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 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 teen who has otitis externa has severe swelling of the external auditory canal
that persists after 2 days of therapy with ototopical antibiotic/corticosteroid
drops. What is the next step in treatment for this child? - CORRECT ANSWER -
Insert a wick into the external auditory canal
An elderly patient has a permanent loss of the sense of smell and diminished
taste. What will be included in teaching this patient about managing these
symptoms? - CORRECT ANSWER -1. The importance of installing smoke detectors
2. Putting dates on food in the fridge
3. Eating regular meals at scheduled times
A toddler exhibits exotropia of the right eye during a cover-uncover screen. The
primary nurse practitioner will refer to a pediatric ophthalmologist to initiate
,which treatment? - CORRECT ANSWER -Patching of the unaffected eye for 2 hours
each day
An adolescent has localized bleeding of the gums when brushing the teeth. An
exam of the mouth reveals the presence of plaque and calculus on the teeth
which are not loose. What will the primary care nurse practitioner recommend? -
CORRECT ANSWER -Consistently brushing and flossing the teeth twice daily
A provider is recommending a cerumenolytic for a patient who has chronic
cerumen buildup. The provider notes that the patient has dry skin in the ear
canal. Which preparation is FDA approved for this use? - CORRECT ANSWER -
Carbamide peroxide
A parent asks about ways to promote dental health in school-aged children while
on family vacation that are convenient while camping and picnicking. What will
the primary care nurse practitioner recommend? - CORRECT ANSWER -Offering
gum containing xylitol after meals
A 7-month-old infant has had two prior acute ear infections and is currently on
the 10th day of therapy with amoxicillin-clavulanate after a failed course of
amoxicillin. The primary care nurse practitioner notes marker middle ear effusion
and erythema of the TM. The child is irritable and has a temperature of 99.8.
What is the next step in management of this child's infection? - CORRECT
ANSWER -Refer the child to an otolayngologist
A patient reports painful swelling in the mouth with increased pain at mealtimes.
The provider notes a mass in the salivary gland region. What is the likely cause of
these symptoms? - CORRECT ANSWER -Sialolithiasis
,During a well child assessment of an African American infant, the primary care
nurse practitioner notes a dark red-brown light reflex in the left eye and a slightly
brighter, red-orange light reflex in the right eye. The nurse practitioner will... -
CORRECT ANSWER -Refer the infant to an opthalmologist
A preschool age child who attend daycare has a 2 day history of matted eyelids in
the morning and burning and itching of the eyes. The primary care NP notes
yellow-green purulent discharge from both eyes, conjunctival erythema and mild
URI symptoms. Which action is correct? - CORRECT ANSWER -Prescribe topical
antibiotic drops
An 18-month-old child with no previous history of otitis media awoke during the
night with right ear pain. The primary care NP notes an axillary temperature of
100.5 and an erythematous, bulging TM. A tympanogram reveals a peak of +15-
mm H2O. What is the recommended treatment for this child? - CORRECT
ANSWER -An analgesic medication and watchful waiting
During a well-child exam on a 4-year-old child, the primary care NP notes that the
clinic nurse recorded 20/50 for the child's vision and noted that the child has
difficulty cooperating with the exam. What will the NP recommend? - CORRECT
ANSWER -Test the child's vision in 1 month
Causes of cough, not related to pulmonary issues - CORRECT ANSWER -Allergies,
GERD, medications (lisinopril)
The primary care NP is providing nutritional counseling for a 9-year-old female
whose weight is at the 95th percentile for her age. What is the goal for this
patient? - CORRECT ANSWER -Maintenance of her current weight
, The primary care NP is performing a well child examination on a 12-year-old child
who was diagnosed with type 1 DM at age 9. The child had a lipid screen at age 10
with an LDL cholesterol <100mg/dL. What will the NP recommend as part of
ongoing management for this child? - CORRECT ANSWER -Comprehensive
ophthalmologic exams
The primary care NP is reviewing lab work and diabetes management with a
school-aged child whose HbA1C is 7.6% who reports usual blood sugars before
meals as being 80-90mg/dL. The NP will consult with the child's endocrinologist to
consider which therapy? - CORRECT ANSWER -Continuous glucose monitoring
The primary care NP notes a musty odor when examining a newborn at a 2-week
checkup. What will the NP suspect? - CORRECT ANSWER -Phenylketonuria
A patient who has diabetes has a blood pressure of 140/90 and albuminuria.
Which initial action by the primary care NP is indicated for management of this
patient? - CORRECT ANSWER -Consulting with a nephrologist
The primary care NP is performing a well-child examination on a 2-year-old child
with a history of intrauterine growth retardation whose height remains less than
the 3rd percentile on a WHO growth chart. What will the NP do? - CORRECT
ANSWER -Refer the child to a pediatric endocrinologist
An infant has congenital adrenal hyperplasia. At a routine well baby checkup, the
primary care NP notes vomiting, poor feeding, lethargy, and mild dehydration.
Which action is correct? - CORRECT ANSWER -Refer the infant to the ED for fluids,
dextrose, and steroids
A patient recently diagnosed with T1DM is in clinic for a follow-up evaluation. The
provider notes that the patient appears confused and irritable and is sweating
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 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 teen who has otitis externa has severe swelling of the external auditory canal
that persists after 2 days of therapy with ototopical antibiotic/corticosteroid
drops. What is the next step in treatment for this child? - CORRECT ANSWER -
Insert a wick into the external auditory canal
An elderly patient has a permanent loss of the sense of smell and diminished
taste. What will be included in teaching this patient about managing these
symptoms? - CORRECT ANSWER -1. The importance of installing smoke detectors
2. Putting dates on food in the fridge
3. Eating regular meals at scheduled times
A toddler exhibits exotropia of the right eye during a cover-uncover screen. The
primary nurse practitioner will refer to a pediatric ophthalmologist to initiate
,which treatment? - CORRECT ANSWER -Patching of the unaffected eye for 2 hours
each day
An adolescent has localized bleeding of the gums when brushing the teeth. An
exam of the mouth reveals the presence of plaque and calculus on the teeth
which are not loose. What will the primary care nurse practitioner recommend? -
CORRECT ANSWER -Consistently brushing and flossing the teeth twice daily
A provider is recommending a cerumenolytic for a patient who has chronic
cerumen buildup. The provider notes that the patient has dry skin in the ear
canal. Which preparation is FDA approved for this use? - CORRECT ANSWER -
Carbamide peroxide
A parent asks about ways to promote dental health in school-aged children while
on family vacation that are convenient while camping and picnicking. What will
the primary care nurse practitioner recommend? - CORRECT ANSWER -Offering
gum containing xylitol after meals
A 7-month-old infant has had two prior acute ear infections and is currently on
the 10th day of therapy with amoxicillin-clavulanate after a failed course of
amoxicillin. The primary care nurse practitioner notes marker middle ear effusion
and erythema of the TM. The child is irritable and has a temperature of 99.8.
What is the next step in management of this child's infection? - CORRECT
ANSWER -Refer the child to an otolayngologist
A patient reports painful swelling in the mouth with increased pain at mealtimes.
The provider notes a mass in the salivary gland region. What is the likely cause of
these symptoms? - CORRECT ANSWER -Sialolithiasis
,During a well child assessment of an African American infant, the primary care
nurse practitioner notes a dark red-brown light reflex in the left eye and a slightly
brighter, red-orange light reflex in the right eye. The nurse practitioner will... -
CORRECT ANSWER -Refer the infant to an opthalmologist
A preschool age child who attend daycare has a 2 day history of matted eyelids in
the morning and burning and itching of the eyes. The primary care NP notes
yellow-green purulent discharge from both eyes, conjunctival erythema and mild
URI symptoms. Which action is correct? - CORRECT ANSWER -Prescribe topical
antibiotic drops
An 18-month-old child with no previous history of otitis media awoke during the
night with right ear pain. The primary care NP notes an axillary temperature of
100.5 and an erythematous, bulging TM. A tympanogram reveals a peak of +15-
mm H2O. What is the recommended treatment for this child? - CORRECT
ANSWER -An analgesic medication and watchful waiting
During a well-child exam on a 4-year-old child, the primary care NP notes that the
clinic nurse recorded 20/50 for the child's vision and noted that the child has
difficulty cooperating with the exam. What will the NP recommend? - CORRECT
ANSWER -Test the child's vision in 1 month
Causes of cough, not related to pulmonary issues - CORRECT ANSWER -Allergies,
GERD, medications (lisinopril)
The primary care NP is providing nutritional counseling for a 9-year-old female
whose weight is at the 95th percentile for her age. What is the goal for this
patient? - CORRECT ANSWER -Maintenance of her current weight
, The primary care NP is performing a well child examination on a 12-year-old child
who was diagnosed with type 1 DM at age 9. The child had a lipid screen at age 10
with an LDL cholesterol <100mg/dL. What will the NP recommend as part of
ongoing management for this child? - CORRECT ANSWER -Comprehensive
ophthalmologic exams
The primary care NP is reviewing lab work and diabetes management with a
school-aged child whose HbA1C is 7.6% who reports usual blood sugars before
meals as being 80-90mg/dL. The NP will consult with the child's endocrinologist to
consider which therapy? - CORRECT ANSWER -Continuous glucose monitoring
The primary care NP notes a musty odor when examining a newborn at a 2-week
checkup. What will the NP suspect? - CORRECT ANSWER -Phenylketonuria
A patient who has diabetes has a blood pressure of 140/90 and albuminuria.
Which initial action by the primary care NP is indicated for management of this
patient? - CORRECT ANSWER -Consulting with a nephrologist
The primary care NP is performing a well-child examination on a 2-year-old child
with a history of intrauterine growth retardation whose height remains less than
the 3rd percentile on a WHO growth chart. What will the NP do? - CORRECT
ANSWER -Refer the child to a pediatric endocrinologist
An infant has congenital adrenal hyperplasia. At a routine well baby checkup, the
primary care NP notes vomiting, poor feeding, lethargy, and mild dehydration.
Which action is correct? - CORRECT ANSWER -Refer the infant to the ED for fluids,
dextrose, and steroids
A patient recently diagnosed with T1DM is in clinic for a follow-up evaluation. The
provider notes that the patient appears confused and irritable and is sweating
