NSG6435 Week 5 Assignment 4 Midterm Exam

16 Jun NSG6435 Week 5 Assignment 4 Midterm Exam

Question
NSG6435 Week 5 Assignment 4 Midterm Exam / NSG 6435 Week 5 Midterm Exam -Family Health – Pediatrics- South University

Question 1.

The incidence of congenital heart defects is estimated to be ________ of all live births.

20%
10%
5%
1%

Question 2
Breastmilk can be safely stored in a freezer below 0 degrees Fahrenheit for how long?
Three months
Six months
One year
Two years
Question 3

Which foreign body needs immediate removal from a five-year-old boy’s nose?
Bean
Bead
Stone
Battery
Question 4

The most useful diagnostic test in delayed puberty is _____________________.
complete thyroid panel
X-Ray of the left wrist and hand
X-Ray of the right wrist and hand
X-Ray of the spinal column
Question 5

An average vision of a two-year-old child is approximately:
20/150
20/400
20/70
20/30
Question 6

A five-year-old female presents for a follow-up emergency room visit with a diagnosis of bronchitis. You would expect which treatment to have been prescribed?
Oral steroids
Azithromycin
Increase rest and fluid
Albuterol
Question 7

An adolescent with a chronic asthma cough notes that symptoms are usually worse _____________.
only with exertion
only during the daytime
only at night
at night and with exertion
Question 8

An average adolescent female usually experiences her biggest growth spurt at approximately what age?
Ten and half years
Eleven and half years
Twelve and half years
Thirteen and half years
Question 9

If an adolescent has a bone age of 10 but is actually 13 years of age, this patient has ______.
an increased risk of fracture in the next three years
an increased risk of osteoporosis as an adult
a higher potential for bone growth
a lower potential for bone growth
Question 10

Gardasil results in greater antibody responses for females who are administered the three-dose series between what ages?
Six to twenty-six years of age
Prior to eleven years of age
Nine to fifteen years of age
Nine to twenty-six years of age
Question 11

An eight-year old has chronic intermittent nasal congestion. All but which of the following would support allergic rhinitis?
Red swollen turbinates
Darkened areas below eyes
Increased basophils on complete blood count (CB
Itchy, watery eyes
Question 12

A fifteen-month old failed treatment with amoxicillin for an otitis media. At his two-week recheck, his tympanic membrane remained red with distorted landmarks and he persisted with nasal discharge that is thick and yellowish. The best action for the nursing practitioner should be to prescribe:
A ten-day-course of augmentin
A three-week-course of a cephalexin
A higher dose amoxicillin
Ceftriaxone and an antihistamine
Question 13

An infant should be able to say his or her first word by:
four to five months
eight to nine months
twelve to fifteen months
twenty four to twenty six months
Question 14

The latter part of adolescence includes the ability to develop ________ and _______ means to be a part of society.
strong attachments; sexuality
career; marriage
critical thinking; basic life skills
moral; intellectual means
Question 15

A fourteen-year-old adolescent presents with fatigue, endocarditis, pulmonary hypertension, arrhythmias, and congestive heart failure. You suspect he may have ____________.
ASD
pulmonary valve stenosis
aortic valve stenosis
a ventricular septal defect (VSD)
Question 16

A four-year-old male patient presents with his mother with a school referral regarding red eyes. Which questions would not assist in establishing a list of differential diagnoses?
Unilateral vs. bilateral presentation
Type of drainage
Vision status
History of a bacterial infection one month ago
Question 17

______________ adolescents should be screened for sexually transmitted diseases.
Males
Females
All
Sexually active
Question 18

An infant should no longer have a head lag when pulled from the supine to sitting position at what age?
Two months
Four months
Six months
Nine months
Question 19

____________ should be given as a supplement in the management of delayed puberty.
Vitamins B1 and B12
Vitamins D and E
Vitamin A and Calcium
Calcium and Vitamin D

Question 20

Parents or guardians of adolescents should ___________________.

not be included in the adolescent’s health care

receive health guidance information at least twice during adolescence

encourage reasonable use of alcohol and tobacco by the adolescent

encourage early sexual activity by providing condoms to the adolescent

Question 21

How does cultural sensitivity impact the care of infants in the primary care setting?

Health-care providers may possess cultural biases that can impact care.

Cultural sensitivities do not exist in health care.

Cultural sensitivity only impacts the parents of infants.

Cultural sensitivity increases access to timely health-care services for infants.

Question 22

The most typical chest radiographic finding consistent with the diagnosis of asthma is ______________.

normal chest film

diffuse airway edema

right upper-lobe infiltrate

hyperinflation

Question 23
A 10 yo has a single painful ulcerated lesion on an erythematous base on the inner buccal mucosa. The most likely diagnosis and treatment would be:
herpes simplex stomatitis–oral acyclovir
herpangina–viscous xylocaine
apthous ulcer–triamcinalone in orabase
Hand, foot, mouth syndrome–antibiotic mouthwash

Question 24

A 9 month old is noted to have a bifid uvula. This would increase his risk of developing which disorder?
otitis media
retropharyngeal abscess
sinusitis
dental malocclusion

Question 25

All of the following may predispose a patient to thrush except:
age
steroid therapy
antibiotics
poor oral hygiene

Question 26

Patients with sinusitis should be instructed not to participate in what activity?
swimming/ diving
boxing/ wrestling
weight lifting
cross country running

Question 27

What complication of sinusitis are adolescent males more prone to?
intracranial abscess
potts puffy tumor
orbital cellulitis
dental infection

Question 28

Acceptable management options for allergic rhinitis include all of the following except:
oral cetirizine
oral montelukast
nasal beclomethsone
nasal neosynephrine

Question 29

A 7 yo has experienced recurrent nose bleeds in the past 2 months. What finding on the physical exam would suggest an underlying medical cause for the epistaxis?
wheezing
grade II murmur
petechiae
tonsil hypertrophy

Question 30

A 2 yo male with a history of chronic serous OM is noted to have a pearly white opacity in the upper outer quadrant of his TM. He currently has no symptoms and appears to be ok. The most likely diagnosis and appropriate managment would be:
tympanosclerosis; no treatment is necessary
persistent perforation; prescribe topical antibiotic drops
foreign body; perform an ear wash for removal
cholesteatoma; refer to otolaryngology

Question 31

A 15 mo failed treatment with amoxicillin for OM. At his 2 week re-check his TM remained red with distorted landmarks and he persisted with nasal congestion, poor sleep, and fever. The next best step would be to treat with:
a 10 day course of augmentin
a 3 week course of cephalosporin
a higher dose of amoxicillin and topical abx
ceftriaxone and an antihistamine

Question 32

All but which one of the following patients are at an increased risk of developing otitis media?
2 yo with cleft palate repair at 1 year of age
15 mo with down syndrome
9 mo with lactose intolerance
3 yo with IgA immune deficiency

Question 33

Patients with otitis externa should be instructed to do which one of the following:
keep ear dry until symptoms improve
limit swimming for the remainder of summer
wear ear plugs at all times with swimming
use alcohol drops before swimming each day

Question 34

A 10 yo has marked ear pain, not wanting anyone to touch his ear. The canal is edematous and exudate is present. TM is normal. How should this be managed?
topical fluoroquinolone
oral steroids and topical neomycin
oral amoxicillin and topical anesthetic
oral amoxicillin and topical steroid

Question 35

A 16 yo was hit in the eye 1 day ago and now has ecchymoses on the upper and lower lids with 5/10 eye pain. All but which of the following would be appropriate to obtain at this time:
visual acuity
intraocular pressure
CT scan
fluorescein stain

Question 36

The greatest risk in a patient with a hyphema is which of the following?
glaucoma
infection
rebleed
cataracts

Question 37

Corneal abrasions can be managed with topical application of which of the following:
anesthetic for pain control
steroids to prevent adhesions
antibiotics to prevent infection
atropine to prevent ciliary spasm

Question 38

Trauma to the eye increases the risk of developing all but which one of the following?
strabismus
glaucoma
cataracts
hyphema

Question 39

Fluorescein staining of the eye is used to detect a:
keratitis
foreign body
corneal abrasion
hyphema

Question 40

Prematurity increases the risk of developing which one of the following?
nystagmus
astigmatism
myopia
glaucoma

Question 41

A 3 month old has a mild asymmetrical corneal light reflex on physical exam. What is the next appropriate step?
observe and reevaluate at the next well check
refer immediately to ophthalmology
begin atropine drops or eye patching
protect eyes from sunlight

Question 42

Which of the following may cause microcephaly?
Hypocalcemia
Craniosynostosis
Skull fracture
Seizure disorder

Question 43

What finding may accompany macrocephaly?
Pulsating anterior fontanel
Sunken fontanel
Premature closure of suture lines
Widened suture lines

Question 44

Obtaining a CT of the head would be indicated in which of these conditions?
Macrocephaly
Cephalohematoma
Craniosynostosis
Caput succedaneum

Question 45

Which one of the following conditions increases the risk of developing hydrocephalus?
Bilateral cephalohematomas
Craniosynostosis
Prematurity
Familial macrocephaly

Question 46

A conjunctivitis appearing in a 2 day old newborn is likely due to:
chemical irritation from eye drops
group B streptocuccus
chlamydia
gonorrhea

Question 47

Confirming the diagnosis of chlamydia conjunctivitis in a newborn would best be done by obtaining which one of the following?
cervical swab of the mother
urine PCR from the mother
culture of the eye discharge
culture of the conjunctival scrapings

Question 48

Which one of the following eye findings would be considered an ophthalmic emergency?
unilateral vesicular lesions on the upper eyelid of a 3 week old
presence of chemosis in a 5 yo with bilateral upper eyelid edema
cobblestone-like appearance along the inner aspect of the upper eyelid in a 15 yo
bilateral redness along the eyelid margins with tiny ulcerated areas in a 16 yo

Question 49

The most appropriate management of a 5 yo with a firm, nontender nodule in the mid-upper eyelid for 3 weeks would be:
cool compresses
topical ophthalmic ointment
oral antibiotics
oral steroids

Question 50

Daily eyelid cleansing with diluted baby shampoo and a cotton tipped applicator would be appropriate in the treatment of which one of the following conditions?
Dacryostenosis
Chalzion
Hordeolum
Blepharitis

Question 51

A 3 year old has an edematous, mildly erythematous right upper eyelid for one day with a fever of 103. An important eye assessment would be:
ocular mobility
conjunctival inflammation
pupillary reaction
optic disk papilledema

Question 52

Concurrent otitis media and conjunctivitis is likely due to which organism?
streptococcus pneumoniae
haemophilus influenza
moraxella catarrhalis
staphylococcus aureus

Question 53

A 16 yo girl makes the following statements to you during her health visit. Which of the following pieces of information should not be kept confidential?
I have been sexually active with three of my boyfriends
I sometimes smoke marijuana
I want to get pregnant
Sometimes I feel like ending my life

Question 54

In performing a physical examination on a nine month old infant, which of the following developmental fears would not be appropriate for you to consider?
Stranger anxiety
Pain
Separation from parents
Bodily harm

Question 55

When performing a physical examination on a toddler, which of the following body parts would you examine last:
Heart and lungs
abdomen and genitals
Ears and throat
Hips and extremities

Question 56

Role play with equipment during the course of a physical examination would be most beneficial with which of the following age groups:
Toddlers
Preschoolers
Young school-age children
Older school-age children

Question 57

Providing reassurance of “normalcy” during the course of an examination would be most important for:
Preschool children
Young school-age children
Older school-age children
Adolescents

Question 58

Which of the following would not elevate the pulse of a child:
Fever
Anemia
Hypothyroidism
Exercise

Question 59

The PNP recognizes which of the following signs as indicators that baby is not receiving sufficient breastmilk?
Sleepiness, jaundice, decreased urine and stool
Diarrhea, nausea, and vomiting
Bulging fontanel and irritability
Sleeplessness and excitability

Question 60

Blood pressure should be measured at WCC beginning at age:
2
3
4
5

Question 61

A wide pulse pressure that results from a high systolic blood pressure is usually not due to which of the following:
Fever
Exercise
Excitement
A patent ductus arteriosus

Question 62

Head and chest circumferences should be equal at:
6 months
1 year
2 years
3 years

Question 63

The anterior fontanel usually closes by:
2 months
6 months
18 months
24 months

Question 64

Diffuse edema of the soft tissue of the scalp which usually crosses suture lines in the newborn is:
Bossing
Caput seccedaneum
Cephalohematoma
Macrocephaly

Question 65

An infant should no longer have head lag when pulled from the supine to sitting position at what age?
2 months
4 months
6 months
9 months

Question 66

“Boggy” nasal mucous membranes with serous drainage upon examination usually suggests:
Sinusitis
Polyps
URI
Allergic rhinitis

Question 67

A white instead of red reflex upon eye examination of a 1 yo child would suggest:
An accommodative error
Retinoblastoma
Papilledema
Retinal detachment

Question 68

A cobblestone appearance of the palpebral conjunctiva usually indicates:
Bacterial infection
Chemical irritation
Viral infection
Severe allergy

Question 69

An eye that deviates in when covered but returns to midline when uncovered is an:
Esophoria
Exophoria
Esotropia
Exotropia

Question 70

Pain produced by manipulation of the auricle or pressure on the tragus suggests:
Acute otitis media
Otitis externa
Otitis media with effusion
Mastoiditis

Question 71

A hypernasal voice and snoring in a child is suggestive of:
Polyps of the larynx
Nasopharyngeal tumor
Hypertrophied adenoids
Cleft palate

Question 72

Physiological splitting of the second heart sound during inspiration in a child:
is normal
should be evaluated with an EKG
Suggests ASD
Should be referred to a cardiologist

Question 73

Which of the following is not characteristic of innocent heart murmurs in children?
Systolic in timing
Varies in loudness with positioning
Usually transmitted to the neck
Usually loudest at lower left sternal border or at second or third intercostal space

Question 74

A grade II musical or vibratory murmur heard best at the lower left sternal border that changes with positioning is suggestive of a:
Pulmonary ejection murmur
Ventricular septal defect
Venous hum
Vibratory or Still’s murmur

Question 75

Wheezing in a child may not be found in which of the following conditions:
Asthma
Bronchiolitis
Pleural friction rub
Cystic fibrosis

Question 76

Gynecomastia in a male may not be a finding in which of the following:
Normal pubertal development
Steroid usage
Hyperthyroidism
Testicular tumor

Question 77

Which of the following would usually not be considered a sign of a pituitary tumor in an adolescent female?
Dysfunctional uterine bleeding
Galactorrhea
Loss of peripheral vision
Increase in headaches

Question 78

Which of the following is not a specific examination test for a dislocated hip?
Barlow’s test
Ortolani’s test
Trendelenburg test
Gower’s test

Question 79

In addition to the knee, which of the following should be examined in a child complaining of knee pain?
Foot
Ankle
Hip
Spine

Question 80

Which of the following infant reflexes should not disappear by 6 months of age?
Moro
rooting
tonic neck
plantar grasp

Question 81

Spasticity in an infant may be an early sign of:
Neurofibromatosis
Hydrocephalus
Cerebral palsy
Muscular dystrophy

Question 82

A shift to the left is present when which of the following are elevated?
Neutrophils
Bands or stabs
Lymphocytes
Eosinophils

Question 83

Which of the following is usually elevated with viral infections?
Neutrophils
Eosinophils
Lymphocytes
Basophils

Question 84

Decreased platelets may not be found in which of the following:
Leukemia
Anemia
Idiopathic thrombocytopenic purpura
Medication usage (e.g. ampicillin, cephalothin)

Question 85

Which of the following does not suggest a urinary tract infection?
Increased protein
Increased WBCs
Increased RBCs
Increased nitrites