NRNP 6531 Final 2 Pediatrics 1

• Question 1 0 out of 0 points When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Selected Ye Answer: s • Question 2 Lisa has Cushing's syndrome. You would suspect her to have or to develop 0 out of 1 points Selected Answer: d. Excitability and nervousness • Question 3 0 out of 1 points A 4-year-old female with profuse vomiting, sweating, lacrimation, and diarrhea, who seizes in the emergency room. Which of the following is the most likely etiology? Selected Answer: e. Esophageal foreign body • Question 4 1 out of 1 points Antibiotic therapy is one of the mainstays of treatment for which of the following causes of wheezing? Selected Answer: d. Epiglottit is • Question 5 1 out of 1 points An 18-month-old African American girl is brought to your office because she has been crying and stopped walking today. She will crawl, however. Her mom denies any injury to the child. On examination, she is crying but consolable in her mother’s arms. She has bruising and swelling just proximal to the left ankle. An x-ray reveals a spiral fracture of the tibia. At this time, you advise the mother that: Selected Answer: a. This is a common fracture resulting from twisting on a planted foot. • Question 6 1 out of 1 points Tracy, the mother of a 2-year-old, is concerned because her daughter walks on her toes lOMoARcPSD| all the time. What do you tell her? Selected Answer: c. Toe walking is considered normal until age 3. • Question 7 0 out of 1 points Vomiting in infancy has a long list of differential diagnoses. Which of the following other symptoms would mostly likely point to pyloric stenosis? Selected Answer: a. Hungry after vomiting • Question 8 1 out of 1 points The following clinical description best matches which genetic disorder? An institutionalized male juvenile delinquent upon close examination has severe nodulocystic acne, mild pectus excavatum, large teeth, prominent glabella, and relatively long face and fingers. His family says he has poor fine motor skills (such as penmanship), an explosive temper, and a low-normal IQ. Selected Answer: d. XYY male • Question 9 1 out of 1 points Newborn R.T. has a vascular lesion that will not fade as she gets older. What is your diagnosis? Selected Answer: a. Port-wine stain (nervus flammeus) • Question 10 A 6-year-old boy is left alone for 10 hours, now with hematemesis and 0 out of 1 points pneumomediastinum on chest x-ray. Which of the following is the most likely etiology? Selected Answer: a. Insecticide ingestion • Question 11 1 out of 1 points In mild to moderate attacks of acute asthma, Albuterol should be given every 4-6 hours prn and routine medication should be lOMoARcPSD| Selected Answer: c. Continued as usual • Question 12 1 out of 1 points A 2-year-old presents to your office with the following symptoms: nasal congestion and rhinorrhea for 48 hours, low-grade fever, and a harsh/barky cough that is significantly worse at night. Inspiratory stridor is present and she has clear but slightly decreased breath sounds. Which of the following treatments is best? Selected Answer: c. One dose of oral dexamethasone • Question 13 0 out of 1 points A small-for-gestational-age, dysmorphic newborn infant has microcephaly and sloping forehead, cutis aplasia (missing portion of the skin and hair) of the scalp, polydactyly, microphthalmia, and omphalocele. Which of these is the most likely diagnosis? Selected Answer: e. Edwards syndrome (trisomy 18) • Question 14 1 out of 1 points Which of the following physical stigmata are common in newborns with Down syndrome? Selected Answer: b. Hypotonia, large-appearing tongue and small mouth, upward slant to eyes • Question 15 1 out of 1 points You have a patient that you think may have intussusception. Which of the following finding may you see? Selected Answer: b. Inconsolable screaming • Question 16 Which of the following is true regarding the diagnosis of epiglottitis? 0 out of 1 points Selected Answer: a. Every effort should be made to visualize the epiglottitis in the office and confirm the diagnosis lOMoARcPSD| • Question 17 1 out of 1 points An 8-month-old baby arrives to the office with his mother with a complaint of decreased left arm movement. He is a product of a normal term pregnancy, has had no medical problems, and was in good health when his mother dropped him off at the daycare center. Upper arm radiographs show a left humerus spiral fracture. Which of the following is the most appropriate next step in management? Selected Answer: d. Send the child to the hospital for admission and call child protective services. • Question 18 1 out of 1 points A 6-week-old boy, born by vaginal delivery after an uncomplicated term gestation, has experienced cough and “fast breathing” for 2 days. His mother relates that he has a 1-week history of nasal congestion and watery eye discharge, but no fever or change in appetite. He has a temperature of 99.4°F and a respiratory rate of 44 breaths/min. He has nasal congestion, clear rhinorrhea, erythematous conjunctivae bilaterally, and watery, right eye discharge. His lungs demonstrate scattered crackles without wheezes. Which of the following is the most likely pathogen? Selected Answer: d. Chlamydia trachomatis • Question 19 1 out of 1 points The parents of an 8-year-old Down Syndrome boy arrive for his annual well-child visit. He wants to participate in sports, including the Special Olympics. Until further examination can be completed, which of the following sports would you suggest as being safe? Selected Answer: d. Tenni s • Question 20 1 out of 1 points Of the following patients, which child should not receive a tuberculin skin test? Selected Answer: d. A 2-year-old who was infected with RSV 2 months ago and is currently asymptomatic. • Question 21 1 out of 1 points A 3-week old presents to the office in January with a 1-week history of nasal congestion and occastional cough. On the night prior to the visit in infant developed a fever 102ºF rectally, was difficult to breastfeed, and had paroxysmal coughing and noisy, labored breathing. On exam, you note an ill-appearing infant who is lethergic with wheezing, lOMoARcPSD| tachypnea, and intercostal retractions. The infant is home with the mom at this time; however, has a sibling who is 4-years-old and is in daycare and recently had cold symptoms. If the patient has been diagnosed with RSV bronchiolitis, which of the following would be the treatment of choice? Selected Answer: b. Fluids and nutritional support and close monitoring • Question 22 The peak incidence for adolescent gynecomastia occurs at age 1 out of 1 points Selected Answer: b. 13 to 14 years of age • Question 23 1 out of 1 points Which of the following statements is not true with slipped capital femoral epiphysis? Selected Answer: a. It is thought to be caused by repetitive stresses in young athletes prior to growth spurts. • Question 24 Which of the following patients least warrents a sweat chloride test? 1 out of 1 points Selected Answer: d. 4-year-old female with noctural cough, which resolves after treatment with bronchodilators and short-term steroids; growth parameters at 10% for age. • Question 25 1 out of 1 points Which of the following objective data are associated with significantly better long-term outcomes in children born with open spina bifida? Selected Answer: b. Perineal sensation • Question 26 Unilateral wheezing is a finding suggestive of 0 out of 1 points Selected Answer: d. Asthm a lOMoARcPSD| • Question 27 Which malignancy is associated with genitourinary anomalies? 1 out of 1 points Selected Answer: c. Wilms' tumor • Question 28 All of the following is treatment for a child with phimosis except 1 out of 1 points Selected Answer: c. Ice packs • Question 29 1 out of 1 points A 14-year-old has a 3-week history of fever, anorexia, and abdominal pain. What additional symptom would cause the NP to suspect Crohn's disease? Selected Answer: a. Blood, mucous diarrhea • Question 30 1 out of 1 points Which of the following is not associated with congenital adrenal hyperplasia? Selected Answer: d. Hypernatre mia • Question 31 Fifth disease is usually 0 out of 1 points Selected Answer: a. Transmitted via deer ticks • Question 32 1 out of 1 points Which of the following is not characteristic of an apparent life-threatening event (ALTE)? Selected Answer: c. Feve r • Question 33 1 out of 1 points lOMoARcPSD| Which of the following conditions is most responsible for developmental delays in children? Selected Answer: a. Fetal Alcohol Syndrome • Question 34 1 out of 1 points Lyme disease is most closely associated with which of the following skin lesions? Selected Answer: c. Erythema migrans • Question 35 1 out of 1 points Jason, age 14, appears with tender discoid breast tissue enlargement (2-3 cm in diameter) beneath the areola. Your next action would be to Selected Answer: d. Perform watchful waiting for 1 year. • Question 36 1 out of 1 points Riley, a 12-year-old girl, has scaly, hyperpigmented lesions in a "Christmas tree" distribution. It is predominantly on her trunk. One lesion is on her buttock that is larger than the other, at about 4 cm in diameter. What is your diagnosis? Selected Answer: d. Pityriasis rosea • Question 37 1 out of 1 points Seborrhea dermatitis is common for both infants and adolescents. Which is not correct for this condition? Selected Answer: a. The condition in adolescents is known as acne with comedones and popular and pustular lesions. • Question 38 1 out of 1 points The following clinical description best matches which genetic disorder? A 15-year-old girl with primary amenorrhea is noted to be well below the 5th percentile for height. She has hypertension, a low posterior hairline, prominent and low-set ears, and excessive nuchal skin. lOMoARcPSD| Selected Answer: d. Turner syndrome (XO) • Question 39 0 out of 1 points When a neonate is initially protected against measles, mumps, and rubella because the mother is immune, this is an example of which type of immunity? Selected Answer: a. Artificial passive • Question 40 0 out of 1 points A 2-year-old presents with a history of wheezing and persistent cough. The father reports the child had a coughing/choking episode about a week ago that was spontaneously resolved. A few days later she began to cough and wheeze. This scenario is most consistent with Selected Answer: d. Foreign body aspiration • Question 41 0 out of 1 points While doing a 5-year-old well child exam, you notice two small patches of hair loss. Broken hair is present, as is erythema and scaling. On the basis of this information, which of these is the likely diagnosis? Selected Answer: c. Trichotilloman ia • Question 42 1 out of 1 points A 3-week-old male infant with 2 days of projectile, nonbilious vomiting and constant feeding. Which of the following is the most likely etiology? Selected Answer: b. Pyloric stenosis • Question 43 0 out of 1 points The most significant major contributor or contributors to asthma morbidity and mortality is/are Selected a. lOMoARcPSD| Answer: Underdiagnosis and inappropriate treatment • Question 44 Individuals with chronic adrenal insufficiency often have 1 out of 1 points Selected Answer: a. A craving for salt • Question 45 1 out of 1 points A healthy 8-month-old infant presents with diarrhea but no dehydration. What is the best advice to give to the parents? Selected Answer: a. Give bananas, cereal, vegetables, and full-strength formula as tolerated. • Question 46 1 out of 1 points Anthony is a known asthmatic. He has symptoms three times a week but never more than once a day. Exacerbations affect his normal activities occasionally. He awakens with cough three to four times a month. You classify his asthma as Selected Answer: c. Mild persistent • Question 47 0 out of 1 points A 9-year-old is diagnosed with dyspepsia without hematemesis, melena, or occult blood. The most appropriate next step is Selected Answer: d. Trial of omeprazole (Prilosec) • Question 48 1 out of 1 points Which of the following is not a sign or symptom of congenital hypothyroidism? Selected Answer: b. Frequent stooling • Question 49 1 out of 1 points A 9-month-old has been diagnosed with gastroenteritis. He attends a daycare facility. lOMoARcPSD| What is the likely cause of the illness? Selected Answer: a. Rotavir us • Question 50 1 out of 1 points A 7-year-old presents with abrupt fever, stridor, drooling, and hyperextension of the neck. You examine the nose and throat and notice one tonsil is enlarged and there is marked erythema of the pharynx with uvular deviation. Which is most appropriate? Selected Answer: b. Refer to otolaryngology for management of a peritonsillar abscess and possible hospital admission • Question 51 1 out of 1 points A 16-year-old presents with pharyngitis, cough, and high fever. Her chest x-ray reveals bilateral pulmonary infiltrates. Her white blood cell count is normal and the neutrophil count is normal. The most likely etiology is Selected Answer: c. Chlamydia pneumonia • Question 52 1 out of 1 points You see a 7-year-old with a positive stool culture for Salmonella enteriditis. The appropriate therapy for a non-dehydrated child is Selected Answer: d. Bland diet with focus on maintaining hydration • Question 53 The most common cause of primary amenorrhea is 0 out of 1 points Selected Answer: a. Constitutional or familial • Question 54 1 out of 1 points A 3-year-old presents with macrocephaly, developmental delay, coarse facial features, large tounge, kyphosis, hip dislocation, tonsillar and adenoidal hypertrophy, and hepatomegaly. She is receiving early intervention services without improvement. What is the best next step?