NURP-532-Exam 1 Questions With Complete Solutions
Select the options below that describe the pathophysiology of fever: - (ANSWER)Cytokines release
prostaglandin E
There is an alteration in the thermoregulatory center of the hypothalamus
When a pathogen or a virus, bacteria, invade the body, an inflammatory process occurs. And this is
because of a release of prostaglandin. So that's going to raise the thermoregulatory set point. And then
we see heat being produced by shivering, vasoconstriction, patients covering them up, and that will just
raise the body temperature.
Which of the following statements is correct? - (ANSWER)Temperature reduction lasts longer with
ibuprofen vs. acetaminophen
True or False - (ANSWER)All neonates with fever should receive a full sepsis work up. TRUE
Signs and symptoms of sepsis in the neonate include progressive jaundice, poor feeding, and a
temperature less than 35.5 degrees C. TRUE
Early onset group B strep infection in a baby occurs in the first 24 hours to 2 weeks, and late onset
occurs at 2 weeks up to 4 weeks of age. FALSE
All neonates with fever should receive empiric treatment with IV antibiotics. TRUE
E.coli is a common organism that causes early onset sepsis in the neonate. TRUE
Which of the following is appropriate to prescribe to reduce fever in a 4-month-old? -
(ANSWER)Acetaminophen 10-15 mg/kg orally every 4-6 hours
Fever - (ANSWER)Pyrogens travel to the hypothalamus to signal for the body to retain more heat.
Temperature greater than 100.4 F.
,NURP-532-Exam 1 Questions With Complete Solutions
Only needs to be treated if the child is uncomfortable.
Pyrogens - (ANSWER)Released by the immune system in response to a bacterial or viral infection.
Signals the body to generate heat to make it an unfavorable habitat for infection.
What is the most accurate method of checking for a fever? - (ANSWER)Rectally for those under 3 years
of age (especially under 12 months of age)
Fever without Focus/Source - (ANSWER)Acute fever without a known source in children less than 24
months of age.
Infants or children who appear ill or "toxic" require a sepsis workup.
Sepsis Workup - (ANSWER)- CBC with diff
- Serous glucose
- CSF testing
- Inflammatory markers
- Urinalysis and urine cultures
- Blood cultures
- CXR
- Stool culturesterm-10
Evaluation of Infants < 29 Days - (ANSWER)Full workup and hospitalization
Evaluation of Infants 29-60 Days - (ANSWER)- CBC with diff
- BC
- UA and UC
,NURP-532-Exam 1 Questions With Complete Solutions
- PCT and CRP
- CXR
- Possibly an LP
Evaluation of Infants 61-90 Days - (ANSWER)- Infants who are well appearing and have no focal or viral
infection: UA and UC
- Infants who received an immunization within the past 24-hours and temperature is less than 38.6
C/101.5 F may be closely monitored and if fever lasts longer than 48 hours, workup is required
- If RSV positive, no further workup is required
- If positive for the flu, UA and UC recommended
Urinalysis - (ANSWER)- UA and UC required for all children less than 90 days with a fever
- UA and UC recommended for children 3-24 months of age that are at risk (temp > 102.2 F, females < 12
months of age, uncircumsized males, and fever > 24 hours)
Management of FWS 29-90 Days - (ANSWER)- Low Risk: close follow-up within 12-24 hours
- Moderate-to-High Risk: hospitalization, CSF studies, and empirical antibiotics
Fever of Unknown Origin (FUO) - (ANSWER)- Fever for greater than 2-3 weeks with no known origin
after testing and work-up
Evaluation of FUO - (ANSWER)- CBC with diff
- BMP with liver function test
- Blood cultures
, NURP-532-Exam 1 Questions With Complete Solutions
- Inflammatory markers
- UA/UC
- CXR
- ID consult
- Empirical antibiotics not recommended
Acetaminophen (Tylenol) - (ANSWER)- Drug of choice in reducing fever
- Dose 10-15mg/kg q4-6hrs to not exceed 5 doses in 24 hours
Ibuprofen (Motrin) - (ANSWER)- May be used in children > 6 months of age
- Dose: 5 mg/kg q6-8 hours for a temp < 102.5 F; 10 mg/kg q6-8hrs for a temp > 102.5 F
The mother of a 12-month-old calls the clinic because her son has had a fever of 101.5 for 2 days, and
she just noticed a rash on his torso. Which of the following questions is most helpful in determining if
the rash may be due to a serious bacterial infection? - (ANSWER)Does the rash blanch under pressure?
All fevers above 101 degrees F in children should be treated with antipyretics. - (ANSWER)False
A 65-day-old male with no PMH presents for a fever of 101 degrees F for 8 hours. The infant received his
2 month vaccines yesterday. He is well-appearing and he has no red flags on history or exam. The nurse
practitioner should - (ANSWER)Order nothing and recheck the patient in 24 hours.
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: - (ANSWER)UA, urine culture, and CBC/diff, PCT, CRP, and blood culture
Kawasaki Disease- Acute Stage - (ANSWER)Lasts approximately 10 days with a high fever for more than 5
days
Select the options below that describe the pathophysiology of fever: - (ANSWER)Cytokines release
prostaglandin E
There is an alteration in the thermoregulatory center of the hypothalamus
When a pathogen or a virus, bacteria, invade the body, an inflammatory process occurs. And this is
because of a release of prostaglandin. So that's going to raise the thermoregulatory set point. And then
we see heat being produced by shivering, vasoconstriction, patients covering them up, and that will just
raise the body temperature.
Which of the following statements is correct? - (ANSWER)Temperature reduction lasts longer with
ibuprofen vs. acetaminophen
True or False - (ANSWER)All neonates with fever should receive a full sepsis work up. TRUE
Signs and symptoms of sepsis in the neonate include progressive jaundice, poor feeding, and a
temperature less than 35.5 degrees C. TRUE
Early onset group B strep infection in a baby occurs in the first 24 hours to 2 weeks, and late onset
occurs at 2 weeks up to 4 weeks of age. FALSE
All neonates with fever should receive empiric treatment with IV antibiotics. TRUE
E.coli is a common organism that causes early onset sepsis in the neonate. TRUE
Which of the following is appropriate to prescribe to reduce fever in a 4-month-old? -
(ANSWER)Acetaminophen 10-15 mg/kg orally every 4-6 hours
Fever - (ANSWER)Pyrogens travel to the hypothalamus to signal for the body to retain more heat.
Temperature greater than 100.4 F.
,NURP-532-Exam 1 Questions With Complete Solutions
Only needs to be treated if the child is uncomfortable.
Pyrogens - (ANSWER)Released by the immune system in response to a bacterial or viral infection.
Signals the body to generate heat to make it an unfavorable habitat for infection.
What is the most accurate method of checking for a fever? - (ANSWER)Rectally for those under 3 years
of age (especially under 12 months of age)
Fever without Focus/Source - (ANSWER)Acute fever without a known source in children less than 24
months of age.
Infants or children who appear ill or "toxic" require a sepsis workup.
Sepsis Workup - (ANSWER)- CBC with diff
- Serous glucose
- CSF testing
- Inflammatory markers
- Urinalysis and urine cultures
- Blood cultures
- CXR
- Stool culturesterm-10
Evaluation of Infants < 29 Days - (ANSWER)Full workup and hospitalization
Evaluation of Infants 29-60 Days - (ANSWER)- CBC with diff
- BC
- UA and UC
,NURP-532-Exam 1 Questions With Complete Solutions
- PCT and CRP
- CXR
- Possibly an LP
Evaluation of Infants 61-90 Days - (ANSWER)- Infants who are well appearing and have no focal or viral
infection: UA and UC
- Infants who received an immunization within the past 24-hours and temperature is less than 38.6
C/101.5 F may be closely monitored and if fever lasts longer than 48 hours, workup is required
- If RSV positive, no further workup is required
- If positive for the flu, UA and UC recommended
Urinalysis - (ANSWER)- UA and UC required for all children less than 90 days with a fever
- UA and UC recommended for children 3-24 months of age that are at risk (temp > 102.2 F, females < 12
months of age, uncircumsized males, and fever > 24 hours)
Management of FWS 29-90 Days - (ANSWER)- Low Risk: close follow-up within 12-24 hours
- Moderate-to-High Risk: hospitalization, CSF studies, and empirical antibiotics
Fever of Unknown Origin (FUO) - (ANSWER)- Fever for greater than 2-3 weeks with no known origin
after testing and work-up
Evaluation of FUO - (ANSWER)- CBC with diff
- BMP with liver function test
- Blood cultures
, NURP-532-Exam 1 Questions With Complete Solutions
- Inflammatory markers
- UA/UC
- CXR
- ID consult
- Empirical antibiotics not recommended
Acetaminophen (Tylenol) - (ANSWER)- Drug of choice in reducing fever
- Dose 10-15mg/kg q4-6hrs to not exceed 5 doses in 24 hours
Ibuprofen (Motrin) - (ANSWER)- May be used in children > 6 months of age
- Dose: 5 mg/kg q6-8 hours for a temp < 102.5 F; 10 mg/kg q6-8hrs for a temp > 102.5 F
The mother of a 12-month-old calls the clinic because her son has had a fever of 101.5 for 2 days, and
she just noticed a rash on his torso. Which of the following questions is most helpful in determining if
the rash may be due to a serious bacterial infection? - (ANSWER)Does the rash blanch under pressure?
All fevers above 101 degrees F in children should be treated with antipyretics. - (ANSWER)False
A 65-day-old male with no PMH presents for a fever of 101 degrees F for 8 hours. The infant received his
2 month vaccines yesterday. He is well-appearing and he has no red flags on history or exam. The nurse
practitioner should - (ANSWER)Order nothing and recheck the patient in 24 hours.
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: - (ANSWER)UA, urine culture, and CBC/diff, PCT, CRP, and blood culture
Kawasaki Disease- Acute Stage - (ANSWER)Lasts approximately 10 days with a high fever for more than 5
days
