NU665A Primary Care of Child II EXAM 3 LATEST FALL
SPRING 2024.2025 GRADED A+ WITH SOLUTIONS
Clinical picture of Croup - ANSWER: Hoarse voice, barking cough, inspiratory stridor,
possible respiratory distress
Typical age range of Croup occurence - ANSWER: 1-6 years of age; 5/100 children
between 1-2 y/o affected
Etiology of Croup - ANSWER: Parainfluenza, types 1,2,3, contribute 65% of cases
Influenza A and B
Adenovirus
RSV
Rarely mycoplasma
When do parents report symptoms of croup? - ANSWER: usually report viral URI
symptoms 12-48 hours prior to cough
Typical course length of croup? - ANSWER: 3-5 days
When should you be worries with croup? - ANSWER: -drooling, toxic appearance,
stridor, incomplete immunizations
Why is the Hib vaccine so imprtant? - ANSWER: prevents Epiglottitis causes by Hib.
Lab tests for Croup? - ANSWER: No value in diagnosing; may for rapid strep test or
throat culture
Imaging for croup? - ANSWER: Not needed for diagnosis as it is a clinical diagnosis;
can see Steeple sign from imaging (subglottic narrowing from inflammation)
Management of mild croup - ANSWER: Cool humidified mist and oxygen
Oral dexamthasone
*if bacterial infection is suspected add antibiotics 2nd generation cephalosporin
arrange out patient follow up*
Dose of oral dexamethasone - ANSWER: 0.15 to 0.6 mg/kg, max dose is 10 mg
A baby can sit alone before he or she is able to crawl. This is true because
development of gross motor skills: - ANSWER: Occurs in a cephalocaudal direction
Physical growth is most rapid during which period? - ANSWER: Birth to 1 year of age
An infant weights & pounds at birth. COnsider the general guideline about infant
weight gain discussed in class. At 4 months, the infant would be expected to weigh: -
ANSWER: 14 pounds
,The primary psycho-social task of infancy is: - ANSWER: development of secure
attachment
If a mother hides a block under her baby's blanket and the baby looks for it, the
nurse understands that the baby has begun to develop the concept of:
1.relativism.
2.object prehension.
3.separation anxiety.
4.object permanence. - ANSWER: object permanence
A full term 2-month old infant should be able to do which of the following -
ANSWER: Lift head 45 degrees when prone
Safety and Injury Prevention for an infant should include all of the following except: -
ANSWER: Place in car seat for naps when URI symptoms compromise airway
You are seeing a 4 month old infant who has eczema on facial cheeks and extensor
surfaces. There is a strong family hx of atopy. Guiac test of the stool sample brought
in is positive for blood. The infant is currently on Similac with iron. You plan to follow
AAP Policy. What will you suggest to Mom? - ANSWER: change to a partially
hydrolyzed or extensively hydrolyzed formula
You are seeing an infant for his 6 month visit. Mom is concerned because she has
had many dental caries. They have well water. What is your best advise for the
infant? - ANSWER: We will start your infant on Fluoride drops
At what age is it safe to give infants cow's milk instead of commercial infant formula
or breast milk? - ANSWER: 12 months
Binocular vision develops - ANSWER: between 4-6 months
A 6-week old infant girl has asymmetrical skin fold creases and a palpable hip click
with gentle adduction of the left hip (positive Barlow sign). Which test should be
ordered? - ANSWER: Ultra sound of the hips
The primary care pediatric nurse practitioner performs a well baby examination on a
7-day-old infant who is nursing well, according to the mother. The NP notes that the
infant weighed 7 lbs 3 oz at birth and 6lbs 10 oz when discharged on the second day
of life. The infant weights 6 lbs 14 oz at this visit. Which action is correct? - ANSWER:
Schedule a weight check in 5-7 days
The standard treatment for Developmental Dysplasia of Hip (DDH) in the first 6
months of life is with: - ANSWER: Pavlik harness
In terms of fine motor development, what should the infant of 8 months be able to
do? - ANSWER: Transfer objects from one hand to other and bang cubes on a table
, Erikson believes toilet training to be representative of which of his stages? -
ANSWER: Autonomy versus shame and doubt
A 24 month old comes to the clinic for a well-child visit. His mother describes him as
a child who falls apart if she changes even the smallest thing in his environment. The
nurse tells his mother that this behavior: - ANSWER: Can be expected from a toddler
because they typically experience ritualism and negativism.
The PNP is examining a 2 year old child, the child is fearful, how should the PNP
proceed with the exam? - ANSWER: examine the child from least invasive to most
invasive in the exam
While listening to a 2.5 year old speak, you note that she occasionally omits final
consonants and her sentences are 2-3 words in length. The appropriate plan of care
would be: - ANSWER: Routine f/u at next well child visit
A mother is concerned b/c her 30 month old son is not toilet trained and other
children in his play group are trained. The NP would tell his mother: - ANSWER: All
children are different, and her child is still w/in the range of normal
Which of the following best decribes head assessment of toddler? - ANSWER:
Anterior fontanel usually closes by 9-18 months, at times not until 2 years
Optimum discipline for a 2 year old can best be described as: - ANSWER: Use of
discipline as a means of teaching and protecting, not punishing
Two toddlers are playing in a sandbox when one child suddenly grabs a toy from the
other child. Which of the following is the best interpretation of this behavior? -
ANSWER: This is typical behavior because toddlers are egocentric
A toddler's parent asks the NP for suggestions on dealing with temper tantrums.
Which of the following is the most appropriate recommendation? - ANSWER:
Remain close by the child but without eye contact or interaction with the child,
ignore the behavior
Which of the following techniques is best for dealing with the negativism of the
toddler? - ANSWER: offer the child acceptable choices
A 24-month old child comes to the clinic for a wlel-child visit. His mother is
concerned b/c he has become "picky" with his eating habits. What is your best
repsonse? - ANSWER: Reassure mom that this normal development. Encourage mom
to eat meals together as a family.
The Np is advising a father about his 2 year old daughter's eating habits. She is at the
40th percentile for both height and weight. He is concerned b/c she seems "to eat
SPRING 2024.2025 GRADED A+ WITH SOLUTIONS
Clinical picture of Croup - ANSWER: Hoarse voice, barking cough, inspiratory stridor,
possible respiratory distress
Typical age range of Croup occurence - ANSWER: 1-6 years of age; 5/100 children
between 1-2 y/o affected
Etiology of Croup - ANSWER: Parainfluenza, types 1,2,3, contribute 65% of cases
Influenza A and B
Adenovirus
RSV
Rarely mycoplasma
When do parents report symptoms of croup? - ANSWER: usually report viral URI
symptoms 12-48 hours prior to cough
Typical course length of croup? - ANSWER: 3-5 days
When should you be worries with croup? - ANSWER: -drooling, toxic appearance,
stridor, incomplete immunizations
Why is the Hib vaccine so imprtant? - ANSWER: prevents Epiglottitis causes by Hib.
Lab tests for Croup? - ANSWER: No value in diagnosing; may for rapid strep test or
throat culture
Imaging for croup? - ANSWER: Not needed for diagnosis as it is a clinical diagnosis;
can see Steeple sign from imaging (subglottic narrowing from inflammation)
Management of mild croup - ANSWER: Cool humidified mist and oxygen
Oral dexamthasone
*if bacterial infection is suspected add antibiotics 2nd generation cephalosporin
arrange out patient follow up*
Dose of oral dexamethasone - ANSWER: 0.15 to 0.6 mg/kg, max dose is 10 mg
A baby can sit alone before he or she is able to crawl. This is true because
development of gross motor skills: - ANSWER: Occurs in a cephalocaudal direction
Physical growth is most rapid during which period? - ANSWER: Birth to 1 year of age
An infant weights & pounds at birth. COnsider the general guideline about infant
weight gain discussed in class. At 4 months, the infant would be expected to weigh: -
ANSWER: 14 pounds
,The primary psycho-social task of infancy is: - ANSWER: development of secure
attachment
If a mother hides a block under her baby's blanket and the baby looks for it, the
nurse understands that the baby has begun to develop the concept of:
1.relativism.
2.object prehension.
3.separation anxiety.
4.object permanence. - ANSWER: object permanence
A full term 2-month old infant should be able to do which of the following -
ANSWER: Lift head 45 degrees when prone
Safety and Injury Prevention for an infant should include all of the following except: -
ANSWER: Place in car seat for naps when URI symptoms compromise airway
You are seeing a 4 month old infant who has eczema on facial cheeks and extensor
surfaces. There is a strong family hx of atopy. Guiac test of the stool sample brought
in is positive for blood. The infant is currently on Similac with iron. You plan to follow
AAP Policy. What will you suggest to Mom? - ANSWER: change to a partially
hydrolyzed or extensively hydrolyzed formula
You are seeing an infant for his 6 month visit. Mom is concerned because she has
had many dental caries. They have well water. What is your best advise for the
infant? - ANSWER: We will start your infant on Fluoride drops
At what age is it safe to give infants cow's milk instead of commercial infant formula
or breast milk? - ANSWER: 12 months
Binocular vision develops - ANSWER: between 4-6 months
A 6-week old infant girl has asymmetrical skin fold creases and a palpable hip click
with gentle adduction of the left hip (positive Barlow sign). Which test should be
ordered? - ANSWER: Ultra sound of the hips
The primary care pediatric nurse practitioner performs a well baby examination on a
7-day-old infant who is nursing well, according to the mother. The NP notes that the
infant weighed 7 lbs 3 oz at birth and 6lbs 10 oz when discharged on the second day
of life. The infant weights 6 lbs 14 oz at this visit. Which action is correct? - ANSWER:
Schedule a weight check in 5-7 days
The standard treatment for Developmental Dysplasia of Hip (DDH) in the first 6
months of life is with: - ANSWER: Pavlik harness
In terms of fine motor development, what should the infant of 8 months be able to
do? - ANSWER: Transfer objects from one hand to other and bang cubes on a table
, Erikson believes toilet training to be representative of which of his stages? -
ANSWER: Autonomy versus shame and doubt
A 24 month old comes to the clinic for a well-child visit. His mother describes him as
a child who falls apart if she changes even the smallest thing in his environment. The
nurse tells his mother that this behavior: - ANSWER: Can be expected from a toddler
because they typically experience ritualism and negativism.
The PNP is examining a 2 year old child, the child is fearful, how should the PNP
proceed with the exam? - ANSWER: examine the child from least invasive to most
invasive in the exam
While listening to a 2.5 year old speak, you note that she occasionally omits final
consonants and her sentences are 2-3 words in length. The appropriate plan of care
would be: - ANSWER: Routine f/u at next well child visit
A mother is concerned b/c her 30 month old son is not toilet trained and other
children in his play group are trained. The NP would tell his mother: - ANSWER: All
children are different, and her child is still w/in the range of normal
Which of the following best decribes head assessment of toddler? - ANSWER:
Anterior fontanel usually closes by 9-18 months, at times not until 2 years
Optimum discipline for a 2 year old can best be described as: - ANSWER: Use of
discipline as a means of teaching and protecting, not punishing
Two toddlers are playing in a sandbox when one child suddenly grabs a toy from the
other child. Which of the following is the best interpretation of this behavior? -
ANSWER: This is typical behavior because toddlers are egocentric
A toddler's parent asks the NP for suggestions on dealing with temper tantrums.
Which of the following is the most appropriate recommendation? - ANSWER:
Remain close by the child but without eye contact or interaction with the child,
ignore the behavior
Which of the following techniques is best for dealing with the negativism of the
toddler? - ANSWER: offer the child acceptable choices
A 24-month old child comes to the clinic for a wlel-child visit. His mother is
concerned b/c he has become "picky" with his eating habits. What is your best
repsonse? - ANSWER: Reassure mom that this normal development. Encourage mom
to eat meals together as a family.
The Np is advising a father about his 2 year old daughter's eating habits. She is at the
40th percentile for both height and weight. He is concerned b/c she seems "to eat
