Burns Pediatric Comprehensive Final
Exam Study Guide with Complete
Solutions
Children are less likely than adults to get wound infections, with an infection rate from
sutured
lacerations at 2%. The PNP should clean and suture the wound. Wounds from animal
bites are
often left to heal by secondary intention to prevent infection. Referral to a plastic
surgeon is
necessary for cosmetic reasons. Delaying closure for several days is recommended for
heavily
contaminated wounds and those caused by high-velocity missile injuries, crush injuries,
and
explosion injuries.
1. 1. According to the 2007 NHIS analysis of the use of CAM therapy, use was higher
among :
a. a. families whose parent or parents had a college education.
b. b. Hispanic and African-American populations.
c. c. persons who had not recently taken prescription medications.
d. d. those living in households earning less than $65,000. - ANSWER-ANS: A
The NHIS review showed that CAM use was higher in households with at least one
college-
educated parent. CAM use was also higher in non-Hispanic Caucasians, persons who
had
taken prescription drugs within the past 3 months, and those living in households with
incomes
higher than $65,000.
1. 1. The mother of a 15-year-old female expresses concerns that her daughter may be
sexually active because she's had a steady boyfriend for over a year. The primary care
pediatric nurse practitioner learns that the family is Catholic and that the mother had an
abortion when she was 16 years old. What will the nurse practitioner do initially?
a. a. Explore the mother's feelings about her own past experience.
b. b. Offer to prescribe contraception to prevent pregnancy.
c. c. Recommend that the mother discuss this with her daughter.
d. d. Suggest that the mother talk to a priest about her daughter. - ANSWER-ANS: A
An initial step when assisting families to manage ethical and behavioral issues is to
assist
,parents and children in values clarification. Before offering other suggestions, the PNP
should
help the mother to clarify her own feelings. The other options may be necessary after
values are
clarified.
1. 1. The parent of a 4-year-old points to a picture and says, "That's your sister." The
child responds by saying, "No! It's my baby!" This is an example of which type of
thinking in
preschool-age children?
a. a. Animism
b. b. Artificialism
c. c. Egocentrism
d. d. Realism - ANSWER-ANS: D
Children at this age are developing their ability to establish causality. Nominal realism
occurs
when children think that one type of thing can only be called by one name. All dogs are
dogs
and not various breeds. Animism refers to the belief that objects possess person-like
qualities.
Artificialism occurs when children think things are caused by a controlling force.
Egocentrism is
when children see things only as they relate to themselves.
1. 1. The parent of a school-age child reports that the child usually has allergic rhinitis
symptoms beginning each fall and that non-sedating antihistamines are only marginally
effective, especially for nasal obstruction symptoms. What will the primary care pediatric
nurse practitioner do?
a. a. Order an intranasal corticosteroid to begin 1 to 2 weeks prior to pollen season.
b. b. Prescribe a decongestant medication as adjunct therapy during pollen season.
c. c. Recommend adding diphenhydramine to the child's regimen for additional
relief.
d. d. Suggest using an over-the-counter intranasal decongestant. - ANSWER-ANS: A
Intranasal corticosteroids are a key component in long-term therapy to manage
symptoms
associated with AR. These should be begun 1 to 2 weeks prior to the beginning of
pollen
season. Decongestants are not recommended for long-term use because of side
effects.
Diphenhydramine causes daytime drowsiness.
1. 1. The primary care pediatric nurse practitioner is evaluating a school-age child who,
after removal of a pituitary tumor, has altered hypothalamic control over hunger and
satiety.
The child is morbidly obese and expresses feeling depressed because of the obesity.
What
,will the nurse practitioner recommend?
a. a. Developing a system to reward compliance with a dietary regimen
b. b. Restricting all access to food in the house and at school
c. c. Suggesting an after-school exercise program to help with weight loss
d. d. Using a food diary to track all calories and food intake - ANSWER-ANS: B
Children with brain dysfunction affecting hypothalamic control may need rigid
restrictions of
access to all foods in refrigerators, cupboards, and even garbage cans
1. 1. The primary care pediatric nurse practitioner is examining a newborn who is
breastfeeding and notes the presence of an ankyloglossia. What will the nurse
practitioner
do next?
a. a. Ask the mother if the infant has any feeding difficulties.
b. b. Refer the infant for a possible frenulectomy.
c. c. Schedule an appointment with a lactation consultant.
d. d. Suggest that the mother feed breast milk by bottle. - ANSWER-ANS: A
Infants with ankyloglossia may have difficulty feeding if the tongue does not extend well.
The
PNP should first assess feeding difficulties and then may refer for a lactation consultant
or
consider a frenulectomy.
1. 10. The mother of a 3-year-old child takes the child to a play group once a week.
She expresses concern that the child plays with toys but does not interact with the other
toddlers. What will the primary care pediatric nurse practitioner counsel the mother?
a. a. The child probably is very shy but will outgrow this tendency with repeated
exposure to other children.
b. b. The toddler may have a language delay that interferes with socialization with
other children.
c. c. Toddlers may be interested in other children but usually do not engage in
interactive play.
d. d. Toddlers need more structured play to encourage interaction and socialization
with others. - ANSWER-ANS: C
Parallel play is common among toddlers who, although they may be fascinated by other
children, generally do not engage with peers in an interactive manner. This does not
mean that
the child is shy or has a language delay, although in preschool years, the development
of
symbolic language increases interactive play. Children need both structured and free
play, but
structured play will not increase interaction during this normally parallel period.
1. 10. The primary care pediatric nurse practitioner is counseling the mother of a
newborn about breastfeeding her infant. Which supplements will the nurse practitioner
recommend?
, a. a. Fat-soluble vitamins
b. b. Iron
c. c. Multivitamins with iron
d. d. Vitamin D - ANSWER-ANS: D
The level of vitamin D in breast milk may not be adequate for breastfed infants, so it
should be
given as a supplement. Human milk has more than adequate amounts of other vitamins.
Iron is
not present, but this is generally added at 6 months of age, when solid foods are added
to the
diet.
1. 10. The primary care pediatric nurse practitioner is examining a school-age child
who has had several hospitalizations for bronchitis and wheezing. The parent reports
that
the child has several coughing episodes associated with chest tightness each week and
gets
relief with an albuterol metered-dose inhaler. What will the nurse practitioner order?
a. a. Allergy testing
b. b. Chest radiography
c. c. Spirometry testing
d. d. Sweat chloride test - ANSWER-ANS: C
Spirometry testing is the gold standard for diagnosing asthma and is then used on a
regular
basis to monitor, evaluate, and manage asthma. Allergy testing should be considered
but is not
diagnostic of asthma. Chest radiography should not be routine. A sweat chloride test is
used
based on history.
1. 10. The primary care pediatric nurse practitioner is examining a toddler who is below
the 3rd percentile for weight even though the parents claim that the child eats
"constantly."
What will the nurse practitioner do initially?
a. a. Evaluate the child's feeding and elimination behaviors and ask the family to
describe mealtime routines.
b. b. Recommend giving a multivitamin and offering high-calorie foods, such as ice
cream.
c. c. Refer the child to a feeding evaluation clinic for a swallow study and evaluation
of possible GERD.
d. d. Suggest that the parents supplement the child's food intake with a high-calorie
formula. - ANSWER-ANS: A
When a child doesn't thrive, it is first necessary to evaluate feeding and elimination
behaviors
Exam Study Guide with Complete
Solutions
Children are less likely than adults to get wound infections, with an infection rate from
sutured
lacerations at 2%. The PNP should clean and suture the wound. Wounds from animal
bites are
often left to heal by secondary intention to prevent infection. Referral to a plastic
surgeon is
necessary for cosmetic reasons. Delaying closure for several days is recommended for
heavily
contaminated wounds and those caused by high-velocity missile injuries, crush injuries,
and
explosion injuries.
1. 1. According to the 2007 NHIS analysis of the use of CAM therapy, use was higher
among :
a. a. families whose parent or parents had a college education.
b. b. Hispanic and African-American populations.
c. c. persons who had not recently taken prescription medications.
d. d. those living in households earning less than $65,000. - ANSWER-ANS: A
The NHIS review showed that CAM use was higher in households with at least one
college-
educated parent. CAM use was also higher in non-Hispanic Caucasians, persons who
had
taken prescription drugs within the past 3 months, and those living in households with
incomes
higher than $65,000.
1. 1. The mother of a 15-year-old female expresses concerns that her daughter may be
sexually active because she's had a steady boyfriend for over a year. The primary care
pediatric nurse practitioner learns that the family is Catholic and that the mother had an
abortion when she was 16 years old. What will the nurse practitioner do initially?
a. a. Explore the mother's feelings about her own past experience.
b. b. Offer to prescribe contraception to prevent pregnancy.
c. c. Recommend that the mother discuss this with her daughter.
d. d. Suggest that the mother talk to a priest about her daughter. - ANSWER-ANS: A
An initial step when assisting families to manage ethical and behavioral issues is to
assist
,parents and children in values clarification. Before offering other suggestions, the PNP
should
help the mother to clarify her own feelings. The other options may be necessary after
values are
clarified.
1. 1. The parent of a 4-year-old points to a picture and says, "That's your sister." The
child responds by saying, "No! It's my baby!" This is an example of which type of
thinking in
preschool-age children?
a. a. Animism
b. b. Artificialism
c. c. Egocentrism
d. d. Realism - ANSWER-ANS: D
Children at this age are developing their ability to establish causality. Nominal realism
occurs
when children think that one type of thing can only be called by one name. All dogs are
dogs
and not various breeds. Animism refers to the belief that objects possess person-like
qualities.
Artificialism occurs when children think things are caused by a controlling force.
Egocentrism is
when children see things only as they relate to themselves.
1. 1. The parent of a school-age child reports that the child usually has allergic rhinitis
symptoms beginning each fall and that non-sedating antihistamines are only marginally
effective, especially for nasal obstruction symptoms. What will the primary care pediatric
nurse practitioner do?
a. a. Order an intranasal corticosteroid to begin 1 to 2 weeks prior to pollen season.
b. b. Prescribe a decongestant medication as adjunct therapy during pollen season.
c. c. Recommend adding diphenhydramine to the child's regimen for additional
relief.
d. d. Suggest using an over-the-counter intranasal decongestant. - ANSWER-ANS: A
Intranasal corticosteroids are a key component in long-term therapy to manage
symptoms
associated with AR. These should be begun 1 to 2 weeks prior to the beginning of
pollen
season. Decongestants are not recommended for long-term use because of side
effects.
Diphenhydramine causes daytime drowsiness.
1. 1. The primary care pediatric nurse practitioner is evaluating a school-age child who,
after removal of a pituitary tumor, has altered hypothalamic control over hunger and
satiety.
The child is morbidly obese and expresses feeling depressed because of the obesity.
What
,will the nurse practitioner recommend?
a. a. Developing a system to reward compliance with a dietary regimen
b. b. Restricting all access to food in the house and at school
c. c. Suggesting an after-school exercise program to help with weight loss
d. d. Using a food diary to track all calories and food intake - ANSWER-ANS: B
Children with brain dysfunction affecting hypothalamic control may need rigid
restrictions of
access to all foods in refrigerators, cupboards, and even garbage cans
1. 1. The primary care pediatric nurse practitioner is examining a newborn who is
breastfeeding and notes the presence of an ankyloglossia. What will the nurse
practitioner
do next?
a. a. Ask the mother if the infant has any feeding difficulties.
b. b. Refer the infant for a possible frenulectomy.
c. c. Schedule an appointment with a lactation consultant.
d. d. Suggest that the mother feed breast milk by bottle. - ANSWER-ANS: A
Infants with ankyloglossia may have difficulty feeding if the tongue does not extend well.
The
PNP should first assess feeding difficulties and then may refer for a lactation consultant
or
consider a frenulectomy.
1. 10. The mother of a 3-year-old child takes the child to a play group once a week.
She expresses concern that the child plays with toys but does not interact with the other
toddlers. What will the primary care pediatric nurse practitioner counsel the mother?
a. a. The child probably is very shy but will outgrow this tendency with repeated
exposure to other children.
b. b. The toddler may have a language delay that interferes with socialization with
other children.
c. c. Toddlers may be interested in other children but usually do not engage in
interactive play.
d. d. Toddlers need more structured play to encourage interaction and socialization
with others. - ANSWER-ANS: C
Parallel play is common among toddlers who, although they may be fascinated by other
children, generally do not engage with peers in an interactive manner. This does not
mean that
the child is shy or has a language delay, although in preschool years, the development
of
symbolic language increases interactive play. Children need both structured and free
play, but
structured play will not increase interaction during this normally parallel period.
1. 10. The primary care pediatric nurse practitioner is counseling the mother of a
newborn about breastfeeding her infant. Which supplements will the nurse practitioner
recommend?
, a. a. Fat-soluble vitamins
b. b. Iron
c. c. Multivitamins with iron
d. d. Vitamin D - ANSWER-ANS: D
The level of vitamin D in breast milk may not be adequate for breastfed infants, so it
should be
given as a supplement. Human milk has more than adequate amounts of other vitamins.
Iron is
not present, but this is generally added at 6 months of age, when solid foods are added
to the
diet.
1. 10. The primary care pediatric nurse practitioner is examining a school-age child
who has had several hospitalizations for bronchitis and wheezing. The parent reports
that
the child has several coughing episodes associated with chest tightness each week and
gets
relief with an albuterol metered-dose inhaler. What will the nurse practitioner order?
a. a. Allergy testing
b. b. Chest radiography
c. c. Spirometry testing
d. d. Sweat chloride test - ANSWER-ANS: C
Spirometry testing is the gold standard for diagnosing asthma and is then used on a
regular
basis to monitor, evaluate, and manage asthma. Allergy testing should be considered
but is not
diagnostic of asthma. Chest radiography should not be routine. A sweat chloride test is
used
based on history.
1. 10. The primary care pediatric nurse practitioner is examining a toddler who is below
the 3rd percentile for weight even though the parents claim that the child eats
"constantly."
What will the nurse practitioner do initially?
a. a. Evaluate the child's feeding and elimination behaviors and ask the family to
describe mealtime routines.
b. b. Recommend giving a multivitamin and offering high-calorie foods, such as ice
cream.
c. c. Refer the child to a feeding evaluation clinic for a swallow study and evaluation
of possible GERD.
d. d. Suggest that the parents supplement the child's food intake with a high-calorie
formula. - ANSWER-ANS: A
When a child doesn't thrive, it is first necessary to evaluate feeding and elimination
behaviors
