NR 602 My final Study set 146 correct
and complete solutions with Rational
NR 602 my final Study set 146 correct
and complete solutions with Rational
A 16yearold sexually active female has a fever, bilateral lower abdominal
pain,and malaise. A speculum and bimanual exam reveals adnexal tenderness.
The urinalysis is normal and cervical cultures are pending. What medications will the
primary care pediatric nurse practitioner prescribe for this patient? - ANSWER-PID- she
is Sexually active+Adnexal Tenderness and negative for UTI.
Ceftriaxone, doxycycline, and metronidazole
Rational- This is PID the treatment is Ceftriaxone 250 mg IM plus Doxyclicline 100 mg
BID for 14 days plus with or without Metronidazole 500 mg PO bid for 14 days.
4. A sexually active adolescent female tests positive for N. gonorrhea
and Chalmydia. She tells the primary care pediatric nurse practitioner that she
wants to be treated today since she is moving out of town the next day. What will the
nurse practitioner order?What is the treatment for her - ANSWER-Ceftriaxone 250 mg
IM and azithromycin 1 g PO one time each
Rational- Remember the G in Gonorehea for or Ceftriaxone and Chlamydia you can
give either Doxycycline 100 mg for 7 days or Azithromycin 1 g PO x1 because she is
moving she are giving this combination.
A 14yearold female has menometrorrhagia with moderate increase in menstrual flow
and irregular periods. Her hemoglobin is 13.1 g/dL. How will this be managed? -
ANSWER-Iron supplementation and prostaglandin inhibitors
Rationale: Her hemoglobin level is at 13.1 and the normal range for this age group is
11.9-15. It is better to give Iron because of the bleeding and for pain reliefe
Prostoglandins such as Ibuprofen.
An adolescent female has heavy periods that are also irregular. The physical exam is
normal. A complete blood count reveals a hemoglobin of 8.9 g/dL. What test will the
primary care pediatric nurse practitioner order next? - ANSWER-Coagulation studies
Rational-The normal Hemoglobin range is 11.9-13.1 and she is outside the range. We
need to look for reasons of this.
An adolescent female has periods every 30 days that are consistently
heavy and last from 5 to 8 days. What is her diagnosis? - ANSWER-Menorrhagia-
,NR 602 My final Study set 146 correct
and complete solutions with Rational
Rationale- The diagnosis for this is periods lasting longer than 7 days. Hers are lasting 8
days. She is consistant with when her periods start so it won't be menometrorrhagia
because that is irregular periods.
A 16yearold female has not had a menstrual period yet and is concerned. She
denies sexual activity. An exam reveals an adult sexual maturity rating.
Which laboratory test will the primary care pediatric nurse practitioner order initially? -
ANSWER-Pregnancy Test
Rationale- All people lie and the number one reason for Ammenorrhea is pregnancy.
After I rule out that then I can look at other things such as nutrition, is she an athlete and
is it Primary Amenorrhea which is failure to have a period for 3 years or creast
development or by age 15. or Secondary Anemia which is no menstrual periods for 3
months or absent of period for 6 months for those on irregular periods.
A 16yearold female reports breast tenderness and a "lump." The primary care pediatric
nurse practitioner palpates a small fluidfilled mass in her right breast. - ANSWER-Order
an Ultra Sound of Breast
Rationale- First thing you always do is order an ultra sound first to determine reason.
Most girls this age do not have breast cancer.
A 15yearold n female has a positive pregnancy test and asks the primary care
pediatric nurse practitioner not to tell her parents. She is tearful and says she isn't sure
she wants to keep the baby. What will the nurse practitioner do first? - ANSWER-
Determine the state mandated reporting laws.
Rationale- Each state has different laws on reporting to parents about STIs and
Pregnancy.
A 17yearold sexually active female who began having periods at age 14 reports having
moderate to severe dull lower abdominal pain associated
predominantly with periods but that occurs at other times as well. The history reveals a
recent onset of these symptoms. A pregnancy test is negative. Which course of action is
most important? - ANSWER-Perform a full diagnostic workup to evaluate potential
causes.
Rationale- This is not normal and needs more workup to determine the reason for it.
She is sexually active so this raises more concerns for other things that might be going
on such as PID or an STI
A 16yearold female reports dull, achy cramping pa in in her lower abdomen
lasting 2 or 3 hours that occurs between her menstrual periods each month.
, NR 602 My final Study set 146 correct
and complete solutions with Rational
The adolescent is not sexually active. What is the treatment for this condition? -
ANSWER-Prostaglandin inhibitor analgesics and a heating pad
Rationale -This is signs of normal period and the 1st line treatment is Prostoglandin and
heating pad.
A schoolage female has had vulvovaginitis for 2 months. All cultures and tests .are
negative, but the symptoms persist after treatment with both topical antibiotics and oral
amoxicillin. What is the next course of action to treat this condition? - ANSWER-
Estrogen cream at bedtime for 2 to 3 weeks
A 4yearold female who has had two urinary tract infections has persistent dysuria and
genital redness. The physical exam reveals a thin, flat membrane from the posterior
fourchette almost to the clitoris. Which treatment is indicated? - ANSWER-Use of
estrogencontaining cream
An adolescent female tells the primary care pediatric nurse practitioner
that shehad unprotected sexual intercourse 4 days prior and is worried she might
become pregnant. What will the nurse practitioner do? - ANSWER-Prescribe ulipristal
acetate (Ella).
Rationale- ella emergency contraception prevents pregnancy up to 5 days after
unprotected sex.
The primary care pediatric nurse practitioner is prescribing contraception
for an adolescent who has not used birth control previously. The adolescent has a
normal exam and has no family history of cardiovascular and peripheral
vascular disease or diabetes. Which preparation is used initially? - ANSWER-A
combination oral contraceptive pills (OCP) with 30 to 35
mcg of estrogen and low progestin
Rationale- Pt does not have history of cardiovascular, thrombosis, stroke of diabetes
use this method first. Remember to start low then increase.
The primary care pediatric nurse practitioner needs to assess a potential
hymenal tear in a prepubertal female who is apprehensive about the exam. Which
approach will the nurse practitioner use? - ANSWER-Place the child in the kneechest
position on the exam table.
The mother of a 12monthold uncircumcised male infant reports that the child
seems to have pain associated with voiding. A physical examination reveals a tight,
pinpoint opening of the foreskin, which thickened and inflamed. What will the primary
care pediatric nurse practitioner do? - ANSWER-Refer to urologist
and complete solutions with Rational
NR 602 my final Study set 146 correct
and complete solutions with Rational
A 16yearold sexually active female has a fever, bilateral lower abdominal
pain,and malaise. A speculum and bimanual exam reveals adnexal tenderness.
The urinalysis is normal and cervical cultures are pending. What medications will the
primary care pediatric nurse practitioner prescribe for this patient? - ANSWER-PID- she
is Sexually active+Adnexal Tenderness and negative for UTI.
Ceftriaxone, doxycycline, and metronidazole
Rational- This is PID the treatment is Ceftriaxone 250 mg IM plus Doxyclicline 100 mg
BID for 14 days plus with or without Metronidazole 500 mg PO bid for 14 days.
4. A sexually active adolescent female tests positive for N. gonorrhea
and Chalmydia. She tells the primary care pediatric nurse practitioner that she
wants to be treated today since she is moving out of town the next day. What will the
nurse practitioner order?What is the treatment for her - ANSWER-Ceftriaxone 250 mg
IM and azithromycin 1 g PO one time each
Rational- Remember the G in Gonorehea for or Ceftriaxone and Chlamydia you can
give either Doxycycline 100 mg for 7 days or Azithromycin 1 g PO x1 because she is
moving she are giving this combination.
A 14yearold female has menometrorrhagia with moderate increase in menstrual flow
and irregular periods. Her hemoglobin is 13.1 g/dL. How will this be managed? -
ANSWER-Iron supplementation and prostaglandin inhibitors
Rationale: Her hemoglobin level is at 13.1 and the normal range for this age group is
11.9-15. It is better to give Iron because of the bleeding and for pain reliefe
Prostoglandins such as Ibuprofen.
An adolescent female has heavy periods that are also irregular. The physical exam is
normal. A complete blood count reveals a hemoglobin of 8.9 g/dL. What test will the
primary care pediatric nurse practitioner order next? - ANSWER-Coagulation studies
Rational-The normal Hemoglobin range is 11.9-13.1 and she is outside the range. We
need to look for reasons of this.
An adolescent female has periods every 30 days that are consistently
heavy and last from 5 to 8 days. What is her diagnosis? - ANSWER-Menorrhagia-
,NR 602 My final Study set 146 correct
and complete solutions with Rational
Rationale- The diagnosis for this is periods lasting longer than 7 days. Hers are lasting 8
days. She is consistant with when her periods start so it won't be menometrorrhagia
because that is irregular periods.
A 16yearold female has not had a menstrual period yet and is concerned. She
denies sexual activity. An exam reveals an adult sexual maturity rating.
Which laboratory test will the primary care pediatric nurse practitioner order initially? -
ANSWER-Pregnancy Test
Rationale- All people lie and the number one reason for Ammenorrhea is pregnancy.
After I rule out that then I can look at other things such as nutrition, is she an athlete and
is it Primary Amenorrhea which is failure to have a period for 3 years or creast
development or by age 15. or Secondary Anemia which is no menstrual periods for 3
months or absent of period for 6 months for those on irregular periods.
A 16yearold female reports breast tenderness and a "lump." The primary care pediatric
nurse practitioner palpates a small fluidfilled mass in her right breast. - ANSWER-Order
an Ultra Sound of Breast
Rationale- First thing you always do is order an ultra sound first to determine reason.
Most girls this age do not have breast cancer.
A 15yearold n female has a positive pregnancy test and asks the primary care
pediatric nurse practitioner not to tell her parents. She is tearful and says she isn't sure
she wants to keep the baby. What will the nurse practitioner do first? - ANSWER-
Determine the state mandated reporting laws.
Rationale- Each state has different laws on reporting to parents about STIs and
Pregnancy.
A 17yearold sexually active female who began having periods at age 14 reports having
moderate to severe dull lower abdominal pain associated
predominantly with periods but that occurs at other times as well. The history reveals a
recent onset of these symptoms. A pregnancy test is negative. Which course of action is
most important? - ANSWER-Perform a full diagnostic workup to evaluate potential
causes.
Rationale- This is not normal and needs more workup to determine the reason for it.
She is sexually active so this raises more concerns for other things that might be going
on such as PID or an STI
A 16yearold female reports dull, achy cramping pa in in her lower abdomen
lasting 2 or 3 hours that occurs between her menstrual periods each month.
, NR 602 My final Study set 146 correct
and complete solutions with Rational
The adolescent is not sexually active. What is the treatment for this condition? -
ANSWER-Prostaglandin inhibitor analgesics and a heating pad
Rationale -This is signs of normal period and the 1st line treatment is Prostoglandin and
heating pad.
A schoolage female has had vulvovaginitis for 2 months. All cultures and tests .are
negative, but the symptoms persist after treatment with both topical antibiotics and oral
amoxicillin. What is the next course of action to treat this condition? - ANSWER-
Estrogen cream at bedtime for 2 to 3 weeks
A 4yearold female who has had two urinary tract infections has persistent dysuria and
genital redness. The physical exam reveals a thin, flat membrane from the posterior
fourchette almost to the clitoris. Which treatment is indicated? - ANSWER-Use of
estrogencontaining cream
An adolescent female tells the primary care pediatric nurse practitioner
that shehad unprotected sexual intercourse 4 days prior and is worried she might
become pregnant. What will the nurse practitioner do? - ANSWER-Prescribe ulipristal
acetate (Ella).
Rationale- ella emergency contraception prevents pregnancy up to 5 days after
unprotected sex.
The primary care pediatric nurse practitioner is prescribing contraception
for an adolescent who has not used birth control previously. The adolescent has a
normal exam and has no family history of cardiovascular and peripheral
vascular disease or diabetes. Which preparation is used initially? - ANSWER-A
combination oral contraceptive pills (OCP) with 30 to 35
mcg of estrogen and low progestin
Rationale- Pt does not have history of cardiovascular, thrombosis, stroke of diabetes
use this method first. Remember to start low then increase.
The primary care pediatric nurse practitioner needs to assess a potential
hymenal tear in a prepubertal female who is apprehensive about the exam. Which
approach will the nurse practitioner use? - ANSWER-Place the child in the kneechest
position on the exam table.
The mother of a 12monthold uncircumcised male infant reports that the child
seems to have pain associated with voiding. A physical examination reveals a tight,
pinpoint opening of the foreskin, which thickened and inflamed. What will the primary
care pediatric nurse practitioner do? - ANSWER-Refer to urologist
