COMPLETE QUESTIONS AND SOLUTIONS
● The primary care pediatric nurse practitioner performs a well baby
examination on a 7-day-old infant who is nursing well, according to the
mother. The nurse practitioner notes that the infant weighed 3250 grams
at birth and 2990 grams when discharged on the second day of life. The
infant weighs 3080 grams at this visit. Which action is correct?
a. Follow up at the 2-month checkup.
b. Refer to a lactation consultant.
c. Schedule a weight check in 1 week.
d. Suggest supplementing with formula.. Answer: C
This infant lost about 8% of its birth weight, which is normal and, since
discharge home, has gained at least 15 grams per day, which is also
normal. The PNP should schedule a weight check in a week to make
sure the infant regains its birth weight, since most should regain this in
10 to 14 days and since this loss of birth weight is at the high end of
normal. It is not necessary to refer to a lactation consultant or
supplement with formula, since the infant is gaining weight adequately.
,● The parent of a newborn infant asks the primary care pediatric nurse
practitioner when to intervene to help the infant's future intellectual
growth. What will the nurse practitioner tell the parent?
a. Cognitive learning begins during the toddler years.
b. Intellectual growth begin when speech develops.
c. Language and literacy skills begin at birth.
d. Preschool is an optimal time to begin general learning.. Answer: c.
Language and literacy skills begin at birth.
General learning and acquisition of skills for later reading and writing
begin at birth, not in kindergarten or first grade, and these skills grow
with everyday loving interactions between infants and caregivers.
Cognitive learning changes during toddler years but begins at birth.
Intellectual growth is not tied to speech alone.
● The parent of a 10 yearold boy tells the primary care pediatric nurse
practitioner that the child doesn't appear to have any interest in girls and
spends most of his time with a couple of other boys. The parent is
worried about the child's sexual identity. The nurse practitioner will tell
the parent:
A. children at this age who prefer interactions with same gender peers
usually have a homosexual orientation.
B. children experiment with sexuality at this age as a means of deciding
later sexual orientation.
,C.this attachment to other same gender children is how the child learns
to interact with others.
D. to encourage mixed gender interactions in order to promote
development of sexual values. Answer: C.this attachment to other same
gender children is how the child learns to interact with others.
● The parent of a 2weekold
infant reports that the infant was diagnosed with
transient tachypnea of the newborn shortly after birth. The primary
carepediatric nurse
practitioner understands that, in this condition,
A. antibiotic therapy is generally necessary to prevent severeinfection.
B. home oxygen therapy is needed until the infant grows out of
thecondition.
C. recovery is usually complete with minimal intervention and
treatments.
D. treatment with exogenous surfactant and mechanical ventilation
isneeded. Answer: C. recovery is usually complete with minimal
intervention and
treatments
● An infant has congenital adrenal hyperplasia. At a routine well baby
checkup, the
, primary care pediatric nurse practitioner notes vomiting, poor feeding,
lethargy, and dehydration. Which action is correct?
A Administer an intramuscular stress dose of hydrocortisone succinate.
B Administer intravenous fluids in the clinic and reassess hydration
status.
C Prescribe an oral hydrocortisone in a replacement dose of 8 to
10mg/M2.
D Refer the infant to the emergency department for fluids, dextrose,
and steroids.. Answer: D Refer the infant to the emergency department
for fluids, dextrose, and steroids.
● The parent of a 4-day-old infant tells the primary care pediatric nurse
practitioner that the infant was diagnosed with hydronephrosis while in
utero and asks what will be done. What will the nurse practitioner tell
this parent?
A.Renal function will be abnormal and will require lifetime treatment.
B. Spontaneous resolution often occurs within 6 months to a yearof
age.
C. The affected kidney will be nonfunctionalbut the
other kidney will
compensate.