NSG 6435 Mid Term Exam 2022/ 2023 with complete solutions

What should a cultural assessment of the family and child include? - ANSWER an assessment of a patient's dominant culture including the accompanying health beliefs, and beliefs about birth, illness, and deaths What question should the provider ask to elicit information about the internal structure of the family? - ANSWER has any family member recently moved in or out of the home? if so, how has this move affected the family? "culture is a social construction of the relationships within and among groups of human beings..." which of the following is not a part of the products of culture? - ANSWER none of the above the provider understands that children who show signs of aggressive behavior, depression, anxiety, and poor school performance may have been exposed to which of the following during childhood? - ANSWER domestic violence which of the following best defines the role of the APN in health care? - ANSWER provides continuity of care for underserved populations Which of the following is considered a development red flag? - ANSWER loss of milestones what would be the most likely weight of a 1yr old child whose weight at birth was 7 pounds? - ANSWER 20-23 pounds the pincer grasp is a fine motor skill the involves the ability to pick up a small object such as cold cereal, with the thumb and forefinger. when is this usually mastered? - ANSWER 9 months the nurse practitioner is completing an examination of an 11 yr old female. it is noted during inspection that there is an appearance of breast buds. which of the following would most likely occur in approximately 2 years? - ANSWER onset of menses when reviewing immunization protocols at your clinic, the nurse practitioner should be aware that the varicella vaccine can be administered at what age? - ANSWER 12 months which of the following is the correct order for introduction of solid foods to an infant? - ANSWER cereal, vegetables, fruits, and meats which of the following information is most important to ask about while performing a sports physical? - ANSWER has the child fainted during exercise the mother of a 16 month old child informs you that she feeds the baby skim milk. what is the best rationale for not using skim milk? - ANSWER provides an inadequate amount of fatty acids which adolescent would be at greater risk for developing anorexia nervosa? - ANSWER 14 yr old competitive gymnast the NP is reviewing strategies to increase physical activity. the patient should also be educated that which of the following are commonly associated with sports injuries? - ANSWER improper training a pediatric patient has just been diagnosed with otitis external. which of the following should the patient be instructed to do? - ANSWER keep ear dry until symptoms improve the NP is performing a fluorescein staining of the eye. which of the following is this intervention used to detect? - ANSWER corneal abrasion the incidence of epiglottitis has decreased due to which of the following immunizations? - ANSWER Hib you are examining a patient who you suspect has 5th disease. which of the following is true regarding this disease? - ANSWER seen in children 5-14 yrs of age which specific viral organism causes hand, foot, and mouth syndrome? - ANSWER coxsackie a NP is completing a cardiac assessment on a child and detects a murmur. which of the following is true regarding innocent murmur? - ANSWER the murmur is of low intensity a child presents to the primary care clinic with chest pain. the provider is aware that chest pain in children is usually a symptom of - ANSWER non cardiac condition which of the following is a common cause of acquired coronary artery disease during childhood? - ANSWER kawasaki disease what type of hemorrhage would be expected with severe factor VIII deficiency? - ANSWER Gross bleeding from mild trauma the NP suspects that a pediatric patient is exhibiting the signs and symptoms consistent with leukemia to confirm this diagnosis, which test/procedure should be ordered? - ANSWER bone marrow aspiration The incidence of congenital heart defects is estimated to be ___ of all live births. - ANSWER 1% brestmild can be safely stored in a freezer below 0 degrees F for how long? - ANSWER 6 months which foreign body needs immediate removal from a 5yr old boys nose? - ANSWER battery themes useful diagnostic test in deleted puberty is - ANSWER x-ray of the left wrist and hand an average vision of a 2yr ol child is approximately - ANSWER 20/70 a 5 yr old female present for a follow up emergency room visit with a diagnosis of bronchitis. you would expect which treatment to have been prescribed? - ANSWER increase rest and fluid an adolescent which a chronic asthma cough notes that symptoms are usually worse - ANSWER at night and with exertion an average adolescent female usually experiences her biggest growth spurt at approximately what age? - ANSWER 10.5 years if an adolescent has a bone age of 10 but is actually 13 years of age, this patient has - ANSWER a lower potential for bone growth Gardasil results in greater antibody responses for females who are administered the 3 dose series between what ages? - ANSWER 9-15 yrs an 8yr old has chronic intermittent nasal congestion. all but which of the following support allergic rhinitis? - ANSWER increased basophils on CBC a 15 month old failed treatment with amoxicillin for an otitis media. at his 2 week recheck, his tympanic membrane remained red with distorted landmarks and he persisted with nasal discharge that is thick and yellowish. the best action for the NP should be to prescribe - ANSWER a 10 day course of augmentin an infant should be able to say his or her first work by - ANSWER 12 - 15 months the latter part of adolescence includes the ability to develop ___ and _____ means to be a part of society - ANSWER marriage critical thinking; basic life skills a 14 yr old adolescent present with fatigue, endocarditis, pulmonary hypertension, arrhythmias, and congestive heart failure. you suspect he may have - ANSWER a ventricular septal defect (VSD) a 4 yr old male patient presents with his mother with a school referral regarding red eyes. which questions would not assist in establishing a list of differential diagnoses? - ANSWER history of a bacterial infection 1 month ago _____ adolescents should be screened for sexually transmitted diseases - ANSWER all sexually active an infant should no longer have a head lag when pulled from the supine to sitting position at what age? - ANSWER 6 months _____ should be given as a supplement in the management of delays puberty - ANSWER calcium and vitamin d parents or guardians of adolescents should - ANSWER revere health guidance information at least twice how does cultural sensitivity impact the care of infants in the primary care setting? - ANSWER healthcare providers may possess cultural biases that can impact care The most typical chest radiographic finding consistent with the diagnosis of asthma is - ANSWER hyperinflation a 10 yr old has a single painful ulcerated lesion on an erythematous base on the inner buccal mucosa. the most likely diagnosis and treatment would be - ANSWER pathos ulcer; triamcinolone in orabase a 9 month old is noted to have a bifid uvula. this would increased his risk of developing which disorder? - ANSWER otitis media all of the following may predispose a patient to thrush except - ANSWER poor oral hygiene patients with sinusitis should be instructed not to participate in what activity - ANSWER swimming/diving what complication of sinusitis are adolescent males more prone to - ANSWER intracranial abscess acceptable management options for allergic rhinitis include all of the following except - ANSWER nasal neosynephrine a 7 yr old has experienced recurrent nose bleeds in the past 2 months. what finding on the physical exam would suggest an underlying medical cause for the epistaxis? - ANSWER petechiae a 2yr old male with a history of chronic serous otitis media is noted to have a pearly white opacity in the upper outer quadrant of his tympanic membrane. he currently has no symptoms and appears to be ok. the most likely diagnosis and appropriate management would be - ANSWER cholesteatoma; refer to otolaryngology all but which one of the following patients are at an increased risk of developing otitis media - ANSWER 9 month old with lactose intolerance a 10 yr old has marked ear pain, not wanting anyone to touch his ear. the canal is edematous and exudate is present. the tympanic membrane is normal. how should this be managed? - ANSWER topical fluoroquinolone a 16 yr old was hit in the eye 1 day ago and now has ecchymoses on the upper and lower lids with 5/10 eye pain. all but which of the following would be appropriate to obtain at this time? - ANSWER intraocular pressure the greatest risk in a patient with a hyphen is which of the following - ANSWER glaucoma corneal abrasions can be managed with topical application of which of the following - ANSWER antibiotics to prevent infection trauma to the eye increased the risk of developing all but which one of the following - ANSWER strabismus fluorescein staining of the eye is used to detect a - ANSWER corneal abrasion Prematurity increases the risk of developing which one of the following? - ANSWER myopia a 3 month old has a mild asymmetrical corneal light reflex on physical exam. what is the next appropriate step - ANSWER observe and reevaluate at the next well check which of the following may cause microcephaly - ANSWER craniosynostosis What finding may accompany macrocephaly? - ANSWER widened suture lines Obtaining a CT of the head would be indicated in which of the conditions? - ANSWER macrocephaly which one of the following conditions increases the risk of developing hydrocephalus - ANSWER prematurity a conjunctivitis appearing in a 2 day old newborn is likely due to - ANSWER chemical irritation from eye drops Confirming the diagnosis of chlamydia conjunctivitis in a newborn would best be done by obtaining which one of the following? - ANSWER culture of the conjunctival scrapings which of the following eye findings would be considered an ophthalmic emergency - ANSWER unilateral vesicular lesion on upper eyelid of a 3 wk old the most appropriate management of a 5 yr old with a firm, contender nodule in the mid-upper eyelid for 3 weeks would be - ANSWER topical ophthalmic ointment Daily eyelid cleansing with diluted baby shampoo and a cotton-tipped applicator would be appropriate in the treatment of which one of the following conditions? - ANSWER blepharitis a 3 yr old has an edematous, mildly erythematous right upper eyelid for one day with a fever of 103F. an important eye assessment would be - ANSWER ocular mobility concurrent otitis media and conjunctivitis is likely due to which organism - ANSWER haemophilus influenza (Hib) A 16 yo girl makes the following statements to you during her health visit. Which of the following pieces of information should not be kept confidential? - ANSWER sometimes I feel like ending my life In performing a physical examination on a nine month old infant, which of the following developmental fears would not be appropriate for you to consider? - ANSWER bodily harm When performing a physical examination on a toddler, which of the following body parts would you examine last: - ANSWER ears and throat Role play with equipment during the course of a physical examination would be most beneficial with which of the following age groups: - ANSWER preschoolers Providing reassurance of "normalcy" during the course of an examination would be most important for - ANSWER adolescents Which of the following would not elevate the pulse of a child: - ANSWER hypothyroidism The PNP recognizes which of the following signs as indicators that baby is not receiving sufficient breastmilk? - ANSWER sleepiness, jaundice, decreased urine and stool Blood pressure should be measured at WCC beginning at age - ANSWER 3 years A wide pulse pressure that results from a high systolic blood pressure is usually not due to which of the following - ANSWER a patent ductus arteriosus Head and chest circumferences should be equal at - ANSWER 1 year The anterior fontanel usually closes by - ANSWER 6 months Diffuse edema of the soft tissue of the scalp which usually crosses suture lines in the newborn is - ANSWER caput seccedaneum "Boggy" nasal mucous membranes with serous drainage upon examination usually suggests - ANSWER allergic rhinitis A white instead of red reflex upon eye examination of a 1 yo child would suggest - ANSWER retinoblastoma A cobblestone appearance of the palpebral conjunctiva usually indicates - ANSWER severe allergy An eye that deviates in when covered but returns to midline when uncovered is an - ANSWER esophoria Pain produced by manipulation of the auricle or pressure on the tragus suggests - ANSWER otitis externa A hypernasal voice and snoring in a child is suggestive of - ANSWER hypertrophied adenoids Physiological splitting of the second heart sound during inspiration in a child - ANSWER normal Which of the following is not characteristic of innocent heart murmurs in children - ANSWER usually transmitted to the neck A grade II musical or vibratory murmur heard best at the lower left sternal border that changes with positioning is suggestive of a - ANSWER vibratory or still's murmur Wheezing in a child may not be found in which of the following conditions - ANSWER pleural friction rub Gynecomastia in a male may not be a finding in which of the following - ANSWER hyperthyroidism Which of the following would usually not be considered a sign of a pituitary tumor in an adolescent female - ANSWER dysfunctional uterine bleeding Which of the following is not a specific examination test for a dislocated hip - ANSWER gower's test In addition to the knee, which of the following should be examined in a child complaining of knee pain? - ANSWER hip Which of the following infant reflexes should not disappear by 6 months of age? - ANSWER plantar grasp Spasticity in an infant may be an early sign of - ANSWER cerebral palsy A shift to the left is present when which of the following are elevated - ANSWER bands or stabs Which of the following is usually elevated with viral infections - ANSWER lymphocytes Decreased platelets may not be found in which of the following - ANSWER anemia Which of the following does not suggest a urinary tract infection? - ANSWER increased protein