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An 18-month-old child who developed upper respiratory
symptoms 1 day prior is brought to the clinic with a high
fever, chills. muscle pains, and a dry, hacking cough. A
rapid influenza test is negative and a viral culture is pend-
ing. What will the primary care pediatric nurse practitioner
d.prescribe oseltamivir and follow closely
do?
a. Consider therapy with rimantadine,
b. Hospitalize for supportive treatment.
c. Wait for cultures to determine treatment.
d..prescribe oseltamivir and follow closely
The parent of an infant asks why some vaccines, such
as MMR, are not given along with the other series of
immunizations at 2, 4. and 6 months of age. What will the
primary care pediatric nurse practitioner tell this parent?
a. The risk of adverse ettects is lower for some vaccines
after the first year. d. Maternal antibodies neutralize some vaccines and are
b. Too many vaccines at once can overwhelm the infant's delayed until 12
immune system.
c. Febrile seizures are more likely in younger infants with
some vaccines.
d. Maternal antibodies neutralize some vaccines and are
delayed until 12 months.
A school-age child has fever of 104°F, sore throat, vomit-
ing and malaise. The primary care pediatric nurse prac-
titioner observes that the tonsils, oropharynx, and palate
are erythematous and covered with exudate; the tongue is
coated and red; and there is a red, sandpaper-like rash on d. Prescribe oral amoxicillin.
the child's neck, trunk, and extremities. A rapid strep test
is positive. What will the nurse practitioner do to manage
this child's illness?
a. Administer intramuscular ceftriaxone.
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b. Refer to a pediatric infectious disease specialist.
c. Hospitalize for further diagnostic tests.
d. Prescribe oral amoxicillin.
An adolescent has a TB skin test prior to working as a
volunteer in a hospital. The adolescent is healthy and has
not travelled to or from a TB-endemic area or had close
contact with anyone who has TB. The Mantoux skin test
shows 10 mm of induration after 48 hours. What will the
primary care pediatric nurse practitioner do? a. Reassure the adolescent that this is a negative screen
a. Reassure the adolescent that this is a negative screen
b. Ask the adolescent about exposure to homeless per-
sons
c. Refer the adolescent to an infectious disease specialist.
d. Order a chest radiograph to rule out active TB.
A 2-month-old infant will receive initial immunizations,
and the parent asks about giving medications to increase
the infant's comfort and minimize fever. What will the
primary care pediatric nurse practitioner recommend?
a. Pre-treating the infant with both ibuprofen and aceta-
minophen c. Administering ibuprofen or acetaminophen as needed
b. Giving ibuprofen and acetaminophen only after the
vaccines
c. Administering ibuprofen or acetaminophen as needed
d. Avoiding antipyretics if possible, to attain better immu-
nity
A child who is immunocompromised has a fever and a
rash consisting of macules, papules, and pustules. What
will the primary care pediatric nurse practitioner do? b. Hospitalize the child for intravenous acyclovir,
a. Administer varicella immune globulin (VariZIG).
b. Hospitalize the child for intravenous acyclovir,
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c. Order intravenous immunoglobulin as an outpatient.
d. Prescribe oral acyelovir for the duration of the illness.
When reviewing a white blood cell (WBC) count. the pri-
mary care pediatric nurse practitioner suspects a viral
infection when which WBC element is elevated?
a. Bands c. Lymphocytes
b. Neutrophils
c. Lymphocytes
d. Leukocytes
A child whose family has been camping in a region with
endemic Lyme disease suttered several tick bites. The
parents report removing the ticks but are not able to verify
the type or the length of time the ticks were attached. The
child is asymptomatic. What is the best course of action? a. Teach the parents which signs and symptoms to report.
a. Teach the parents which signs and symptoms to report.
b. Administer a prophylactic single dose of doxycycline.
c. Prescribe amoxicillin three times daily for 14 to 21 days.
d. Perform serologic testing for (gG or igM antibodies.
A two month old infant has a stacatto cough and fever.
which aspect of the history is most important in determin-
ing the diagnosis?
A. Day care attendance B. Immunization History
B. Immunization history
C. Medication history
D. Past Medical history
According to recent research, which populations have
higher rates of immunizations than others?
B. People with graduate degrees
A. Asians
B. People with graduate degrees
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C. Poor people
D. People who have primary providers
The parent of a 2 month old is reluctant to have the baby
vaccinated. What is the initial step in responding to these
concerns?
a. Inform the parent that all vaccines may be given without
thimerosol
c. Question the parent's reasons for concern about immu-
b. Providing Vaccine information statements for the parent
nizations
to review
c. Question the parent's reasons for concern about immu-
nizations
d. Remind the parent that the infant is exposed to thou-
sands of germs each day.
A parent is concerned about vaccine adverse reactions.
Based on an Institute of Medicine report, what will the
primary care NP tell the parent?
a. administering multiple vaccines may trigger the devel-
opment of DM1
b. The MMR may be linked to febrile seizures in immuno-
b. The MMR may be linked to febrile seizures in immuno-
compromised children.
compromised children.
c. There is some risk of CNS disorders associated with the
Hep B vaccine.
d. Vaccines containing thimerosol are linked to pervasive
developmental disorders
Which lab value is most concerning in an infant with fever
and a suspected bacterial infection?
I. Creative protein of 11.5 mg/L
I. Creative protein of 11.5 mg/L
J. Lymphocyte count of 8.7
K. Platelet count of 475
L. White blood cell count of 14