Nrnp 6541 Midterm Exam Questions With 100% Correct Answers | Latest Update 2023/2024 (Graded)

The nurse practitioner role was initially established to Improve access to care and partially saw physician shortage 44. An 8-year-old female is brought into the office by her mother. She has complaints of fever and sore throat for the past 2 days. She denies difficulty swallowing but has loss of appetite and mild diarrhea. A few classmates have similar symptoms. A review of systems reveals clear nasal drainage, dry cough, and hoarseness. On exam she has a 101.5 temperature, 3+ erythematous tonsils, and anterior cervical lymphadenopathy. What is the likely diagnosis? Viral pharyngitis (NOT- Strep pharyngitis) 45. Josh, age 13, has some enlargement of the scrotum and testes, a reddened scrotal sac, and some hair texture alteration. His penis is not enlarged. He is in Tanner stage II 46. Mark is in the exam room. You are concerned he may have epiglottitis. In what position do these patients prefer to sit? Sitting up and leaning forward 47. Hannah, age 4, is brought into the office by her father. She complains of a sore throat, difficulty swallowing, copious oral secretions, stridor, and a temperature of 102F. She does not have pharyngeal erythema or cough. What do you suspect? Epiglottitis 48. John is diagnosed with allergic conjunctivitis. What type of discharge do you expect to see upon exam? Clear, watery discharge 49. The first sign of the onset of female puberty is usually: Breast buds 50. A 6- month-old infant has been growing poorly. His parents have changed his formula three times without success. His examination is remarkable for a pale, emaciated child with little subcutaneous fat and anterior fontanelle fullness. His laboratory test results are notable for a hemolytic anemia and prolonged bleeding times. Which of the following is the most appropriate next step? Obtain a sweat chloride concentration The patient appears to have failure to thrive, with deficiencies of vitamin K (bleeding problems), vitamin A (fontanelle fullness), and vitamin E (hemolytic anemia). Cystic fibrosis (associated with vitamin malabsorption) would explain this condition. 51. Which of the following statements about "routine" screening tests is true? 52. A mother of a 6-month-old asks you about normal sleep patterns for an infant this age. The best response is: 10 hours at night and 3-4 hours during the day/ 2 or 3 naps during the day. 53. A Mantoux test in a child with no risk factors is considered positive with a reaction of: At least 15 MM induration 54. Which is the correct order for introduction of solid foods to an infant? Cereal, vegetables, fruits, and meats 55. Initial screening tests for an 11-year-old with a family history of hyperlipidemia and weight at the 97th percentile include: Lipid screening (NOT-Fasting glucose, postprandial, fasting lipid profile) 56. Luke, a 17-month-old, failed treatment with amoxicillin for otitis media. At the two-week recheck, his TM was still erythematous and you cannot see the landmarks. He has persistent nasal congestion, he is not sleeping at night, and he has a 101F fever. What is the next best step for Luke? A 10-day course of Augmentin ( NOT- Ceftriaxone and an antihistamine) 57. A 2-year-old boy has been slightly less than the 50th percentile for weight, height and head circumference, but in the last 6 months he has fallen to slightly less than the 25th percentile for weight. The pregnancy was normal, his development is as expected, and the family reports no psychosocial problems. The mother says that he is now a finicky eater (wants only macaroni and cheese at all meals), but she insists that he eat a variety of foods. The meals are marked by much frustration for everyone. His examination is normal. Which of the following is the best next step in his care? Reassurance and counseling for family about childhood normal develop- mental stage (NOT-Sweat chloride testing) 58. The parent of a 2-year-old tells you her daughter recently started having breath-holding spells. She tells you the older sibling �did the same thing� and asks you for help. You advise her that after a breath-holding event: Act as if nothing abnormal happened. 59. Which of the following represents normal sequencing of development in a toddler? Feeds self, can undress self with help, wash his hands, imitate house work. 60. You diagnose a 16-year-old with acute otitis media and need to prescribe an antibiotic with beta-lactamase coverage. What do you choose? Amoxicillin and potassium clavulanate- Augmentin 61. A 14-year-old has ataxia. He is brought to the local emergency department, where he appears euphoric, emotionally labile, and a bit disoriented. He has nystagmus and hypersalivation. Many notice his abusive language. Which of the following agents is most likely responsible for his condition? Alcohol (NOT- Phencyclidine) 62. Medicaid provides health insurance coverage to Certain categories of people whose personal income falls below a certain percentage of the federal poverty level. 63. Which of the following vaccines is routinely recommended at 4 months of age? Diphtheria, tetanus, acellular pertussis (DTaP) 64. A 13-month-old child is noted to be at the 25th percentile for weight, the 10th percentile for height, and less than the 5th percentile for head circumference. She was born at term. She was noted to have a small head at birth, to be developmentally delayed throughout her life, and to have required cataract surgery shortly after birth. She currently takes phenobarbital for seizures. Which of the following would most likely explain this child’s small size? Congenital cytomegalovirus infection 65. A 3-year-old (37 months) refuses to have bowel movements on the toilet. He is bladder trained. He goes and hides and squats when having bowel movements. Positive encouragement and praise is not working. You advise: Tell the parents this is normal, the child will eventually train himself, but it is difficult to wait 66. Which of the following children should be referred for a comprehensive developmental evaluation? A 2-year-old who lost the ability to perform previously attained developmental milestones. 67. Which of the following injuries is most likely to be caused by abuse of a toddler? A displaced posterior rib fracture. 68. You would be concerned about the language development of a child who: (NOT-pronounce his words that are not understandable at two years of age) Pronounces words that are not understandable at 36 months Speech is 50% understandable at 36 months of age 69. A 7-month-old m