Peds Exam 1 Test Questions With
Complete Correct Solutions.
1. The primary care pediatric nurse practitioner performs a vision screen on a 4-month-old
infant and notes the presence of convergence and accommodation with mild esotropia of the
left eye. What will the nurse practitioner do? - Answer Refer the infant to a pediatric
ophthalmologist.
2. During a well-child exam on a 4yearold child, the primary care pediatric nurse practitioner
notes that the clinic nurse recorded "20/50" for the child's vision and noted that the child had
difficulty cooperating with the exam. What will the nurse practitioner recommend? - Answer
Test the child's vision in 1 month.
3. During a well-child assessment of an African American infant, the primary care pediatric
nurse practitioner notes a dark red-brown light reflex in the left eye and a slightly brighter, red-
orange light reflex in the right eye. The nurse practitioner will - Answer Refer the infant to an
ophthalmologist
4. The primary care pediatric nurse practitioner performs a Hirschberg test to evaluate - Answer
ocular alignment.
5. The primary care pediatric nurse practitioner applies a fluorescein stain to a child's eye. When
examining the eye with a cobalt blue filter light, the entire cornea appears cloudy. What does
this indicate? - Answer There is too much stain on the cornea
6. A toddler exhibits exotropia of the right eye during a cover-uncover screen. The primary care
pediatric nurse practitioner will refer to a pediatric ophthalmologist to initiate which treatment?
- Answer Patching of the unaffected eye for 2 hours each day
7. The primary care pediatric nurse practitioner performs a well-child examination on
a 9-month-old infant who has a history of prematurity at 28 weeks' gestation. The infant was
treated for retinopathy of prematurity (ROP) and all symptoms have resolved. When will the
infant need an ophthalmologic exam? - Answer At 12 months of age
8. During a well-baby assessment on a 1weekold infant who had a normal exam when
discharged from the newborn nursery 2 days prior, the primary care pediatric nurse practitioner
notes moderate eyelid swelling, bulbar conjunctival injections, and moderate amounts of thick,
,9. The primary care pediatric nurse practitioner performs a well baby assessment of a 5-day old
infant and notes mild conjunctivitis, corneal opacity, and serosanguinous discharge in the right
eye. Which course of action is correct? - Answer Admit the infant to the hospital immediately.
14. A school-age child has a history of chronic otitis media and is seen in the clinic with vertigo.
The primary care pediatric nurse practitioner notes profuse purulent otorrhea from both
pressure-equalizing tubes and a pearly-white lesion on one tympanic
membrane. Which condition is most likely? - Answer Cholesteatoma
the parent of a 4-month-old infant is concerned that the infant cannot hear. Which test will the
primary care pediatric nurse practitioner order to evaluate potential hearing loss in this infant? -
Answer Auditory brainstem response (ABR)
2. The primary care pediatric nurse practitioner obtains a tympanogram on a child that reveals a
sharp peak of 180 mm H2O. What does this value indicate? - Answer Negative ear pressure
13. A child who was treated with amoxicillin and then amoxicillin-clavulanate for acute
otitis media is seen for a follow-up. The primary care pediatric nurse practitioner notes dull gray
tympanic membranes with a visible air-fluid level. The child is afebrile and without pain. What is
the
next course of action? - Answer Monitoring ear fluid levels for 3 months
12. The primary care pediatric nurse practitioner diagnoses acute otitis media in a 2-year-old
child who has a history of three ear infections in the first 6 months of life. The child's tympanic
membrane is intact and the child has a temperature of 101.5°F. What will the
nurse practitioner prescribe for this child? - Answer An analgesic medication and watchful
waiting
an 18-month-old child with no previous history of otitis media awoke during the night with right
ear pain. The primary care pediatric nurse practitioner notes an axillary temperature of 100.5°F
and an erythematous, bulging tympanic membrane. A tympanogram
reveals a peak of +150 mm H 2 O. What is the recommended treatment for this child? - Answer
An analgesic medication and watchful waiting
4. A 7-month-old infant has had two prior acute ear infections and is currently on the
10th day of therapy with amoxicillin-clavulanate after a failed course of amoxicillin. The primary
, irritable and has a temperature of 99.8°F. What is the next step in the management of this
child's ear
infection? - Answer Refer the child to an otolaryngologist.
11. A 3-year-old child has had one episode of acute otitis media 3 weeks prior with a
normal tympanogram just after treatment with amoxicillin. In the clinic today, the child has a
type B
tympanogram, a temperature of 102.5°F, and a bulging tympanic membrane. What will the
primary care pediatric nurse practitioner order? - Answer Amoxicillin-clavulanate twice daily
10. The primary care pediatric nurse practitioner notes a small, round object in a child's external
auditory canal, near the tympanic membrane. The child's parent thinks it is probably a dried
pea. What will the nurse practitioner do to remove this object? - Answer Refer the child to an
otolaryngologist for removal.
5. A 3-year-old child with pressure-equalizing tubes (PET) in both ears has otalgia in one ear. The
primary care pediatric nurse practitioner is able to visualize the tube and does not see exudate
in the ear canal and obtains a type A tympanogram. What will the nurse practitioner do? -
Answer Order ototopical antibiotic/corticosteroid drops.
6. What will the primary care pediatric nurse practitioner teach the parents of a child
who has new pressure-equalizing tubes (PET) in both ears? - Answer Parents should notice
improved hearing in their child.
7. A child with a history of otitis externa asks about ways to prevent this condition.
What will the primary care pediatric nurse practitioner recommend? - Answer Drying the ear
canal with a hair dryer
9. A child who has otitis externa has severe swelling of the external auditory canal that persists
after 2 days of therapy with ototopical antibiotic/corticosteroid drops. What is the next step in
treatment for this child? - Answer Insert a wick into the external auditory canal.
8. A child complains of itching in both ears and is having trouble hearing. The primary care
pediatric nurse practitioner notes periauricular edema and marked swelling of the external
auditory canal and elicits severe pain when manipulating the external ear
structures. Which is an appropriate intervention? - Answer Order ototopical
Complete Correct Solutions.
1. The primary care pediatric nurse practitioner performs a vision screen on a 4-month-old
infant and notes the presence of convergence and accommodation with mild esotropia of the
left eye. What will the nurse practitioner do? - Answer Refer the infant to a pediatric
ophthalmologist.
2. During a well-child exam on a 4yearold child, the primary care pediatric nurse practitioner
notes that the clinic nurse recorded "20/50" for the child's vision and noted that the child had
difficulty cooperating with the exam. What will the nurse practitioner recommend? - Answer
Test the child's vision in 1 month.
3. During a well-child assessment of an African American infant, the primary care pediatric
nurse practitioner notes a dark red-brown light reflex in the left eye and a slightly brighter, red-
orange light reflex in the right eye. The nurse practitioner will - Answer Refer the infant to an
ophthalmologist
4. The primary care pediatric nurse practitioner performs a Hirschberg test to evaluate - Answer
ocular alignment.
5. The primary care pediatric nurse practitioner applies a fluorescein stain to a child's eye. When
examining the eye with a cobalt blue filter light, the entire cornea appears cloudy. What does
this indicate? - Answer There is too much stain on the cornea
6. A toddler exhibits exotropia of the right eye during a cover-uncover screen. The primary care
pediatric nurse practitioner will refer to a pediatric ophthalmologist to initiate which treatment?
- Answer Patching of the unaffected eye for 2 hours each day
7. The primary care pediatric nurse practitioner performs a well-child examination on
a 9-month-old infant who has a history of prematurity at 28 weeks' gestation. The infant was
treated for retinopathy of prematurity (ROP) and all symptoms have resolved. When will the
infant need an ophthalmologic exam? - Answer At 12 months of age
8. During a well-baby assessment on a 1weekold infant who had a normal exam when
discharged from the newborn nursery 2 days prior, the primary care pediatric nurse practitioner
notes moderate eyelid swelling, bulbar conjunctival injections, and moderate amounts of thick,
,9. The primary care pediatric nurse practitioner performs a well baby assessment of a 5-day old
infant and notes mild conjunctivitis, corneal opacity, and serosanguinous discharge in the right
eye. Which course of action is correct? - Answer Admit the infant to the hospital immediately.
14. A school-age child has a history of chronic otitis media and is seen in the clinic with vertigo.
The primary care pediatric nurse practitioner notes profuse purulent otorrhea from both
pressure-equalizing tubes and a pearly-white lesion on one tympanic
membrane. Which condition is most likely? - Answer Cholesteatoma
the parent of a 4-month-old infant is concerned that the infant cannot hear. Which test will the
primary care pediatric nurse practitioner order to evaluate potential hearing loss in this infant? -
Answer Auditory brainstem response (ABR)
2. The primary care pediatric nurse practitioner obtains a tympanogram on a child that reveals a
sharp peak of 180 mm H2O. What does this value indicate? - Answer Negative ear pressure
13. A child who was treated with amoxicillin and then amoxicillin-clavulanate for acute
otitis media is seen for a follow-up. The primary care pediatric nurse practitioner notes dull gray
tympanic membranes with a visible air-fluid level. The child is afebrile and without pain. What is
the
next course of action? - Answer Monitoring ear fluid levels for 3 months
12. The primary care pediatric nurse practitioner diagnoses acute otitis media in a 2-year-old
child who has a history of three ear infections in the first 6 months of life. The child's tympanic
membrane is intact and the child has a temperature of 101.5°F. What will the
nurse practitioner prescribe for this child? - Answer An analgesic medication and watchful
waiting
an 18-month-old child with no previous history of otitis media awoke during the night with right
ear pain. The primary care pediatric nurse practitioner notes an axillary temperature of 100.5°F
and an erythematous, bulging tympanic membrane. A tympanogram
reveals a peak of +150 mm H 2 O. What is the recommended treatment for this child? - Answer
An analgesic medication and watchful waiting
4. A 7-month-old infant has had two prior acute ear infections and is currently on the
10th day of therapy with amoxicillin-clavulanate after a failed course of amoxicillin. The primary
, irritable and has a temperature of 99.8°F. What is the next step in the management of this
child's ear
infection? - Answer Refer the child to an otolaryngologist.
11. A 3-year-old child has had one episode of acute otitis media 3 weeks prior with a
normal tympanogram just after treatment with amoxicillin. In the clinic today, the child has a
type B
tympanogram, a temperature of 102.5°F, and a bulging tympanic membrane. What will the
primary care pediatric nurse practitioner order? - Answer Amoxicillin-clavulanate twice daily
10. The primary care pediatric nurse practitioner notes a small, round object in a child's external
auditory canal, near the tympanic membrane. The child's parent thinks it is probably a dried
pea. What will the nurse practitioner do to remove this object? - Answer Refer the child to an
otolaryngologist for removal.
5. A 3-year-old child with pressure-equalizing tubes (PET) in both ears has otalgia in one ear. The
primary care pediatric nurse practitioner is able to visualize the tube and does not see exudate
in the ear canal and obtains a type A tympanogram. What will the nurse practitioner do? -
Answer Order ototopical antibiotic/corticosteroid drops.
6. What will the primary care pediatric nurse practitioner teach the parents of a child
who has new pressure-equalizing tubes (PET) in both ears? - Answer Parents should notice
improved hearing in their child.
7. A child with a history of otitis externa asks about ways to prevent this condition.
What will the primary care pediatric nurse practitioner recommend? - Answer Drying the ear
canal with a hair dryer
9. A child who has otitis externa has severe swelling of the external auditory canal that persists
after 2 days of therapy with ototopical antibiotic/corticosteroid drops. What is the next step in
treatment for this child? - Answer Insert a wick into the external auditory canal.
8. A child complains of itching in both ears and is having trouble hearing. The primary care
pediatric nurse practitioner notes periauricular edema and marked swelling of the external
auditory canal and elicits severe pain when manipulating the external ear
structures. Which is an appropriate intervention? - Answer Order ototopical
