Primary Care PNP Exam Review-Additional Review Questions and Answers Latest Updated

The PNP knows that assessing weight, length, and head circumference are part of which domain of growth and development? a) Physical domain b) Cognitive domain c) Psychosocial domain - ANSWER-a pg. 5 The PNP is assessing a 6 month old patient. He knows that Tiffany will grow in an orderly manner. How will Tiffany grow? a) Proximal to Distal b) Cephalo to Caudal c) Both A & B - ANSWER-c pg. 5 Jackie is in for her 4-month check up. She eats 4 oz of formula every 3 hours. The PNP knows that the calorie count for a child this age is a) 70 to 100 kcal/kg/day b) 100 kcal/kg/day c) 120 kcal/kg/day - ANSWER-c pg.5 The PNP knows that a child who is 6 months old or less has nutritional requirements of 120 kcal/kg/day. What would are a child who is 7 months old to 12 months old nutritional requirements? a) 70 to 100 kcal/kg/day b) 100 kcal/kg/day c) 110 kcal/kg/day - ANSWER-b pg. 5 The PNP is seeing Jackson who is 17 years old. He is worried that he is continuing to gain weight even though he practices a healthy lifestyle. Jackson is currently 85kg and 182cm. What does the PNP educate Jackson as the maximum amount of kcal/day he should eat? a) 2,210 kcal/day b) 5,950 kcal/day c) 3,825 kcal/day - ANSWER-c pg. 5 As an adolescent, he should a maximum of 45 kcal/kg/day. The PNP is planning a nutritional class for parents of school age children. She wants to ensure that the parents know if their child is meeting their nutritional requirements. How many kcal/kg/day should a child this age take in? a) 120 kcal/kg/day b) 70 kcal/kg/day c) 45 kcal/kg/day - ANSWER-b pg. 5 Children 2 to 10 years old require 70 to 100 kcal/kg/day. The PNP is educating an expectant mother about feeding choices for her baby. The mother asks about why breastfeeding is considered the best option vs. formula feeding. Which of the following does the PNP state? a) With formula feeding, the baby is more likely to gastrointestinal problems such as GERD. b) With formula feeding, the baby receive maternal antibodies that help prevent infection and decrease allergies c) Formula is a duplicate breast milk, and the baby will receive the same benefits. - ANSWER-a pg. 5-6 Megan is here for her 2-week check up. Her mom asks the PNP how long she should consider breastfeeding before switching to formula. Which of the following does the PNP say to educate the mother? a. "After 2-months breast feeding does not provide nutritional value." b. "The baby should be ok to switch to formula whenever you want." c. "It is suggested that your baby be exclusively breastfed for 6 months." - ANSWER-c pg. 6 When educated a prenatal class about the benefits of breastfeeding, the PNP states which of the following? a. Breastfeeding during painful procedures provides analgesia. b. The longer a child is breastfed, the more a chance a child will be overweight. c. Children who are breastfed experience more food allergies. - ANSWER-a pg. 6 The PNP is seeing a 2 month old patient. How much weight should the baby be gaining to confirm adequate nutritional intake? a. 15 to 20g/day b. 30g/day c. 40g/day - ANSWER-b pg. 6 Infants 3 months old should gain 30g/day (1oz/day). Allie is here for her 4-month well child appointment. Her mom is concerned that she is not gaining enough weight because she is smaller than her cousin who is the same age. How much weight should Allie be gaining? a. 15 to 20g/day b. 30g/day c. 40g/day - ANSWER-a pg. 6 After 3 months of age, infants should gain 15 to 20g/day for the next 3 months. Oliver is here for his 2-month well child appointment and scheduled immunizations. His mother is a vegetarian and strictly breastfeeds Oliver. What nutritional education should the PNP provide? a. Vitamin A supplements should be started at 400 IU per day b. Vitamin B6 supplements should be given c. Vitamin B12 supplements should be given. - ANSWER-c pg. 6 Infants of strictly breastfed mothers should be given Vitamin B12 to prevent neurological abnormalities. The PNP is seeing Riley for his 4-month well child appointment. What supplement should all breastfed infants receive at 2-months of age? a. Vitamin A b. Vitamin B c. Vitamin D - ANSWER-c pg. 6 At age 2 months old infants should be started on Vitamin D 400 IU/day. Savannah is here for her 6-month check up. She is exclusively breastfed and has not started baby foods yet. What nutritional education should the PNP provide? a. Because she is breastfed, Savannah does not need to start baby foods until she is 12 months old. b. Savannah can start iron-fortified foods such as baby oatmeal. c. Savannah can stop her Vitamin D supplement when she starts table foods. - ANSWER-b pg. 6 Exclusively breastfed babies should receive 1mg/kg/day of iron after 6 months old. Ideally iron comes from iron-fortified foods. Savannah is in for her 9-month well child appointment. She weighs 6.8kg and is 68cm long. Her mom is concerned that she is pale because she is not getting enough iron. How much iron is recommended for a child of Savannah? a. 6.8mg/day b. 10.2mg/day c. 13.6mg/day - ANSWER-a pg. 6 Exclusively breastfed babies should receive 1mg/kg/day of iron after 6 months old. Sadie is in for her 9-month check up. The PNP knows that Sadie lives in a rural area. What should the PNP do in order to assess how much fluoride is available in the local water? a. Call the Environmental Protection Agency b. Call the Board of Health c. Call the local water company - ANSWER-b *Stated at live review James is in for his 4-month check up. His mom asks if she needs to provide iron supplementation even though James is exclusively breastfed. What does the PNP educate? a. James will not need iron supplements unless he is anemic. b. James should already be on iron supplements 1mg/kg/day. c. James should start iron-fortified foods at 6 months old. - ANSWER-c pg. 6 The PNP is assessing the need for fluoride supplements in her rural town. She knows that supplementation is not required for the first 6 months of life. When is the local water supply considered deficient. a. .8 parts per million/ppm b. .6 parts per million/ppm c. .3 parts per million/ppm - ANSWER-c pg. 6 The PNP is seeing Olivia for her 1 week weight check. Olivia lost the expected 10% of weight after birth. When should Olivia be back to her birth weight? a. 5 to 7 days b. 8 to 10 days c. 7 to 14 days - ANSWER-c pg. 6 The PNP is educating a group of new moms. One of the moms asks when her child will double his birth weight. What does the PNP state? a. 4 months b. 5 months c. 8 months - ANSWER-b pg. 6 The PNP is seeing a patient for his 1-year check up. When analyzing the patient's weight, the PNP expects which of the following? a. The patient doubles his weight b. The patient triples his weight. c. The patient quadruples his weight. - ANSWER-b pg. 6 Jonathan is scheduled for his 2-year EPSDT. He weighed 8lbs at birth. How much does the PNP expect Jonathan to weight today? a. 32lbs b. 28lbs c. 24 lbs - ANSWER-a pg. 6 At 2 years old, children should quadruple their birth weight. 7-year-old Josephine's mom has scheduled a sick appointment because she is concerned that Josephine has stopped growing. What does the PNP educate Josephine's mom that a child of her age should grow? a. 1.5 in/year b. 2.5 in/year c. 3.5 in/year - ANSWER-b pg. 6 Children 3 years old through school age should grow 2.5 inches/year The PNP knows that a school age child grows at a slower rate than an infant. How much weight should a school age child gain yearly? a. 5 to 7 pounds b. 4 to 6 pounds c. 7 to 10 pounds - ANSWER-a pg. 6 The PNP knows that Grant should have his primary central incisor erupt at what age? a. 4 to 6 months old b. 6 to 7 months old c. 7 to 9 months old - ANSWER-b pg. 7 The PNP knows that Grant should have his primary lateral incisor erupt at what age? a. 4 to 6 months old b. 6 to 7 months old c. 7 to 9 months old - ANSWER-c pg. 7 The PNP knows that Grant should have his primary cuspid teeth erupt at what age? a. 7 to 9 months old b. 16 to 18 months old c. 20 to 24 months old - ANSWER-b pg. 7 At his 12-month well child appointment, the PNP expects Elizabeth to have which teeth erupting? a. Cuspid teeth b. Front molars c. Back molars - ANSWER-b pg. 7 20-month-old Ava is in for fussiness. The PNP diagnoses her with teething. At what age can the PNP educate Ava's mom that all of her primary teeth should be erupted? a. 2 years old b. 3 years old c. 12 years old - ANSWER-a *stated at live review 5-year-old Heath asks when he will lose a tooth since his best friend already lost one. When does the PNP expect Heath to lose primary central incisor? a. 5 to 6 years old b. 6 to 8 years old c. 7 to 10 years old - ANSWER-b pg. 7 When should the PNP expect all permanent teeth to have erupted? a. 8 years old b. 10 years old c. 12 years old - ANSWER-c *stated at live review Catherine in 1 month old. The PNP expects her to be in what cognitive stage? a. Sensorimotor state b. Preoperational stage c. Trust vs. Mistrust - ANSWER-a pg. 7 At what age does a child begin to understand their actions can cause other actions to happen? a. 3 years old b. 4 years old c. 10 years old - ANSWER-b pg. 7 Egocentrism is part of which of Piaget's stages of cognitive domain? a. 1 year old b. 3 years old c. 5 years old - ANSWER-b pg. 7 Children who are 2 to 4 years old experience egocentrism. The PNP is assessing 4-year-old Bella who states "I'm a doctor, too". The PNP knows that Bella is in which cognitive stage? a. Sensorimotor state b. Preoperational stage c. Trust vs. Mistrust - ANSWER-b pg. 7 6-year-old Addison's mom is concerned that Addison is irrational and not capable of logical thought most times. At what age does, the PNP knows that Addison will enter the cognitive stage of concrete thinking? a. 4 to 5 years old b. 5 to 7 years old c. 7 to 11 years old - ANSWER-c pg. 7 The PNP is thinking of creative ways to assess a child's cognitive stage. At what age could the PNP consider asking a child to name state capitols to demonstrate concrete thinking? a. 7 to 11 years old b. 5 to 7 years old c. 12 to 14 years old - ANSWER-a pg. 7 At what age should the PNP expect his patients to demonstrate formal operational thoughts? a. 4 to 7 years old b. 7 to 11 years old c. 11 to 15 years old - ANSWER-c pg. 7 The PNP educates a new mom to respond to her baby every time the baby cries. The mom responding helps to establish what psychosocial development? a. Trust vs. Mistrust b. Autonomy vs. Shame and Doubt c. Industry vs. Inferiority - ANSWER-a pg. 8 The PNP expects a toddler to be in which psychosocial stage? a. Trust vs. Mistrust b. Autonomy vs. Shame and Doubt c. Industry vs. Inferiority - ANSWER-b pg. 8 A preschooler who is ok with going to school and leaving their parent is in which psychosocial stage? a. Trust vs. Mistrust b. Autonomy vs. Shame and Doubt c. Initiative vs. Guilt - ANSWER-c pg. 8 Which of Erikson's psychosocial stages, does the PNP expect a child to be interested in earning trophies? a. Initiative vs. Guilt b. Identity vs. Role confusion c. Industry vs. Inferiority - ANSWER-c pg. 8 The PNP expects her 16-year-old patient here for a sports physical to be in which of Erikson's psychosocial stages? a. Initiative vs. Guilt b. Identity vs. Role confusion c. Industry vs. Inferiority - ANSWER-b pg. 8 According to Freud, what age does a child to become orally aggressive and start biting their playmates? a. 6 months old b. 7 to 18 months old c. 18 to 24 months old - ANSWER-b pg. 8 At what age does the PNP expect a child to have an awareness of their anatomical sexual parts? a. 3 to 6 years old b. 1 to 3 years old c. 6 to 7 years old - ANSWER-a pg. 8 Freud's phallic stage Annabelle was born at 32-weeks gestation. She is now 6-months-old, and her mom wants to know when she will be like a "normal child". The PNP educates Annabelle's mom that corrected gestational age is considered until she is _______ years old. a. 1 b. 1.5 c. 2 - ANSWER-c pg. 8 The PNP is deciding what to assess on a 2-old-child. Which of the following is appropriate? a. Blood pressure b. Bone mass c. Body mass index - ANSWER-c pg. 9 The PNP is trying to decide how to assess cognitive development. Which of the following screening tools is the most established? a. Denver II b. Ages and Stages c. PSQ-9 - ANSWER-a pg. 9 *Stated at live review The PNP educates Sophia's mother to look for which of the following fine motor skills at 3 to 4 months old? a. Reaches for an object b. Grasps and shakes rattle c. Hand-to-hand transfer - ANSWER-a pg. 10 The PNP educates Sophia's mother to look for which of the following fine motor skills at 5 to 6 months old? a. Reaches for an object b. Grasps and shakes rattle c. Hand-to-hand transfer - ANSWER-c pg. 10 At what age should the PNP expect to assess pincer grasp on an infant? a. 5 to 6 months old b. 7 to 8 months old c. 8 to 10 months old - ANSWER-c pg. 10 How many blocks should 18-month old Evan be able to stack? a. 3 blocks b. 5 blocks c. 6 blocks - ANSWER-a pg. 10 17-18month old infants should be able to stack 3 blocks At what age should Susannah be able to say "Mama" and "Dada" and wave 'bye-bye"? a. 5 to 6 months old b. 7 to 8 months old c. 8 to 9 months old - ANSWER-c pg. 10 Max is here for a 2-year-old EPSDT. Which of the following fine motor skills should the PNP assess for? a. Jumps b. Stacks 6 to 7 blocks c. Walks up and down stairs - ANSWER-b pg. 10 The other 2 are gross motor skills Which of the following language skills does the PNP expect 15 month old Emerson to demonstrate? a. 2-word sentences b. 30 to 50 word vocabulary c. Point to body parts - ANSWER-c pg. 10 15-18 months old should be able to demonstrate. 2-word sentences at 18-22 months. 30 to 50 word vocabulary at 22 to 24 months old. 8-month-old Alex is unable to demonstrate hand-to-hand transfer. What diagnosis should the PNP consider exploring? a. Cerebral Palsy b. Duchenne's Muscular Dystrophy c. Syndactyly - ANSWER-a *stated at live review The Denver II screening tool is used for child 6 years of age and younger. How does the PNP assess cognition in older children? a. Denver III Screening Tool b. IQ testing c. School achievement - ANSWER-c *stated at live review According to the AAP, car seats should be rear-facing until age 2. What age do most states require rear-facing car seats? a. 1 year old b. 2 years old c. 3 years old - ANSWER-a *stated at live review The PNP is seeing a 2-day in the nursery. What immunizations does the PNP expect this infant to receive? a. Hepatitis A b. Hepatitis B c. Hepatitis C - ANSWER-b pg. 17 The PNP is seeing an 8-hour old infant. The infant's mother was HBsAG positive. The PNP expects to order which of the following? a. Hepatitis B immune globulin .5ml b. HBsAG antibodies c. Intravenous fluids - ANSWER-a pg. 17 Within 12 hours of birth, infant should receive Hep B vaccine and HBIG. After the child completes the HepB series obtain HBsAG and antibodies to HBsAG. Noah is a 9-month-old who was born to a HBsAG positive mother. He completed his Hepatitis B immunization series at his 6-month check up. Along with his routine labs, what does the PNP expect to order? a. HBsAG b. HBsAG antibodies c. Both a and b - ANSWER-b pg. 17 They should be obtained when the child has completed the HepB series around ages 9 to 18 months. The PNP is admitting a neonate to the newborn nursery. The mother's HBsAG status is unknown. What order does the PNP expect to write? a. Administer HepB vaccine within 12 hours of birth b. Obtain labwork for HBsAG from infant c. Administer IVF at 12cc/hour x 12 hours - ANSWER-a pg. 17 Determine mother's status ASAP. If mother tests positive, admin HBIG within 1 weeks of age. The PNP is seeing 9-month-old Holden who is behind on his vaccines. Which of the following vaccines can he not receive at this time? a. DTaP b. Hepatitis B c. Rotavirus - ANSWER-c pg. 17 Can't be given after 8 months old The PNP is seeing 7-year-old George who is behind on his vaccines. Which of the following vaccines can he receive? a. Hib Conjugate Vaccine b. Rotavirus c. Tdap - ANSWER-c pg. 18 Hib is not recommend for children older than 5 years old. 17-year-old Jeremy is getting ready for college in the fall. He is up-to-date on vaccines except for receives the Meningococcal vaccine. Jeremy asks if he need anymore shots after he receives the Menactra vaccine. The PNP states which of the following? a. "You will need a varicella booster at 18-years-old." b. "You will need a tetanus shot 10 years after your received your first one." c. "You will need a meningococcal vaccine in 4 to 5 years." - ANSWER-b pg. 19 If received after 16 years old, Meningococcal booster not needed. The PNP orders for 11-year-old Brittany to receive the Tdap, Meningococcal, and Human Papillomavirus Vaccines. Which of the following actions, should the nurse take after administering the vaccines? a. Administer Tylenol b. Have the Brittany sit for 15 minutes c. Educate Brittany to receive a booster of Tdap at 16 years old. - ANSWER-b pg. 19 The PNP understands that which of the following is a genotypic presentation of a genetic disorder? a. Developmental delay b. Trisomy of chromosome analysis c. Microcephaly - ANSWER-b pg. 21 For genotypic characteristics you must perform a lab test. Phenotypic characteristics are physical presentations. The PNP is making a genogram of Haley's family. What is the minimum number of generations that a genogram includes? a. 3 b. 4 c. 2 - ANSWER-a pg. 21 Amy has Trisomy 21. Which of the following findings is not associated with her chromosomal makeup? a. Macrocephaly b. Flattened nose c. Protruding tongue - ANSWER-a pg. 22 Microcephaly and abnormal shaped head are associated with Trisomy 21 Zach has Trisomy 21. Which of the following findings is not associated with his chromosomal makeup? a. Inner epicanthal folds b. Single palmar crease c. Downward slanting eyes - ANSWER-c pg. 22 Upward slanting eyes are associated with Trisomy 21 Kim has Trisomy 21. Which of the following findings is not associated with his chromosomal makeup? a. Hypertonia b. Hearing impairment c. Brushfield spots - ANSWER-a pg. 22 Hypotonia is associated with Trisomy 21 17-year-old Henry is in for a sports physical. Upon assessment, the PNP sees that Henry is tall, Tanner stage 2, and has difficulty in school. The PNP orders a karyotype. What results does he expect? a. X b. XYY c. XXY - ANSWER-c pg. 22 Patient has physical manifestations of Klinefelter's Syndrome The PNP is assessing a new patient who was diagnosed with Turner's Syndrome in utero. Which of the following findings is not a typical finding of Turner's Syndrome? a. Lymphedema b. Tall stature c. Webbed neck - ANSWER-b pg. 23 The PNP has a concern for Turner's Syndrome when her patient presents with which of the following physical findings? a. Widely-spaced nipples b. Lack of secondary sex characteristics c. Both a and b - ANSWER-c pg. 23 The PNP has a newborn patient diagnosed with Turner's Syndrome in utero. Which congenital heart defect is most associated with Turner's Syndrome? a. Coarctation of aorta b. Ventricular septal defect c. Patent ductus arteriosus - ANSWER-a pg. 23 Biscuspid aortic valve is also associated with Turner's Syndrome The PNP is performing a physical exam on 17-year-old Logan. Logan has no past medical history and is up-to-date with his vaccines. She notes his tall stature, long narrow face, thin extremities, and a heart murmur. What genetic condition does the PNP suspect? a. Klinefelter's Syndrome b. Turner's Syndrome