Solutions
• What hormone has been shown to help with relieving the mood
discomfort cluster of symptoms of PMS?
• Diuretics
• NSAID
• Progesterone
• Fluoxetine Correct Answers • Progesterone
A 10-year-old child 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?
A. Appendicitis w/perf
B. Gastroenteritis
C. Pelvic inflammatory disease (PID)
D. UTI Correct Answers A. Appendicitis w/perf
A 12-month old infant exhibits poor wt. gain after previously
normal growth patterns. There is no hx of V/D, or irregular BM,
and the PE is normal. What is the next step in evaluating these
findings?
A. CBC and electrolytes
B. Feeding and stooling hx and 3-day diet hx
C. Stool cx for ova and parasites
D. swallow study with videofluoroscopy Correct Answers B.
Feeding and stooling hx and 3-day diet hx
,A 12-year-old child has a recent hx of inc thirst & frequent
urination. This child's wt has been in the 95th percentile for
several yrs. A dipstick UA is positive for glucose, & random
plasma glucose is 350 mg/dL. What test will the NP order to
determine the type of diabetes in this child?
A. fasting plasma glucose
B. Hgb A1C
C. Pancreatic autoantibodies
D. Thyroid function tests Correct Answers C. Pancreatic
autoantibodies
A 13-year-old child has exhibited sx of mild depression for
several weeks. The parent reports feeling relieved that the sx
have passed but concerned that the child now seems to have
boundless energy and an inability to sit still. What will the NP
do?
A. Administer an ADHD dx scale and consider an ADHD med
B. Consult w/a child psychiatrist to prescribe an antidepressant
med
C. Reassure the parent that this behavior is common after mild
depression sx
D. Refer the child to a child psychiatrist for evaluation of bipolar
disorder Correct Answers D. Refer the child to a child
psychiatrist for evaluation of bipolar disorder
A 13-year-old Native American female has a body mass index
(BMI) at the 90th percentile for age. The NP notes the presence
of a hyperpigmented velvet-like rash in skin folds. The child
denies polydipsia, polyphagia, and polyuria. The NP will take
what action?
A. Counsel the child to lose weight to prevent type 2 DM
,B. Diagnose DM2 in the child has a random glucose of
180ml/dL
C. Order a fasting blood sample for a metabolic screen for DM2
D. Refer the child to a pediatric endocrinologist Correct
Answers C. Order a fasting blood sample for a metabolic screen
for DM2
A 14-year old female comes to the clinic with amenorrhea for 3
months. A pregnancy test is negative. The adolescent's body
weight is at 82% of expected for height and age. The mother
reports that her daughter often throws up and refuses to eat most
foods. Which condition does the NP suspect?
A. Anorexia nervosa
B. Bulimia nervosa
C. Depression
D. Substance abuse Correct Answers A. Anorexia nervosa
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
Correct Answers B. Eliminating certain foods from the mother's
diet.
, A 2-year-old child has an acute diarrheal illness. The child is
afebrile and with oral rehydration measures, has remained well
hydrated. The parent asks what can be done to help shorten the
course of this illness. What will the primary care pediatric NP
recommend?
A. Clear liquids only
B. Lactobacillus
C. Loperamide
D. Peppermint oil Correct Answers B. Lactobacillus
A 30-month-old girl who has been toilet trained for 6 mo has
daytime enuresis and dysuria and a low-grade fever. A dipstick
urinalysis is negative for leukocyte esterase and nitrates. What is
the next step?
a. begin empiric tx w/trimethoprim-sulfamethoxazole
b. discuss behavioral interventions for toilet training
c. reassure the child's parents that the child does not have a UTI
d. send the urine to the lab for cx Correct Answers d. send the
urine to the lab for cx
A 6-month-old infant has a retractile testis that was noted at the
2-month well baby exam. What will the NP do to manage this
condition?
A. Reassure the parent that the testis will most likely descend
into place on its own
B. Refer the infant to a pediatric urologist or surgeon for
possible orchiopexy
C. Teach the parent to manipulate the testis into the scrotum
during diaper changes