BURNS PEDIATRIC COMPREHENSIVE QUESTIONS
AND ANSWERS SURE A+
✔✔1. The primary care pediatric nurse practitioner is performing a pre-participation
sports physical
examination on a 14-year-old male who will be on the wrestling team at school. What
will the nurse
practitioner include when discussing healthy practices with this adolescent?
a. Risks associated with repeatedly losing and gaining weight
b. The need for an electrocardiogram or echocardiogram prior to participation
c. The need to consume 20 to 30 grams of protein after exercise
d. To consume water with CHO prior to activity lasting up to an hour - ✔✔ANS: A
Wrestlers often try to lose weight rapidly prior to wrestling matches to put themselves
into a lower weight
category. It is important to teach young athletes about the risks associated with
repeated weight loss and
gain. ECG and echocardiograms are not recommended as a requirement for all pre-
participation physical
exams unless there is an indication for doing so, such as with syncope or murmurs.
Athletes do not need
to consume 10 to 20 grams of protein after exercise
✔✔complex carbohydrates are recommended to improve
muscle glycogen resynthesis. Plain water is recommended before, during, and after all
activity lasting up
to an hour. - ✔✔
✔✔2. The primary care pediatric nurse practitioner counseling the parent of an
overweight school-age child
about improving overall fitness. What will the nurse practitioner include?
a. Encourage the child to begin by engaging in swimming or cycling.
b. Exercise will help lower total cholesterol and low-density lipoproteins.
c. School-age children need 60 minutes of moderate exercise daily.
,d. Strength training exercises are not safe for school-age children. - ✔✔ANS: A
The AAP suggests that overweight children initially participate in activities that place
less stress on
weight-bearing joints, such as swimming or cycling. Exercise helps raise HDL levels but
does not reduce
total cholesterol or LDL levels. School-age children need 60 minutes of physical activity
but not
necessarily exercise each day. Strength training exercises are safe, but powerlifting and
maximal weight
training are not, because of effects on developing bones.
✔✔3. The parents of a pre-pubertal female who is on the local swim team tell the
primary care pediatric
nurse practitioner that their daughter wants to begin a strength training program to help
improve her
swimming ability. What will the nurse practitioner recommend?
a. Avoiding strength training programs until after puberty to minimize the risk for injury
b. Enrolling their daughter in a program that uses fixed weight machines or resistance
bands
c. Having their daughter participate in weight training 4 or 5 times each week for
maximum effect
d. Making sure that their daughter begins with the greatest weight tolerable using lower
repetitions - ✔✔ANS: B
Fixed weights or resistance bands are recommended for pre-pubertal youth to help
prevent injury.
Strength training prior to menarche helps to strengthen long bones and is considered
beneficial. Weight
training should be 2 to 3 times weekly with a day in between sessions. Initially, youth
should begin with a
low number of sets and low intensity.
✔✔4. The parent of a 14-year-old child asks the primary care pediatric nurse
practitioner how to help the
child prevent injuries when basketball tryouts begin later in the school year. Which
recommendation
will be of most benefit?
a. Preseason conditioning
b. Proper footwear
c. Protective knee braces
d. Stretching before practices - ✔✔ANS: A
Conditioning in the preseason is one of the most important things children can do to
build muscle
strength, to prevent sports injuries, and to learn how to make twisting, jumping, and
landing movements
safely. Proper footwear is also recommended but is not the most important. Protective
knee braces may be
,worn but do not prevent injury. Stretching should be done after warming up to maintain
flexibility.
✔✔5. The parent of a high school basketball player tells the primary care pediatric
nurse practitioner that the
adolescent becomes short of breath only when exercising. What will the nurse
practitioner
recommend?
a. Permanent discontinuation of all strenuous and aerobic activities
b. Enrollment in a conditioning program to improve performance
c. Evaluation for underlying cardiac causes of this symptom
d. Treatment for exercise-induced asthma with a bronchodilator - ✔✔ANS: C
While shortness of breath may indicate several more benign causes, athletes who
exhibit this symptom
should be evaluated for underlying cardiac causes to prevent sudden cardiac death.
Once this is ruled out,
other causes may be considered, such as EIA or poor conditioning.
✔✔6. A 15-year-old female basketball player who has secondary amenorrhea is
evaluated by the primary
care pediatric nurse practitioner who notes a BMI in the 3rd percentile. What will the
nurse
practitioner counsel this patient?
a. That amenorrhea in female athletes is not concerning
b. That she should begin a program of plyometrics and strength trainin
c. To consider a different sport, such as volleyball
d. To work with a dietician to improve healthy weight gain - ✔✔ANS: D
Female athletes who have amenorrhea have an increased risk of stress fractures. The
adolescent should
work to attain a healthy weight, which should allow normal periods to return and reduce
this risk. Even
though amenorrhea in female athletes is common, it is concerning. Plyometrics and
volleyball can
increase the risk of stress fractures since both involve jumping and thus not be
suggested.
✔✔7. The parent of a child who has asthma asks the primary care pediatric nurse
practitioner about whether
the child may engage in strenuous exercise. What will the nurse practitioner tell the
parent?
a. Children with asthma should be excluded from vigorous exercise and most strenuous
sports.
b. Children with asthma show improved aerobic and anaerobic fitness with moderate to
vigorous/physical activity.
c. Physical activity has been shown to improve overall pulmonary function in children
with asthma.
, d. Vigorous exercise helps improve symptoms in children with poorly controlled asthma.
- ✔✔ANS: B
Children with mild or well-controlled asthma may participate in moderate to vigorous
sports and show
benefits to aerobic and anaerobic fitness, which helps lung function and overall health
outcomes. It is not
necessary to exclude children with asthma from sports as long as symptoms are well
controlled. Overall
pulmonary function does not substantially improve with exercise. Children with poor
control should not
engage in sports until symptoms are under control.
✔✔8. The primary care pediatric nurse practitioner diagnoses a high school basketball
player with
mononucleosis. The adolescent asks when she may resume play. What will the nurse
practitioner tell
her?
a. After 3 weeks, she may begin lifting weights but not full sports.
b. After 4 weeks, she may return to full play and practice.
c. At 4 weeks, she must have an exam to determine fitness for play.
d. She may engage in moderate exertion and practice after 3 weeks. - ✔✔ANS: C
Full return to play should be determined on a case-by-case basis and is generally
considered safe at 4
weeks after symptom onset, assuming physical stamina has returned, all symptoms
have resolved, and the
sport does not increase intraabdominal pressure during play. Athletes should avoid any
form of exertion,
including all sports during the first 3 weeks at a minimum and should avoid anything
with a risk of chest
or abdominal contact or anything that involves increased intra-abdominal pressure.
Splenic rupture can
occur spontaneously (rare), but the risk of rupture increases when participating in a
contact or collision
sport or a sport in which there is an increase in intraabdominal pressure. The nurse
practitioner should
recommend an exam at 4 weeks to determine fitness for play.
✔✔9. The primary care pediatric nurse practitioner is counseling a parent about bicycle
helmet use. The
parent reports having a helmet used a year previously by an older child and wonders
about using it for
a younger child since they are so expensive. What will the nurse practitioner tell the
parent?
a. "As long as the helmet does not have cracks, you may use it."
b. "If the helmet is free from marks, you may use it."
c. "You may continue to use a helmet up to 10 years."
AND ANSWERS SURE A+
✔✔1. The primary care pediatric nurse practitioner is performing a pre-participation
sports physical
examination on a 14-year-old male who will be on the wrestling team at school. What
will the nurse
practitioner include when discussing healthy practices with this adolescent?
a. Risks associated with repeatedly losing and gaining weight
b. The need for an electrocardiogram or echocardiogram prior to participation
c. The need to consume 20 to 30 grams of protein after exercise
d. To consume water with CHO prior to activity lasting up to an hour - ✔✔ANS: A
Wrestlers often try to lose weight rapidly prior to wrestling matches to put themselves
into a lower weight
category. It is important to teach young athletes about the risks associated with
repeated weight loss and
gain. ECG and echocardiograms are not recommended as a requirement for all pre-
participation physical
exams unless there is an indication for doing so, such as with syncope or murmurs.
Athletes do not need
to consume 10 to 20 grams of protein after exercise
✔✔complex carbohydrates are recommended to improve
muscle glycogen resynthesis. Plain water is recommended before, during, and after all
activity lasting up
to an hour. - ✔✔
✔✔2. The primary care pediatric nurse practitioner counseling the parent of an
overweight school-age child
about improving overall fitness. What will the nurse practitioner include?
a. Encourage the child to begin by engaging in swimming or cycling.
b. Exercise will help lower total cholesterol and low-density lipoproteins.
c. School-age children need 60 minutes of moderate exercise daily.
,d. Strength training exercises are not safe for school-age children. - ✔✔ANS: A
The AAP suggests that overweight children initially participate in activities that place
less stress on
weight-bearing joints, such as swimming or cycling. Exercise helps raise HDL levels but
does not reduce
total cholesterol or LDL levels. School-age children need 60 minutes of physical activity
but not
necessarily exercise each day. Strength training exercises are safe, but powerlifting and
maximal weight
training are not, because of effects on developing bones.
✔✔3. The parents of a pre-pubertal female who is on the local swim team tell the
primary care pediatric
nurse practitioner that their daughter wants to begin a strength training program to help
improve her
swimming ability. What will the nurse practitioner recommend?
a. Avoiding strength training programs until after puberty to minimize the risk for injury
b. Enrolling their daughter in a program that uses fixed weight machines or resistance
bands
c. Having their daughter participate in weight training 4 or 5 times each week for
maximum effect
d. Making sure that their daughter begins with the greatest weight tolerable using lower
repetitions - ✔✔ANS: B
Fixed weights or resistance bands are recommended for pre-pubertal youth to help
prevent injury.
Strength training prior to menarche helps to strengthen long bones and is considered
beneficial. Weight
training should be 2 to 3 times weekly with a day in between sessions. Initially, youth
should begin with a
low number of sets and low intensity.
✔✔4. The parent of a 14-year-old child asks the primary care pediatric nurse
practitioner how to help the
child prevent injuries when basketball tryouts begin later in the school year. Which
recommendation
will be of most benefit?
a. Preseason conditioning
b. Proper footwear
c. Protective knee braces
d. Stretching before practices - ✔✔ANS: A
Conditioning in the preseason is one of the most important things children can do to
build muscle
strength, to prevent sports injuries, and to learn how to make twisting, jumping, and
landing movements
safely. Proper footwear is also recommended but is not the most important. Protective
knee braces may be
,worn but do not prevent injury. Stretching should be done after warming up to maintain
flexibility.
✔✔5. The parent of a high school basketball player tells the primary care pediatric
nurse practitioner that the
adolescent becomes short of breath only when exercising. What will the nurse
practitioner
recommend?
a. Permanent discontinuation of all strenuous and aerobic activities
b. Enrollment in a conditioning program to improve performance
c. Evaluation for underlying cardiac causes of this symptom
d. Treatment for exercise-induced asthma with a bronchodilator - ✔✔ANS: C
While shortness of breath may indicate several more benign causes, athletes who
exhibit this symptom
should be evaluated for underlying cardiac causes to prevent sudden cardiac death.
Once this is ruled out,
other causes may be considered, such as EIA or poor conditioning.
✔✔6. A 15-year-old female basketball player who has secondary amenorrhea is
evaluated by the primary
care pediatric nurse practitioner who notes a BMI in the 3rd percentile. What will the
nurse
practitioner counsel this patient?
a. That amenorrhea in female athletes is not concerning
b. That she should begin a program of plyometrics and strength trainin
c. To consider a different sport, such as volleyball
d. To work with a dietician to improve healthy weight gain - ✔✔ANS: D
Female athletes who have amenorrhea have an increased risk of stress fractures. The
adolescent should
work to attain a healthy weight, which should allow normal periods to return and reduce
this risk. Even
though amenorrhea in female athletes is common, it is concerning. Plyometrics and
volleyball can
increase the risk of stress fractures since both involve jumping and thus not be
suggested.
✔✔7. The parent of a child who has asthma asks the primary care pediatric nurse
practitioner about whether
the child may engage in strenuous exercise. What will the nurse practitioner tell the
parent?
a. Children with asthma should be excluded from vigorous exercise and most strenuous
sports.
b. Children with asthma show improved aerobic and anaerobic fitness with moderate to
vigorous/physical activity.
c. Physical activity has been shown to improve overall pulmonary function in children
with asthma.
, d. Vigorous exercise helps improve symptoms in children with poorly controlled asthma.
- ✔✔ANS: B
Children with mild or well-controlled asthma may participate in moderate to vigorous
sports and show
benefits to aerobic and anaerobic fitness, which helps lung function and overall health
outcomes. It is not
necessary to exclude children with asthma from sports as long as symptoms are well
controlled. Overall
pulmonary function does not substantially improve with exercise. Children with poor
control should not
engage in sports until symptoms are under control.
✔✔8. The primary care pediatric nurse practitioner diagnoses a high school basketball
player with
mononucleosis. The adolescent asks when she may resume play. What will the nurse
practitioner tell
her?
a. After 3 weeks, she may begin lifting weights but not full sports.
b. After 4 weeks, she may return to full play and practice.
c. At 4 weeks, she must have an exam to determine fitness for play.
d. She may engage in moderate exertion and practice after 3 weeks. - ✔✔ANS: C
Full return to play should be determined on a case-by-case basis and is generally
considered safe at 4
weeks after symptom onset, assuming physical stamina has returned, all symptoms
have resolved, and the
sport does not increase intraabdominal pressure during play. Athletes should avoid any
form of exertion,
including all sports during the first 3 weeks at a minimum and should avoid anything
with a risk of chest
or abdominal contact or anything that involves increased intra-abdominal pressure.
Splenic rupture can
occur spontaneously (rare), but the risk of rupture increases when participating in a
contact or collision
sport or a sport in which there is an increase in intraabdominal pressure. The nurse
practitioner should
recommend an exam at 4 weeks to determine fitness for play.
✔✔9. The primary care pediatric nurse practitioner is counseling a parent about bicycle
helmet use. The
parent reports having a helmet used a year previously by an older child and wonders
about using it for
a younger child since they are so expensive. What will the nurse practitioner tell the
parent?
a. "As long as the helmet does not have cracks, you may use it."
b. "If the helmet is free from marks, you may use it."
c. "You may continue to use a helmet up to 10 years."
