NR 328 Exam
Pediatric Nursing NR 328 Exam 2 PREDICTOR
VERIFIED QUESTIONS AND CORRECT
DETAILED ANSWERS ALREADY GRADED A+.
100% Verified Solutions | Updated Per Latest
Guidelines | Graded A+
1. A child who had GABHS 2 weeks prior is in the clinic with periorbital edema, dyspnea, and
elevated
blood pressure. A urinalysis reveals tea-colored urine with hematuria and mild proteinuria.
What will
the primary care pediatric nurse practitioner do to manage this condition?
a. Prescribe a 10- to 14-day course of high-dose amoxicillin.
b. Prescribe high-dose steroids in consultation with a nephrologist.
A+ TEST BANK 1
, NR 328 Exam
c. Reassure the parents that this condition will resolve spontaneously.
d. Refer the child to a pediatric nephrologist for hospitalization. –
Correct Answer :ANS: D
This child has symptoms of post-streptococcal glomerulonephritis and signs indicating a need
for
hospitalization: elevated BP, edema, and dyspnea. The PNP should refer the child to a
nephrologist for
hospital admission and care. Amoxicillin is not indicated; this condition is an immunologic
response to
GABHS and not an infection. Steroids are not effective in treating this disease. Although the
condition
usually does self-resolve, the child needs hospitalization for close monitoring and follow-up.
2. An adolescent has right-sided flank pain without fever. A dipstick urinalysis reveals gross
hematuria
without signs of infection or bacteriuria, and the primary care pediatric nurse practitioner
diagnoses
possible nephrolithiasis. What is the initial treatment for this condition?
a. Extracorporeal shockwave lithotripsy (ESWL)
b. Increasing fluid intake up to 2 L daily
A+ TEST BANK 2
, NR 328 Exam
c. Percutaneous removal of renal calculi
d. Referral to a pediatric nephrologist –
Correct Answer :ANS: B
The first line of therapy for all stone types is increasing fluids. ESWL may be indicated if
symptoms
worsen and stones are not passed. Percutaneous removal of renal calculi and referral to
nephrology may
be indicated with worsening symptoms.
3. A 9-month-old infant with a history of three urinary tract infections is diagnosed with grade
II
vesicoureteral reflux. Which medication will be prescribed?
a. Amoxicillin 10 mg/kg as a single daily dose
b. Ceftriaxone IM 50 mg/kg as a single daily dose
c. Nitrofurantoin 1-2 mg/kg as a single daily dose
d. TMP-SMX; TMP 2 mg/kg as a single daily dose –
Correct Answer :ANS: D
TMP-SMX is a first-line medication for grade II VUR prophylaxis. TMP-SMX: TMP 2 mg/kg as a
single
A+ TEST BANK 3
, NR 328 Exam
daily dose or 5 mg/kg twice/wk (based on TMP component) if older than 1 month.Amoxicillin
is a first-
line treatment in infants younger than 2 months. It is not necessary to give IM medications.
Nitrofurantoin
is expensive and poorly tolerated.
4. A healthy 14-year-old female has a dipstick urinalysis that is positive for 5-6 RBCs per hpf but
otherwise normal. What is the first question the primary care pediatric nurse practitioner will
ask this
patient?
a. "Are you sexually active?"
b. "Are you taking any medications?"
c. "Have you had a recent fever?"
d. "When was your last menstrual period (LMP)?" –
Correct Answer :ANS: D
Menstrual blood may appear in urine and is a common cause of urine with RBCs present, so
this would be
an appropriate first question of an adolescent. Asking about sexual activity or recent fevers
may be part of
the diagnostic reasoning if common causes are not present. Medications may discolor the
urine but do not
cause RBCs to be present.
A+ TEST BANK 4
Pediatric Nursing NR 328 Exam 2 PREDICTOR
VERIFIED QUESTIONS AND CORRECT
DETAILED ANSWERS ALREADY GRADED A+.
100% Verified Solutions | Updated Per Latest
Guidelines | Graded A+
1. A child who had GABHS 2 weeks prior is in the clinic with periorbital edema, dyspnea, and
elevated
blood pressure. A urinalysis reveals tea-colored urine with hematuria and mild proteinuria.
What will
the primary care pediatric nurse practitioner do to manage this condition?
a. Prescribe a 10- to 14-day course of high-dose amoxicillin.
b. Prescribe high-dose steroids in consultation with a nephrologist.
A+ TEST BANK 1
, NR 328 Exam
c. Reassure the parents that this condition will resolve spontaneously.
d. Refer the child to a pediatric nephrologist for hospitalization. –
Correct Answer :ANS: D
This child has symptoms of post-streptococcal glomerulonephritis and signs indicating a need
for
hospitalization: elevated BP, edema, and dyspnea. The PNP should refer the child to a
nephrologist for
hospital admission and care. Amoxicillin is not indicated; this condition is an immunologic
response to
GABHS and not an infection. Steroids are not effective in treating this disease. Although the
condition
usually does self-resolve, the child needs hospitalization for close monitoring and follow-up.
2. An adolescent has right-sided flank pain without fever. A dipstick urinalysis reveals gross
hematuria
without signs of infection or bacteriuria, and the primary care pediatric nurse practitioner
diagnoses
possible nephrolithiasis. What is the initial treatment for this condition?
a. Extracorporeal shockwave lithotripsy (ESWL)
b. Increasing fluid intake up to 2 L daily
A+ TEST BANK 2
, NR 328 Exam
c. Percutaneous removal of renal calculi
d. Referral to a pediatric nephrologist –
Correct Answer :ANS: B
The first line of therapy for all stone types is increasing fluids. ESWL may be indicated if
symptoms
worsen and stones are not passed. Percutaneous removal of renal calculi and referral to
nephrology may
be indicated with worsening symptoms.
3. A 9-month-old infant with a history of three urinary tract infections is diagnosed with grade
II
vesicoureteral reflux. Which medication will be prescribed?
a. Amoxicillin 10 mg/kg as a single daily dose
b. Ceftriaxone IM 50 mg/kg as a single daily dose
c. Nitrofurantoin 1-2 mg/kg as a single daily dose
d. TMP-SMX; TMP 2 mg/kg as a single daily dose –
Correct Answer :ANS: D
TMP-SMX is a first-line medication for grade II VUR prophylaxis. TMP-SMX: TMP 2 mg/kg as a
single
A+ TEST BANK 3
, NR 328 Exam
daily dose or 5 mg/kg twice/wk (based on TMP component) if older than 1 month.Amoxicillin
is a first-
line treatment in infants younger than 2 months. It is not necessary to give IM medications.
Nitrofurantoin
is expensive and poorly tolerated.
4. A healthy 14-year-old female has a dipstick urinalysis that is positive for 5-6 RBCs per hpf but
otherwise normal. What is the first question the primary care pediatric nurse practitioner will
ask this
patient?
a. "Are you sexually active?"
b. "Are you taking any medications?"
c. "Have you had a recent fever?"
d. "When was your last menstrual period (LMP)?" –
Correct Answer :ANS: D
Menstrual blood may appear in urine and is a common cause of urine with RBCs present, so
this would be
an appropriate first question of an adolescent. Asking about sexual activity or recent fevers
may be part of
the diagnostic reasoning if common causes are not present. Medications may discolor the
urine but do not
cause RBCs to be present.
A+ TEST BANK 4
