NURP-532-Exam 1 Questions With Complete Solutions
A 10-year-old female presents to the primary care clinic with
complaints of a runny nose, sneezing, and watery eyes. Her
mother reports that she always seems to have a cold. She is
always sniffling and rubbing her nose. Her mother has noticed
that she has developed a crease on the bridge of her nose. She
looks fatigued to her mother and has dark circles under her eyes.
Based on the suspected diagnosis, what should be included in
the management plan? Correct Answers Intranasal
corticosteroid
A 12-month old girl presents with irritability, vomiting, and no
wet diapers in 6 hours. UTI is suspected. What is the
management? Correct Answers Refer the child to the ER
A 19-month old with a fever of 100.5-101 degrees for 2 days
and moderate bulging erythema of both TMs. Management?
Correct Answers Treat with high dose amoxicillin for 10 days
and ibuprofen PRN.
A 19-year-old woman presents to her primary care clinic
complaining of a sore throat for 2 days. She also reports a fever
that reached 100.5 degrees Fahrenheit the previous day. She
denies cough. A friend at her place of employment also had
similar symptoms. On physical examination, her neck reveals
tender anterior cervical lymphadenopathy, and her tonsils are
inflamed and without exudate. What should the nurse
practitioner do next? Correct Answers Perform a rapid strep test
and treat with antibiotics if positive
,A 21 month old presents with nasal congestion, cough, and a
temp of 100 for days. What is the diagnosis? Correct Answers
Otitis media with effusion
A 25-year-old man presents to the primary care clinic with 3
weeks of facial pain and pressure. He describes a right-sided
fullness and tenderness over his cheek. He has also had yellow-
green drainage from his nose along with subjective fever,
halitosis, and malaise. He felt as though he was getting better 1
week ago, but then his symptoms returned worse than ever. On
physical examination, his right maxillary sinus is tender to
palpation and percussion. Which of the following should be
included in the management plan? Correct Answers Treat with
amoxicillin or amoxicillin-clavulanate
A 28 year old with sudden onset of persistent dizziness
associated with nausea and vomiting for 6 hours. No hearing
loss. Correct Answers Vestibular neuritis
A 3 y.o with a fever has a CBC with diff showing leukocytosis,
neutrophils, and bandemia. The infection is likely: Correct
Answers Bacterial
A 3-year-old child has just completed a 7-day course of
amoxicillin for a second febrile urinary tract infection and
currently has a negative urine culture. What is the next course of
action? Correct Answers Obtain a renal and bladder ultrasound
A 3-year-old male presents for rhinorrhea, sneezing, and watery
eyes for 2 weeks. The parents reports that he has been afebrile
and otherwise is active, playful, and has a good appetite. The
,child and parents deny pain, sore throat, cough, trouble
breathing, or gastrointestinal symptoms. He does not attend
daycare/preschool. First-line pharmacologic management of this
patient should include Correct Answers Fluticasone nasal spray.
A 30-year-old with inflammatory bowel disease presents with
redness, pain, photophobia, blurred vision and tearing in the
right eye. The nurse practitioner notes a constricted pupil on
exam and conjunctival hyperemia of the right eye. What
diagnosis is most likely? Correct Answers Uveitis
A 35-year-old patient reports suddenly experiencing an
asymmetric smile along with drooping and tearing in one eye.
The patient has a history of a recent viral illness but is otherwise
healthy. During the exam, the provider notes that there is
unilateral full-face paralysis on the right side. What is the initial
intervention for this patient? Correct Answers Prescribe oral
corticosteroids
A 40-day-old female born at term presents with a fever of 100.9
F for 12 hours. She has no PMH, takes no medications, she is
feeding well, and has normal urine output and stool. Her ROS is
negative. The child is nontoxic appearing and has an otherwise
normal exam. The FNP understands that the infant will require:
Correct Answers UA, urine culture, and CBC/diff, PCT, CRP,
and blood culture
A 45-year-old male woke up 3 days ago with dizziness when
turning over in bed. The dizziness has persisted, and he notes
that it occurs with turning his head or position change. The
episodes are brief, about 30 seconds, and are associated with
, mild nausea without vomiting. He denies headaches, hearing
loss, tinnitus, ear pain, vision problems or weakness. His
physical exam is normal. The nurse practitioner should next
perform Correct Answers the Dix-Hallpike test.
A 48-year-old male presents for intermittent dizziness for 3-4
days associated with decreased hearing in the left ear. The
patient denies ear pain, tinnitus, or recent upper respiratory
infection. He reports that he feels like he is spinning. The
episodes are not triggered and they last 2-3 hours. He denies
nausea or vomiting. He has a normal neurological exam. The
weber exam lateralizes to the right ear and the Rinne reveals air
conduction is greater than bone conduction in the left ear. Which
of the following should be part of the management plan? Correct
Answers Perform a canalith repositioning maneuver
A 5-year-old child presents with swelling around the right eye
for 2 days. The parents report that the child has been afebrile,
but is complaining of pain in the eye. On examination, there is
erythema and edema surrounding the eye and chemosis. The
child has difficulty and pain when moving the eye. What is the
best management plan for this presentation? Correct Answers
Refer to the ER
A 5-year-old child who is fully immunized has a 1-week history
of fever of 103 to 104 °F that is unresponsive to antipyretics.
The primary care nurse practitioner examines the child and notes
bilateral conjunctival injection and a polymorphous exanthem.
The nurse practitioner has a high suspicion for Kawasaki
disease. Which of the following statements it correct? Correct
A 10-year-old female presents to the primary care clinic with
complaints of a runny nose, sneezing, and watery eyes. Her
mother reports that she always seems to have a cold. She is
always sniffling and rubbing her nose. Her mother has noticed
that she has developed a crease on the bridge of her nose. She
looks fatigued to her mother and has dark circles under her eyes.
Based on the suspected diagnosis, what should be included in
the management plan? Correct Answers Intranasal
corticosteroid
A 12-month old girl presents with irritability, vomiting, and no
wet diapers in 6 hours. UTI is suspected. What is the
management? Correct Answers Refer the child to the ER
A 19-month old with a fever of 100.5-101 degrees for 2 days
and moderate bulging erythema of both TMs. Management?
Correct Answers Treat with high dose amoxicillin for 10 days
and ibuprofen PRN.
A 19-year-old woman presents to her primary care clinic
complaining of a sore throat for 2 days. She also reports a fever
that reached 100.5 degrees Fahrenheit the previous day. She
denies cough. A friend at her place of employment also had
similar symptoms. On physical examination, her neck reveals
tender anterior cervical lymphadenopathy, and her tonsils are
inflamed and without exudate. What should the nurse
practitioner do next? Correct Answers Perform a rapid strep test
and treat with antibiotics if positive
,A 21 month old presents with nasal congestion, cough, and a
temp of 100 for days. What is the diagnosis? Correct Answers
Otitis media with effusion
A 25-year-old man presents to the primary care clinic with 3
weeks of facial pain and pressure. He describes a right-sided
fullness and tenderness over his cheek. He has also had yellow-
green drainage from his nose along with subjective fever,
halitosis, and malaise. He felt as though he was getting better 1
week ago, but then his symptoms returned worse than ever. On
physical examination, his right maxillary sinus is tender to
palpation and percussion. Which of the following should be
included in the management plan? Correct Answers Treat with
amoxicillin or amoxicillin-clavulanate
A 28 year old with sudden onset of persistent dizziness
associated with nausea and vomiting for 6 hours. No hearing
loss. Correct Answers Vestibular neuritis
A 3 y.o with a fever has a CBC with diff showing leukocytosis,
neutrophils, and bandemia. The infection is likely: Correct
Answers Bacterial
A 3-year-old child has just completed a 7-day course of
amoxicillin for a second febrile urinary tract infection and
currently has a negative urine culture. What is the next course of
action? Correct Answers Obtain a renal and bladder ultrasound
A 3-year-old male presents for rhinorrhea, sneezing, and watery
eyes for 2 weeks. The parents reports that he has been afebrile
and otherwise is active, playful, and has a good appetite. The
,child and parents deny pain, sore throat, cough, trouble
breathing, or gastrointestinal symptoms. He does not attend
daycare/preschool. First-line pharmacologic management of this
patient should include Correct Answers Fluticasone nasal spray.
A 30-year-old with inflammatory bowel disease presents with
redness, pain, photophobia, blurred vision and tearing in the
right eye. The nurse practitioner notes a constricted pupil on
exam and conjunctival hyperemia of the right eye. What
diagnosis is most likely? Correct Answers Uveitis
A 35-year-old patient reports suddenly experiencing an
asymmetric smile along with drooping and tearing in one eye.
The patient has a history of a recent viral illness but is otherwise
healthy. During the exam, the provider notes that there is
unilateral full-face paralysis on the right side. What is the initial
intervention for this patient? Correct Answers Prescribe oral
corticosteroids
A 40-day-old female born at term presents with a fever of 100.9
F for 12 hours. She has no PMH, takes no medications, she is
feeding well, and has normal urine output and stool. Her ROS is
negative. The child is nontoxic appearing and has an otherwise
normal exam. The FNP understands that the infant will require:
Correct Answers UA, urine culture, and CBC/diff, PCT, CRP,
and blood culture
A 45-year-old male woke up 3 days ago with dizziness when
turning over in bed. The dizziness has persisted, and he notes
that it occurs with turning his head or position change. The
episodes are brief, about 30 seconds, and are associated with
, mild nausea without vomiting. He denies headaches, hearing
loss, tinnitus, ear pain, vision problems or weakness. His
physical exam is normal. The nurse practitioner should next
perform Correct Answers the Dix-Hallpike test.
A 48-year-old male presents for intermittent dizziness for 3-4
days associated with decreased hearing in the left ear. The
patient denies ear pain, tinnitus, or recent upper respiratory
infection. He reports that he feels like he is spinning. The
episodes are not triggered and they last 2-3 hours. He denies
nausea or vomiting. He has a normal neurological exam. The
weber exam lateralizes to the right ear and the Rinne reveals air
conduction is greater than bone conduction in the left ear. Which
of the following should be part of the management plan? Correct
Answers Perform a canalith repositioning maneuver
A 5-year-old child presents with swelling around the right eye
for 2 days. The parents report that the child has been afebrile,
but is complaining of pain in the eye. On examination, there is
erythema and edema surrounding the eye and chemosis. The
child has difficulty and pain when moving the eye. What is the
best management plan for this presentation? Correct Answers
Refer to the ER
A 5-year-old child who is fully immunized has a 1-week history
of fever of 103 to 104 °F that is unresponsive to antipyretics.
The primary care nurse practitioner examines the child and notes
bilateral conjunctival injection and a polymorphous exanthem.
The nurse practitioner has a high suspicion for Kawasaki
disease. Which of the following statements it correct? Correct
