MN580 Child Care Midterm Exam With Answers (61 Solved Questions)

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MN580 MIDTERM EXAM1.Cyclicvomiting may:1.Last fordays.2.RequireSSRIstostophurting.3.Notbeassociatedwithaheadache.4.RequirespainmedicationandZofran.ANS: 32. A 5-day old infant comes in for a newborn checkup. On assessment of the newborn, you notethattheskinisjaundiceincolor.Theanteriorfontanelisslightlysunken.Permom,theinfanthasonly had 2 diapers today. The infant is strictly breastfed, and this is moms first child. She statesbaby is having troublelatching on. A bilirubin level is sent andcomes back at 18. You identifythis newborn to be dehydrated and is most likely to have breast milk jaundice. Which nursingintervention(s)willberequiredfor this baby?1.Phototherapy2.Providingsupportandeducationforthelactatingmother3.Strictmonitoring ofintakeandoutput4.All of the aboveANS43. You are taking care of an infant who was admitted with dehydration. His weight is 6kg. YouhavebeenwatchinghisI&Os.Whatwouldyouexpect theinfantsurinaryoutput tobe inorderto maintainadequatehydration?1.0.52ml/kg/hr2.0.52.5ml/kg/hr3.13ml/kg/hr4.Aslongasheishavingwetdiapersit doesnot matterANS: 34.The primary care pediatric nurse practitioner diagnoses a 5yearold child with asthma andprescribes an oral steroid and ashort acting beta-adrenergic medication via a metered doseinhalertomanageacutesymptoms.Alongwitheducationabouttheprescribedmedications,whatinformation isimportantto givethe child’s familyatthisvisit?A.AnasthmaactionplanB.EffectsandsideeffectsofcurrentmedicationsCorrectC.Informationaboutspirometrytesting

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D.Instructionsformedicationsatschool5.The primary care pediatricnurse practitioner orders a pulmonology consult for a child who hassevere asthma. The nurse practitioner writes “child with asthma refractory to conventionaltreatments needs suggestions for alternative treatments.” The nurse practitioner expects thepulmonologist toA.confirmthemedicaldiagnosisforthechild’sparents.B.makerecommendationsfordiseasemanagement.CorrectC.stresstheimportanceofadherencetothemedicationregimen.D.takeovermanagementofthischild’schronicillness.6.The parent of an18monthold child calls the clinic to report that the child has a rectaltemperature of 100.4°F (38°C). The child is playing normally, taking fluids well, and has aslightlyreducedappetite.Whatwilltheprimarycarepediatricnursepractitionerrecommend?A.AdministeringanantipyreticmedicationB.BringingthechildtotheclinicforevaluationC.OfferingextrafluidsandcallingifsymptomschangeCorrectD.Orderingoutpatientlab worksuchasaCBC7.The primary care pediatric nurse practitioner isevaluating a 10yearold child who is describingshooting pain in both legs associated with aching, tingling, and burning. The child is unable topinpointspecificlocationsforthispain.Whichtypeofpaindoesthe nursepractitionersuspect?A.ChronicpainB.NeuropathicpainCorrectC.Somatic painDVisceralpain8.A3yearoldchildisrecoveringfrom injuriessustained inamotorvehicleaccident.How willthe primary care pediatricnursepractitionerevaluatethischild’spain?A.Askthechildtoratepainintensityona4to 5itempaindiscrimination scale.

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B.Havethechilddescribeanypainas“nopain,alittlepain,oralot ofpain.” CorrectC.Questionthechildabout theintensityand specificlocationofany pain.D.Relyonnonverbalresponsessuchasfacialexpressionsandlimbmovements.9.A 4yearold child has just been releasedfrom the hospital after orthopedic surgery on one legfollowing a bicycle accident. The child is sitting quietly on the exam table. When asked to ratepain,thechildpointstothe“1”onafacesratingpainscale.Whatwilltheprimarycarepediatricnursepractitioner do next?A.Assessthechild’svitalsignsandabilitytowalkwithoutpain.CorrectB.Refilltheprescriptionforanarcoticanalgesicmedication.C.Suggestthattheparentsgiveacetaminophenformildpain.D.Teachtheparenttogiveanalgesicsbasedonthechild’sreportofpain.10.A developmentally and cognitivelydisabled 10yearold child who is unable to communicatemustundergoaseriesofsurgeries,andthechild’sparentaskshowtoknowifthechildisinpainand when to give pain medication. What will the primary care pediatric nurse practitioner teachthisparentto useto assessthischild’s pain?A.ComfortscaleB.FLACCscaleC.NCCPCRCorrectD.Nonverbalobservations11.The primary care pediatric nurse practitioner is preparing to perform a painful procedure on a4monthold infant. Besides providing local anesthesia, what other pain control method providesanalgesic effects?A.ProvidingtoysB.SingingormusicC.SucrosesolutionCorrectD.Swaddlingorcuddling

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12.An adolescent female reports moderate dysmenorrhea with periods and tells the primary carepediatricnursepractitionerthat 400mgibuprofenevery6to 8completely controlherpain.Whatwill thenursepractitionerrecommend?A.Increasingtheibuprofen doseto600to800mg every6to 8hoursB.Takingextrastrengthacetaminophen1000mgevery4to6hoursC.Takingnaproxen500mginitiallyandthen250mgevery6to8hourscorrectD.Usingextendedreleasenaproxen500mgevery12hours13.Whatisthemostimportantdoselimitingfactorwhenprescribingacetaminophenwithhydrocodone?A.AcetaminophendoseCorrectB.GastrointestinalsideeffectsC.PruritissymptomsD.Urinaryretention14.Anadolescenttakesibuprofen,acetaminophen,andatricyclicantidepressant(TCA)totreatphantom limb pain and reports that the medications are no longer effective. What will theprimarycarepediatricnursepractitionerdo?A.Change theTCAtoaselective serotoninreuptakeinhibitor.B.Evaluatetheadolescentfordrugseekingbehavior.C.IncreasetheTCAdoseandreevaluatein2to3weeks.D.Refertheadolescenttoapainmanagementspecialist.Correct15.The parent of a school age child with a chronic pain condition tells theprimary care pediatricnurse practitioner that the child has requested to stay home from school more often in the pastfew months. The child’s exam does not reveal any significant change in pathology, and a reviewof the child’s medications indicatesappropriate dosing of analgesic medications. What will thenursepractitioner recommend?A.Assessingthechild’spaineverydaytodeterminechangesB.Ensuringthechildstaysquiet inbed withvideoswhenhaving painC.HavingthechilddohomeworkwhenstayinghomefromschoolCorrect

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D.Requiringthechildtogotoschooleven duringpain episodes16.The parent of a 2weekold infant reports that the infant was diagnosed with transienttachypneaofthenewbornshortlyafterbirth.Theprimarycarepediatricnursepractitionerunderstandsthat, inthis condition,A.antibiotictherapyisgenerallynecessarytopreventsevereinfection.B.homeoxygentherapy isneeded until theinfantgrowsoutofthecondition.C.recoveryisusuallycompletewithminimalinterventionandtreatments.CorrectD.treatmentwithexogenoussurfactantandmechanicalventilationisneeded.17.A 2monthold infant has a staccato cough and fever.Which aspect of the history is mostimportant in determining thediagnosis?A.DaycareattendanceB.ImmunizationhistoryCorrectC.MedicationhistoryD.Pastmedicalhistory18.According to recent research, which populations may have higher rates of underimmunization than others?A.ThosewithhigherratesofAsiansB.ThosewithhigherratesofgraduatedegreesCorrectC.Thosewith lowerratesofpovertyD.Thosewithlowerratesofprimaryproviders19.Theparentofa2monthold infantisreluctantto havethe babyvaccinated.Whatisan initialstepin respondingtotheseconcerns.A.Informtheparentthatallvaccinesmaybegivenwithoutthimerosol.B.ProvidingVaccineInformationStatementsfortheparenttoreview.C.Questiontheparent’sreasonsforconcernaboutimmunizations.CorrectD.Remind the parent that the infant is exposed to thousands of germs eachday.

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