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The primary care pediatric nurse practitioner is examining a 2 week old
infant and auscultates a wide splitting of S2 during expiration. What
condition may this finding represent?
a. Atrial septal defect
b. Coarctation of the aorta
c. Patent ductus arteriosis
d. Ventricular septal defect - 🧠 ANSWER ✔✔a. Atrial septal defect
,2. The primary care pediatric nurse practitioner auscultates a new grade II
vibratory, mid systolic murmur at the mid sternal border in a 4yearold child
that is louder when the child is supine. What type of murmur is most likely?
a. Pathologic murmur
b. Pulmonary flow murmur
c. Still's murmur
d. Venous hum - 🧠 ANSWER ✔✔c. Still's murmur
During a well child assessment, the primary care pediatric nurse
practitioner auscultates a harsh, blowing grade IV/VI murmur in a 6 month
old infant. What will the nurse practitioner do next?
a. Get a complete blood count to rule out severe anemia
.b. Obtain an electrocardiogram to assess for arrhythmia
.c. Order a chest radiograph to evaluate for cardiomegaly.
d. Refer to a pediatric cardiologist for further evaluation. - 🧠 ANSWER ✔✔d.
Refer to a pediatric cardiologist for further evaluation.
The primary care pediatric nurse practitioner provides primary care for a
4monthold infant who has a ventricular septal defect. The infant has been
,breastfeeding well but in the past month has dropped from the 20th
percentile to the 5th for weight. What will the nurse practitioner
recommend?a. Adding solid foods to the infant's diet to increase caloric
intake
b. Fortifying breast milk to increase the number of calories per ounce
c. Stopping breastfeeding and giving 30 kcal/ounce formula
d. Supplementing breastfeeding with 24 kcal/ounce formula - 🧠 ANSWER
✔✔b. Fortifying breast milk to increase the number of calories per ounce
A 12-month-old infant who had cardiopulmonary bypass with RBC and
plasma infusions during surgery at 8 months is seen for a well child
examination. Which vaccine may be administered at this visit?
a. MMR
b. OPV
c. PCV13
d. Varivax - 🧠 ANSWER ✔✔c. PCV13
The primary care pediatric nurse practitioner performs a well child
examination on a 12monthold child who had repair of a congenital heart
defect at 8 months of age. The child has a normal exam. The parent
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, reports that the child is not taking any medications. The nurse practitioner
will contact the child's cardiologist to discuss whether the child needs which
medication?a. Amoxicillin
b. Capoten
c. Digoxin
d. Furosemide - 🧠 ANSWER ✔✔a. Amoxicillin
During a well baby examination of a 6weekold infant, the primary care
pediatric nurse practitioner notes poor weight gain, acrocyanosis of the
hands and feet, and a respiratory rate of 60 breaths per minute. Oxygen
saturation on room air is 93%. The remainder of the exam is unremarkable.
Which action is correct?
a. Follow up in 1 week to assess the infant's weight.
b. Order a chest radiograph and an electrocardiogram.
c. Reassure the parents that the exam is within normal limits.
d. Refer the infant to a pediatric cardiologist. - 🧠 ANSWER ✔✔a. Follow up
in 1 week to assess the infant's weight.
3monthold infant who was previously healthy now has a persistent cough,
bilateral lung crackles, and poor appetite. The primary care pediatric nurse