NR 602 Final Study Set with Complete
Solutions
A 16yearold sexually active female has a fever, bilateral lower abdominal
pain,and malaise. A speculum and bimanual exam reveals adnexal tenderness.
The urinalysis is normal and cervical cultures are pending. What medications will the
primary care pediatric nurse practitioner prescribe for this patient? - ANSWER-PID- she
is Sexually active+Adnexal Tenderness and negative for UTI.
Ceftriaxone, doxycycline, and metronidazole
Rational- This is PID the treatment is Ceftriaxone 250 mg IM plus Doxyclicline 100 mg
BID for 14 days plus with or without Metronidazole 500 mg PO bid for 14 days.
4. A sexually active adolescent female tests positive for N. gonorrhea
and Chalmydia. She tells the primary care pediatric nurse practitioner that she
wants to be treated today since she is moving out of town the next day. What will the
nurse practitioner order?What is the treatment for her - ANSWER-Ceftriaxone 250 mg
IM and azithromycin 1 g PO one time each
Rational- Remember the G in Gonorehea for or Ceftriaxone and Chlamydia you can
give either Doxycycline 100 mg for 7 days or Azithromycin 1 g PO x1 because she is
moving she are giving this combination.
A 14yearold female has menometrorrhagia with moderate increase in menstrual flow
and irregular periods. Her hemoglobin is 13.1 g/dL. How will this be managed? -
ANSWER-Iron supplementation and prostaglandin inhibitors
,Rationale: Her hemoglobin level is at 13.1 and the normal range for this age group is
11.9-15. It is better to give Iron because of the bleeding and for pain reliefe
Prostoglandins such as Ibuprofen.
An adolescent female has heavy periods that are also irregular. The physical exam is
normal. A complete blood count reveals a hemoglobin of 8.9 g/dL. What test will the
primary care pediatric nurse practitioner order next? - ANSWER-Coagulation studies
Rational-The normal Hemoglobin range is 11.9-13.1 and she is outside the range. We
need to look for reasons of this.
An adolescent female has periods every 30 days that are consistently
heavy and last from 5 to 8 days. What is her diagnosis? - ANSWER-Menorrhagia-
Rationale- The diagnosis for this is periods lasting longer than 7 days. Hers are lasting 8
days. She is consistant with when her periods start so it won't be menometrorrhagia
because that is irregular periods.
A child has gross hematuria, abdominal pain, and arthralgia as well as a
rash. What diagnosis is most likely? - ANSWER-HenochSchönlein purpura
Rationale-most common in children under 10
A preschoolage child with no previous history has mild flank pain and fever but no
abdominal pain or vomiting. A urinalysis is positive for leukocyte esterase and nitrites. A
culture is pending. Which is the correct course of treatment for this child? - ANSWER-
amoxicillin clavulanate
A 3yearold child has just completed a 7day course of amoxicillin for a second
febrile urinary tract infection and currently has a negative urine culture.
What is the next course of action? - ANSWER-Obtain a renal and bladder ultrasound.
, A dipstick urinalysis is positive for leukocyte esterase and nitrites in a
schoolage child with dysuria and foulsmelling urine but no fever who has not had
previous urinary tract infections. A culture is pending. What will the pediatric nurse
practitioner do to treat this child? - ANSWER-trimethoprimsulfamethoxazole
(TMP) twice daily for 3 to 5 days
Rationale- Some of the medication you can use for UTIs are Amoxicillin, Trimethoprim
sulfamethoxazole and first line cephalosporins if you are allergic to Penacillin.
A 17yearold sexually active female who began having periods at age 14 reports having
moderate to severe dull lower abdominal pain associated
predominantly with periods but that occurs at other times as well. The history reveals a
recent onset of these symptoms. A pregnancy test is negative. Which course of action is
most important? - ANSWER-Perform a full diagnostic workup to evaluate potential
causes.
Rationale- This is not normal and needs more workup to determine the reason for it.
She is sexually active so this raises more concerns for other things that might be going
on such as PID or an STI
A 16yearold female reports dull, achy cramping pa in in her lower abdomen
lasting 2 or 3 hours that occurs between her menstrual periods each month.
The adolescent is not sexually active. What is the treatment for this condition? -
ANSWER-Prostaglandin inhibitor analgesics and a heating pad
Rationale -This is signs of normal period and the 1st line treatment is Prostoglandin and
heating pad.
A schoolage female has had vulvovaginitis for 2 months. All cultures and tests .are
negative, but the symptoms persist after treatment with both topical antibiotics and oral
Solutions
A 16yearold sexually active female has a fever, bilateral lower abdominal
pain,and malaise. A speculum and bimanual exam reveals adnexal tenderness.
The urinalysis is normal and cervical cultures are pending. What medications will the
primary care pediatric nurse practitioner prescribe for this patient? - ANSWER-PID- she
is Sexually active+Adnexal Tenderness and negative for UTI.
Ceftriaxone, doxycycline, and metronidazole
Rational- This is PID the treatment is Ceftriaxone 250 mg IM plus Doxyclicline 100 mg
BID for 14 days plus with or without Metronidazole 500 mg PO bid for 14 days.
4. A sexually active adolescent female tests positive for N. gonorrhea
and Chalmydia. She tells the primary care pediatric nurse practitioner that she
wants to be treated today since she is moving out of town the next day. What will the
nurse practitioner order?What is the treatment for her - ANSWER-Ceftriaxone 250 mg
IM and azithromycin 1 g PO one time each
Rational- Remember the G in Gonorehea for or Ceftriaxone and Chlamydia you can
give either Doxycycline 100 mg for 7 days or Azithromycin 1 g PO x1 because she is
moving she are giving this combination.
A 14yearold female has menometrorrhagia with moderate increase in menstrual flow
and irregular periods. Her hemoglobin is 13.1 g/dL. How will this be managed? -
ANSWER-Iron supplementation and prostaglandin inhibitors
,Rationale: Her hemoglobin level is at 13.1 and the normal range for this age group is
11.9-15. It is better to give Iron because of the bleeding and for pain reliefe
Prostoglandins such as Ibuprofen.
An adolescent female has heavy periods that are also irregular. The physical exam is
normal. A complete blood count reveals a hemoglobin of 8.9 g/dL. What test will the
primary care pediatric nurse practitioner order next? - ANSWER-Coagulation studies
Rational-The normal Hemoglobin range is 11.9-13.1 and she is outside the range. We
need to look for reasons of this.
An adolescent female has periods every 30 days that are consistently
heavy and last from 5 to 8 days. What is her diagnosis? - ANSWER-Menorrhagia-
Rationale- The diagnosis for this is periods lasting longer than 7 days. Hers are lasting 8
days. She is consistant with when her periods start so it won't be menometrorrhagia
because that is irregular periods.
A child has gross hematuria, abdominal pain, and arthralgia as well as a
rash. What diagnosis is most likely? - ANSWER-HenochSchönlein purpura
Rationale-most common in children under 10
A preschoolage child with no previous history has mild flank pain and fever but no
abdominal pain or vomiting. A urinalysis is positive for leukocyte esterase and nitrites. A
culture is pending. Which is the correct course of treatment for this child? - ANSWER-
amoxicillin clavulanate
A 3yearold child has just completed a 7day course of amoxicillin for a second
febrile urinary tract infection and currently has a negative urine culture.
What is the next course of action? - ANSWER-Obtain a renal and bladder ultrasound.
, A dipstick urinalysis is positive for leukocyte esterase and nitrites in a
schoolage child with dysuria and foulsmelling urine but no fever who has not had
previous urinary tract infections. A culture is pending. What will the pediatric nurse
practitioner do to treat this child? - ANSWER-trimethoprimsulfamethoxazole
(TMP) twice daily for 3 to 5 days
Rationale- Some of the medication you can use for UTIs are Amoxicillin, Trimethoprim
sulfamethoxazole and first line cephalosporins if you are allergic to Penacillin.
A 17yearold sexually active female who began having periods at age 14 reports having
moderate to severe dull lower abdominal pain associated
predominantly with periods but that occurs at other times as well. The history reveals a
recent onset of these symptoms. A pregnancy test is negative. Which course of action is
most important? - ANSWER-Perform a full diagnostic workup to evaluate potential
causes.
Rationale- This is not normal and needs more workup to determine the reason for it.
She is sexually active so this raises more concerns for other things that might be going
on such as PID or an STI
A 16yearold female reports dull, achy cramping pa in in her lower abdomen
lasting 2 or 3 hours that occurs between her menstrual periods each month.
The adolescent is not sexually active. What is the treatment for this condition? -
ANSWER-Prostaglandin inhibitor analgesics and a heating pad
Rationale -This is signs of normal period and the 1st line treatment is Prostoglandin and
heating pad.
A schoolage female has had vulvovaginitis for 2 months. All cultures and tests .are
negative, but the symptoms persist after treatment with both topical antibiotics and oral
