NUR 652 - Final Exam Questions With Complete Solutions
A 12-year-old child whose BMI is greater than the 95th
percentile has a blood pressure at the 98th percentile for age,
sex, and height. After lifestyle changes that include diet and
exercise, the child's BMI drops to the 90th percentile, but the
blood pressure remains the same. What is the primary care nurse
practitioner's next step in treating this child? Correct Answer
Referral to a nephrologist or cardiologist
A 12-year-old child whose weight and BMI are in the 75th
percentile has a diastolic blood pressure that is between the 95th
and 99th percentiles for age, sex, and height on three separate
occasions. Initial tests for this child will include Correct
Answer renal function and plasma renin tests.
A 13-year-old child has had abdominal pain for 2 days, which
began in the periumbilical area and then localized to the right
lower quadrant. The child vomited once today and then
experienced relief from pain followed by an increased fever.
What is the likely diagnosis? Correct Answer Appendicitis
with perforation
A 13-year-old Native American female has a BMI at the 90th
percentile for age. The primary care pediatric nurse practitioner
notes the presence of a hyperpigmented velvet-like rash in skin
folds. The child denies polydipsia, polyphagia, and polyuria.
The nurse practitioner will Correct Answer order a fasting
blood sample for a metabolic screen for type 2 diabetes.
,A 13-year-old with cerebral palsy receives all nutrition via
gastrostomy tube. What will the primary care nurse practitioner
recommend to promote dental health in this child? Correct
Answer Daily chlorhexidine gluconate
A 14-year-old boy who is overweight develops a unilateral limp
with pain in the hip and knee on the affected side. An exam
reveals external rotation of the hip when flexed and pain
associated with attempts to internally rotate the hip. What is
most important initially when managing this child's condition?
Correct Answer Place the child on crutches or in a wheelchair
to prevent weightbearing.
A 15-year-old child has a recent history of increased thirst and
frequent urination. The child's weight has been in the 95th
percentile for several years. A dipstick UA is positive for
glucose, and random plasma glucose is 350mg/dL. Which test
will the primary care NP order to determine the type of diabetes
in this child? Correct Answer Pancreatic antibodies
A 16-year-old adolescent female whose BMI is at the 90th
percentile reports irregular periods. The primary care pediatric
nurse practitioner notes widespread acne on her face and back
and an abnormal distribution of facial hair. The nurse
practitioner will evaluate her further based on a suspicion of
which diagnosis? Correct Answer Polycystic ovary syndrome.
A 2-month-old infant cries up to 4 hours each day and,
according to the parents, is inconsolable during crying episodes
with fists and legs noted to be tense and stiff. The infant is
breastfeeding frequently but is often fussy during feedings. The
,physical exam is normal, and the infant is gaining weight
normally. What will the primary care pediatric nurse practitioner
recommend? Correct Answer Eliminating certain foods from
the mother's diet
A 2-year-old child is brought to the clinic after developing a
hoarse, bark-like cough during the night with "trouble catching
his breath" according to the parent. The history reveals a 2 day
history of low-grade fever and upper respiratory symptoms. On
exam, the child has a respiratory rate of 40 breaths per minute,
occasional stridor when crying, and a temperature of 101.3°F.
What is the next step in treatment for this child? Correct
Answer Prescribe oral dexamethasone for 2 days
A 3-month-old male infant has edema and painless swelling of
the scrotum. On physical examination, the provider is able to
transilluminate the scrotum. What will the provider recommend?
Correct Answer Observation and reassurance that spontaneous
resolution may occur
A 3-year-old child is brought to the clinic by a parent who
reports that the child refuses to use the right arm after being
swung by both arms while playing. The child is sitting with the
right arm held slightly flexed and close to the body. There is no
swelling or ecchymosis present. What will the primary care
pediatric nurse practitioner do? Correct Answer Gently
attempt a supination and flexion technique
A 5-month old infant who has a 3-day history of cough and
rhinorrhea has developed symptoms of respiratory distress with
audible expiratory wheezes and increased coughing. The infant's
, immunizations are up-to-date. The physical exam reveals a
respiratory rate of 50 breaths per minute, coarse expiratory
wheezing, and prolonged expiration. An oxygen saturation is
96% on room air. What is the recommended treatment for this
infant? Correct Answer Recommend increased fluids and
close follow-up.
A 5-year-old child is hit in the face with a baseball bat and is
brought to the clinic by a parent. An exam reveals three avulsed
front teeth. Radiologic studies are negative for facial fractures.
What is the recommended treatment? Correct Answer Refer
the child to the dentist immediately for further evaluation
A 50-year-old man reports having erectile dysfunction. What is
an important response by the provider when developing a plan
of care for this patient? Correct Answer Evaluating the patient
for cardiovascular disease
A 6-year-old female has had a recent growth spurt and an exam
reveals breast and pubic hair development. Her bone age is
determined to be 8 years. What will the primary care nurse
practitioner do next? Correct Answer Refer the child to a
pediatric endocrinologist for management.
A 65-year-old patient who has not had an influenza vaccine is
exposed to influenza and comes to the clinic the following day
with fever and watery, red eyes. What will the provider do
initially? Correct Answer Perform a nasal swab for RT-PCR
assay.
A 12-year-old child whose BMI is greater than the 95th
percentile has a blood pressure at the 98th percentile for age,
sex, and height. After lifestyle changes that include diet and
exercise, the child's BMI drops to the 90th percentile, but the
blood pressure remains the same. What is the primary care nurse
practitioner's next step in treating this child? Correct Answer
Referral to a nephrologist or cardiologist
A 12-year-old child whose weight and BMI are in the 75th
percentile has a diastolic blood pressure that is between the 95th
and 99th percentiles for age, sex, and height on three separate
occasions. Initial tests for this child will include Correct
Answer renal function and plasma renin tests.
A 13-year-old child has had abdominal pain for 2 days, which
began in the periumbilical area and then localized to the right
lower quadrant. The child vomited once today and then
experienced relief from pain followed by an increased fever.
What is the likely diagnosis? Correct Answer Appendicitis
with perforation
A 13-year-old Native American female has a BMI at the 90th
percentile for age. The primary care pediatric nurse practitioner
notes the presence of a hyperpigmented velvet-like rash in skin
folds. The child denies polydipsia, polyphagia, and polyuria.
The nurse practitioner will Correct Answer order a fasting
blood sample for a metabolic screen for type 2 diabetes.
,A 13-year-old with cerebral palsy receives all nutrition via
gastrostomy tube. What will the primary care nurse practitioner
recommend to promote dental health in this child? Correct
Answer Daily chlorhexidine gluconate
A 14-year-old boy who is overweight develops a unilateral limp
with pain in the hip and knee on the affected side. An exam
reveals external rotation of the hip when flexed and pain
associated with attempts to internally rotate the hip. What is
most important initially when managing this child's condition?
Correct Answer Place the child on crutches or in a wheelchair
to prevent weightbearing.
A 15-year-old child has a recent history of increased thirst and
frequent urination. The child's weight has been in the 95th
percentile for several years. A dipstick UA is positive for
glucose, and random plasma glucose is 350mg/dL. Which test
will the primary care NP order to determine the type of diabetes
in this child? Correct Answer Pancreatic antibodies
A 16-year-old adolescent female whose BMI is at the 90th
percentile reports irregular periods. The primary care pediatric
nurse practitioner notes widespread acne on her face and back
and an abnormal distribution of facial hair. The nurse
practitioner will evaluate her further based on a suspicion of
which diagnosis? Correct Answer Polycystic ovary syndrome.
A 2-month-old infant cries up to 4 hours each day and,
according to the parents, is inconsolable during crying episodes
with fists and legs noted to be tense and stiff. The infant is
breastfeeding frequently but is often fussy during feedings. The
,physical exam is normal, and the infant is gaining weight
normally. What will the primary care pediatric nurse practitioner
recommend? Correct Answer Eliminating certain foods from
the mother's diet
A 2-year-old child is brought to the clinic after developing a
hoarse, bark-like cough during the night with "trouble catching
his breath" according to the parent. The history reveals a 2 day
history of low-grade fever and upper respiratory symptoms. On
exam, the child has a respiratory rate of 40 breaths per minute,
occasional stridor when crying, and a temperature of 101.3°F.
What is the next step in treatment for this child? Correct
Answer Prescribe oral dexamethasone for 2 days
A 3-month-old male infant has edema and painless swelling of
the scrotum. On physical examination, the provider is able to
transilluminate the scrotum. What will the provider recommend?
Correct Answer Observation and reassurance that spontaneous
resolution may occur
A 3-year-old child is brought to the clinic by a parent who
reports that the child refuses to use the right arm after being
swung by both arms while playing. The child is sitting with the
right arm held slightly flexed and close to the body. There is no
swelling or ecchymosis present. What will the primary care
pediatric nurse practitioner do? Correct Answer Gently
attempt a supination and flexion technique
A 5-month old infant who has a 3-day history of cough and
rhinorrhea has developed symptoms of respiratory distress with
audible expiratory wheezes and increased coughing. The infant's
, immunizations are up-to-date. The physical exam reveals a
respiratory rate of 50 breaths per minute, coarse expiratory
wheezing, and prolonged expiration. An oxygen saturation is
96% on room air. What is the recommended treatment for this
infant? Correct Answer Recommend increased fluids and
close follow-up.
A 5-year-old child is hit in the face with a baseball bat and is
brought to the clinic by a parent. An exam reveals three avulsed
front teeth. Radiologic studies are negative for facial fractures.
What is the recommended treatment? Correct Answer Refer
the child to the dentist immediately for further evaluation
A 50-year-old man reports having erectile dysfunction. What is
an important response by the provider when developing a plan
of care for this patient? Correct Answer Evaluating the patient
for cardiovascular disease
A 6-year-old female has had a recent growth spurt and an exam
reveals breast and pubic hair development. Her bone age is
determined to be 8 years. What will the primary care nurse
practitioner do next? Correct Answer Refer the child to a
pediatric endocrinologist for management.
A 65-year-old patient who has not had an influenza vaccine is
exposed to influenza and comes to the clinic the following day
with fever and watery, red eyes. What will the provider do
initially? Correct Answer Perform a nasal swab for RT-PCR
assay.
