NURS 612 ENGAGING MARYVILLE UNIVERSITY ASSESSMENT EXAM 2 FOR HEALTH SCIENCES 2025/2026 EXAM QUESTIONS AND VERIFIED ANSWERS

1. On your patient schedule see a diagnosis of plagiocephaly on your patient schedule. You vaguely recall learning something about this in Nurs 612 so you check UpToDate and are able to explain the etiology of this head growth disturbance is to the parents of this 4-month-old : A. Your child's head appears small. His head size is 2 SD below the mean, this can result abnormal brain development from a genetic or teratogenic exposure B. Your child's head appears flat. This form of craniostenosis can result from premature fusion of lambdoidal or coronal skull sutures and often results in brain injury. C. Your child's head appears large. His head size is 2 SD above the mean, this can result from hydrocephalus while skull sutures are open. D. Your child's head appears flat. This form of craniostenosis can result from premature fusion of lambdoidal or coronal skull sutures and is often only cosmetic and can be treated with a s - Answer D. Your child's head appears flat. This form of craniostenosis can result from premature fusion of lambdoidal or coronal skull sutures and is often only cosmetic and can be treated with a special helmet. 2. During a 1-week-old male well child check the head circumference is 3 S.D. (standard deviations) below the predicted mean. What risk factors increases the risk of this finding? A. Positioning infant on their back B. Prenatal Zika virus exposure C. Hydrocephaly D. Subdural hematoma or tumor - Answer B. Prenatal Zika virus exposure 3. You are seeing a 6-month-old today for follow-up after a febrile seizure yesterday. On exam you expect to find: A. the anterior fontanel closed. B. the posterior fontanel closed C. sleepiness from a post-ictal state D. nuchal rigidity - Answer B. the posterior fontanel closed 4. You are examining a 22-month-old today for follow-up after a with a new sudden onset of jerking movements while febrile earlier today. Which of the following is not typical of this type seizure? A. Positive family history B. Age onset between 3 months and 5 years C. Seizure lasting more than 15 minutes D. Most likely to occur with a rapid rise in body temperature - Answer C. Seizure lasting more than 15 minutes 5. A 15-year-old with a diagnosis of epilepsy had a seizure in your office lasting 12 minutes requiring rectal diazepam (Valium). He is stable in a postictal state. His parents express concern as his last seizure was 2 years ago and he wanted to be weaned off his phenytoin (Dilantin).Which of the following may have contributed to this seizure? A. Experimentation with alcohol consumption which lowers seizure threshold. B. Recent growth spurt resulting in decreased kg/mg dosage C. Adolescent may be challenging diagnosis and non-compliant with phenytoin regimen D. All choices are correct - Answer D. All choices are correct 6. What question in an adolescent's history is the MOST important to ask concerning new onset of headaches? A. Alcohol use B. Caffeine use C. History of headache most severe when arising from sleep D. Positive family history for headaches - Answer C. History of headache most severe when arising from sleep 7. A 17-year-old arrives for evaluation of a headache. He states it is worse in the morning and does not respond to ibuprofen. His caffeine intake has not changed, he has no known head trauma. On exam you note he is slow to respond to questions and your fundoscopic exam the optic disc borders are blurred (papilledema). You explain your next action A. He exhibits a focal neurological sign, order a CT B. He exhibits a focal neurological sign, discharge the patient home prescribing bedrest, acetaminophen and recommend sunglasses C. He exhibits no focal neurological signs, discharge the patient home on bedrest, teaching family members signs warning signs of increased ICP D. He exhibits no focal neurological signs. discharge the patient home recommending return to school, but no contact sports until headache resolved - Answer A. He exhibits a focal neurological sign, order a CT 8. A 17-year-old gymnast presents following her competition with a resolving headache rated 3/10, after her spotter missed her and she fell 4 feet and struck her head. Although she did not lose consciousness and seems fine now, her parents are concerned because she does not remember how she got off the gym floor. Which of the following would NOT be indicated. A. Prescribe bedrest, acetaminophen and recommend sunglasses if light sensitive B. Teach warning signs of head injuryand send home on bedrest C. Order a CT of the Head D. Recommend return to school, but no contact sports until headache resolved. - Answer C. Order a CT of the Head 9. An 11-year-old male presents with a history head trauma resulting from a "hard hit" while playing football 2 days ago. His GCS score is 14. Despite 20/15 vision recorded 3 months ago during his sports physical he states he has blurred vision and is unable to read fine print, otherwise his neuro exam is normal. What is your best plan of care? A. You assess this is not a mild concussion and order a CT because he exhibits a focal neurological sign B. You assess this is a moderate concussion and discharge the patient home prescribing bedrest, acetaminophen and recommend sunglasses if light sensitive C. You assess this is a mild concussion discharge the patient home and teaching family members signs warning signs of head injury, send home on bedrest D. You assess this is a mild concussion discharge the patient home and recommend return to school, but no contact sports until headache resolved - Answer A. You assess this is not a mild concussion and order a CT because he exhibits a focal neurological sign 10. You are examining a 4-month-old with a fever who suddenly stares blankly and her limbs start twitching. You time the episode which lasts 3 minutes. What are next steps? A. Administer IV antibiotic following obtaining lumbar puncture and blood culture B. Order a STAT EEG C. Lie child on their side and time the event, administer antipyretic D. Administer rectal valium - Answer C. Lie child on their side and time the event, administer antipyretic 11. Your are treating a 16-year-old female with chronic headaches. Effective management of headache in an adolescent patient includes which of the following A. Appropriate medication or other pain relieving intervention B. Explanation of the likely cause and expected course of the headache C. Elimination of headache triggers D. All answers are correct - Answer D. All answers are correct 12. Your 12-year-old male patient has a history of cord compression and anoxia at birth presents with spasticity and partial paralysis. His likely diagnosis is: A. erb's palsy B. brachial plexus palsy C. cerebral palsy D. muscular dystrophy - Answer C. cerebral palsy 13. A 3 year-old-femaie presents with loss of the use of her left arm since her forcep delivery birth. Which of the following is her most likely diagnosis? A. brachial plexus palsy B. cerebral palsy C. Bell's palsy D. none are likely diagnoses - Answer A. brachial plexus palsy 14. 9-year-old Sarah presents with her normal-height parents who are concerned about her short stature. Physical exam is unremarkable except for height and weight are in the 3rd percentile, you note she is Tanner Stage 1, her endocrine work-up is normal except for a delayed bone age (8 years). The treatment for Sarah's suspected diagnosis: A. Reassurance, close observation, with anticipated growth acceleration B. Urgent endocrine referral for growth hormone, with anticipated growth acceleration C. Urgent endocrine referral for Turner syndrome D. Reassurance, close observation, with anticipated short stature - Answer A. Reassurance, close observation, with anticipated growth acceleration 15. 16-year-old Michael presents with his 60-year-old father with a concern about delayed puberty, physical exam is remarkable for scant body hair, tall stature, mild gynecomastia and hypogonadism. The treatment for Michael's suspected diagnosis is: A. Reassurance, close observation, with anticipated catch up sexual maturity B. Endocrine referral for growth hormone, with anticipated catch up sexual maturity C. Endocrine referral for likely Klinefelter syndrome and consideration of testosterone therapy D. Endocrine referral for likely Klinefelter syndrome for consideration of growth hormone therapy - Answer C. Endocrine referral for likely Klinefelter syndrome and consideration of testosterone therapy 16. 15-year-old Dana presents with her 60-year-old mother w a concern about delayed puberty with amenorrhea, physical exam is remarkable noting short stature, low set ears and hair line, cubitus valgus and web necked. The treatment for Dana's suspected diagnosis is: A. Reassurance, close observation, with anticipated catch up sexual maturity B. Endocrine referral for likely Turner's syndrome and consideration of estrogen, progesterone AND growth hormone therapy C. Endocrine referral for likely Turner's syndrome and consideration of estrogen, and progesterone hormone therapy D. Endocrine referral for growth hormone, with anticipated catch up sexual maturity - Answer B. Endocrine referral for likely Turner's syndrome and consideration of estrogen, progesterone AND growth hormone therapy 17. A 4-year-old girl presents with her mother with concerned about her breast development. Her family history is negative for endocrine disorders. Physical exam is unremarkable except for stage 1 breast development, no pubic with no signs of axillary or pubic hair . Her height and weight are above the 95th percentile. Which of the following BEST describes this child's physical findings? A. Normal variant B. Precocious puberty C. Premature thelarche D. Premature adrenarche - Answer C. Premature thelarche 18. Identified risk factors for nonorganic failure to thrive include all of the following EXCEPT A. Diabetes Type I B. Parental neglect C. Underfeeding D. Inadequate caloric intake - Answer A. Diabetes Type I 19. You are seeing a 2-month-old infant girl that you suspect has Turner's syndrome. Based on your knowledge of the physical manifestations of Turner's syndrome, what would you expect to see at this 2-month exam? A. Webbed neck, cubitus valgus B. Hypertelorism, low-set ears C. Micrognathia, hip dysplasia D. Microcephaly, cubitus valgus - Answer A. Webbed neck, cubitus valgus 20. A 5-year-old presents with lethargy, on exam you note a1-kg weight loss since her WCC 8 months ago. Your differential diagnosis includes diabetes. Which of the following is THE MOST common presenting complaint of Type 1 diabetes in children? A. Polyphagia and BMI >85% B. Ketoacidosis C. Arrested growth D. Polyuria, polydipsia or nighttime enuresis - Answer D. Polyuria, polydipsia or nighttime enuresis 21. A 12-year-old female has a recent history of recurrent vaginal yeast infection effectively treated with miconazole vaginal cream. The child's weight has been in the 95th percentile for several years, but height has only been in the 50th percentile. A dipstick UA is positive for glucose, and random plasma glucose is 250 mg/dL. Considering the likely diagnosis, what will be the most appropriate plan of care? A. Metformin prescription, urine dipsticks for urine glucose monitoring, healthy diet and exercise regimen B. Insulin prescription, home glucometer for blood glucose monitoring, healthy diet and exercise regimen C. Metformin prescription, home glucometer for blood glucose monitoring, healthy diet and exercise D. Insulin prescription, urine dipsticks for urine glucose monitoring, healthy diet and exercise - Answer C. Metformin prescription, home glucometer for blood glucose monitoring, healthy diet and exercise 22. A newborn JT in your care tests positive for PKU. His parents ask if switching his formula will improve his musty odor. They understand this disorder may impact his brain development and are requesting an MRI of his brain. As the FNP, you offer the following explanation of JT's PKU is due to: A. missing a hormone needed to synthesize important brain chemicals like norepinephrine, his new formula and supplements will help his brain development. This is monitored with PKU blood levels and not measurable with the MRI B. missing a hormone needed to synthesize important brain chemicals like melanin, his new formula and supplements will help his brain development. C. This is monitored with PKU blood levels and not measurable with the MRIRI 23. missing a hormone needed to synthesize important brain chemicals, his new formula and supplements will help his brain development. This is monitored with an MRI. 24. D. missing a hormone ne - Answer A. missing a hormone needed to synthesize important brain chemicals like norepinephrine, his new formula and supplements will help his brain development. This is monitored with PKU blood levels and not measurable with the MRI 25. A 7-year-old male has a recent history of viral infection and now presents with polyuria, polydipsia and a 1.5- kg weight loss. A dipstick UA is positive for glucose, and random plasma glucose is 350 mg/dL. Considering the likely diagnosis, what will included in the most appropriate plan of care? A. Metformin prescription, home glucometer for blood glucose monitoring, healthy diet and exercise regimen B. Insulin prescription (sq. infusion via pump or injection), home glucometer for blood glucose monitoring, healthy diet and exercise regimen C. Metformin prescription, urine dipsticks for urine glucose monitoring, healthy diet and exercise regimen D. Insulin prescription (sq. infusion via pump or injection), urine dipsticks for urine glucose monitoring, healthy diet and exercise regimen - Answer B. Insulin prescription (sq. infusion via pump or injection), home glucometer for blood glucose monitoring, healthy diet and exercise regimen 26. What is hypospadias? - Answer termination of urethra on ventral penile surface 27. What is epispadias? - Answer open of urethra on dorsal penial surface 28. Which is more common: hypospadias or epispadias? - Answer hypospadias 29. What is contraindicated in newborn males with hypospadias? Why? - Answer circumcision; child will grow, foreskin will later be used for repair. 30. What is phimosis and paraphimosis? - Answer phimosis is constriction of the prepuce or penile foreskin that prevents retraction over the glans. paraphimosis is when the foreskin is so tight it cannot cover the glans (most common in catheterized males). 31. Describe peyronie's disease - Answer localized and progressive fibrosis of unknown origin that affects the tunica albuginea. characterized by painful erection, bent erection, and presence of hard, fibrotic mass where fibrosis has occurred 32. What is priapism? - Answer urologic emergency from prolonged, involuntary, painful erection. 33. what is low flow priapism? - Answer Venous stasis in corpora cavernosa caused by a failure to subside erection. considered ischemic. 34. what is high flow priapism? - Answer persistent arterial flow into corpora cavernosa r/t trauma. 35. primary priapism results from what types of injuries? what is primary priapism? - Answer trauma, infection, infection, and neoplasms; condition r/t penis 36. secondary priapism results from what type of conditions? what is secondary priapism? - Answer hematologic conditions, neurologic conditions, renal failure; conditions indirectly r/t penis 37. what are risk factors for penial arterial insufficiency? - Answer hypertension, hyperlipidemia, cigarette smoking, DM, pelvic irradiation. consider which ones are reversible. 38. what is balanitis? - Answer acute or chronic inflammation of the glans penis 39. What is balanoposthitis? - Answer inflammation/infection of glans AND prepuce; happens because the foreskin interferes with cleanliness and promotes bacterial growth 40. What is cryptorchidism? - Answer occurs when one or both testes do not descend into scrotal sac. normally descend between 7-9 months gestation. 41. What is testicular torsion? What is absent? - Answer surgical emergency where testicle is high in scrotum, in an abnormal orientation, with absent cremasteric reflex 42. what is the acronym TWIST for? - Answer Testicular pain, warning signs (pain, swelling, redness), immediately tell someone, see a doctor, time is of essence. 43. What is epididymitis and diagnosis consist of? - Answer inflammation of epididymis; STIs=urethritis; Non-STIs=UTIs and prostatitis. normal cremasteric reflex. 44. what is orchitis caused by? - Answer mumps*, scarlet fever, pneumonia; infection of testicles; mumps most common. 45. what are possible etiologies for scrotal cancer? - Answer exposure to tar, soot, oils (chimney sweeps); poor hygiene; chronic inflammation r/t untreated HPV infection 46. what are the possible etiologies for testicular cancer? - Answer cryptochorchidism; genetic factors; testicular development disorders. 47. what is a seminoma? - Answer cancer from germ cell tumors in 20-34 y.o. 48. signs and symptoms of testicular cancer - Answer PAINLESS lump on testicle that can vary in size; feeling of heaviness/ache in lower abdomen/scrotum. 49. what is acute prostatitis? what is the treatment for it? - Answer acute bacterial infection that came from the urethra. antibiotics for 4 weeks.