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The parent of an infant experiencing colic asks about using a probiotic
medication. What will the primary care pediatric NP tell this parent?
A. Probiotic medications have demonstrated efficacy in treating colic.
B. Probiotics are not safe to use to treat infants who have colic.
C. There are no studies showing usefulness of probiotic to manage colic.
D. There is no conclusive evidence about using probiotics to treat colic. -
🧠ANSWER ✔✔D. There is no conclusive evidence about using probiotics
to treat colic.
A toddler who was born prematurely refuses most solid foods and has poor
weight gain. A barium swallow study reveals a normal esophagus. What
will the primary care pediatric NP consider the next to manage this child's
nutritional needs?
A. consultation with dietician
B. Fiberoptic endoscopy evaluation.
C. MRI
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,D. Videofluroscopy swallowing study (VOSS) - 🧠ANSWER ✔✔D.
Videofluroscopy swallowing study (VOSS)
A toddler is seen in clinic after a 2-day hx of intermittent V/D. An
assessment reveals an irritable child with dry mucous membranes, 3-
second cap refill. 2-second recoil of skin, mild tachycardia and tachypnea,
and cool hands and feet. The child has had 2 wet diapers in the past 24
hours. What will the primary care pediatric NP recommend?
A. anti-diarrheal medication & clear fluids for 24H
B. Bolus of IV NS in the clinic until improvement
C. Hospital admission for IV rehydration & oral fluids
D. Oral rehydration solution with f/u in 24H - 🧠ANSWER ✔✔D. Oral
rehydration solution with f/u in 24H
A 9-year old girl has a hx of frequent vomiting and her mother has frequent
migraine ha. The child has recently begun having more frequent and
prolonged episodes accompanied by headaches. An exam reveals
abnormal eye movement and mild ataxia. What is the correct action?
A. begin using anti-migraine meds to prevent HA
B. Prescribe ondansetron and lorazepam to help manage sx
C. Reassure the parent that this is expected with cyclic vomiting syndrome
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,D. Refer to a pediatric gastroenterologist for further workup. - 🧠ANSWER
✔✔D. Refer to a pediatric gastroenterologist for further workup.
The parent of a 3-month-old reports that the infant reports that the infant
arches and gags while feeding and spits up undigested formula frequently.
The infant's weight gain has dropped to the 5th percentile from the 12th.
What is the best course of tx for this infant?
A. Begin a trial of extensively hydrolyzed protein formula for 2-4 wks.
B. Institute an emperic trial of acid suppression with a PPI
C. Perform esophageal pH monitoring to determine the degree of reflux.
D. Reassure the parent that these sx will likely resolved by 12-24 mo. -
🧠ANSWER ✔✔A. Begin a trial of extensively hydrolyzed protein formula for
2-4 wks.
A school-age child has a 3-month hx of dull, aching epigastric pain that
worsens with eating and awakens from sleep. A CBC shows a Hgb of
8mg/dL. What is the next step in management.
A. Administration of H RA or PPI meds
B. Empiric therapy for H. pylori
C. Ordering an upper GI series
D. Referral for EGD - 🧠ANSWER ✔✔D. Referral for EGD
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, A 2-mo old infant cries up to 4 hours each day and according to the
parents, is inconsolable during crying episodes with fits and legs notes to
be tense and stiff. The infant is breastfeeding frequently but is often fussy
during feedings. The PE is normal and the infant is gaining weight normally.
What will the primary care pediatric NP recommend?
A. A complete work-up, including lab and radiologic tests.
B. Eliminating certain foods from the mother's diet.
C. Empiric tx w/PPI
D. Stopping breastfeeding & beginning a hydrolyzed formula - 🧠ANSWER
✔✔B. Eliminating certain foods from the mother's diet.
A child is in the clinic after swallowing a metal bead. A radiograph of the GI
tract shows a 6 mm cylindrical object in the child's stomach. The child is
able to swallow without difficulty and is not experiencing pain. What is the
correct course of treatment?
a. Administer ipecac to induce vomiting.
b. Have the parents watch for the object in the child's stool.
c. Insert a nasogastric tube to flush out the object.
d. Refer the child for endoscopic removal of the object. - 🧠ANSWER ✔✔b.
Have the parents watch for the object in the child's stool.
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