NR 602 Final exam questions with correct answers
Step 1 Asthma approach-Intermittent Correct Answer-symptoms 2x or
less per week
asymptomatic and normal PED
requires SABA 2 days/week
no interference with normal activities
brief exacerbations
nighttime symptoms 2x or less a month
lung fx- FEV>80% predicted
Step 2 Asthma Approach-Mild persistent Correct Answer-Symptoms >2
x a week, less than once per day
requires SABA more than 2days/week, no more than once a day
exacerbations may affect activity
nighttime symptoms 3-4x a month
FEV> 80% predicted
Step 3 Asthma Approach-Moderate Persistant Correct Answer-daily
symptoms
daily use of SABA
some limitations
2x or more per week exacerbations
nighttime symptoms more than 1x per week, not nightly
,FEV >60% but <80%
Step 4 Asthma Approach-Severe Persistent Correct Answer-continual
symptoms
requires SABA multiple x a day
extremely limited activity
nighttime symptoms 7x a week
FEV <60%
Tx of asthma Correct Answer-Stepwise approach
step 1: SABA PRN
step 2: low dose ICS
Step 3: low dose ICS+ LABA or medium dose ICS
step 4: Medium dose ICS+LABA
Step 5: high dose ICS+ LABA
Step 6: High dose ICS+LABA + corticosteroid
Step 6 Asthma Approach Correct Answer-
Bulbar/palpebral conjunctival infection Correct Answer-May be
unilateral or bilateral
Leukocoria Correct Answer-abnormal appearance of a white film in the
pupil; immediate referral to pediatric ophthalmologist warranted
,Causes: retinal detachment, cataract, retinal dysplasia, newborn
retinoblastoma
Visual screening in children Correct Answer-At least once between ages
3-5 y/o according to USPSTF
AOM Correct Answer-RF: genetics, males, Native American, siblings,
low economic status, ages 6mo-3y, winter, supine bottle feeding,
daycare, tobacco smoke
S/S of AOM Correct Answer-erythema, otalgia, bulging TM, absent
cone of light
Dx of AOM Correct Answer-Audiometry, tympanometry, possible
lateral neck xray to r/o mass
TX of AOM Correct Answer-uncomplicated: supportive with
tylenol/ibuprofen; watchful waiting 48-72 in 6m-2y/o; <5 benzocaine
otic drops
1st line antx: amoxicillin 80-90mg/kg/day Q12 x 10days
if allergy to PCN- augmentin, cefuroxime
Bacterial rhinosinusitis Correct Answer-Preceded by URI-typically
worsens after 5-7 days- not resolved in 2 weeks
, Sx of bacterial rhinosinusitis Correct Answer-Purulant nasal congestion,
drainage, facial pain, headache, fever
No imaging required- if no improvement refer to ENT
Bronchiolitis Correct Answer-Usually caused by RSV
wheezing present
<2 y/o
other causes; influenza, adenovirus, rhinovirus
S/s of bronchiolitis Correct Answer-Increased work of breathing,
prolonged expiration, grunting, retractions, nasal flaring
Croup sx Correct Answer-Low grade fever, URI symptoms, barking
cough, inspiratory stridor can occur
Croup dx Correct Answer-Made from symptoms
Croup tx Correct Answer-Glucocorticoids possibly
0.6mg/kg-1mg/kg
humidified air
bronchodilators
Lead poisoning Correct Answer-Inactivated heme synthesis by
inhibiting insertion of iron-leads to microcytic hypochromic anemia
Step 1 Asthma approach-Intermittent Correct Answer-symptoms 2x or
less per week
asymptomatic and normal PED
requires SABA 2 days/week
no interference with normal activities
brief exacerbations
nighttime symptoms 2x or less a month
lung fx- FEV>80% predicted
Step 2 Asthma Approach-Mild persistent Correct Answer-Symptoms >2
x a week, less than once per day
requires SABA more than 2days/week, no more than once a day
exacerbations may affect activity
nighttime symptoms 3-4x a month
FEV> 80% predicted
Step 3 Asthma Approach-Moderate Persistant Correct Answer-daily
symptoms
daily use of SABA
some limitations
2x or more per week exacerbations
nighttime symptoms more than 1x per week, not nightly
,FEV >60% but <80%
Step 4 Asthma Approach-Severe Persistent Correct Answer-continual
symptoms
requires SABA multiple x a day
extremely limited activity
nighttime symptoms 7x a week
FEV <60%
Tx of asthma Correct Answer-Stepwise approach
step 1: SABA PRN
step 2: low dose ICS
Step 3: low dose ICS+ LABA or medium dose ICS
step 4: Medium dose ICS+LABA
Step 5: high dose ICS+ LABA
Step 6: High dose ICS+LABA + corticosteroid
Step 6 Asthma Approach Correct Answer-
Bulbar/palpebral conjunctival infection Correct Answer-May be
unilateral or bilateral
Leukocoria Correct Answer-abnormal appearance of a white film in the
pupil; immediate referral to pediatric ophthalmologist warranted
,Causes: retinal detachment, cataract, retinal dysplasia, newborn
retinoblastoma
Visual screening in children Correct Answer-At least once between ages
3-5 y/o according to USPSTF
AOM Correct Answer-RF: genetics, males, Native American, siblings,
low economic status, ages 6mo-3y, winter, supine bottle feeding,
daycare, tobacco smoke
S/S of AOM Correct Answer-erythema, otalgia, bulging TM, absent
cone of light
Dx of AOM Correct Answer-Audiometry, tympanometry, possible
lateral neck xray to r/o mass
TX of AOM Correct Answer-uncomplicated: supportive with
tylenol/ibuprofen; watchful waiting 48-72 in 6m-2y/o; <5 benzocaine
otic drops
1st line antx: amoxicillin 80-90mg/kg/day Q12 x 10days
if allergy to PCN- augmentin, cefuroxime
Bacterial rhinosinusitis Correct Answer-Preceded by URI-typically
worsens after 5-7 days- not resolved in 2 weeks
, Sx of bacterial rhinosinusitis Correct Answer-Purulant nasal congestion,
drainage, facial pain, headache, fever
No imaging required- if no improvement refer to ENT
Bronchiolitis Correct Answer-Usually caused by RSV
wheezing present
<2 y/o
other causes; influenza, adenovirus, rhinovirus
S/s of bronchiolitis Correct Answer-Increased work of breathing,
prolonged expiration, grunting, retractions, nasal flaring
Croup sx Correct Answer-Low grade fever, URI symptoms, barking
cough, inspiratory stridor can occur
Croup dx Correct Answer-Made from symptoms
Croup tx Correct Answer-Glucocorticoids possibly
0.6mg/kg-1mg/kg
humidified air
bronchodilators
Lead poisoning Correct Answer-Inactivated heme synthesis by
inhibiting insertion of iron-leads to microcytic hypochromic anemia
