1
NURS 6541 MIDTERM EXAM ACTUAL EXAM 2025
QUESTIONS AND CORRECT ANSWERS (PROFESSOR
VERIFIED) | ALREADY GRADED | LATEST EDITION
Recommended treatment for RSV in a 7 month old (outpatient) - (answers)Use of
saline drops and suctioning of the nares. Indications of when to use antipyretics.
Signs of respiratory distress or dehydration. Guidelines for feeding an infant with
signs of mild respiratory distress which includes smaller more frequent feedings;
monitoring of the respiratory rate; and guarding against vomiting. The parents
should be educated that the child may have the symptoms over the course of 2-3
weeks
Epiglottitis s/s - (answers)Acute and rapid onset of high fever, chills, and toxicity.
Severe sore throat and drooling saliva. Will not eat or drink, muffled (hot potato)
voice, and anxiety. Sitting posture with hyperextended neck with open-mouth
breathing. Stridor, tachycardia, and tachypnea
Epiglottitis prevention - (answers)Haemophilus influenzae type B (Hib) vaccine
Steeple sign - (answers)a radiologic sign found on radiograph where the subglottic
tracheal narrowing produces a shape of a church steeple which supports a
diagnosis of croup
Foreign body aspiration antibiotic? - (answers)Depends on the nature of the
material aspirated, plus the location and degree of obstruction. Bronchial or
laryngeal foreign body aspiration, a bronchoscopy must be performed for removal
of the foreign body
, 2
Antibiotics for bronchiolitis? - (answers)Use of saline drops and suctioning of the
nares. There is no evidence to support the routine use of antibiotics
Antibiotics for croup? - (answers)Nebulized epinephrine, corticosteroids
(dexamethasone oral or IM), blow by oxygen or heliox in severe croup. Racemic
epinephrine with the use of corticosteroids to limit rebound swelling
Antibiotics for epiglottitis? - (answers)Establish an airway preferably by
nasotracheal intubation. Administer IV antibiotics such as rocephin to cover
H.influenzae. Administer oxygen and respiratory support. Antibiotics should be
continued for 10 days. Rifampin prophylaxis 20 mg/kg in a single dose (maximum
of 600 mg) for 4 days for infants and children, 600 mg once a day for adults for 4
days. Should be provided for household contacts who are at risk (Younger than 4
years old who is non-immunized or incompletely immunized, children less than 12
months who have not received primary series of Hib, and immunocompromised
children.
Asthma treatment - (answers)The pharmacological management of asthma in
children is based on the severity of asthma and the child's age. After initial
control, decrease treatment to the least amount of medication needed to
maintain control. Systemic corticosteroids may be needed at any time and
stepped up if there is a major flare-up of symptoms.
Step 1 Asthma management for children 0-4 years old - (answers)Step 1: SABA
(Short acting beta2-agonist) PRN: With viral respiratory symptoms short acting
beta 2-agonist should be used every 4-6 hours up to 24 hours (longer with a
physician consult). Consider short course of oral systemic corticosteroids if severe
exacerbation. Frequent use of SABA may indicate the need to step up treatment
, 3
Step 2 Asthma management for children 0-4 years old - (answers)Step 2: Consider
consultation with asthma specialist. Low dose of inhaled corticosteroids.
Step 3 asthma mgmt for children 0-4 yrs - (answers)Step 3: Medium-dose of
inhaled corticosteroids
Steps 4-6 asthma mgmt for children 0-4 yrs - (answers)Step 4: Medium-dose ICS
and Long acting beta2-agonist or montelukast.
Step 5: High dose ICS and Long acting beta 2-agonist or montelukast.
Step 6: High dose of ICS and LABA or montelukast and oral corticosteroids
Steps 1-3 asthma mgmt for children 5-11 yrs - (answers)Step 1: SABA (Short acting
beta 2-agonist) PRN: Increasing the use of short-acting beta 2-agonist or use
greater than 2 days a week for symptom relief generally indicates inadequate
control and the need to step up treatment.
Step 2: Consider consultation with asthma specialist. Low dose of inhaled
corticosteroids.
Step 3: Low dose of inhaled corticosteroid and LABA. Or medium dose of inhaled
corticosteroids.
, 4
Steps 4-6 asthma mgmt for children 5-11 yrs - (answers)Step 4: Medium-dose ICS
and LABA or medium dose of inhaled corticosteroid and leukotriene receptor
antagonist or theophylline. .
Step 5: High dose ICS and LABA or high dose of inhaled corticosteroid and
leukotriene receptor antagonist or theophylline. .
Step 6: High dose of ICS and LABA and oral corticosteroids or high dose of inhaled
corticosteroids and leukotriene receptor antagonist or theophylline and oral
corticosteroids.
** Theophylline levels must be monitored.
Differentials for patient with sore throat - (answers)Strep pharyngitis
Peritonsillar abscess
Viral pharyngitis
Infectious mononucleosis
Epiglottitis
small-for-gestational-age infants: which type of chromosomal analysis should be
included? - (answers)Trisomy 18
Holt-Olram
Trisomy 13
NURS 6541 MIDTERM EXAM ACTUAL EXAM 2025
QUESTIONS AND CORRECT ANSWERS (PROFESSOR
VERIFIED) | ALREADY GRADED | LATEST EDITION
Recommended treatment for RSV in a 7 month old (outpatient) - (answers)Use of
saline drops and suctioning of the nares. Indications of when to use antipyretics.
Signs of respiratory distress or dehydration. Guidelines for feeding an infant with
signs of mild respiratory distress which includes smaller more frequent feedings;
monitoring of the respiratory rate; and guarding against vomiting. The parents
should be educated that the child may have the symptoms over the course of 2-3
weeks
Epiglottitis s/s - (answers)Acute and rapid onset of high fever, chills, and toxicity.
Severe sore throat and drooling saliva. Will not eat or drink, muffled (hot potato)
voice, and anxiety. Sitting posture with hyperextended neck with open-mouth
breathing. Stridor, tachycardia, and tachypnea
Epiglottitis prevention - (answers)Haemophilus influenzae type B (Hib) vaccine
Steeple sign - (answers)a radiologic sign found on radiograph where the subglottic
tracheal narrowing produces a shape of a church steeple which supports a
diagnosis of croup
Foreign body aspiration antibiotic? - (answers)Depends on the nature of the
material aspirated, plus the location and degree of obstruction. Bronchial or
laryngeal foreign body aspiration, a bronchoscopy must be performed for removal
of the foreign body
, 2
Antibiotics for bronchiolitis? - (answers)Use of saline drops and suctioning of the
nares. There is no evidence to support the routine use of antibiotics
Antibiotics for croup? - (answers)Nebulized epinephrine, corticosteroids
(dexamethasone oral or IM), blow by oxygen or heliox in severe croup. Racemic
epinephrine with the use of corticosteroids to limit rebound swelling
Antibiotics for epiglottitis? - (answers)Establish an airway preferably by
nasotracheal intubation. Administer IV antibiotics such as rocephin to cover
H.influenzae. Administer oxygen and respiratory support. Antibiotics should be
continued for 10 days. Rifampin prophylaxis 20 mg/kg in a single dose (maximum
of 600 mg) for 4 days for infants and children, 600 mg once a day for adults for 4
days. Should be provided for household contacts who are at risk (Younger than 4
years old who is non-immunized or incompletely immunized, children less than 12
months who have not received primary series of Hib, and immunocompromised
children.
Asthma treatment - (answers)The pharmacological management of asthma in
children is based on the severity of asthma and the child's age. After initial
control, decrease treatment to the least amount of medication needed to
maintain control. Systemic corticosteroids may be needed at any time and
stepped up if there is a major flare-up of symptoms.
Step 1 Asthma management for children 0-4 years old - (answers)Step 1: SABA
(Short acting beta2-agonist) PRN: With viral respiratory symptoms short acting
beta 2-agonist should be used every 4-6 hours up to 24 hours (longer with a
physician consult). Consider short course of oral systemic corticosteroids if severe
exacerbation. Frequent use of SABA may indicate the need to step up treatment
, 3
Step 2 Asthma management for children 0-4 years old - (answers)Step 2: Consider
consultation with asthma specialist. Low dose of inhaled corticosteroids.
Step 3 asthma mgmt for children 0-4 yrs - (answers)Step 3: Medium-dose of
inhaled corticosteroids
Steps 4-6 asthma mgmt for children 0-4 yrs - (answers)Step 4: Medium-dose ICS
and Long acting beta2-agonist or montelukast.
Step 5: High dose ICS and Long acting beta 2-agonist or montelukast.
Step 6: High dose of ICS and LABA or montelukast and oral corticosteroids
Steps 1-3 asthma mgmt for children 5-11 yrs - (answers)Step 1: SABA (Short acting
beta 2-agonist) PRN: Increasing the use of short-acting beta 2-agonist or use
greater than 2 days a week for symptom relief generally indicates inadequate
control and the need to step up treatment.
Step 2: Consider consultation with asthma specialist. Low dose of inhaled
corticosteroids.
Step 3: Low dose of inhaled corticosteroid and LABA. Or medium dose of inhaled
corticosteroids.
, 4
Steps 4-6 asthma mgmt for children 5-11 yrs - (answers)Step 4: Medium-dose ICS
and LABA or medium dose of inhaled corticosteroid and leukotriene receptor
antagonist or theophylline. .
Step 5: High dose ICS and LABA or high dose of inhaled corticosteroid and
leukotriene receptor antagonist or theophylline. .
Step 6: High dose of ICS and LABA and oral corticosteroids or high dose of inhaled
corticosteroids and leukotriene receptor antagonist or theophylline and oral
corticosteroids.
** Theophylline levels must be monitored.
Differentials for patient with sore throat - (answers)Strep pharyngitis
Peritonsillar abscess
Viral pharyngitis
Infectious mononucleosis
Epiglottitis
small-for-gestational-age infants: which type of chromosomal analysis should be
included? - (answers)Trisomy 18
Holt-Olram
Trisomy 13
