FNP 593 Final Exam Questions and Verified
Answers
Question 1
The primary care pediatric nurse practitioner diagnoses acute otitis media in a 2-year-
old child who has a history of three ear infections in the first 6 months of life. The
child's tympanic membrane is intact and the child has a temperature of 101.5°F. What
will the nurse practitioner prescribe for this child?
a. Amoxicillin twice daily for 10 days
b. An analgesic medication and watchful waiting c. Antibiotic ear drops and ibuprofen
d. Ceftriaxone given once intramuscularly
Correct Answer
b. An analgesic medication and watchful waiting
Question 2
A complete blood count on a 12-month-old infant reveals microcytic, hypochromic
anemia with a hemoglobin of 9.5 g/dL. The infant has mild pallor with no
hepatosplenomegaly. The primary care pediatric nurse practitioner suspects
a. hereditary spherocytosis.
b. iron-deficiency anemia.
c. lead intoxication.
d. sickle-cell anemia.
Correct Answer
b. iron-deficiency anemia.
Page 1 of 125
,Question 3
An 8-yea-rold child is diagnosed with systemic lupus erythematosus (SLE), and the
child's parent asks if there is a cure. What will the primary care pediatric nurse
practitioner tell the parent?
a. Complete remission occurs in some children at the age of puberty.
b. Periods of remission may occur but there is no permanent cure.
c. SLE can be cured with effective medication and treatment.
d. The disease is always progressive with no cure and no remissions.
Correct Answer
b. Periods of remission may occur but there is no permanent cure.
Question 4
During a well child assessment of an infant, the primary care pediatric nurse
practitioner (NP) notes a dark red-brown light reflex in the left eye and a slightly
brighter, red-orange light reflex in the right eye. What will the nurse practitioner do
next?
a. dilate the pupils and reassess the red reflex.
b. order auto-refractor screening of the eyes.
c. recheck the red reflex in 1 month.
d. refer the infant to an ophthalmologist.
Correct Answer
d. refer the infant to an ophthalmologist.
Question 5
A school-age child has an abrupt onset of sore throat, nausea, headache, and a
temperature of 102.3°F. An examination reveals petechiae on the soft palate, beefy-
red tonsils with yellow exudate, and a scarlatiniform rash. A Rapid Antigen Detection
Test (RADT) is negative. What
is the next step in management for this child?
a. Consider a sexual abuse diagnosis.
b. Obtain an anti-streptococcal antibody titer.
c. Perform a follow-up throat culture.
d. Prescribe amoxicillin for 10 days.
Correct Answer
c. Perform a follow-up throat culture.
Page 2 of 125
,Question 6
After 14 days of treatment with amoxicillin 45 mg/kg/day for acute rhinosinusitis, a
child continues to have mucopurulent nasal discharge along with induration, swelling,
and erythema of both eyelids. What is the next course of treatment?
a. Amoxicillin 80 mg/kg/day for 14 days
b. Amoxicillin-clavulanate for 10 to 14 days
c. Antibiotic ophthalmic drops for 5 to 7 days
d. Referral to a pediatric otolaryngologist
Correct Answer
d. Referral to a pediatric otolaryngologist
Question 7
The primary care pediatric nurse practitioner observes a tender, swollen red furuncle
on the upper lid margin of a child's eye. What treatment will the nurse practitioner
recommend?
a. Culture of the lesion to determine causative organism
b. Referral to ophthalmology for incision and drainage
c. Topical steroid medication
d. Warm, moist compresses 3 to 4 times daily
Correct Answer
d. Warm, moist compresses 3 to 4 times daily
Question 8
A 10-year-old child has a 1-week history of fever of 104°F that is unresponsive to
antipyretics. The primary care pediatric nurse practitioner examines the child and
notes bilateral conjunctival injection and a polymorphous exanthema, with no other
symptoms. Lab tests show elevated ESR, CRP, and platelets. Cultures are all negative.
What will the nurse practitioner do?
a. Begin treatment with intravenous methyl prednisone.
b. Consider IVIG therapy if symptoms persist one more week.
c. Order a baseline echocardiogram today and another in 2 weeks.
d. Reassure the child's parents that this is a selflimiting disorder.
Correct Answer
c. Order a baseline echocardiogram today and another in 2 weeks. (Possible atypical
Kawasaki disease)
Page 3 of 125
, Question 9
An 8-year-old boy has a recent history of an upper respiratory infection and comes to
the clinic with a maculopapular rash on his lower extremities and swelling and
tenderness in both ankles. The pediatric nurse practitioner performs a UA, which
shows proteinuria and hematuria and diagnoses Henoch-Schönlein Purpura (HSP).
What ongoing evaluation will the nurse practitioner perform during the course of this
disease?
a. ANA titers
b. Blood pressure measurement
c. Chest radiographs
d. Liver function studies
Correct Answer
b. Blood pressure measurement
Question 10
The parent of a newborn reports using echinacea for family members to help treat
viral illnesses and feels that it is usually effective. What will the primary care pediatric
nurse practitioner tell this parent?
a. That echinacea has no known therapeutic effects and should not be given
b. That the supplement should not be given to children under 2 years of age
c. To give half the recommended adult dose until the child is 5 years old
d. To wait until the infant is at least 1 month old before giving this product
Correct Answer
b. That the supplement should not be given to children under 2 years of age
Question 11
The primary care pediatric nurse practitioner examines a child who has had stiffness
and warmth in the right knee and left ankle for 7 or 8 months but no back pain. The
nurse practitioner will refer the child to a rheumatology specialist to evaluate for
a. enthesitisrelated JIA.
b. oligoarticular JIA.
c. polyarticular JIA.
d. systemic JIA.
Correct Answer
b. oligoarticular JIA.
Page 4 of 125
Answers
Question 1
The primary care pediatric nurse practitioner diagnoses acute otitis media in a 2-year-
old child who has a history of three ear infections in the first 6 months of life. The
child's tympanic membrane is intact and the child has a temperature of 101.5°F. What
will the nurse practitioner prescribe for this child?
a. Amoxicillin twice daily for 10 days
b. An analgesic medication and watchful waiting c. Antibiotic ear drops and ibuprofen
d. Ceftriaxone given once intramuscularly
Correct Answer
b. An analgesic medication and watchful waiting
Question 2
A complete blood count on a 12-month-old infant reveals microcytic, hypochromic
anemia with a hemoglobin of 9.5 g/dL. The infant has mild pallor with no
hepatosplenomegaly. The primary care pediatric nurse practitioner suspects
a. hereditary spherocytosis.
b. iron-deficiency anemia.
c. lead intoxication.
d. sickle-cell anemia.
Correct Answer
b. iron-deficiency anemia.
Page 1 of 125
,Question 3
An 8-yea-rold child is diagnosed with systemic lupus erythematosus (SLE), and the
child's parent asks if there is a cure. What will the primary care pediatric nurse
practitioner tell the parent?
a. Complete remission occurs in some children at the age of puberty.
b. Periods of remission may occur but there is no permanent cure.
c. SLE can be cured with effective medication and treatment.
d. The disease is always progressive with no cure and no remissions.
Correct Answer
b. Periods of remission may occur but there is no permanent cure.
Question 4
During a well child assessment of an infant, the primary care pediatric nurse
practitioner (NP) notes a dark red-brown light reflex in the left eye and a slightly
brighter, red-orange light reflex in the right eye. What will the nurse practitioner do
next?
a. dilate the pupils and reassess the red reflex.
b. order auto-refractor screening of the eyes.
c. recheck the red reflex in 1 month.
d. refer the infant to an ophthalmologist.
Correct Answer
d. refer the infant to an ophthalmologist.
Question 5
A school-age child has an abrupt onset of sore throat, nausea, headache, and a
temperature of 102.3°F. An examination reveals petechiae on the soft palate, beefy-
red tonsils with yellow exudate, and a scarlatiniform rash. A Rapid Antigen Detection
Test (RADT) is negative. What
is the next step in management for this child?
a. Consider a sexual abuse diagnosis.
b. Obtain an anti-streptococcal antibody titer.
c. Perform a follow-up throat culture.
d. Prescribe amoxicillin for 10 days.
Correct Answer
c. Perform a follow-up throat culture.
Page 2 of 125
,Question 6
After 14 days of treatment with amoxicillin 45 mg/kg/day for acute rhinosinusitis, a
child continues to have mucopurulent nasal discharge along with induration, swelling,
and erythema of both eyelids. What is the next course of treatment?
a. Amoxicillin 80 mg/kg/day for 14 days
b. Amoxicillin-clavulanate for 10 to 14 days
c. Antibiotic ophthalmic drops for 5 to 7 days
d. Referral to a pediatric otolaryngologist
Correct Answer
d. Referral to a pediatric otolaryngologist
Question 7
The primary care pediatric nurse practitioner observes a tender, swollen red furuncle
on the upper lid margin of a child's eye. What treatment will the nurse practitioner
recommend?
a. Culture of the lesion to determine causative organism
b. Referral to ophthalmology for incision and drainage
c. Topical steroid medication
d. Warm, moist compresses 3 to 4 times daily
Correct Answer
d. Warm, moist compresses 3 to 4 times daily
Question 8
A 10-year-old child has a 1-week history of fever of 104°F that is unresponsive to
antipyretics. The primary care pediatric nurse practitioner examines the child and
notes bilateral conjunctival injection and a polymorphous exanthema, with no other
symptoms. Lab tests show elevated ESR, CRP, and platelets. Cultures are all negative.
What will the nurse practitioner do?
a. Begin treatment with intravenous methyl prednisone.
b. Consider IVIG therapy if symptoms persist one more week.
c. Order a baseline echocardiogram today and another in 2 weeks.
d. Reassure the child's parents that this is a selflimiting disorder.
Correct Answer
c. Order a baseline echocardiogram today and another in 2 weeks. (Possible atypical
Kawasaki disease)
Page 3 of 125
, Question 9
An 8-year-old boy has a recent history of an upper respiratory infection and comes to
the clinic with a maculopapular rash on his lower extremities and swelling and
tenderness in both ankles. The pediatric nurse practitioner performs a UA, which
shows proteinuria and hematuria and diagnoses Henoch-Schönlein Purpura (HSP).
What ongoing evaluation will the nurse practitioner perform during the course of this
disease?
a. ANA titers
b. Blood pressure measurement
c. Chest radiographs
d. Liver function studies
Correct Answer
b. Blood pressure measurement
Question 10
The parent of a newborn reports using echinacea for family members to help treat
viral illnesses and feels that it is usually effective. What will the primary care pediatric
nurse practitioner tell this parent?
a. That echinacea has no known therapeutic effects and should not be given
b. That the supplement should not be given to children under 2 years of age
c. To give half the recommended adult dose until the child is 5 years old
d. To wait until the infant is at least 1 month old before giving this product
Correct Answer
b. That the supplement should not be given to children under 2 years of age
Question 11
The primary care pediatric nurse practitioner examines a child who has had stiffness
and warmth in the right knee and left ankle for 7 or 8 months but no back pain. The
nurse practitioner will refer the child to a rheumatology specialist to evaluate for
a. enthesitisrelated JIA.
b. oligoarticular JIA.
c. polyarticular JIA.
d. systemic JIA.
Correct Answer
b. oligoarticular JIA.
Page 4 of 125
