NSG6435 Week 5 Assignment 4 Midterm Exam / NSG 6435 Week 5 Midterm Exam -Family Health - Pediatrics- South University
NSG6435 Week 5 Assignment 4 Midterm Exam / NSG 6435 Week 5 Midterm Exam -Family Health - Pediatrics- South University
The incidence of congenital heart defects is estimated to be ________ of all live births.
Breastmilk can be safely stored in a freezer below 0 degrees Fahrenheit for how long?
Which foreign body needs immediate removal from a five-year-old boy’s nose?
The most useful diagnostic test in delayed puberty is _____________________.
complete thyroid panel
X-Ray of the left wrist and hand
X-Ray of the right wrist and hand
X-Ray of the spinal column
An average vision of a two-year-old child is approximately:
A five-year-old female presents for a follow-up emergency room visit with a diagnosis of bronchitis. You would expect which treatment to have been prescribed?
Increase rest and fluid
An adolescent with a chronic asthma cough notes that symptoms are usually worse _____________.
only with exertion
only during the daytime
only at night
at night and with exertion
An average adolescent female usually experiences her biggest growth spurt at approximately what age?
Ten and half years
Eleven and half years
Twelve and half years
Thirteen and half years
If an adolescent has a bone age of 10 but is actually 13 years of age, this patient has ______.
an increased risk of fracture in the next three years
an increased risk of osteoporosis as an adult
a higher potential for bone growth
a lower potential for bone growth
Gardasil results in greater antibody responses for females who are administered the three-dose series between what ages?
Six to twenty-six years of age
Prior to eleven years of age
Nine to fifteen years of age
Nine to twenty-six years of age
An eight-year old has chronic intermittent nasal congestion. All but which of the following would support allergic rhinitis?
Red swollen turbinates
Darkened areas below eyes
Increased basophils on complete blood count (CB
Itchy, watery eyes
A fifteen-month old failed treatment with amoxicillin for an otitis media. At his two-week recheck, his tympanic membrane remained red with distorted landmarks and he persisted with nasal discharge that is thick and yellowish. The best action for the nursing practitioner should be to prescribe:
A ten-day-course of augmentin
A three-week-course of a cephalexin
A higher dose amoxicillin
Ceftriaxone and an antihistamine
An infant should be able to say his or her first word by:
four to five months
eight to nine months
twelve to fifteen months
twenty four to twenty six months
The latter part of adolescence includes the ability to develop ________ and _______ means to be a part of society.
strong attachments; sexuality
critical thinking; basic life skills
moral; intellectual means
A fourteen-year-old adolescent presents with fatigue, endocarditis, pulmonary hypertension, arrhythmias, and congestive heart failure. You suspect he may have ____________.
pulmonary valve stenosis
aortic valve stenosis
a ventricular septal defect (VSD)
A four-year-old male patient presents with his mother with a school referral regarding red eyes. Which questions would not assist in establishing a list of differential diagnoses?
Unilateral vs. bilateral presentation
Type of drainage
History of a bacterial infection one month ago
______________ adolescents should be screened for sexually transmitted diseases.
An infant should no longer have a head lag when pulled from the supine to sitting position at what age?
____________ should be given as a supplement in the management of delayed puberty.
Vitamins B1 and B12
Vitamins D and E
Vitamin A and Calcium
Calcium and Vitamin D
Parents or guardians of adolescents should ___________________.
not be included in the adolescent's health care
receive health guidance information at least twice during adolescence
encourage reasonable use of alcohol and tobacco by the adolescent
encourage early sexual activity by providing condoms to the adolescent
How does cultural sensitivity impact the care of infants in the primary care setting?
Health-care providers may possess cultural biases that can impact care.
Cultural sensitivities do not exist in health care.
Cultural sensitivity only impacts the parents of infants.
Cultural sensitivity increases access to timely health-care services for infants.
The most typical chest radiographic finding consistent with the diagnosis of asthma is ______________.
normal chest film
diffuse airway edema
right upper-lobe infiltrate
A 10 yo has a single painful ulcerated lesion on an erythematous base on the inner buccal mucosa. The most likely diagnosis and treatment would be:
herpes simplex stomatitis--oral acyclovir
apthous ulcer--triamcinalone in orabase
Hand, foot, mouth syndrome--antibiotic mouthwash
A 9 month old is noted to have a bifid uvula. This would increase his risk of developing which disorder?
All of the following may predispose a patient to thrush except:
poor oral hygiene
Patients with sinusitis should be instructed not to participate in what activity?
cross country running
What complication of sinusitis are adolescent males more prone to?
potts puffy tumor
Acceptable management options for allergic rhinitis include all of the following except:
A 7 yo has experienced recurrent nose bleeds in the past 2 months. What finding on the physical exam would suggest an underlying medical cause for the epistaxis?
grade II murmur
A 2 yo male with a history of chronic serous OM is noted to have a pearly white opacity in the upper outer quadrant of his TM. He currently has no symptoms and appears to be ok. The most likely diagnosis and appropriate managment would be:
tympanosclerosis; no treatment is necessary
persistent perforation; prescribe topical antibiotic drops
foreign body; perform an ear wash for removal
cholesteatoma; refer to otolaryngology
A 15 mo failed treatment with amoxicillin for OM. At his 2 week re-check his TM remained red with distorted landmarks and he persisted with nasal congestion, poor sleep, and fever. The next best step would be to treat with:
a 10 day course of augmentin
a 3 week course of cephalosporin
a higher dose of amoxicillin and topical abx
ceftriaxone and an antihistamine
All but which one of the following patients are at an increased risk of developing otitis media?
2 yo with cleft palate repair at 1 year of age
15 mo with down syndrome
9 mo with lactose intolerance
3 yo with IgA immune deficiency
Patients with otitis externa should be instructed to do which one of the following:
keep ear dry until symptoms improve
limit swimming for the remainder of summer
wear ear plugs at all times with swimming
use alcohol drops before swimming each day
A 10 yo has marked ear pain, not wanting anyone to touch his ear. The canal is edematous and exudate is present. TM is normal. How should this be managed?
oral steroids and topical neomycin
oral amoxicillin and topical anesthetic
oral amoxicillin and topical steroid
A 16 yo was hit in the eye 1 day ago and now has ecchymoses on the upper and lower lids with 5/10 eye pain. All but which of the following would be appropriate to obtain at this time:
The greatest risk in a patient with a hyphema is which of the following?
Corneal abrasions can be managed with topical application of which of the following:
anesthetic for pain control
steroids to prevent adhesions
antibiotics to prevent infection
atropine to prevent ciliary spasm
Trauma to the eye increases the risk of developing all but which one of the following?
Fluorescein staining of the eye is used to detect a:
Prematurity increases the risk of developing which one of the following?
A 3 month old has a mild asymmetrical corneal light reflex on physical exam. What is the next appropriate step?
observe and reevaluate at the next well check
refer immediately to ophthalmology
begin atropine drops or eye patching
protect eyes from sunlight
Which of the following may cause microcephaly?
What finding may accompany macrocephaly?
Pulsating anterior fontanel
Premature closure of suture lines
Widened suture lines
Obtaining a CT of the head would be indicated in which of these conditions?
Which one of the following conditions increases the risk of developing hydrocephalus?
A conjunctivitis appearing in a 2 day old newborn is likely due to:
chemical irritation from eye drops
group B streptocuccus
Confirming the diagnosis of chlamydia conjunctivitis in a newborn would best be done by obtaining which one of the following?
cervical swab of the mother
urine PCR from the mother
culture of the eye discharge
culture of the conjunctival scrapings
Which one of the following eye findings would be considered an ophthalmic emergency?
unilateral vesicular lesions on the upper eyelid of a 3 week old
presence of chemosis in a 5 yo with bilateral upper eyelid edema
cobblestone-like appearance along the inner aspect of the upper eyelid in a 15 yo
bilateral redness along the eyelid margins with tiny ulcerated areas in a 16 yo
The most appropriate management of a 5 yo with a firm, nontender nodule in the mid-upper eyelid for 3 weeks would be:
topical ophthalmic ointment
Daily eyelid cleansing with diluted baby shampoo and a cotton tipped applicator would be appropriate in the treatment of which one of the following conditions?
A 3 year old has an edematous, mildly erythematous right upper eyelid for one day with a fever of 103. An important eye assessment would be:
optic disk papilledema
Concurrent otitis media and conjunctivitis is likely due to which organism?
A 16 yo girl makes the following statements to you during her health visit. Which of the following pieces of information should not be kept confidential?
I have been sexually active with three of my boyfriends
I sometimes smoke marijuana
I want to get pregnant
Sometimes I feel like ending my life
In performing a physical examination on a nine month old infant, which of the following developmental fears would not be appropriate for you to consider?
Separation from parents
When performing a physical examination on a toddler, which of the following body parts would you examine last:
Heart and lungs
abdomen and genitals
Ears and throat
Hips and extremities
Role play with equipment during the course of a physical examination would be most beneficial with which of the following age groups:
Young school-age children
Older school-age children
Providing reassurance of "normalcy" during the course of an examination would be most important for:
Young school-age children
Older school-age children
Which of the following would not elevate the pulse of a child:
The PNP recognizes which of the following signs as indicators that baby is not receiving sufficient breastmilk?
Sleepiness, jaundice, decreased urine and stool
Diarrhea, nausea, and vomiting
Bulging fontanel and irritability
Sleeplessness and excitability
Blood pressure should be measured at WCC beginning at age:
A wide pulse pressure that results from a high systolic blood pressure is usually not due to which of the following:
A patent ductus arteriosus
Head and chest circumferences should be equal at:
The anterior fontanel usually closes by:
Diffuse edema of the soft tissue of the scalp which usually crosses suture lines in the newborn is:
An infant should no longer have head lag when pulled from the supine to sitting position at what age?
"Boggy" nasal mucous membranes with serous drainage upon examination usually suggests:
A white instead of red reflex upon eye examination of a 1 yo child would suggest:
An accommodative error
A cobblestone appearance of the palpebral conjunctiva usually indicates:
An eye that deviates in when covered but returns to midline when uncovered is an:
Pain produced by manipulation of the auricle or pressure on the tragus suggests:
Acute otitis media
Otitis media with effusion
A hypernasal voice and snoring in a child is suggestive of:
Polyps of the larynx
Physiological splitting of the second heart sound during inspiration in a child:
should be evaluated with an EKG
Should be referred to a cardiologist
Which of the following is not characteristic of innocent heart murmurs in children?
Systolic in timing
Varies in loudness with positioning
Usually transmitted to the neck
Usually loudest at lower left sternal border or at second or third intercostal space
A grade II musical or vibratory murmur heard best at the lower left sternal border that changes with positioning is suggestive of a:
Pulmonary ejection murmur
Ventricular septal defect
Vibratory or Still's murmur
Wheezing in a child may not be found in which of the following conditions:
Pleural friction rub
Gynecomastia in a male may not be a finding in which of the following:
Normal pubertal development
Which of the following would usually not be considered a sign of a pituitary tumor in an adolescent female?
Dysfunctional uterine bleeding
Loss of peripheral vision
Increase in headaches
Which of the following is not a specific examination test for a dislocated hip?
In addition to the knee, which of the following should be examined in a child complaining of knee pain?
Which of the following infant reflexes should not disappear by 6 months of age?
Spasticity in an infant may be an early sign of:
A shift to the left is present when which of the following are elevated?
Bands or stabs
Which of the following is usually elevated with viral infections?
Decreased platelets may not be found in which of the following:
Idiopathic thrombocytopenic purpura
Medication usage (e.g. ampicillin, cephalothin)
Which of the following does not suggest a urinary tract infection?
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