MN580- Final
GU.
1. A 30monthold girl who has been toilet trained for 6 months has daytime enuresis and dysuria
and a low-grade fever. A dipstick urinalysis is negative for leukocyte esterase and nitrites. What
is the next step?
a. Begin empiric treatment with trimethoprim sulfamethoxazole.
b. Discuss behavioral interventions for toilet training.
c. Reassure the child’s parents that the child does not have a urinary tract infection.
d. Send the urine to the lab for culture. Correct
2. The clean catch urine specimen of a child with dysuria, frequency, and fever has a
colony count between 50,000 and 100,000 of E. coli. What is the treatment for this child?
a. Obtain a complete blood count and C reactive protein.
b. Perform sensitivity testing before treating with antibiotics.
c. Repeat the culture if symptoms persist or worsen.
d. Treat with antibiotics for urinary tract infection. Correct
3. A dipstick urinalysis is positive for leukocyte esterase and nitrites in a school aged child with
dysuria and foul-smelling urine but no fever who has not had previous urinary tract infections.
A culture is pending. What will the pediatric nurse practitioner do to treat this child?
a. Order ciprofloxacin ER once daily for 3 days if the culture is positive.
b. Prescribe trimethoprim sulfamethoxazole (TMP) twice daily for 3 to 5 days. Correct
c. Reassure the child’s parents that this is likely an asymptomatic bacteriuria.
d. Wait for urine culture results to determine the correct course of treatment.
4. A child is diagnosed with nephrotic syndrome, and the pediatric nurse practitioner provides
primary care in consultation with a pediatric nephrologist. The child was treated with steroids
and responded well to this treatment. What will the nurse practitioner tell the child’s parents
about this disease?
a. “Future episodes are likely to have worse outcomes.”
b. “Steroids will be used when relapses occur.” Correct
c. “This represents a cure from this disease.”
d. “Your child will need to take steroids indefinitely.
5. A child who has nephrotic syndrome is on a steroid and a salt restricted diet for a relapse of
symptoms. A dipstick urinalysis shows 1+ protein, down from 3+ at the beginning of the
episode.
,MN580- Final
In consultation with the child’s nephrologist, what is the correct course of treatment considering
this finding?
a. Begin a taper of the steroid medication while continuing salt restrictions.
b. Continue with steroids and salt restrictions until the urine is negative for protein.
Correct
c. Discontinue the steroids and salt restrictions now that improvement has occurred.
d. Relax salt restrictions and continue administration of steroids until proteinuria is gone.
5. A child who had GABHS 2 weeks prior is in the clinic with periorbital edema, dyspnea, and
elevated blood pressure. A urinalysis reveals tea colored urine with hematuria and mild
proteinuria. What will the primary care pediatric nurse practitioner do to manage this
condition?
a. Prescribe a 10to 14day course of high dose amoxicillin.
b. Prescribe high dose steroids in consultation with a nephrologist.
c. Reassure the parents that this condition will resolve spontaneously.
d. Refer the child to a pediatric nephrologist for hospitalization. Correct
6. During a well child examination of a 2yearold child, the primary care pediatric nurse
practitioner palpates a unilateral, smooth, firm abdominal mass which does not cross the midline.
What is the next course of action that?
a. Order a CT scan of the chest, abdomen, and pelvis.
b. Perform urinalysis, CBC, and renal function tests.
c. Reevaluate the mass in 1 to 2 weeks.
d. Refer the child to an oncologist immediately. Correct
7. A 6monthold infant has a retractile testis that was noted at the 2month well baby exam. What
will the primary care pediatric nurse practitioner do to manage this condition?
a. Reassure the parent that the testis will most likely descend into place on its own.
b. Refer the infant to a pediatric urologist or surgeon for possible orchiopexy. Correct
c. Teach the parent to manipulate the testis into the scrotum during diaper changes.
d. Tell the parent that hormonal therapy may be needed to correct the condition.
8. A 9monthold infant is brought to the clinic with scrotal swelling and fussiness. The primary
care pediatric nurse practitioner notes a tender mass in the affected scrotum that is difficult to
reduce. What is the correct action?
a. Obtain an abdominal radiograph.
, MN580- Final
b. Refer immediately to a pediatric surgeon. Correct
c. Schedule an appointment with a pediatric urologist.
d. Teach the parents signs of
incarceration GI.
9. The parent of an infant asks about using a probiotic medication. What will the primary
care pediatric nurse practitioner tell this parent?
a. Probiotic medications have demonstrated efficacy in treating colic.
b. Probiotics are not safe to use to treat infants who have colic.
c. There are no studies showing usefulness of probiotics to manage colic.
d. There is no conclusive evidence about using probiotics to treat colic. Correct
10. A toddler who was born prematurely refuses most solid foods and has poor weight gain. A
barium swallow study reveals a normal esophagus. What will the primary care pediatric nurse
practitioner consider next to manage this child’s nutritional needs?
a. Consultation with a dietician
b. Fiberoptic endoscopy evaluation
c. Magnetic resonance image.
D. Video fluoroscopy swallowing study Correct.
11. A toddler is seen in the clinic after a 2day history of intermittent vomiting and diarrhea. An
assessment reveals an irritable child with dry mucous membranes, 3second capillary refill,
2second recoil of skin, mild tachycardia and tachypnea, and cool hands and feet. The child has
had two wet diapers in the past 24 hours. What will the primary care pediatric nurse
practitioner recommend?
a. Antidiarrheal medication and clear fluids for 24 hours
b. Bolus of IV normal saline in the clinic until improvement
c. Hospital admission for IV rehydration and oral fluids
d. Oral rehydration solution with follow up in 24 hours Correct
12. A 9yearold girl has a history of frequent vomiting and her mother has frequent migraine
headaches. The child has recently begun having more frequent and prolonged episodes.
accompanied by headaches. An exam reveals abnormal eye movements and mild ataxia. What
is the correct action?
a. Begin using an antimigraine medication to prevent headaches.
b. Prescribe ondansetron and lorazepam to help manage symptoms.
GU.
1. A 30monthold girl who has been toilet trained for 6 months has daytime enuresis and dysuria
and a low-grade fever. A dipstick urinalysis is negative for leukocyte esterase and nitrites. What
is the next step?
a. Begin empiric treatment with trimethoprim sulfamethoxazole.
b. Discuss behavioral interventions for toilet training.
c. Reassure the child’s parents that the child does not have a urinary tract infection.
d. Send the urine to the lab for culture. Correct
2. The clean catch urine specimen of a child with dysuria, frequency, and fever has a
colony count between 50,000 and 100,000 of E. coli. What is the treatment for this child?
a. Obtain a complete blood count and C reactive protein.
b. Perform sensitivity testing before treating with antibiotics.
c. Repeat the culture if symptoms persist or worsen.
d. Treat with antibiotics for urinary tract infection. Correct
3. A dipstick urinalysis is positive for leukocyte esterase and nitrites in a school aged child with
dysuria and foul-smelling urine but no fever who has not had previous urinary tract infections.
A culture is pending. What will the pediatric nurse practitioner do to treat this child?
a. Order ciprofloxacin ER once daily for 3 days if the culture is positive.
b. Prescribe trimethoprim sulfamethoxazole (TMP) twice daily for 3 to 5 days. Correct
c. Reassure the child’s parents that this is likely an asymptomatic bacteriuria.
d. Wait for urine culture results to determine the correct course of treatment.
4. A child is diagnosed with nephrotic syndrome, and the pediatric nurse practitioner provides
primary care in consultation with a pediatric nephrologist. The child was treated with steroids
and responded well to this treatment. What will the nurse practitioner tell the child’s parents
about this disease?
a. “Future episodes are likely to have worse outcomes.”
b. “Steroids will be used when relapses occur.” Correct
c. “This represents a cure from this disease.”
d. “Your child will need to take steroids indefinitely.
5. A child who has nephrotic syndrome is on a steroid and a salt restricted diet for a relapse of
symptoms. A dipstick urinalysis shows 1+ protein, down from 3+ at the beginning of the
episode.
,MN580- Final
In consultation with the child’s nephrologist, what is the correct course of treatment considering
this finding?
a. Begin a taper of the steroid medication while continuing salt restrictions.
b. Continue with steroids and salt restrictions until the urine is negative for protein.
Correct
c. Discontinue the steroids and salt restrictions now that improvement has occurred.
d. Relax salt restrictions and continue administration of steroids until proteinuria is gone.
5. A child who had GABHS 2 weeks prior is in the clinic with periorbital edema, dyspnea, and
elevated blood pressure. A urinalysis reveals tea colored urine with hematuria and mild
proteinuria. What will the primary care pediatric nurse practitioner do to manage this
condition?
a. Prescribe a 10to 14day course of high dose amoxicillin.
b. Prescribe high dose steroids in consultation with a nephrologist.
c. Reassure the parents that this condition will resolve spontaneously.
d. Refer the child to a pediatric nephrologist for hospitalization. Correct
6. During a well child examination of a 2yearold child, the primary care pediatric nurse
practitioner palpates a unilateral, smooth, firm abdominal mass which does not cross the midline.
What is the next course of action that?
a. Order a CT scan of the chest, abdomen, and pelvis.
b. Perform urinalysis, CBC, and renal function tests.
c. Reevaluate the mass in 1 to 2 weeks.
d. Refer the child to an oncologist immediately. Correct
7. A 6monthold infant has a retractile testis that was noted at the 2month well baby exam. What
will the primary care pediatric nurse practitioner do to manage this condition?
a. Reassure the parent that the testis will most likely descend into place on its own.
b. Refer the infant to a pediatric urologist or surgeon for possible orchiopexy. Correct
c. Teach the parent to manipulate the testis into the scrotum during diaper changes.
d. Tell the parent that hormonal therapy may be needed to correct the condition.
8. A 9monthold infant is brought to the clinic with scrotal swelling and fussiness. The primary
care pediatric nurse practitioner notes a tender mass in the affected scrotum that is difficult to
reduce. What is the correct action?
a. Obtain an abdominal radiograph.
, MN580- Final
b. Refer immediately to a pediatric surgeon. Correct
c. Schedule an appointment with a pediatric urologist.
d. Teach the parents signs of
incarceration GI.
9. The parent of an infant asks about using a probiotic medication. What will the primary
care pediatric nurse practitioner tell this parent?
a. Probiotic medications have demonstrated efficacy in treating colic.
b. Probiotics are not safe to use to treat infants who have colic.
c. There are no studies showing usefulness of probiotics to manage colic.
d. There is no conclusive evidence about using probiotics to treat colic. Correct
10. A toddler who was born prematurely refuses most solid foods and has poor weight gain. A
barium swallow study reveals a normal esophagus. What will the primary care pediatric nurse
practitioner consider next to manage this child’s nutritional needs?
a. Consultation with a dietician
b. Fiberoptic endoscopy evaluation
c. Magnetic resonance image.
D. Video fluoroscopy swallowing study Correct.
11. A toddler is seen in the clinic after a 2day history of intermittent vomiting and diarrhea. An
assessment reveals an irritable child with dry mucous membranes, 3second capillary refill,
2second recoil of skin, mild tachycardia and tachypnea, and cool hands and feet. The child has
had two wet diapers in the past 24 hours. What will the primary care pediatric nurse
practitioner recommend?
a. Antidiarrheal medication and clear fluids for 24 hours
b. Bolus of IV normal saline in the clinic until improvement
c. Hospital admission for IV rehydration and oral fluids
d. Oral rehydration solution with follow up in 24 hours Correct
12. A 9yearold girl has a history of frequent vomiting and her mother has frequent migraine
headaches. The child has recently begun having more frequent and prolonged episodes.
accompanied by headaches. An exam reveals abnormal eye movements and mild ataxia. What
is the correct action?
a. Begin using an antimigraine medication to prevent headaches.
b. Prescribe ondansetron and lorazepam to help manage symptoms.
