NU664A Final Exam questions and answers
2025
In the United States, the most common cause of myocarditis in children is: - ANSWER Viruses
The characteristic that is most concerning in the school-aged child with a cardiac murmur. -
ANSWER Progressive exercise intolerance
A parent of a child with a history of a benign cardiac murmur states she read that children with
heart disease need to have an antibiotic before dental procedures. How would you answer the
mother as the PNP? - ANSWER Certain children do need an antibiotic to prevent something
called bacterial endocarditis, but these are children who have had a surgical repair done.
Your next patient is a 12-year-old male here for his well-child exam. When reviewing his height,
weight, and BMI, it is noted that his BMI is in the 90th percentile. The mother states that her
child is "big-boned" and is not concerned of any cardiovascular disease risk. What would you
discuss with the mother? - ANSWER Although a risk of cardiovascular disease exists, with a
healthy diet and regular exercise, your son likely will be able to reduce his BMI and reduce his
risk.
Your next patient is a 5-year-old child with a history of moderate persistent asthma. He has been
wheezing and coughing for the past two days, and his mother brings him in today for
evaluation. He has been using albuterol every four hours. His respiratory rate is 13 breaths per
minute; his lungs are clear to auscultation; and no retractions are noted. What may be your
assessment and intervention based on this information? - ANSWER Your child is breathing
slower than normal for his age. We need to send him to the ER for further intervention.
Your next patient is a 6-year-old male here for his annual influenza vaccine. He has a history of
mild persistent asthma. What would you discuss for medications when reviewing his asthma
action plan? - ANSWER Your child should continue his low-dose inhaled corticosteroid daily and
add albuterol as needed for an exacerbation.
, Which of the following is a common cause of acquired coronary artery disease in children? -
ANSWER Kawasaki disease
Your next patient is a 14-year-old female who presents to your office with a complaint of
syncope at school. She had just stood up from her chair at the end of the day, felt dizzy and
nauseous, and then woke up on the floor. She did not hit her head and woke up within 30
seconds. What is your impression, and what would you do next? - ANSWER At this age, children
may have these episodes called neurally mediated syncope. We will schedule an EKG.
A child is brought to the clinic immediately after being stung by a wasp while playing in the yard.
The PE reveals localized redness and edema at the site along with abdominal tenderness,
watery eyes and generalized hives. What is the initial treatment? - ANSWER Administer IM
epinephrine
A child is brought to the clinic with a generalized annular rash characterized by raised wheals
with pale centers. On PE, the child's lungs are clear and there is no peripheral edema. A history
reveals ingestion of strawberries earlier in the day. What is the initial treatment? - ANSWER
Diphenhydramine .05-1 mg/kg/dose every 4-6 hours
A child who has been diagnosed with asthma for several years has been using a short-acting
Beta-agonist (SABA) to control symptoms. The PNP learns that the child has recently begun
using the SABA 2-3 times each week to prevent wheezing and shortness of breath. The child
currently has clear breath sounds and an FEV1 of 75% of personal best. What will the NP do? -
ANSWER Add an inhaled corticosteroid.
A child has fever and arthralgia. The PNP learns that the child had a sore throat 3 weeks prior
and auscultates a murmur in the clinic.
§What test will the PNP order? - ANSWER ASO titer
2025
In the United States, the most common cause of myocarditis in children is: - ANSWER Viruses
The characteristic that is most concerning in the school-aged child with a cardiac murmur. -
ANSWER Progressive exercise intolerance
A parent of a child with a history of a benign cardiac murmur states she read that children with
heart disease need to have an antibiotic before dental procedures. How would you answer the
mother as the PNP? - ANSWER Certain children do need an antibiotic to prevent something
called bacterial endocarditis, but these are children who have had a surgical repair done.
Your next patient is a 12-year-old male here for his well-child exam. When reviewing his height,
weight, and BMI, it is noted that his BMI is in the 90th percentile. The mother states that her
child is "big-boned" and is not concerned of any cardiovascular disease risk. What would you
discuss with the mother? - ANSWER Although a risk of cardiovascular disease exists, with a
healthy diet and regular exercise, your son likely will be able to reduce his BMI and reduce his
risk.
Your next patient is a 5-year-old child with a history of moderate persistent asthma. He has been
wheezing and coughing for the past two days, and his mother brings him in today for
evaluation. He has been using albuterol every four hours. His respiratory rate is 13 breaths per
minute; his lungs are clear to auscultation; and no retractions are noted. What may be your
assessment and intervention based on this information? - ANSWER Your child is breathing
slower than normal for his age. We need to send him to the ER for further intervention.
Your next patient is a 6-year-old male here for his annual influenza vaccine. He has a history of
mild persistent asthma. What would you discuss for medications when reviewing his asthma
action plan? - ANSWER Your child should continue his low-dose inhaled corticosteroid daily and
add albuterol as needed for an exacerbation.
, Which of the following is a common cause of acquired coronary artery disease in children? -
ANSWER Kawasaki disease
Your next patient is a 14-year-old female who presents to your office with a complaint of
syncope at school. She had just stood up from her chair at the end of the day, felt dizzy and
nauseous, and then woke up on the floor. She did not hit her head and woke up within 30
seconds. What is your impression, and what would you do next? - ANSWER At this age, children
may have these episodes called neurally mediated syncope. We will schedule an EKG.
A child is brought to the clinic immediately after being stung by a wasp while playing in the yard.
The PE reveals localized redness and edema at the site along with abdominal tenderness,
watery eyes and generalized hives. What is the initial treatment? - ANSWER Administer IM
epinephrine
A child is brought to the clinic with a generalized annular rash characterized by raised wheals
with pale centers. On PE, the child's lungs are clear and there is no peripheral edema. A history
reveals ingestion of strawberries earlier in the day. What is the initial treatment? - ANSWER
Diphenhydramine .05-1 mg/kg/dose every 4-6 hours
A child who has been diagnosed with asthma for several years has been using a short-acting
Beta-agonist (SABA) to control symptoms. The PNP learns that the child has recently begun
using the SABA 2-3 times each week to prevent wheezing and shortness of breath. The child
currently has clear breath sounds and an FEV1 of 75% of personal best. What will the NP do? -
ANSWER Add an inhaled corticosteroid.
A child has fever and arthralgia. The PNP learns that the child had a sore throat 3 weeks prior
and auscultates a murmur in the clinic.
§What test will the PNP order? - ANSWER ASO titer
