FINAL EXAM
High-Yield Qs & Answers with
Rationales
This Exam Description:
High-Yield Qs
Answers with Rationales
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1
,A 16yearold |sexually |active |female |has |a |fever, |bilateral |lower
|abdominal
pain,and |malaise. |A |speculum |and |bimanual |exam |reveals |adnexal
|tenderness.
The |urinalysis |is |normal |and |cervical |cultures |are |pending. |What
|medications |will |the |primary |care |pediatric |nurse |practitioner
|prescribe |for |this |patient? |- |Correct Answer✓✓|PID- |she |is |Sexually
|active+Adnexal |Tenderness |and |negative |for |UTI. |
Ceftriaxone, |doxycycline, |and |metronidazole |
Rational- |This |is |PID |the |treatment |is |Ceftriaxone |250 |mg |IM |plus
|Doxyclicline |100 |mg |BID |for |14 |days |plus |with |or |without
|Metronidazole |500 |mg |PO |bid |for |14 |days.
4. |A |sexually |active |adolescent |female |tests |positive |for |N. |gonorrhea
|
and |Chalmydia. |She |tells |the |primary |care |pediatric |nurse
|practitioner |that |she |
wants |to |be |treated |today |since |she |is |moving |out |of |town |the |next
|day. |What |will |the |nurse |practitioner |order?What |is |the |treatment
|for |her |- |Correct Answer✓✓|Ceftriaxone |250 |mg |IM |and |azithromycin
|1 |g |PO |one |time |each
Rational- |Remember |the |G |in |Gonorehea |for |or |Ceftriaxone |and
|Chlamydia |you |can |give |either |Doxycycline |100 |mg |for |7 |days |or
|Azithromycin |1 |g |PO |x1 |because |she |is |moving |she |are |giving |this
|combination.
2
,A |14yearold |female |has |menometrorrhagia |with |moderate |increase |in
|menstrual |flow |and |irregular |periods. |Her |hemoglobin |is |13.1 |g/dL.
|How |will |this |be |managed? |- |Correct Answer✓✓|Iron |supplementation
|and |prostaglandin |inhibitors
Rationale: |Her |hemoglobin |level |is |at |13.1 |and |the |normal |range |for
|this |age |group |is |11.9-15. |It |is |better |to |give |Iron |because |of |the
|bleeding |and |for |pain |reliefe |Prostoglandins |such |as |Ibuprofen.
An |adolescent |female |has |heavy |periods |that |are |also |irregular. |The
|physical |exam |is |normal. |A |complete |blood |count |reveals |a
|hemoglobin |of |8.9 |g/dL. |What |test |will |the |primary |care |pediatric
|nurse |practitioner |order |next? |- |Correct Answer✓✓|Coagulation
|studies
Rational-The |normal |Hemoglobin |range |is |11.9-13.1 |and |she |is
|outside |the |range. |We |need |to |look |for |reasons |of |this.
An |adolescent |female |has |periods |every |30 |days |that |are |consistently
|
heavy |and |last |from |5 |to |8 |days. |What |is |her |diagnosis? |- |Correct
Answer✓✓|Menorrhagia- |
Rationale- |The |diagnosis |for |this |is |periods |lasting |longer |than |7 |days.
|Hers |are |lasting |8 |days. |She |is |consistant |with |when |her |periods
|start |so |it |won't |be |menometrorrhagia |because |that |is |irregular
|periods.
A |16yearold |female |has |not |had |a |menstrual |period |yet |and |is
|concerned. |She
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, denies |sexual |activity. |An |exam |reveals |an |adult |sexual |maturity
|rating. |
Which |laboratory |test |will |the |primary |care |pediatric |nurse
|practitioner |order |initially? |- |Correct Answer✓✓|Pregnancy |Test
Rationale- |All |people |lie |and |the |number |one |reason |for
|Ammenorrhea |is |pregnancy. |After |I |rule |out |that |then |I |can |look |at
|other |things |such |as |nutrition, |is |she |an |athlete |and |is |it |Primary
|Amenorrhea |which |is |failure |to |have |a |period |for |3 |years |or |creast
|development |or |by |age |15. |or |Secondary |Anemia |which |is |no
|menstrual |periods |for |3 |months |or |absent |of |period |for |6 |months |for
|those |on |irregular |periods.
A |16yearold |female |reports |breast |tenderness |and |a |"lump." |The
|primary |care |pediatric |nurse |practitioner |palpates |a |small |fluidfilled
|mass |in |her |right |breast. |- |Correct Answer✓✓|Order |an |Ultra |Sound |of
|Breast
Rationale- |First |thing |you |always |do |is |order |an |ultra |sound |first |to
|determine |reason. |Most |girls |this |age |do |not |have |breast |cancer.
A |15yearold |n |female |has |a |positive |pregnancy |test |and |asks |the
|primary |care
pediatric |nurse |practitioner |not |to |tell |her |parents. |She |is |tearful
|and |says |she |isn't |sure |she |wants |to |keep |the |baby. |What |will |the
|nurse |practitioner |do |first? |- |Correct Answer✓✓|Determine |the |state
|mandated |reporting |laws. |
Rationale- |Each |state |has |different |laws |on |reporting |to |parents |about
|STIs |and |Pregnancy.
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