NUR 652 Final Exam test with possible solutins
1. A 5-year-old child is hit in the face with a baseball bat and is brought to the
clinic by a parent. An exam reveals three avulsed front teeth. Radiologic studies
are negative for facial fractures. What is the recommended treatment?-
: Refer the child to the dentist immediately for further evaluation
2. A 13-year-old with cerebral palsy receives all nutrition via gastrostomy tube.
What will the primary care nurse practitioner recommend to promote dental
health in this child?: Daily chlorhexidine gluconate
3. A teen who has otitis externa has severe swelling of the external auditory
canal that persists after 2 days of therapy with ototopical antibiotic/corticosteroid
drops. What is the next step in treatment for this child?: Insert a wick into the
external auditory canal
4. An elderly patient has a permanent loss of the sense of smell and
diminished taste. What will be included in teaching this patient about managing
these symptoms?: 1. The importance of installing smoke detectors
2. Putting dates on food in the fridge
3. Eating regular meals at scheduled times
5. A toddler exhibits exotropia of the right eye during a cover-uncover screen. The
primary nurse practitioner will refer to a pediatric ophthalmologist to initiate
which treatment?: Patching of the unaffected eye for 2 hours each day 6. An
adolescent has localized bleeding of the gums when brushing the teeth. An exam
of the mouth reveals the presence of plaque and calculus on the teeth which are
not loose. What will the primary care nurse practitioner recommend?:
Consistently brushing and flossing the teeth twice daily
7. A provider is recommending a cerumenolytic for a patient who has chronic
cerumen buildup. The provider notes that the patient has dry skin in the ear
canal. Which preparation is FDA approved for this use?: Carbamide peroxide 8.
A parent asks about ways to promote dental health in school-aged children
while on family vacation that are convenient while camping and picnicking.
,What will the primary care nurse practitioner recommend?: Offering gum
containing xylitol after meals
9. A 7-month-old infant has had two prior acute ear infections and is currently
on the 10th day of therapy with amoxicillin-clavulanate after a failed course
of amoxicillin. The primary care nurse practitioner notes marker middle ear
effusion and erythema of the TM. The child is irritable and has a temperature
of 99.8. What is the next step in management of this child's infection?: Refer
the child to an otolayngologist
10. A patient reports painful swelling in the mouth with increased pain at
mealtimes. The provider notes a mass in the salivary gland region. What is
the likely cause of these symptoms?: Sialolithiasis
11. During a well child assessment of an African American infant, the primary
care nurse practitioner notes a dark red-brown light reflex in the left eye and
a slightly brighter, red-orange light reflex in the right eye. The nurse
practitioner will...: Refer the infant to an opthalmologist
12. A preschool age child who attend daycare has a 2 day history of matted
eyelids in the morning and burning and itching of the eyes. The primary care
NP notes yellow-green purulent discharge from both eyes, conjunctival
erythema and mild URI symptoms. Which action is correct?: Prescribe topical
antibiotic drops
13. An 18-month-old child with no previous history of otitis media awoke during
the night with right ear pain. The primary care NP notes an axillary
temperature of 100.5 and an erythematous, bulging TM. A tympanogram
reveals a peak of +15-mm H2O. What is the recommended treatment for this
child?: An analgesic medication and watchful waiting
14. During a well-child exam on a 4-year-old child, the primary care NP notes
that the clinic nurse recorded 20/50 for the child's vision and noted that the
child has difficulty cooperating with the exam. What will the NP
recommend?-
: Test the child's vision in 1 month
15. Causes of cough, not related to pulmonary issues: Allergies, GERD,
medications (lisinopril)
16. The primary care NP is providing nutritional counseling for a 9-year-old
female whose weight is at the 95th percentile for her age. What is the goal for
this patient?: Maintenance of her current weight
17. The primary care NP is performing a well child examination on a
, 12-year-old child who was diagnosed with type 1 DM at age 9. The child had a
lipid screen at age 10 with an LDL cholesterol <100mg/dL. What will the NP
recommend as part of ongoing management for this child?: Comprehensive
ophthalmologic exams
18. The primary care NP is reviewing lab work and diabetes management with a
school-aged child whose HbA1C is 7.6% who reports usual blood sugars
before meals as being 80-90mg/dL. The NP will consult with the child's
endocrinologist to consider which therapy?: Continuous glucose monitoring
19. The primary care NP notes a musty odor when examining a newborn at a
2-week checkup. What will the NP suspect?: Phenylketonuria
20. A patient who has diabetes has a blood pressure of 140/90 and
albuminuria. Which initial action by the primary care NP is indicated for
management of this patient?: Consulting with a nephrologist
21. The primary care NP is performing a well-child examination on a 2-year-
old child with a history of intrauterine growth retardation whose height
remains less than the 3rd percentile on a WHO growth chart. What will the NP
do?: Refer the child to a pediatric endocrinologist
22. An infant has congenital adrenal hyperplasia. At a routine well baby
checkup, the primary care NP notes vomiting, poor feeding, lethargy, and mild
dehydration. Which action is correct?: Refer the infant to the ED for fluids,
dextrose, and steroids
23. A patient recently diagnosed with T1DM is in clinic for a follow-up
evaluation. The provider notes that the patient appears confused and irritable
and is sweating and shaking. What intervention will the provider expect to
perform once the POC blood glucose is known?: Giving a rapid acting
carbohydrate 24. A 15-year-old child has a recent history of increased thirst and
frequent urination. The child's weight has been in the 95th percentile for
several years. A dipstick UA is positive for glucose, and random plasma glucose
is 350mg/dL. Which test will the primary care NP order to determine the type of
diabetes in this child?: Pancreatic antibodies
25. A patient has thyroid nodules and the provider suspects thyroid cancer. To
evaluate thyroid nodules for potential malignancy, which test is performed?:
Thyroid ultrasound
26. The primary care NP diagnoses a 14-year-old child with T1DM after a routine
urine screen is positive for glucose and negative for ketones and plasma
glucose is 350mg/dL. The child's weight is normal and the parents report a
1. A 5-year-old child is hit in the face with a baseball bat and is brought to the
clinic by a parent. An exam reveals three avulsed front teeth. Radiologic studies
are negative for facial fractures. What is the recommended treatment?-
: Refer the child to the dentist immediately for further evaluation
2. A 13-year-old with cerebral palsy receives all nutrition via gastrostomy tube.
What will the primary care nurse practitioner recommend to promote dental
health in this child?: Daily chlorhexidine gluconate
3. A teen who has otitis externa has severe swelling of the external auditory
canal that persists after 2 days of therapy with ototopical antibiotic/corticosteroid
drops. What is the next step in treatment for this child?: Insert a wick into the
external auditory canal
4. An elderly patient has a permanent loss of the sense of smell and
diminished taste. What will be included in teaching this patient about managing
these symptoms?: 1. The importance of installing smoke detectors
2. Putting dates on food in the fridge
3. Eating regular meals at scheduled times
5. A toddler exhibits exotropia of the right eye during a cover-uncover screen. The
primary nurse practitioner will refer to a pediatric ophthalmologist to initiate
which treatment?: Patching of the unaffected eye for 2 hours each day 6. An
adolescent has localized bleeding of the gums when brushing the teeth. An exam
of the mouth reveals the presence of plaque and calculus on the teeth which are
not loose. What will the primary care nurse practitioner recommend?:
Consistently brushing and flossing the teeth twice daily
7. A provider is recommending a cerumenolytic for a patient who has chronic
cerumen buildup. The provider notes that the patient has dry skin in the ear
canal. Which preparation is FDA approved for this use?: Carbamide peroxide 8.
A parent asks about ways to promote dental health in school-aged children
while on family vacation that are convenient while camping and picnicking.
,What will the primary care nurse practitioner recommend?: Offering gum
containing xylitol after meals
9. A 7-month-old infant has had two prior acute ear infections and is currently
on the 10th day of therapy with amoxicillin-clavulanate after a failed course
of amoxicillin. The primary care nurse practitioner notes marker middle ear
effusion and erythema of the TM. The child is irritable and has a temperature
of 99.8. What is the next step in management of this child's infection?: Refer
the child to an otolayngologist
10. A patient reports painful swelling in the mouth with increased pain at
mealtimes. The provider notes a mass in the salivary gland region. What is
the likely cause of these symptoms?: Sialolithiasis
11. During a well child assessment of an African American infant, the primary
care nurse practitioner notes a dark red-brown light reflex in the left eye and
a slightly brighter, red-orange light reflex in the right eye. The nurse
practitioner will...: Refer the infant to an opthalmologist
12. A preschool age child who attend daycare has a 2 day history of matted
eyelids in the morning and burning and itching of the eyes. The primary care
NP notes yellow-green purulent discharge from both eyes, conjunctival
erythema and mild URI symptoms. Which action is correct?: Prescribe topical
antibiotic drops
13. An 18-month-old child with no previous history of otitis media awoke during
the night with right ear pain. The primary care NP notes an axillary
temperature of 100.5 and an erythematous, bulging TM. A tympanogram
reveals a peak of +15-mm H2O. What is the recommended treatment for this
child?: An analgesic medication and watchful waiting
14. During a well-child exam on a 4-year-old child, the primary care NP notes
that the clinic nurse recorded 20/50 for the child's vision and noted that the
child has difficulty cooperating with the exam. What will the NP
recommend?-
: Test the child's vision in 1 month
15. Causes of cough, not related to pulmonary issues: Allergies, GERD,
medications (lisinopril)
16. The primary care NP is providing nutritional counseling for a 9-year-old
female whose weight is at the 95th percentile for her age. What is the goal for
this patient?: Maintenance of her current weight
17. The primary care NP is performing a well child examination on a
, 12-year-old child who was diagnosed with type 1 DM at age 9. The child had a
lipid screen at age 10 with an LDL cholesterol <100mg/dL. What will the NP
recommend as part of ongoing management for this child?: Comprehensive
ophthalmologic exams
18. The primary care NP is reviewing lab work and diabetes management with a
school-aged child whose HbA1C is 7.6% who reports usual blood sugars
before meals as being 80-90mg/dL. The NP will consult with the child's
endocrinologist to consider which therapy?: Continuous glucose monitoring
19. The primary care NP notes a musty odor when examining a newborn at a
2-week checkup. What will the NP suspect?: Phenylketonuria
20. A patient who has diabetes has a blood pressure of 140/90 and
albuminuria. Which initial action by the primary care NP is indicated for
management of this patient?: Consulting with a nephrologist
21. The primary care NP is performing a well-child examination on a 2-year-
old child with a history of intrauterine growth retardation whose height
remains less than the 3rd percentile on a WHO growth chart. What will the NP
do?: Refer the child to a pediatric endocrinologist
22. An infant has congenital adrenal hyperplasia. At a routine well baby
checkup, the primary care NP notes vomiting, poor feeding, lethargy, and mild
dehydration. Which action is correct?: Refer the infant to the ED for fluids,
dextrose, and steroids
23. A patient recently diagnosed with T1DM is in clinic for a follow-up
evaluation. The provider notes that the patient appears confused and irritable
and is sweating and shaking. What intervention will the provider expect to
perform once the POC blood glucose is known?: Giving a rapid acting
carbohydrate 24. A 15-year-old child has a recent history of increased thirst and
frequent urination. The child's weight has been in the 95th percentile for
several years. A dipstick UA is positive for glucose, and random plasma glucose
is 350mg/dL. Which test will the primary care NP order to determine the type of
diabetes in this child?: Pancreatic antibodies
25. A patient has thyroid nodules and the provider suspects thyroid cancer. To
evaluate thyroid nodules for potential malignancy, which test is performed?:
Thyroid ultrasound
26. The primary care NP diagnoses a 14-year-old child with T1DM after a routine
urine screen is positive for glucose and negative for ketones and plasma
glucose is 350mg/dL. The child's weight is normal and the parents report a
