NU 665 final Comprehensive
Questions with Verified
Answers Graded A+
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? - 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? - 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? - 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? - 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? - Answer: 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.
What will the primary care pediatric nurse practitioner do? - 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? -
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 rotation 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? - Answer: Place the child on crutches or in a wheelchair to prevent weight-
bearing.
A parent 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 primary care pediatric nurse
practitioner? - 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 tenderness at the tibial tuberosities, with pain worsening
when asked to extend the knees against resistance. What is the treatment for this condition? -
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? - 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? - 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? - 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. - Answer: Take time to actively listen to the 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? - 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? - 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 engaging in solitary play when the parent arrives to pick
up the child. What will the primary care pediatric nurse practitioner do? - 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? - 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 pediatric nurse practitioner tell
the parent? - 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? - Answer:
Play therapy
A 9-year-old child exhibits school refusal and a reluctance to attend sleepovers with classmates.
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? - 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? - 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. What will the primary care pediatric nurse practitioner recommend to
this parent? - Answer: Cognitive behavioral therapy
The parents of a 4-year-old boy are concerned because he has begun twisting and pulling out
his hair, especially when he is tired or stressed. What will the primary care pediatric nurse
practitioner recommend as part of an initial approach to treat this behavior? - Answer: Cutting
his hair so that it is too short to pull
Questions with Verified
Answers Graded A+
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? - 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? - 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? - 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? - 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? - Answer: 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.
What will the primary care pediatric nurse practitioner do? - 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? -
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 rotation 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? - Answer: Place the child on crutches or in a wheelchair to prevent weight-
bearing.
A parent 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 primary care pediatric nurse
practitioner? - 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 tenderness at the tibial tuberosities, with pain worsening
when asked to extend the knees against resistance. What is the treatment for this condition? -
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? - 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? - 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? - 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. - Answer: Take time to actively listen to the 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? - 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? - 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 engaging in solitary play when the parent arrives to pick
up the child. What will the primary care pediatric nurse practitioner do? - 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? - 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 pediatric nurse practitioner tell
the parent? - 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? - Answer:
Play therapy
A 9-year-old child exhibits school refusal and a reluctance to attend sleepovers with classmates.
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? - 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? - 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. What will the primary care pediatric nurse practitioner recommend to
this parent? - Answer: Cognitive behavioral therapy
The parents of a 4-year-old boy are concerned because he has begun twisting and pulling out
his hair, especially when he is tired or stressed. What will the primary care pediatric nurse
practitioner recommend as part of an initial approach to treat this behavior? - Answer: Cutting
his hair so that it is too short to pull
