Correct Answers)
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? —Answer: Refer the child to the dentist immediately for
further evaluation
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? —Answer:
Daily chlorhexidine gluconate
A teen who has otitis externa has severe swelling of the external auditory canal that persists
after 2 days of therapy with ototopical antibiotic/corticosteroid drops. What is the next step in
treatment for this child? —Answer: Insert a wick into the external auditory canal
An elderly patient has a permanent loss of the sense of smell and diminished taste. What will be
included in teaching this patient about managing these symptoms? —Answer: 1. The
importance of installing smoke detectors
2. Putting dates on food in the fridge
3. Eating regular meals at scheduled times
A toddler exhibits exotropia of the right eye during a cover-uncover screen. The primary nurse
practitioner will refer to a pediatric ophthalmologist to initiate which treatment? —Answer:
Patching of the unaffected eye for 2 hours each day
An adolescent has localized bleeding of the gums when brushing the teeth. An exam of the
mouth reveals the presence of plaque and calculus on the teeth which are not loose. What will
the primary care nurse practitioner recommend? —Answer: Consistently brushing and flossing
the teeth twice daily
A provider is recommending a cerumenolytic for a patient who has chronic cerumen buildup.
The provider notes that the patient has dry skin in the ear canal. Which preparation is FDA
approved for this use? —Answer: Carbamide peroxide
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,A parent asks about ways to promote dental health in school-aged children while on family
vacation that are convenient while camping and picnicking. What will the primary care nurse
practitioner recommend? —Answer: Offering gum containing xylitol after meals
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? —
Answer: Refer the child to an otolayngologist
A patient reports painful swelling in the mouth with increased pain at mealtimes. The provider
notes a mass in the salivary gland region. What is the likely cause of these symptoms? —
Answer: Sialolithiasis
During a well child assessment of an African American infant, the primary care nurse
practitioner notes a dark red-brown light reflex in the left eye and a slightly brighter, red-
orange light reflex in the right eye. The nurse practitioner will... —Answer: Refer the infant to
an opthalmologist
A preschool age child who attend daycare has a 2 day history of matted eyelids in the morning
and burning and itching of the eyes. The primary care NP notes yellow-green purulent
discharge from both eyes, conjunctival erythema and mild URI symptoms. Which action is
correct? —Answer: Prescribe topical antibiotic drops
An 18-month-old child with no previous history of otitis media awoke during the night with
right ear pain. The primary care NP notes an axillary temperature of 100.5 and an
erythematous, bulging TM. A tympanogram reveals a peak of +15-mm H2O. What is the
recommended treatment for this child? —Answer: An analgesic medication and watchful
waiting
During a well-child exam on a 4-year-old child, the primary care NP notes that the clinic nurse
recorded 20/50 for the child's vision and noted that the child has difficulty cooperating with the
exam. What will the NP recommend? —Answer: Test the child's vision in 1 month
Causes of cough, not related to pulmonary issues —Answer: Allergies, GERD, medications
(lisinopril)
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, The primary care NP is providing nutritional counseling for a 9-year-old female whose weight
is at the 95th percentile for her age. What is the goal for this patient? —Answer: Maintenance of
her current weight
The primary care NP is performing a well child examination on a 12-year-old child who was
diagnosed with type 1 DM at age 9. The child had a lipid screen at age 10 with an LDL
cholesterol <100mg/dL. What will the NP recommend as part of ongoing management for this
child? —Answer: Comprehensive ophthalmologic exams
The primary care NP is reviewing lab work and diabetes management with a school-aged child
whose HbA1C is 7.6% who reports usual blood sugars before meals as being 80-90mg/dL. The
NP will consult with the child's endocrinologist to consider which therapy? —Answer:
Continuous glucose monitoring
The primary care NP notes a musty odor when examining a newborn at a 2-week checkup.
What will the NP suspect? —Answer: Phenylketonuria
A patient who has diabetes has a blood pressure of 140/90 and albuminuria. Which initial action
by the primary care NP is indicated for management of this patient? —Answer: Consulting
with a nephrologist
The primary care NP is performing a well-child examination on a 2-year-old child with a
history of intrauterine growth retardation whose height remains less than the 3rd percentile on
a WHO growth chart. What will the NP do? —Answer: Refer the child to a pediatric
endocrinologist
An infant has congenital adrenal hyperplasia. At a routine well baby checkup, the primary care
NP notes vomiting, poor feeding, lethargy, and mild dehydration. Which action is correct? —
Answer: Refer the infant to the ED for fluids, dextrose, and steroids
A patient recently diagnosed with T1DM is in clinic for a follow-up evaluation. The provider
notes that the patient appears confused and irritable and is sweating and shaking. What
intervention will the provider expect to perform once the POC blood glucose is known? —
Answer: Giving a rapid acting carbohydrate
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,
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