NU665
A 10-year-old male is being seen today with concerns of change in school performance, some tremors,
and complaints of heart palpitations for the past few weeks. Mom states there have been no changes in
social history and family history is positive for thyroid disease. He had routine labs done one month ago
and his T3 was elevated. What are the next steps in the care of this child? - Answers Refer the child to a
pediatric endocrinologist for further workup
A 15-year-old adolescent female whose BMI is at the 90th percentile reports irregular periods. Menarche
was at 12 years of age. Through the assessment, it is noted that the child has widespread acne on her
face and back. The child also states that she has noticed hair on her breasts and wants to know what she
can do about this. The nurse practitioner will evaluate her further based on a suspicion of which
diagnosis? - Answers Polycystic Ovary Syndrome
A 15-year-old adolescent male presents today for his annual exam. He states he had a good day at school
today and has soccer practice after his appointment. His routine urine dipstick indicates 2+ protein. He
asks if this is normal. As the PNP, what would you tell him? - Answers This warrants some further
investigation. I will order a first-morning urine sample and check the level of protein in your urine.
A 7-month-old infant has an undescended testis that was noted at the end of his previous well-baby
exam. What will the primary care pediatric nurse practitioner do to manage this condition? - Answers
Refer the child to a pediatric urologist for further evaluation.
A school-aged child is brought to the clinic with her father for increased urinary frequency, dysuria, and
discomfort for the past two days. Today, she has a fever and some abdominal pain. The child was able to
produce a clean catch urine sample and the urinalysis results include positive nitrites and leukocyte
esterase. As the PNP, what would you do next? - Answers Since the child is symptomatic, send the urine
for culture and sensitivity and start oral antibiotics.
The father of a 7-year-old boy expresses concern that his son has grown 2 inches in the past six months.
Upon examination, the PNP noted the presence of pubic hair. What would the PNP's next steps be in the
care of this child? - Answers Refer the child to a pediatric endocrinologist for further work-up.
You receive the results of newborn screening from a healthy, term neonate and find that the TSH done
on the newborn screen is 82 mIU/L (elevated). What is your next step? - Answers Start thyroid
supplementation and refer to pediatric endocrinology urgently.
A 10-year-old male is being seen today with concerns of change in school performance, some tremors,
and complaints of heart palpitations for the past few weeks. Mom states there have been no changes in
social history and family history is positive for thyroid disease. He had routine labs done one month ago
and his T3 was elevated. What are the next steps in the care of this child? - Answers Refer the child to a
pediatric endocrinologist for further workup
A 15-year-old adolescent female whose BMI is at the 90th percentile reports irregular periods. Menarche
was at 12 years of age. Through the assessment, it is noted that the child has widespread acne on her
face and back. The child also states that she has noticed hair on her breasts and wants to know what she
can do about this. The nurse practitioner will evaluate her further based on a suspicion of which
diagnosis? - Answers Polycystic Ovary Syndrome
A 15-year-old adolescent male presents today for his annual exam. He states he had a good day at school
today and has soccer practice after his appointment. His routine urine dipstick indicates 2+ protein. He
asks if this is normal. As the PNP, what would you tell him? - Answers This warrants some further
investigation. I will order a first-morning urine sample and check the level of protein in your urine.
A 7-month-old infant has an undescended testis that was noted at the end of his previous well-baby
exam. What will the primary care pediatric nurse practitioner do to manage this condition? - Answers
Refer the child to a pediatric urologist for further evaluation.
A school-aged child is brought to the clinic with her father for increased urinary frequency, dysuria, and
discomfort for the past two days. Today, she has a fever and some abdominal pain. The child was able to
produce a clean catch urine sample and the urinalysis results include positive nitrites and leukocyte
esterase. As the PNP, what would you do next? - Answers Since the child is symptomatic, send the urine
for culture and sensitivity and start oral antibiotics.
The father of a 7-year-old boy expresses concern that his son has grown 2 inches in the past six months.
Upon examination, the PNP noted the presence of pubic hair. What would the PNP's next steps be in the
care of this child? - Answers Refer the child to a pediatric endocrinologist for further work-up.
You receive the results of newborn screening from a healthy, term neonate and find that the TSH done
on the newborn screen is 82 mIU/L (elevated). What is your next step? - Answers Start thyroid
supplementation and refer to pediatric endocrinology urgently.
