MN580 MIDTERM EXAM REVIEW QUESTIONS WITH ANSWERS LATEST UPDATE (GRADED A+)

MN580 MIDTERM EXAM REVIEW QUESTIONS WITH ANSWERS LATEST UPDATE (GRADED A+)The primary care pediatric nurse practitioner orders a pulmonology consult for a child who has severe asthma. The nurse practitioner writes “child with asthma refractory to conventional treatments needs suggestions for alternative treatments.” The nurse practitioner expects the pulmonologist to A. confirm the medical diagnosis for the child’s parents. B. make recommendations for disease management. Correct C. stress the importance of adherence to the medication regimen. D. take over management of this child’s chronic illness. 6. The parent of an 18monthold child calls the clinic to report that the child has a rectal temperature of 100.4°F (38°C). The child is playing normally, taking fluids well, and has a slightly reduced appetite. What will the primary care pediatric nurse practitioner recommend? A. Administering an antipyretic medication B. Bringing the child to the clinic for evaluation C. Offering extra fluids and calling if symptoms change Correct D. Ordering outpatient lab work such as a CBC 7. The primary care pediatric nurse practitioner is evaluating a 10yearold child who is describing shooting pain in both legs associated with aching, tingling, and burning. The child is unable to pinpoint specific locations for this pain. Which type of pain does the nurse practitioner suspect? A. Chronic pain B. Neuropathic pain Correct C. Somatic pain D Visceral pain 8. A 3yearold child is recovering from injuries sustained in a motor vehicle accident. How will the primary care pediatric nurse practitioner evaluate this child’s pain? A. Ask the child to rate pain intensity on a 4 to 5 item pain discrimination scale. B. Have the child describe any pain as “no pain, a little pain, or a lot of pain.” Correct C. Question the child about the intensity and specific location of any pain. D. Rely on nonverbal responses such as facial expressions and limb movements. 9. A 4yearold child has just been released from the hospital after orthopedic surgery on one leg following a bicycle accident. The child is sitting quietly on the exam table. When asked to rate pain, the child points to the “1” on a faces rating pain scale. What will the primary care pediatric nurse practitioner do next? A. Assess the child’s vital signs and ability to walk without pain. Correct B. Refill the prescription for a narcotic analgesic medication. C. Suggest that the parents give acetaminophen for mild pain. D. Teach the parent to give analgesics based on the child’s report of pain. 10. A developmentally and cognitively disabled 10yearold child who is unable to communicate must undergo a series of surgeries, and the child’s parent asks how to know if the child is in pain and when to give pain medication. What will the primary care pediatric nurse practitioner teach this parent to use to assess this child’s pain? A. Comfort scale B. FLACC scale C. NCCPCR Correct D. Nonverbal observations 11. The primary care pediatric nurse practitioner is preparing to perform a painful procedure on a 4monthold infant. Besides providing local anesthesia, what other pain control method provides analgesic effects? A. Providing toys B. Singing or music C. Sucrose solution Correct D. Swaddling or cuddling 12. An adolescent female reports moderate dysmenorrhea with periods and tells the primary care pediatric nurse practitioner that 400 mg ibuprofen every 6 to 8 completely control her pain. What will the nurse practitioner recommend? A. Increasing the ibuprofen dose to 600 to 800 mg every 6 to 8 hours B. Taking extra strength acetaminophen 1000 mg every 4 to 6 hours C. Taking naproxen 500 mg initially and then 250 mg every 6 to 8 hours correct D. Using extended release naproxen 500 mg every 12 hours 13. What is the most important dose limiting factor when prescribing acetaminophen with hydrocodone? A. Acetaminophen dose Correct B. Gastrointestinal side effects C. Pruritis symptoms D. Urinary retention 14. An adolescent takes ibuprofen, acetaminophen, and a tricyclic antidepressant (TCA) to treat phantom limb pain and reports that the medications are no longer effective. What will the primary care pediatric nurse practitioner do? A. Change the TCA to a selective serotonin reuptake inhibitor. B. Evaluate the adolescent for drug seeking behavior. C. Increase the TCA dose and reevaluate in 2 to 3 weeks. D. Refer the adolescent to a pain management specialist. Correct 15. The parent of a school age child with a chronic pain condition tells the primary care pediatric nurse practitioner that the child has requested to stay home from school more often in the past few months. The child’s exam does not reveal any significant change in pathology, and a review of the child’s medications indicates appropriate dosing of analgesic medications. What will the nurse practitioner recommend? A. Assessing the child’s pain every day to determine changes B. Ensuring the child stays quiet in bed with videos when having pain C. Having the child do homework when staying home from school Correct MN580 MIDTERM EXAM D. Requiring the child to go to school even during pain episodes 16. The parent of a 2weekold infant reports that the infant was diagnosed with transient tachypnea of the newborn shortly after birth. The primary care pediatric nurse practitioner understands that, in this condition, A. antibiotic therapy is generally necessary to prevent severe infection. B. home oxygen therapy is needed until the infant grows out of the condition. C. recovery is usually complete with minimal intervention and treatments. Correct D. treatment with exogenous surfactant and mechanical ventilation is needed. 17. A 2monthold infant has a staccato cough and fever. Which aspect of the history is most important in determining the diagnosis? A. Day care attendance B. Immunization history Correct C. Medication history D. Past medical history 18. According to recent research, which populations may have higher rates of under immunization than others? A. Those with higher rates of Asians B. Those with higher rates of graduate degrees Correct C. Those with lower rates of poverty D. Those with lower rates of primary providers 19. The parent of a 2monthold infant is reluctant to have the baby vaccinated. What is an initial step in responding to these concerns. A. Inform the parent that all vaccines may be given without thimerosol. B. Providing Vaccine Information Statements for the parent to review. C. Question the parent’s reasons for concern about immunizations. Correct D. Remind the parent that the infant is exposed to thousands of germs each day. MN580 MIDTERM EXAM 20. A parent is concerned about vaccine adverse reactions. Based on an Institute of Medicine report, what will the primary care pediatric nurse practitioner tell the parent? A. Administering multiple vaccines may trigger the development of type 1 diabetes. B. The MMR may be linked to febrile seizures in immunocompromised children. Correct C. There is some risk of CNS disorders associated with the hepatitis B vaccine. D. Vaccines containing thimerosol are linked to pervasive developmental disorders. 21. A 2monthold infant will receive initial immunizations, and the parent asks about giving medications to increase the infant’s comfort and minimize fever. What will the pediatric nurse practitioner recommend? A. Administering ibuprofen or acetaminophen as needed Correct B. Avoiding antipyretics if possible to attain better immunity C. Giving ibuprofen and acetaminophen only after the vaccines D. Pretreating the infant with both ibuprofen and acetaminophen 22. The primary care pediatric nurse practitioner reviews the immunization records of an 18monthold child and notes that the child received an MMR immunization 2 days prior to the first birthday. What will the nurse practitioner do? A. Administer a reduced dose of MMR to ensure adequate immunity. B. Obtain mumps, measles, and rubella titers to determine immunity. C. Recommend the next dose of MMR vaccine at 4 to 5 years of age. Correct D. Repeat the MMR vaccine since the first dose was given too soon