NR602 FINAL EXAM / NR 602 |! |! |! |! |! |!
FINAL EXAM LATEST REAL EXAM |! |! |! |! |!
WITH CORRECT ANSWERS |! |!
The parent of an infant experiencing colic asks about using a
|! |! |! |! |! |! |! |! |! |! |!
probiotic medication. What will the primary care pediatric NP tell
|! |! |! |! |! |! |! |! |!
this parent?
|! |!
A. Probiotic medications have demonstrated efficacy in treating
|! |! |! |! |! |! |! |!
colic.
B. Probiotics are not safe to use to treat infants who have colic.
|! |! |! |! |! |! |! |! |! |! |! |! |!
C. There are no studies showing usefulness of probiotic to
|! |! |! |! |! |! |! |! |! |!
manage colic. |!
D. There is no conclusive evidence about using probiotics to
|! |! |! |! |! |! |! |! |! |!
treat colic. - Correct answer ✔D. There is no conclusive evidence
|! |! |! |! |! |! |! |! |! |!
about using probiotics to treat colic.
|! |! |! |! |! |!
A toddler who was born prematurely refuses most solid foods
|! |! |! |! |! |! |! |! |! |!
and has poor weight gain. A barium swallow study reveals a
|! |! |! |! |! |! |! |! |! |! |!
normal esophagus. What will the primary care pediatric NP
|! |! |! |! |! |! |! |! |!
consider the next to manage this child's nutritional needs?
|! |! |! |! |! |! |! |!
A. consultation with dietician
|! |! |!
B. Fiberoptic endoscopy evaluation.
|! |! |!
C. MRI |!
D. Videofluroscopy swallowing study (VOSS) - Correct answer
|! |! |! |! |! |! |! |!
✔D. Videofluroscopy swallowing study (VOSS)
|! |! |! |!
,A toddler is seen in clinic after a 2-day hx of intermittent V/D.
|! |! |! |! |! |! |! |! |! |! |! |! |!
An assessment reveals an irritable child with dry mucous
|! |! |! |! |! |! |! |! |!
membranes, 3-second cap refill. 2-second recoil of skin, mild |! |! |! |! |! |! |! |! |!
tachycardia and tachypnea, and cool hands and feet. The child |! |! |! |! |! |! |! |! |! |!
has had 2 wet diapers in the past 24 hours. What will the
|! |! |! |! |! |! |! |! |! |! |! |! |!
primary care pediatric NP recommend? |! |! |! |!
A. anti-diarrheal medication & clear fluids for 24H
|! |! |! |! |! |! |!
B. Bolus of IV NS in the clinic until improvement
|! |! |! |! |! |! |! |! |!
C. Hospital admission for IV rehydration & oral fluids
|! |! |! |! |! |! |! |!
D. Oral rehydration solution with f/u in 24H - Correct answer ✔D.
|! |! |! |! |! |! |! |! |! |! |!
Oral rehydration solution with f/u in 24H
|! |! |! |! |! |! |!
A 9-year old girl has a hx of frequent vomiting and her mother
|! |! |! |! |! |! |! |! |! |! |! |! |!
has frequent migraine ha. The child has recently begun having
|! |! |! |! |! |! |! |! |! |!
more frequent and prolonged episodes accompanied by
|! |! |! |! |! |! |!
headaches. An exam reveals abnormal eye movement and mild |! |! |! |! |! |! |! |! |!
ataxia. What is the correct action? |! |! |! |! |!
A. begin using anti-migraine meds to prevent HA
|! |! |! |! |! |! |!
B. Prescribe ondansetron and lorazepam to help manage sx
|! |! |! |! |! |! |! |!
C. Reassure the parent that this is expected with cyclic vomiting
|! |! |! |! |! |! |! |! |! |! |!
syndrome
D. Refer to a pediatric gastroenterologist for further workup. -
|! |! |! |! |! |! |! |! |! |!
Correct answer ✔D. Refer to a pediatric gastroenterologist for
|! |! |! |! |! |! |! |! |!
further workup. |!
The parent of a 3-month-old reports that the infant reports that
|! |! |! |! |! |! |! |! |! |! |!
the infant arches and gags while feeding and spits up
|! |! |! |! |! |! |! |! |! |!
undigested formula frequently. The infant's weight gain has |! |! |! |! |! |! |! |!
,dropped to the 5th percentile from the 12th. What is the best
|! |! |! |! |! |! |! |! |! |! |! |!
course of tx for this infant? |! |! |! |! |!
A. Begin a trial of extensively hydrolyzed protein formula for 2-4
|! |! |! |! |! |! |! |! |! |! |!
wks.
B. Institute an emperic trial of acid suppression with a PPI
|! |! |! |! |! |! |! |! |! |!
C. Perform esophageal pH monitoring to determine the degree of
|! |! |! |! |! |! |! |! |!
reflux.
|!
D. Reassure the parent that these sx will likely resolved by 12-
|! |! |! |! |! |! |! |! |! |! |!
24 mo. - Correct answer ✔A. Begin a trial of extensively
|! |! |! |! |! |! |! |! |! |! |!
hydrolyzed protein formula for 2-4 wks. |! |! |! |! |!
A school-age child has a 3-month hx of dull, aching epigastric
|! |! |! |! |! |! |! |! |! |! |!
pain that worsens with eating and awakens from sleep. A CBC
|! |! |! |! |! |! |! |! |! |! |!
shows a Hgb of 8mg/dL. What is the next step in management.
|! |! |! |! |! |! |! |! |! |! |! |!
A. Administration of H RA or PPI meds
|! |! |! |! |! |! |!
B. Empiric therapy for H. pylori
|! |! |! |! |!
C. Ordering an upper GI series
|! |! |! |! |!
D. Referral for EGD - Correct answer ✔D. Referral for EGD
|! |! |! |! |! |! |! |! |! |!
A 2-mo old infant cries up to 4 hours each day and according to
|! |! |! |! |! |! |! |! |! |! |! |! |! |!
the parents, is inconsolable during crying episodes with fits and
|! |! |! |! |! |! |! |! |! |!
legs notes to be tense and stiff. The infant is breastfeeding
|! |! |! |! |! |! |! |! |! |! |!
frequently but is often fussy during feedings. The PE is normal |! |! |! |! |! |! |! |! |! |! |!
and the infant is gaining weight normally. What will the primary
|! |! |! |! |! |! |! |! |! |! |!
care pediatric NP recommend? |! |! |!
A. A complete work-up, including lab and radiologic tests.
|! |! |! |! |! |! |! |!
B. Eliminating certain foods from the mother's diet.
|! |! |! |! |! |! |!
C. Empiric tx w/PPI
|! |! |!
, D. Stopping breastfeeding & beginning a hydrolyzed formula -
|! |! |! |! |! |! |! |! |!
Correct answer ✔B. Eliminating certain foods from the mother's
|! |! |! |! |! |! |! |! |!
diet.
A child is in the clinic after swallowing a metal bead. A
|! |! |! |! |! |! |! |! |! |! |! |!
radiograph of the GI tract shows a 6 mm cylindrical object in the |! |! |! |! |! |! |! |! |! |! |! |!
child's stomach. The child is able to swallow without difficulty
|! |! |! |! |! |! |! |! |! |! |!
and is not experiencing pain. What is the correct course of
|! |! |! |! |! |! |! |! |! |! |!
treatment?
a. Administer ipecac to induce vomiting.
|! |! |! |! |!
b. Have the parents watch for the object in the child's stool.
|! |! |! |! |! |! |! |! |! |! |!
c. Insert a nasogastric tube to flush out the object.
|! |! |! |! |! |! |! |! |!
d. Refer the child for endoscopic removal of the object. - Correct
|! |! |! |! |! |! |! |! |! |! |! |!
answer ✔b. Have the parents watch for the object in the child's
|! |! |! |! |! |! |! |! |! |! |! |!
stool.
A 10-year-old child has had abdominal pain for 2 days, which
|! |! |! |! |! |! |! |! |! |! |!
began in the periumbilical area and then localized to the RLQ.
|! |! |! |! |! |! |! |! |! |! |!
The child vomited once today and then experienced relief from
|! |! |! |! |! |! |! |! |! |!
pain followed by an increased fever. What is the likely diagnosis?
|! |! |! |! |! |! |! |! |! |!
A. Appendicitis w/perf
|! |!
B. Gastroenteritis
|!
C. Pelvic inflammatory disease (PID)
|! |! |! |!
D. UTI - Correct answer ✔A. Appendicitis w/perf
|! |! |! |! |! |! |!
An 18-month-old child has a 1-day hx of intermittent, cramping
|! |! |! |! |! |! |! |! |! |!
abd pain w/non-bilious vomiting. The child observed to scream
|! |! |! |! |! |! |! |! |!
and draw up his legs during pain episodes and becomes
|! |! |! |! |! |! |! |! |! |!
FINAL EXAM LATEST REAL EXAM |! |! |! |! |!
WITH CORRECT ANSWERS |! |!
The parent of an infant experiencing colic asks about using a
|! |! |! |! |! |! |! |! |! |! |!
probiotic medication. What will the primary care pediatric NP tell
|! |! |! |! |! |! |! |! |!
this parent?
|! |!
A. Probiotic medications have demonstrated efficacy in treating
|! |! |! |! |! |! |! |!
colic.
B. Probiotics are not safe to use to treat infants who have colic.
|! |! |! |! |! |! |! |! |! |! |! |! |!
C. There are no studies showing usefulness of probiotic to
|! |! |! |! |! |! |! |! |! |!
manage colic. |!
D. There is no conclusive evidence about using probiotics to
|! |! |! |! |! |! |! |! |! |!
treat colic. - Correct answer ✔D. There is no conclusive evidence
|! |! |! |! |! |! |! |! |! |!
about using probiotics to treat colic.
|! |! |! |! |! |!
A toddler who was born prematurely refuses most solid foods
|! |! |! |! |! |! |! |! |! |!
and has poor weight gain. A barium swallow study reveals a
|! |! |! |! |! |! |! |! |! |! |!
normal esophagus. What will the primary care pediatric NP
|! |! |! |! |! |! |! |! |!
consider the next to manage this child's nutritional needs?
|! |! |! |! |! |! |! |!
A. consultation with dietician
|! |! |!
B. Fiberoptic endoscopy evaluation.
|! |! |!
C. MRI |!
D. Videofluroscopy swallowing study (VOSS) - Correct answer
|! |! |! |! |! |! |! |!
✔D. Videofluroscopy swallowing study (VOSS)
|! |! |! |!
,A toddler is seen in clinic after a 2-day hx of intermittent V/D.
|! |! |! |! |! |! |! |! |! |! |! |! |!
An assessment reveals an irritable child with dry mucous
|! |! |! |! |! |! |! |! |!
membranes, 3-second cap refill. 2-second recoil of skin, mild |! |! |! |! |! |! |! |! |!
tachycardia and tachypnea, and cool hands and feet. The child |! |! |! |! |! |! |! |! |! |!
has had 2 wet diapers in the past 24 hours. What will the
|! |! |! |! |! |! |! |! |! |! |! |! |!
primary care pediatric NP recommend? |! |! |! |!
A. anti-diarrheal medication & clear fluids for 24H
|! |! |! |! |! |! |!
B. Bolus of IV NS in the clinic until improvement
|! |! |! |! |! |! |! |! |!
C. Hospital admission for IV rehydration & oral fluids
|! |! |! |! |! |! |! |!
D. Oral rehydration solution with f/u in 24H - Correct answer ✔D.
|! |! |! |! |! |! |! |! |! |! |!
Oral rehydration solution with f/u in 24H
|! |! |! |! |! |! |!
A 9-year old girl has a hx of frequent vomiting and her mother
|! |! |! |! |! |! |! |! |! |! |! |! |!
has frequent migraine ha. The child has recently begun having
|! |! |! |! |! |! |! |! |! |!
more frequent and prolonged episodes accompanied by
|! |! |! |! |! |! |!
headaches. An exam reveals abnormal eye movement and mild |! |! |! |! |! |! |! |! |!
ataxia. What is the correct action? |! |! |! |! |!
A. begin using anti-migraine meds to prevent HA
|! |! |! |! |! |! |!
B. Prescribe ondansetron and lorazepam to help manage sx
|! |! |! |! |! |! |! |!
C. Reassure the parent that this is expected with cyclic vomiting
|! |! |! |! |! |! |! |! |! |! |!
syndrome
D. Refer to a pediatric gastroenterologist for further workup. -
|! |! |! |! |! |! |! |! |! |!
Correct answer ✔D. Refer to a pediatric gastroenterologist for
|! |! |! |! |! |! |! |! |!
further workup. |!
The parent of a 3-month-old reports that the infant reports that
|! |! |! |! |! |! |! |! |! |! |!
the infant arches and gags while feeding and spits up
|! |! |! |! |! |! |! |! |! |!
undigested formula frequently. The infant's weight gain has |! |! |! |! |! |! |! |!
,dropped to the 5th percentile from the 12th. What is the best
|! |! |! |! |! |! |! |! |! |! |! |!
course of tx for this infant? |! |! |! |! |!
A. Begin a trial of extensively hydrolyzed protein formula for 2-4
|! |! |! |! |! |! |! |! |! |! |!
wks.
B. Institute an emperic trial of acid suppression with a PPI
|! |! |! |! |! |! |! |! |! |!
C. Perform esophageal pH monitoring to determine the degree of
|! |! |! |! |! |! |! |! |!
reflux.
|!
D. Reassure the parent that these sx will likely resolved by 12-
|! |! |! |! |! |! |! |! |! |! |!
24 mo. - Correct answer ✔A. Begin a trial of extensively
|! |! |! |! |! |! |! |! |! |! |!
hydrolyzed protein formula for 2-4 wks. |! |! |! |! |!
A school-age child has a 3-month hx of dull, aching epigastric
|! |! |! |! |! |! |! |! |! |! |!
pain that worsens with eating and awakens from sleep. A CBC
|! |! |! |! |! |! |! |! |! |! |!
shows a Hgb of 8mg/dL. What is the next step in management.
|! |! |! |! |! |! |! |! |! |! |! |!
A. Administration of H RA or PPI meds
|! |! |! |! |! |! |!
B. Empiric therapy for H. pylori
|! |! |! |! |!
C. Ordering an upper GI series
|! |! |! |! |!
D. Referral for EGD - Correct answer ✔D. Referral for EGD
|! |! |! |! |! |! |! |! |! |!
A 2-mo old infant cries up to 4 hours each day and according to
|! |! |! |! |! |! |! |! |! |! |! |! |! |!
the parents, is inconsolable during crying episodes with fits and
|! |! |! |! |! |! |! |! |! |!
legs notes to be tense and stiff. The infant is breastfeeding
|! |! |! |! |! |! |! |! |! |! |!
frequently but is often fussy during feedings. The PE is normal |! |! |! |! |! |! |! |! |! |! |!
and the infant is gaining weight normally. What will the primary
|! |! |! |! |! |! |! |! |! |! |!
care pediatric NP recommend? |! |! |!
A. A complete work-up, including lab and radiologic tests.
|! |! |! |! |! |! |! |!
B. Eliminating certain foods from the mother's diet.
|! |! |! |! |! |! |!
C. Empiric tx w/PPI
|! |! |!
, D. Stopping breastfeeding & beginning a hydrolyzed formula -
|! |! |! |! |! |! |! |! |!
Correct answer ✔B. Eliminating certain foods from the mother's
|! |! |! |! |! |! |! |! |!
diet.
A child is in the clinic after swallowing a metal bead. A
|! |! |! |! |! |! |! |! |! |! |! |!
radiograph of the GI tract shows a 6 mm cylindrical object in the |! |! |! |! |! |! |! |! |! |! |! |!
child's stomach. The child is able to swallow without difficulty
|! |! |! |! |! |! |! |! |! |! |!
and is not experiencing pain. What is the correct course of
|! |! |! |! |! |! |! |! |! |! |!
treatment?
a. Administer ipecac to induce vomiting.
|! |! |! |! |!
b. Have the parents watch for the object in the child's stool.
|! |! |! |! |! |! |! |! |! |! |!
c. Insert a nasogastric tube to flush out the object.
|! |! |! |! |! |! |! |! |!
d. Refer the child for endoscopic removal of the object. - Correct
|! |! |! |! |! |! |! |! |! |! |! |!
answer ✔b. Have the parents watch for the object in the child's
|! |! |! |! |! |! |! |! |! |! |! |!
stool.
A 10-year-old child has had abdominal pain for 2 days, which
|! |! |! |! |! |! |! |! |! |! |!
began in the periumbilical area and then localized to the RLQ.
|! |! |! |! |! |! |! |! |! |! |!
The child vomited once today and then experienced relief from
|! |! |! |! |! |! |! |! |! |!
pain followed by an increased fever. What is the likely diagnosis?
|! |! |! |! |! |! |! |! |! |!
A. Appendicitis w/perf
|! |!
B. Gastroenteritis
|!
C. Pelvic inflammatory disease (PID)
|! |! |! |!
D. UTI - Correct answer ✔A. Appendicitis w/perf
|! |! |! |! |! |! |!
An 18-month-old child has a 1-day hx of intermittent, cramping
|! |! |! |! |! |! |! |! |! |!
abd pain w/non-bilious vomiting. The child observed to scream
|! |! |! |! |! |! |! |! |!
and draw up his legs during pain episodes and becomes
|! |! |! |! |! |! |! |! |! |!
