REGIS NU 665 F INAL EXAM 2024 QUESTIONS AND DETAILED ANSWERS LATEST VERSION | VERIFIED CORRECT SOLUTIONS A school -age child has a fractured wrist with a Salter Harris Type II fracture, according to the radiologist. What is true about this type of fracture? Correct Answer There is a metaphyseal fragment on the compression side of fracture. What will the primary care pediatric nurse practitioner elicit when obtaining a positive Barlow maneuver when screening for developmental dysplasia of the hip? Correct Answer Dislocation of an unstable hip 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 school -age child falls off a swing and suffers a closed fracture of the right clavicle. How will this be managed? Correct Answer Immobilization with a sling to support the affected extremity A young adolescent reports chest pain associated with coughing and lifting. Physical examination reveals tenderness over several ribs, radiating to the back. Auscultation of the heart, lungs, and abdomen are normal. There is no history of injury. What will the primary care pediatric nurse practitioner do? Correct Ans wer Recommend NSAIDs, stretching exercises, and ice packs to the area. A young adolescent female is observed to have mild unequal scapula prominences on gross examination while standing. In the Adams forward bending position, this inequality disappears. W hat will the primary care pediatric nurse practitioner do? Correct Answer Discuss posture and exercise and ask about backpacks and books. The primary care pediatric nurse practitioner elicits positive Ortolani and Barlow signs in a 6 -month -old infant not previously noted in the medical record. What is the correct treatment? Correct Answer Surgical intervention 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 rotatio n 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 weight -bearing. A pare nt is concerned that a 12 -month -old child is "bowlegged." A physical examination reveals internal tibial torsion bilaterally. A radiograph reveals asymmetric bowing of the legs with an angle greater than 15 degrees. What is the correct action for the prima ry care pediatric nurse practitioner? Correct Answer Refer to a pediatric orthopedic specialist for treatment. A child who plays soccer is in the clinic reporting pa in and swelling in both knees. A physical examination reveals swelling and focal tenderne ss at the tibial tuberosities, with pain worsening when asked to extend the knees against resistance. What is the treatment for this condition? Correct Answer Apply ice packs to both knees and avoid activities that cause pain. During a well baby examination of a newborn, the primary care pediatric nurse practitioner notes adduction of the right forefoot, with normal position of the mid and hindfoot, along with a convex shaped lateral border of the foot. What will the nurse practitioner do to evaluate this deformity? Correct Answer Grasp the heel with one hand and abduct the forefoot with the other hand. During a well child examination on a 4 -month -old infant, the primary care pediatric nurse practitioner evaluates mental health issues. Which statement by the parent indicates a potential problem with the parent -
infant relationship? Correct Answer "I let my baby cry a while to learn to be patient." A child has a difficult temperament. What will the primary care pediatric nurse practitioner tell the parent about managing this child's behavior? Correct Answer It is important for the parent to learn to manage criticism and power struggles. During a well child assessment of a preschool -age child, the parent voices concerns that because the child has behavior problems at school, the child may have a mental health disorder. Which initial approach will provide the best information? JJJJ. Ask the parent whether other caregivers have voiced similar concerns. Correct Answer Take time to actively listen to t he parent's and child's perceptions of the problem . The primary care pediatric nurse practitioner attempts to learn more about the emotional health of an 18 -month -old child through which assessment strategy? Correct Answer Observation of the child with caretakers in structured and unstructured situations A middle school age child is skipping school frequently and getting poor grades since the child's father was killed while deployed in the military. How will the primary care pediatric nurse practitioner manage this situation? Correct Answer Refer the child to a mental health specialist for evaluation and treatment. The parent of a 4 -year-old child reports that the child seems to be having trouble adjusting to a new daycare and reportedly is always engagin g in solitary play when the parent arrives to pick up the child. What will the primary care pediatric nurse practitioner do? Correct Answer Ask the parent if the child is slow to warm up to other new situations. The parent of a school -age child is concerned because the child has started to express anger about a grandparent's death even though this occurred when the child was a toddler. What will the primary care pediatric nurse practitioner tell the parent? Correc t Answer The significance of this loss must be reworked at each developmental level. The parent of a school -age child reports that the child doesn't like being alone in rooms because of a fear of aliens hiding in closets. What will the primary care pediat ric nurse practitioner tell the parent? Correct Answer "Fear of imaginary creatures does not usually occur at this age." The parent of a preschool age child reports that the child often appears anxious and nervous and that this is associated occasionally with a rapid heart rate and tremors. What is the best type of referral that the primary care pediatric nurse practitioner could recommend? Correct Answer Play therapy A 9-year-old child exhibits school refusal and a reluctance to attend sleepovers with cl assmates. The parent is concerned because the child has recently begun sleeping in the parents' bed. Which initial action by the primary care pediatric nurse practitioner is appropriate? Correct Answer Assess for environmental stress, parental dysfunction, and maternal depression . The parent of a school -age child reports that the child becomes frustrated when unable to perform tasks well and often has temper tantrums and difficulty sleeping. Which disorder may be considered in this child? Correct Answer Generalized anxiety disorder (GAD) The parent of a school -age girl reports that the child has difficulty getting ready for school and is often late because of a need to check and recheck whether her teeth are clean and her room light has been turned off. Wh at will the primary care pediatric nurse practitioner recommend to this parent? Correct Answer Cognitive behavioral therapy
infant relationship? Correct Answer "I let my baby cry a while to learn to be patient." A child has a difficult temperament. What will the primary care pediatric nurse practitioner tell the parent about managing this child's behavior? Correct Answer It is important for the parent to learn to manage criticism and power struggles. During a well child assessment of a preschool -age child, the parent voices concerns that because the child has behavior problems at school, the child may have a mental health disorder. Which initial approach will provide the best information? JJJJ. Ask the parent whether other caregivers have voiced similar concerns. Correct Answer Take time to actively listen to t he parent's and child's perceptions of the problem . The primary care pediatric nurse practitioner attempts to learn more about the emotional health of an 18 -month -old child through which assessment strategy? Correct Answer Observation of the child with caretakers in structured and unstructured situations A middle school age child is skipping school frequently and getting poor grades since the child's father was killed while deployed in the military. How will the primary care pediatric nurse practitioner manage this situation? Correct Answer Refer the child to a mental health specialist for evaluation and treatment. The parent of a 4 -year-old child reports that the child seems to be having trouble adjusting to a new daycare and reportedly is always engagin g in solitary play when the parent arrives to pick up the child. What will the primary care pediatric nurse practitioner do? Correct Answer Ask the parent if the child is slow to warm up to other new situations. The parent of a school -age child is concerned because the child has started to express anger about a grandparent's death even though this occurred when the child was a toddler. What will the primary care pediatric nurse practitioner tell the parent? Correc t Answer The significance of this loss must be reworked at each developmental level. The parent of a school -age child reports that the child doesn't like being alone in rooms because of a fear of aliens hiding in closets. What will the primary care pediat ric nurse practitioner tell the parent? Correct Answer "Fear of imaginary creatures does not usually occur at this age." The parent of a preschool age child reports that the child often appears anxious and nervous and that this is associated occasionally with a rapid heart rate and tremors. What is the best type of referral that the primary care pediatric nurse practitioner could recommend? Correct Answer Play therapy A 9-year-old child exhibits school refusal and a reluctance to attend sleepovers with cl assmates. The parent is concerned because the child has recently begun sleeping in the parents' bed. Which initial action by the primary care pediatric nurse practitioner is appropriate? Correct Answer Assess for environmental stress, parental dysfunction, and maternal depression . The parent of a school -age child reports that the child becomes frustrated when unable to perform tasks well and often has temper tantrums and difficulty sleeping. Which disorder may be considered in this child? Correct Answer Generalized anxiety disorder (GAD) The parent of a school -age girl reports that the child has difficulty getting ready for school and is often late because of a need to check and recheck whether her teeth are clean and her room light has been turned off. Wh at will the primary care pediatric nurse practitioner recommend to this parent? Correct Answer Cognitive behavioral therapy
