MARYVILLE NURS 612 FINAL EXAM ADVANCED HEALTH
ASSESSMENT 2026/2027 QUESTIONS WITH DETAILED
VERIFIED ANSWERS / EXAM QUESTIONS AND VERIFIED
ANSWERS |ALREADY GRADED A+|
A newborn year-old male presents with umbilicus that continues
to bleed despite prior cautery with silver nitrate. On exam you
note marked ecchymosis and edema, with no history of recent
trauma. Mom states it always takes a long time for his bruises to
heal. Current lab work reveals a prolonged PTT with a normal
platelet count and PT. Considering his most likely diagnosis what
is the most appropriate treatment to order?
A. Vitamin K
B. Platelet infusion
C. Hydroxyurea
D. Factor 8 - ANSWER-Factor 8 (hemophilia)
UTI - ANSWER-HPI: urgency, frequency, abd pain (lower
tract/simple), fever nausea, vomiting (upper tract; complicated)
Dysuria: specific female 90% probably- painful urination - can
treat over the phone)/males (STI)
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Increased risk: uncircumcised, Diarrhea, constipation, sexually
active - females - short urethra
PE: suprapubic tenderness, CVA tenderness (renal), vulvitis
Differential dx: Cystitis, pyelonephritis, candidiasis, DM
Fever in young - usually infection
UTI DX - ANSWER-UA Bag vs cath
>50K enough in culture considered uti
UTI x 2 - us scarring of kidney
UTI tx - ANSWER-Upper tract (complicated) 10 day course: if
N&V - shot of rocephin
A second gen or third gen cephalosporin (probability of resistance
to first gen cephalosporins, TM, OR AMOX is relatively high, and
the tissue conc of nitrofurantoin may not be adequate to eradicate
organism.
Cefuroxime 30 mg/kg bid x 10 days
Cefixime 16 mg/kg day 1 then 8 mg/kg qd x 10 days
Cefdinir 14 mg/kg qd x 10 days
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Lower tract infection (simple) 3-5 day course
Cephalexin 50-100 mg/kg bid (if <15% local resistance)
Male GU presentations - ANSWER-Cryptorchidism (undescended
testes) Usually descend by 3-6 mo - refer if not
Tx hormone or surgery
Hydrocele - fluid collection in scrotum - often resolves
spontaneously, > 1 yr surgical referreral
Testicular torsion - urgent treatment - medical emergency.
Renal disease - ANSWER-Glomerulus filters blood "sieve"
Nephrotic syndrome: endothelial cells podocytes function loss in
bowman's capsule allows protein escape
Glomerular nephritis: inflammatory response to immune reaction
(antigen/Ab complex) in the capillary allow RBC and WBC AND
PROTEIN ESCAPE.
HPI: swelling facial and extremities, fatigue, hx of strep - swelling
in little guys usually kidney, not CHF
PE: edema, HTN frothy or hematuria
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Nephrotic syndrome - ANSWER-Endothelial cells podocytes
Bowmans, capsule allows protein escape.
Idiopathic podocyte function loss; frothy urine, albumin loss; liver
response (att 3 loss- clotting) lipid increase
++ swelling; HTN; elevated BUN Cr
Relapse risk, watch weight. Clot formation, Na, and fluid
restriction.
Massive protein loss >3.5 g per day.
ages 2-5
TX: prednisone, immunosuppressant
Glomerular nephritis - ANSWER-ages 2-10
Inflammatory response to immune reaction (antigen/ab complex)
in the capillary allow RBC and WBC and protein to escape
body's reaction to Strep exposure
ASO titer
Cola/tea colored urine
+ swelling; HTN; Elevated BUN and Cr
Mindful of strep recurrence (skin, throat)