OBJECTIVE ASSESSMENT
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Includes Frequently Tested Questions With ELABORATED
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1. A child is brought to the clinic immediately after being stung by a wasp.
Physical examination reveals localized erythema and edema at the sting site,
abdominal tenderness, watery eyes, and generalized urticaria. What is the initial
treatment?
A. Oral antihistamine
B. Oral corticosteroids
C. Intramuscular epinephrine
D. Observation only
Correct Answer: C. Intramuscular epinephrine
2. A child is bitten by a snake near a swimming pool in an area known to have
copperhead snakes. The parents cannot describe the snake. Examination reveals
severe local pain and edema at the bite site. What should the primary care
pediatric nurse practitioner do first?
A. Apply a pressure dressing
B. Attempt to identify the snake
C. Transport the child by ambulance to a medical center
D. Administer oral antibiotics
, Correct Answer: C. Transport the child by ambulance to a medical center
3. A mother is concerned about her child’s nightmares. The family nurse
practitioner explains that the key difference between nightmares and night terrors
is that:
A. Night terrors occur during REM sleep
B. Nightmares are not remembered by the child
C. Nightmares are vivid, frightening dreams recalled by the child
D. Night terrors are associated with daytime anxiety
Correct Answer: C. Nightmares are vivid, frightening dreams recalled by the
child
4. During a physical exam of a child with chronic recurrent seizures treated with
antiepileptic medication, the nurse practitioner notes gingival hyperplasia. This
finding is most commonly associated with:
A. Valproic acid
B. Carbamazepine
C. Phenobarbital
D. Phenytoin
Correct Answer: D. Phenytoin
5. Which of the following is a known effect of prenatal cocaine exposure on
newborns?
A. Congenital heart defects
B. Increased incidence of prematurity
C. Macrocephaly
D. Hypoglycemia
, Correct Answer: B. Increased incidence of prematurity
6. The parent of a 7-year-old asks about eliminating sugar from the child’s diet due
to teacher concerns about behavior. What advice should the nurse practitioner
provide?
A. Sugar directly causes hyperactivity
B. All sugar should be eliminated
C. Moderate sugar intake rarely produces inappropriate behavior
D. Sugar intake worsens ADHD symptoms
Correct Answer: C. Moderate sugar intake rarely produces inappropriate
behavior
7. A teenager reports being raped several hours ago by her boyfriend. What is the
most appropriate immediate action by the family nurse practitioner?
A. Provide emotional support and send her home
B. Prescribe emergency contraception
C. Accompany her to the emergency department for evaluation
D. Report the incident immediately to law enforcement
Correct Answer: C. Accompany her to the emergency department for
evaluation
8. When closing a child’s forehead laceration with topical skin adhesive, which
technique is correct?
A. Apply adhesive directly into the wound
B. Apply adhesive under the skin edges
C. Hold wound edges together and apply adhesive on top of the skin
D. Apply a thick layer and allow it to dry uncovered
, Correct Answer: C. Hold wound edges together and apply adhesive on top of
the skin
9. A 3-week-old infant is diagnosed with bacterial meningitis. What is the most
common causative organism?
A. Escherichia coli
B. Streptococcus pneumoniae
C. Group B Streptococcus
D. Neisseria meningitidis
Correct Answer: C. Group B Streptococcus
10. An adolescent girl has brief episodes of staring lasting 1–3 minutes with no
postictal confusion. Neurologic exam is normal. What should the nurse
practitioner suspect?
A. Complex partial seizures
B. Absence seizures
C. Daydreaming
D. Attention deficit disorder
Correct Answer: B. Absence seizures
11. Deep nighttime extremity pain in school-age children that is not joint-related
and occurs after periods of activity is most consistent with:
A. Juvenile idiopathic arthritis
B. Osteomyelitis
C. Growing pains
D. Stress fracture
Correct Answer: C. Growing pains