PedsCE PNP-PC Exam Practice Q&A

The most likely cause of bilateral purulent conjunctivitis in a 1-day old infant is a. Gonorrheal opthalmia b. Chlamydia infection c. Symphilitic opthalmia d. Adenovirus infection - Answer- a. Gonorrheal ophthalmia Rationale: Gonorrehea usually appears in the first 3-5 days of life. Chlamydia is between days 5-14. The other 2 are less common in neonates. Most common causes of conjunctivitis in newborn includes, Chlamydia, Gonorrhea, HSV, and chemical induced conjunctivitis. (Burns) Which of the following circumstances is most suggestive of excessive stress in a family with a chronically ill child? a. The father takes a second job to meet financial responsibilities b. The mother provides the majority of the care for the child c. The parents stop participation in a support group d. A sibling exhibits decline in school performance - Answer- c. The parents stop participation in a support group Rationale: Chronic illness takes a significant stress on the family. It can result in changes in roles as well as the sibling feeling unloved or left out in some way. Can also result in depression/anxiety of parents and other family members. Positive social networks are a positive influence on parents and the PNP should be concerned if the family is withdrawing from supportive social networks. This could indicate depression or extreme stress on the family unit. (Burns) An otherwise healthy 2-year old boy is brought to the emergency room with a four-week history of wheezing and persistent cough. Prior to the start of these symptoms, the parent recalls a coughing event which resolved spontaneously. Of the following the most likely diagnosis is: a. Viral pneumonia b. Acute laryngotracheobronchitis c. Bronchiolitis d. Foreign body aspiration - Answer- d. Foreign body aspiration Rationale: An initial choking, gagging, or coughing episode following by spontaneous resolution is often present in history finding of a child with foreign body aspiration. The episode is typically followed by respiratory symptoms such as stridor, wheezing, and prolonged cough in the absence of illness. Acute layngotracheobronchitis, bronchitis, and viral pneumonia are also associated with coughing and wheezing but also involve other symptoms such as fever, rhinorrhea, fatigue and usually resolve within 10-14 d