Burns Pediatric Final Exam Study Guide
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1. 1. A child has a 1-cm laceration on the forehead proximal to the hairline after
running into a pole while playing sports. To minimize the risk of infection, the primary care
pediatric nurse practitioner will irrigate the wound and
a. a. allow the wound to heal by secondary intention.
b. b. delay closure of the wound for several days.
c. c. refer the child to a plastic surgeon for wound closure.
d. d. suture the wound within 6 hours. - ANS: D
Children are less likely than adults to get wound infections, with an infection rate from sutured
lacerations at 2%. The PNP should clean and suture the wound. Wounds from animal bites are
often left to heal by secondary intention to prevent infection. Referral to a plastic surgeon is
necessary for cosmetic reasons. Delaying closure for several days is recommended for heavily
contaminated wounds and those caused by high-velocity missile injuries, crush injuries, and
explosion injuries.
1. 1. According to the 2007 NHIS analysis of the use of CAM therapy, use was higher
among :
a. a. families whose parent or parents had a college education.
b. b. Hispanic and African-American populations.
c. c. persons who had not recently taken prescription medications.
d. d. those living in households earning less than $65,000. - ANS: A
The NHIS review showed that CAM use was higher in households with at least one college-
,educated parent. CAM use was also higher in non-Hispanic Caucasians, persons who had
taken prescription drugs within the past 3 months, and those living in households with incomes
higher than $65,000.
1. 1. The mother of a 15-year-old female expresses concerns that her daughter may be
sexually active because she's had a steady boyfriend for over a year. The primary care
pediatric nurse practitioner learns that the family is Catholic and that the mother had an
abortion when she was 16 years old. What will the nurse practitioner do initially?
a. a. Explore the mother's feelings about her own past experience.
b. b. Offer to prescribe contraception to prevent pregnancy.
c. c. Recommend that the mother discuss this with her daughter.
d. d. Suggest that the mother talk to a priest about her daughter. - ANS: A
An initial step when assisting families to manage ethical and behavioral issues is to assist
parents and children in values clarification. Before offering other suggestions, the PNP should
help the mother to clarify her own feelings. The other options may be necessary after values
are
clarified.
1. 1. The parent of a 4-year-old points to a picture and says, "That's your sister." The
child responds by saying, "No! It's my baby!" This is an example of which type of thinking in
preschool-age children?
a. a. Animism
b. b. Artificialism
c. c. Egocentrism
d. d. Realism - ANS: D
Children at this age are developing their ability to establish causality. Nominal realism occurs
when children think that one type of thing can only be called by one name. All dogs are dogs
and not various breeds. Animism refers to the belief that objects possess person-like qualities.
,Artificialism occurs when children think things are caused by a controlling force. Egocentrism is
when children see things only as they relate to themselves.
1. 1. The parent of a school-age child reports that the child usually has allergic rhinitis
symptoms beginning each fall and that non-sedating antihistamines are only marginally
effective, especially for nasal obstruction symptoms. What will the primary care pediatric
nurse practitioner do?
a. a. Order an intranasal corticosteroid to begin 1 to 2 weeks prior to pollen season.
b. b. Prescribe a decongestant medication as adjunct therapy during pollen season.
c. c. Recommend adding diphenhydramine to the child's regimen for additional
relief.
d. d. Suggest using an over-the-counter intranasal decongestant. - ANS: A
Intranasal corticosteroids are a key component in long-term therapy to manage symptoms
associated with AR. These should be begun 1 to 2 weeks prior to the beginning of pollen
season. Decongestants are not recommended for long-term use because of side effects.
Diphenhydramine causes daytime drowsiness.
1. 1. The primary care pediatric nurse practitioner is evaluating a school-age child who,
after removal of a pituitary tumor, has altered hypothalamic control over hunger and satiety.
The child is morbidly obese and expresses feeling depressed because of the obesity. What
will the nurse practitioner recommend?
a. a. Developing a system to reward compliance with a dietary regimen
b. b. Restricting all access to food in the house and at school
c. c. Suggesting an after-school exercise program to help with weight loss
d. d. Using a food diary to track all calories and food intake - ANS: B
Children with brain dysfunction affecting hypothalamic control may need rigid restrictions of
access to all foods in refrigerators, cupboards, and even garbage cans
1. 1. The primary care pediatric nurse practitioner is examining a newborn who is
, breastfeeding and notes the presence of an ankyloglossia. What will the nurse practitioner
do next?
a. a. Ask the mother if the infant has any feeding difficulties.
b. b. Refer the infant for a possible frenulectomy.
c. c. Schedule an appointment with a lactation consultant.
d. d. Suggest that the mother feed breast milk by bottle. - ANS: A
Infants with ankyloglossia may have difficulty feeding if the tongue does not extend well. The
PNP should first assess feeding difficulties and then may refer for a lactation consultant or
consider a frenulectomy.
1. 10. The mother of a 3-year-old child takes the child to a play group once a week.
She expresses concern that the child plays with toys but does not interact with the other
toddlers. What will the primary care pediatric nurse practitioner counsel the mother?
a. a. The child probably is very shy but will outgrow this tendency with repeated
exposure to other children.
b. b. The toddler may have a language delay that interferes with socialization with
other children.
c. c. Toddlers may be interested in other children but usually do not engage in
interactive play.
d. d. Toddlers need more structured play to encourage interaction and socialization
with others. - ANS: C
Parallel play is common among toddlers who, although they may be fascinated by other
children, generally do not engage with peers in an interactive manner. This does not mean that
the child is shy or has a language delay, although in preschool years, the development of
symbolic language increases interactive play. Children need both structured and free play, but
structured play will not increase interaction during this normally parallel period.
1. 10. The primary care pediatric nurse practitioner is counseling the mother of a
newborn about breastfeeding her infant. Which supplements will the nurse practitioner
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1. 1. A child has a 1-cm laceration on the forehead proximal to the hairline after
running into a pole while playing sports. To minimize the risk of infection, the primary care
pediatric nurse practitioner will irrigate the wound and
a. a. allow the wound to heal by secondary intention.
b. b. delay closure of the wound for several days.
c. c. refer the child to a plastic surgeon for wound closure.
d. d. suture the wound within 6 hours. - ANS: D
Children are less likely than adults to get wound infections, with an infection rate from sutured
lacerations at 2%. The PNP should clean and suture the wound. Wounds from animal bites are
often left to heal by secondary intention to prevent infection. Referral to a plastic surgeon is
necessary for cosmetic reasons. Delaying closure for several days is recommended for heavily
contaminated wounds and those caused by high-velocity missile injuries, crush injuries, and
explosion injuries.
1. 1. According to the 2007 NHIS analysis of the use of CAM therapy, use was higher
among :
a. a. families whose parent or parents had a college education.
b. b. Hispanic and African-American populations.
c. c. persons who had not recently taken prescription medications.
d. d. those living in households earning less than $65,000. - ANS: A
The NHIS review showed that CAM use was higher in households with at least one college-
,educated parent. CAM use was also higher in non-Hispanic Caucasians, persons who had
taken prescription drugs within the past 3 months, and those living in households with incomes
higher than $65,000.
1. 1. The mother of a 15-year-old female expresses concerns that her daughter may be
sexually active because she's had a steady boyfriend for over a year. The primary care
pediatric nurse practitioner learns that the family is Catholic and that the mother had an
abortion when she was 16 years old. What will the nurse practitioner do initially?
a. a. Explore the mother's feelings about her own past experience.
b. b. Offer to prescribe contraception to prevent pregnancy.
c. c. Recommend that the mother discuss this with her daughter.
d. d. Suggest that the mother talk to a priest about her daughter. - ANS: A
An initial step when assisting families to manage ethical and behavioral issues is to assist
parents and children in values clarification. Before offering other suggestions, the PNP should
help the mother to clarify her own feelings. The other options may be necessary after values
are
clarified.
1. 1. The parent of a 4-year-old points to a picture and says, "That's your sister." The
child responds by saying, "No! It's my baby!" This is an example of which type of thinking in
preschool-age children?
a. a. Animism
b. b. Artificialism
c. c. Egocentrism
d. d. Realism - ANS: D
Children at this age are developing their ability to establish causality. Nominal realism occurs
when children think that one type of thing can only be called by one name. All dogs are dogs
and not various breeds. Animism refers to the belief that objects possess person-like qualities.
,Artificialism occurs when children think things are caused by a controlling force. Egocentrism is
when children see things only as they relate to themselves.
1. 1. The parent of a school-age child reports that the child usually has allergic rhinitis
symptoms beginning each fall and that non-sedating antihistamines are only marginally
effective, especially for nasal obstruction symptoms. What will the primary care pediatric
nurse practitioner do?
a. a. Order an intranasal corticosteroid to begin 1 to 2 weeks prior to pollen season.
b. b. Prescribe a decongestant medication as adjunct therapy during pollen season.
c. c. Recommend adding diphenhydramine to the child's regimen for additional
relief.
d. d. Suggest using an over-the-counter intranasal decongestant. - ANS: A
Intranasal corticosteroids are a key component in long-term therapy to manage symptoms
associated with AR. These should be begun 1 to 2 weeks prior to the beginning of pollen
season. Decongestants are not recommended for long-term use because of side effects.
Diphenhydramine causes daytime drowsiness.
1. 1. The primary care pediatric nurse practitioner is evaluating a school-age child who,
after removal of a pituitary tumor, has altered hypothalamic control over hunger and satiety.
The child is morbidly obese and expresses feeling depressed because of the obesity. What
will the nurse practitioner recommend?
a. a. Developing a system to reward compliance with a dietary regimen
b. b. Restricting all access to food in the house and at school
c. c. Suggesting an after-school exercise program to help with weight loss
d. d. Using a food diary to track all calories and food intake - ANS: B
Children with brain dysfunction affecting hypothalamic control may need rigid restrictions of
access to all foods in refrigerators, cupboards, and even garbage cans
1. 1. The primary care pediatric nurse practitioner is examining a newborn who is
, breastfeeding and notes the presence of an ankyloglossia. What will the nurse practitioner
do next?
a. a. Ask the mother if the infant has any feeding difficulties.
b. b. Refer the infant for a possible frenulectomy.
c. c. Schedule an appointment with a lactation consultant.
d. d. Suggest that the mother feed breast milk by bottle. - ANS: A
Infants with ankyloglossia may have difficulty feeding if the tongue does not extend well. The
PNP should first assess feeding difficulties and then may refer for a lactation consultant or
consider a frenulectomy.
1. 10. The mother of a 3-year-old child takes the child to a play group once a week.
She expresses concern that the child plays with toys but does not interact with the other
toddlers. What will the primary care pediatric nurse practitioner counsel the mother?
a. a. The child probably is very shy but will outgrow this tendency with repeated
exposure to other children.
b. b. The toddler may have a language delay that interferes with socialization with
other children.
c. c. Toddlers may be interested in other children but usually do not engage in
interactive play.
d. d. Toddlers need more structured play to encourage interaction and socialization
with others. - ANS: C
Parallel play is common among toddlers who, although they may be fascinated by other
children, generally do not engage with peers in an interactive manner. This does not mean that
the child is shy or has a language delay, although in preschool years, the development of
symbolic language increases interactive play. Children need both structured and free play, but
structured play will not increase interaction during this normally parallel period.
1. 10. The primary care pediatric nurse practitioner is counseling the mother of a
newborn about breastfeeding her infant. Which supplements will the nurse practitioner
