MN580 Child Care Final Exam With Answers (85 Solved Questions)

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MN580-FinalGU.1.A 30monthold girl who has beentoilet trained for 6 months has daytime enuresis and dysuriaand a low-grade fever. A dipstick urinalysis isnegative for leukocyte esterase and nitrites. Whatisthenextstep?a.Beginempirictreatmentwithtrimethoprimsulfamethoxazole.b.Discussbehavioralinterventionsfortoilettraining.c.Reassurethechild’sparentsthatthechilddoesnothaveaurinarytractinfection.d.Sendtheurinetothelabforculture.Correct2.Thecleancatchurinespecimenofachildwithdysuria,frequency,andfeverhasacolonycount between 50,000 and100,000 ofE.coli.What is thetreatmentforthischild?a.ObtainacompletebloodcountandCreactiveprotein.b.Performsensitivitytestingbeforetreatingwithantibiotics.c.Repeatthecultureif symptomspersistorworsen.d.Treatwithantibioticsforurinarytractinfection.Correct3.A dipstick urinalysis is positive forleukocyte esterase and nitrites in a school aged child withdysuriaandfoul-smellingurinebutnofever whohasnothadpreviousurinary tractinfections.Acultureispending.What willthe pediatricnurse practitioner do totreatthischild?a.OrderciprofloxacinER oncedaily for3daysifthe cultureispositive.b.Prescribetrimethoprimsulfamethoxazole(TMP)twicedailyfor3to5days.Correctc.Reassurethechild’sparentsthatthisislikelyanasymptomaticbacteriuria.d.Waitforurinecultureresultstodeterminethecorrectcourseoftreatment.4.A child is diagnosed with nephroticsyndrome, and the pediatric nursepractitioner providesprimary care in consultation with a pediatric nephrologist. The child was treated with steroidsand responded well to this treatment. What will the nurse practitioner tell the child’s parentsabout this disease?a.“Futureepisodesarelikelytohaveworseoutcomes.”b.“Steroidswillbeusedwhenrelapsesoccur.”Correctc.“Thisrepresents acurefromthisdisease.”d.“Yourchildwillneedtotakesteroidsindefinitely.5.A child who has nephrotic syndrome is on a steroid and a salt restricteddiet for a relapse ofsymptoms.Adipstick urinalysisshows1+protein,downfrom3+atthe beginning oftheepisode.

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Inconsultationwiththechild’snephrologist,whatisthecorrectcourseoftreatmentconsideringthisfinding?a.Beginataperofthesteroidmedicationwhilecontinuingsaltrestrictions.b.Continuewithsteroidsandsaltrestrictionsuntiltheurineisnegativeforprotein.Correctc.Discontinuethesteroidsandsaltrestrictionsnowthatimprovementhasoccurred.d.Relaxsaltrestrictionsandcontinueadministrationofsteroidsuntilproteinuriaisgone.5.A child who had GABHS 2 weeks prior isin the clinic with periorbital edema, dyspnea, andelevated blood pressure. A urinalysis reveals tea colored urine with hematuria and mildproteinuria.Whatwilltheprimarycarepediatricnursepractitionerdotomanagethiscondition?a.Prescribea10to14daycourseofhighdoseamoxicillin.b.Prescribehighdosesteroidsinconsultationwithanephrologist.c.Reassuretheparentsthatthisconditionwillresolvespontaneously.d.Referthechildtoapediatricnephrologistforhospitalization.Correct6.During a well child examination of a 2yearold child, the primary care pediatric nursepractitionerpalpatesaunilateral,smooth,firmabdominalmasswhichdoesnotcrossthemidline.Whatis thenextcourseof actionthat?a.OrderaCTscanofthechest,abdomen,andpelvis.b.Performurinalysis,CBC,andrenalfunctiontests.c.Reevaluatethemassin1to2weeks.d.Referthechildtoanoncologistimmediately.Correct7.A 6monthold infant has a retractiletestis that was noted at the 2month well baby exam. Whatwill the primary carepediatricnursepractitionerdotomanagethiscondition?a.Reassuretheparentthatthetestiswillmostlikelydescendintoplace onitsown.b.Refertheinfanttoapediatricurologistorsurgeonforpossibleorchiopexy.Correctc.Teachtheparenttomanipulatethetestisintothescrotumduringdiaperchanges.d.Telltheparentthathormonaltherapymaybeneededtocorrectthecondition.8.A 9monthold infant is brought tothe clinic with scrotal swelling and fussiness. The primarycare pediatric nurse practitioner notes a tender mass in the affectedscrotum that is difficult toreduce.Whatis thecorrectaction?a.Obtainanabdominalradiograph.

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b.Referimmediatelytoapediatricsurgeon.Correctc.Scheduleanappointmentwithapediatricurologist.d.TeachtheparentssignsofincarcerationGI.9.Theparentofaninfant asksaboutusingaprobioticmedication.Whatwillthe primarycarepediatricnursepractitioner tellthisparent?a.Probioticmedicationshavedemonstratedefficacyintreatingcolic.b.Probioticsarenot safetousetotreat infantswhohavecolic.c.Therearenostudiesshowingusefulnessofprobioticstomanagecolic.d.Thereisnoconclusiveevidenceaboutusingprobioticstotreatcolic.Correct10.A toddler who was born prematurelyrefuses most solid foods and has poor weight gain. Abarium swallow study reveals a normal esophagus. What will the primary care pediatric nursepractitionerconsider nextto managethischild’snutritionalneeds?a.Consultationwithadieticianb.Fiberopticendoscopyevaluationc.Magneticresonanceimage.D.VideofluoroscopyswallowingstudyCorrect.11.A toddler is seen in the clinicafter a 2day history of intermittent vomiting and diarrhea. Anassessment reveals an irritable child with dry mucous membranes, 3second capillary refill,2second recoil of skin, mild tachycardia and tachypnea, and cool hands and feet. The child hashadtwowet diapersinthepast24hours.Whatwilltheprimarycare pediatricnursepractitionerrecommend?a.Antidiarrhealmedicationandclearfluidsfor24hoursb.BolusofIVnormalsalineintheclinicuntil improvementc.HospitaladmissionforIVrehydrationandoralfluidsd.Oralrehydrationsolutionwithfollowupin24hoursCorrect12.A 9yearold girl has a history of frequent vomiting and her mother has frequent migraineheadaches. The childhas recently begun having more frequent and prolonged episodes.accompaniedbyheadaches.Anexamrevealsabnormaleyemovements andmildataxia.Whatisthe correctaction?a.Beginusinganantimigrainemedicationtopreventheadaches.b.Prescribeondansetronandlorazepamtohelpmanagesymptoms.

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c.Reassuretheparentthatthisisexpectedwithcyclicvomitingsyndrome.d.Refertoapediatricgastroenterologistforfurtherworkup.Correct.13.A child is in the clinic after swallowinga metal bead. Aradiograph of the GI tract shows a 6mmcylindricalobjectinthechild’sstomach.Thechildisabletoswallowwithoutdifficultyandisnotexperiencing pain.Whatis thecorrectcourseof treatment?a.Administeripecactoinducevomiting.b.Havetheparentswatchfortheobjectinthechild’sstoolCorrectc.Insertanasogastric tubetoflushoutthe object.d.Referthechildforendoscopicremovaloftheobject.14.A 10yearold child has had abdominalpain for 2 days, which began in the periumbilical areaand thenlocalized to the right lower quadrant. The child vomited once today and thenexperiencedrelieffrompainfollowedbyanincreasedfever.Whatisthe likelydiagnosis?a.AppendicitiswithperforationCorrectb.Gastroenteritis.c.Pelvicinflammatorydisease(PID)d.Urinarytractinfection(UTI)15.An 18monthold child has a 1day history of intermittent, cramping abdominal pain withnonbiliousvomiting.Thechild isobservedtoscream anddrawuphislegsduringpainepisodesand becomes lethargic in between. The primarycare pediatric nurse practitioner notes a smallamountofbloody, mucousstoolin thediaper.Whatisthemostlikelydiagnosis?a.Appendicitisb.GastroenteritisC.IntussusceptionCorrectD.Testiculartorsion16.A school age child has had abdominalpain for 3months that occurs once or twice weeklyandisassociatedwithaheadacheandoccasionaldifficultysleeping,oftencausingthechildtostay home from school. The child does not have vomiting or diarrhea and is gaining weightnormally. The physical examis normal. According to Bishop, what is included in the initialdiagnosticworkup for this child?a.CBC,ESR,amylase,lipase,UA,andabdominalultrasoundCorrectb.CBC,ESR,CRP,andfecalcalprotectinc.CBC,ESR,CRP,UA,stoolforova,parasites,andculture

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d.StoolforH.pyloriantigenandserumIgA,IgG,tTg17.An adolescent is diagnosed with functional abdominal pain (FAP). The child’s symptomsworsenduringstressfulevents,especiallywithschoolanxiety.Whatwillbeanimportantpartoftreatmentfor this child?a.Informingthe parentsthatthe painismost likely notrealb.Institutingalactosefreedietalongwithlactobacillus supplements.c.TeachingaboutthebraingutinteractioncausingsymptomsCorrectd.Usinghistamine2blockerstohelpalleviatesymptoms18.A school age child has recurrent diarrhea with foul smelling stools, excessive flatus,abdominaldistension,and failuretothrive.A2week lactose freetrialfailed to reduce symptoms.Whatis thenextstepin diagnosingthis condition?a.Lactosehydrogenbreathtestb.SerologictestingforceliacdiseaseCorrectc.Stoolforovaandparasitesc.Sweatchloridetestforcysticfibrosis19.AchildisdiagnosedwithCrohn disease.Whatarelikelycomplications for this child?a.Cancerofthecolonandpossiblecolectomyb.IntestinalobstructionwithscarringandstricturesCorrectc.Intestinalperforationandhemorrhaged.Liverdiseaseandsepsis20.A 12monthold infant exhibits poor weight gain after previously normal growth patterns.There is no history of vomiting,diarrhea, or irregular bowel movements, and the physical examisnormal.Whatisthenextstep in evaluating thesefindings?a.Completebloodcountandelectrolytesb.Feedingandstoolinghistoryand3daydiethistoryCorrectc.Stoolculturesforovaandparasitesd.Swallowstudywithvideofluoroscopy.21.A 2yearold child has an acute diarrhealillness. The child is afebrile and, with oral rehydrationmeasures, has remained well hydrated. The parent asks what can be done to help shorten thecourseofthisillness.Whatwill theprimarycare pediatric nurse practitioner recommend?a.Clearliquidsonly

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b.LactobacillusCorrectc.Loperamided.Peppermint oil.Cardiac22.The primary care pediatric nurse practitioner is examining a 2weekold infant and auscultatesawidesplitting ofS2during expiration.Whatconditionmaythisfinding represent?a.AtrialseptaldefectCorrectb.Coarctationofthe aortac.Patentductusarteriosisd.Ventricularseptaldefect23.The primary care pediatric nurse practitioner auscultates a newgrade II vibratory, midsystolic murmur at the mid sternal border in a 4yearold child that is louder when the child issupine.Whattypeof murmur is mostlikely?a.Pathologicmurmurb.Pulmonaryflowmurmurc.Still’smurmurCorrectd.Venoushum.24.During a wellchild assessment, the primary care pediatric nurse practitioner auscultates aharsh,blowinggradeIV/VImurmurina6montholdinfant.What willthenursepractitionerdonext?a.Getacompletebloodcount torule outsevereanemiab.Obtainanelectrocardiogramtoassessforarrhythmia.c.Orderachestradiographtoevaluateforcardiomegaly.d.Refertoapediatriccardiologistforfurtherevaluation.Correct25.A3montholdinfantwhowaspreviouslyhealthynowhas a persistentcough,bilaterallungcrackles, and poor appetite. The primary care pediatric nurse practitioner auscultates a gradeIII/VI,lowpitched,holosystolicmurmurovertheleft lowersternalborderandpalpatestheliverat onecentimeter below theribs.Whatdiagnosis islikely?a.Atrialseptaldefectb.Coarctationofthe aortac.Patentductusarteriosis

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