NR602 Final Exam Peds
What will the NP tell the parents about the use of probiotics? ANS: There is no conclusive evidence
about using probiotics to treat colic
Premature infant with poor feeding has a barium study with a normal esophagus what should the NP
consider next to manage the child's nutritional needs? ANS: Video fluoroscopy swallowing study
A toddler is seen in the clinic for 2 days of vomiting & diarrhea. Assessment reveals an irritable child,
with dry mucous membranes, 3 second cap refill, 2 second recoil of skin, mild tachycardia and
tachypnea. Cool hands and feet. The child has had two wet diapers in 24 hours. What will the NP
recommend? ANS: Oral rehydration solution with follow up in 24 hours
A 9 year old girl has a history of frequent vomiting and her mother has frequent migraines. The child has
begun having more frequent and prolonged episodes accompanied by headaches. An exam reveals
abnormal eye movement and mild ataxia. What is the correct action? ANS: Refer to pediatric
gastroenterologist for further workup
The parent of a 3 month old reports that the infant arches and gags while feeding and spits up
undigested formula frequently. The infants weight gain has dropped to 5th percentile from 12th
percentile. What is the best course of treatment for this infant? ANS: Begin a trial of extensively
hydrolyzed protein formula for 2 to 4 weeks
A school aged child has a 3 month history of dull, aching, epigastric pain that worsens with eating and
awakens the child from sleep. A CBC shows a hemoglobin of 8mg/dL. What is the next step in
management? ANS: Referral for esophagogastroduodenoscopy (EGD)
A 2 month old infant cries up to 4 hours each day and according to the parents is inconsolable during
crying episodes with fists and legs noted to be tense and stiff. The infant is breastfeeding exclusively and
is often fussy during feedings. Physical exam is normal with infant gaining weight normally. What would
the NP recommend? ANS: Eliminating certain food from the mothers diet
, A child is in the clinic after swallowing a metal bead. A xray of the GI tract shows a 6mm 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? ANS: Have the parents watch for the object in the child's stool
A 10 year old has had abdominal pain for 2 days which began in the periumbilical area and then localized
to the RLQ. The child vomited once today and then experienced relief from pain followed by an
increased fever. What is the likely diagnosis? ANS: Appendicitis with perforation
A 18 month old child has 1 day history of intermittent cramping abdominal pain with nonbilious
vomiting. The child is observed to scream and draw up his legs during pain episodes and becomes
lethargic in between. The NP notes a small amount of bloody, mucous stool in the diaper. What is the
most likely diagnosis? ANS: Intussusception
A school age child has had abdominal pain for 3 months that occurs once or twice weekly and is
associated with a headache and occasional difficulty sleeping, often causing the child to stay home from
school. The child has not vomited or had diarrhea and is gaining weight normally. The physical exam is
normal. What should be included in the initial diagnostic workup? ANS: CBC, ESR, amylase, lipase, UA,
and abdominal US
An adolescent is diagnosed with functional abdominal pain. The child's symptoms worsen during
stressful events, especially school anxiety. What will be an important part of treatment for this child?
ANS: Teaching about the brain gut interaction causing symptoms
A school age child has recurrent diarrhea with foul smelling stools, excessive flatus, abdominal
distention, and failure to thrive. A 2 week lactose free trial failed to reduce symptoms. What is the next
step in diagnosing the child? ANS: Serologic testing for celiac disease
A child is diagnosed with Crohn disease. What are the likely complications for this child? ANS: Intestinal
obstruction with scarring and strictures
A 12 month old infant exhibits poor weight gain after previous normal growth patterns. There is no
history of vomiting, diarrhea, or irregular bowel movements and the physical exam is normal. What is
the next step in evaluating these findings? ANS: Feeding and stool history and 3 day diet history
What will the NP tell the parents about the use of probiotics? ANS: There is no conclusive evidence
about using probiotics to treat colic
Premature infant with poor feeding has a barium study with a normal esophagus what should the NP
consider next to manage the child's nutritional needs? ANS: Video fluoroscopy swallowing study
A toddler is seen in the clinic for 2 days of vomiting & diarrhea. Assessment reveals an irritable child,
with dry mucous membranes, 3 second cap refill, 2 second recoil of skin, mild tachycardia and
tachypnea. Cool hands and feet. The child has had two wet diapers in 24 hours. What will the NP
recommend? ANS: Oral rehydration solution with follow up in 24 hours
A 9 year old girl has a history of frequent vomiting and her mother has frequent migraines. The child has
begun having more frequent and prolonged episodes accompanied by headaches. An exam reveals
abnormal eye movement and mild ataxia. What is the correct action? ANS: Refer to pediatric
gastroenterologist for further workup
The parent of a 3 month old reports that the infant arches and gags while feeding and spits up
undigested formula frequently. The infants weight gain has dropped to 5th percentile from 12th
percentile. What is the best course of treatment for this infant? ANS: Begin a trial of extensively
hydrolyzed protein formula for 2 to 4 weeks
A school aged child has a 3 month history of dull, aching, epigastric pain that worsens with eating and
awakens the child from sleep. A CBC shows a hemoglobin of 8mg/dL. What is the next step in
management? ANS: Referral for esophagogastroduodenoscopy (EGD)
A 2 month old infant cries up to 4 hours each day and according to the parents is inconsolable during
crying episodes with fists and legs noted to be tense and stiff. The infant is breastfeeding exclusively and
is often fussy during feedings. Physical exam is normal with infant gaining weight normally. What would
the NP recommend? ANS: Eliminating certain food from the mothers diet
, A child is in the clinic after swallowing a metal bead. A xray of the GI tract shows a 6mm 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? ANS: Have the parents watch for the object in the child's stool
A 10 year old has had abdominal pain for 2 days which began in the periumbilical area and then localized
to the RLQ. The child vomited once today and then experienced relief from pain followed by an
increased fever. What is the likely diagnosis? ANS: Appendicitis with perforation
A 18 month old child has 1 day history of intermittent cramping abdominal pain with nonbilious
vomiting. The child is observed to scream and draw up his legs during pain episodes and becomes
lethargic in between. The NP notes a small amount of bloody, mucous stool in the diaper. What is the
most likely diagnosis? ANS: Intussusception
A school age child has had abdominal pain for 3 months that occurs once or twice weekly and is
associated with a headache and occasional difficulty sleeping, often causing the child to stay home from
school. The child has not vomited or had diarrhea and is gaining weight normally. The physical exam is
normal. What should be included in the initial diagnostic workup? ANS: CBC, ESR, amylase, lipase, UA,
and abdominal US
An adolescent is diagnosed with functional abdominal pain. The child's symptoms worsen during
stressful events, especially school anxiety. What will be an important part of treatment for this child?
ANS: Teaching about the brain gut interaction causing symptoms
A school age child has recurrent diarrhea with foul smelling stools, excessive flatus, abdominal
distention, and failure to thrive. A 2 week lactose free trial failed to reduce symptoms. What is the next
step in diagnosing the child? ANS: Serologic testing for celiac disease
A child is diagnosed with Crohn disease. What are the likely complications for this child? ANS: Intestinal
obstruction with scarring and strictures
A 12 month old infant exhibits poor weight gain after previous normal growth patterns. There is no
history of vomiting, diarrhea, or irregular bowel movements and the physical exam is normal. What is
the next step in evaluating these findings? ANS: Feeding and stool history and 3 day diet history
