NUR 602 EXAM STUDY GUIDE 110 QUESTIONS AND MULTIPLE CHOICE ANSWERS
1. 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.There is no conclusive evidence about using probiotics
to treat colic.
Answer D. There is no conclusive evidence about using probiotics to treat colic.
2. 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. Video fluoroscopy swallowing study (VOSS)
Answer D. Video fluoroscopy swallowing study (VOSS)
3. 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
Answer D. Oral rehydration solution with f/u in 24H
, NUR 602 EXAM STUDY GUIDE 110 QUESTIONS AND MULTIPLE CHOICE ANSWERS
4. 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.
Answer D. Refer to a pediatric gastroenterologist for further workup.
5. 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.
Answer A. Begin a trial of extensively hydrolyzed protein formula for 2-4 wks.
6. 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
Answer D. Referral for EGD
, NUR 602 EXAM STUDY GUIDE 110 QUESTIONS AND MULTIPLE CHOICE ANSWERS
7. 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
Answer B. Eliminating certain foods from the mother's diet.
8. 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.
Answer b. Have the parents watch for the object in the child's stool.
9. 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
Answer A. Appendicitis w/perf
, NUR 602 EXAM STUDY GUIDE 110 QUESTIONS AND MULTIPLE CHOICE ANSWERS
10. 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 lethargic in between. The primary care pediatric NP notes ta
small amount of bloody, mucous stool in the diaper. What is the most likely diagnosis?
A. Appendicitis
B. Gastroenteritis
C. Intussusception
D. Testicular torsion
Answer C. Intussusception
11. A school-age child has had abd pain for 3 mo htat occurs once to twice weekly and is associated with a h/a and occ diff
sleeping, often causing the child to stay home from school. The child does not have V/D & is gaining weight normally. The PE is
normal. According to Bishop, what is included in the initial diagnostic work-up for this child?
A. CBC, ESR, amylase, lipase, UA, & abd US
B. CBC, ESR, CRP, and fecal calprotectin
C. CBC, ESR, CRP, UA, stool for ova, parasites, and culture
D. Stool for H.pylori antigen and serum IgA, IgG, tTg
Answer A. CBC, ESR, amylase, lipase, UA, & Abd US
12. An adolescent is dx with functional abdominal pain (FAP). The child's sx worsen during stressful events, esp w/school
anxiety. What will be an important part of tx for this child?
A. informing the parents that the pain is most likely not real
B. instituting a lactose-free diet along w/lactobacillus supplements
C. teaching about the brain-gut interaction causing sx
D. using histamine2-blockers to help alleviate sx
Answer C. teaching about the brain-gut interaction causing sx
1. 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.There is no conclusive evidence about using probiotics
to treat colic.
Answer D. There is no conclusive evidence about using probiotics to treat colic.
2. 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. Video fluoroscopy swallowing study (VOSS)
Answer D. Video fluoroscopy swallowing study (VOSS)
3. 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
Answer D. Oral rehydration solution with f/u in 24H
, NUR 602 EXAM STUDY GUIDE 110 QUESTIONS AND MULTIPLE CHOICE ANSWERS
4. 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.
Answer D. Refer to a pediatric gastroenterologist for further workup.
5. 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.
Answer A. Begin a trial of extensively hydrolyzed protein formula for 2-4 wks.
6. 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
Answer D. Referral for EGD
, NUR 602 EXAM STUDY GUIDE 110 QUESTIONS AND MULTIPLE CHOICE ANSWERS
7. 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
Answer B. Eliminating certain foods from the mother's diet.
8. 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.
Answer b. Have the parents watch for the object in the child's stool.
9. 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
Answer A. Appendicitis w/perf
, NUR 602 EXAM STUDY GUIDE 110 QUESTIONS AND MULTIPLE CHOICE ANSWERS
10. 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 lethargic in between. The primary care pediatric NP notes ta
small amount of bloody, mucous stool in the diaper. What is the most likely diagnosis?
A. Appendicitis
B. Gastroenteritis
C. Intussusception
D. Testicular torsion
Answer C. Intussusception
11. A school-age child has had abd pain for 3 mo htat occurs once to twice weekly and is associated with a h/a and occ diff
sleeping, often causing the child to stay home from school. The child does not have V/D & is gaining weight normally. The PE is
normal. According to Bishop, what is included in the initial diagnostic work-up for this child?
A. CBC, ESR, amylase, lipase, UA, & abd US
B. CBC, ESR, CRP, and fecal calprotectin
C. CBC, ESR, CRP, UA, stool for ova, parasites, and culture
D. Stool for H.pylori antigen and serum IgA, IgG, tTg
Answer A. CBC, ESR, amylase, lipase, UA, & Abd US
12. An adolescent is dx with functional abdominal pain (FAP). The child's sx worsen during stressful events, esp w/school
anxiety. What will be an important part of tx for this child?
A. informing the parents that the pain is most likely not real
B. instituting a lactose-free diet along w/lactobacillus supplements
C. teaching about the brain-gut interaction causing sx
D. using histamine2-blockers to help alleviate sx
Answer C. teaching about the brain-gut interaction causing sx
