A 13-year-old Native American female has a BMI at the 90th
percentile for age. The primary care NP notes the presence of a
hyperpigmented velvet-like rash in skin folds. The child denies
polydipsia, polyphagia, and polyuria. The NP will Correct
Answer order a fasting blood sample for a metabolic screen for
type 2 DM
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 rinses
A 15-year-old child has a recent history of increased thirst and
frequent urination. The child's weight has been in the 95th
percentile for several years. A dipstick UA is positive for
glucose, and random plasma glucose is 350mg/dL. Which test
will the primary care NP order to determine the type of diabetes
in this child? Correct Answer Pancreatic antibodies
A 16-year-old female whose BMI is at the 90th percentile
reports irregular periods. The primary care NP notes widespread
acne on her face and back and an abnormal distribution of facial
hair. The NP will evaluate her further based on a suspicion of
which diagnosis? Correct Answer Polycystic ovary syndrome
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 6-year-old female has had a recent growth spurt and an exam
reveals breast and pubic hair development. Her bone age is
determined to be 8 years. What will the NP do next? Correct
Answer Refer the child to a pediatric endocrinologist for
management
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
otolaryngologist
A child complains of itching in both ears and is having trouble
hearing. The primary care nurse practitioner notes periauricular
edema and marked swelling of the external auditory canal and
elicits severe pain when manipulating the external ear structures.
Which is an appropriate intervention? Correct Answer Order
ototopical antibiotic/corticosteroid drops
A child who was treated with amoxicillin and then amoxicillin-
clavulanate for acute otitis media is seen for follow-up. The
primary care nurse practitioner notes dull-gray tympanic
membranes with a visible air-fluid level. The child is afebrile
and without pain. What is the next course of action? Correct
Answer Monitoring ear fluid levels for 3 months