FNP PEDIATRIC LATEST ACTUAL EXAM WITH VERIFIED
QUESTIONS & CORRECT ANSWERS
Question 1.
Leading causes of death and prevention
ANSWER
Diarrhea and pneumonia are leading causes of childhood mortality and morbidity
Rotavirus and strep pneumonia (vaccine-preventable diseases) most common causes
Successful vaccination programs are effective
Question 2.
What effects global food
ANSWER
i. Hunger and under-nutrition occur without access to safe, nutritious foods
ii. Climate change and its effects on crops and food
iii. distribution
iv. Undernutrition an important determinant of maternal/child health
v. Breastfeeding increases survival rates
Question 3.
American Academy of Pe-
diatrics recommendation for preventative pediatric health care
ANSWER
Uncoupling of periodicity of visits and immunizations to a greater emphasis on healthy
growth/developmental surveillance
,Question 4.
Health literacy Chpt 2
ANSWER
All children need nurturing and attention from adults in their lives
Mother's education levels, beliefs/attitudes about health, health practices affect health of
children
Parental stress/mental illness affect health care
Maternal depression in 1st year of life associated with
poor caregiving leading to poor language
development
Maternal depression predictive of asthma symptoms
in inner-city African-American families
Lack of consistent, affectionate attention can have devastating results
"Poor fit" between child and adult can cause later social adjustment issues
Question 5.
Otitis Media signs and symptoms/ treatment
ANSWER
Accurate diagnosis
Rapid onset of otalgia, middle ear effusion
Confirmed with pneumatic otoscopy/tympanogram
signs of middle ear inflammation
Pain management
Antipyretics/analgesics
Distraction, oil application, external heat/cold
Initial observation versus antibiotics
Appropriate antibiotic choice
•Amoxicillin
•Augmentin
Preventive measures
Plan for recurrence
•Referral if indicated
Question 6.
Pressure-Equalizing Tubes
ANSWER
Clinical practice guidelines - refer if recurrent AOM 3 times/6 months or 4 times/year
,Question 7.
otits externa signs and symptoms
ANSWER
Diffuse inflammation of external ear canal (EAC); may involve pinna, TM
Simple infection - edema, discharge, erythema
Furuncles or small abscesses in hair follicles
Impetigo or infection in superficial epidermis
Most frequently by retained moisture in EAC
Usually acidic environment changes to neutral or
basic
Chlorine kills normal ear flora
Regular cleaning removes the cerumen barrier
Soap, local trauma, sweating, allergy, stress can
contribute
P. aeruginosa, S. aureus most common; may be polybacterial
Question 8.
otitis externa treatment
ANSWER
inflammation of the outer ear
Eardrops: cipro; acetic acid drops might be effective in mild episodes; antibiotics with steroid
otic drops are the treatment of choice. Symptoms should be improved in 7 days but can take
up to 2 weeks.
Avoid ototoxic drops if risk of perforation
Systemic antibiotics not used unless severe
Thorough patient education about drops
Use a wick if significant swelling
Avoid cleaning, manipulating, getting water into ear - no swimming
Analgesics for pain
Debridement with cotton-tipped applicator
Clean canal with water or antiseptic solution if impetigo and apply antibiotic ointment
Treat fungal infections with clotrimazole-miconazole, or nystatin
, Question 9.
Otitis Externa (Swimmer's Ear) clinical findings
- physical examination
ANSWER
i. Pain with movement of tragus or pinna or with attempts to examine with otoscope
ii. Swollen EAC with debris
iii. Rare otorrhea
iv. Occasional regional lymphadenopathy
v. Red, crusty, or pustular lesions
vi. Pruritis associated with thick, black, gray, blue-green, yellow, or white otorrhea (mycosis)
vii. Dry-appearing canal/atrophy with chronic OE
viii. Presence of PET or perforation of TM
Question 10.
Otitis Externa (Swimmer's Ear) Prevention
ANSWER
i. Avoid water in ear canals
ii. Well-fitting earplugs for swimming
iii. Alcohol/vinegar/distilled water otic mix (2:1:1); 3-5 drops daily, especially after swimming
iv. Blow dryer on warm setting to dry EAC
v. Avoid persistent scratching/cleaning of EAC
vi. Avoid prolonged use of cerumenolytic agents
QUESTIONS & CORRECT ANSWERS
Question 1.
Leading causes of death and prevention
ANSWER
Diarrhea and pneumonia are leading causes of childhood mortality and morbidity
Rotavirus and strep pneumonia (vaccine-preventable diseases) most common causes
Successful vaccination programs are effective
Question 2.
What effects global food
ANSWER
i. Hunger and under-nutrition occur without access to safe, nutritious foods
ii. Climate change and its effects on crops and food
iii. distribution
iv. Undernutrition an important determinant of maternal/child health
v. Breastfeeding increases survival rates
Question 3.
American Academy of Pe-
diatrics recommendation for preventative pediatric health care
ANSWER
Uncoupling of periodicity of visits and immunizations to a greater emphasis on healthy
growth/developmental surveillance
,Question 4.
Health literacy Chpt 2
ANSWER
All children need nurturing and attention from adults in their lives
Mother's education levels, beliefs/attitudes about health, health practices affect health of
children
Parental stress/mental illness affect health care
Maternal depression in 1st year of life associated with
poor caregiving leading to poor language
development
Maternal depression predictive of asthma symptoms
in inner-city African-American families
Lack of consistent, affectionate attention can have devastating results
"Poor fit" between child and adult can cause later social adjustment issues
Question 5.
Otitis Media signs and symptoms/ treatment
ANSWER
Accurate diagnosis
Rapid onset of otalgia, middle ear effusion
Confirmed with pneumatic otoscopy/tympanogram
signs of middle ear inflammation
Pain management
Antipyretics/analgesics
Distraction, oil application, external heat/cold
Initial observation versus antibiotics
Appropriate antibiotic choice
•Amoxicillin
•Augmentin
Preventive measures
Plan for recurrence
•Referral if indicated
Question 6.
Pressure-Equalizing Tubes
ANSWER
Clinical practice guidelines - refer if recurrent AOM 3 times/6 months or 4 times/year
,Question 7.
otits externa signs and symptoms
ANSWER
Diffuse inflammation of external ear canal (EAC); may involve pinna, TM
Simple infection - edema, discharge, erythema
Furuncles or small abscesses in hair follicles
Impetigo or infection in superficial epidermis
Most frequently by retained moisture in EAC
Usually acidic environment changes to neutral or
basic
Chlorine kills normal ear flora
Regular cleaning removes the cerumen barrier
Soap, local trauma, sweating, allergy, stress can
contribute
P. aeruginosa, S. aureus most common; may be polybacterial
Question 8.
otitis externa treatment
ANSWER
inflammation of the outer ear
Eardrops: cipro; acetic acid drops might be effective in mild episodes; antibiotics with steroid
otic drops are the treatment of choice. Symptoms should be improved in 7 days but can take
up to 2 weeks.
Avoid ototoxic drops if risk of perforation
Systemic antibiotics not used unless severe
Thorough patient education about drops
Use a wick if significant swelling
Avoid cleaning, manipulating, getting water into ear - no swimming
Analgesics for pain
Debridement with cotton-tipped applicator
Clean canal with water or antiseptic solution if impetigo and apply antibiotic ointment
Treat fungal infections with clotrimazole-miconazole, or nystatin
, Question 9.
Otitis Externa (Swimmer's Ear) clinical findings
- physical examination
ANSWER
i. Pain with movement of tragus or pinna or with attempts to examine with otoscope
ii. Swollen EAC with debris
iii. Rare otorrhea
iv. Occasional regional lymphadenopathy
v. Red, crusty, or pustular lesions
vi. Pruritis associated with thick, black, gray, blue-green, yellow, or white otorrhea (mycosis)
vii. Dry-appearing canal/atrophy with chronic OE
viii. Presence of PET or perforation of TM
Question 10.
Otitis Externa (Swimmer's Ear) Prevention
ANSWER
i. Avoid water in ear canals
ii. Well-fitting earplugs for swimming
iii. Alcohol/vinegar/distilled water otic mix (2:1:1); 3-5 drops daily, especially after swimming
iv. Blow dryer on warm setting to dry EAC
v. Avoid persistent scratching/cleaning of EAC
vi. Avoid prolonged use of cerumenolytic agents
