NR 602 Mid-term Exam Questions And Answers 100% Guaranteed.

Infant development - correct answer -1m: dolls eyes, nose breathing, hands closed, sees 20-25cm away, sleeps 16-17 hrs a day -2m: post fontanel closes, decr head lag, coos,follows toy side to side, sleeps 8.5-10rs/night & 6-7 hrs day -3m: all primitive reflexes fading, holds head, bears weight on legs, does not reach for rattle, babbling, mirrors, recognizes familiar objects and faces, sleeps 15-16 hours per day. Infant development - correct answer -4m: drooling, no morrow/tonic neck, sits if propped, plays with hands, pulls on things, shows mood, laughs, focus on things 1/2in from face, regular sleep/wake pattern - 5m: double birth wt, rolls back to belly, pull objects to mouth, follows dropped object, sleeps 10-11 hrs & 3 naps. - 6m: growth slows (3-5oz/week, 1/2in/month), rolls back to belly, sits in chair with back, recognize parent, definite likes/dislikes, 13-14 hours sleep, 2-3 naps. - 7m: leans to tripod position, bounce when standing, bang objects, 4 vowels said, knows name, stranger anxiety Infant Development - correct answer -8m: regular b/b pattern, sits unsupported, pincer grasp, knows "no", more stranger anxiety, sleeps 11-12hrs + 2-3 naps - 9m: refined pincer grasp, steadily sits unsupported, pulls to stand, wants to please parents, 2 naps -10m: mature pincer,walks holding on, grabs by the handle, "mama/dada", object permanence, 2 naps -11m: lower lat incisors, pivots when standing, imitates sounds, rolls ball when asked -12m: triples birth wt, length by 50%, walks holding 1 hand, 5-7 words, security object Tanner (pubic hair) - correct answer 1) no pubic hair 2) initial, scarce pigmented hair along medial border of labia 3) sparse, dark, visibly pigmented curly hair on labia 4) hair coarse and curly, abundant but less than adult 5) lateral spreading, triangle spread of adult hair to medial surface of thighs Tanner (Males) - correct answer 1) Prepubertal 2) enlargement of scrotum & testes & change in scrotum texture. May be reddened 3) further penile growth (length first) & testes & scrotum 4) significantly enlarged ion length & circumference penis. more development of glans penis. darkening of scrotal skin (facial hair after this only) 5) adult genitals Tanner (Breasts) - correct answer 1) prepubertal 2) Breast buds palpable under areola, enlargement of areola 3) breast tissue palpable outside areola- no areolar development or separation of contour 4) Areola elevated above contour of breast forming "double scoop" appearance 5) Areola mound recedes back into single breast contour with areolar hyperpigmentation, papillae development/ projection & nipple protrusion chalazion - correct answer -chronic sterile inflammation of eyelid from a lipogranuloma of the meibomian gland - initially, mild redness & swelling, then after a few days, a slow-growing, round, nonpigmented PAINLESS mass remains. - Acute tx: hot compress, refer to eye MD Blepharitis - correct answer - acute or chronic bacterial (staph) inflammation of eyelash follicle or sebaceous gland of eyelid. bilateral usually -flaky, scaly debris over eyelid margin when awakening - tx: warm compress, scrub with weak shampoo, sometimes bacitracin or erythromycin, -no contacts during tx Otitis Media - correct answer - bulging TM, ear pain, , ETD, fever,irritability, otorrhea, absent TM mobility -RSV/influenza most common viruses - onia, haemophilus, strep (bacteria) - Tx: Amoxicillin (1st time), Amox/clavu (when AOM within 30 days), ceftriaxone, azith (penicillin allergy) - <2: treat 10 days, >2, 5-7 days - ofloxacin or cipro gtts is TM perforated, or draining PE tubes Otitis Externa (Swimmer's Ear) - correct answer - swelling of EAC and pinna/TM - sx: itching, irritation, pain, pressure in eat, conductive or SNHL, pain with tragus or pinna movement, maybe lymphadenopathy, red, crusting lesions, dry canal, -tx: DROPS- ciprodex, vasocidin (ok if rupture tm). cortisporin, cipro HC (TM intact), domeboro (cleaning only) Conjunctivitis - correct answer -most common peds infection, yellow-green purulent discharge, matted eyes when waking, itching -bacterial (unilateral), viral (bilateral) - usually self-limiting, but may treat with atbx - tx: sodium sulfacetamide or tmp+polymycin B, or erythromycin, azith (>12m), -floxacins (>12m). no -mycins) -newborn: chlamydia trach. (erythromycin PO), gonorrhea (ceftriaxone IM/IV). DFA conjunctival test - Milia - correct answer - pearly, white papules over forehead, nose, and cheeks. - no tx salmon patch - correct answer - flat lesion or vascular malformation on back of neck, upper eyelids and glabella - 60-70% of newborns have on back of neck - no spontaneous resolution Cafe au lait spots - correct answer - First sign of Neurofibromatosis -Tan to brown macules found anywhere on skin. hemangioma - correct answer -papule made of blood vessels impetigo - correct answer -bacterial infection (strep, *s*, or MRSA) - Bullous: more in infants and young children. large, superficial oval pustules - Sx: fever, papules/pustules that progress to vesicles that rupture-honey colored crust. face, hands, neck, extremities, or perineum, regional lymphadenopathy - Tx: topical mupirocin. or amox/clauv, cephalexin, dicloxacillin - Prev: moisturize skin Molluscum Contagiosum - correct answer - viral skin infection - spread by direct contact, autoinoculation - incubation period 2-7 weeks (up to 6m) - Sx: itching, small, pink or flesh papules (1-6mm), - Tx: allow to dissapear (6m-2-4 years), curettage, salicylic acid, KOH, - Evaluate for HIV infection if hundreds of lesions are found Verruca Vulgaris (warts) - correct answer - HPV virus - flesh-colored, scaly, irregular surface, black pinpoints - Tx: watchful waiting, high recurrence, salicylic acid (>20%), retinoic acid (4-6 weeks, flat warts), duct tape, cryotherapy (liquid nitrogen), surgical excision (painful, scarring) Herpetic whitlow - correct answer - swollen, painful lesion on finger or thumb, - on thumb-sucking children with gingivostomatitis or adolescents with genital HSV infection - Tx: Acyclovir 200mg 5x/day for 5-10 days atrial septal defect - correct answer - hole in atrial septum (5-10% OF CHD) - Sx: easily fatigued, no murmur till 2-3yo, murmur at pulmonic area split S1 sometimes, split S2, - Tx: may close spontaneously, or need surgery, ASA x 6m post surgery Murmur grading - correct answer -1: Soft -2: Soft, but easily heard -3: loud, but without palpable thrill -4: loud and with precordial thrill -5: loud with thrill and audible with only the edge of stethoscope -6: very loud and audible with the stethoscope off the chest ventricular septal defect (VSD) - correct answer - hole in ventricular septum (37% of all CHD) -