Test Bank for Primary Care Medicine Office
Evaluation and Management of the Adult
Patient
A mother brings her 9 month infant in for a routine visit. What milestone would be appropriate for the
doctor as if the infant is meeting? - answersRolls back to stomach and stomach to back
5 day old infant comes in for newborn checkup. On assessment — skin is jaundice, anterior fontanelle is
slightly sunken, only had 2 diapers today, infant has trouble latching on, mom's first child. Bilirubin is sent
and comes back at 18. Baby is most likely having breast milk jaundice. Which nursing intervention is
required? - answersAll of above — Phototherapy, providing support and education for the lactating
mother, strict monitoring of intake and output
Excessive heat loss results in which of these:
1. RDS
2. Depletion of glucose levels
3. Jaundice
4. Increase in surfactant levels - answersDepletion of glucose levels
4 week old infant brought into ED. Mom states baby hasn't been eating well and has had decreased
diaper for 2 days. baby has been sleeping more and has been hard to wake up. On assessment, you find
that the baby is difficult to arouse, is hypotonic, and temperature is 35.4 rectal. What is an important lab
value to check? - answersBlood glucose
A part of injury prevention is making and keeping infant appointments. The required checkups and
vaccinations are at: - answers2 months, 4 months, 6 month, 9 months, and 1 year
,While interviewing the mother of an infant, you note that the mother gets frustrated as she explains that
her baby has been up all night crying at least 3 times a week for the last 2 weeks. She states that she has
tried everything and feels hopeless. What would be the BEST response from you as the nurse? -
answersYou are doing nothing wrong. This can be a common occurrence in infants and you should not
feel guilty.
The parent of a newborn infant asks the PNP when to intervene to help the infant's future intellectual
growth. What will the NP tell the parent? - answersLanguage and literacy skills begin at birth
The PNP performs a well baby examination on a 7 day old infant who is nursing well. The NP notes that
the infant weighed 3250 grams at birth and 2990 grams when discharged on the second day of life. The
infant weighs 3080 grams at this visit. Which action is correct? - answersSchedule a weight check in 1
week
During an assessment of a 4 week old infant, the PNP learns that a breastfed infant nurses every 2 hours
during the day but is able to sleep for a 4 hour period during the night. The infant has gained 20 grams
per day in the interval since last seen in the clinic. What will the NP recommend? - answersContinue to
nurse the infant using the current pattern
The PNP is performing a well baby examination on a 2 month old infant who has gained 25 grams per
day in the last interval. The mother is nursing and tells the NP that her infant seems fussy and wants to
nurse more often. What will the NP tell her? - answersthe infant may be going through an expected
growth spurt
The mother of a 6 week old breastfeeding infant tells the PNP that her baby, who previously had bowel
movement with each feeding, now has a BM once every third day. What will the NP tell her? -
answersThis may be normal for breastfed babies
The mother of a 3 month old child tells the PNP that it is "so much fun" now that her infant coos and
smiles and wants to play. What is important for the NP to teach this mother? - answersHow to read the
infants cues for overstimulation
,The parent of a 5 month old is worried b/c the infant becomes fussy but doesnt always seem interested
in nursing. What will the NP tell the parent? - answersThe infant may be expressing a desire to play or to
rest.
The mother of a 6 month old is distressed because the infant can say "dada" but not "mama" and asks
the PNP why this is when she is the one who spends more time with the infant. How will the NP
respond? - answers"At this age, your baby does not understand the meaning of sounds"
The PNP is performing a well child examination on a 9 month old infant whose hearing is normal but who
responds to verbal cues with only single syllabus vocalizations. What will the NP recommend to the
parents to improve speech and language skills in this infant? - answersRead simple board books to the
infant at bedtime
The PNP is examining a 12 month old infant who was 6 weeks premature and observes that the infant
uses a raking motion to pick up small objects. The PEDS questionnaire completed by the parent did not
show significant developmental delays. What will the NP do first? - answersPerform an in-depth
developmental assessment
Which region globally has the highest infant mortality rate? - answer Sub-Saharan Africa
What intervention is most effective for reducing child mortality from pneumonia and diarrhea? - answer
Vaccinations
What recent trend has been observed in obesity rates among 2 to 5-year-olds in the U.S.? - answer A
significant decrease.
What major child health outcome is associated with worldwide climate change? - answer Nutrition.
What is the focus of the American Academy of Pediatrics Recommendations for Preventive Pediatric
Health Care for infants? - answer Scheduling well-baby visits to coincide with key developmental
milestones.
, What does the term 'therapeutic milieu' refer to in pediatric care? - answer The place where the child is
receiving care, including personal interactions and group therapy.
What should be the placement for a 16-year-old expressing suicidal thoughts? - answer In an area where
he can be watched one-on-one.
What has been scientifically linked to learning disabilities in children? - answer Genetics.
How should behavioral challenges in a child be described to a teacher? - answer The child may be defiant
or have tantrums.
What could cause a child to revert to enuresis after four years without issues? - answer Stress.
What intervention needs may not be necessary for a caller to a crisis line? - answer Discussing the
individual's everyday activities.
When should a nurse take a child out of a seclusion room? - answer When he starts headbutting the
window.
What behaviors are included in the MacDonald Triad? - answer Enuresis, pushing others, and pyromania.
What is the correct response for a child exhibiting the MacDonald Triad? - answer Swinging a cat by the
tail, bed-wetting, and lighting paper on fire in the trash can.
What discharge planning instruction is important for a teenager with borderline personality disorder? -
answer Obtaining support from family and friends.
What intervention should a mother use to help a child with executive functioning issues? - answer
Placing visual aids on the bathroom mirror so that the child will follow the morning routine.
Evaluation and Management of the Adult
Patient
A mother brings her 9 month infant in for a routine visit. What milestone would be appropriate for the
doctor as if the infant is meeting? - answersRolls back to stomach and stomach to back
5 day old infant comes in for newborn checkup. On assessment — skin is jaundice, anterior fontanelle is
slightly sunken, only had 2 diapers today, infant has trouble latching on, mom's first child. Bilirubin is sent
and comes back at 18. Baby is most likely having breast milk jaundice. Which nursing intervention is
required? - answersAll of above — Phototherapy, providing support and education for the lactating
mother, strict monitoring of intake and output
Excessive heat loss results in which of these:
1. RDS
2. Depletion of glucose levels
3. Jaundice
4. Increase in surfactant levels - answersDepletion of glucose levels
4 week old infant brought into ED. Mom states baby hasn't been eating well and has had decreased
diaper for 2 days. baby has been sleeping more and has been hard to wake up. On assessment, you find
that the baby is difficult to arouse, is hypotonic, and temperature is 35.4 rectal. What is an important lab
value to check? - answersBlood glucose
A part of injury prevention is making and keeping infant appointments. The required checkups and
vaccinations are at: - answers2 months, 4 months, 6 month, 9 months, and 1 year
,While interviewing the mother of an infant, you note that the mother gets frustrated as she explains that
her baby has been up all night crying at least 3 times a week for the last 2 weeks. She states that she has
tried everything and feels hopeless. What would be the BEST response from you as the nurse? -
answersYou are doing nothing wrong. This can be a common occurrence in infants and you should not
feel guilty.
The parent of a newborn infant asks the PNP when to intervene to help the infant's future intellectual
growth. What will the NP tell the parent? - answersLanguage and literacy skills begin at birth
The PNP performs a well baby examination on a 7 day old infant who is nursing well. The NP notes that
the infant weighed 3250 grams at birth and 2990 grams when discharged on the second day of life. The
infant weighs 3080 grams at this visit. Which action is correct? - answersSchedule a weight check in 1
week
During an assessment of a 4 week old infant, the PNP learns that a breastfed infant nurses every 2 hours
during the day but is able to sleep for a 4 hour period during the night. The infant has gained 20 grams
per day in the interval since last seen in the clinic. What will the NP recommend? - answersContinue to
nurse the infant using the current pattern
The PNP is performing a well baby examination on a 2 month old infant who has gained 25 grams per
day in the last interval. The mother is nursing and tells the NP that her infant seems fussy and wants to
nurse more often. What will the NP tell her? - answersthe infant may be going through an expected
growth spurt
The mother of a 6 week old breastfeeding infant tells the PNP that her baby, who previously had bowel
movement with each feeding, now has a BM once every third day. What will the NP tell her? -
answersThis may be normal for breastfed babies
The mother of a 3 month old child tells the PNP that it is "so much fun" now that her infant coos and
smiles and wants to play. What is important for the NP to teach this mother? - answersHow to read the
infants cues for overstimulation
,The parent of a 5 month old is worried b/c the infant becomes fussy but doesnt always seem interested
in nursing. What will the NP tell the parent? - answersThe infant may be expressing a desire to play or to
rest.
The mother of a 6 month old is distressed because the infant can say "dada" but not "mama" and asks
the PNP why this is when she is the one who spends more time with the infant. How will the NP
respond? - answers"At this age, your baby does not understand the meaning of sounds"
The PNP is performing a well child examination on a 9 month old infant whose hearing is normal but who
responds to verbal cues with only single syllabus vocalizations. What will the NP recommend to the
parents to improve speech and language skills in this infant? - answersRead simple board books to the
infant at bedtime
The PNP is examining a 12 month old infant who was 6 weeks premature and observes that the infant
uses a raking motion to pick up small objects. The PEDS questionnaire completed by the parent did not
show significant developmental delays. What will the NP do first? - answersPerform an in-depth
developmental assessment
Which region globally has the highest infant mortality rate? - answer Sub-Saharan Africa
What intervention is most effective for reducing child mortality from pneumonia and diarrhea? - answer
Vaccinations
What recent trend has been observed in obesity rates among 2 to 5-year-olds in the U.S.? - answer A
significant decrease.
What major child health outcome is associated with worldwide climate change? - answer Nutrition.
What is the focus of the American Academy of Pediatrics Recommendations for Preventive Pediatric
Health Care for infants? - answer Scheduling well-baby visits to coincide with key developmental
milestones.
, What does the term 'therapeutic milieu' refer to in pediatric care? - answer The place where the child is
receiving care, including personal interactions and group therapy.
What should be the placement for a 16-year-old expressing suicidal thoughts? - answer In an area where
he can be watched one-on-one.
What has been scientifically linked to learning disabilities in children? - answer Genetics.
How should behavioral challenges in a child be described to a teacher? - answer The child may be defiant
or have tantrums.
What could cause a child to revert to enuresis after four years without issues? - answer Stress.
What intervention needs may not be necessary for a caller to a crisis line? - answer Discussing the
individual's everyday activities.
When should a nurse take a child out of a seclusion room? - answer When he starts headbutting the
window.
What behaviors are included in the MacDonald Triad? - answer Enuresis, pushing others, and pyromania.
What is the correct response for a child exhibiting the MacDonald Triad? - answer Swinging a cat by the
tail, bed-wetting, and lighting paper on fire in the trash can.
What discharge planning instruction is important for a teenager with borderline personality disorder? -
answer Obtaining support from family and friends.
What intervention should a mother use to help a child with executive functioning issues? - answer
Placing visual aids on the bathroom mirror so that the child will follow the morning routine.
