NURS 500 - exam one Questions With Complete Solutions
Birth weight: extremely low birth weight Correct Answer
<1000g
Birth weight: low birth weight Correct Answer <2500g
Birth weight: normal Correct Answer >/= 2500g
Birth weight: very low birth weight Correct Answer <1500g
Gestational age: late preterm Correct Answer 34-36 weeks
Gestational age: post term Correct Answer >42 weeks
Gestational age: preterm Correct Answer <34 weeks
Gestational age: term Correct Answer 37-42 weeks
Growth and development: 12 months Correct Answer Stand,
say 1-3 words
Growth and development: 3 months Correct Answer Lift their
head (no head lag), clasp hands, coo
Growth and development: 6 months Correct Answer Roll
over, reach for objects, turn to voices, babble, sit with support
Growth and development: 9 months Correct Answer Neat
pincer grasp (self-feed), indicate wants, "stranger danger"
,Growth and development: adolescent (11-20 years) Correct
Answer - Puberty begins at 10 in girls, 11 in boys
- Growth spurt at 14 for girls and 16 for boys
- Formal operational: ability to reason logically and abstractly
and consider future implications of current actions
Growth and development: early childhood (1-4 years) Correct
Answer - Physical growth slows by half (preschool years grow
3.5 in and gain 4 lbs)
- Become more lean and muscular
- Run by 2 years, jumps and pedals bike at 4 years
- Sensorimotor to symbolic thinking, solving simple problems,
remember songs, imitative play
- Preoperational: NO sustained, logical thought process
Growth and development: middle childhood (5-10 years)
Correct Answer - Concrete operational: limited logic and more
complex learning, clear sense of wrong/right
- Remains rooted in the present with little ability to understand
consequences
- Self-efficacy, more independent
How and why would you approach a pediatric or adolescent
history/exam differently than an adult? Correct Answer
Examination varies according to child's age and comfort level
- Less invasive early and distressing interventions near the end
- Exam areas of pain last
How do we define weight loss? Overweight? Obesity? What are
some etiologies that we would consider? Correct Answer
Overweight: BMI >25-29
,Obese: BMI >30
Weight loss: loss of >5% over a 6 month period
Etiologies of weight loss: anorexia, depression, dysphagia,
vomiting, abdominal pain, defective GI
absorption/inflammation, increased metabolic requirements,
substance abuse, HIV/AIDS, malignancy, endocrine disorders
How do you correct for prematurity when considering growth
and development? Correct Answer For babies born
prematurely, adjust expected developmental milestones for the
gestational age up to 2 years
How should the FNP quantify tobacco use? Correct Answer
Pack years - a person who has smoked 1.5 packs a day for 12
years has an 18 pack/year history
How should you approach the history of the patient with an
altered mental status or delirium? Correct Answer Obtain
historical information from other sources (family members or
caregivers)
Cannot disclose patient information unless informant is the
healthcare proxy, has durable power of attorney, or permission
from the patient
Determine if patient has "decision making capacity" (if no
healthcare proxy, may default to spouse or family member)
How would you approach the confusing patient? What should
you consider as part of your DDx for the confusing patient?
, Correct Answer If patient presents with an array of symptoms
("a positive ROS") - focus on context of symptom, emphasize
patient's perspective, guide the interview into a psychosocial
assessment
Consider mental status change, delirium in acutely ill or
intoxicated patients, dementia in elderly --> shift to MSE and
focus on LOC, orientation, memory, capacity to understand
How would you approach the patient with a language barrier?
What would you look for in the ideal interpreter? Correct
Answer Ideal interpreter - "cultural navigator" who is neutral
and trained in both languages/cultures
Guidelines for working with an interpreter: introductions, note
goals, transparency, ethics, respect beliefs, patient focus, retain
control, explain, thanks
How would you approach the patient with a low literacy or low
health literacy? What are some strategies that you can use during
a visit with this patient? Correct Answer Ask about years
completed in school or check how well the patient reads written
instructions (hand a patient a book upside down)
Identify reasons - language barrier, learning disorder, poor
vision, level of education
How would you approach the patient with hearing loss? What
are some strategies that you can use during a visit with this
patient? Correct Answer Determine the patient's preferred
method of communication, if they belong to the hearing or deaf
Birth weight: extremely low birth weight Correct Answer
<1000g
Birth weight: low birth weight Correct Answer <2500g
Birth weight: normal Correct Answer >/= 2500g
Birth weight: very low birth weight Correct Answer <1500g
Gestational age: late preterm Correct Answer 34-36 weeks
Gestational age: post term Correct Answer >42 weeks
Gestational age: preterm Correct Answer <34 weeks
Gestational age: term Correct Answer 37-42 weeks
Growth and development: 12 months Correct Answer Stand,
say 1-3 words
Growth and development: 3 months Correct Answer Lift their
head (no head lag), clasp hands, coo
Growth and development: 6 months Correct Answer Roll
over, reach for objects, turn to voices, babble, sit with support
Growth and development: 9 months Correct Answer Neat
pincer grasp (self-feed), indicate wants, "stranger danger"
,Growth and development: adolescent (11-20 years) Correct
Answer - Puberty begins at 10 in girls, 11 in boys
- Growth spurt at 14 for girls and 16 for boys
- Formal operational: ability to reason logically and abstractly
and consider future implications of current actions
Growth and development: early childhood (1-4 years) Correct
Answer - Physical growth slows by half (preschool years grow
3.5 in and gain 4 lbs)
- Become more lean and muscular
- Run by 2 years, jumps and pedals bike at 4 years
- Sensorimotor to symbolic thinking, solving simple problems,
remember songs, imitative play
- Preoperational: NO sustained, logical thought process
Growth and development: middle childhood (5-10 years)
Correct Answer - Concrete operational: limited logic and more
complex learning, clear sense of wrong/right
- Remains rooted in the present with little ability to understand
consequences
- Self-efficacy, more independent
How and why would you approach a pediatric or adolescent
history/exam differently than an adult? Correct Answer
Examination varies according to child's age and comfort level
- Less invasive early and distressing interventions near the end
- Exam areas of pain last
How do we define weight loss? Overweight? Obesity? What are
some etiologies that we would consider? Correct Answer
Overweight: BMI >25-29
,Obese: BMI >30
Weight loss: loss of >5% over a 6 month period
Etiologies of weight loss: anorexia, depression, dysphagia,
vomiting, abdominal pain, defective GI
absorption/inflammation, increased metabolic requirements,
substance abuse, HIV/AIDS, malignancy, endocrine disorders
How do you correct for prematurity when considering growth
and development? Correct Answer For babies born
prematurely, adjust expected developmental milestones for the
gestational age up to 2 years
How should the FNP quantify tobacco use? Correct Answer
Pack years - a person who has smoked 1.5 packs a day for 12
years has an 18 pack/year history
How should you approach the history of the patient with an
altered mental status or delirium? Correct Answer Obtain
historical information from other sources (family members or
caregivers)
Cannot disclose patient information unless informant is the
healthcare proxy, has durable power of attorney, or permission
from the patient
Determine if patient has "decision making capacity" (if no
healthcare proxy, may default to spouse or family member)
How would you approach the confusing patient? What should
you consider as part of your DDx for the confusing patient?
, Correct Answer If patient presents with an array of symptoms
("a positive ROS") - focus on context of symptom, emphasize
patient's perspective, guide the interview into a psychosocial
assessment
Consider mental status change, delirium in acutely ill or
intoxicated patients, dementia in elderly --> shift to MSE and
focus on LOC, orientation, memory, capacity to understand
How would you approach the patient with a language barrier?
What would you look for in the ideal interpreter? Correct
Answer Ideal interpreter - "cultural navigator" who is neutral
and trained in both languages/cultures
Guidelines for working with an interpreter: introductions, note
goals, transparency, ethics, respect beliefs, patient focus, retain
control, explain, thanks
How would you approach the patient with a low literacy or low
health literacy? What are some strategies that you can use during
a visit with this patient? Correct Answer Ask about years
completed in school or check how well the patient reads written
instructions (hand a patient a book upside down)
Identify reasons - language barrier, learning disorder, poor
vision, level of education
How would you approach the patient with hearing loss? What
are some strategies that you can use during a visit with this
patient? Correct Answer Determine the patient's preferred
method of communication, if they belong to the hearing or deaf
