NUR 652 - FINAL EXAM | 209 QUESTIONS | WITH
COMPLETE SOLUTIONS!!
A 5-year-old child is hit in the face with a baseball bat and is brought to the clinic by a parent. An
exam reveals three avulsed front teeth. Radiologic studies are negative for facial fractures. What is
the recommended treatment? Answer - Refer the child to the dentist immediately for further
evaluation
A 13-year-old with cerebral palsy receives all nutrition via gastrostomy tube. What will the primary
care nurse practitioner recommend to promote dental health in this child? Answer - Daily
chlorhexidine gluconate
A teen 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
An elderly patient has a permanent loss of the sense of smell and diminished taste. What will be
included in teaching this patient about managing these symptoms? Answer - 1. The importance of
installing smoke detectors
2. Putting dates on food in the fridge
3. Eating regular meals at scheduled times
A toddler exhibits exotropia of the right eye during a cover-uncover screen. The primary nurse
practitioner will refer to a pediatric ophthalmologist to initiate which treatment? Answer - Patching
of the unaffected eye for 2 hours each day
An adolescent has localized bleeding of the gums when brushing the teeth. An exam of the mouth
reveals the presence of plaque and calculus on the teeth which are not loose. What will the primary
care nurse practitioner recommend? Answer - Consistently brushing and flossing the teeth twice
daily
A provider is recommending a cerumenolytic for a patient who has chronic cerumen buildup. The
provider notes that the patient has dry skin in the ear canal. Which preparation is FDA approved for
this use? Answer - Carbamide peroxide
,A parent asks about ways to promote dental health in school-aged children while on family vacation
that are convenient while camping and picnicking. What will the primary care nurse practitioner
recommend? Answer - Offering gum containing xylitol after meals
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 care nurse
practitioner notes marker middle ear effusion and erythema of the TM. The child is irritable and has
a temperature of 99.8. What is the next step in management of this child's infection? Answer - Refer
the child to an otolayngologist
A patient reports painful swelling in the mouth with increased pain at mealtimes. The provider notes
a mass in the salivary gland region. What is the likely cause of these symptoms? Answer -
Sialolithiasis
During a well child assessment of an African American infant, the primary care 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 opthalmologist
A preschool age child who attend daycare has a 2 day history of matted eyelids in the morning and
burning and itching of the eyes. The primary care NP notes yellow-green purulent discharge from
both eyes, conjunctival erythema and mild URI symptoms. Which action is correct? Answer -
Prescribe topical antibiotic drops
An 18-month-old child with no previous history of otitis media awoke during the night with right ear
pain. The primary care NP notes an axillary temperature of 100.5 and an erythematous, bulging TM.
A tympanogram reveals a peak of +15-mm H2O. What is the recommended treatment for this child?
Answer - An analgesic medication and watchful waiting
During a well-child exam on a 4-year-old child, the primary care NP notes that the clinic nurse
recorded 20/50 for the child's vision and noted that the child has difficulty cooperating with the
exam. What will the NP recommend? Answer - Test the child's vision in 1 month
Causes of cough, not related to pulmonary issues Answer - Allergies, GERD, medications (lisinopril)
The primary care NP is providing nutritional counseling for a 9-year-old female whose weight is at the
95th percentile for her age. What is the goal for this patient? Answer - Maintenance of her current
weight
, The primary care NP is performing a well child examination on a 12-year-old child who was
diagnosed with type 1 DM at age 9. The child had a lipid screen at age 10 with an LDL cholesterol
<100mg/dL. What will the NP recommend as part of ongoing management for this child? Answer -
Comprehensive ophthalmologic exams
The primary care NP is reviewing lab work and diabetes management with a school-aged child whose
HbA1C is 7.6% who reports usual blood sugars before meals as being 80-90mg/dL. The NP will
consult with the child's endocrinologist to consider which therapy? Answer - Continuous glucose
monitoring
The primary care NP notes a musty odor when examining a newborn at a 2-week checkup. What will
the NP suspect? Answer - Phenylketonuria
A patient who has diabetes has a blood pressure of 140/90 and albuminuria. Which initial action by
the primary care NP is indicated for management of this patient? Answer - Consulting with a
nephrologist
The primary care NP is performing a well-child examination on a 2-year-old child with a history of
intrauterine growth retardation whose height remains less than the 3rd percentile on a WHO growth
chart. What will the NP do? Answer - Refer the child to a pediatric endocrinologist
An infant has congenital adrenal hyperplasia. At a routine well baby checkup, the primary care NP
notes vomiting, poor feeding, lethargy, and mild dehydration. Which action is correct? Answer -
Refer the infant to the ED for fluids, dextrose, and steroids
A patient recently diagnosed with T1DM is in clinic for a follow-up evaluation. The provider notes
that the patient appears confused and irritable and is sweating and shaking. What intervention will
the provider expect to perform once the POC blood glucose is known? Answer - Giving a rapid acting
carbohydrate
A 15-year-old child has a recent history of increased thirst and frequent urination. The child's weight
has been in the 95th percentile for several years. A dipstick UA is positive for glucose, and random
plasma glucose is 350mg/dL. Which test will the primary care NP order to determine the type of
diabetes in this child? Answer - Pancreatic antibodies
A patient has thyroid nodules and the provider suspects thyroid cancer. To evaluate thyroid nodules
for potential malignancy, which test is performed? Answer - Thyroid ultrasound
COMPLETE SOLUTIONS!!
A 5-year-old child is hit in the face with a baseball bat and is brought to the clinic by a parent. An
exam reveals three avulsed front teeth. Radiologic studies are negative for facial fractures. What is
the recommended treatment? Answer - Refer the child to the dentist immediately for further
evaluation
A 13-year-old with cerebral palsy receives all nutrition via gastrostomy tube. What will the primary
care nurse practitioner recommend to promote dental health in this child? Answer - Daily
chlorhexidine gluconate
A teen 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
An elderly patient has a permanent loss of the sense of smell and diminished taste. What will be
included in teaching this patient about managing these symptoms? Answer - 1. The importance of
installing smoke detectors
2. Putting dates on food in the fridge
3. Eating regular meals at scheduled times
A toddler exhibits exotropia of the right eye during a cover-uncover screen. The primary nurse
practitioner will refer to a pediatric ophthalmologist to initiate which treatment? Answer - Patching
of the unaffected eye for 2 hours each day
An adolescent has localized bleeding of the gums when brushing the teeth. An exam of the mouth
reveals the presence of plaque and calculus on the teeth which are not loose. What will the primary
care nurse practitioner recommend? Answer - Consistently brushing and flossing the teeth twice
daily
A provider is recommending a cerumenolytic for a patient who has chronic cerumen buildup. The
provider notes that the patient has dry skin in the ear canal. Which preparation is FDA approved for
this use? Answer - Carbamide peroxide
,A parent asks about ways to promote dental health in school-aged children while on family vacation
that are convenient while camping and picnicking. What will the primary care nurse practitioner
recommend? Answer - Offering gum containing xylitol after meals
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 care nurse
practitioner notes marker middle ear effusion and erythema of the TM. The child is irritable and has
a temperature of 99.8. What is the next step in management of this child's infection? Answer - Refer
the child to an otolayngologist
A patient reports painful swelling in the mouth with increased pain at mealtimes. The provider notes
a mass in the salivary gland region. What is the likely cause of these symptoms? Answer -
Sialolithiasis
During a well child assessment of an African American infant, the primary care 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 opthalmologist
A preschool age child who attend daycare has a 2 day history of matted eyelids in the morning and
burning and itching of the eyes. The primary care NP notes yellow-green purulent discharge from
both eyes, conjunctival erythema and mild URI symptoms. Which action is correct? Answer -
Prescribe topical antibiotic drops
An 18-month-old child with no previous history of otitis media awoke during the night with right ear
pain. The primary care NP notes an axillary temperature of 100.5 and an erythematous, bulging TM.
A tympanogram reveals a peak of +15-mm H2O. What is the recommended treatment for this child?
Answer - An analgesic medication and watchful waiting
During a well-child exam on a 4-year-old child, the primary care NP notes that the clinic nurse
recorded 20/50 for the child's vision and noted that the child has difficulty cooperating with the
exam. What will the NP recommend? Answer - Test the child's vision in 1 month
Causes of cough, not related to pulmonary issues Answer - Allergies, GERD, medications (lisinopril)
The primary care NP is providing nutritional counseling for a 9-year-old female whose weight is at the
95th percentile for her age. What is the goal for this patient? Answer - Maintenance of her current
weight
, The primary care NP is performing a well child examination on a 12-year-old child who was
diagnosed with type 1 DM at age 9. The child had a lipid screen at age 10 with an LDL cholesterol
<100mg/dL. What will the NP recommend as part of ongoing management for this child? Answer -
Comprehensive ophthalmologic exams
The primary care NP is reviewing lab work and diabetes management with a school-aged child whose
HbA1C is 7.6% who reports usual blood sugars before meals as being 80-90mg/dL. The NP will
consult with the child's endocrinologist to consider which therapy? Answer - Continuous glucose
monitoring
The primary care NP notes a musty odor when examining a newborn at a 2-week checkup. What will
the NP suspect? Answer - Phenylketonuria
A patient who has diabetes has a blood pressure of 140/90 and albuminuria. Which initial action by
the primary care NP is indicated for management of this patient? Answer - Consulting with a
nephrologist
The primary care NP is performing a well-child examination on a 2-year-old child with a history of
intrauterine growth retardation whose height remains less than the 3rd percentile on a WHO growth
chart. What will the NP do? Answer - Refer the child to a pediatric endocrinologist
An infant has congenital adrenal hyperplasia. At a routine well baby checkup, the primary care NP
notes vomiting, poor feeding, lethargy, and mild dehydration. Which action is correct? Answer -
Refer the infant to the ED for fluids, dextrose, and steroids
A patient recently diagnosed with T1DM is in clinic for a follow-up evaluation. The provider notes
that the patient appears confused and irritable and is sweating and shaking. What intervention will
the provider expect to perform once the POC blood glucose is known? Answer - Giving a rapid acting
carbohydrate
A 15-year-old child has a recent history of increased thirst and frequent urination. The child's weight
has been in the 95th percentile for several years. A dipstick UA is positive for glucose, and random
plasma glucose is 350mg/dL. Which test will the primary care NP order to determine the type of
diabetes in this child? Answer - Pancreatic antibodies
A patient has thyroid nodules and the provider suspects thyroid cancer. To evaluate thyroid nodules
for potential malignancy, which test is performed? Answer - Thyroid ultrasound
