NR 602 Final exam Question and Answers
Updted
Acyanotic cardiac disease -CORRECT ANSWERS-left to right shunting-increased pulmonary blood flow
atrial septal defect
ventricular sepal defect
patent ductus arteriosus
obstruction to ventricular outflow
coarctation of the aorta
pulmonary stenosis
aortic stenosis
amblyopia -CORRECT ANSWERS--a dimness of vision or the partial loss of sight, especially in one eye,
without detectable disease of the eye
-results in reduced or permanent loss of vision
-Findings: squinting, abnormal vision, pain and/or headaches, fatigue, dizziness, developmental delay
-usually responds to 2 hours of daily patching
Anemia of prematurity -CORRECT ANSWERS--MC anemia in premature, low birth weight infant
-low RBC production and short RBC lifespan
-normocytic normochromic anemia
-*retic low* (v hemolytic, sickle cell - retic high)
-normal WBC, plt count
-normal total bili (v hemolytic)
-tx: iron supplemnts, blood transfusion
annular ligament displacement -CORRECT ANSWERS-Nurse maids elbow
Tx: supination and flexion or pronation
do not perform if epitrochanter tenderness is present
palpable click is successful reduction
,AOM -CORRECT ANSWERS-RF: genetics, males, Native American, siblings, low economic status, ages
6mo-3y, winter, supine bottle feeding, daycare, tobacco smoke
Bacterial conjunctivits -CORRECT ANSWERS-erythema, itching, burning, mucopurulant d/c
Dx: R/O URI, pharyngitis, AOM
Tx: neonates-erythromycin
> 1 year fourth generation fluoroquinolone (moxifloxacin)
Bacterial rhinosinusitis -CORRECT ANSWERS-Preceded by URI-typically worsens after 5-7 days- not
resolved in 2 weeks
Barlow maneuver -CORRECT ANSWERS-place your index and middle finger over the greater tronchanter.
Gently push both knees together at midline downwards.
Positive:"Clunk" sounds or palpating trochangter being displaced by the index/middle finger
Bipolar disorder -CORRECT ANSWERS-1-2% of children <18 meet diagnostic criteria
early onset irritability; continuous rapid cycling
Sx: severe mood changes, inflated self esteem, decrease need for sleep, racing thoughts
depression typically first symptoms
Tx: refer to behavior health
medications-mood stabilizers, lithium, valproate, risperidone
blapharoptosis -CORRECT ANSWERS-drooping of the upper eyelid
if vision is compromised surgery is performed
Blepharitis -CORRECT ANSWERS-inflammation of the eyelash follicles
bilateral
Findings: swelling, erythema of eyelids, flaky debris upon wakening, gritty/burning in eyes
Tx: Bacitracin or erythromycin ointment
purchase new makeup, cool compresses
Bronchiolitis -CORRECT ANSWERS-Usually caused by RSV
wheezing present
<2 y/o
other causes; influenza, adenovirus, rhinovirus
Bulbar/palpebral conjunctival infection -CORRECT ANSWERS-May be unilateral or bilateral
Candiasis -CORRECT ANSWERS-Tx: thrush-oral nystatin QID
, if resistant to tx: oral fluconazole
skin diaper rash-nystatin, ketonazole
Cellulitis -CORRECT ANSWERS-In children often periorbital, perivaginal, perinatal, or buccal
Cellulitis Dx -CORRECT ANSWERS-CBC, BCx if child appears toxic, has fever, or is <1
Cellulitis exam -CORRECT ANSWERS-Buccal cellulitis-blue/purple tinged= h.influenzae
Cellulitis hx -CORRECT ANSWERS-Recent URI, fever, pain, malaise
Cellulitis tx -CORRECT ANSWERS-IV antx
if streptococcal= PCN, if allergy 3rd generation cephalosporin
if staphylococcus=bactrim if child >2 months; doxy if child >8 and < 45 kg
MRSA suspected= clindamycin
H.influenzae=augmentin x 10 days
cerebral palsy -CORRECT ANSWERS-paralysis caused by damage to the area of the brain responsible for
movement
symptoms appear within first few years of life
Exam= orthopedic-scoliosis, contractures, dislocated hips
neuro- asymmetrical or abnormal DTR, persistent tonic neck or Moro reflexes
macrocephaly or microcephaly
CF Dx -CORRECT ANSWERS-newborn screening
sweat testing- sweat chloride >60 is indicative of CF
LFTs are abnormal
CF manifestations -CORRECT ANSWERS-Neonate-meconium ileus, prolonged jaundice, hemorrhagic
disease of newborn (vit K deficiency)
infancy- cough, pneumonia, FTT, steatorrhea, abdominal distention
childhood- poor weight gain, constipation, sinusitis, poorly controlled asthma, digital clubbing
adolescents- diabetes, osteoporosis, chronic pansinusitis
CF tx -CORRECT ANSWERS--inhaled dornase- decreases mucosal viscosity
-CFTR modulators
-high dose ibuprofen and azithromycin 3x a week
-pancreatic enzyme replacement therapy (PERT) with every meal and snack
Updted
Acyanotic cardiac disease -CORRECT ANSWERS-left to right shunting-increased pulmonary blood flow
atrial septal defect
ventricular sepal defect
patent ductus arteriosus
obstruction to ventricular outflow
coarctation of the aorta
pulmonary stenosis
aortic stenosis
amblyopia -CORRECT ANSWERS--a dimness of vision or the partial loss of sight, especially in one eye,
without detectable disease of the eye
-results in reduced or permanent loss of vision
-Findings: squinting, abnormal vision, pain and/or headaches, fatigue, dizziness, developmental delay
-usually responds to 2 hours of daily patching
Anemia of prematurity -CORRECT ANSWERS--MC anemia in premature, low birth weight infant
-low RBC production and short RBC lifespan
-normocytic normochromic anemia
-*retic low* (v hemolytic, sickle cell - retic high)
-normal WBC, plt count
-normal total bili (v hemolytic)
-tx: iron supplemnts, blood transfusion
annular ligament displacement -CORRECT ANSWERS-Nurse maids elbow
Tx: supination and flexion or pronation
do not perform if epitrochanter tenderness is present
palpable click is successful reduction
,AOM -CORRECT ANSWERS-RF: genetics, males, Native American, siblings, low economic status, ages
6mo-3y, winter, supine bottle feeding, daycare, tobacco smoke
Bacterial conjunctivits -CORRECT ANSWERS-erythema, itching, burning, mucopurulant d/c
Dx: R/O URI, pharyngitis, AOM
Tx: neonates-erythromycin
> 1 year fourth generation fluoroquinolone (moxifloxacin)
Bacterial rhinosinusitis -CORRECT ANSWERS-Preceded by URI-typically worsens after 5-7 days- not
resolved in 2 weeks
Barlow maneuver -CORRECT ANSWERS-place your index and middle finger over the greater tronchanter.
Gently push both knees together at midline downwards.
Positive:"Clunk" sounds or palpating trochangter being displaced by the index/middle finger
Bipolar disorder -CORRECT ANSWERS-1-2% of children <18 meet diagnostic criteria
early onset irritability; continuous rapid cycling
Sx: severe mood changes, inflated self esteem, decrease need for sleep, racing thoughts
depression typically first symptoms
Tx: refer to behavior health
medications-mood stabilizers, lithium, valproate, risperidone
blapharoptosis -CORRECT ANSWERS-drooping of the upper eyelid
if vision is compromised surgery is performed
Blepharitis -CORRECT ANSWERS-inflammation of the eyelash follicles
bilateral
Findings: swelling, erythema of eyelids, flaky debris upon wakening, gritty/burning in eyes
Tx: Bacitracin or erythromycin ointment
purchase new makeup, cool compresses
Bronchiolitis -CORRECT ANSWERS-Usually caused by RSV
wheezing present
<2 y/o
other causes; influenza, adenovirus, rhinovirus
Bulbar/palpebral conjunctival infection -CORRECT ANSWERS-May be unilateral or bilateral
Candiasis -CORRECT ANSWERS-Tx: thrush-oral nystatin QID
, if resistant to tx: oral fluconazole
skin diaper rash-nystatin, ketonazole
Cellulitis -CORRECT ANSWERS-In children often periorbital, perivaginal, perinatal, or buccal
Cellulitis Dx -CORRECT ANSWERS-CBC, BCx if child appears toxic, has fever, or is <1
Cellulitis exam -CORRECT ANSWERS-Buccal cellulitis-blue/purple tinged= h.influenzae
Cellulitis hx -CORRECT ANSWERS-Recent URI, fever, pain, malaise
Cellulitis tx -CORRECT ANSWERS-IV antx
if streptococcal= PCN, if allergy 3rd generation cephalosporin
if staphylococcus=bactrim if child >2 months; doxy if child >8 and < 45 kg
MRSA suspected= clindamycin
H.influenzae=augmentin x 10 days
cerebral palsy -CORRECT ANSWERS-paralysis caused by damage to the area of the brain responsible for
movement
symptoms appear within first few years of life
Exam= orthopedic-scoliosis, contractures, dislocated hips
neuro- asymmetrical or abnormal DTR, persistent tonic neck or Moro reflexes
macrocephaly or microcephaly
CF Dx -CORRECT ANSWERS-newborn screening
sweat testing- sweat chloride >60 is indicative of CF
LFTs are abnormal
CF manifestations -CORRECT ANSWERS-Neonate-meconium ileus, prolonged jaundice, hemorrhagic
disease of newborn (vit K deficiency)
infancy- cough, pneumonia, FTT, steatorrhea, abdominal distention
childhood- poor weight gain, constipation, sinusitis, poorly controlled asthma, digital clubbing
adolescents- diabetes, osteoporosis, chronic pansinusitis
CF tx -CORRECT ANSWERS--inhaled dornase- decreases mucosal viscosity
-CFTR modulators
-high dose ibuprofen and azithromycin 3x a week
-pancreatic enzyme replacement therapy (PERT) with every meal and snack
