NR602 Verified Multiple Choice and Conceptual
Actual Emended Exam Questions With Reviewed
100% Correct Detailed Answers
Guaranteed Pass!!Current Update
1. A 3-year-old child has had one episode of acute otitis media 3 weeks prior
with a normal tympanogram just after treatment with amoxicillin. In the clinic
today, the child has a type B tympanogram, a temperature of 102.5°F, and a
bulging tympanic membrane. What will the primary care pediatric nurse
practitioner order?
a) A referral for tympanocentesis
b) Amoxicillin twice daily
c) Amoxicillin-clavulanate twice daily
d) Intramuscular ceftriaxone - ANSWER ANS: C
Amoxicillin-clavulanate should be given for failed therapy with amoxicillin or when
the child has had AOM treated with amoxicillin within the past month.
2. A 3-year-old child with pressure-equalizing tubes (PET) in both ears has
otalgia in one ear. The primary care pediatric nurse practitioner is able to
visualize the tube and does not see exudate in the ear canal and obtains a type
A tympanogram. What will the nurse practitioner do?
a) Order ototopical antibiotic/corticosteroid drops.
b) Prescribe a prophylactic antibiotic medication.
c) Reassure the parent that this is a normal exam.
d) Refer the child to an otolaryngologist for follow-up - ANSWER ANS: A
A normal, or type A, tympanogram in a child with PET may indicate a clogged
tube. Ototopical antibiotic/corticosteroid drops can occasionally clear a clogged
,PET. Prophylactic antibiotics are not recommended to prevent otitis media. It is
not necessary to refer unless the pain continues in spite of standard measures.
3. The primary care pediatric nurse practitioner obtains a tympanogram on a
child that reveals a sharp peak of -180 mm H2O. What does this value
indicate?
a) A normal tympanic membrane
b) Middle ear effusion
c) Negative ear pressure
d) Tympanic membrane perforation - ANSWER ANS: C
The type C tympanogram has a sharp peak between -100 and -200 mm H2O and
reflects negative ear pressure. A normal tympanogram has a sharp positive peak
or a type A tympanogram. Middle ear effusion and a TM perforation both cause a
type B tympanogram with either no peak or a flattened wave.
4. A child complains of itching in both ears and is having trouble hearing. The
primary care pediatric nurse practitioner notes periauricular edema and
marked swelling of the external auditory canal and elicits severe pain when
manipulating the external ear structures. Which is an appropriate
intervention?
a) Obtain a culture of the external auditory canal.
b) Order ototopical antibiotic/corticosteroid drops.
c) Prescribe oral amoxicillin-clavulanate.
d) Refer the child to an otolaryngologist. - ANSWER ANS: B
Ototopical antibiotic/corticosteroid drops are the mainstay of therapy for OE. It is
not necessary to obtain a culture unless the infection does not respond to
treatment. Oral antibiotics are not indicated unless impetigo occurs and is severe.
A referral to a specialist is not recommended.
,5. The primary care pediatric nurse practitioner notes a small, round object in a
child's external auditory canal, near the tympanic membrane. The child's
parent thinks it is probably a dried pea. What will the nurse practitioner do to
remove this object?
a) Irrigate the external auditory canal to flush out the object.
b) Refer the child to an otolaryngologist for removal.
c) Remove the object with a wire loop curette.
d) Use a bayonet forceps to grasp and remove the object. - ANSWER ANS:
B
Spherical objects are the most difficult to remove and should be referred.
Irrigation is not recommended for objects made of organic material and also
increases the risk of pushing the object farther down.
6. A 15-year-old female has a positive pregnancy test and asks the primary care
pediatric nurse practitioner not to tell her parents. She is tearful and says she
isn't sure she wants to keep the baby. What will the nurse practitioner do first?
a) Determine the state-mandated reporting laws.
b) Encourage the adolescent to talk to her parents.
c) Obtain a social work consult to discuss adoption options.
d) Refer her to a prenatal care specialist for follow-up. - ANSWER ANS: A
The PNP should first determine what the state's reporting laws are in case there
are mandatory provisions for reporting statutory rape. The other options may be
correct, depending on the laws and on the decisions of the adolescent.
7. An adolescent female has heavy periods that are also irregular. The physical
exam is normal. A complete blood count reveals a hemoglobin of 8.9 g/dL.
What test will the primary care pediatric nurse practitioner order next?
a) Coagulation studies
b) C-reactive protein
c) Thyroid function
, d) Ultrasound of pelvis - ANSWER ANS: A
If the patient's hemoglobin is low, coagulation studies should be ordered. CRP is
ordered if infection is suspected. Thyroid function is indicated if systemic disease
is suspected. A pelvic ultrasound is ordered if a mass is palpated, anomaly is
suspected, bimanual exam cannot be completed, or if the condition is
unresponsive to treatment.
8. A 16-year-old female reports dull, achy cramping pain in her lower abdomen
lasting 2 or 3 hours that occurs between her menstrual periods each month.
The adolescent is not sexually active. What is the treatment for this condition?
a) Abdominal ultrasound to rule out ovarian cyst
b) Oral contraceptives to suppress ovulation
c) Prostaglandin inhibitor analgesics and a heating pad
d) Referral to a pediatric gynecologist - ANSWER ANS: C
The adolescent is experiencing mittelschmerz pain, which is thought to occur
when the follicle ruptures at the time of ovulation. Unless the pain is severe, the
adolescent should be reassured and offered strategies to relieve discomfort, such
as a heating pad and NSAIDs. The pain is intermittent and occurs between
periods; if it were persistent and severe, abdominal US would be indicated. Oral
contraceptives are rarely used to suppress ovulation when symptoms are severe.
Referral to a pediatric gynecologist is not indicated.
9. An adolescent female tells the primary care pediatric nurse practitioner that
she had unprotected sexual intercourse 4 days prior and is worried she might
become pregnant. What will the nurse practitioner do?
a) Prescribe ulipristal acetate (Ella).
b) Recommend levonorgestrel (Plan B One Step).
c) Start a combination OCP at regular doses.
d) Suggest using the less expensive After Pill preparation. - ANSWER ANS:
A
Actual Emended Exam Questions With Reviewed
100% Correct Detailed Answers
Guaranteed Pass!!Current Update
1. A 3-year-old child has had one episode of acute otitis media 3 weeks prior
with a normal tympanogram just after treatment with amoxicillin. In the clinic
today, the child has a type B tympanogram, a temperature of 102.5°F, and a
bulging tympanic membrane. What will the primary care pediatric nurse
practitioner order?
a) A referral for tympanocentesis
b) Amoxicillin twice daily
c) Amoxicillin-clavulanate twice daily
d) Intramuscular ceftriaxone - ANSWER ANS: C
Amoxicillin-clavulanate should be given for failed therapy with amoxicillin or when
the child has had AOM treated with amoxicillin within the past month.
2. A 3-year-old child with pressure-equalizing tubes (PET) in both ears has
otalgia in one ear. The primary care pediatric nurse practitioner is able to
visualize the tube and does not see exudate in the ear canal and obtains a type
A tympanogram. What will the nurse practitioner do?
a) Order ototopical antibiotic/corticosteroid drops.
b) Prescribe a prophylactic antibiotic medication.
c) Reassure the parent that this is a normal exam.
d) Refer the child to an otolaryngologist for follow-up - ANSWER ANS: A
A normal, or type A, tympanogram in a child with PET may indicate a clogged
tube. Ototopical antibiotic/corticosteroid drops can occasionally clear a clogged
,PET. Prophylactic antibiotics are not recommended to prevent otitis media. It is
not necessary to refer unless the pain continues in spite of standard measures.
3. The primary care pediatric nurse practitioner obtains a tympanogram on a
child that reveals a sharp peak of -180 mm H2O. What does this value
indicate?
a) A normal tympanic membrane
b) Middle ear effusion
c) Negative ear pressure
d) Tympanic membrane perforation - ANSWER ANS: C
The type C tympanogram has a sharp peak between -100 and -200 mm H2O and
reflects negative ear pressure. A normal tympanogram has a sharp positive peak
or a type A tympanogram. Middle ear effusion and a TM perforation both cause a
type B tympanogram with either no peak or a flattened wave.
4. A child complains of itching in both ears and is having trouble hearing. The
primary care pediatric nurse practitioner notes periauricular edema and
marked swelling of the external auditory canal and elicits severe pain when
manipulating the external ear structures. Which is an appropriate
intervention?
a) Obtain a culture of the external auditory canal.
b) Order ototopical antibiotic/corticosteroid drops.
c) Prescribe oral amoxicillin-clavulanate.
d) Refer the child to an otolaryngologist. - ANSWER ANS: B
Ototopical antibiotic/corticosteroid drops are the mainstay of therapy for OE. It is
not necessary to obtain a culture unless the infection does not respond to
treatment. Oral antibiotics are not indicated unless impetigo occurs and is severe.
A referral to a specialist is not recommended.
,5. The primary care pediatric nurse practitioner notes a small, round object in a
child's external auditory canal, near the tympanic membrane. The child's
parent thinks it is probably a dried pea. What will the nurse practitioner do to
remove this object?
a) Irrigate the external auditory canal to flush out the object.
b) Refer the child to an otolaryngologist for removal.
c) Remove the object with a wire loop curette.
d) Use a bayonet forceps to grasp and remove the object. - ANSWER ANS:
B
Spherical objects are the most difficult to remove and should be referred.
Irrigation is not recommended for objects made of organic material and also
increases the risk of pushing the object farther down.
6. A 15-year-old female has a positive pregnancy test and asks the primary care
pediatric nurse practitioner not to tell her parents. She is tearful and says she
isn't sure she wants to keep the baby. What will the nurse practitioner do first?
a) Determine the state-mandated reporting laws.
b) Encourage the adolescent to talk to her parents.
c) Obtain a social work consult to discuss adoption options.
d) Refer her to a prenatal care specialist for follow-up. - ANSWER ANS: A
The PNP should first determine what the state's reporting laws are in case there
are mandatory provisions for reporting statutory rape. The other options may be
correct, depending on the laws and on the decisions of the adolescent.
7. An adolescent female has heavy periods that are also irregular. The physical
exam is normal. A complete blood count reveals a hemoglobin of 8.9 g/dL.
What test will the primary care pediatric nurse practitioner order next?
a) Coagulation studies
b) C-reactive protein
c) Thyroid function
, d) Ultrasound of pelvis - ANSWER ANS: A
If the patient's hemoglobin is low, coagulation studies should be ordered. CRP is
ordered if infection is suspected. Thyroid function is indicated if systemic disease
is suspected. A pelvic ultrasound is ordered if a mass is palpated, anomaly is
suspected, bimanual exam cannot be completed, or if the condition is
unresponsive to treatment.
8. A 16-year-old female reports dull, achy cramping pain in her lower abdomen
lasting 2 or 3 hours that occurs between her menstrual periods each month.
The adolescent is not sexually active. What is the treatment for this condition?
a) Abdominal ultrasound to rule out ovarian cyst
b) Oral contraceptives to suppress ovulation
c) Prostaglandin inhibitor analgesics and a heating pad
d) Referral to a pediatric gynecologist - ANSWER ANS: C
The adolescent is experiencing mittelschmerz pain, which is thought to occur
when the follicle ruptures at the time of ovulation. Unless the pain is severe, the
adolescent should be reassured and offered strategies to relieve discomfort, such
as a heating pad and NSAIDs. The pain is intermittent and occurs between
periods; if it were persistent and severe, abdominal US would be indicated. Oral
contraceptives are rarely used to suppress ovulation when symptoms are severe.
Referral to a pediatric gynecologist is not indicated.
9. An adolescent female tells the primary care pediatric nurse practitioner that
she had unprotected sexual intercourse 4 days prior and is worried she might
become pregnant. What will the nurse practitioner do?
a) Prescribe ulipristal acetate (Ella).
b) Recommend levonorgestrel (Plan B One Step).
c) Start a combination OCP at regular doses.
d) Suggest using the less expensive After Pill preparation. - ANSWER ANS:
A
