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The primary care pediatric nurse practitioner is examining a 5-year-old child
who has had recurrent fevers, bone pain, and a recent loss of weight. The
physical exam reveals scattered petechia, lymphadenopathy, and bruising.
A complete blood count shows thrombocytopenia, anemia, and an elevated
white cell blood count. The nurse practitioner will refer this child to a
specialist for
a. bone marrow biopsy.
b. corticosteroids and IVIG.
c. hemoglobin electrophoresis.
,d. immunoglobulin testing. - 🧠 ANSWER ✔✔a. bone marrow biopsy.
A toddler who presents with anemia and reticulocytopenia has a history of
a gradual decrease in energy and increase in pallor beginning after a
recent viral infection. How will the primary care pediatric nurse practitioner
treat this child?
a. Closely observe the child's symptoms and lab values.
b. Consult with a pediatric hematologist.
c. Prescribe supplemental iron for 4 to 6 months.
d. Refer for transfusions to correct the anemia. - 🧠 ANSWER ✔✔a. Closely
observe the child's symptoms and lab values.
The primary care pediatric nurse practitioner is performing a well child
examination on a school-age child who has a history of cancer treated with
cranial irradiation. What will the nurse practitioner monitor in this child?
a. Cardiomyopathy and arrhythmias
b. Leukoencephalopathy
c. Obesity and gonadal dysfunction
,d. Peripheral neuropathy and hearing loss - 🧠 ANSWER ✔✔b.
Leukoencephalopathy
The primary care pediatric nurse practitioner reviews hematology reports
on a child with beta-thalassemia minor and notes an Hgb level of 8 g/dL.
What will the nurse practitioner do?
a. Evaluate serum ferritin.
b. Order Hgb electrophoresis.
c. Prescribe supplemental iron.
d. Refer for RBC transfusions. - 🧠 ANSWER ✔✔a. Evaluate serum ferritin.
The primary care pediatric nurse practitioner evaluates a 5-year-old child
who presents with pallor and obtains labs revealing a hemoglobin of 8.5
g/dL and a hematocrit of 31%. How will the nurse practitioner manage this
patient?
a. Prescribe elemental iron and recheck labs in 1 month.
b. Reassure the parent that this represents mild anemia.
c. Recommend a diet high in iron-rich foods.
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, d. Refer to a hematologist for further evaluation. - 🧠 ANSWER ✔✔a.
Prescribe elemental iron and recheck labs in 1 month.
A school-age child comes to the clinic for evaluation of excessive bruising.
The primary care pediatric nurse practitioner notes a history of an upper
respiratory infection 2 weeks prior. The physical exam is negative for
hepatosplenomegaly and lymphadenopathy. Blood work reveals a platelet
count of 60,000/mm° with normal PT and aPTT. How will the nurse
practitioner manage this child's condition?
a. Admit to the hospital for IVIG therapy.
b. Begin a short course of corticosteroid therapy.
c. Refer to a pediatric hematologist.
d. Teach to avoid NSAIDs and contact sports. - 🧠 ANSWER ✔✔d. Teach to
avoid NSAIDs and contact sports.
The primary care pediatric nurse practitioner is treating an infant with
lacrimal duct obstruction who has developed bacterial conjunctivitis. After 2
weeks of treatment with topical antibiotics along with massage and frequent
cleansing of secretions. the infant's symptoms have not improved. Which
action is correct?