NSG 6320 AGNP Board Exam – Pediatrics
Assessment Exam
1. Question:
A child sustained a "full-thickness" burn injury. This type injury involves
tissue destruction down to the:
epidermis.
dermis.
subcutaneous tissue. Correct
internal organs.
Explanation:
A full-thickness burn involves all skin layers, including the epidermis, dermis,
and the subcutaneous tissue and fat. Muscles and tendons may be involved.
A superficial thickness burn involves the epidermis only. A superficial partial
thickness burn involves the epidermis and the dermis. A deep thickness burn
involves the entire layer of dermis, and is more severe than a superficial
partial thickness burn.
2. Question:
A child was involved in a vehicular accident and sustained burns on the lower
extremities. Examination reveals a dry, waxy, whitish appearance of both
lower legs and some visualization of the tibialis anterior. This type of burn
would be classified as a:
superficial thickness burn.
superficial partial thickness burn.
deep partial thickness burn.
full thickness burn. Correct
Explanation:
Types of burn injuries are chemical, electric, radiation, or thermal and are
classified by the depth of damaged skin it caused. Full thickness burns
involve the destruction of all skin elements with coagulation of subdermal
plexus, muscle, and or tendons. Symptoms of superficial partial thickness
burns include: moist areas that are red to ivory white in color, blisters
forming almost immediately, and painful to touch. Since the pain receptors
are intact, pain is perceived. Superficial thickness burns appear
erythematous without blisters and usually have local pain. Deep partial
thickness burns have a dry waxy, whitish appearance and resemble full
thickness burns. Sometimes grafts are needed.
3. Question:
The earliest recognizable clinical manifestation(s) of cystic fibrosis in an
infant is:
, History of poor intestinal absorption
Foul smelling, frothy, greasy stools
Meconium ileus
Salty taste on the skin Correct
Explanation:
The signs and symptoms of cystic fibrosis (CF) vary from person to person
and over time. Sometimes there will be few symptoms and other times,
symptoms may become more severe. One of the first signs of CF that
parents may notice is that their baby's skin tastes salty when kissed, or the
baby doesn't pass stool when first born. Most of the other signs and
symptoms of CF happen later. They're related to how CF affects the
respiratory, digestive, or reproductive systems of the body.
4. Question:
An infant presents with a rash in the diaper area. Which description likely
indicates candidal diaper rash?
Red, moist, maculopapular patch with poorly defined borders in diaper
area
Bright red, moist patches with sharply demarcated borders, some loose
scales noted in the diaper area Correct
Moist, thin-roofed vesicles with a thin, erythematous base noted in the
diaper area
Erythematous and symmetric rash noted in the diaper area
Explanation:
Candidiasis is characteristic of a rash appearing with bright red, moist
patches with sharply demarcated borders, with some loose scales noted in
the diaper area. Red, moist, maculopapular patch with poorly defined
borders in diaper area is diaper dermatitis. Moist, thin-roofed vesicles with a
thin, erythematous base noted in the diaper area would be consistent with
impetigo. Hives appear as erythematous and symmetric and can be
generalized over the body including the diaper area.
5. Question:
Examination of a child who experienced a burn from a curling iron on the
forearm appears red without blistering but is painful to touch. This type of
burn would be classified as a:
superficial thickness burn. Correct
superficial partial thickness burn.
deep partial thickness burn.
full thickness burn.
Explanation:
,Types of burn injuries are chemical, electric, radiation, or thermal and are
classified by the depth of damaged skin. Superficial thickness burns appear
erythematous without blisters and usually have local pain. Symptoms of
superficial partial thickness burns include: moist areas that are red to ivory
white in color, blisters forming almost immediately, and painful to touch.
Since the pain receptors are intact, pain is perceived. Deep partial thickness
burns have a dry waxy, whitish appearance and resemble full thickness
burns. Sometimes grafts are needed. Full thickness burns involve the
destruction of all skin elements with coagulation of subdermal plexus,
muscle, and or tendons.
6. Question:
A small child sustained burns to the posterior trunk and posterior surface of
both arms. According to the "Rule of Nines" for small children, what
percentage of the total body surface area was involved?
9%.
18%.
27%. Correct
32.5%.
Explanation:
The "Rule of Nines" assigns percentage of body surface area burned based
on the location of the burn. The percentages are as follows: head and neck =
18%, anterior and posterior chest = 18% each, arms (anterior and posterior)
= 4.5% each, legs (anterior and posterior) = 6.7% each, and perineum = 1%.
For this example, 18% for posterior trunk plus 9% for arms = 27%.
7. Question:
If a newborn is suspected of having congenital hypothyroidism, which clinical
manifestation would be evident?
Prematurity
Hyperthermia
Hyperactivity
Enlarged anterior fontanel Correct
Explanation:
Infants with congenital hypothyroidism are usually born at term or after
term. Most practitioners now depend on the screening test in newborns to
diagnose this condition since the symptoms or signs take time to develop.
The symptoms of congenital hypothyroidism may include some of the
following: puffy face, coarse facial features, enlarged anterior fontanel, thick
protruding tongue, poor feeding, constipation or reduced stooling, prolonged
jaundice, decreased activity with hypotonia, hypothermia and cool and pale
skin, goiter, birth defects (e.g., heart valve abnormality), poor weight gain
due to poor appetite, and swollen hands, feet and genitals.
, 8. Question:
A child has a maculopapular, blotchy rash and on examination of his mouth,
red eruptions with white centers on the buccal mucosa are visualized. These
eruptions are called:
rubella spots.
aphthous ulcers.
Pastia's spots.
Koplik spots. Correct
Explanation:
Koplik spots are seen with measles. They are small, white spots (often on a
reddened background) that occur on the inside of the cheeks early in the
course of red measles, rubeola. Pastia's spots are pink or red lines that are
formed of confluent petechiae found in skin creases and are seen in patients
who have scarlet fever. Aphthous ulcers are recurrent small, round, or ovoid
ulcers with circumscribed margins, erythematous haloes, and yellow or gray
floors occurring in the mouth.
9. Question:
When suspecting pediculosis capitis, the chief complaint is:
itching. Correct
hives.
alopecia.
vesicles.
Explanation:
With pediculosis capitis (lice), itching is the most common symptom and is
caused by an allergic reaction. Lice will bite the skin in order to feed on the
infected person's blood. Saliva from these bites causes the allergic reaction
and itching. The lice lay eggs that eventually hatch which causes more
irritation. Vesicles, fluid filled lesions, are not usually seen in this condition.
Alopecia may be seen with tinea capitis.
10. Question:
A reddish blue, irregularly shaped, solid and spongy mass of blood vessels
that may be present at birth and enlarge during the first 10 to 15 months is
characteristic of a:
cavernous hemangioma. Correct
strawberry mark.
telangiectasia.
port-wine stain.
Explanation:
A cavernous hemangioma appears as a reddish blue, irregularly shaped,
solid and spongy mass of blood vessels. It may be present at birth, may
Assessment Exam
1. Question:
A child sustained a "full-thickness" burn injury. This type injury involves
tissue destruction down to the:
epidermis.
dermis.
subcutaneous tissue. Correct
internal organs.
Explanation:
A full-thickness burn involves all skin layers, including the epidermis, dermis,
and the subcutaneous tissue and fat. Muscles and tendons may be involved.
A superficial thickness burn involves the epidermis only. A superficial partial
thickness burn involves the epidermis and the dermis. A deep thickness burn
involves the entire layer of dermis, and is more severe than a superficial
partial thickness burn.
2. Question:
A child was involved in a vehicular accident and sustained burns on the lower
extremities. Examination reveals a dry, waxy, whitish appearance of both
lower legs and some visualization of the tibialis anterior. This type of burn
would be classified as a:
superficial thickness burn.
superficial partial thickness burn.
deep partial thickness burn.
full thickness burn. Correct
Explanation:
Types of burn injuries are chemical, electric, radiation, or thermal and are
classified by the depth of damaged skin it caused. Full thickness burns
involve the destruction of all skin elements with coagulation of subdermal
plexus, muscle, and or tendons. Symptoms of superficial partial thickness
burns include: moist areas that are red to ivory white in color, blisters
forming almost immediately, and painful to touch. Since the pain receptors
are intact, pain is perceived. Superficial thickness burns appear
erythematous without blisters and usually have local pain. Deep partial
thickness burns have a dry waxy, whitish appearance and resemble full
thickness burns. Sometimes grafts are needed.
3. Question:
The earliest recognizable clinical manifestation(s) of cystic fibrosis in an
infant is:
, History of poor intestinal absorption
Foul smelling, frothy, greasy stools
Meconium ileus
Salty taste on the skin Correct
Explanation:
The signs and symptoms of cystic fibrosis (CF) vary from person to person
and over time. Sometimes there will be few symptoms and other times,
symptoms may become more severe. One of the first signs of CF that
parents may notice is that their baby's skin tastes salty when kissed, or the
baby doesn't pass stool when first born. Most of the other signs and
symptoms of CF happen later. They're related to how CF affects the
respiratory, digestive, or reproductive systems of the body.
4. Question:
An infant presents with a rash in the diaper area. Which description likely
indicates candidal diaper rash?
Red, moist, maculopapular patch with poorly defined borders in diaper
area
Bright red, moist patches with sharply demarcated borders, some loose
scales noted in the diaper area Correct
Moist, thin-roofed vesicles with a thin, erythematous base noted in the
diaper area
Erythematous and symmetric rash noted in the diaper area
Explanation:
Candidiasis is characteristic of a rash appearing with bright red, moist
patches with sharply demarcated borders, with some loose scales noted in
the diaper area. Red, moist, maculopapular patch with poorly defined
borders in diaper area is diaper dermatitis. Moist, thin-roofed vesicles with a
thin, erythematous base noted in the diaper area would be consistent with
impetigo. Hives appear as erythematous and symmetric and can be
generalized over the body including the diaper area.
5. Question:
Examination of a child who experienced a burn from a curling iron on the
forearm appears red without blistering but is painful to touch. This type of
burn would be classified as a:
superficial thickness burn. Correct
superficial partial thickness burn.
deep partial thickness burn.
full thickness burn.
Explanation:
,Types of burn injuries are chemical, electric, radiation, or thermal and are
classified by the depth of damaged skin. Superficial thickness burns appear
erythematous without blisters and usually have local pain. Symptoms of
superficial partial thickness burns include: moist areas that are red to ivory
white in color, blisters forming almost immediately, and painful to touch.
Since the pain receptors are intact, pain is perceived. Deep partial thickness
burns have a dry waxy, whitish appearance and resemble full thickness
burns. Sometimes grafts are needed. Full thickness burns involve the
destruction of all skin elements with coagulation of subdermal plexus,
muscle, and or tendons.
6. Question:
A small child sustained burns to the posterior trunk and posterior surface of
both arms. According to the "Rule of Nines" for small children, what
percentage of the total body surface area was involved?
9%.
18%.
27%. Correct
32.5%.
Explanation:
The "Rule of Nines" assigns percentage of body surface area burned based
on the location of the burn. The percentages are as follows: head and neck =
18%, anterior and posterior chest = 18% each, arms (anterior and posterior)
= 4.5% each, legs (anterior and posterior) = 6.7% each, and perineum = 1%.
For this example, 18% for posterior trunk plus 9% for arms = 27%.
7. Question:
If a newborn is suspected of having congenital hypothyroidism, which clinical
manifestation would be evident?
Prematurity
Hyperthermia
Hyperactivity
Enlarged anterior fontanel Correct
Explanation:
Infants with congenital hypothyroidism are usually born at term or after
term. Most practitioners now depend on the screening test in newborns to
diagnose this condition since the symptoms or signs take time to develop.
The symptoms of congenital hypothyroidism may include some of the
following: puffy face, coarse facial features, enlarged anterior fontanel, thick
protruding tongue, poor feeding, constipation or reduced stooling, prolonged
jaundice, decreased activity with hypotonia, hypothermia and cool and pale
skin, goiter, birth defects (e.g., heart valve abnormality), poor weight gain
due to poor appetite, and swollen hands, feet and genitals.
, 8. Question:
A child has a maculopapular, blotchy rash and on examination of his mouth,
red eruptions with white centers on the buccal mucosa are visualized. These
eruptions are called:
rubella spots.
aphthous ulcers.
Pastia's spots.
Koplik spots. Correct
Explanation:
Koplik spots are seen with measles. They are small, white spots (often on a
reddened background) that occur on the inside of the cheeks early in the
course of red measles, rubeola. Pastia's spots are pink or red lines that are
formed of confluent petechiae found in skin creases and are seen in patients
who have scarlet fever. Aphthous ulcers are recurrent small, round, or ovoid
ulcers with circumscribed margins, erythematous haloes, and yellow or gray
floors occurring in the mouth.
9. Question:
When suspecting pediculosis capitis, the chief complaint is:
itching. Correct
hives.
alopecia.
vesicles.
Explanation:
With pediculosis capitis (lice), itching is the most common symptom and is
caused by an allergic reaction. Lice will bite the skin in order to feed on the
infected person's blood. Saliva from these bites causes the allergic reaction
and itching. The lice lay eggs that eventually hatch which causes more
irritation. Vesicles, fluid filled lesions, are not usually seen in this condition.
Alopecia may be seen with tinea capitis.
10. Question:
A reddish blue, irregularly shaped, solid and spongy mass of blood vessels
that may be present at birth and enlarge during the first 10 to 15 months is
characteristic of a:
cavernous hemangioma. Correct
strawberry mark.
telangiectasia.
port-wine stain.
Explanation:
A cavernous hemangioma appears as a reddish blue, irregularly shaped,
solid and spongy mass of blood vessels. It may be present at birth, may
