Final Exam: NR 509 / NR509 Advanced Physical Assessment Final Practice Questions with Verified Answers (2024 / 2025 Update) - Chamberlain

Final Exam: NR 509 / NR509 Advanced Physical Assessment Final Practice Questions with Verified Answers (2024 / 2025 Update) - Chamberlain 1. A mother brings her 15-month-old toddler to the clinic for his preventive health care visit. The clinician takes the history and observes the child's interactions and behaviors and is then ready to begin the rest of the examination. Which of the following best describes the general approach to the pediatric examination of the young child? ~ Answer: Begin with lease invasive parts of the exam 2. In caring for children, physicians and other clinicians need to understand child development. Of the following, which is a principle of normal child development? ~ Answer: Child development proceeds along a predictable pathway in a healthy child. 3. The parents of a 21-month-old child explain that their son used to speak nearly 50 words and was using 2-word phrases. In the last month or so, the child has not been using as many words and tends to echo what is being said to him rather than use language spontaneously. They want to know if this is normal. After taking a thorough developmental history, the clinician finds that the child makes poor eye contact and does not play with toys in a purposeful manner. The physical examination is normal except for the child's limited social interactions. There is a family history of autism in two first cousins. Which of the following would be the best response to the parents at this time? ~ Answer: Refer the child to a developmental and behavioral pediatrician 4. A clinician is meeting the mother of a 5-year-old with asthma for the first time. The mother notes that the asthma has been poorly controlled and that the child has had multiple hospitalizations. The clinician inquires about family stressors and finds that the parents are divorced, the mother recently lost her job, and the child spent 2 months living with her grandparents who both smoke. Which of the following is the best example of the role of health promotion with this family? ~ Answer: Develop a health promotion plan that includes more frequent visits and guidance to assist family with stressors and improve the child's asthma symptoms. 5. A clinician is reading the chart of a full-term newborn whose mother had an uneventful pregnancy in the hospital for the first time on the day of birth. In reviewing the infant's chart, the clinician notes that, in the delivery room, at 5 minutes, the infant had a heart rate >100, strong respiratory effort, was crying vigorously, moving actively, and had good color except for some acrocyanosis of the hands and feet. This infant's APGAR score is closest to which of the following? ~ Answer: 9 6. A newborn who is floppy and limp, blue in color, with a heart rate of 60, and minimal respiratory effort has just been delivered. The infant has no grimace and only a very weak cry. What is the best immediate response to the infant in this situation? ~ Answer: Begin neonatal resusciation 7. An infant is born 4 weeks preterm to a mother with a history of hypertension, severe diabetes, and alcohol abuse. The infant is noted to be small for gestational age (SGA), weighing just 1,500 g. Which of the following is the most important reason for assessing both gestational age and birth weight for any infant? ~ Answer: These two factors help to anticipate certain medical and developmental problems. 8. A clinician arrives at the hospital several hours after the birth of a full-term infant. The infant is rooming in with her parents and appears to be doing well. There were no problems with the pregnancy, labor, or delivery. The nurse asks if the baby should be taken back to the nursery for examination. What is the best response to the nurse? ~ Answer: State that the infant should be examined in the presence of the parents so they can be taught about what their newborn can do. 9. The nurse in the newborn nursery reports that she is concerned about Baby Boy Jones, who was born full-term by cesarean section for failure to progress. The pregnancy was complicated only by a maternal urinary tract infection in the first trimester. He had APGARs of 9 and 10 at 1 and 5 minutes, respectively, and had been doing well. However, now, on the fourth day of life, the infant has developed a tremor. Which of the following factors would cause the most concern about the tremor? ~ Answer: The infant also has asymmetric limb movements. 10. A mother brings her 9-month-old son to the practice for the first time, concerned that he is not yet sitting by himself. After taking a careful history, the physician notes that the infant has good head control and can grasp a rattle but is unable to roll over, crawl, or pull to stand. What should the clinician explain to the mother? ~ Answer: The delay in his physical motor skills is concerning and warrants a more complete developmental history and possible referral for early intervention. 11. A 42-year-old school teacher with a history of irregular periods who underwent successful intrauterine insemination (IUI) on January 25th presents to the clinic for care on March 19th. Her last menstrual period (LMP) was November 11th of the previous year. Which of the following is true about the gestational age of her pregnancy? ~ Answer: It is determined by date of insemination plus 2 weeks. 12. A 32-year-old patient with two prior pregnancies presents to clinic concerned that she may be pregnant after missing one cycle of her menses, which was previously very regular. A urine human chorionic gonadotropin (HCG) test is positive. Presuming a normal pregnancy, what can the physician expect to find on examination and ultrasound? ~ Answer: A bluish hue of the cervix known as the Chadwick sign