NRNP 6541 Midterm Exam Questions With Verified Answers Latest Updated 2023/2024 (Score 100%)

When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Selected Answer: Ye s  Question 2 1 out of 1 points Which of the following statements regarding adolescent substance use is true? Selected Answer: a. Tobacco is the most commonly abused substance during adolescence.  Question 3 1 out of 1 points You see a 4-year-old for a well-child visit. He has received four diphtheria, tetanus, and acellular pertussis vaccines (DTaP); three injected polio vaccines (IPV); one measles, mumps, and rubella vaccine (MMR); one varicella vaccine; and two hepatitis B (Hep B) vaccines. What do you order today? Selected Answer: d. DTaP, IPV, MMR, and Varivax  Question 4 1 out of 1 points The parents of a 7-year-old are concerned their son does not want to attend school. Which of the historical findings are not usually associated with the diagnosis of school phobia? Selected c. Answer: Chronic medical illness  Question 5 1 out of 1 points Chelsea, age 8, complains that she feels as if something is stuck in her ear. What action is contraindicated? Selected Answer: b. Flushing the ear with water.  Question 6 1 out of 1 points You see a 7-year-old with complaints of "having accidents at night." Physical exam and history are unremarkable. Urinalysis, urine culture, and specific gravity are normal. His parents ask about the best treatment for this problem. The best response is Selected Answer: c. Fluid restriction and voiding prior to the night may be effective.  Question 7 1 out of 1 points You are doing a kindergarten physical on a 5-year-old girl. Which of the following scenarios would suggest the child is not ready to start kindergarten in the fall? Selected Answer: d. Counts to 4 and draws a person with three parts.  Question 8 1 out of 1 points Upon eye examination of a newborn, you note inner canthal folds and Brushfield spots. What do you suspect? Selected Answer: c. Down syndrome  Question 9 1 out of 1 points I like to use my pincer grasp that involves the ablitily to pick up a small object such as a raisin or piece of cereal with the thumb and forefinger, and that is mastered around what age? Selected Answer: b. 9 months  Question 10 1 out of 1 points Mark, a 10-year-old, has a lot of ear pain. He does not want anyone to touch it and is crying in pain. The ear canal is swollen and exudate is preswent. The TM is normal. What is the proper management for his patient? Selected Answer: b. Topical Fluoroquiolone  Question 11 1 out of 1 points The diagnostic criteria for autism spectrum disorder include all of the following except Selected Answer: d. Tolerance of flexibility with routines  Question 12 1 out of 1 points Luke, a 17-month-old, failed treatment with amoxicillin for otitis media. At the twoweek recheck, his TM was still erythematous and you cannot see the landmarks. He has persistent nasal congestion, he is not sleeping at night, and he has a 101°F fever. What is the next best step for Luke? Selected Answer: d. A 10 day course of Augmentin  Question 13 1 out of 1 points Which of the following would not suggest an eating disorder with a purging component? Selected Answer: d. Diarrhe a  Question 14 1 out of 1 points Role-play with equipment during the course of the physical exam would be the most beneficial with which age group? Selected Answer: d. Preschoole rs  Question 15 1 out of 1 points While assessing the skin of an infant, you note cafe-au-lait spots. Which disease should be ruled out? Selected Answer: d. Neurofibromato sis  Question 16 1 out of 1 points An expected milestone of a 4-year-old is the ability to Selected Answer: c. Copy a cross  Question 17 1 out of 1 points You receive a phone call from the mother of a 2-year-old. She states her child has sleep refusal. You suggest the child should be able to: Selected Answer: a. Set his own bedtime based on his internal clock.  Question 18 0 out of 1 points An eye that deviates in when covered but that returns to midline when uncovered is an Selected Answer: a. esotropi a  Question 19 1 out of 1 points A 4-year-old believes there is more juice in a tall, thin glass than a shorter, wider one. The child has not yet achieved which of the principles of Piaget? Selected Answer: b. Conservati on  Question 20 1 out of 1 points A healthy, well-developed 6-year-old child arrives as a new patient to your clinic. His immunization card reveals that he received an immunization at birth and some when he was 2 months old, but none sense. Which of the following statements about him is correct? Selected Answer: b. He is too old to receive the Haemophilus influenzae Type B vaccine.  Question 21 1 out of 1 points Which of the following issues or concepts is relevant to the school-age child? Selected Answer: b. Erikson's initiative versus guilt  Question 22 1 out of 1 points You would be concerned about the language development of a child who: Selected Answer: c. Stutters when excited or tired at the age of 7  Question 23 1 out of 1 points You diagnose a 16-year-old with acute otitis media and need to prescribe an antibiotic with beta-lactamase coverage. What do you choose? Selected Answer: b. amoxicillin and potassium clavulanate (Augmentin)  Question 24 1 out of 1 points A 2-year-old boy has been slightly less than the 50th percentile for weight, height and head circumference, but in the last 6 months he has fallen to slightly less than the 25th percentile for weight. The pregnancy was normal, his development is as expected, and the family reports no psychosocial problems. The mother says that he is now a finicky eater (wants only macaroni and cheese at all meals), but she insists that he eat a variety of foods. The meals are marked by much frustration for everyone. His examination is normal. Which of the following is the best next step in his care? Selected Answer: b. Reassurance and counseling for family about childhood normal developmental stage  Question 25 1 out of 1 points Which of the following characterizes middle adolescence (14 to 16 years old)? Selected Answer: a. Intense peer group involvement, feelings of immortality, sexual experimentation  Question 26 1 out of 1 points Which of the following foreign body in the nose requires immediate removal? Selected Answer: c. batter y  Question 27 1 out of 1 points Which is the correct order for introduction of solid foods to an infant? Selected Answer: d. Cereal, vegetables, fruits, and meats  Question 28 1 out of 1 points FIRST-LINE therapy for preschoolers (4-5 years of age) diagnosed with attention-deficit hyperactive disorder is: Selected Answer: d. Behavior therapy  Question 29 1 out of 1 points A 15-month-old boy says “mama” and “dada,” points and gestures if he wants things, and follows simple one-step commands. Your best response is which of the following? Selected Answer: c. Tell parent, "Your child's language development is normal."  Question 30 1 out of 1 points A 4-month-old child has poor weight gain. Her current weight is less than the 5th percentile, height about the 10th percentile, and head circumference at the 50th percentile. The planned pregnancy resulted in a normal, spontaneous, vaginal delivery; mother and child were discharged after a 48-hour hospitalization. Feeding is via breast and bottle; the quantity seems sufficient. The child has had no illness. The examination is unremarkable except for the child’s small size. Screening laboratory shows the hemoglobin and hematocrit are 11 mg/dL and 33% respectively, with a platelet count of 198,000/mm3. Serum electrolyte levels are sodium 140, chloride 105, potassium 3.5, bicarbonate 17, blood urea nitrogen 15, and creatinine 0.3. Liver function tests are normal. Urinalysis reveals a pH of 8 with occasional epithelial cells but no white blood cells, bacteria, protein, ketones, or reducing substances. Which of the following is the most appropriate therapy for this child? Selected Answer: e. Oral supplementation with bicarbonate  Question 31 1 out of 1 points Which of the following signs may indicate a baby is not receiving sufficient breastmilk? Selected Answer: c. Sleepiness, jaundice, and vomiting  Question 32 0 out of 1 points Which of the following children should be referred for a comprehensive developmental evaluation? Selected Answer: b. A 19-month-old with explosive temper tantrums.  Question 33 1 out of 1 points By what age should most children be able to sit well without support? Selected Answer: c. 9 months  Question 34 1 out of 1 points I can roll over, grasp a rattle, and reach for things and have begun feeding myself finger foods, but I can’t wave bye-bye yet. How old am I? Selected Answer: d. 6 months  Question 35 1 out of 1 points Parents bring their 16-year-old daughter for a “well-child” checkup. She looks normal on examination. As part of your routine care you plan a urinalysis. The father pulls you aside and asks you to secretly run a UDS on his daughter. Which of the following is the most appropriate course of action? Selected Answer: d. Explore the reasons for the request with the parents and the adolescent and perform a UDS with the adolescent's permission if the history warrants.  Question 36 1 out of 1 points A teenage female who is overweight has moderate acne on the face and chest, and irregular menses. Elevation of which laboratory test provides the test evidence of polycystic ovarian syndrome? Selected Answer: b. free testosterone  Question 37 1 out of 1 points Which of the following complication of strep pharyngitis cannot be prevented with antibiotics? Selected Answer: c. Glomerulonephri tis  Question 38 1 out of 1 points A fifteen-year-old female makes a statement to you during a well visit. Which of the following statements should not be kept confidential? Selected Answer: d. "Sometimes I feel like ending my life."  Question 39 1 out of 1 points Which of the following screenings should adolescents have done annually? Selected Answer: a. Psychosocial screening, blood pressure, body mass index  Question 40 1 out of 1 points Which of the following substances is associated with pupillary constriction? Selected Answer: b. Heroi n  Question 41 1 out of 1 points The appropriate lab tests in assessment of cervical adenitis include all of the following except: Selected Answer: d. Blood culture  Question 42 1 out of 1 points What method can be safely used to remove cerumen in a 15-month-old child's ear? Selected Answer: b. Irrigation using warm water from a soft bulb syringe  Question 43 1 out of 1 points Max, a 9-year-old boy, is a very active child with limited self-control. He is easily distracted and has difficulty staying on task. You determine that he should have a neurodevelopmental evaluation because he is showing signs of Selected Answer: b. ADH D  Question 44 1 out of 1 points A mother states that her 4-year-old son constantly grinds his teeth at night. You document this as: Selected Answer: c. Bruxis m  Question 45 1 out of 1 points The father of a 3-year-old is concerned because the child stutters. What should your approach be? Selected Answer: d. Explain that this can be normal until 4 years of age.  Question 46 1 out of 1 points A mother of a 6-month-old asks you about normal sleep patterns for an infant this age. The best response is: Selected Answer: b. 10 hours at night and 3-4 hours during the day  Question 47 1 out of 1 points Josh, age 13, has some enlargement of the scrotum and testes, a reddened scrotal sac, and some hair texture alteration. His penis is not enlarged. He is in Tanner stage Selected Answer: d. II  Question 48 1 out of 1 points Which of the following eye findings would be considered an ophthalmic emergency? Selected Answer: d. Unilateral vesicular lesions on the upper eyelid in a 3-week old.  Question 49 1 out of 1 points Mark is in the exam room. You are concerned he may have epiglottitis. In what position do these patients prefer to sit? Selected Answer: d. Sitting up and leaning forward  Question 50 1 out of 1 points A 14-year-old female comes into the office for an urgent visit after taking 10 valium tablets. Following the initial emergent care and stailization, the most important part of the management is: Selected Answer: c. Assessing the family supports available to the child.  Question 51 1 out of 1 points Which of the following statements about bullying is true? Selected Answer: d. It occurs most commonly during unstructured times (lunch, recess, etc.).  Question 52 1 out of 1 points For adolescent girls, peak height velocity should occur by Tanner Stage (SMR): Selected Answer: c. 3  Question 53 1 out of 1 points You see a 30-month-old who speaks in mixed Spanish and English. The child’s vocabulary is normal but at the low end of the normal language spectrum. The parent is worried the child’s development will not be normal because she mixes up the two languages. You respond: Selected Answer: b. "Your child's speech is normal and bilingual children commonly intermix the words from both languages until about 3 years of age."  Question 54 1 out of 1 points A 4-month-old presents with both eyes turning inward. What is this called? Selected Answer: b. Esotropi a