Exam 2 Pediatrics Chapter 21,22,24,25,26 A+ Graded

Exam 2 Pediatrics Chapter 21,22,24,25,26 A+ Graded 1. 46. Jason, an 8 year old with type 1 DM is being seen for a 3-day history of frequency and nocturia. He denies flank pain and is afebrile. The urinalysis result is negative for blood and nitrites but is positive for a large amount of leukocytes and ketones. He has a trace amount of protein. Which of the following is the best test to order initially? A) Urine for culture and sensitivity B) 24-hour urine for protein and creatinine clearance C) 24-hour urine for microalbumin D) An intravenous pyelogram Rational: A) Urine for culture and sensitivity An 8-year-old male patient with the diagnosis of diabetes has a high risk of urinary tract infections. A large amount of leukocytes in the urinalysis is abnormal and he has been having symptoms of frequency and nocturia for the past 3 days. The urine culture would be ordered because he has a high risk of infection. The urine culture and sensitivity (C& S) is the best evaluation for diagnosing a urinary tract infection 2. In which of the following groups of patients is tight glycemic control contraindicated? a. Adolescent males. b. Middle-aged females. c. Middle-aged males. d. Children under age 6. Rationale: Tight glycemic control is contraindicated in infants < 2 years of age and should be instituted with extreme caution in children < 7 years of age to avoid injuring the developing brain. 3. On initial exam of a child with newly diagnosed Kawasaki disease, the APRN would expect: 1. Dry, swollen, fissured lips. 2. Non-palpable lymph nodes. 3. Conjunctivitis with exudates. 4. Cyanosis of the hands and feet Answer: Dry, swollen, fissured lips are symptoms of Kawasaki disease. (Lymph nodes can be palpable, conjunctivitis is present but without exudates, and hands and feet are typically erythematous.) 4. Systemic medications like dicloxacillin should be used in the treatment of superficial folliculitis in which circumstances (check all that apply)? a. Sever3 cases -* b. Immunocompromised patients- * c. Patient's with atopic dermatitis d. Patient's diagnosed with diabetes - * a, b, d 5. You are seeing a 17-year-old female patient. During the visit, you consider her risk factors for type 2 DM would likely include all of the following except: A. Obesity B. Native American ancestry C. Family history of type 1 DM D. Personal history of polycystic ovary syndrome Answer C 6. The most common cause of hyperthyroidism in children and adolescents is a-Graves Disease b-thyroid cancer c-thyroid nodules d-pituitary tumor a-Graves Disease 7. An infant with polydipsia, polyuria, irritability and failure to thrive should be evaluated for: a-Diabetes Insipidus b-Homocystinuria c-Growth Hormone Deficiency d-hyperglycemia a-Diabetes Insipidus 8. Which of the following is not a signs or symptoms of congenital hypothyroidism? a-hoarse cry b-frequent stooling c-course features D-lethargy b-frequent stooling 9. A 9 yo boy presents with a fever of 102 F and complaint of leg pain. His mother reports that he had an upper respiratory infection with a sore throat about 2 weeks ago, which subsided without therapy. On physical examination he has tender swollen knees. Hr is 120 and a blowing systolic murmur is heard at the apex. No murmur was noted at the previous well visit. The most likely diagnosis is: a-kawasaki disease b-rheumatic fever c-sickle cell anemia d-viral illness b-rheumatic fever 10. When counseling an adolescent with a family history of hyperinsulinemia and type 2 diabetes, the primary care pediatric nurse practitioner will recommend avoiding Processed breads Canned vegetables Baked potato chips High-fiber cereals Processed breads 11. Antipyretics are ineffective in what types of fever? Raising of the hypothalamic set point in the CNS Result of heat production exceeding heat loss Defective heat loss Rationale: antipyretics are ineffective for 2 and 3 12. Fever accounts for 30% of office and emergency room visits? T/F 10 %- to 20% answer is false 13. Fever is the least common presenting complaint to a pediatric practice T/F Answer is False- most common complaint