,
,
,
,Biologic therapies currently in clinical use for pediatric patients include differentiation therapy,
immunotherapy, small-molecule kinase inhibitors, and monoclonal antibody therapies.
Differentiation therapy has been used in acute promyelocytic leukemia and neuroblastoma. An
example of immunotherapy is stem-cell transplantation. Monoclonal antibody therapy is typically
used in the context of bone marrow transplantation.
A newborn female whose weight and length are between the 2nd and 10th percentile, respectively,
for gestational age has significant pedal edema, a low hairline, and loose skinfolds at the nape of the
neck. Which screening test is MOST appropriate?
A. ACTH stimulation test
B. Contrast enema
C. Echocardiogram
D. Head ultrasound - CORRECT ANSWER-C. Echocardiogram
The symptoms are characteristic of Turner syndrome. Many infants who have Turner syndrome
exhibit a low birth weight and decreased length. Cardiac defects are commonly associated with
Turner syndrome, and a comprehensive cardiovascular evaluation including echocardiography and
consultation with a cardiologist specializing in congenital heart defects should be done. The most
common cardiac defects occurring in females with Turner syndrome include bicuspid aortic valve,
ascending aortic dilatation, coarctation of the aorta, and partial anomalous pulmonary venous
return.
Turner syndrome is not known to be associated with intracranial, adrenal, or gastrointestinal
anomalies.
Following a motor vehicle collision, an adolescent presents with hemoptysis, tachypnea, and a pulse
oximetry (SpO2) reading of 85% on a non-rebreather mask. Chest radiograph reveals right upper and
middle lobe consolidations with subcutaneous emphysema. Following intubation, initial oxygenation
index (OI) is 15.
The MOST appropriate ventilator management strategy includes permissive hypercapnia and:
A. TV of 6-8 ml/kg & PaO2 of 55-80 mmHg
B. TV of 6-8 ml/kg & PaO2 of 70-95 mmHg
C. TV of 9-10 ml/kg & PaO2 of 55-80 mmHg
D. TV of 9-10 ml/kg & PaO2 of 70-95 mmHg - CORRECT ANSWER-A. TV of 6-8 ml/kg & PaO2 of 55-80
mmHg
Diagnosis is pulmonary contusion AMB hemoptysis, respiratory distress, and hypoxia, with
subcutaneous emphysema and consolidation on CXR .
Management includes targeting low tidal volumes (6-8mL/kg), permissive hypercapnia, and titration
of PEEP and FiO2 to maintain lower oxygenation goals (PaO2 55-80 mmHg) to prevent oxygen
toxicity.
, An afebrile school-age child presents with a painful, erythematous, fluctuant lesion on the arm that
measures 1.5 cm in diameter. Appropriate treatment includes:
A. Topical antibiotic ointment & covering lesion with a dressing
B. Empiric PO antibiotics with office f/u in a week
C. Washing daily with soap and water and keeping dry
D. Incision & drainage with Gram stain of fluid - CORRECT ANSWER-D. Incision & drainage with Gram
stain of fluid
For purulent skin soft tissue infections, I&D is indicated, specifically in mild cases lacking systemic
symptoms. Sending the drainage for Gram stain and culture is recommended. The choice to
prescribe antibiotics for S. aureus should be limited to those patients with moderate to severe
purulent infections with symptoms of SIRS, such as fever, tachypnea, tachycardia, or WBC count
elevated over 12,000, or for any patient with a nonpurulent skin infection such as cellulitis,
necrotizing fasciitis, or erysipelas.
Antibiotics should be considered for children with impairment of host defenses, such as those who
are immunocompromised. If antibiotics are prescribed, they should be prescribed after I&D & f/u
should occur in 48 hours to assess efficacy of treatment.
Following I&D, simply covering the site with a dry dressing is usually the easiest and most effective
treatment. Topical antimicrobials are not recommended for the treatment of mild skin infections
After an occurrence of nephrolithiasis, which intervention is MOST importantly included in education
provided to the adolescent and family related to long-term prevention of this condition?
A. Taking a citrate supplement
B. Adhering to a low sodium diet
C. Taking a daily diuretic medication
D. Ensuring at least 2 liters of fluid intake daily - CORRECT ANSWER-D. Ensuring at least 2 liters of
fluid intake daily
Nephrolithiasis (kidney stones), are due to congenital and structural urologic abnormalities,
hypercalciuria, hyperoxaluria/oxalosis, hypocitraturia, or other metabolic abnormalities.
Management is centered around pain control, urine culture with treatment of concomitant UTI, and
hydration. Urologic intervention such as extracorporeal shock wave lithotripsy or percutaneous
nephrolithotomy may be necessary in high risk cases (e.g., single kidney) or cases of unrelenting pain
or urinary obstruction.
Which of the following characterizes "privileging" for a new nurse practitioner (NP)?
A. The State Board of Nursing grants the ability to practice after the NP meets state defined criteria
for safe practice
,
,
,Biologic therapies currently in clinical use for pediatric patients include differentiation therapy,
immunotherapy, small-molecule kinase inhibitors, and monoclonal antibody therapies.
Differentiation therapy has been used in acute promyelocytic leukemia and neuroblastoma. An
example of immunotherapy is stem-cell transplantation. Monoclonal antibody therapy is typically
used in the context of bone marrow transplantation.
A newborn female whose weight and length are between the 2nd and 10th percentile, respectively,
for gestational age has significant pedal edema, a low hairline, and loose skinfolds at the nape of the
neck. Which screening test is MOST appropriate?
A. ACTH stimulation test
B. Contrast enema
C. Echocardiogram
D. Head ultrasound - CORRECT ANSWER-C. Echocardiogram
The symptoms are characteristic of Turner syndrome. Many infants who have Turner syndrome
exhibit a low birth weight and decreased length. Cardiac defects are commonly associated with
Turner syndrome, and a comprehensive cardiovascular evaluation including echocardiography and
consultation with a cardiologist specializing in congenital heart defects should be done. The most
common cardiac defects occurring in females with Turner syndrome include bicuspid aortic valve,
ascending aortic dilatation, coarctation of the aorta, and partial anomalous pulmonary venous
return.
Turner syndrome is not known to be associated with intracranial, adrenal, or gastrointestinal
anomalies.
Following a motor vehicle collision, an adolescent presents with hemoptysis, tachypnea, and a pulse
oximetry (SpO2) reading of 85% on a non-rebreather mask. Chest radiograph reveals right upper and
middle lobe consolidations with subcutaneous emphysema. Following intubation, initial oxygenation
index (OI) is 15.
The MOST appropriate ventilator management strategy includes permissive hypercapnia and:
A. TV of 6-8 ml/kg & PaO2 of 55-80 mmHg
B. TV of 6-8 ml/kg & PaO2 of 70-95 mmHg
C. TV of 9-10 ml/kg & PaO2 of 55-80 mmHg
D. TV of 9-10 ml/kg & PaO2 of 70-95 mmHg - CORRECT ANSWER-A. TV of 6-8 ml/kg & PaO2 of 55-80
mmHg
Diagnosis is pulmonary contusion AMB hemoptysis, respiratory distress, and hypoxia, with
subcutaneous emphysema and consolidation on CXR .
Management includes targeting low tidal volumes (6-8mL/kg), permissive hypercapnia, and titration
of PEEP and FiO2 to maintain lower oxygenation goals (PaO2 55-80 mmHg) to prevent oxygen
toxicity.
, An afebrile school-age child presents with a painful, erythematous, fluctuant lesion on the arm that
measures 1.5 cm in diameter. Appropriate treatment includes:
A. Topical antibiotic ointment & covering lesion with a dressing
B. Empiric PO antibiotics with office f/u in a week
C. Washing daily with soap and water and keeping dry
D. Incision & drainage with Gram stain of fluid - CORRECT ANSWER-D. Incision & drainage with Gram
stain of fluid
For purulent skin soft tissue infections, I&D is indicated, specifically in mild cases lacking systemic
symptoms. Sending the drainage for Gram stain and culture is recommended. The choice to
prescribe antibiotics for S. aureus should be limited to those patients with moderate to severe
purulent infections with symptoms of SIRS, such as fever, tachypnea, tachycardia, or WBC count
elevated over 12,000, or for any patient with a nonpurulent skin infection such as cellulitis,
necrotizing fasciitis, or erysipelas.
Antibiotics should be considered for children with impairment of host defenses, such as those who
are immunocompromised. If antibiotics are prescribed, they should be prescribed after I&D & f/u
should occur in 48 hours to assess efficacy of treatment.
Following I&D, simply covering the site with a dry dressing is usually the easiest and most effective
treatment. Topical antimicrobials are not recommended for the treatment of mild skin infections
After an occurrence of nephrolithiasis, which intervention is MOST importantly included in education
provided to the adolescent and family related to long-term prevention of this condition?
A. Taking a citrate supplement
B. Adhering to a low sodium diet
C. Taking a daily diuretic medication
D. Ensuring at least 2 liters of fluid intake daily - CORRECT ANSWER-D. Ensuring at least 2 liters of
fluid intake daily
Nephrolithiasis (kidney stones), are due to congenital and structural urologic abnormalities,
hypercalciuria, hyperoxaluria/oxalosis, hypocitraturia, or other metabolic abnormalities.
Management is centered around pain control, urine culture with treatment of concomitant UTI, and
hydration. Urologic intervention such as extracorporeal shock wave lithotripsy or percutaneous
nephrolithotomy may be necessary in high risk cases (e.g., single kidney) or cases of unrelenting pain
or urinary obstruction.
Which of the following characterizes "privileging" for a new nurse practitioner (NP)?
A. The State Board of Nursing grants the ability to practice after the NP meets state defined criteria
for safe practice
