NURS 6541 FINAL EXAM (Graded Download to Score High)

NURS 6541 FINAL EXAM (Graded Download to Score High) An 11-year-old has been diagnosed with mild intermittent asthma. Which of the following is not a routine part of the clinical management? Selected Answer: c. School excuse to not participate in recess and/or physical education activities Question 2 1 out of 1 points A 14-year-old has a 3-week history of fever, anorexia, and abdominal pain. What additional symptom would cause the NP to suspect Crohn's disease? Selected Answer: b. Blood, mucous diarrhea Question 3 1 out of 1 points A 9-year-old is diagnosed with dyspepsia without hematemesis, melena, or occult blood. The most appropriate next step is Selected Answer: a. Trial of ranitidine (Zantac) Question 4 1 out of 1 points Jesse, age 5, has a diagnosis of encopresis. After the diagnosis, what would be your next action? Selected Answer: a. Rule out a neurologic disorder. Question 5 0 out of 1 points A 15-year-old girl has experienced abdominal pain, vomiting, and lethargy for 3 days. Her chest and throat examinations are clear, but her abdominal examination is significant for right lower quadrant pain. Rectal examination is equivocal for pain, and her pelvic examination is remarkable for pain upon movement of her cervix. Laboratory data include elevated white blood cell count, serum glucose level of 145 mg/dL, and serum bicarbonate level of 21mEq/dL. Her urinalysis is remarkable for 1+ white blood cells, 1+ glucose, and 1+ ketones. Which of the following is the most likely diagnosis? Selected Answer: a. Appendicitis Question 6 0 out of 1 points A previously healthy male has a 3-month history of increasing headaches, blurred vision, and personality changes. Previously he admitted to marijuana experimentation more than 1 year ago. On examination he is a healthy, athletic-appearing 17-year-old with decreased extraocular range of motion and left eye visual acuity. Which of the following is the best next step in his management? Selected Answer: e. Urine drug screen Question 7 1 out of 1 points Kelly, your 11-year-old well visit patient, presents to the office with weight loss, polyuria, and polydipsia. Which of the following do you need to rule out? Selected Answer: c. Diabetes mellitus Question 8 0 out of 1 points Lisa has Cushing's syndrome. You would suspect her to have or to develop Selected Answer: d. Generalized increased pigmentations of the skin Question 9 1 out of 1 points Tracy, the mother of a 2-year-old, is concerned because her daughter walks on her toes all the time. What do you tell her? Selected Answer: b. Toe walking is considered normal until age 3. Question 10 1 out of 1 points The peak incidence for adolescent gynecomastia occurs at age Selected Answer: d. 13 to 14 years of age Question 11 0 out of 1 points A 12-year-old girl was brought to the emergency department because of severe sore throat, muffled voice, drooling, and fatigue. She had been sick for the past 3 days and is unable to eat because of painful swallowing. The parents deny any history of recurrent pharyngitis. The patient still managed to open her mouth and you were able to see an abscess at the upper pole of the right tonsil with deviation of the uvula toward the midline. Examination of the neck reveals enlarged and tender lymph nodes. Which of the following is the most appropriate management? Selected Answer: d. Nebulized racemic epinephrine Question 12 1 out of 1 points Newborn R.T. has a vascular lesion that will not fade as she gets older. What is your diagnosis? Selected Answer: a. Port-wine stain (nervus flammeus) Question 13 0 out of 1 points A 16-year-old presents with pharyngitis, cough, and high fever. Her chest x-ray reveals bilateral pulmonary infiltrates. Her white blood cell count is normal and the neutrophil count is normal. The most likely etiology is Selected Answer: a. Streptococcus pneumonia Question 14 1 out of 1 points A common cause of in-toeing in childhood is Selected Answer: c. Internal tibial torsion Question 15 1 out of 1 points A 2-year-old presents to your office with the following symptoms: nasal congestion and rhinorrhea for 48 hours, low-grade fever, and a harsh/barky cough that is significantly worse at night. Inspiratory stridor is present and she has clear but slightly decreased breath sounds. Which of the following treatments is best? Selected Answer: b. One dose of oral dexamethasone Question 16 1 out of 1 points All of the following is treatment for a child with phimosis except Selected Answer: a. Ice packs Question 17 1 out of 1 points Which of the following is not a feature of DiGeorge syndrome? Selected Answer: b. Frontal bossing Question 18 1 out of 1 points A small-for-gestational-age, dysmorphic newborn infant has microcephaly and sloping forehead, cutis aplasia (missing portion of the skin and hair) of the scalp, polydactyly, microphthalmia, and omphalocele. Which of these is the most likely diagnosis? Selected Answer: e. Patau syndrome (trisomy 13) Question 19 1 out of 1 points Which of the following physical stigmata are common in newborns with Down syndrome? Selected Answer: b. Hypotonia, large-appearing tongue and small mouth, upward slant to eyes Question 20 1 out of 1 points Which of the following is not associated with congenital adrenal hyperplasia? Selected Answer: d. Hypernatremia Question 21 0 out of 1 points Ana is a 14-year-old female and has not yet started her menstrual cycle. The history is noncontributory and the physical is normal. Mom started her menstrual cycle at 14-years of age. Ana's breast development and pubic hair began about a year ago. Mom is very concerned. The most appropriate initial step would be to