NR 605 FINAL EXAM DIAGNOSIS &
MANAGEMENT IN
PSYCHIATRIC-MENTAL HEALTH
ACROSS THE LIFESPANI
PRACTICUM | WEEKS 5 - 8 COVERED
| QUESTIONS WITH COMPLETE
SOLUTIONS | 100% VERIFIED -
CHAMBERLAIN
1. # of dx or tx options- doc the problem as: ANS: self limiting or
minor established, stable or improved established, worsening new, no
additional workup new, additional workup planned
2.The expected hemoglobin range for sickle cell anemia is:
a. 6.5-9.5g/dl
b. 13.5-16.5g/dl
c. 8.5-12.5g/dl
d. 9.5-13.5g/d ANS: A
3. What type of hemorrhage would be expected with severe
factor VIII deficiency?
a. Severe hemorrhage following moderate to severe trauma
b. Gross bleeding following mild to moderate trauma
,c. Gynecologic hemorrhage
d. Spontaneous hemarthosis ANS: D
4. A 16-year-old adolescent comes to the school-based clinic
with chest pain. The most common cause of cardiac pain in
children and adolescents is:
A) Tachycardia
B) Mitral valve prolapse
C) Myocarditis
D) Preventricular contractions ANS: B
5. A 5-year-old child has sudden onset of nonblanching purpuric
lesions scattered over the body and petechiae scattered over the
neck and shoulders. The mother reports that the child has been
healthy, except for a cold a few weeks ago. The child is not
taking any medications. Physical examination reveals a healthy,
afebrile child with no other significant findings. The laboratory
data show a hemoglobin level of 12.5 g/dL, white blood cell
count of 6500/mm3, and platelet count of 20,000/mm3. Based on
this information, what should the PNP do next?
A) Reassure the parents that these findings are consistent with
acute idiopathic thrombocytopenia purpura (ITP), and advise a
hematology consultation for confirmation
B) Refer the child immediately to the pediatric
hematology/oncology department of the nearest tertiary care center
C) Report the family to the local protective services department as
soon as possible because of the ANS: A
,6. A 9yo boy presents with a fever of 102F and complaints of leg
pains. His mother reports that he had upper respiratory infection
with a sore throat approximately two weeks ago, which subsided
without therapy. On physical exam, he has tender, swollen
knees bilaterally. His heart rate is 120/min and blowing systolic
murmur is heard at apex. No murmur was noted on previous
well-child visit. The most likely diagnosis is:
a. Kawasaki disease
b. Rheumatic fever
c. Sickle cell anemia
d. Viral illness ANS: B
(High fever and new onset murmur)
7. A child with asthma symptoms which occur less than twice a
week, with night symptoms less than twice a month and normal
peak flow meter
a. daily use of a low dose inhaled corticosteroid
b. daily use of leukotriene receptor agonist
c. albuterol nebulizer or MDI for use with symptoms
d. medium dose inhaled corticosteroid, administered twice a day
ANS: C
8.A long acting bronchodilator that improves airway function in
patients with mild persistent or exercise induced asthma ANS:
cromolyn/nedocromil
(mediator inhibitors)
, 9.A newborn male infant is noted to have respiratory distress 2
days after birth. On examination he is mottled and has weak
upper extremity pulses with no palpable femoral pulses. On PE
you note a blowing systolic murmur at his left axilla. His ABG
shows a profound metabolic acidosis. What is your diagnosis
ANS: Coarctation of aorta
14. A newborn was mildly cyanotic at birth, but otherwise
stable. In the next few days he becomes ashen gray tachypnic,
and listless. On exam you note only ONE heart sound. What is
your diagnosis? ANS: Hypoplastic left heart syndrome
15. A pediatric nurse practitioner evaluates an established
patient for fever. The nurse practitioner documents the chief
complaint (fever), history of present illness (duration, height of
fever, associated symptoms, and timing), and a review of
systems involving 3 organ systems. Physical examination is
documented and includes full vital signs, general appearance,
and head/neck/lung/cardiac/abdominal/skin examinations. Final
diagnosis is fever with lower respiratory tract infection. The
pediatric nurse practitioner should bill for which level of
service?
a. Detailed
b. Expanded problem-focused
c. Problem-focused
d. Comprehensive ANS: B
18. abusive head trauma ANS: CDC: "injury to the skull or
intracranial contents of an infant or young child (<5) due to inflicted
blunt impact and/or violent shaking"
MANAGEMENT IN
PSYCHIATRIC-MENTAL HEALTH
ACROSS THE LIFESPANI
PRACTICUM | WEEKS 5 - 8 COVERED
| QUESTIONS WITH COMPLETE
SOLUTIONS | 100% VERIFIED -
CHAMBERLAIN
1. # of dx or tx options- doc the problem as: ANS: self limiting or
minor established, stable or improved established, worsening new, no
additional workup new, additional workup planned
2.The expected hemoglobin range for sickle cell anemia is:
a. 6.5-9.5g/dl
b. 13.5-16.5g/dl
c. 8.5-12.5g/dl
d. 9.5-13.5g/d ANS: A
3. What type of hemorrhage would be expected with severe
factor VIII deficiency?
a. Severe hemorrhage following moderate to severe trauma
b. Gross bleeding following mild to moderate trauma
,c. Gynecologic hemorrhage
d. Spontaneous hemarthosis ANS: D
4. A 16-year-old adolescent comes to the school-based clinic
with chest pain. The most common cause of cardiac pain in
children and adolescents is:
A) Tachycardia
B) Mitral valve prolapse
C) Myocarditis
D) Preventricular contractions ANS: B
5. A 5-year-old child has sudden onset of nonblanching purpuric
lesions scattered over the body and petechiae scattered over the
neck and shoulders. The mother reports that the child has been
healthy, except for a cold a few weeks ago. The child is not
taking any medications. Physical examination reveals a healthy,
afebrile child with no other significant findings. The laboratory
data show a hemoglobin level of 12.5 g/dL, white blood cell
count of 6500/mm3, and platelet count of 20,000/mm3. Based on
this information, what should the PNP do next?
A) Reassure the parents that these findings are consistent with
acute idiopathic thrombocytopenia purpura (ITP), and advise a
hematology consultation for confirmation
B) Refer the child immediately to the pediatric
hematology/oncology department of the nearest tertiary care center
C) Report the family to the local protective services department as
soon as possible because of the ANS: A
,6. A 9yo boy presents with a fever of 102F and complaints of leg
pains. His mother reports that he had upper respiratory infection
with a sore throat approximately two weeks ago, which subsided
without therapy. On physical exam, he has tender, swollen
knees bilaterally. His heart rate is 120/min and blowing systolic
murmur is heard at apex. No murmur was noted on previous
well-child visit. The most likely diagnosis is:
a. Kawasaki disease
b. Rheumatic fever
c. Sickle cell anemia
d. Viral illness ANS: B
(High fever and new onset murmur)
7. A child with asthma symptoms which occur less than twice a
week, with night symptoms less than twice a month and normal
peak flow meter
a. daily use of a low dose inhaled corticosteroid
b. daily use of leukotriene receptor agonist
c. albuterol nebulizer or MDI for use with symptoms
d. medium dose inhaled corticosteroid, administered twice a day
ANS: C
8.A long acting bronchodilator that improves airway function in
patients with mild persistent or exercise induced asthma ANS:
cromolyn/nedocromil
(mediator inhibitors)
, 9.A newborn male infant is noted to have respiratory distress 2
days after birth. On examination he is mottled and has weak
upper extremity pulses with no palpable femoral pulses. On PE
you note a blowing systolic murmur at his left axilla. His ABG
shows a profound metabolic acidosis. What is your diagnosis
ANS: Coarctation of aorta
14. A newborn was mildly cyanotic at birth, but otherwise
stable. In the next few days he becomes ashen gray tachypnic,
and listless. On exam you note only ONE heart sound. What is
your diagnosis? ANS: Hypoplastic left heart syndrome
15. A pediatric nurse practitioner evaluates an established
patient for fever. The nurse practitioner documents the chief
complaint (fever), history of present illness (duration, height of
fever, associated symptoms, and timing), and a review of
systems involving 3 organ systems. Physical examination is
documented and includes full vital signs, general appearance,
and head/neck/lung/cardiac/abdominal/skin examinations. Final
diagnosis is fever with lower respiratory tract infection. The
pediatric nurse practitioner should bill for which level of
service?
a. Detailed
b. Expanded problem-focused
c. Problem-focused
d. Comprehensive ANS: B
18. abusive head trauma ANS: CDC: "injury to the skull or
intracranial contents of an infant or young child (<5) due to inflicted
blunt impact and/or violent shaking"
