NU 664: Exam 1 Study Guide
Questions with Quality Answers 2026-
2027 Updated.
Gold standard for CAP diagnosis: - Answer Chest x-ray
If CAP symptoms present but no obvious signs of infection on CXR treatment is... - Answer
Same as if CXR was positive
Immunizations for people over 65 or younger people with comorbidities such as asthma, CHF
COPD: - Answer Pneumonia and flu vaccines
Who is at risk for CAP? - Answer Extremes of age, smokers, alcoholics, GERD, chronic disease,
institutionalization
CAP presentation in adults: - Answer Cough (may be nonproductive), dyspnea, fever,
hemoptysis, chest pain, fatigue, tachycardia
If lymphocytes are elevated? - Answer Indicative of viral process
If monocytes are elevated? - Answer Indicative of chronic process
If eosinophils are elevated? - Answer Indicative of asthma, allergic reaction
If basophils are elevated? - Answer Indicative of chronic process
If neutrophils are elevated? - Answer Indicative of acute bacterial process
CAP: patient present with symptoms of chills, fever, chest pain, productive cough with purulent
sputum, positive chest x-ray, and patient had URI last week? - Answer Streptococcus
pneumonia: gram +
In the United States, the most common cause of myocarditis in children is: - Answer Viruses
Your next patient is a 5-year-old child with a history of moderate persistent asthma. He has been
wheezing and coughing for the past two days, and his mother brings him in today for
evaluation. He has been using albuterol every four hours. His respiratory rate is 13 breaths per
, minute; his lungs are clear to auscultation; and no retractions are noted. What may be your
assessment and intervention based on this information? - Answer Your child is breathing
slower than normal for his age. We need to send him to the ER for further intervention.
Your next patient is a 6-year-old male here for his annual influenza vaccine. He has a history of
mild persistent asthma. What would you discuss for medications when reviewing his asthma
action plan? - Answer Your child should continue his low-dose inhaled corticosteroid daily
and add albuterol as needed for an exacerbation.
A child who has been diagnosed with asthma for several years has been using a short-acting
Beta-agonist (SABA) to control symptoms. The PNP learns that the child has recently begun
using the SABA 2-3 times each week to prevent wheezing and shortness of breath. The child
currently has clear breath sounds and an FEV1 of 75% of personal best. What will the NP do? -
Answer Add an inhaled corticosteroid.
Your next patient is a six-month-old infant who just completed amoxicillin for otitis media. The
mother states her child is better except for a diaper rash. Upon examination, you note red scaly
plaques in the diaper area with satellite lesions to his upper thighs. What would you do next as
the PNP? - Answer Your child has a rash that is likely due to a fungus, Candida, and commonly
occurs after taking antibiotics. I will prescribe nystatin to be applied to the diaper area.
A 12 y.o. female presents to the clinic after being bit by a dog on the face. Abrasion with 2
puncture wounds on the upper right cheek, approximately 1 inch below the eye. The area is
slightly erythematous, with a small amount of bruising and raised area along the cheekbone. -
Answer Using normal saline, irrigate the wounds using high pressure (greater than 4 pounds
per square inch) and high volume (greater than 1 L). Isolated puncture wounds should not be
irrigated, instead soak the wound in a diluted solution of tap water and povidone-iodine for
15 .minutes • Prescribe a 3- to 5-day course of prophylactic antibiotics
A 4 yo child has clusters of small, clear, tense vesicles with an erythematous base on one side of
the mouth along the vermillion border, which are causing discomfort and difficulty eating. What
will the PNP recommend as treatment? - Answer Topical diphenhydramine and magnesium
hydroxide.
A 4 year old child with PE tubes in both ears has otalgia in one ear. The PNP is able to visualize
the tube and does not see exudate in the ear canal and obtains a type A tympanogram. What
will the NP do? - Answer Order ototopical corticosteroid/antibiotic drops.
The parent of a 1-week old is concerned about the unusual shape of their child's head. In the
physical exam, which of the following signs would not support the diagnosis of
craniosynostosis? - Answer A palpable lesion at the occipital region.
Questions with Quality Answers 2026-
2027 Updated.
Gold standard for CAP diagnosis: - Answer Chest x-ray
If CAP symptoms present but no obvious signs of infection on CXR treatment is... - Answer
Same as if CXR was positive
Immunizations for people over 65 or younger people with comorbidities such as asthma, CHF
COPD: - Answer Pneumonia and flu vaccines
Who is at risk for CAP? - Answer Extremes of age, smokers, alcoholics, GERD, chronic disease,
institutionalization
CAP presentation in adults: - Answer Cough (may be nonproductive), dyspnea, fever,
hemoptysis, chest pain, fatigue, tachycardia
If lymphocytes are elevated? - Answer Indicative of viral process
If monocytes are elevated? - Answer Indicative of chronic process
If eosinophils are elevated? - Answer Indicative of asthma, allergic reaction
If basophils are elevated? - Answer Indicative of chronic process
If neutrophils are elevated? - Answer Indicative of acute bacterial process
CAP: patient present with symptoms of chills, fever, chest pain, productive cough with purulent
sputum, positive chest x-ray, and patient had URI last week? - Answer Streptococcus
pneumonia: gram +
In the United States, the most common cause of myocarditis in children is: - Answer Viruses
Your next patient is a 5-year-old child with a history of moderate persistent asthma. He has been
wheezing and coughing for the past two days, and his mother brings him in today for
evaluation. He has been using albuterol every four hours. His respiratory rate is 13 breaths per
, minute; his lungs are clear to auscultation; and no retractions are noted. What may be your
assessment and intervention based on this information? - Answer Your child is breathing
slower than normal for his age. We need to send him to the ER for further intervention.
Your next patient is a 6-year-old male here for his annual influenza vaccine. He has a history of
mild persistent asthma. What would you discuss for medications when reviewing his asthma
action plan? - Answer Your child should continue his low-dose inhaled corticosteroid daily
and add albuterol as needed for an exacerbation.
A child who has been diagnosed with asthma for several years has been using a short-acting
Beta-agonist (SABA) to control symptoms. The PNP learns that the child has recently begun
using the SABA 2-3 times each week to prevent wheezing and shortness of breath. The child
currently has clear breath sounds and an FEV1 of 75% of personal best. What will the NP do? -
Answer Add an inhaled corticosteroid.
Your next patient is a six-month-old infant who just completed amoxicillin for otitis media. The
mother states her child is better except for a diaper rash. Upon examination, you note red scaly
plaques in the diaper area with satellite lesions to his upper thighs. What would you do next as
the PNP? - Answer Your child has a rash that is likely due to a fungus, Candida, and commonly
occurs after taking antibiotics. I will prescribe nystatin to be applied to the diaper area.
A 12 y.o. female presents to the clinic after being bit by a dog on the face. Abrasion with 2
puncture wounds on the upper right cheek, approximately 1 inch below the eye. The area is
slightly erythematous, with a small amount of bruising and raised area along the cheekbone. -
Answer Using normal saline, irrigate the wounds using high pressure (greater than 4 pounds
per square inch) and high volume (greater than 1 L). Isolated puncture wounds should not be
irrigated, instead soak the wound in a diluted solution of tap water and povidone-iodine for
15 .minutes • Prescribe a 3- to 5-day course of prophylactic antibiotics
A 4 yo child has clusters of small, clear, tense vesicles with an erythematous base on one side of
the mouth along the vermillion border, which are causing discomfort and difficulty eating. What
will the PNP recommend as treatment? - Answer Topical diphenhydramine and magnesium
hydroxide.
A 4 year old child with PE tubes in both ears has otalgia in one ear. The PNP is able to visualize
the tube and does not see exudate in the ear canal and obtains a type A tympanogram. What
will the NP do? - Answer Order ototopical corticosteroid/antibiotic drops.
The parent of a 1-week old is concerned about the unusual shape of their child's head. In the
physical exam, which of the following signs would not support the diagnosis of
craniosynostosis? - Answer A palpable lesion at the occipital region.
