By Expert
Gold standard for CAP diagnosis: Correct Answer - Chest x-ray
If CAP symptoms present but no obvious signs of infection on CXR
treatment is... Correct Answer - Same as if CXR was positive
Immunizations for people over 65 or younger people with
comorbidities such as asthma, CHF COPD: Correct Answer -
Pneumonia and flu vaccines
Who is at risk for CAP? Correct Answer - Extremes of age,
smokers, alcoholics, GERD, chronic disease, institutionalization
CAP presentation in adults: Correct Answer - Cough (may be
nonproductive), dyspnea, fever, hemoptysis, chest pain, fatigue,
tachycardia
If lymphocytes are elevated? Correct Answer - Indicative of
viral process
If monocytes are elevated? Correct Answer - Indicative of
chronic process
If eosinophils are elevated? Correct Answer - Indicative of
asthma, allergic reaction
If basophils are elevated? Correct Answer - Indicative of
chronic process
If neutrophils are elevated? Correct Answer - Indicative of
acute bacterial process
,CAP: patient present with symptoms of chills, fever, chest pain,
productive cough with purulent sputum, positive chest x-ray, and
patient had URI last week? Correct Answer - Streptococcus
pneumonia: gram +
In the United States, the most common cause of myocarditis in
children is: Correct Answer - Viruses
Your next patient is a 5-year-old child with a history of moderate
persistent asthma. He has been wheezing and coughing for the past
two days, and his mother brings him in today for evaluation. He has
been using albuterol every four hours. His respiratory rate is 13
breaths per minute; his lungs are clear to auscultation; and no
retractions are noted. What may be your assessment and
intervention based on this information? Correct Answer - Your
child is breathing slower than normal for his age. We need to send
him to the ER for further intervention.
Your next patient is a 6-year-old male here for his annual influenza
vaccine. He has a history of mild persistent asthma. What would you
discuss for medications when reviewing his asthma action plan?
Correct Answer - Your child should continue his low-dose
inhaled corticosteroid daily and add albuterol as needed for an
exacerbation.
A child who has been diagnosed with asthma for several years has
been using a short-acting Beta-agonist (SABA) to control symptoms.
The PNP learns that the child has recently begun using the SABA 2-3
times each week to prevent wheezing and shortness of breath. The
child currently has clear breath sounds and an FEV1 of 75% of
personal best. What will the NP do? Correct Answer - Add an
inhaled corticosteroid.
, Your next patient is a six-month-old infant who just completed
amoxicillin for otitis media. The mother states her child is better
except for a diaper rash. Upon examination, you note red scaly
plaques in the diaper area with satellite lesions to his upper thighs.
What would you do next as the PNP? Correct Answer - Your
child has a rash that is likely due to a fungus, Candida, and
commonly occurs after taking antibiotics. I will prescribe nystatin to
be applied to the diaper area.
A 12 y.o. female presents to the clinic after being bit by a dog on the
face. Abrasion with 2 puncture wounds on the upper right cheek,
approximately 1 inch below the eye. The area is slightly
erythematous, with a small amount of bruising and raised area along
the cheekbone. Correct Answer - Using normal saline, irrigate
the wounds using high pressure (greater than 4 pounds per square
inch) and high volume (greater than 1 L). Isolated puncture wounds
should not be irrigated, instead soak the wound in a diluted solution
of tap water and povidone-iodine for 15 .minutes • Prescribe a 3- to
5-day course of prophylactic antibiotics
A 4 yo child has clusters of small, clear, tense vesicles with an
erythematous base on one side of the mouth along the vermillion
border, which are causing discomfort and difficulty eating. What will
the PNP recommend as treatment? Correct Answer - Topical
diphenhydramine and magnesium hydroxide.
A 4 year old child with PE tubes in both ears has otalgia in one ear.
The PNP is able to visualize the tube and does not see exudate in the
ear canal and obtains a type A tympanogram. What will the NP do?
Correct Answer - Order ototopical corticosteroid/antibiotic
drops.
The parent of a 1-week old is concerned about the unusual shape of
their child's head. In the physical exam, which of the following signs