NUNP 6541 Pediatric Final Exam- |\ |\ |\ |\
Walden U questions with answers |\ |\ |\ |\
Recommended treatment for RSV in a 7 month old (outpatient) - |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔Use of saline drops and suctioning of the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
nares. Indications of when to use antipyretics. Signs of
|\ |\ |\ |\ |\ |\ |\ |\ |\
respiratory distress or dehydration. Guidelines for feeding an
|\ |\ |\ |\ |\ |\ |\ |\
infant with signs of mild respiratory distress which includes
|\ |\ |\ |\ |\ |\ |\ |\ |\
smaller more frequent feedings; monitoring of the respiratory
|\ |\ |\ |\ |\ |\ |\ |\
rate; and guarding against vomiting. The parents should be
|\ |\ |\ |\ |\ |\ |\ |\ |\
educated that the child may have the symptoms over the course
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
of 2-3 weeks
|\ |\
Epiglottitis s/s - CORRECT ANSWERS ✔✔Acute and rapid onset of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
high fever, chills, and toxicity. Severe sore throat and drooling
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
saliva. Will not eat or drink, muffled (hot potato) voice, and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
anxiety. Sitting posture with hyperextended neck with open-
|\ |\ |\ |\ |\ |\ |\
mouth breathing. Stridor, tachycardia, and tachypnea
|\ |\ |\ |\ |\
Epiglottitis prevention - CORRECT ANSWERS ✔✔Haemophilus
|\ |\ |\ |\ |\ |\
influenzae type B (Hib) vaccine |\ |\ |\ |\
Steeple sign - CORRECT ANSWERS ✔✔a radiologic sign found on
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
radiograph where the subglottic tracheal narrowing produces a
|\ |\ |\ |\ |\ |\ |\ |\
shape of a church steeple which supports a diagnosis of croup
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Foreign body aspiration antibiotic? - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\
✔✔Depends on the nature of the material aspirated, plus the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
,location and degree of obstruction. Bronchial or laryngeal foreign
|\ |\ |\ |\ |\ |\ |\ |\ |\
body aspiration, a bronchoscopy must be performed for removal
|\ |\ |\ |\ |\ |\ |\ |\ |\
of the foreign body
|\ |\ |\
Antibiotics for bronchiolitis? - CORRECT ANSWERS ✔✔Use of |\ |\ |\ |\ |\ |\ |\ |\
saline drops and suctioning of the nares. There is no evidence to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
support the routine use of antibiotics |\ |\ |\ |\ |\
Antibiotics for croup? - CORRECT ANSWERS ✔✔Nebulized |\ |\ |\ |\ |\ |\ |\
epinephrine, corticosteroids (dexamethasone oral or IM), blow by |\ |\ |\ |\ |\ |\ |\ |\
oxygen or heliox in severe croup. Racemic epinephrine with the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
use of corticosteroids to limit rebound swelling
|\ |\ |\ |\ |\ |\
Antibiotics for epiglottitis? - CORRECT ANSWERS ✔✔Establish an |\ |\ |\ |\ |\ |\ |\ |\
airway preferably by nasotracheal intubation. Administer IV
|\ |\ |\ |\ |\ |\ |\
antibiotics such as rocephin to cover H.influenzae. Administer
|\ |\ |\ |\ |\ |\ |\ |\
oxygen and respiratory support. Antibiotics should be continued
|\ |\ |\ |\ |\ |\ |\ |\
for 10 days. Rifampin prophylaxis 20 mg/kg in a single dose
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
(maximum of 600 mg) for 4 days for infants and children, 600 |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
mg once a day for adults for 4 days. Should be provided for
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
household contacts who are at risk (Younger than 4 years old
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
who is non-immunized or incompletely immunized, children less
|\ |\ |\ |\ |\ |\ |\ |\
than 12 months who have not received primary series of Hib, and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
immunocompromised children.
|\ |\
Asthma treatment - CORRECT ANSWERS ✔✔The pharmacological
|\ |\ |\ |\ |\ |\ |\
management of asthma in children is based on the severity of |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
asthma and the child's age. After initial control, decrease
|\ |\ |\ |\ |\ |\ |\ |\ |\
treatment to the least amount of medication needed to maintain
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
control. Systemic corticosteroids may be needed at any time and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
stepped up if there is a major flare-up of symptoms.
|\ |\ |\ |\ |\ |\ |\ |\ |\
,Step 1 Asthma management for children 0-4 years old -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔Step 1: SABA (Short acting beta2-
|\ |\ |\ |\ |\ |\ |\
agonist) PRN: With viral respiratory symptoms short acting beta
|\ |\ |\ |\ |\ |\ |\ |\ |\
2-agonist should be used every 4-6 hours up to 24 hours (longer
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
with a physician consult). Consider short course of oral systemic
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
corticosteroids if severe exacerbation. Frequent use of SABA may |\ |\ |\ |\ |\ |\ |\ |\
indicate the need to step up treatment
|\ |\ |\ |\ |\ |\ |\
Step 2 Asthma management for children 0-4 years old -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔Step 2: Consider consultation with
|\ |\ |\ |\ |\ |\ |\
asthma specialist. Low dose of inhaled corticosteroids.
|\ |\ |\ |\ |\ |\
Step 3 asthma mgmt for children 0-4 yrs - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔Step 3: Medium-dose of inhaled corticosteroids
|\ |\ |\ |\ |\
Steps 4-6 asthma mgmt for children 0-4 yrs - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔Step 4: Medium-dose ICS and Long acting beta2-agonist or
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
montelukast. |\
Step 5: High dose ICS and Long acting beta 2-agonist or
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
montelukast. |\
Step 6: High dose of ICS and LABA or montelukast and oral
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
corticosteroids
Steps 1-3 asthma mgmt for children 5-11 yrs - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔Step 1: SABA (Short acting beta 2-agonist) PRN:
|\ |\ |\ |\ |\ |\ |\ |\ |\
Increasing the use of short-acting beta 2-agonist or use greater
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
, than 2 days a week for symptom relief generally indicates
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
inadequate control and the need to step up treatment. |\ |\ |\ |\ |\ |\ |\ |\ |\
Step 2: Consider consultation with asthma specialist. Low dose of
|\ |\ |\ |\ |\ |\ |\ |\ |\
inhaled corticosteroids.
|\ |\ |\
Step 3: Low dose of inhaled corticosteroid and LABA. Or medium
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
dose of inhaled corticosteroids.
|\ |\ |\
Steps 4-6 asthma mgmt for children 5-11 yrs - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔Step 4: Medium-dose ICS and LABA or medium
|\ |\ |\ |\ |\ |\ |\ |\ |\
dose of inhaled corticosteroid and leukotriene receptor antagonist
|\ |\ |\ |\ |\ |\ |\
or theophylline. .
|\ |\ |\ |\
Step 5: High dose ICS and LABA or high dose of inhaled
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
corticosteroid and leukotriene receptor antagonist or |\ |\ |\ |\ |\ |\
theophylline. . |\ |\
Step 6: High dose of ICS and LABA and oral corticosteroids or
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
high dose of inhaled corticosteroids and leukotriene receptor
|\ |\ |\ |\ |\ |\ |\ |\
antagonist or theophylline and oral corticosteroids. |\ |\ |\ |\ |\ |\
** Theophylline levels must be monitored.
|\ |\ |\ |\ |\
Differentials for patient with sore throat - CORRECT ANSWERS |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔Strep pharyngitis |\
Peritonsillar abscess |\
Walden U questions with answers |\ |\ |\ |\
Recommended treatment for RSV in a 7 month old (outpatient) - |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔Use of saline drops and suctioning of the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
nares. Indications of when to use antipyretics. Signs of
|\ |\ |\ |\ |\ |\ |\ |\ |\
respiratory distress or dehydration. Guidelines for feeding an
|\ |\ |\ |\ |\ |\ |\ |\
infant with signs of mild respiratory distress which includes
|\ |\ |\ |\ |\ |\ |\ |\ |\
smaller more frequent feedings; monitoring of the respiratory
|\ |\ |\ |\ |\ |\ |\ |\
rate; and guarding against vomiting. The parents should be
|\ |\ |\ |\ |\ |\ |\ |\ |\
educated that the child may have the symptoms over the course
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
of 2-3 weeks
|\ |\
Epiglottitis s/s - CORRECT ANSWERS ✔✔Acute and rapid onset of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
high fever, chills, and toxicity. Severe sore throat and drooling
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
saliva. Will not eat or drink, muffled (hot potato) voice, and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
anxiety. Sitting posture with hyperextended neck with open-
|\ |\ |\ |\ |\ |\ |\
mouth breathing. Stridor, tachycardia, and tachypnea
|\ |\ |\ |\ |\
Epiglottitis prevention - CORRECT ANSWERS ✔✔Haemophilus
|\ |\ |\ |\ |\ |\
influenzae type B (Hib) vaccine |\ |\ |\ |\
Steeple sign - CORRECT ANSWERS ✔✔a radiologic sign found on
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
radiograph where the subglottic tracheal narrowing produces a
|\ |\ |\ |\ |\ |\ |\ |\
shape of a church steeple which supports a diagnosis of croup
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Foreign body aspiration antibiotic? - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\
✔✔Depends on the nature of the material aspirated, plus the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
,location and degree of obstruction. Bronchial or laryngeal foreign
|\ |\ |\ |\ |\ |\ |\ |\ |\
body aspiration, a bronchoscopy must be performed for removal
|\ |\ |\ |\ |\ |\ |\ |\ |\
of the foreign body
|\ |\ |\
Antibiotics for bronchiolitis? - CORRECT ANSWERS ✔✔Use of |\ |\ |\ |\ |\ |\ |\ |\
saline drops and suctioning of the nares. There is no evidence to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
support the routine use of antibiotics |\ |\ |\ |\ |\
Antibiotics for croup? - CORRECT ANSWERS ✔✔Nebulized |\ |\ |\ |\ |\ |\ |\
epinephrine, corticosteroids (dexamethasone oral or IM), blow by |\ |\ |\ |\ |\ |\ |\ |\
oxygen or heliox in severe croup. Racemic epinephrine with the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
use of corticosteroids to limit rebound swelling
|\ |\ |\ |\ |\ |\
Antibiotics for epiglottitis? - CORRECT ANSWERS ✔✔Establish an |\ |\ |\ |\ |\ |\ |\ |\
airway preferably by nasotracheal intubation. Administer IV
|\ |\ |\ |\ |\ |\ |\
antibiotics such as rocephin to cover H.influenzae. Administer
|\ |\ |\ |\ |\ |\ |\ |\
oxygen and respiratory support. Antibiotics should be continued
|\ |\ |\ |\ |\ |\ |\ |\
for 10 days. Rifampin prophylaxis 20 mg/kg in a single dose
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
(maximum of 600 mg) for 4 days for infants and children, 600 |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
mg once a day for adults for 4 days. Should be provided for
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
household contacts who are at risk (Younger than 4 years old
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
who is non-immunized or incompletely immunized, children less
|\ |\ |\ |\ |\ |\ |\ |\
than 12 months who have not received primary series of Hib, and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
immunocompromised children.
|\ |\
Asthma treatment - CORRECT ANSWERS ✔✔The pharmacological
|\ |\ |\ |\ |\ |\ |\
management of asthma in children is based on the severity of |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
asthma and the child's age. After initial control, decrease
|\ |\ |\ |\ |\ |\ |\ |\ |\
treatment to the least amount of medication needed to maintain
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
control. Systemic corticosteroids may be needed at any time and
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
stepped up if there is a major flare-up of symptoms.
|\ |\ |\ |\ |\ |\ |\ |\ |\
,Step 1 Asthma management for children 0-4 years old -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔Step 1: SABA (Short acting beta2-
|\ |\ |\ |\ |\ |\ |\
agonist) PRN: With viral respiratory symptoms short acting beta
|\ |\ |\ |\ |\ |\ |\ |\ |\
2-agonist should be used every 4-6 hours up to 24 hours (longer
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
with a physician consult). Consider short course of oral systemic
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
corticosteroids if severe exacerbation. Frequent use of SABA may |\ |\ |\ |\ |\ |\ |\ |\
indicate the need to step up treatment
|\ |\ |\ |\ |\ |\ |\
Step 2 Asthma management for children 0-4 years old -
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔Step 2: Consider consultation with
|\ |\ |\ |\ |\ |\ |\
asthma specialist. Low dose of inhaled corticosteroids.
|\ |\ |\ |\ |\ |\
Step 3 asthma mgmt for children 0-4 yrs - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔Step 3: Medium-dose of inhaled corticosteroids
|\ |\ |\ |\ |\
Steps 4-6 asthma mgmt for children 0-4 yrs - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔Step 4: Medium-dose ICS and Long acting beta2-agonist or
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
montelukast. |\
Step 5: High dose ICS and Long acting beta 2-agonist or
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
montelukast. |\
Step 6: High dose of ICS and LABA or montelukast and oral
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
corticosteroids
Steps 1-3 asthma mgmt for children 5-11 yrs - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔Step 1: SABA (Short acting beta 2-agonist) PRN:
|\ |\ |\ |\ |\ |\ |\ |\ |\
Increasing the use of short-acting beta 2-agonist or use greater
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
, than 2 days a week for symptom relief generally indicates
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
inadequate control and the need to step up treatment. |\ |\ |\ |\ |\ |\ |\ |\ |\
Step 2: Consider consultation with asthma specialist. Low dose of
|\ |\ |\ |\ |\ |\ |\ |\ |\
inhaled corticosteroids.
|\ |\ |\
Step 3: Low dose of inhaled corticosteroid and LABA. Or medium
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
dose of inhaled corticosteroids.
|\ |\ |\
Steps 4-6 asthma mgmt for children 5-11 yrs - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔Step 4: Medium-dose ICS and LABA or medium
|\ |\ |\ |\ |\ |\ |\ |\ |\
dose of inhaled corticosteroid and leukotriene receptor antagonist
|\ |\ |\ |\ |\ |\ |\
or theophylline. .
|\ |\ |\ |\
Step 5: High dose ICS and LABA or high dose of inhaled
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
corticosteroid and leukotriene receptor antagonist or |\ |\ |\ |\ |\ |\
theophylline. . |\ |\
Step 6: High dose of ICS and LABA and oral corticosteroids or
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
high dose of inhaled corticosteroids and leukotriene receptor
|\ |\ |\ |\ |\ |\ |\ |\
antagonist or theophylline and oral corticosteroids. |\ |\ |\ |\ |\ |\
** Theophylline levels must be monitored.
|\ |\ |\ |\ |\
Differentials for patient with sore throat - CORRECT ANSWERS |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔Strep pharyngitis |\
Peritonsillar abscess |\
