 out of 1 points Which of the following statements is not true with slipped capital femoral epiphysis? Selected Answer: d. Unilateral involvement is more common than bilateral.  Question 57 1 out of 1 points A mother brings a 2-year-old to your office with the complaint that she passes 5 to 10 watery stools per day that often contain undigested food. The child appears healthy and has no other GI symptoms. She is acting, eating, and voiding normally. Weight gain is normal and the mother states she often drinks (her favorite drink is Kool-Aid) instead of eating. The best management for this condition is: