NR 602 Final Exam Complete Accurate
Actual Questions with Expert Graded
100% Correct 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.
D. 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. Videofluroscopy swallowing study (VOSS) - ANSWER D.
Videofluroscopy swallowing study (VOSS)
3. 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.
4. 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
5. 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
6. 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
,7. 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
8. A school-age child has recurrent diarrhea w/foul-smelling stools, excessive
flatus, abd distention, and FTT. A 2-week lactose-free trial failed to reduce
sx. What is the next step in diagnosing this condition?
A. lactose hydrogen breath test
B. serologic testing for celiac disease
C. stool for ova and parasites
D. Sweat chloride test for cystic fiborisis - ANSWER B. serologic
testing for celiac disease
9. A child is diagnosed w/Chron disease. What are the likely complications for
this child?
A. cancer of the colon and possible colectomy
B. intestinal obstruction w/scarring and strictures
C. intestinal perforation and hemorrhage
D. liver disease and sepsis - ANSWER B. intestinal obstruction
w/scarring and strictures
10.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
11.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.
12.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.
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
Actual Questions with Expert Graded
100% Correct 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.
D. 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. Videofluroscopy swallowing study (VOSS) - ANSWER D.
Videofluroscopy swallowing study (VOSS)
3. 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.
4. 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
5. 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
6. 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
,7. 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
8. A school-age child has recurrent diarrhea w/foul-smelling stools, excessive
flatus, abd distention, and FTT. A 2-week lactose-free trial failed to reduce
sx. What is the next step in diagnosing this condition?
A. lactose hydrogen breath test
B. serologic testing for celiac disease
C. stool for ova and parasites
D. Sweat chloride test for cystic fiborisis - ANSWER B. serologic
testing for celiac disease
9. A child is diagnosed w/Chron disease. What are the likely complications for
this child?
A. cancer of the colon and possible colectomy
B. intestinal obstruction w/scarring and strictures
C. intestinal perforation and hemorrhage
D. liver disease and sepsis - ANSWER B. intestinal obstruction
w/scarring and strictures
10.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
11.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.
12.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.
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
