NU 664 Exam 1 UPDATED Exam
Questions and CORRECT Answers
Gold standard for CAP diagnosis: - CORRECT ANSWER- Chest x-ray
If CAP symptoms present but no obvious signs of infection on CXR treatment is... -
CORRECT ANSWER- Same as if CXR was positive
Immunizations for people over 65 or younger people with comorbidities such as asthma, CHF
COPD: - CORRECT ANSWER- Pneumonia and flu vaccines
Who is at risk for CAP? - CORRECT ANSWER- Extremes of age, smokers, alcoholics,
GERD, chronic disease, institutionalization
CAP presentation in adults: - CORRECT ANSWER- Cough (may be nonproductive),
dyspnea, fever, hemoptysis, chest pain, fatigue, tachycardia
If lymphocytes are elevated? - CORRECT ANSWER- Indicative of viral process
If monocytes are elevated? - CORRECT ANSWER- Indicative of chronic process
If eosinophils are elevated? - CORRECT ANSWER- Indicative of asthma, allergic reaction
If basophils are elevated? - CORRECT ANSWER- Indicative of chronic process
If neutrophils are elevated? - CORRECT ANSWER- Indicative of acute bacterial process
CAP: patient present with symptoms of chills, fever, chest pain, productive cough with
purulent sputum, positive chest x-ray, and patient had URI last week? - CORRECT
ANSWER- Streptococcus pneumonia: gram +
In the United States, the most common cause of myocarditis in children is: - CORRECT
ANSWER- Viruses
, Your next patient is a 5-year-old child with a history of moderate persistent asthma. He has
been wheezing and coughing for the past two days, and his mother brings him in today for
evaluation. He has been using albuterol every four hours. His respiratory rate is 13 breaths
per minute; his lungs are clear to auscultation; and no retractions are noted. What may be
your assessment and intervention based on this information? - CORRECT ANSWER- Your
child is breathing slower than normal for his age. We need to send him to the ER for further
intervention.
Your next patient is a 6-year-old male here for his annual influenza vaccine. He has a history
of mild persistent asthma. What would you discuss for medications when reviewing his
asthma action plan? - CORRECT ANSWER- Your child should continue his low-dose
inhaled corticosteroid daily and add albuterol as needed for an exacerbation.
A child who has been diagnosed with asthma for several years has been using a short-acting
Beta-agonist (SABA) to control symptoms. The PNP learns that the child has recently begun
using the SABA 2-3 times each week to prevent wheezing and shortness of breath. The child
currently has clear breath sounds and an FEV1 of 75% of personal best. What will the NP do?
- CORRECT ANSWER- Add an inhaled corticosteroid.
Your next patient is a six-month-old infant who just completed amoxicillin for otitis media.
The mother states her child is better except for a diaper rash. Upon examination, you note red
scaly plaques in the diaper area with satellite lesions to his upper thighs. What would you do
next as the PNP? - CORRECT ANSWER- Your child has a rash that is likely due to a fungus,
Candida, and commonly occurs after taking antibiotics. I will prescribe nystatin to be applied
to the diaper area.
A 12 y.o. female presents to the clinic after being bit by a dog on the face. Abrasion with 2
puncture wounds on the upper right cheek, approximately 1 inch below the eye. The area is
slightly erythematous, with a small amount of bruising and raised area along the cheekbone. -
CORRECT ANSWER- Using normal saline, irrigate the wounds using high pressure (greater
than 4 pounds per square inch) and high volume (greater than 1 L). Isolated puncture wounds
should not be irrigated, instead soak the wound in a diluted solution of tap water and
povidone-iodine for 15 .minutes • Prescribe a 3- to 5-day course of prophylactic antibiotics
A 4 yo child has clusters of small, clear, tense vesicles with an erythematous base on one side
of the mouth along the vermillion border, which are causing discomfort and difficulty eating.
What will the PNP recommend as treatment? - CORRECT ANSWER- Topical
diphenhydramine and magnesium hydroxide.
Questions and CORRECT Answers
Gold standard for CAP diagnosis: - CORRECT ANSWER- Chest x-ray
If CAP symptoms present but no obvious signs of infection on CXR treatment is... -
CORRECT ANSWER- Same as if CXR was positive
Immunizations for people over 65 or younger people with comorbidities such as asthma, CHF
COPD: - CORRECT ANSWER- Pneumonia and flu vaccines
Who is at risk for CAP? - CORRECT ANSWER- Extremes of age, smokers, alcoholics,
GERD, chronic disease, institutionalization
CAP presentation in adults: - CORRECT ANSWER- Cough (may be nonproductive),
dyspnea, fever, hemoptysis, chest pain, fatigue, tachycardia
If lymphocytes are elevated? - CORRECT ANSWER- Indicative of viral process
If monocytes are elevated? - CORRECT ANSWER- Indicative of chronic process
If eosinophils are elevated? - CORRECT ANSWER- Indicative of asthma, allergic reaction
If basophils are elevated? - CORRECT ANSWER- Indicative of chronic process
If neutrophils are elevated? - CORRECT ANSWER- Indicative of acute bacterial process
CAP: patient present with symptoms of chills, fever, chest pain, productive cough with
purulent sputum, positive chest x-ray, and patient had URI last week? - CORRECT
ANSWER- Streptococcus pneumonia: gram +
In the United States, the most common cause of myocarditis in children is: - CORRECT
ANSWER- Viruses
, Your next patient is a 5-year-old child with a history of moderate persistent asthma. He has
been wheezing and coughing for the past two days, and his mother brings him in today for
evaluation. He has been using albuterol every four hours. His respiratory rate is 13 breaths
per minute; his lungs are clear to auscultation; and no retractions are noted. What may be
your assessment and intervention based on this information? - CORRECT ANSWER- Your
child is breathing slower than normal for his age. We need to send him to the ER for further
intervention.
Your next patient is a 6-year-old male here for his annual influenza vaccine. He has a history
of mild persistent asthma. What would you discuss for medications when reviewing his
asthma action plan? - CORRECT ANSWER- Your child should continue his low-dose
inhaled corticosteroid daily and add albuterol as needed for an exacerbation.
A child who has been diagnosed with asthma for several years has been using a short-acting
Beta-agonist (SABA) to control symptoms. The PNP learns that the child has recently begun
using the SABA 2-3 times each week to prevent wheezing and shortness of breath. The child
currently has clear breath sounds and an FEV1 of 75% of personal best. What will the NP do?
- CORRECT ANSWER- Add an inhaled corticosteroid.
Your next patient is a six-month-old infant who just completed amoxicillin for otitis media.
The mother states her child is better except for a diaper rash. Upon examination, you note red
scaly plaques in the diaper area with satellite lesions to his upper thighs. What would you do
next as the PNP? - CORRECT ANSWER- Your child has a rash that is likely due to a fungus,
Candida, and commonly occurs after taking antibiotics. I will prescribe nystatin to be applied
to the diaper area.
A 12 y.o. female presents to the clinic after being bit by a dog on the face. Abrasion with 2
puncture wounds on the upper right cheek, approximately 1 inch below the eye. The area is
slightly erythematous, with a small amount of bruising and raised area along the cheekbone. -
CORRECT ANSWER- Using normal saline, irrigate the wounds using high pressure (greater
than 4 pounds per square inch) and high volume (greater than 1 L). Isolated puncture wounds
should not be irrigated, instead soak the wound in a diluted solution of tap water and
povidone-iodine for 15 .minutes • Prescribe a 3- to 5-day course of prophylactic antibiotics
A 4 yo child has clusters of small, clear, tense vesicles with an erythematous base on one side
of the mouth along the vermillion border, which are causing discomfort and difficulty eating.
What will the PNP recommend as treatment? - CORRECT ANSWER- Topical
diphenhydramine and magnesium hydroxide.
