CMN 568||CMN 568 FINAL EXAM QUESTION WITH VERIFIED ANSWERS REVIEW (Intro to Family NP)2024/25 A+

CMN 568||CMN 568 FINAL EXAM
QUESTION WITH VERIFIED
ANSWERS REVIEW (Intro to Family
NP)2024/25 A+
Incidence of Fever (CORRECT ANSWER) One of most common
reasons for parents to seek medical care.
Preschoolers have an average 6-8 febrile illnesses a year.


Definition of fever (CORRECT ANSWER) Rectal temperature ≥
100.4°F


Tympanic temperature (CORRECT ANSWER) Not accurate in infants
under 3 months


Fever Causes (CORRECT ANSWER) Most common Benign viral
illness, can also caused by bacterial or fungal infections, drug reactions
including immunizations, malignancies, autoimmune or metabolic
disorders, CNS disorders, excessive environmental temperatures.


Factors that increase likelihood of serious bacterial illness (CORRECT
ANSWER) Age under 3 months, history of prematurity, chronic medical
conditions such as immunosupression or aspenia, previous
hospitalizations, daycare. Toxic appearance

,Non-Toxic appearance (CORRECT ANSWER) Strong cry
Consolable
Alert and easy to arouse
Pink skin tones
Good hydration; good turgor, tears, moist mucous membranes
Smiles, responsive to environment


Toxic appearance (CORRECT ANSWER) Weak or high pitched cry
Inconsolable
Difficult to arouse
Pale, ashen, cyanotic, or mottled skin tones
Poor hydration; poor turgor, dry mucous membranes, no tears
No smile, listless, dull, infant won't alert to environment


Signs of serious illness (CORRECT ANSWER) Fever greater than 40
(105)
Nuchal rigidity
Petechial skin rash
Seizure activity
Stridor or increased WOB


Physical exam signs of serious infection: Skin (CORRECT ANSWER)
Petechiae, rashes

,Physical exam signs of serious infection: head/neck (CORRECT
ANSWER) Sunken or bulging fontanelles, nuchal rigidity


Physical exam signs of serious infection: ears (CORRECT ANSWER)
Bulging TM, AOM, mastoiditis


Physical exam signs of serious infection: Chest (CORRECT ANSWER)
Tachypnea, wheezing, rales, rhonchi


Physical exam signs of serious infection: Heart (CORRECT ANSWER)
Murmurs


Physical exam signs of serious infection: Abdomen (CORRECT
ANSWER) Tenderness, distension


Physical exam signs of serious infection: Musculoskeletal (CORRECT
ANSWER) Refusal to bear weight or use an extremity,
erythema/warmth over joint


Diagnostic tests for fever in infant and young child (CORRECT
ANSWER) CBC w/ Diff (WBC > 15,000 may indicate SBI. Child with
overwhelming sepsis my have WBC <5,000)
UA/ C&S: R/O UTI
CXR: R/O Pneumonia
Lumbar Puncture: R/O meningitis
Blood cultures: R/O Bacteremia

, Stools for C&S: R/O Infectious diarrhea


Management of fever in infant < 4 weeks (CORRECT ANSWER) Refer
to pediatrician
Hospitalization
Full septic workup
IV antibiotics pending culture results


Management of fever in infant 4 weeks - 3Mo (CORRECT ANSWER)
Toxic appearance:
Refer to pediatrician
Hospitalization
Full septic workup
IV antibiotics pending culture results
Non-Toxic appearance/No risk factors for SBI:
Full septic workup
Specific treatment for any diagnosed conditions
Empiric antibiotics after cultures: Rocephin 50mg/kg/day (up to 1 gm
max)
Must have reliable caregiver with phone and transportation
Close followup in 24 hours


Management of fever in 3Mo to Preschool (CORRECT ANSWER)
Toxic appearance: