NURS 629 Peds Q&A for all 4 test combined Maryville University 2022/23
r r r r r r r r r r r
1. 14. A schoolage child has a history of chronic otitis media and is seen inthe c
r r r r r r r r r r r r r r r r
linicmwith vertigo. The primary care pediatric nurse practitioner notesprofuse r r r r r r r r r
purulent otorrhea from both pressureequalizing tubes and a pearlywhite lesi
r r r r r r r r r r
on on one tympanic
r r r
membrane. Which condition is most likely?: Ans- Cholesteatoma r r r r r r r
2. 3. A dipstick urinalysis is positive for leukocyte esterase and nitrites in asch
r r r r r r r r r r r r r
oolage
child with dysuria and foulsmelling urine but no fever who has not hadpre
r r r r r r r r r r r r r
vious urinary tract r r
infections. A culture is pending. What will the pediatric nurse practitioner doto t r r r r r r r r r r r r r
reat this child?: Ans- r r r
Prescribe trimethoprimsulfamethoxazole (TMP) twice daily for 3 to 5 days
r r r r r r r r r r
3. the parent of a 4monthold infant is concerned that the infant cannot hear.Whi
r r r r r r r r r r r r r
ch test will the primary care pediatric nurse practitioner order to evaluatepotenti
r r r r r r r r r r r r
al hearing loss in this infant?: Ans- Auditory brainstem response (ABR)
r r r r r r r r r r
4. 4. The primary care pediatric nurse practitioner attempts to learn moreab
r r r r r r r r r r r
out the ID: Ans- 13348419842
r r r r
emotional health of an 18monthold child through which assessment strate- r r r r r r r r r
gy?: Ans-
r r
Observation of the child with caretakers in structured and unstructured situations
r r r r r r r r r r r
5. 6. What will the primary care pediatric nurse practitioner teach the parentsof a
r r r r r r r r r r r r r r
child
who has new pressureequalizing tubes (PET) in both ears?: Ans-
r r r r r r r r r
Parentsshould notice improved hearing in their child.
r r r r r r r r
6. 4. A preschoolage child with no previous history has mild flank pain and feve
r r r r r r r r r r r r r
r but no abdominal pain or vomiting. Aurinalysis is positive for leukocyteesterase
r r r r r r r r r r r r r
and nitrites. A culture is pending. Which is the correct course of treatment for this
r r r r r r r r r r r r r r r r
child?: Ans- Order amoxicillin clavulanate r r r r
7. 7. A child with a history of otitis externa asks about ways to prevent thiscon
r r r r r r r r r r r r r r r
dition.
What will the primary care pediatric nurse practitioner recommend?: Ans-
r r r r r r r r r
Drying the ear canal with a hair dryer r r r r r r r
8. 12. The primary care pediatric nurse practitioner is evaluating recurrentst
r r r r r r r r r r
omach pain in r r
a schoolage child. The child's exam is normal. The nurse practitioner learnsthat t
r r r r r r r r r r r r r
e child reports
r r
1r/r57
, NURS 629 Peds Q&A for all 4 test combined Maryville University 2022/23
r r r r r r r r r r r
pain most evenings after school and refuses to participate in sports but doesnot h
r r r r r r r r r r r r r r
ve nausea or r r
vomiting.The child's grandmother recently had gallbladder surgery.Whichacti r r r r r r r r r
on is correct?: Ans-
r r r
Encourage the child to keep a log of pain, stool patterns, and dietary intake
r r r r r r r r r r r r r r
9. 9. A child who has otitis externa has severe swelling of the external audi-
r r r r r r r r r r r r r
tory canal that persists after 2 days of therapy with ototopical antibiotic/cor-
r r r r r r r r r r r r
ticosteroid drops. What is the next step in treatment for this child?: Ans-
r r r r r r r r r r r r r
Insert a wick into the external auditory canal.
r r r r r r r r
10. 5. A 3yearold child has just completed a 7day course of amoxicillin for asec
r r r r r r r r r r r r r r
ondfebrile urinary tract infection and currently has a negative urine cul- r r r r r r r r r r
ture. What is the next course of action?: Ans-
r r r r r r r r r
Obtain a renal and bladder ultrasound.
r r r r r r
11. 8. A child complains of itching in both ears and is having trouble hearing.
r r r r r r r r r r r r r
The
primary care pediatric nurse practitioner notes periauricular edema andm
r r r r r r r r r
arked swelling r
of the external auditory canal and elicits severe pain when manipulating theext
r r r r r r r r r r r r
ernal ear r
structures. Which is an appropriate intervention?: Ans- r r r r r r
Order ototopicalantibiot- ic/corticosteroid drops.
r r r r r
12. 5. A middleschoolage child is skipping school frequently and getting poorgra
r r r r r r r r r r r
des
since the child's father was killed while deployed in the military. How will theprima
r r r r r r r r r r r r r r
y care pediatric
r r
nurse practitioner manage this situation?: Ans-
r r r r r
Refer the child to a mentalhealth specialist for evaluation and treatment.
r r r r r r r r r r r r
13. The primary care pediatric nurse practitioner is examining a 2weekoldinf
r r r r r r r r r r
ant and r
auscultates a wide splitting of S 2 during expiration. What condition may thisfindi r r r r r r r r r r r r r
g represent?: Ans- Atrial septal defect
r r r r r
14. A 9monthold infant with a history of three urinary tract infections is diagno
r r r r r r r r r r r r
sed with grade II vesicoureteral reflux. Which medication will be pre-
r r r r r r r r r r
scribed?: Ans- TMPSMX~ TMP 2 mg/kg as a single daily dose
r r r r r r r r r r r
15. 2. The primary care pediatric nurse practitioner auscultates a new gradeII vi
r r r r r r r r r r r r
bratory,
midsystolic murmur at the mid sternal border in a 4yearold child that is r r r r r r r r r r r r
2r/r57
, NURS 629 Peds Q&A for all 4 test combined Maryville University 2022/23
r r r r r r r r r r r
louder when the child is r r r r
supine. What type of murmur is most likely?: Ans- Still's murmur
r r r r r r r r r r
16. 4. The primary care pediatric nurse practitioner is performing a well babyexa
r r r r r r r r r r r r
mination on a 2monthold infant who has gained 25 grams per day in thelast inte
r r r r r r r r r r r r r r r
rval.The r
mother is nursing and tells the nurse practitioner that her infant seems fussy and w
r r r r r r r r r r r r r r
ants to nurse r r
more often. What will the nurse practitioner tell her?: Ans-
r r r r r r r r r
The infant may be going through an expected growth spurt.
r r r r r r r r r r
17. 3. During a well child assessment, the primary care pediatric nurse prac-
r r r r r r r r r r r
titioner
r
auscultates a harsh, blowing grade IV/VI murmur in a 6monthold infant. What will t r r r r r r r r r r r r r
he nurse r
practitioner do next?: Ans- Refer to a pediatric cardiologist for further evaluation r r r r r r r r r r r
18. 12. A child who has nephrotic syndrome is on a steroids and a saltrestrict-
r r r r r r r r r r r r r
ed diet for a relapse of symptoms. A dipstick urinalysis shows 1+ protein, dow
r r r r r r r r r r r r r r
n from 3+ at the beginning of the episode. In consultation with the child's nephr
r r r r r r r r r r r r r r
ologist, what is the correct course of treatment considering thisfinding?: Ans-
r r r r r r r r r r r
Continue with steroids and salt restrictions until the urine is negative for protein
r r r r r r r r r r r r r
19. 4. The primary care pediatric nurse practitioner provides primary care fora 4
r r r r r r r r r r r r
month
old infant who has a ventricular septal defect. The infant has been breast-
r r r r r r r r r r r r
feeding well but in the
r r r r r
past month has dropped from the 20th percentile to the 5th for weight. Whatwill th
r r r r r r r r r r r r r r r
nurse practitioner recommend?: Ans-
r r r
Fortifying breast milk to increase thenumber of calories per ounce
r r r r r r r r r r r
20. 6. The parent of a 4yearold child reports that the child seems to be havingtrou
r r r r r r r r r r r r r r r
ble
adjusting to a new day care and reportedly is always engaging in solitaryplay w
r r r r r r r r r r r r r r
hen the r
parent arrives to pick up the child. What will the primary care pediatric nursepra
r r r r r r r r r r r r r r
ctitioner do?: Ans- r r
Ask the parent if the child is slow to warm up to other new situations
r r r r r r r r r r r r r r r
21. 5. A 12monthold infant who had cardiopulmonary bypass with RBC andpla
r r r r r r r r r r r
sma
3r/r57
, NURS 629 Peds Q&A for all 4 test combined Maryville University 2022/23
r r r r r r r r r r r
infusions during surgery at 8 months is seen for a well child examination.
r r r r r r r r r r r r
Which vaccine may be r r r
administered at this visit?\: Ans- PCV13 r r r r r
22. 13. A child who had GABHS 2 weeks prior is in the clinic with periorbitalede
r r r r r r r r r r r r r r r
ma,
dyspnea, and elevated blood pressure. A urinalysis reveals teacolored urinewit
r r r r r r r r r r
h hematuria and
r r
mild proteinuria. What will the primary care pediatric nurse practitioner do toma
r r r r r r r r r r r r
nage this condition?: Ans- Refer the child to a pediatric nephrologist for hospital-
r r r r r r r r r r r r
ization.
r
23. The primary care pediatric nurse practitioner performs a well child exam-
r r r r r r r r r r
ination on
r r
a 12monthold child who had repair of a congenital heart defect at 8 monthsof a
r r r r r r r r r r r r r r r
ge.The child has a
r r r r
normal exam.The parent reports that the child is not taking any medications.
r r r r r r r r r r r r
The nurse practitioner
r r
will contact the child's cardiologist to discuss whether the child needs whichmed
r r r r r r r r r r r r
ation?: Ans- Amoxicillin r r
24. 7. The primary care pediatric nurse practitioner sees a developmentallydel
r r r r r r r r r r
ayed
toddler for an initial visit.The family has just moved to the area and asks thenurse
r r r r r r r r r r r r r r r r
ractitioner
about community services and resources for their child. What should thenurse p
r r r r r r r r r r r r
actitioner do r
initially?: Ans- Ask the parents if theyhave an individualized familyservice plan(IFSP).
r r r r r r r r r r r r r
25. 20. A 7yearold child who has a history of a repaired congenital heartdef
r r r r r r r r r r r r r
ect has r
many dental caries along with gingival erythema and irritation and a temper-
r r r r r r r r r r r
ature of
r r
102.5°F. What will the primary care pediatric nurse practitioner do next?:An
r r r r r r r r r r r
s- Ad- mit to the hospital with a pediatric cardiology consult.
r r r r r r r r r r
26. 16. A6monthold infant has a retractile testis thatwas noted at the 2monthwell
r r r r r r r r r r r r r r
baby exam. What will the primary care pediatric nurse practitioner do tomanag
r r r r r r r r r r r r
e this condition?: Ans-
r r r
Refer the infant to a pediatric urologist or surgeon for possible orchiopexy
r r r r r r r r r r r r
4r/r57
r r r r r r r r r r r
1. 14. A schoolage child has a history of chronic otitis media and is seen inthe c
r r r r r r r r r r r r r r r r
linicmwith vertigo. The primary care pediatric nurse practitioner notesprofuse r r r r r r r r r
purulent otorrhea from both pressureequalizing tubes and a pearlywhite lesi
r r r r r r r r r r
on on one tympanic
r r r
membrane. Which condition is most likely?: Ans- Cholesteatoma r r r r r r r
2. 3. A dipstick urinalysis is positive for leukocyte esterase and nitrites in asch
r r r r r r r r r r r r r
oolage
child with dysuria and foulsmelling urine but no fever who has not hadpre
r r r r r r r r r r r r r
vious urinary tract r r
infections. A culture is pending. What will the pediatric nurse practitioner doto t r r r r r r r r r r r r r
reat this child?: Ans- r r r
Prescribe trimethoprimsulfamethoxazole (TMP) twice daily for 3 to 5 days
r r r r r r r r r r
3. the parent of a 4monthold infant is concerned that the infant cannot hear.Whi
r r r r r r r r r r r r r
ch test will the primary care pediatric nurse practitioner order to evaluatepotenti
r r r r r r r r r r r r
al hearing loss in this infant?: Ans- Auditory brainstem response (ABR)
r r r r r r r r r r
4. 4. The primary care pediatric nurse practitioner attempts to learn moreab
r r r r r r r r r r r
out the ID: Ans- 13348419842
r r r r
emotional health of an 18monthold child through which assessment strate- r r r r r r r r r
gy?: Ans-
r r
Observation of the child with caretakers in structured and unstructured situations
r r r r r r r r r r r
5. 6. What will the primary care pediatric nurse practitioner teach the parentsof a
r r r r r r r r r r r r r r
child
who has new pressureequalizing tubes (PET) in both ears?: Ans-
r r r r r r r r r
Parentsshould notice improved hearing in their child.
r r r r r r r r
6. 4. A preschoolage child with no previous history has mild flank pain and feve
r r r r r r r r r r r r r
r but no abdominal pain or vomiting. Aurinalysis is positive for leukocyteesterase
r r r r r r r r r r r r r
and nitrites. A culture is pending. Which is the correct course of treatment for this
r r r r r r r r r r r r r r r r
child?: Ans- Order amoxicillin clavulanate r r r r
7. 7. A child with a history of otitis externa asks about ways to prevent thiscon
r r r r r r r r r r r r r r r
dition.
What will the primary care pediatric nurse practitioner recommend?: Ans-
r r r r r r r r r
Drying the ear canal with a hair dryer r r r r r r r
8. 12. The primary care pediatric nurse practitioner is evaluating recurrentst
r r r r r r r r r r
omach pain in r r
a schoolage child. The child's exam is normal. The nurse practitioner learnsthat t
r r r r r r r r r r r r r
e child reports
r r
1r/r57
, NURS 629 Peds Q&A for all 4 test combined Maryville University 2022/23
r r r r r r r r r r r
pain most evenings after school and refuses to participate in sports but doesnot h
r r r r r r r r r r r r r r
ve nausea or r r
vomiting.The child's grandmother recently had gallbladder surgery.Whichacti r r r r r r r r r
on is correct?: Ans-
r r r
Encourage the child to keep a log of pain, stool patterns, and dietary intake
r r r r r r r r r r r r r r
9. 9. A child who has otitis externa has severe swelling of the external audi-
r r r r r r r r r r r r r
tory canal that persists after 2 days of therapy with ototopical antibiotic/cor-
r r r r r r r r r r r r
ticosteroid drops. What is the next step in treatment for this child?: Ans-
r r r r r r r r r r r r r
Insert a wick into the external auditory canal.
r r r r r r r r
10. 5. A 3yearold child has just completed a 7day course of amoxicillin for asec
r r r r r r r r r r r r r r
ondfebrile urinary tract infection and currently has a negative urine cul- r r r r r r r r r r
ture. What is the next course of action?: Ans-
r r r r r r r r r
Obtain a renal and bladder ultrasound.
r r r r r r
11. 8. A child complains of itching in both ears and is having trouble hearing.
r r r r r r r r r r r r r
The
primary care pediatric nurse practitioner notes periauricular edema andm
r r r r r r r r r
arked swelling r
of the external auditory canal and elicits severe pain when manipulating theext
r r r r r r r r r r r r
ernal ear r
structures. Which is an appropriate intervention?: Ans- r r r r r r
Order ototopicalantibiot- ic/corticosteroid drops.
r r r r r
12. 5. A middleschoolage child is skipping school frequently and getting poorgra
r r r r r r r r r r r
des
since the child's father was killed while deployed in the military. How will theprima
r r r r r r r r r r r r r r
y care pediatric
r r
nurse practitioner manage this situation?: Ans-
r r r r r
Refer the child to a mentalhealth specialist for evaluation and treatment.
r r r r r r r r r r r r
13. The primary care pediatric nurse practitioner is examining a 2weekoldinf
r r r r r r r r r r
ant and r
auscultates a wide splitting of S 2 during expiration. What condition may thisfindi r r r r r r r r r r r r r
g represent?: Ans- Atrial septal defect
r r r r r
14. A 9monthold infant with a history of three urinary tract infections is diagno
r r r r r r r r r r r r
sed with grade II vesicoureteral reflux. Which medication will be pre-
r r r r r r r r r r
scribed?: Ans- TMPSMX~ TMP 2 mg/kg as a single daily dose
r r r r r r r r r r r
15. 2. The primary care pediatric nurse practitioner auscultates a new gradeII vi
r r r r r r r r r r r r
bratory,
midsystolic murmur at the mid sternal border in a 4yearold child that is r r r r r r r r r r r r
2r/r57
, NURS 629 Peds Q&A for all 4 test combined Maryville University 2022/23
r r r r r r r r r r r
louder when the child is r r r r
supine. What type of murmur is most likely?: Ans- Still's murmur
r r r r r r r r r r
16. 4. The primary care pediatric nurse practitioner is performing a well babyexa
r r r r r r r r r r r r
mination on a 2monthold infant who has gained 25 grams per day in thelast inte
r r r r r r r r r r r r r r r
rval.The r
mother is nursing and tells the nurse practitioner that her infant seems fussy and w
r r r r r r r r r r r r r r
ants to nurse r r
more often. What will the nurse practitioner tell her?: Ans-
r r r r r r r r r
The infant may be going through an expected growth spurt.
r r r r r r r r r r
17. 3. During a well child assessment, the primary care pediatric nurse prac-
r r r r r r r r r r r
titioner
r
auscultates a harsh, blowing grade IV/VI murmur in a 6monthold infant. What will t r r r r r r r r r r r r r
he nurse r
practitioner do next?: Ans- Refer to a pediatric cardiologist for further evaluation r r r r r r r r r r r
18. 12. A child who has nephrotic syndrome is on a steroids and a saltrestrict-
r r r r r r r r r r r r r
ed diet for a relapse of symptoms. A dipstick urinalysis shows 1+ protein, dow
r r r r r r r r r r r r r r
n from 3+ at the beginning of the episode. In consultation with the child's nephr
r r r r r r r r r r r r r r
ologist, what is the correct course of treatment considering thisfinding?: Ans-
r r r r r r r r r r r
Continue with steroids and salt restrictions until the urine is negative for protein
r r r r r r r r r r r r r
19. 4. The primary care pediatric nurse practitioner provides primary care fora 4
r r r r r r r r r r r r
month
old infant who has a ventricular septal defect. The infant has been breast-
r r r r r r r r r r r r
feeding well but in the
r r r r r
past month has dropped from the 20th percentile to the 5th for weight. Whatwill th
r r r r r r r r r r r r r r r
nurse practitioner recommend?: Ans-
r r r
Fortifying breast milk to increase thenumber of calories per ounce
r r r r r r r r r r r
20. 6. The parent of a 4yearold child reports that the child seems to be havingtrou
r r r r r r r r r r r r r r r
ble
adjusting to a new day care and reportedly is always engaging in solitaryplay w
r r r r r r r r r r r r r r
hen the r
parent arrives to pick up the child. What will the primary care pediatric nursepra
r r r r r r r r r r r r r r
ctitioner do?: Ans- r r
Ask the parent if the child is slow to warm up to other new situations
r r r r r r r r r r r r r r r
21. 5. A 12monthold infant who had cardiopulmonary bypass with RBC andpla
r r r r r r r r r r r
sma
3r/r57
, NURS 629 Peds Q&A for all 4 test combined Maryville University 2022/23
r r r r r r r r r r r
infusions during surgery at 8 months is seen for a well child examination.
r r r r r r r r r r r r
Which vaccine may be r r r
administered at this visit?\: Ans- PCV13 r r r r r
22. 13. A child who had GABHS 2 weeks prior is in the clinic with periorbitalede
r r r r r r r r r r r r r r r
ma,
dyspnea, and elevated blood pressure. A urinalysis reveals teacolored urinewit
r r r r r r r r r r
h hematuria and
r r
mild proteinuria. What will the primary care pediatric nurse practitioner do toma
r r r r r r r r r r r r
nage this condition?: Ans- Refer the child to a pediatric nephrologist for hospital-
r r r r r r r r r r r r
ization.
r
23. The primary care pediatric nurse practitioner performs a well child exam-
r r r r r r r r r r
ination on
r r
a 12monthold child who had repair of a congenital heart defect at 8 monthsof a
r r r r r r r r r r r r r r r
ge.The child has a
r r r r
normal exam.The parent reports that the child is not taking any medications.
r r r r r r r r r r r r
The nurse practitioner
r r
will contact the child's cardiologist to discuss whether the child needs whichmed
r r r r r r r r r r r r
ation?: Ans- Amoxicillin r r
24. 7. The primary care pediatric nurse practitioner sees a developmentallydel
r r r r r r r r r r
ayed
toddler for an initial visit.The family has just moved to the area and asks thenurse
r r r r r r r r r r r r r r r r
ractitioner
about community services and resources for their child. What should thenurse p
r r r r r r r r r r r r
actitioner do r
initially?: Ans- Ask the parents if theyhave an individualized familyservice plan(IFSP).
r r r r r r r r r r r r r
25. 20. A 7yearold child who has a history of a repaired congenital heartdef
r r r r r r r r r r r r r
ect has r
many dental caries along with gingival erythema and irritation and a temper-
r r r r r r r r r r r
ature of
r r
102.5°F. What will the primary care pediatric nurse practitioner do next?:An
r r r r r r r r r r r
s- Ad- mit to the hospital with a pediatric cardiology consult.
r r r r r r r r r r
26. 16. A6monthold infant has a retractile testis thatwas noted at the 2monthwell
r r r r r r r r r r r r r r
baby exam. What will the primary care pediatric nurse practitioner do tomanag
r r r r r r r r r r r r
e this condition?: Ans-
r r r
Refer the infant to a pediatric urologist or surgeon for possible orchiopexy
r r r r r r r r r r r r
4r/r57