NUR 507: EXAM 4 QUESTIONS WITH 100% ACCURATE
SOLUTIONS
1) An unimmunized school age child whose mother is in her first trimester of
pregnancy is diagnosed with rubella after a local outbreak. What will the primary
care pediatric nurse practitioner recommend?
A) Assessment of maternal rubella titers
B) Intravenous immunoglobulin for the child
C) MMR vaccine for the mother and child
D) Possible termination of the pregnancy -- Correct Answer ✔✔ A.
Assessment of maternal rubella titers
2) A child is brought to the clinic with a fever, headache, malaise, and a red, annular
macule surrounded by an area of clearing and a larger, erythematous annular ring.
The child complains of itching at the site. What will the PCP do to determine the
diagnosis?
A) ask about recent tick bites
B) obtain a skin culture'
C) order blood cultures
, D) perform serologic testing -- Correct Answer ✔✔ a. ask about
recent tick bites
3) A child whose family has been camping in a region with endemic Lyme disease
suffered several tick bites. The parents report removing the ticks but are notable
to or the length of time the ticks were attached. The child is asymptomatic. What
is the action?
A) Administer a prophylactic single dose of doxycycline.
B) Perform serologic testing for IgG or IgM antibodies.
C) Prescribe amoxicillin three times daily for 14 to 21 days.
D) Teach the parents which signs and symptoms to report. -- Correct
Answer ✔✔ D. Teach the parents which signs and symptoms to
report.
4) A 10monthold infant has an erythematous, fluctuant, nondraining abscess on the
right buttock after 10 days of treatment with amoxicillin for impetigo. What is the
next step in managing this infant's care?
A) Consultation with a pediatric infectious disease specialist
B) Culture of any superficial open surface wounds
C) Empiric treatment with clindamycin
D) Incision and drainage of the abscess with culture -- Correct Answer
✔✔ D. Incision and drainage of the abscess with culture
5) A child with a history of a pustular rash at the site of a cat scratch on one arm
now has warm, tender, swollen axillary lymph nodes on the affected side. The
primary care pediatric nurse practitioner notes induration and erythema of these
nodes. What will the nurse practitioner do?
A) Obtain a complete blood count and C reactive protein.
B) Order an immunofluorescent assay (IFA) for serum antibodies.
C) Perform a needle aspiration of the affected lymph nodes.
, D) .Prescribe a 5daycourse of azithromycin. -- Correct Answer ✔✔ B.
Order an immunofluorescent assay (IFA) for serum antibodies.
6) A 7year old child whose immunizations are up to date has a fever, headache, stiff
neck, and photophobia. What course of treatment is indicated?
A) Empiric treatment with oral antibiotics or intramuscular ceftriaxone
B) Hospitalization for diagnosis and treatment with antibiotics
C) Immediate vaccination with meningococcal vaccine
D) Outpatient lab work, including a CBC and blood and CSF cultures --
Correct Answer ✔✔ B. Hospitalization for diagnosis and treatment
with antibiotics
7) A school age child has fever of 104°F, sore throat, vomiting and malaise. The
primary care pediatric nurse practitioner observes that the tonsils, oropharynx,
and palate are erythematous and covered with exudate; the tongue is coated and
red; and there is a red, sand paper like rash on the child's neck, trunk, and
extremities. A rapid strep test is positive. What will the nurse practitioner do to
manage this
A) Administer intramuscular ceftriaxone.
B) Hospitalize for further diagnostic tests.
C) Prescribe oral amoxicillin.
D) Refer to a pediatric infectious disease specialist. -- Correct Answer
✔✔ C. Prescribe oral amoxicillin.
8) An adolescent has a TB skin test prior to working as a volunteer in a hospital.
The adolescent is healthy and has not travelled to or from a TB endemic area or
had close contact with anyone who has TB. The Mantoux skin test shows 10 mm
of induration after48 hours. What will the primary care pediatric nurse
practitioner do?
A) Ask the adolescent about exposure to homeless persons.
B) Order a chest radiograph to rule out active TB.
, C) Reassure the adolescent that this is a negative screen.
D) Refer the adolescent to an infectious disease specialist. -- Correct
Answer ✔✔ C. Reassure the adolescent that this is a negative
screen.
9) The primary care pediatric nurse practitioner is examining a 2montholdinfant with
fever and cough. A WBC is 14,000/mm3 and a chest radiograph is normal. The
infant is nursing well and having normal stools. What would be an appropriate
next step?
A) Admitting the infant to the hospital for LP and IV antibiotics
B) Obtaining a blood culture, erythrocyte sedimentation rate, and
Creactive protein
C) Performing a catheterized urinalysis to screen for leukocytes and
nitrites
D) Prescribing empiric, broad spectrum antibiotics with close follow up
-- Correct Answer ✔✔ C. Performing a catheterized urinalysis to
screen for leukocytes and nitrites
10) Which of the following is a consideration in the administration of immunizations?
A) Immunizations can only be administered if a child is free from any
illnesses.
B) Caregivers should administer aspirin prior to the injection to
prevent any side effects.
C) Children should be isolated from other children for 24 hours after
receiving immunizations.
D) Caregivers should be advised that immunizations may cause a mild
fever or soreness and redness at the injection site -- Correct
Answer ✔✔ D. Caregivers should be advised that immunizations
may cause a mild fever or soreness and redness at the injection site
11) A vaccine that contains fragments of cells that stimulate an immune response, but
does not contain the whole cell is known as a:
SOLUTIONS
1) An unimmunized school age child whose mother is in her first trimester of
pregnancy is diagnosed with rubella after a local outbreak. What will the primary
care pediatric nurse practitioner recommend?
A) Assessment of maternal rubella titers
B) Intravenous immunoglobulin for the child
C) MMR vaccine for the mother and child
D) Possible termination of the pregnancy -- Correct Answer ✔✔ A.
Assessment of maternal rubella titers
2) A child is brought to the clinic with a fever, headache, malaise, and a red, annular
macule surrounded by an area of clearing and a larger, erythematous annular ring.
The child complains of itching at the site. What will the PCP do to determine the
diagnosis?
A) ask about recent tick bites
B) obtain a skin culture'
C) order blood cultures
, D) perform serologic testing -- Correct Answer ✔✔ a. ask about
recent tick bites
3) A child whose family has been camping in a region with endemic Lyme disease
suffered several tick bites. The parents report removing the ticks but are notable
to or the length of time the ticks were attached. The child is asymptomatic. What
is the action?
A) Administer a prophylactic single dose of doxycycline.
B) Perform serologic testing for IgG or IgM antibodies.
C) Prescribe amoxicillin three times daily for 14 to 21 days.
D) Teach the parents which signs and symptoms to report. -- Correct
Answer ✔✔ D. Teach the parents which signs and symptoms to
report.
4) A 10monthold infant has an erythematous, fluctuant, nondraining abscess on the
right buttock after 10 days of treatment with amoxicillin for impetigo. What is the
next step in managing this infant's care?
A) Consultation with a pediatric infectious disease specialist
B) Culture of any superficial open surface wounds
C) Empiric treatment with clindamycin
D) Incision and drainage of the abscess with culture -- Correct Answer
✔✔ D. Incision and drainage of the abscess with culture
5) A child with a history of a pustular rash at the site of a cat scratch on one arm
now has warm, tender, swollen axillary lymph nodes on the affected side. The
primary care pediatric nurse practitioner notes induration and erythema of these
nodes. What will the nurse practitioner do?
A) Obtain a complete blood count and C reactive protein.
B) Order an immunofluorescent assay (IFA) for serum antibodies.
C) Perform a needle aspiration of the affected lymph nodes.
, D) .Prescribe a 5daycourse of azithromycin. -- Correct Answer ✔✔ B.
Order an immunofluorescent assay (IFA) for serum antibodies.
6) A 7year old child whose immunizations are up to date has a fever, headache, stiff
neck, and photophobia. What course of treatment is indicated?
A) Empiric treatment with oral antibiotics or intramuscular ceftriaxone
B) Hospitalization for diagnosis and treatment with antibiotics
C) Immediate vaccination with meningococcal vaccine
D) Outpatient lab work, including a CBC and blood and CSF cultures --
Correct Answer ✔✔ B. Hospitalization for diagnosis and treatment
with antibiotics
7) A school age child has fever of 104°F, sore throat, vomiting and malaise. The
primary care pediatric nurse practitioner observes that the tonsils, oropharynx,
and palate are erythematous and covered with exudate; the tongue is coated and
red; and there is a red, sand paper like rash on the child's neck, trunk, and
extremities. A rapid strep test is positive. What will the nurse practitioner do to
manage this
A) Administer intramuscular ceftriaxone.
B) Hospitalize for further diagnostic tests.
C) Prescribe oral amoxicillin.
D) Refer to a pediatric infectious disease specialist. -- Correct Answer
✔✔ C. Prescribe oral amoxicillin.
8) An adolescent has a TB skin test prior to working as a volunteer in a hospital.
The adolescent is healthy and has not travelled to or from a TB endemic area or
had close contact with anyone who has TB. The Mantoux skin test shows 10 mm
of induration after48 hours. What will the primary care pediatric nurse
practitioner do?
A) Ask the adolescent about exposure to homeless persons.
B) Order a chest radiograph to rule out active TB.
, C) Reassure the adolescent that this is a negative screen.
D) Refer the adolescent to an infectious disease specialist. -- Correct
Answer ✔✔ C. Reassure the adolescent that this is a negative
screen.
9) The primary care pediatric nurse practitioner is examining a 2montholdinfant with
fever and cough. A WBC is 14,000/mm3 and a chest radiograph is normal. The
infant is nursing well and having normal stools. What would be an appropriate
next step?
A) Admitting the infant to the hospital for LP and IV antibiotics
B) Obtaining a blood culture, erythrocyte sedimentation rate, and
Creactive protein
C) Performing a catheterized urinalysis to screen for leukocytes and
nitrites
D) Prescribing empiric, broad spectrum antibiotics with close follow up
-- Correct Answer ✔✔ C. Performing a catheterized urinalysis to
screen for leukocytes and nitrites
10) Which of the following is a consideration in the administration of immunizations?
A) Immunizations can only be administered if a child is free from any
illnesses.
B) Caregivers should administer aspirin prior to the injection to
prevent any side effects.
C) Children should be isolated from other children for 24 hours after
receiving immunizations.
D) Caregivers should be advised that immunizations may cause a mild
fever or soreness and redness at the injection site -- Correct
Answer ✔✔ D. Caregivers should be advised that immunizations
may cause a mild fever or soreness and redness at the injection site
11) A vaccine that contains fragments of cells that stimulate an immune response, but
does not contain the whole cell is known as a:
