MN 580 PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+RECENT VERSION

MN 580 PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+RECENT VERSION 1. The mother of a 16yearold male was recently divorced after several years of an abusive relationship and tells the primary care pediatric nurse practitioner that the adolescent has begun skipping school and hanging out with friends at the local shopping mall. When she confronts her child, he responds by saying that he hates her. What will the nurse practitioner tell this mother? a. Adolescence is marked by an inability to comprehend complex situations .b. Adolescence is typically marked by tempestuous and transient episodes. c. Adolescents normally have extreme, disruptive conflicts with parents. d. Adolescents often need counseling to help them cope with life events - answer d 2. The primary care pediatric nurse practitioner performs a well baby examination on a 7-day-old infant who is nursing well, according to the mother. The nurse practitioner notes that the infant weighed 3250 grams at birth and 2990 grams when discharged on the second day of life. The infant weighs 3080 grams at this visit. Which action is correct? a. Follow up at the 2-month checkup. b. Refer to a lactation consultant. c. Schedule a weight check in 1 week. d. Suggest supplementing with formula. - answer C 3. This infant lost about 8% of its birth weight, which is normal and, since discharge home, has gained at least 15 grams per day, which is also normal. The PNP should schedule a weight check in a week to make sure the infant regains its birth weight, since most should regain this in 10 to 14 days and since this loss of birth weight is at the high end of normal. It is not necessary to refer to a lactation consultant or supplement with formula, since the infant is gaining weight adequately. 4. The parent of a newborn infant asks the primary care pediatric nurse practitioner when to intervene to help the infant's future intellectual growth. What will the nurse practitioner tell the parent? a. Cognitive learning begins during the toddler years. b. Intellectual growth begin when speech develops. c. Language and literacy skills begin at birth. d. Preschool is an optimal time to begin general learning. - answer c. Language and literacy skills begin at birth. 5. The parent of a 10 yearold boy tells the primary care pediatric nurse practitioner that the child doesn't appear to have any interest in girls and spends most of his time with a couple of other boys. The parent is worried about the child's sexual identity. The nurse practitioner will tell the parent: A. children at this age who prefer interactions with same gender peers usually have a homosexual orientation. B. children experiment with sexuality at this age as a means of deciding later sexual orientation. C.this attachment to other same gender children is how the child learns to interact with others. D. to encourage mixed gender interactions in order to promote development of sexual values - answer C.this attachment to other same gender children is how the child learns to interact with others. 6. The parent of a 2weekold infant reports that the infant was diagnosed with transient tachypnea of the newborn shortly after birth. The primary care pediatric nurse practitioner understands that, in this condition, A. antibiotic therapy is generally necessary to prevent severe infection. B. home oxygen therapy is needed until the infant grows out of the condition. C. recovery is usually complete with minimal intervention and treatments. D. treatment with exogenous surfactant and mechanical ventilation is needed - answer C. recovery is usually complete with minimal intervention and treatments 7. An infant has congenital adrenal hyperplasia. At a routine well baby checkup, the primary care pediatric nurse practitioner notes vomiting, poor feeding, lethargy, and dehydration. Which action is correct? A Administer an intramuscular stress dose of hydrocortisone succinate. B Administer intravenous fluids in the clinic and reassess hydration status. C Prescribe an oral hydrocortisone in a replacement dose of 8 to 10mg/M2. D Refer the infant to the emergency department for fluids, dextrose,and steroids. - answer D Refer the infant to the emergency department for fluids, dextrose, and steroids. 8. The parent of a 4-day-old infant tells the primary care pediatric nurse practitioner that the infant was diagnosed with hydronephrosis while in utero and asks what will be done. What will the nurse practitioner tell this parent? A. Renal function will be abnormal and will require lifetime treatment. B. Spontaneous resolution often occurs within 6 months to a year of age. C. The affected kidney will be non functional but the other kidney will compensate. D The infant will eventually require renal transplantation for that kidney. - answer B. Spontaneous resolution often occurs within 6 months to a year of age. 9. An initial key part of management of a child suspected of having an inborn error of metabolism is a. consulting a metabolic specialist b. obtaining a complete family history .c. ordering metabolic screening tests. d. referring the family to a dietician. - answer a. consulting a metabolic specialist 10. The primary care pediatric nurse practitioner notes a musty odor when examining a newborn at a 2 week checkup. What will the nurse practitioner suspect? A. Galactosemia B. Glucose6phosphatase deficiency C. Phenylketonuria D. Urea cycle disorder - answer C. Phenylketonuria 11. A 16-year-old adolescent female whose BMI is at the 90th percentile reports irregular periods. The primary care pediatric nurse practitioner notes widespread acne on her face and back and an abnormal distribution of facial hair. The nurse practitioner will evaluate her further based on a suspicion of which diagnosis? A. Dyslipidemia B. Hypothyroidism C. Nonalcoholic steatohepatitis D. Polycystic ovary syndrome - answer D. Polycystic ovary syndrome 12. The primary care pediatric nurse practitioner prescribes metformin for a 15yearold adolescent newly diagnosed with type 2 diabetes. What will the nurse practitioner include when teaching the adolescent about this drug? A. That insulin therapy will be necessary in the future B. The importance of checking blood glucose 3 or 4 times daily C To consume a diet with foods that are high in vitamin B12 D To use a stool softener to prevent gastrointestinal side effects - answer B. The importance of checking blood glucose 3 or 4 times daily 13. The primary care pediatric nurse practitioner notes the presence of a hyperpigmented velvet like rash in skin folds. The child denies polydipsia, polyphagia, and polyuria. The nurse practitioner will A counsel the child to lose weight to prevent type 2 diabetes. B. diagnose type 2 diabetes if the child has a random glucose of 180mg/dL. C. order a fasting blood sample for a metabolic screen for type 2 diabetes. D. refer the child to a pediatric endocrinologist - answer C. order a fasting blood sample for a metabolic screen for type 2 diabetes. 14. The mother of a female infant is concerned that her daughter is developing breasts. The primary care pediatric nurse practitioner notes mild breast development but no pubic or axillary hair. What is the likely diagnosis? A Congenital adrenal hyperplasia causing breast development B. Precocious puberty needing endocrinology management C. Premature adrenarche which will lead to pubic hair onset D. Premature thelarche which will resolve over time - answer D. Premature thelarche which will resolve over time 15. Select the statement that best describes the thelarche stage of puberty in females. Appearance of pubic hair Appearance of breast tissue maturation Onset of first menstrual period All the above - answer 4. All the above 16. The parent of a school age child reports that the child is on a gluten free diet. When questioned about the reason for this diet, the parent states that the child has fewer stomach aches since beginning the diet but has never been diagnosed with celiac disease. The parent reports using gluten free grain products for all family members. The nurse practitioner will tell this parent that gluten free diets A are generally low in sugar and fat. B. are healthy and help prevent obesity. C. may be deficient in essential nutrients. D. provide adequate protein to meet daily needs - answer C. may be deficient in essential nutrients. 17. A school age child has recurrent diarrhea with foul smelling stools, excessive flatus, abdominal distension, and failure to thrive. A 2week lactose free trial failed to reduce symptoms. What is the next step in diagnosing this condition? A. Lactose hydrogen breath test B. Serologic testing for celiac disease C. Stool for ova and parasites D. Sweat chloride test for cystic fibrosis - answer B. Serologic testing for celiac disease 18. Cyclic vomiting may: Last for days. Require SSRIs to stop hurting. Not be associated with a headache. Requires pain medication and Zofran. - answer 3. Not be associated with a headache 19. 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? A Acoustic reflectometry B Audiometry C. Auditory brainstem response (ABR) D.Evoked otooacoustic emission (EOAE) testing - answer C. Auditory brainstem response (ABR) 20. The primary care pediatric nurse practitioner obtains a tympanogram on a child that reveals a sharp peak of 180mm H2O. What does this value indicate? A. A normal tympanic membrane B. Middle ear effusion C. Negative ear pressure D. Tympanic membrane perforation - answer C. Negative ear pressure 21. 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? A. Order ototopical antibiotic/corticosteroid drops. B. Prescribe a prophylactic antibiotic medication. C. Reassure the parent that this is a normal exam. D. Refer the child to an otolaryngologist for followup - answer A. Order ototopical antibiotic/corticosteroid drops 22. The primary care pediatric nurse practitioner notes a small, round objectin 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? A. Irrigate the external auditory canal to flush out the object. B. Refer the child to an otolaryngologist for removal. C. Remove the object with a wire loop curette. D. Use a bayonet forceps to grasp and remove the object. - answer B. Refer the child to an otolaryngologist for removal. 23. A 3-year-old child has had one episode of acute otitis media 3 weeks prior with abnormal 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? A. A referral for tympanocentesis B. Amoxicillin twice daily C. Amoxicillin clavulanate twice daily D. Intramuscular ceftriaxone - answer C. Amoxicillinclavulanate twice daily 24. The primary care pediatric nurse practitioner performs a well child examination on a 9monthold 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? A. At 12 months of age B At 24 months of age C. At 48 months of age D. At 60 months of age - answer A. At 12 months of age 25. An adolescent takes ibuprofen, acetaminophen, and a tricyclic antidepressant (TCA) to treat phantom limb pain and reports that the medications are no longer effective. What will the primary care pediatric nurse practitioner do? A. Change the TCA to a selective serotonin reuptake inhibitor. B. Evaluate the adolescent for drug seeking behavior. C. Increase the TCA dose and reevaluate in 2 to 3 weeks. D Refer the adolescent to a pain management specialist. - answer D. Refer the adolescent to a pain management specialist. 26. The primary care pediatric nurse practitioner is examining a 2-week-old infant and auscultates a wide splitting of S2 during expiration. What condition may this finding represent? A. Atrial septal defect B. Coarctation of the aorta C. Patent ductus arteriosis D. Ventricular septal defect - answer A. Atrial septal defect 27. The primary care pediatric nurse practitioner auscultates a new grade II vibratory, mid systolic murmur at the mid sternal border in a 4-year-old child that is louder when the child is supine. What type of murmur is most likely? A. Pathologic murmur B. Pulmonary flow murmur C. Still's murmur D. Venous hum - answer C. Still's murmur