NURS 6541 final exam 2023-graded A
Question 1
1 out of 1 points
A small-for-gestational-age, dysmorphic newborn infant has microcephaly and sloping forehead,
cutis aplasia (missing portion of the skin and hair) of the scalp, polydactyly, microphthalmia, and
omphalocele. Which of these is the most likely diagnosis?
Selected Answer: a.
Patau syndrome (trisomy 13)
• Question 2
• 1 out of 1 points
A 16-year-old girl has enuresis, frequent urination, a white vaginal discharge,
and a dark rash around her neck. Her serum glucose level is 250 mg/dL, and her
urinalysis is positive for 2+ glucose but is otherwise negative. Which of the
following is the most likely diagnosis?
Selected Answer: c.
Type II diabetes
• Question 3
• 1 out of 1 points
Mark, age 15, is 5 feet tall andn weighs 85 pounds. You suspect anorexia and know that the best
initial approach is to
Selected Answer: d.
Confront Mark with the fact that you suspect an eating
disorder.
• Question 4
• 1 out of 1 points
Which of the following is not a sign or symptom of congenital hypothyroidism?
Selected Answer: d.
Frequent stooling
• Question 5
• 0 out of 1 points
While doing a 5-year-old well child exam, you notice two small patches of hair loss. Broken hair is
present, as is erythema and scaling. On the basis of this information, which of these is the likely
diagnosis?
Selected Answer: c.
Alopecia areata
, • Question 6
• 1 out of 1 points
Hope is a 7-month-old who presents in January with a 1-day history of cough,
yellow nasal discharge, and low-grade temp (T max 100°F). She was previously
healthy. She does have 2+ edema of the nasal turbinates and cloudy
rhinorrhea. She is afebrile in the office. Her chest, mouth, and ears are clear.
You prescribe:
Selected Answer: d.
Saline drops, bulb suction, humidified air, and increased PO
fluids
• Question 7
• 1 out of 1 points
The parents of an 8-year-old Down Syndrome boy arrive for his annual well-child visit. He wants to
participate in sports, including the Special Olympics. Until further examination can be completed,
which of the following sports would you suggest as being safe?
Selected Answer: a.
Tennis
• Question 8
• 1 out of 1 points
Jason, age 14, appears with tender discoid breast tissue enlargement (2-3 cm in diameter)
beneath the areola. Your next action would be to
Selected Answer: a.
Perform watchful waiting for 1 year.
• Question 9
• 1 out of 1 points
You see a 7-year-old boy a day after he was bitten by his pet dog. According to
the mother, the dog bit the child after he snuck up on the dog and grabbed his
tail. The dog has had all its vaccinations, including rabies. The child has had no
fever, has full movement of the injured limb, and has no sign of neurologic or
vascular injury. The wound is on the child’s forearm, is not deep, and is not
bleeding, but has developed about 2 cm of erythema surrounding the site.
Which of the following is the most appropriate treatment?
Selected Answer: c.
Oral amoxicillin-clavulanate for 7-14 days
• Question 10
• 1 out of 1 points
A head injury in which bruising or tearing of the cerebral structures occurs is a
Selected Answer: d.
, Contusion
• Question 11
• 1 out of 1 points
A 14-year-old has a 3-week history of fever, anorexia, and abdominal pain. What additional
symptom would cause the NP to suspect Crohn's disease?
Selected Answer: b.
Blood, mucous diarrhea
• Question 12
• 1 out of 1 points
Which of the following should be done annually after 1 year of age in a child with Down syndrome?
Selected Answer: a.
Thyroid screenings
• Question 13
• 1 out of 1 points
A previously healthy male has a 3-month history of increasing headaches,
blurred vision, and personality changes. Previously he admitted to marijuana
experimentation more than 1 year ago. On examination he is a healthy, athletic-
appearing 17-year-old with decreased extraocular range of motion and left eye
visual acuity. Which of the following is the best next step in his management?
Selected Answer: c.
Neuroimaging
• Question 14
• 1 out of 1 points
Kelly, your 11-year-old well visit patient, presents to the office with weight loss, polyuria, and
polydipsia. Which of the following do you need to rule out?
Selected Answer: d.
Diabetes mellitus
• Question 15
• 1 out of 1 points
A 3-week old presents to the office in January with a 1-week history of nasal congestion and
occastional cough. On the night prior to the visit in infant developed a fever 102ºF rectally, was
difficult to breastfeed, and had paroxysmal coughing and noisy, labored breathing. On exam, you
note an ill-appearing infant who is lethergic with wheezing, tachypnea, and intercostal
retractions. The infant is home with the mom at this time; however, has a sibling who is 4-years-
old and is in daycare and recently had cold symptoms. If the patient has been diagnosed with RSV
bronchiolitis,
, which of the following would be the treatment of choice?
Selected Answer: a.
Fluids and nutritional support and close monitoring
• Question 16
• 1 out of 1 points
Chest pain in young children is usually
Selected Answer: a.
Noncardiac in origin
• Question 17
• 1 out of 1 points
Maddie, age 2, had a complete blood count (CBC) drawn at her last visit. It indicates that she has a
microcytic hypochromic anemia. What should you do now at this visit?
Selected Answer: a.
Obtain a lead level.
• Question 18
• 1 out of 1 points
Most children with Duchenne muscular dystrophy become wheelchair dependent by what age?
Selected Answer: b.
4 to 6 years of age
• Question 19
• 1 out of 1 points
The following clinical description best matches which genetic disorder? A tall,
thin 14-year- old boy has no signs of puberty. He was delayed in his speech
development and always has done less well in school than his siblings. He is
shy, and teachers report his activity is immature. Physical examination reveals
breast development, and long limbs with a decreased upper segment/lower
segment ration. He has small testes and phallus.
Selected Answer: e.
Klinefelter syndrome (XXY)
• Question 20
• 1 out of 1 points
Of the following patients, which child should not receive a tuberculin skin test?
Selected d.
Answer: A 2-year-old who was infected with RSV 2 months ago and is currently
Question 1
1 out of 1 points
A small-for-gestational-age, dysmorphic newborn infant has microcephaly and sloping forehead,
cutis aplasia (missing portion of the skin and hair) of the scalp, polydactyly, microphthalmia, and
omphalocele. Which of these is the most likely diagnosis?
Selected Answer: a.
Patau syndrome (trisomy 13)
• Question 2
• 1 out of 1 points
A 16-year-old girl has enuresis, frequent urination, a white vaginal discharge,
and a dark rash around her neck. Her serum glucose level is 250 mg/dL, and her
urinalysis is positive for 2+ glucose but is otherwise negative. Which of the
following is the most likely diagnosis?
Selected Answer: c.
Type II diabetes
• Question 3
• 1 out of 1 points
Mark, age 15, is 5 feet tall andn weighs 85 pounds. You suspect anorexia and know that the best
initial approach is to
Selected Answer: d.
Confront Mark with the fact that you suspect an eating
disorder.
• Question 4
• 1 out of 1 points
Which of the following is not a sign or symptom of congenital hypothyroidism?
Selected Answer: d.
Frequent stooling
• Question 5
• 0 out of 1 points
While doing a 5-year-old well child exam, you notice two small patches of hair loss. Broken hair is
present, as is erythema and scaling. On the basis of this information, which of these is the likely
diagnosis?
Selected Answer: c.
Alopecia areata
, • Question 6
• 1 out of 1 points
Hope is a 7-month-old who presents in January with a 1-day history of cough,
yellow nasal discharge, and low-grade temp (T max 100°F). She was previously
healthy. She does have 2+ edema of the nasal turbinates and cloudy
rhinorrhea. She is afebrile in the office. Her chest, mouth, and ears are clear.
You prescribe:
Selected Answer: d.
Saline drops, bulb suction, humidified air, and increased PO
fluids
• Question 7
• 1 out of 1 points
The parents of an 8-year-old Down Syndrome boy arrive for his annual well-child visit. He wants to
participate in sports, including the Special Olympics. Until further examination can be completed,
which of the following sports would you suggest as being safe?
Selected Answer: a.
Tennis
• Question 8
• 1 out of 1 points
Jason, age 14, appears with tender discoid breast tissue enlargement (2-3 cm in diameter)
beneath the areola. Your next action would be to
Selected Answer: a.
Perform watchful waiting for 1 year.
• Question 9
• 1 out of 1 points
You see a 7-year-old boy a day after he was bitten by his pet dog. According to
the mother, the dog bit the child after he snuck up on the dog and grabbed his
tail. The dog has had all its vaccinations, including rabies. The child has had no
fever, has full movement of the injured limb, and has no sign of neurologic or
vascular injury. The wound is on the child’s forearm, is not deep, and is not
bleeding, but has developed about 2 cm of erythema surrounding the site.
Which of the following is the most appropriate treatment?
Selected Answer: c.
Oral amoxicillin-clavulanate for 7-14 days
• Question 10
• 1 out of 1 points
A head injury in which bruising or tearing of the cerebral structures occurs is a
Selected Answer: d.
, Contusion
• Question 11
• 1 out of 1 points
A 14-year-old has a 3-week history of fever, anorexia, and abdominal pain. What additional
symptom would cause the NP to suspect Crohn's disease?
Selected Answer: b.
Blood, mucous diarrhea
• Question 12
• 1 out of 1 points
Which of the following should be done annually after 1 year of age in a child with Down syndrome?
Selected Answer: a.
Thyroid screenings
• Question 13
• 1 out of 1 points
A previously healthy male has a 3-month history of increasing headaches,
blurred vision, and personality changes. Previously he admitted to marijuana
experimentation more than 1 year ago. On examination he is a healthy, athletic-
appearing 17-year-old with decreased extraocular range of motion and left eye
visual acuity. Which of the following is the best next step in his management?
Selected Answer: c.
Neuroimaging
• Question 14
• 1 out of 1 points
Kelly, your 11-year-old well visit patient, presents to the office with weight loss, polyuria, and
polydipsia. Which of the following do you need to rule out?
Selected Answer: d.
Diabetes mellitus
• Question 15
• 1 out of 1 points
A 3-week old presents to the office in January with a 1-week history of nasal congestion and
occastional cough. On the night prior to the visit in infant developed a fever 102ºF rectally, was
difficult to breastfeed, and had paroxysmal coughing and noisy, labored breathing. On exam, you
note an ill-appearing infant who is lethergic with wheezing, tachypnea, and intercostal
retractions. The infant is home with the mom at this time; however, has a sibling who is 4-years-
old and is in daycare and recently had cold symptoms. If the patient has been diagnosed with RSV
bronchiolitis,
, which of the following would be the treatment of choice?
Selected Answer: a.
Fluids and nutritional support and close monitoring
• Question 16
• 1 out of 1 points
Chest pain in young children is usually
Selected Answer: a.
Noncardiac in origin
• Question 17
• 1 out of 1 points
Maddie, age 2, had a complete blood count (CBC) drawn at her last visit. It indicates that she has a
microcytic hypochromic anemia. What should you do now at this visit?
Selected Answer: a.
Obtain a lead level.
• Question 18
• 1 out of 1 points
Most children with Duchenne muscular dystrophy become wheelchair dependent by what age?
Selected Answer: b.
4 to 6 years of age
• Question 19
• 1 out of 1 points
The following clinical description best matches which genetic disorder? A tall,
thin 14-year- old boy has no signs of puberty. He was delayed in his speech
development and always has done less well in school than his siblings. He is
shy, and teachers report his activity is immature. Physical examination reveals
breast development, and long limbs with a decreased upper segment/lower
segment ration. He has small testes and phallus.
Selected Answer: e.
Klinefelter syndrome (XXY)
• Question 20
• 1 out of 1 points
Of the following patients, which child should not receive a tuberculin skin test?
Selected d.
Answer: A 2-year-old who was infected with RSV 2 months ago and is currently
