FNP 593 Test 1 Prep | Verified with 100% Correct Answers

FNP 593 Test 1 Prep | Verified with 100% Correct Answers The primary care pediatric nurse practitioner is examining a young child who has cerebral palsy. Which part of the family history raises concerns about potential child maltreatment? a. Child attends day care b. Limited financial resources c. Mother works outside the home d. No membership in a church The primary care pediatric nurse practitioner suspects that the parent of a child who is doing poorly in school is being abused by a partner. What is a priority response by the nurse practitioner? a. Notifying the child's school counselor about this problem b. Referring the child and family to a social worker c. Reporting this according to any mandated reporting laws d. Suggesting that the parent avoid the abusive situation The primary care pediatric nurse practitioner is examining a young child who was brought in by a grandmother for evaluation of a partial thickness burn on one arm. The PNP suspects that this is an intentional injury, but the grandmother states that the parents are "just careless" and that the child is now living with her. What will the PNP do? a. Flag this as a concerning incident in the child's record. b. Reassure the grandmother that she is doing the right thing. c. Refer the child's parents to a parenting resource center. d. Report a suspicion of abuse to child protective services. The primary care pediatric nurse practitioner is evaluating a 12yearold girl who reports penile penetration of her vagina by her mother's boyfriend the day before yesterday. The PNP reports this to the local child abuse hotline. What is the PNP's next action? a. Attaining a history of the abuse from the child b. Obtaining urethral specimens for STI testing c. Performing a colposcopic examination to evaluate for trauma d. Referring the child to the ED for forensic specimen collection What intervention should the primary care provider (PCP) encourage all parents to implement to engage in the best management of potential serious child related injuries? a. Being aware of the causes of common childhood injuries b. Actively engaging in attentive parenting practices c. Actively supporting state and federal programs like Safe Kids USA d. Being proficient in basic pediatric life support techniques A 3-year-old child is recovering from injuries sustained in a motor vehicle accident. How will the primary care pediatric nurse practitioner evaluate this child's pain? a. Ask the child to rate pain intensity on a 4- to 5-item pain discrimination scale. b. Have the child describe any pain as "no pain, a little pain, or a lot of pain." c. Question the child about the intensity and specific location of any pain. d. Rely on nonverbal responses such as facial expressions and limb movements. A 4-year-old child has just been released from the hospital after orthopedic surgery on one leg following a bicycle accident. The child is sitting quietly on the exam table. When asked to rate pain, the child points to the "1" on a faces rating pain scale. What will the primary care pediatric nurse practitioner do next? a. Assess the child's vital signs and ability to walk without pain. b. Refill the prescription for a narcotic analgesic medication. c. Suggest that the parents give acetaminophen for mild pain. d. Teach the parent to give analgesics based on the child's report of pain. The primary care pediatric nurse practitioner is preparing to perform a painful procedure on a 4-month-old infant. Besides providing local anesthesia, what other pain control method provides analgesic effects? a. Providing toys b. Singing or music c. Sucrose solution d. Swaddling or cuddling An adolescent takes ibuprofen, acetaminophen, and a tricyclic antidepressant (TCA) to treat phantom limb pain and reports that the medications are no longer effective. What will the primary care pediatric nurse practitioner do? a. Change the TCA to a selective serotonin reuptake inhibitor. b. Evaluate the adolescent for drug seeking behavior. c. Increase the TCA dose and reevaluate in 2 to 3 weeks. d. Refer the adolescent to a pain management specialist. The parent of a school age child with a chronic pain condition tells the primary care pediatric nurse practitioner that the child has requested to stay home from school more often in the past few months. The child's exam does not reveal any significant change in pathology, and a review of the child's medications indicates appropriate dosing of analgesic medications. What will the nurse practitioner recommend? a. Assessing the child's pain every day to determine changes b. Ensuring the child stays quiet in bed with videos when having pain c. Having the child do homework when staying home from school d. Requiring the child to go to school even during pain episodes The parent of a 2-week-old infant reports that the infant was diagnosed with transient tachypnea of the newborn shortly after birth. The primary care pediatric nurse practitioner understands that, in this condition, a. antibiotic therapy is generally necessary to prevent severe infection. b. home oxygen therapy is needed until the infant grows out of the condition. c. recovery is usually complete with minimal intervention and treatments. d. treatment with exogenous surfactant and mechanical ventilation is needed. The parent of a 4-week-old infant reports that the infant began having forceful vomiting 1 week prior, which has worsened over time. The infant continues to nurse well but is losing weight. A physical examination reveals a 90g weight loss over the past 2 weeks, dry mucous membranes, and a sunken fontanel. What will the primary care pediatric nurse practitioner do? a. Encourage the mother to nurse the infant more frequently for shorter duration. b. Obtain serum electrolytes and hospitalize for surgical intervention. c. Recommend oral rehydration fluids for 24 to 48 hours to correct dehydration. d. Suggest trying a soy based or hydrolyzed protein formula until vomiting resolves. A 5-day-old infant who was delivered at home has abdominal distension and poor feeding. The mother is worried that the infant is constipated because he didn't have a first stool until yesterday and has only passed a small amount of meconium. What will the primary care pediatric nurse practitioner do? a. Obtain a sweat chloride skin test to evaluate for possible cystic fibrosis. b. Order an abdominal radiograph and refer the infant to a pediatric surgeon. c. Prescribe glycerin suppositories to use as needed until bowel function is normal. d. Suggest that the mother increase her fluid intake to help with constipation. The parent of a 4-day-old infant tells the primary care pediatric nurse practitioner that the infant was diagnosed with hydronephrosis while in utero and asks what will be done. What will the nurse practitioner tell this parent? a. Renal function will be abnormal and will require lifetime treatment. b. Spontaneous resolution often occurs within 6 months to a year of age. c. The affected kidney will be nonfunctional but the other kidney will compensate. d. The infant will eventually require renal transplantation for that kidney. A 2-month-old infant has increased head circumference from the 10th percentile at the 2week exam to the 30th percentile today. What will the primary care pediatric nurse practitioner do? a. Order a magnetic resonance imaging exam of the infant's head. b. Refer the infant immediately to a pediatric neurosurgeon. c. Schedule frequent clinic visits to monitor head growth. d. Watch the infant closely over time if the rest of the exam is normal. The primary care pediatric nurse practitioner is performing a well-baby examination on a 7-day-old infant born to a Chlamydia-positive mother. The infant's eyes are clear without exudate. The infant is free from cough and lungs are clear. What will the primary care pediatric nurse practitioner do to prevent illness in this infant? a. Administer a single dose of intramuscular ceftriaxone. b. Obtain bacterial cultures of both conjunctivae. c. Prescribe prophylactic erythromycin suspension. d. Schedule a followup appointment in 1 week. A child who has attention-deficit/hyperactivity disorder (ADHD) has difficulty stopping activities to begin other activities at school. The primary care pediatric nurse practitioner understands that this is due to difficulty with the self regulation component of a. emotional control. b. flexibility. c. inhibition. d. problem solving. The primary care pediatric nurse practitioner cares for a preschool-age child who was exposed to drugs prenatally. The child bites other children and has tantrums when asked to stop but is able to state later why this behavior is wrong. This child most likely has a disorder of a. executive function. b. information processing. c. sensory processing. d. social cognition. The parent of a child diagnosed with ADHD tells the primary care pediatric nurse practitioner that the child gets overwhelmed by homework assignments, doesn't seem to know which ones to do first, and then doesn't do any assignments. The nurse practitioner tells the parent that this represents impairment in which executive function? a. Activation b. Effort c. Emotion d. Focus The primary care pediatric nurse practitioner is performing an examination on a 5-year-old child who exhibits ritualistic behaviors, avoids contact with other children, and has limited speech. The parent reports having had concerns more than 2 years ago about autism, but was told that it was too early to diagnose. What will the nurse practitioner do first? a. Administer an MCHAT screen to screen the child for communication andsocialization delays. b. Ask the parent to describe the child's earlier behaviors from infancy through preschool. c. Reassure the parent that if symptoms weren't present earlier, the likelihood of autism is low. d. Refer the child to a pediatric behavioral specialist to develop a plan of treatment and management. The primary care pediatric nurse practitioner is examining a 3yearold child who speaks loudly, in a monotone, does not make eye contact, and prefers to sit on the exam room floor moving a toy truck back and forth in a repetitive manner. Which disorder does the nurse practitioner suspect? a. Attention deficit/hyperactivity disorder b. Autism spectrum disorder c. Executive function disorder d. Sensory processing disorder The primary care pediatric nurse practitioner is conducting a follow-up examination on a child who has recently begun taking a low-dose stimulant medication to treat ADHD. The child's school performance and home behaviors have improved. The child's parent reports noticing a few tics, such a twitching of the eyelids, but the child is unaware of them and isn't bothered by them. What will the nurse practitioner recommend? a. Adding an alpha agonist medication b. Changing to a nonstimulant medication c. Continuing the medication as prescribed d. Stopping the medication immediately A 9-year-old child exhibits school refusal and a reluctance to attend sleepovers with classmates. The parent is concerned because the child has recently begun sleeping in the parents' bed. Which initial action by the primary care pediatric nurse practitioner is appropriate? a. Assess for environmental stress, parental dysfunction, and maternal depression. b. Ask about recent traumatic events that may have precipitated this behavior. c. Consider a possible pediatric autoimmune neuropsychiatric disorder cause. d. Recommend firm insistence on school and activity attendance. The parent of a school age child reports that the child becomes frustrated when unable to perform tasks well and often has temper tantrums and difficulty sleeping. Which disorder may be considered in this child? a. Generalized anxiety disorder (GAD) b. Obsessive-compulsive disorder (OCD) c. Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANDAS) d. Separation anxiety disorder (SAD) The parent of a school-age girl reports that the child has difficulty getting ready for school and is often late because of a need to check and recheck whether her teeth are clean and her room light has been turned off. What will the primary care pediatric nurse practitioner recommend to this parent? a. Cognitive-behavioral therapy b. Deferral of treatment until symptoms worsen c. Medication management with an SSRI d. Referral to a child psychiatrist A newly divorced mother of a toddler reports that the child began having difficulty sleeping and nightmares along with exhibiting angry outbursts and tantrums 2 months prior. The primary care pediatric nurse practitioner learns that the child refuses to play with usual playmates and often spends time sitting quietly. What will the nurse practitioner do initially? a. Ask the mother about the child's relationship with the father. b. Consult with a child psychiatrist to prescribe medications. c. Recommend cognitive behavioral or psychodynamic therapy. d. Refer the family to a child behavioral specialist for counseling. An adolescent has recently begun doing poorly in school and has stopped participating in sports and other extracurricular activities. During the history interview, the adolescent reports feeling tired, having difficulty concentrating, and experiencing a loss of appetite for the past few weeks but cannot attribute these changes to any major life event. Which is an important next step in managing this patient? a. Administering a diagnostic rating scale for depression b. Considering a short term trial of an antidepressant medication c. Determining suicidal ideation and risk of suicide d. Referring the adolescent to a mental health specialist An adolescent is diagnosed with major depression, and the mental health specialist has prescribed fluoxetine. What other treatment is important to protect against suicide risk? a. Addition of risperidone therapy b. Cognitive-behavioral therapy c. Family therapy d. Hospitalization A 13-year-old child has exhibited symptoms of mild depression for several weeks. The parent reports feeling relieved that the symptoms have passed but concerned that the child now seems to have boundless energy and an inability to sit still. What will the primary care pediatric nurse practitioner do? A. Administer an ADHD diagnostic scale and consider an ADHD medication. B. Consult with a child psychiatrist to prescribe an antidepressant medication. C. Reassure the parent that this behavior is common after mild depressive symptoms D. Refer the child to a child psychiatrist for evaluation of bipolar disorder. A toddler has begun hitting and biting other children at a day care center and is exhibiting temper tantrums and bad language at home. The parent reports that these behaviors began shortly after a sibling was born. What will the primary care pediatric nurse practitioner do? A. Advise the parent that the child is exhibiting early symptoms of ADHD. B. Engage the parent in positive parenting strategies to facilitate appropriate child coping. C. Recommend evaluating the child for conduct or oppositional defiant disorder. D. Suggest putting the child in another day care center to ameliorate the problems. A 14-year-old female comes to the clinic with amenorrhea for 3 months. A pregnancy test is negative. The adolescent's body weight is at 82% of expected for height and age. The mother reports that her daughter often throws up and refuses to eat most foods. Which condition does the primary care pediatric nurse practitioner suspect? A. Anorexia nervosa B. Bulimia nervosa C. Depression D. Substance abuse The primary care pediatric nurse practitioner reviews a child's complete blood count with differential white blood cell values and recognizes a "left shift" because of a. a decreased eosinophil count. b. a decreased lymphocyte count. c. an elevated monocyte count. d. an elevated neutrophil count. A complete blood count on a 12-month-old infant reveals microcytic, hypochromic anemia with a hemoglobin of 9.5 g/dL. The infant has mild pallor with no hepatosplenomegaly. The primary care pediatric nurse practitioner suspects a. hereditary spherocytosis. b. iron-deficiency anemia. c. lead intoxication. d. sickle-cell anemia. The primary care pediatric nurse practitioner evaluates a 5-year-old child who presents with pallor and obtains labs revealing a hemoglobin of 8.5 g/dL and a hematocrit of 31%. How will the nurse practitioner manage this patient? a. Prescribe elemental iron and recheck labs in 1 month. b. Reassure the parent that this represents mild anemia. c. Recommend a diet high in iron rich foods. d. Refer to a hematologist for further evaluation. The primary care pediatric nurse practitioner is managing care for a child diagnosed with iron-deficiency anemia who had an initial hemoglobin of 8.8 g/dL and hematocrit of 32% who has been receiving ferrous sulfate as 3 mg/kg/day of elemental iron for 4 weeks. The child's current lab work reveals elevations in Hgb/Hct and reticulocytes with a hemoglobin of 10.5 g/dL and a hematocrit of 36%. What is the next step in management of this patient? a. Continue the current dose of ferrous sulfate and recheck labs in 1 to 2 months. b. Discontinue the supplemental iron and encourage an iron enriched diet. c. Increase the ferrous sulfate dose to 4 to 6 mg/kg/day of elemental iron. d. Refer the child to a pediatric hematologist to further evaluate the anemia. The primary care pediatric nurse practitioner performs a well baby examination on a 4monthold infant who is exclusively breastfed and whose mother plans to introduce only small amounts of fruits and vegetables in addition to breastfeeding. To ensure that the infant gets adequate amounts of iron, what will the nurse practitioner recommend? a. Elemental iron supplementation of 1 mg/kg/day until cereals are added b. Elemental iron supplementation of 3 mg/kg/day for the duration of breastfeeding c. Monitoring the infant's hemoglobin and hematocrit at every well-baby checkup d. Offering iron fortified formula to ensure adequate iron intake The primary care pediatric nurse practitioner reviews hematology reports on a child with beta thalassemia minor and notes an Hgb level of 8 g/dL. What will the nurse practitioner do? a. Evaluate serum ferritin. b. Order Hgb electrophoresis. c. Prescribe supplemental iron. d. Refer for RBC transfusions The primary care pediatric nurse practitioner sees a 12-month-old infant who is being fed goat's milk and a vegetarian diet. The child is pale and has a beefy-red, sore tongue and oral mucous membranes. Which tests will the nurse practitioner order to evaluate this child's condition? a. Hemoglobin electrophoresis b. RBC folate, iron, and B12 levels c. Reticulocyte levels d. Serum lead levels A toddler who presents with anemia and reticulocytopenia has a history of a gradual decrease in energy and increase in pallor beginning after a recent viral infection. How will the primary care pediatric nurse practitioner treat this child? a. Closely observe the child's symptoms and lab values. b. Consult with a pediatric hematologist. c. Prescribe supplemental iron for 4 to 6 months. d. Refer for transfusions to correct the anemia. The pediatric nurse practitioner provides primary care for a 30-month-old child who has sickle cell anemia who has had one dose of 23-valent pneumococcal vaccine. Which is an appropriate action for health maintenance in this child? a. Administer an initial meningococcal vaccine. b. Begin folic acid dietary supplementation. c. Decrease the dose of penicillin V prophylaxis. d. Give a second dose of 23-valent pneumococcal vaccine. A 2-year-old child who has sickle cell anemia (SCA) comes to the clinic with a cough and a fever of 101.5°C. The child currently takes penicillin V prophylaxis 125 mg orally twice daily. What will the primary care pediatric nurse practitioner do? a. Admit the child to the hospital to evaluate for sepsis b. Give intravenous fluids and antibiotics in clinic. c. Increase the penicillin V dose to 250 mg. d. Order a chest radiograph to rule out pneumonia. A school-age child comes to the clinic for evaluation of excessive bruising. The primary care pediatric nurse practitioner notes a history of an upper respiratory infection 2 weeks prior. The physical exam is negative for hepatosplenomegaly and lymphadenopathy. Blood work reveals a platelet count of 60,000/mm3 with normal PT and aPTT. How will the nurse practitioner manage this child's condition? a. Admit to the hospital for IVIG therapy. b. Begin a short course of corticosteroid therapy. c. Refer to a pediatric hematologist. d. Teach to avoid NSAIDs and contact sports. The primary care pediatric nurse practitioner is examining a 5yearold child who has had recurrent fevers, bone pain, and a recent loss of weight. The physical exam reveals scattered petechiae, lymphadenopathy, and bruising. A complete blood count shows thrombocytopenia, anemia, and an elevated white cell blood count. The nurse practitioner will refer this child to a specialist for a. bone marrow biopsy. b. corticosteroids and IVIG. c. hemoglobin electrophoresis. d. immunoglobulin testing. The primary care pediatric nurse practitioner is performing a well child examination on a school age child who has a history of cancer treated with cranial irradiation. What will the nurse practitioner monitor in this child? a. Cardiomyopathy and arrhythmias b. Leukoencephalopathy c. Obesity and gonadal dysfunction d. Peripheral neuropathy and hearing loss When reviewing a white blood cell (WBC) count, the primary care pediatric nurse practitioner suspects a viral infection when which WBC element is elevated? a. Bands b. Leukocytes c. Lymphocytes d. Neutrophils Which lab value is most concerning in an infant with fever and a suspected bacterial infection? a. C-reactive protein of 11.5 mg/L b. Lymphocyte count of 8.7 c. Platelet count of 475 d. White blood cell count of 14 A 3-year-old child who attends day care has had a fever, nausea, and vomiting several weeks prior and now has darkened urine and constipation along with hepatomegaly and right upper quadrant tenderness. What treatment is warranted for this child? a. HAV vaccine b. Immunoglobulin G c. Interferon-alfa d. Supportive care A 10-month-old infant who is new to the clinic has chronic hepatitis B infection. What will the primary care pediatric nurse practitioner do to manage this infant's disease? a. Consult a pediatric infectious disease specialist. b. Prescribe interferon alfa. c. Provide supportive care. d. Consider use of lamivudine. A 9-month-old infant has had a fever of 103°F for 2 days and now has a diffuse, maculopapular rash that blanches on pressure. The infant's immunizations are up-to-date. What will the primary care pediatric nurse practitioner do? a. Administer immunoglobulin G to prevent fulminant illness. b. Perform serologic testing for human herpes virus 6 and human herpes virus 7. c. Reassure the parent that this is a mild, self-limiting disease. d. Recommend avoiding contact with pregnant women. A child who is immunocompromised has a fever and a rash consisting of macules papules, and pustules. What will the primary care pediatric nurse practitioner do? a. Administer varicella immune globulin (VariZIG). b. Hospitalize the child for intravenous acyclovir. c. Order intravenous immunoglobulin as an outpatient. d. Prescribe oral acyclovir for the duration of the illness. The primary care pediatric nurse practitioner is reviewing medical records for a newborn that is new to the clinic. The toddler's mother was found to be HIV positive during her pregnancy with this child and received antiretroviral therapy during pregnancy. The child was born by cesarean section, begun on antiretroviral prophylaxis, and did not breastfeed. What is the correct management for this child? a. Consult with a pediatric HIV specialist. b. Discontinue cART after 4 weeks of age. c. Obtain a CD4+ cell count and HIV RNA levels. d. Reinforce the need to give cART for life. A preschool age child is brought to clinic for evaluation of a rash. The primary care pediatric nurse practitioner notes an intense red eruption on the child's cheeks and circumoral pallor. What will the nurse practitioner tell the parents about this rash? a. This rash may be a prodromal sign of rubella or roseola. b. The child will need immunization boosters to prevent serious disease. c. This is a benign rash with no known serious complications. d. Expect a lacy, maculopapular rash to develop on the trunk and extremities. An unimmunized school-age child whose mother is in her first trimester of pregnancy is diagnosed with rubella after a local outbreak. What will the primary care pediatric nurse practitioner recommend? a. Assessment of maternal rubella titers b. Intravenous immunoglobulin for the child c. MMR vaccine for the mother and child d. Possible termination of the pregnancy A child is brought to the clinic with a fever, headache, malaise, and a red, annular macule surrounded by an area of clearing and a larger, erythematous annular ring. The child complains of itching at the site. What will the primary care pediatric nurse practitioner do to determine the diagnosis? a. Ask about recent tick bites b. Obtain a skin culture c. Order blood cultures d. Perform serologic testing A child whose family has been camping in a region with endemic Lyme disease suffered several tick bites. The parents report removing the ticks but are not able to or the length of time the ticks were attached. The child is asymptomatic. What is the action? a. Administer a prophylactic single dose of doxycycline. b. Perform serologic testing for IgG or IgM antibodies. c. Prescribe amoxicillin three times daily for 14 to 21 days. d. Teach the parents which signs and symptoms to report. A child with a history of a pustular rash at the site of a cat scratch on one arm now has warm, tender, swollen axillary lymph nodes on the affected side. The primary care pediatric nurse practitioner notes induration and erythema of these nodes. What will the nurse practitioner do? a. Obtain a complete blood count and C-reactive protein. b. Order an immunofluorescent assay (IFA) for serum antibodies. c. Perform a needle aspiration of the affected lymph nodes. d. Prescribe a 5day course of azithromycin. A school-age child has fever of 104°F, sore throat, vomiting and malaise. The primary care pediatric nurse practitioner observes that the tonsils, oropharynx, and palate are erythematous and covered with exudate; the tongue is coated and red; and there is a red, sandpaper like rash on the child's neck, trunk, and extremities. A rapid strep test is positive. What will the nurse practitioner do to manage this child's illness? a. Administer intramuscular ceftriaxone. b. Hospitalize for further diagnostic tests. c. Prescribe oral amoxicillin. d. Refer to a pediatric infectious disease specialist. An adolescent has a TB skin test prior to working as a volunteer in a hospital. The adolescent is healthy and has not travelled to or from a TB endemic area or had close contact with anyone who has TB. The Mantoux skin test shows 10 mm of induration after 48 hours. What will the primary care pediatric nurse practitioner do? a. Ask the adolescent about exposure to homeless persons. b. Order a chest radiograph to rule out active TB. c. Reassure the adolescent that this is a negative screen. d. Refer the adolescent to an infectious disease specialist. What are the clinical findings suggestive of Down syndrome? (Select all that apply) a. Brushfield spots b. Brachycephaly c. Protruding tongue d. Large ears e. Double palmar creases Which clinical findings tend to support a diagnosis of Klinefelter syndrome? (Select all that apply.) a. Short arm span b. Scoliosis c. Small penis d. Large testes e. Gynecomastia Which developmental cues are associated with Prader-Willi syndrome? (Select all that apply.) a. Language delays b. Poor coordination c. Low pain tolerance d. ADHD e. Mild intellectual disability Which assessment finding noted at birth is an indication of Beckwith-Weidemann syndrome? a. Underdevelopment of one side to the body b. Abnormally long umbilical cord c. Small eyes d. Microglossia What is the primary care provider's (PCP) care intervention for a child diagnosed with achondroplasia? a. Visual screening b. Monitoring for hydrocephalus c. Skin cancer screening d. Monitoring for signs of depression An 8-yea-rold child is diagnosed with systemic lupus erythematosus (SLE), and the child's parent asks if there is a cure. What will the primary care pediatric nurse practitioner tell the parent? a. Complete remission occurs in some children at the age of puberty. b. Periods of remission may occur but there is no permanent cure. c. SLE can be cured with effective medication and treatment. d. The disease is always progressive with no cure and no remissions. The primary care pediatric nurse practitioner examines a child who has had stiffness and warmth in the right knee and left ankle for 7 or 8 months but no back pain. The nurse practitioner will refer the child to a rheumatology specialist to evaluate for a. enthesitis related JIA. b. oligoarticular JIA. c. polyarticular JIA. d. systemic JIA. The primary care pediatric nurse a practitioner is managing care for a child who has juvenile idiopathic arthritis (JIA) who has a positive antinuclear antibody (ANA). Which specialty referral is critical for this child? a. Cardiology b. Ophthalmology c. Orthopedics d. Pain management The primary care pediatric nurse practitioner is prescribing ibuprofen for a 25 kg child with JIA who has oligoarthitis. If the child will take 4 doses per day, what is the maximum amount the child will receive per dose? a. 200 mg b. 250 mg c. 400 mg d. 450 mg The parent of a school-age child who is diagnosed with oligoarticular JIA asks the primary care pediatric nurse practitioner what exercises the child may do to help reduce symptoms. What will the nurse practitioner recommend? a. Running b. Swimming c. Weights d. Yoga A 12-year-old child is brought to the clinic with joint pain, a 3-week history of low-grade fever, and a facial rash. The primary care pediatric nurse practitioner palpates an enlarged liver 2 cm below the subcostal margin along with diffuse lymphadenopathy. An antinuclear antibody (ANA) test is positive. Which test may be ordered to confirm a diagnosis of systemic lupus erythematosus (SLE)? a. Antidoublestrand DNA antibodies b. AntiLa antibodies c. AntiRo antibodies d. AntiSm antibodies The primary care pediatric nurse practitioner is reviewing the rheumatology plan of care for a child who is diagnosed with systemic lupus erythematosus (SLE). Besides reinforcing information about prescribed medications, what will the nurse practitioner teach the family to help minimize flaring of episodes? a. Have the child rest between activities. b. Obtain regular ophthalmology exams. c. Participate in low-impact exercises. d. Use ultraviolet A (UVA) and ultraviolet B (UVB) sunscreen daily. An adolescent female reports poor sleep, fatigue, muscle and joint paint, and anxiety lasting for several months. The primary care pediatric nurse practitioner notes point tenderness at several sites. What will the nurse practitioner do next? a. Evaluate the adolescent's pain using a numeric pain scale. b. Obtain ANA, CBC, liver function, and muscle enzymes tests. c. Reassure the adolescent that this condition is not life-threatening. d. Refer the adolescent to a rheumatologist for further evaluation. A child has a fever and arthralgia. The primary care pediatric nurse practitioner learns that the child had a sore throat 3 weeks prior and auscultates a murmur in the clinic. Which test will the nurse practitioner order? a. Anti-DNase B test b. anti-streptolysin O (ASO) titer