NURS 629 Peds Q&A for all 4 test combined Maryville University 2022/23
g g g g g g g g g g g
1. 14. A schoolage child has a history of chronic otitis media and is seen inth
g g g g g g g g g g g g g g g
e clinicmwith vertigo. The primary care pediatric nurse practitioner notespro
g g g g g g g g g g
fuse purulent otorrhea from both pressureequalizing tubes and a pearlywhit
g g g g g g g g g
e lesion on one tympanic
g g g g
membrane. Which condition is most likely?: Ans- Cholesteatoma g g g g g g g
2. 3. A dipstick urinalysis is positive for leukocyte esterase and nitrites in asc
g g g g g g g g g g g g g
hoolage
child with dysuria and foulsmelling urine but no fever who has not hadpr
g g g g g g g g g g g g g
evious urinary tract g g
infections. A culture is pending. What will the pediatric nurse practitioner doto
g g g g g g g g g g g g
gtreat this child?: Ans- g g g
gPrescribe trimethoprimsulfamethoxazole (TMP) twice daily for 3 to 5 days
g g g g g g g g g
3. the parent of a 4monthold infant is concerned that the infant cannot hear.W
g g g g g g g g g g g g g
hich test will the primary care pediatric nurse practitioner order to evaluatepot
g g g g g g g g g g g g
ential hearing loss in this infant?: Ans- Auditory brainstem response (ABR)
g g g g g g g g g g
4. 4. The primary care pediatric nurse practitioner attempts to learn morea
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bout the ID: Ans- 13348419842
g g g g
emotional health of an 18monthold child through which assessment strate-
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gy?: Ans-
g g
gObservation of the child with caretakers in structured and unstructured situations
g g g g g g g g g g
5. 6. What will the primary care pediatric nurse practitioner teach the parentsof
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ga childg
who has new pressureequalizing tubes (PET) in both ears?: Ans-
g g g g g g g g g
gParentsshould notice improved hearing in their child.
g g g g g g g
6. 4. A preschoolage child with no previous history has mild flank pain and fe
g g g g g g g g g g g g g
ver but no abdominal pain or vomiting. A urinalysis is positive for leukocyteeste
g g g g g g g g g g g g g
rase and nitrites. A culture is pending. Which is the correct course of treatment f
g g g g g g g g g g g g g g
or this child?: Ans- Order amoxicillin clavulanate
g g g g g g
7. 7. A child with a history of otitis externa asks about ways to prevent thisco
g g g g g g g g g g g g g g g
ndition.
What will the primary care pediatric nurse practitioner recommend?: Ans-
g g g g g g g g g
Drying the ear canal with a hair dryer
g g g g g g g
8. 12. The primary care pediatric nurse practitioner is evaluating recurrents
g g g g g g g g g g
tomach pain in g g
a schoolage child. The child's exam is normal. The nurse practitioner learnstha
g g g g g g g g g g g g
the child reports
g g
1g/g57
,NURS 629 Peds Q&A for all 4 test combined Maryville University 2022/23
g g g g g g g g g g g
pain most evenings after school and refuses to participate in sports but doesnot
g g g g g g g g g g g g g
have nausea or g g
vomiting. The child's grandmother recently had gallbladder surgery. Whichac
g g g g g g g g g
tion is correct?: Ans-
g g g
gEncourage the child to keep a log of pain, stool patterns, and dietary intake
g g g g g g g g g g g g g
9. 9. A child who has otitis externa has severe swelling of the external audi-
g g g g g g g g g g g g g
tory canal that persists after 2 days of therapy with ototopical antibiotic/cor-
g g g g g g g g g g g g
ticosteroid drops. What is the next step in treatment for this child?: Ans-
g g g g g g g g g g g g g
Insert a wick into the external auditory canal.
g g g g g g g g
10. 5. A 3yearold child has just completed a 7day course of amoxicillin for ase
g g g g g g g g g g g g g g
condfebrile urinary tract infection and currently has a negative urine cul-
g g g g g g g g g g
gture. What is the next course of action?: Ans-
g g g g g g g g
gObtain a renal and bladder ultrasound.
g g g g g
11. 8. A child complains of itching in both ears and is having trouble hearing.
g g g g g g g g g g g g g
The
primary care pediatric nurse practitioner notes periauricular edema and
g g g g g g g g g
marked swelling g
of the external auditory canal and elicits severe pain when manipulating thee
g g g g g g g g g g g g
xternal ear g
structures. Which is an appropriate intervention?: Ans- g g g g g g
gOrder ototopicalantibiot- ic/corticosteroid drops.
g g g g
12. 5. A middleschoolage child is skipping school frequently and getting poorg
g g g g g g g g g g g
rades
since the child's father was killed while deployed in the military. How will theprim
g g g g g g g g g g g g g g
ary care pediatric
g g
nurse practitioner manage this situation?: Ans-
g g g g g
gRefer the child to a mentalhealth specialist for evaluation and treatment.
g g g g g g g g g g g
13. The primary care pediatric nurse practitioner is examining a 2weekoldi
g g g g g g g g g g
nfant and g
auscultates a wide splitting of S 2 during expiration. What condition may thisfind
g g g g g g g g g g g g g
ng represent?: Ans- Atrial septal defect
g g g g g
14. A 9monthold infant with a history of three urinary tract infections is diagn
g g g g g g g g g g g g
osed with grade II vesicoureteral reflux. Which medication will be pre-
g g g g g g g g g g
scribed?: Ans- TMPSMX~ TMP 2 mg/kg as a single daily dose
g g g g g g g g g g g
15. 2. The primary care pediatric nurse practitioner auscultates a new gradeII
g g g g g g g g g g g g
vibratory,
midsystolic murmur at the mid sternal border in a 4yearold child that is g g g g g g g g g g g g
2g/g57
,NURS 629 Peds Q&A for all 4 test combined Maryville University 2022/23
g g g g g g g g g g g
louder when the child isg g g g
supine. What type of murmur is most likely?: Ans- Still's murmur
g g g g g g g g g g
16. 4. The primary care pediatric nurse practitioner is performing a well babye
g g g g g g g g g g g g
xamination on a 2monthold infant who has gained 25 grams per day in thelast
g g g g g g g g g g g g g g
ginterval. The g
mother is nursing and tells the nurse practitioner that her infant seems fussy and
g g g g g g g g g g g g g
gwants to nurse g g
more often. What will the nurse practitioner tell her?: Ans-
g g g g g g g g g
gThe infant may be going through an expected growth spurt.
g g g g g g g g g
17. 3. During a well child assessment, the primary care pediatric nurse prac-
g g g g g g g g g g g
titioner
g
auscultates a harsh, blowing grade IV/VI murmur in a 6monthold infant. What will
g g g g g g g g g g g g g
the nurse
g
practitioner do next?: Ans- Refer to a pediatric cardiologist for further evaluation
g g g g g g g g g g g
18. 12. A child who has nephrotic syndrome is on a steroids and a saltrestrict-
g g g g g g g g g g g g g
ed diet for a relapse of symptoms. A dipstick urinalysis shows 1+ protein, do
g g g g g g g g g g g g g g
wn from 3+ at the beginning of the episode. In consultation with the child's ne
g g g g g g g g g g g g g g
phrologist, what is the correct course of treatment considering thisfinding?: A
g g g g g g g g g g g
ns- Continue with steroids and salt restrictions until the urine is negative for protein
g g g g g g g g g g g g g
19. 4. The primary care pediatric nurse practitioner provides primary care fora
g g g g g g g g g g g g
4month
old infant who has a ventricular septal defect. The infant has been breast-
g g g g g g g g g g g g
feeding well but in the
g g g g g
past month has dropped from the 20th percentile to the 5th for weight. Whatwil
g g g g g g g g g g g g g g
he
nurse practitioner recommend?: Ans-
g g g
gFortifying breast milk to increase thenumber of calories per ounce
g g g g g g g g g g
20. 6. The parent of a 4yearold child reports that the child seems to be havingtr
g g g g g g g g g g g g g g g
ouble
adjusting to a new day care and reportedly is always engaging in solitaryplay
g g g g g g g g g g g g g g
when the g
parent arrives to pick up the child. What will the primary care pediatric nursepr
g g g g g g g g g g g g g g
actitioner do?: Ans- g g
gAsk the parent if the child is slow to warm up to other new situations
g g g g g g g g g g g g g g
21. 5. A 12monthold infant who had cardiopulmonary bypass with RBC andpl
g g g g g g g g g g g
asma
3g/g57
, NURS 629 Peds Q&A for all 4 test combined Maryville University 2022/23
g g g g g g g g g g g
infusions during surgery at 8 months is seen for a well child examination.
g g g g g g g g g g g g
Which vaccine may be g g g
administered at this visit?\: Ans- PCV13 g g g g g
22. 13. A child who had GABHS 2 weeks prior is in the clinic with periorbitaled
g g g g g g g g g g g g g g g
ema,
dyspnea, and elevated blood pressure. A urinalysis reveals teacolored urinew
g g g g g g g g g g
ith hematuria and
g g
mild proteinuria. What will the primary care pediatric nurse practitioner do tom
g g g g g g g g g g g g
anage this condition?: Ans- g g g
gRefer the child to a pediatric nephrologist for hospital- ization.
g g g g g g g g g
23. The primary care pediatric nurse practitioner performs a well child exam-
g g g g g g g g g g
ination on
g g
a 12monthold child who had repair of a congenital heart defect at 8 monthsof
g g g g g g g g g g g g g g g
age. The child has ag g g g
normal exam. The parent reports that the child is not taking any medications.
g g g g g g g g g g g g
The nurse practitioner
g g
will contact the child's cardiologist to discuss whether the child needs whichme
g g g g g g g g g g g g
ication?: Ans- Amoxicillin g g
24. 7. The primary care pediatric nurse practitioner sees a developmentallyd
g g g g g g g g g g
elayed
toddler for an initial visit. The family has just moved to the area and asks thenur
g g g g g g g g g g g g g g g g
e practitioner
g
about community services and resources for their child. What should thenurse
g g g g g g g g g g g
practitioner do g
initially?: Ans- Ask the parents if they have an individualized family service plan(IFSP
g g g g g g g g g g g g g
25. 20. A 7yearold child who has a history of a repaired congenital heartd
g g g g g g g g g g g g g
efect has g
many dental caries along with gingival erythema and irritation and a temper-
g g g g g g g g g g g
ature of
g g
102.5°F. What will the primary care pediatric nurse practitioner do next?: A
g g g g g g g g g g g
ns- Ad- mit to the hospital with a pediatric cardiology consult.
g g g g g g g g g g
26. 16. A 6monthold infant has a retractile testis that was noted at the 2monthw
g g g g g g g g g g g g g g
ell
baby exam. What will the primary care pediatric nurse practitioner do tomana
g g g g g g g g g g g g
ge this condition?: Ans-
g g g
gRefer the infant to a pediatric urologist or surgeon for possible orchiopexy
g g g g g g g g g g g
4g/g57
g g g g g g g g g g g
1. 14. A schoolage child has a history of chronic otitis media and is seen inth
g g g g g g g g g g g g g g g
e clinicmwith vertigo. The primary care pediatric nurse practitioner notespro
g g g g g g g g g g
fuse purulent otorrhea from both pressureequalizing tubes and a pearlywhit
g g g g g g g g g
e lesion on one tympanic
g g g g
membrane. Which condition is most likely?: Ans- Cholesteatoma g g g g g g g
2. 3. A dipstick urinalysis is positive for leukocyte esterase and nitrites in asc
g g g g g g g g g g g g g
hoolage
child with dysuria and foulsmelling urine but no fever who has not hadpr
g g g g g g g g g g g g g
evious urinary tract g g
infections. A culture is pending. What will the pediatric nurse practitioner doto
g g g g g g g g g g g g
gtreat this child?: Ans- g g g
gPrescribe trimethoprimsulfamethoxazole (TMP) twice daily for 3 to 5 days
g g g g g g g g g
3. the parent of a 4monthold infant is concerned that the infant cannot hear.W
g g g g g g g g g g g g g
hich test will the primary care pediatric nurse practitioner order to evaluatepot
g g g g g g g g g g g g
ential hearing loss in this infant?: Ans- Auditory brainstem response (ABR)
g g g g g g g g g g
4. 4. The primary care pediatric nurse practitioner attempts to learn morea
g g g g g g g g g g g
bout the ID: Ans- 13348419842
g g g g
emotional health of an 18monthold child through which assessment strate-
g g g g g g g g g
gy?: Ans-
g g
gObservation of the child with caretakers in structured and unstructured situations
g g g g g g g g g g
5. 6. What will the primary care pediatric nurse practitioner teach the parentsof
g g g g g g g g g g g g
ga childg
who has new pressureequalizing tubes (PET) in both ears?: Ans-
g g g g g g g g g
gParentsshould notice improved hearing in their child.
g g g g g g g
6. 4. A preschoolage child with no previous history has mild flank pain and fe
g g g g g g g g g g g g g
ver but no abdominal pain or vomiting. A urinalysis is positive for leukocyteeste
g g g g g g g g g g g g g
rase and nitrites. A culture is pending. Which is the correct course of treatment f
g g g g g g g g g g g g g g
or this child?: Ans- Order amoxicillin clavulanate
g g g g g g
7. 7. A child with a history of otitis externa asks about ways to prevent thisco
g g g g g g g g g g g g g g g
ndition.
What will the primary care pediatric nurse practitioner recommend?: Ans-
g g g g g g g g g
Drying the ear canal with a hair dryer
g g g g g g g
8. 12. The primary care pediatric nurse practitioner is evaluating recurrents
g g g g g g g g g g
tomach pain in g g
a schoolage child. The child's exam is normal. The nurse practitioner learnstha
g g g g g g g g g g g g
the child reports
g g
1g/g57
,NURS 629 Peds Q&A for all 4 test combined Maryville University 2022/23
g g g g g g g g g g g
pain most evenings after school and refuses to participate in sports but doesnot
g g g g g g g g g g g g g
have nausea or g g
vomiting. The child's grandmother recently had gallbladder surgery. Whichac
g g g g g g g g g
tion is correct?: Ans-
g g g
gEncourage the child to keep a log of pain, stool patterns, and dietary intake
g g g g g g g g g g g g g
9. 9. A child who has otitis externa has severe swelling of the external audi-
g g g g g g g g g g g g g
tory canal that persists after 2 days of therapy with ototopical antibiotic/cor-
g g g g g g g g g g g g
ticosteroid drops. What is the next step in treatment for this child?: Ans-
g g g g g g g g g g g g g
Insert a wick into the external auditory canal.
g g g g g g g g
10. 5. A 3yearold child has just completed a 7day course of amoxicillin for ase
g g g g g g g g g g g g g g
condfebrile urinary tract infection and currently has a negative urine cul-
g g g g g g g g g g
gture. What is the next course of action?: Ans-
g g g g g g g g
gObtain a renal and bladder ultrasound.
g g g g g
11. 8. A child complains of itching in both ears and is having trouble hearing.
g g g g g g g g g g g g g
The
primary care pediatric nurse practitioner notes periauricular edema and
g g g g g g g g g
marked swelling g
of the external auditory canal and elicits severe pain when manipulating thee
g g g g g g g g g g g g
xternal ear g
structures. Which is an appropriate intervention?: Ans- g g g g g g
gOrder ototopicalantibiot- ic/corticosteroid drops.
g g g g
12. 5. A middleschoolage child is skipping school frequently and getting poorg
g g g g g g g g g g g
rades
since the child's father was killed while deployed in the military. How will theprim
g g g g g g g g g g g g g g
ary care pediatric
g g
nurse practitioner manage this situation?: Ans-
g g g g g
gRefer the child to a mentalhealth specialist for evaluation and treatment.
g g g g g g g g g g g
13. The primary care pediatric nurse practitioner is examining a 2weekoldi
g g g g g g g g g g
nfant and g
auscultates a wide splitting of S 2 during expiration. What condition may thisfind
g g g g g g g g g g g g g
ng represent?: Ans- Atrial septal defect
g g g g g
14. A 9monthold infant with a history of three urinary tract infections is diagn
g g g g g g g g g g g g
osed with grade II vesicoureteral reflux. Which medication will be pre-
g g g g g g g g g g
scribed?: Ans- TMPSMX~ TMP 2 mg/kg as a single daily dose
g g g g g g g g g g g
15. 2. The primary care pediatric nurse practitioner auscultates a new gradeII
g g g g g g g g g g g g
vibratory,
midsystolic murmur at the mid sternal border in a 4yearold child that is g g g g g g g g g g g g
2g/g57
,NURS 629 Peds Q&A for all 4 test combined Maryville University 2022/23
g g g g g g g g g g g
louder when the child isg g g g
supine. What type of murmur is most likely?: Ans- Still's murmur
g g g g g g g g g g
16. 4. The primary care pediatric nurse practitioner is performing a well babye
g g g g g g g g g g g g
xamination on a 2monthold infant who has gained 25 grams per day in thelast
g g g g g g g g g g g g g g
ginterval. The g
mother is nursing and tells the nurse practitioner that her infant seems fussy and
g g g g g g g g g g g g g
gwants to nurse g g
more often. What will the nurse practitioner tell her?: Ans-
g g g g g g g g g
gThe infant may be going through an expected growth spurt.
g g g g g g g g g
17. 3. During a well child assessment, the primary care pediatric nurse prac-
g g g g g g g g g g g
titioner
g
auscultates a harsh, blowing grade IV/VI murmur in a 6monthold infant. What will
g g g g g g g g g g g g g
the nurse
g
practitioner do next?: Ans- Refer to a pediatric cardiologist for further evaluation
g g g g g g g g g g g
18. 12. A child who has nephrotic syndrome is on a steroids and a saltrestrict-
g g g g g g g g g g g g g
ed diet for a relapse of symptoms. A dipstick urinalysis shows 1+ protein, do
g g g g g g g g g g g g g g
wn from 3+ at the beginning of the episode. In consultation with the child's ne
g g g g g g g g g g g g g g
phrologist, what is the correct course of treatment considering thisfinding?: A
g g g g g g g g g g g
ns- Continue with steroids and salt restrictions until the urine is negative for protein
g g g g g g g g g g g g g
19. 4. The primary care pediatric nurse practitioner provides primary care fora
g g g g g g g g g g g g
4month
old infant who has a ventricular septal defect. The infant has been breast-
g g g g g g g g g g g g
feeding well but in the
g g g g g
past month has dropped from the 20th percentile to the 5th for weight. Whatwil
g g g g g g g g g g g g g g
he
nurse practitioner recommend?: Ans-
g g g
gFortifying breast milk to increase thenumber of calories per ounce
g g g g g g g g g g
20. 6. The parent of a 4yearold child reports that the child seems to be havingtr
g g g g g g g g g g g g g g g
ouble
adjusting to a new day care and reportedly is always engaging in solitaryplay
g g g g g g g g g g g g g g
when the g
parent arrives to pick up the child. What will the primary care pediatric nursepr
g g g g g g g g g g g g g g
actitioner do?: Ans- g g
gAsk the parent if the child is slow to warm up to other new situations
g g g g g g g g g g g g g g
21. 5. A 12monthold infant who had cardiopulmonary bypass with RBC andpl
g g g g g g g g g g g
asma
3g/g57
, NURS 629 Peds Q&A for all 4 test combined Maryville University 2022/23
g g g g g g g g g g g
infusions during surgery at 8 months is seen for a well child examination.
g g g g g g g g g g g g
Which vaccine may be g g g
administered at this visit?\: Ans- PCV13 g g g g g
22. 13. A child who had GABHS 2 weeks prior is in the clinic with periorbitaled
g g g g g g g g g g g g g g g
ema,
dyspnea, and elevated blood pressure. A urinalysis reveals teacolored urinew
g g g g g g g g g g
ith hematuria and
g g
mild proteinuria. What will the primary care pediatric nurse practitioner do tom
g g g g g g g g g g g g
anage this condition?: Ans- g g g
gRefer the child to a pediatric nephrologist for hospital- ization.
g g g g g g g g g
23. The primary care pediatric nurse practitioner performs a well child exam-
g g g g g g g g g g
ination on
g g
a 12monthold child who had repair of a congenital heart defect at 8 monthsof
g g g g g g g g g g g g g g g
age. The child has ag g g g
normal exam. The parent reports that the child is not taking any medications.
g g g g g g g g g g g g
The nurse practitioner
g g
will contact the child's cardiologist to discuss whether the child needs whichme
g g g g g g g g g g g g
ication?: Ans- Amoxicillin g g
24. 7. The primary care pediatric nurse practitioner sees a developmentallyd
g g g g g g g g g g
elayed
toddler for an initial visit. The family has just moved to the area and asks thenur
g g g g g g g g g g g g g g g g
e practitioner
g
about community services and resources for their child. What should thenurse
g g g g g g g g g g g
practitioner do g
initially?: Ans- Ask the parents if they have an individualized family service plan(IFSP
g g g g g g g g g g g g g
25. 20. A 7yearold child who has a history of a repaired congenital heartd
g g g g g g g g g g g g g
efect has g
many dental caries along with gingival erythema and irritation and a temper-
g g g g g g g g g g g
ature of
g g
102.5°F. What will the primary care pediatric nurse practitioner do next?: A
g g g g g g g g g g g
ns- Ad- mit to the hospital with a pediatric cardiology consult.
g g g g g g g g g g
26. 16. A 6monthold infant has a retractile testis that was noted at the 2monthw
g g g g g g g g g g g g g g
ell
baby exam. What will the primary care pediatric nurse practitioner do tomana
g g g g g g g g g g g g
ge this condition?: Ans-
g g g
gRefer the infant to a pediatric urologist or surgeon for possible orchiopexy
g g g g g g g g g g g
4g/g57
