RNSG 6435: EXAM STUDY GUIDE WITH EXPLAINED ANS
Bacterial
Pneumo
Hospitial
ize
when?
• Infants 3 weeks-4 months who are febrile or hypoxic
• Hypoxemia >92%
• Dehydration
• Respiratory distress-RR > 70 in infants under 12 months or > than 50 in older children
• Respiratory
distress Chronic
illness
TB Sx
• Fever
• Productive cough
• Weight loss
• Malaise
• Night sweats
• Hemoptysis
textfill-fill-themecolor: text1;mso-style-textfill-fill-color:black;mso-style-textfill-fill-
alpha:100.0%'>If allergic to macrolides and over 8 years consider Doxycycline
Epstein Barr Virus (MONO)
, Incubation 30-50 days
sypmtoms: fever, sore throat, swollen glands, lethargy
attaches to epithelial cells of pharynx (after 4-7 weeks it migrates to
body) develop lifetime immunity (stays in B cells)
treat with rest and steroid for inflammation
Epstein-Barr virus (mono)
spread through saliva
great fatigue, sore throat, sore muscles, fever; spleen, liver, lymph node enlargement
3-7 week intubation period; self limiting course 4-6 weeks
dx:
monospot test
antibody test- mix pt's blood with modified IgG and IgM
erythema multiforme (rash)
small, flat, discolored spots
Mono S/Sx
• ~10% have a rash
• Enlarged spleen-~50%
• Laboratory Evaluation
–CBC-WBC between 10,000 and 20,000 mm3
–+ atypical lymphocytes
–Tansient hepatitisà increased transminase levels, alkaline phosphotase & lactate dehydrogenase
–Monospot test-detects EBV
• Sensitivity of >86%
• If negative but symptoms suspiciousàrepeat
• May also check EBV titers
,1.
A congenital heart abnormality often discovered during the newborn period is coarctation of the
aorta. How is this assessed?
By comparing right and left femoral
pulses By comparing right and left
pedal pulses
By comparing upper and lower extremity blood pressures
By auscultating an audible bruit in the carotid arteries
2.
A child who can stack a maximum of 5 blocks is probably:
1 yr of age
15 months of age
2 years of
age 3 years
of age 3.
A 6 yr old child who has moderate persistent asthma is diagnosed with pneumonia after chest x-
ray and lab studies. He developed a sudden onset of fever with chills. He is in no distress. What
is the preferred treatment for him?
Supportive measures, it is probably
viral Amoxicillin
Azithromyc
in
Doxycycline
, 4.
A healthy appearing 3-yr old female presents with non-blanchable redness over both knees and
elbows. During the exam, she is found to have normal growth and development, and she
interacts appropriately with the NP. She had an upper respiratory infection about 4 wks ago that
cleared without incident. A CBC and UA were obtained. The most likely diagnosis is:
Septic arthritis
Acute lymphocytic leukemia
(ALL) von Willebrands
disease
idiopathic thrombocytopenia purpura (ITP)
5.
An adolescent has acne. The NP prescribed a benzoyl peroxide product for him. What important
teaching point should be given to this adolescent regarding the benzoyl peroxide?
Don't apply this product more than once a
day This often causes peeling of the skin
Photosensitivity of the skin can occur
Hypersensitivity can occur with repeat use
6.
a 6-wk old male infant is brought to the NP because of vomiting. The mother describes
vomiting after feeding and feeling a knot in his abdomen especially after he vomits. The child
appears adequately nourished. What is the likely etiology?
GERD
Pyloric stenosis
Constipation
Bacterial
Pneumo
Hospitial
ize
when?
• Infants 3 weeks-4 months who are febrile or hypoxic
• Hypoxemia >92%
• Dehydration
• Respiratory distress-RR > 70 in infants under 12 months or > than 50 in older children
• Respiratory
distress Chronic
illness
TB Sx
• Fever
• Productive cough
• Weight loss
• Malaise
• Night sweats
• Hemoptysis
textfill-fill-themecolor: text1;mso-style-textfill-fill-color:black;mso-style-textfill-fill-
alpha:100.0%'>If allergic to macrolides and over 8 years consider Doxycycline
Epstein Barr Virus (MONO)
, Incubation 30-50 days
sypmtoms: fever, sore throat, swollen glands, lethargy
attaches to epithelial cells of pharynx (after 4-7 weeks it migrates to
body) develop lifetime immunity (stays in B cells)
treat with rest and steroid for inflammation
Epstein-Barr virus (mono)
spread through saliva
great fatigue, sore throat, sore muscles, fever; spleen, liver, lymph node enlargement
3-7 week intubation period; self limiting course 4-6 weeks
dx:
monospot test
antibody test- mix pt's blood with modified IgG and IgM
erythema multiforme (rash)
small, flat, discolored spots
Mono S/Sx
• ~10% have a rash
• Enlarged spleen-~50%
• Laboratory Evaluation
–CBC-WBC between 10,000 and 20,000 mm3
–+ atypical lymphocytes
–Tansient hepatitisà increased transminase levels, alkaline phosphotase & lactate dehydrogenase
–Monospot test-detects EBV
• Sensitivity of >86%
• If negative but symptoms suspiciousàrepeat
• May also check EBV titers
,1.
A congenital heart abnormality often discovered during the newborn period is coarctation of the
aorta. How is this assessed?
By comparing right and left femoral
pulses By comparing right and left
pedal pulses
By comparing upper and lower extremity blood pressures
By auscultating an audible bruit in the carotid arteries
2.
A child who can stack a maximum of 5 blocks is probably:
1 yr of age
15 months of age
2 years of
age 3 years
of age 3.
A 6 yr old child who has moderate persistent asthma is diagnosed with pneumonia after chest x-
ray and lab studies. He developed a sudden onset of fever with chills. He is in no distress. What
is the preferred treatment for him?
Supportive measures, it is probably
viral Amoxicillin
Azithromyc
in
Doxycycline
, 4.
A healthy appearing 3-yr old female presents with non-blanchable redness over both knees and
elbows. During the exam, she is found to have normal growth and development, and she
interacts appropriately with the NP. She had an upper respiratory infection about 4 wks ago that
cleared without incident. A CBC and UA were obtained. The most likely diagnosis is:
Septic arthritis
Acute lymphocytic leukemia
(ALL) von Willebrands
disease
idiopathic thrombocytopenia purpura (ITP)
5.
An adolescent has acne. The NP prescribed a benzoyl peroxide product for him. What important
teaching point should be given to this adolescent regarding the benzoyl peroxide?
Don't apply this product more than once a
day This often causes peeling of the skin
Photosensitivity of the skin can occur
Hypersensitivity can occur with repeat use
6.
a 6-wk old male infant is brought to the NP because of vomiting. The mother describes
vomiting after feeding and feeling a knot in his abdomen especially after he vomits. The child
appears adequately nourished. What is the likely etiology?
GERD
Pyloric stenosis
Constipation
