NU664A FINAL EXAM 2026 EXAM
PREPARATION PACK KEY CLINICAL DECISION
MAKING EVIDENCE BASED PRACTICE AND
PATIENT MANAGEMENT WITH SAMPLE
QUESTIONS
◉ A child is brought to the clinic with a generalized annular rash
characterized by raised wheals with pale centers. On PE, the child's
lungs are clear and there is no peripheral edema. A history reveals
ingestion of strawberries earlier in the day. What is the initial
treatment? Answer: Diphenhydramine .05-1 mg/kg/dose every 4-6
hours
◉ A child who has been diagnosed with asthma for several years has
been using a short-acting Beta-agonist (SABA) to control symptoms.
The PNP learns that the child has recently begun using the SABA 2-3
times each week to prevent wheezing and shortness of breath. The
child currently has clear breath sounds and an FEV1 of 75% of
personal best. What will the NP do? Answer: Add an inhaled
corticosteroid.
◉ A child has fever and arthralgia. The PNP learns that the child had
a sore throat 3 weeks prior and auscultates a murmur in the clinic.
§What test will the PNP order? Answer: ASO titer
,◉ A child has an area of inflammation on the neck that began after
wearing a hand knitted woolen sweater. On examination, the skin
appears chafed with mild erythematous patches. The lesions are not
pruritic. Answer: Topical corticosteroids applied 2-3 times QD.
◉ RBCs disorders Answer: Anemia, Sickle-cell anemia, Hemolytic
disease of the newborn
◉ WBCs disorders Answer: Neutropenia, Cancer
◉ Platelets/Coagulation function disorders Answer: ITP-Hemophilia
A,B and von Willebrand's
◉ A 9 month old infant is brought to the clinic today by her parents
for her well check. A finger stick lead is completed with a result of 6
micrograms/deciliter (mcg/dl). The parents ask if this is fine. What
will the PNP do? Answer: We will need to repeat this lab through
venipuncture at a local laboratory.
◉ A complete blood count on a 12-month old infant reveals
microcytic hypochromic anemia with a Hgb of 9.5 g/dL. The infant
has mild pallor with not hepatosplenomegaly. The PNP suspects:
Answer: Iron-deficiency anemia
, ◉ A toddler who presents with anemia and reticulocytopenia has a
history of a decrease in energy and increase in pallor beginning after
a recent viral infection. How will the PNP treat this child? Answer:
Closely observe the child's symptoms and lab values
◉ The PNP evaluates a 5 yo who presents to the office with pallor
and reveals a Hgb of 8.5 g/dL and Hct of 31%. How would this
patient be managed? Answer: Prescribe elemental iron and recheck
labs in one month
◉ The PNP is managing care for a child diagnosed with iron-
deficiency anemia who has an initial hemoglobin of 8.8 g/dL and
hematocrit of 32% who has been receiving ferrous sulfate as
3mg/kg/day of elemental iron for 4 weeks. The child's current lab
work reveals elevations in Hgb/Hct and reticulocytes with a H/H
10.5/36. What is the next step of management? Answer: Continue
current dose of ferrous sulfate and recheck labs in 1-2 months
◉ sickle cell disease Answer: §Complex chronic disorder
characterized by hemolysis, unpredictable acute complications that
may become life threatening-chronic organ damage.
§Autosomal recessive in heritance pattern
§Routine newborn screening identifies most children.
PREPARATION PACK KEY CLINICAL DECISION
MAKING EVIDENCE BASED PRACTICE AND
PATIENT MANAGEMENT WITH SAMPLE
QUESTIONS
◉ A child is brought to the clinic with a generalized annular rash
characterized by raised wheals with pale centers. On PE, the child's
lungs are clear and there is no peripheral edema. A history reveals
ingestion of strawberries earlier in the day. What is the initial
treatment? Answer: Diphenhydramine .05-1 mg/kg/dose every 4-6
hours
◉ A child who has been diagnosed with asthma for several years has
been using a short-acting Beta-agonist (SABA) to control symptoms.
The PNP learns that the child has recently begun using the SABA 2-3
times each week to prevent wheezing and shortness of breath. The
child currently has clear breath sounds and an FEV1 of 75% of
personal best. What will the NP do? Answer: Add an inhaled
corticosteroid.
◉ A child has fever and arthralgia. The PNP learns that the child had
a sore throat 3 weeks prior and auscultates a murmur in the clinic.
§What test will the PNP order? Answer: ASO titer
,◉ A child has an area of inflammation on the neck that began after
wearing a hand knitted woolen sweater. On examination, the skin
appears chafed with mild erythematous patches. The lesions are not
pruritic. Answer: Topical corticosteroids applied 2-3 times QD.
◉ RBCs disorders Answer: Anemia, Sickle-cell anemia, Hemolytic
disease of the newborn
◉ WBCs disorders Answer: Neutropenia, Cancer
◉ Platelets/Coagulation function disorders Answer: ITP-Hemophilia
A,B and von Willebrand's
◉ A 9 month old infant is brought to the clinic today by her parents
for her well check. A finger stick lead is completed with a result of 6
micrograms/deciliter (mcg/dl). The parents ask if this is fine. What
will the PNP do? Answer: We will need to repeat this lab through
venipuncture at a local laboratory.
◉ A complete blood count on a 12-month old infant reveals
microcytic hypochromic anemia with a Hgb of 9.5 g/dL. The infant
has mild pallor with not hepatosplenomegaly. The PNP suspects:
Answer: Iron-deficiency anemia
, ◉ A toddler who presents with anemia and reticulocytopenia has a
history of a decrease in energy and increase in pallor beginning after
a recent viral infection. How will the PNP treat this child? Answer:
Closely observe the child's symptoms and lab values
◉ The PNP evaluates a 5 yo who presents to the office with pallor
and reveals a Hgb of 8.5 g/dL and Hct of 31%. How would this
patient be managed? Answer: Prescribe elemental iron and recheck
labs in one month
◉ The PNP is managing care for a child diagnosed with iron-
deficiency anemia who has an initial hemoglobin of 8.8 g/dL and
hematocrit of 32% who has been receiving ferrous sulfate as
3mg/kg/day of elemental iron for 4 weeks. The child's current lab
work reveals elevations in Hgb/Hct and reticulocytes with a H/H
10.5/36. What is the next step of management? Answer: Continue
current dose of ferrous sulfate and recheck labs in 1-2 months
◉ sickle cell disease Answer: §Complex chronic disorder
characterized by hemolysis, unpredictable acute complications that
may become life threatening-chronic organ damage.
§Autosomal recessive in heritance pattern
§Routine newborn screening identifies most children.
