NURS 629 exam 4 Updated with
complete solution
Rovsing sign - Answer apply pressure to lower left abdomen. Pain felt on right side of
abdomen when pressure released.
+ Ant/ Post Drawer sign - Answer assess for injury of ant/post cruciate ligament
Osgood- Schlatter disease - Answer most common in later childhood and early
adolescence. Painful swelling and tenderness of tibial tuberosity. Most common in
children in sports. *initial TX is stretching.
TX for sprained ankle - Answer apply cold for 20 min, off for 20-45 min. Repeat 1st 24-
48hrs. Rest, elevate, compress (RICE)
Legg-calve perthes - Answer idiopathic osteonecrosis of femoral head. 4x more
common in males. Hip pain, knee pain, painless limp that is worse at end of day. Frog
leg xray best to diagnose.
Viral gastroenteritis - Answer Most common complication is dehydration.Tx is small,
frequent amounts of oral rehydration solution.
BG for 4y/o - Answer goal of 90-130
Suspected growth hormone deficiency - Answer short, slow growth. Childlike faces with
prominent forehead. *Initial eval include TSH, BG (hypoglycemia), GI illness, CBC, sed
rate, UA, growth factor.
Initial eval in cases of isolated menarche - Answer *sexual abuse should be ruled out
first
essentials for childs mental health - Answer predictable home, childcare, school
routines
Migraine - Answer unilateral, pulsating, occasional photophobia.
Iron deficiency anemia - Answer *Microcytic, hypochromic. Most common cause is poor
dietary intake/ breastfeeding risk. Prevalence is 25% of children between ages 10-15
mos.
Depression Comorbidities - Answer anxiety disorder, mixed anxiety/depression. ADHD,
conduct/learning/oppositional defiant disorders. SAD, eating disorders, stress.
Depression risk factors - Answer attention, conduct, learning disorders. Chronic illness
(diabetes). abuse/neglect. other trauma or natural disasters. *Separation anxiety.
, PHQ9 - Answer depression screening tool for ages 11 and up
signs of PTSD - Answer re-experiencing trauma thru intrusive distressing recollections
of event, flashbacks, nightmares. Avoidance of places, people, and activities that are
reminders of trauma, and emotional numbness. Increased arousal such as difficulty
sleeping and concentrating, feeling jumpy, easily irritated and angered. *Extreme
temper tantrums in preschool aged kids.
slipped capital femoral epiphysis risk factors - Answer Obesity, males, sports, femoral
retroversion, hypothyroidism, avg age presentation is 12y/o for females and 13y/o for
males.
slipped capital femoral epiphysis clinical findings: - Answer limping, knee/hip pain, pain
worse with activity, localized pain to ant thigh or knee. May be unable to bear wt all
together, loss of internal rotation of hip with flexion, affected extremity is usually shorter.
Loss of abduction and extension
slipped capital femoral epiphysis DX and TX - Answer -xray. Always refer to peds
ortho. Keep non wt bearing until surgical eval.
Scoliosis - Answer most common type is idiopathic. *In order to confirm suspected, get
AP and lateral standing Xray view of spine
Bactrim - Answer treatment of choice for UTI in children
TX for gastroenteritis - Answer small, frequent amounts of oral rehydration solution
Appendicits - Answer Constant periumbilical pain shifting to RLQ. Worsens over period
of 4hrs. Pain subsides as it migrates to RLQ and then worsens with movement, deep
respir, and coughing.Pain/Fever are late sign, leading to perforation. Vomiting.
*Elevated WBC.
Neural mediated syncope - Answer most common form of fainting/ frequent ED visits.
Happens in part of nervous system that regulates BP. Place pt reclining position to
restore blood flow/ consciousness. Situational syncope, vasovagal, reflex,
neurocardiogenic part of it. Residual findings are pallor, fatigue, diaphoresis
Cardiac syncope - Answer causes: bradycardia, tachycardia, hypotension, exercise
triggered. Palpitations. Residual findings: incontinence, disorientation, or injury.
Goiter - Answer commonly found on exam with hyperthyroidism
DM1 treatment goals - Answer achieve normal growth/development. Achieve optimal
glycemic control. + psychosocial adjustment to diabetes. Hgb A1C < 7.5
complete solution
Rovsing sign - Answer apply pressure to lower left abdomen. Pain felt on right side of
abdomen when pressure released.
+ Ant/ Post Drawer sign - Answer assess for injury of ant/post cruciate ligament
Osgood- Schlatter disease - Answer most common in later childhood and early
adolescence. Painful swelling and tenderness of tibial tuberosity. Most common in
children in sports. *initial TX is stretching.
TX for sprained ankle - Answer apply cold for 20 min, off for 20-45 min. Repeat 1st 24-
48hrs. Rest, elevate, compress (RICE)
Legg-calve perthes - Answer idiopathic osteonecrosis of femoral head. 4x more
common in males. Hip pain, knee pain, painless limp that is worse at end of day. Frog
leg xray best to diagnose.
Viral gastroenteritis - Answer Most common complication is dehydration.Tx is small,
frequent amounts of oral rehydration solution.
BG for 4y/o - Answer goal of 90-130
Suspected growth hormone deficiency - Answer short, slow growth. Childlike faces with
prominent forehead. *Initial eval include TSH, BG (hypoglycemia), GI illness, CBC, sed
rate, UA, growth factor.
Initial eval in cases of isolated menarche - Answer *sexual abuse should be ruled out
first
essentials for childs mental health - Answer predictable home, childcare, school
routines
Migraine - Answer unilateral, pulsating, occasional photophobia.
Iron deficiency anemia - Answer *Microcytic, hypochromic. Most common cause is poor
dietary intake/ breastfeeding risk. Prevalence is 25% of children between ages 10-15
mos.
Depression Comorbidities - Answer anxiety disorder, mixed anxiety/depression. ADHD,
conduct/learning/oppositional defiant disorders. SAD, eating disorders, stress.
Depression risk factors - Answer attention, conduct, learning disorders. Chronic illness
(diabetes). abuse/neglect. other trauma or natural disasters. *Separation anxiety.
, PHQ9 - Answer depression screening tool for ages 11 and up
signs of PTSD - Answer re-experiencing trauma thru intrusive distressing recollections
of event, flashbacks, nightmares. Avoidance of places, people, and activities that are
reminders of trauma, and emotional numbness. Increased arousal such as difficulty
sleeping and concentrating, feeling jumpy, easily irritated and angered. *Extreme
temper tantrums in preschool aged kids.
slipped capital femoral epiphysis risk factors - Answer Obesity, males, sports, femoral
retroversion, hypothyroidism, avg age presentation is 12y/o for females and 13y/o for
males.
slipped capital femoral epiphysis clinical findings: - Answer limping, knee/hip pain, pain
worse with activity, localized pain to ant thigh or knee. May be unable to bear wt all
together, loss of internal rotation of hip with flexion, affected extremity is usually shorter.
Loss of abduction and extension
slipped capital femoral epiphysis DX and TX - Answer -xray. Always refer to peds
ortho. Keep non wt bearing until surgical eval.
Scoliosis - Answer most common type is idiopathic. *In order to confirm suspected, get
AP and lateral standing Xray view of spine
Bactrim - Answer treatment of choice for UTI in children
TX for gastroenteritis - Answer small, frequent amounts of oral rehydration solution
Appendicits - Answer Constant periumbilical pain shifting to RLQ. Worsens over period
of 4hrs. Pain subsides as it migrates to RLQ and then worsens with movement, deep
respir, and coughing.Pain/Fever are late sign, leading to perforation. Vomiting.
*Elevated WBC.
Neural mediated syncope - Answer most common form of fainting/ frequent ED visits.
Happens in part of nervous system that regulates BP. Place pt reclining position to
restore blood flow/ consciousness. Situational syncope, vasovagal, reflex,
neurocardiogenic part of it. Residual findings are pallor, fatigue, diaphoresis
Cardiac syncope - Answer causes: bradycardia, tachycardia, hypotension, exercise
triggered. Palpitations. Residual findings: incontinence, disorientation, or injury.
Goiter - Answer commonly found on exam with hyperthyroidism
DM1 treatment goals - Answer achieve normal growth/development. Achieve optimal
glycemic control. + psychosocial adjustment to diabetes. Hgb A1C < 7.5
