UPDATED NURS 5434 FAMILY III EXAM WITH
ANSWERS 2025-2026
Treatment of RLS
1st line: reduce caffeine, alcohol, nicotine, regularly
exercise, good sleep hygiene
If iron is low- replace iron for a goal of ferritin >75
Rx: dopamine agonists (pramipexole, ropinirole) or
alpha-2-delta calcium channel ligands (gabapentin)
When to consider migraine prevention?
equal to or more than 4 migraine days per month
severe attacks that impair function despite abortive
tx
overuse of acute meds
BP screening in children
every year in children 3 and older
every visit in children 3 and older with risk factors
(obesity, renal disease, diabetes, etc)
initial management of HTN in children
Elevated BP - lifestyle recommendations and then
BP recheck in 6 months, then 6 months later
Stage 1 HTN - if pt is asymptomatic, lifestyle mods
,and recheck in 1-2 weeks, then 3 months later
Stage 2 HTN - check upper and lower extremity
pressure and recheck in 1 week, refer to specialist
within 1 week
diagnosing pediatric HTN
auscultatory BP is over 95th percentile on 3
separate visits, to confirm - ambulatory BP
monitoring
HTN in age < 13 yo
elevated BP - >/= 90-95th percentile OR 120/80-95th
percentile
Stage 1 - >/= 95th percentile to <90th + 12mmHg OR
130/80 to 139/89
Stage 2 - >/= 95th percentile + 12mmHg OR >/=
140/90
HTN in age >13 yo
Elevated - 120/<80 to 129/<80
Stage 1 - 130/80-139/89
Stage 2 - >/= 140/90
determining cuff size in peds
cuff should be 40% of arm circumference and
bladder 80-100% of arm circumference
,approved meds for pediatric HTN
ACEIs
ARBs
CCBs
Thiazide diuretics
when is an echo needed in pediatric HTN?
symptomatic HTN
stage 2 HTN with modifiable risk factor (like
obesity)
LVH
HTN with CKD or DM
persistent HTN despite lifestyle modifications
most common cause of HTN in adolescents and <13
yo
adolescents primary cause: obesity
younger primary cause: secondary causes, often
renal disease
secondary causes of HTN in pediatrics
renal parenchymal disease
rheumatologic disorder
renal artery stenosis
obstructive sleep apnea
, mineralocorticoid excess
hyperthyroidism
coarctation of aorta
cushings disease
drugs (steroids, cocaine, meth, OCPs, caffeine, diet
pills)
diagnostic tests for pediatric HTN pts
all patients:
- urinalysis
- chemistry panel (electrolytes, BUN, Cr)
- lipid profile
- renal ultrasound in <6 yo or with abnormal
urinalysis or renal function
obese pts:
- HbgA1c
- renal function tests
- fasting lipid panel
optional:
- sleep study
- drug screen
- fasting glucose
- TSH
ANSWERS 2025-2026
Treatment of RLS
1st line: reduce caffeine, alcohol, nicotine, regularly
exercise, good sleep hygiene
If iron is low- replace iron for a goal of ferritin >75
Rx: dopamine agonists (pramipexole, ropinirole) or
alpha-2-delta calcium channel ligands (gabapentin)
When to consider migraine prevention?
equal to or more than 4 migraine days per month
severe attacks that impair function despite abortive
tx
overuse of acute meds
BP screening in children
every year in children 3 and older
every visit in children 3 and older with risk factors
(obesity, renal disease, diabetes, etc)
initial management of HTN in children
Elevated BP - lifestyle recommendations and then
BP recheck in 6 months, then 6 months later
Stage 1 HTN - if pt is asymptomatic, lifestyle mods
,and recheck in 1-2 weeks, then 3 months later
Stage 2 HTN - check upper and lower extremity
pressure and recheck in 1 week, refer to specialist
within 1 week
diagnosing pediatric HTN
auscultatory BP is over 95th percentile on 3
separate visits, to confirm - ambulatory BP
monitoring
HTN in age < 13 yo
elevated BP - >/= 90-95th percentile OR 120/80-95th
percentile
Stage 1 - >/= 95th percentile to <90th + 12mmHg OR
130/80 to 139/89
Stage 2 - >/= 95th percentile + 12mmHg OR >/=
140/90
HTN in age >13 yo
Elevated - 120/<80 to 129/<80
Stage 1 - 130/80-139/89
Stage 2 - >/= 140/90
determining cuff size in peds
cuff should be 40% of arm circumference and
bladder 80-100% of arm circumference
,approved meds for pediatric HTN
ACEIs
ARBs
CCBs
Thiazide diuretics
when is an echo needed in pediatric HTN?
symptomatic HTN
stage 2 HTN with modifiable risk factor (like
obesity)
LVH
HTN with CKD or DM
persistent HTN despite lifestyle modifications
most common cause of HTN in adolescents and <13
yo
adolescents primary cause: obesity
younger primary cause: secondary causes, often
renal disease
secondary causes of HTN in pediatrics
renal parenchymal disease
rheumatologic disorder
renal artery stenosis
obstructive sleep apnea
, mineralocorticoid excess
hyperthyroidism
coarctation of aorta
cushings disease
drugs (steroids, cocaine, meth, OCPs, caffeine, diet
pills)
diagnostic tests for pediatric HTN pts
all patients:
- urinalysis
- chemistry panel (electrolytes, BUN, Cr)
- lipid profile
- renal ultrasound in <6 yo or with abnormal
urinalysis or renal function
obese pts:
- HbgA1c
- renal function tests
- fasting lipid panel
optional:
- sleep study
- drug screen
- fasting glucose
- TSH
