NURP 502 Exam 1 Solution Manual Fully Solved Latest Update 2025 Already Passed
What is a fever of unknown origin (FUO)? - Answers Fever of 100.4 or greater that lasts more than 10-14
days without a documented source from physical exam/screening labs
What is prolonged fever? - Answers Single illness in which fever that exceeds that which expected for
the clinical dx. Ex- fever >10 days for viral URI or >3 wks for mono
What is the preferred method to take temp? - Answers Rectal or oral
What education should be provided to caregivers about a child's fever? - Answers Fever is symptom, not
a disease.
Fever has positive attributes such as killing bacteria/viruses
Treat the comfort of the child, fever does not always have to be brought down
If child is bundled up, unbundle and assess temp
Always record a temp, not hand to forehead
What is on the common reasons for delayed dx? - Answers Missed hx clues. Ex- animal/insect exposure,
travel hx, TB r/f, dietary (unpasteurized milk)
90% of time should be spent asking questions
What medication is the gold standard for children with fever? - Answers Acetaminophen
What is the dosing for acetaminophen? - Answers ONLY use 160mg/5 ml (NOT 100mg)
10-15mg/kg/dose q 4-8hours
Max 4-5 doses per 24hrs
12y/o+ = max 4g/day
>12y/o = max 2.6g/day
What is the dosing for ibuprofen? - Answers 6mo and up
Fever <102.5 = 5mg/kg/dose
Fever >102.5 = 10mg/kg/dose
Max 40 mg/kg/day
EXCEPT JRA, asthmatics may have NSAID sensitivity
, What workup/testing should be done for FUO? - Answers 1st line is appropriate to be done in primary
care
CMC, CMP, Sed rate, CRP (expensive, takes time)
UA and cx, Blood cx, PPD, CXR, EBV and CMV serologies
Urine specimen (straight cath is the best way)
Febrile >3wks- proceed with other testing like CT, etc
Be mindful of insurance, cost
Which type of pneumonia is more common in kids? - Answers Viral
How does penumonia present? - Answers Sudden onset, absence of respiration sx, presence of localized
findings on chest auscultation-- suspect bacterial pneumo. Most common causative organism is strep
pneumo
What are atypical types of pneumonia? - Answers Mycoplasma, chlamydial
Reason to admit with PNA? - Answers Suspicion of MRSA, underlying CV or cardiopulmonary condition,
metabolic d/o, neuro d/o, developmental delay, infants > 4-6 mo
Tx of PNA? - Answers High dose amoxicillin 90mg/kg/day divided in 2 doses
If PNA thought to be atypical, then use a macrolide
Should see clinical improvement 48-72 hrs
Which of the following would indicate impending resp failure in a child with croup?
Barking cough
Audible stridor at rest
Suprasternal and sternal retractions at rest
Lethary or decreased level of consicousness - Answers Lethargy
pay attention to stridor and retractions always tho
Which of the following abx should be rx for the empiric tx of FUO in immucompetent children?
Amoxicillin-clavulanate
Azithromycin
Isoniazid
What is a fever of unknown origin (FUO)? - Answers Fever of 100.4 or greater that lasts more than 10-14
days without a documented source from physical exam/screening labs
What is prolonged fever? - Answers Single illness in which fever that exceeds that which expected for
the clinical dx. Ex- fever >10 days for viral URI or >3 wks for mono
What is the preferred method to take temp? - Answers Rectal or oral
What education should be provided to caregivers about a child's fever? - Answers Fever is symptom, not
a disease.
Fever has positive attributes such as killing bacteria/viruses
Treat the comfort of the child, fever does not always have to be brought down
If child is bundled up, unbundle and assess temp
Always record a temp, not hand to forehead
What is on the common reasons for delayed dx? - Answers Missed hx clues. Ex- animal/insect exposure,
travel hx, TB r/f, dietary (unpasteurized milk)
90% of time should be spent asking questions
What medication is the gold standard for children with fever? - Answers Acetaminophen
What is the dosing for acetaminophen? - Answers ONLY use 160mg/5 ml (NOT 100mg)
10-15mg/kg/dose q 4-8hours
Max 4-5 doses per 24hrs
12y/o+ = max 4g/day
>12y/o = max 2.6g/day
What is the dosing for ibuprofen? - Answers 6mo and up
Fever <102.5 = 5mg/kg/dose
Fever >102.5 = 10mg/kg/dose
Max 40 mg/kg/day
EXCEPT JRA, asthmatics may have NSAID sensitivity
, What workup/testing should be done for FUO? - Answers 1st line is appropriate to be done in primary
care
CMC, CMP, Sed rate, CRP (expensive, takes time)
UA and cx, Blood cx, PPD, CXR, EBV and CMV serologies
Urine specimen (straight cath is the best way)
Febrile >3wks- proceed with other testing like CT, etc
Be mindful of insurance, cost
Which type of pneumonia is more common in kids? - Answers Viral
How does penumonia present? - Answers Sudden onset, absence of respiration sx, presence of localized
findings on chest auscultation-- suspect bacterial pneumo. Most common causative organism is strep
pneumo
What are atypical types of pneumonia? - Answers Mycoplasma, chlamydial
Reason to admit with PNA? - Answers Suspicion of MRSA, underlying CV or cardiopulmonary condition,
metabolic d/o, neuro d/o, developmental delay, infants > 4-6 mo
Tx of PNA? - Answers High dose amoxicillin 90mg/kg/day divided in 2 doses
If PNA thought to be atypical, then use a macrolide
Should see clinical improvement 48-72 hrs
Which of the following would indicate impending resp failure in a child with croup?
Barking cough
Audible stridor at rest
Suprasternal and sternal retractions at rest
Lethary or decreased level of consicousness - Answers Lethargy
pay attention to stridor and retractions always tho
Which of the following abx should be rx for the empiric tx of FUO in immucompetent children?
Amoxicillin-clavulanate
Azithromycin
Isoniazid
