Answers for NRNP-6541-17-Primary Care of Adolescents & Children Midterm Exam
NRNP-6541-17-Primary Care of Adolescents & Children Midterm Exam
A child can typically pick up a small object using a pincer grasp by:
A. | 3 months | |
B. | 6 months | |
C. | 12 months | |
D. | 2 years |
c
Mumps is an acute generalized viral disease with painful enlargement of one or more:
A. | Parotid glands | |
B. | Parathyroid glands | |
C. | Tonsils | |
D. | Adenoids |
A
A common name for a pertussis infection is:
A. | Polio | |
B. | Whooping cough | |
C. | Chicken pox | |
D. | Diphtheria |
B
Sheila is a five-year-old who comes in with a pruritic area on her left arm. Mom denies changing any soaps, detergents, lotions, etc. The only thing new in their environment is a new cat they adopted that had been “hanging around” outside the house. On exam, you note that there is an area on the left forearm that is an oval, flat, scaly, slightly erythematous patch that has well-defined borders. Based on this information, this lesion is most consistent with:
A. | Tinea corporis | |
B. | Impetigo | |
C. | Scarlet fever | |
D. | Varicella |
B
Retinoblastsoma is:
A. | Another term for congenital cataracts. | |
B. | Common in premature infants. | |
C. | An intraocular tumor. | |
D. | An infection of the retina. |
C
A useful point to remember about common imaging tests is:
A. | Computed tomography (CT) scans do not involve radiation exposure | |
B. | Ultrasonography provides 3D images | |
C. | With Doppler ultrasound, blood flow direction and velocity can be measured | |
D. | Conventional radiographs are one of the more expensive imaging tests |
c
The CDC and the USPTF recommend prophylactic administration of antibiotic eye medication within one hour of birth. The recommended antibiotic is:
A. | Erythromycin ointment | |
B. | Silver nitrate drops | |
C. | Bacitracin ointment | |
D. | Sodium sulfacetamide drops |
A
The gold standard for the diagnosis of cystic fibrosis is:
A. | The pilocarpine iontophoresis sweat test | |
B. | A sputum culture | |
C. | The CF blood panel | |
D. | A CF urine regimate test |
a
Pectus excavatum can affect:
A. | Cardiac function | |
B. | Adrenal function | |
C. | Respiratory function | |
D. | A and C | |
E. | A, B, and C |
D
The AAP recommends giving ________ to all breastfed infants through one year of age.
A. | 200 mg of Vitamin C per day | |
B. | Iron supplementation-dosage based on weight | |
C. | 400 iu of Vitamin D per day | |
D. | No vitamins or minerals |
B
Order NRNP-6541-17-Primary Care of Adolescents & Children Midterm Exam
A basic first-grade readiness skill is the child can:
A. | Balance on each foot for 12 seconds | |
B. | Copy geometric shapes (circle, square, triangle) | |
C. | Recognize four colors | |
D. | B and C | |
E. | A, B, and C |
E
The two distinct phases of normal sleep are:
A. | Light sleep and deep sleep | |
B. | Stage I and Stage II | |
C. | REM and NREM sleep | |
D. | Twilight sleep and Heavy sleep |
c
Families and older children with innocent murmurs should be:
A. | Told that this can be very concerning, and exercise should be limited. | |
B. | Told that they should stay on a low sodium diet and exercise 20 minutes daily. | |
C. | Reassured there is no cardiac pathology | |
D. | Sent immediately to the cardiologist |
C
Fecal incontinence after an age when the child should be able to control bowel movements is called:
A. | Enuresis | |
B. | Encopresis | |
C. | Stool retention | |
D. | Diarrhea |
b
Night terrors are characterized by:
A. | A sudden arousal from sleep to a fully awake state | |
B. | Occur during sleep and the child does not remember them the following day | |
C. | Are recalled in detail the following day | |
D. | Occur during REM sleep | |
E. | B and D |
B
Adelaide comes in to see you because she is concerned about her breast. She is breastfeeding her 8-week-old and her left breast is very sore. She has also noticed a “lump” in the lower outer quadrant of the breast that is warm and slightly red. She also feels very tired and “flu-like”. You examine the area and note the lump and that there is some reddish streaking on the breast by the lump. It is very painful to her when you touch the area. You tell her it appears she has mastitis, which is an infection of the breast that can occur anytime during lactation. You advise her to:
A. | Stop breastfeeding or the bacteria may pass to the baby and make her very ill. | |
B. | Nurse or pump more frequently to “empty” the breast. | |
C. | Use warm compresses on the area. | |
D. | B and C |
D
A developmental red flag for a six-year-old is:
A. | Difficulty holding a pencil with penmanship | |
B. | Problems throwing a ball | |
C. | Unable to print name | |
D. | Picture of self includes less than 8 parts |
A
In a child with pectus excavatum, clinical findings may include:
A. | Posterior depression of the sternum and costal cartilage | |
B. | More protuberant abdomen | |
C. | Anterior bowing of the sternum | |
D. | A and B |
D
When performing a newborn ophthalmic exam, it is important to note:
A. | Can fix on and follow a toy in all directions. | |
B. | That a red reflex is present. | |
C. | That tears are present | |
D. | B and C | |
E. | A, B, and C |
D
eggy comes in to see you because her nipples are very sore. Her baby is four weeks old and she is exclusively breastfeeding. You examine her and they are cracked and peeling. You advise her to:
A. | Immediately quit breastfeeding. This can be harmful to her breasts. | |
B. | Rub some breastmilk onto the nipple and areola after every feeding and let it air-dry. | |
C. | Nurse from the least sore side first. | |
D. | B and C |
D
At birth, a newborn can see:
A. | About 8-12” | |
B. | With 20/20 vision | |
C. | Across a room | |
D. | About 20 feet |
A
Ectropion is a condition where:
A. | The eyelid margins evert | |
B. | There is a wide palpebral fissure | |
C. | The eyelids invert | |
D. | There is a contusion to the eye, resulting in a “black eye” |
A
uring the day, a newborn should breastfeed about:
A. | Every hour | |
B. | Every 2-3 hours | |
C. | Every 4-6 hours | |
D. | Three times a day |
B
For children ages 6 months to 12 years, the following anti-pyretic(s) can be used:
A. | Acetaminophen | |
B. | Ibuprofen | |
C. | Naproxen | |
D. | A and B | |
E. | A, B, and C |
D
The Denver Developmental Screening Test II divides content into the following four areas:
A. | Gross motor, language, fine motor, personal and social | |
B. | Visual motor integration, Auditory integration, Olfactory integration, Touch integration | |
C. | Neurodevelopmental, behavioral, emotional, physical | |
D. | Knowledge, self-awareness, basic skills, strategies |
a
An echocardiogram:
A. | Monitors the electrical activity of the heart from different locations and different planes of the body | |
B. | Uses reflected sound waves to identify intracardiac structures and their motion | |
C. | Rules out anemia or polycythemia as a cause of a murmur | |
D. | Provides information about cardiac output |
A
Deaths from sudden infant death syndrome (SIDS) have decreased since the AAP recommended:
A. | That all babies sleep on their backs | |
B. | That all babies be awakened every two hours during the night | |
C. | That all babies sleep with a pacifier | |
D. | That babies who have asthma sleep on their sides |
A
A subconjunctival hemorrhage:
A. | Is very painful | |
B. | Results from the bursting of conjunctival vessels | |
C. | Needs surgical drainage | |
D. | Results in immediate vision loss |
B
Otitis externa is:
A. | A diffuse inflammation of the external auditory canal. | |
B. | An infection of the tympanic membrane. | |
C. | Also known as an infection of the labyrinthine | |
D. | Commonly known as “swimmer’s ear”. | |
E. | A and D |
E
n example of a circadian rhythm disorder is:
A. | Sleep refusal | |
B. | Delayed sleep phase | |
C. | Sleep-onset association disorder | |
D. | Hypersomnia |
B
Hyperopia is also known as:
A. | Nearsightedness | |
B. | Farsightedness | |
C. | Legal blindness | |
D. | Color blindness |
B
Characteristics that are unique to multiple birth children include:
A. | They function with more dependence and need more parental attention | |
B. | Display less sibling rivalry than other types of families | |
C. | Develop a special sibling relationship marked by loyalty and cooperative play | |
D. | None of the above |
A
Sleep bruxism is:
A. | Sleep talking | |
B. | Head banging during sleep | |
C. | Grinding the teeth during sleep | |
D. | Body rocking during sleep |
C
Viral conjunctivitis may be caused by:
A. | An adenovirus | |
B. | Herpes simplex | |
C. | Enterovirus | |
D. | All of the above |
D
To enhance a child’s language development, it is recommended:
A. | To start having the child watch several educational programs on TV starting at age 6 months. | |
B. | To teach the child use of the computer at an early age and let the child work on the computer as much as he/she wants. | |
C. | To limit screen time to 1-2 hours a day for all children under age 5. | |
D. | To not allow screen time at all under the age of 2 years and then allow 1-2 hours per day of appropriate programs for older children. |
C
ustine has a three-month-old baby. She is breastfeeding and all has been going well. The baby is voiding 6-8 times every 24 hours, but Justine is concerned because the baby only has a bowel movement every 3-4 days. She is curious if the baby is chronically constipated. The baby is alert and appears happy. Exam is unremarkable. You tell Justine:
A. | That is quite odd. We need to start the baby on some laxatives to get things moving. | |
B. | This is common in babies. As many as 40% of infants do not stool every day. | |
C. | This is quite uncommon in breastfed babies. We should do an abdominal ultrasound to see if there is an anatomical problem. | |
D. | I am going to prescribe some glycerin suppositories for the baby to soften things up and get things moving. |
ustine has a three-month-old baby. She is breastfeeding and all has been going well. The baby is voiding 6-8 times every 24 hours, but Justine is concerned because the baby only has a bowel movement every 3-4 days. She is curious if the baby is chronically constipated. The baby is alert and appears happy. Exam is unremarkable. You tell Justine:
A. | That is quite odd. We need to start the baby on some laxatives to get things moving. | |
B. | This is common in babies. As many as 40% of infants do not stool every day. | |
C. | This is quite uncommon in breastfed babies. We should do an abdominal ultrasound to see if there is an anatomical problem. | |
D. | I am going to prescribe some glycerin suppositories for the baby to soften things up and get things moving. |
B
In the first 3-4 days of life, the baby should urinate approximately _____ times in 24 hours.
A. | 1-2 | |
B. | 3-4 | |
C. | 6-8 | |
D. | 12-15 |
c
A persistent unilateral nasal discharge may be a sign of:
A. | A URI | |
B. | A nasal foreign body | |
C. | A migraine headache | |
D. | Allergies |
B
Erythema infectiosum is also known as,
A. | Third disease | |
B. | Roseola | |
C. | Fifth disease | |
D. | Strep throat |
C
A non-contact infrared forehead thermometer can also be used on the __________ if the forehead is not available.
A. | Navel | |
B. | Earlobe | |
C. | Knee | |
D. | First finger |
B
When feeding pumped breast milk, it is important to:
A. | Warm it up in the microwave prior to feeding. | |
B. | Warm it in warm water prior to feeding. | |
C. | Never warm it up, as that causes bacterial overgrowth. | |
D. | Ensure that the milk has been in the refrigerator less than 72 hours. |
C
Ophthalmia neonatorum, or conjunctivitis of the newborn, is most commonly caused by:
A. | Staphylococcus aureus. | |
B. | Pseudomonas | |
C. | Escherichia coli | |
D. | Chlamydia trachomatis |
D
School-age children tend to be rather ________ in their sense of right or wrong.
A. | Flexible | |
B. | Rigid | |
C. | Fluid | |
D. | Relaxed |
B
In bacterial pneumonia, 90% of cases are caused by:
A. | Chlamydia trachomatis | |
B. | Staphylococcus aureus | |
C. | Mycoplasma pneumoniae | |
D. | Streptococcus pneumoniae |
D
The largest organ of the body is the:
A. | Heart | |
B. | Lung | |
C. | Skin | |
D. | Liver |
C
Ideally, solids should be started:
A. | By 2 months | |
B. | At 4-6 months | |
C. | At 7-9 months | |
D. | At 1 year |
C
The movement with nystagmus may be:
A. | Horizontal | |
B. | Vertical | |
C. | Rotary | |
D. | A and B | |
E. | A, B, and C |
E
The World Health Organization (WHO) recommends handwashing for:
A. | 10 seconds | |
B. | 20-30 seconds | |
C. | 40-60 seconds | |
D. | 2 minutes |
B
An absolute contraindication to swimming is:
A. | Otitis externa | |
B. | Otitis media | |
C. | Tympanic membrane perforation | |
D. | A and C |
D
The following are barriers to care:
A. | Financial issues | |
B. | Insurance issues | |
C. | Clinic services that are available outside working hours | |
D. | A and B | |
E. | A, B, and C |
D
Monosymptomatic nocturnal enuresis is defined as:
A. | Involuntary urination at an age when toilet training should be complete. | |
B. | Involuntary urination during waking hours only. | |
C. | Nighttime wetting when child has normal daytime elimination with no concerns. | |
D. | Involuntary stooling at nighttime only. |
The following are consistent with symptoms of the common cold:
A. | Malaise, sneezing, watery nasal discharge, mild sore throat, may have fever-all within the past 0-10 days | |
B. | Persistent nasal symptoms for more than 10 days with URI, purulent or colored nasal drainage, cough, fever | |
C. | Malaise, nasal obstruction, unilateral or bilateral nasal discharge | |
D. | Persistent nasal symptoms for more than 30 days with URI |
Cora is a first-time mother. Her baby was born at 40 weeks and weighed 8 pounds, 1 oz. Cora is breastfeeding her baby. The baby is voiding 6-8 wet diapers every 24 hours and is stooling 3-5 times/day. She brings her baby in for a 1 week check up and her baby weighs 7 lbs., 15 oz. Cora is upset at the weight loss. You explain to her:
A. | It is indeed concerning. Babies need to gain weight steadily. | |
B. | This is not something to worry about. Babies typically lose 5-8% of birth weight but should regain it by 10-14 days. | |
C. | Babies do lose weight initially, but she should at least be back to birth weight by now. I will need to do a weight check tomorrow. | |
D. | This is extremely concerning. We need to admit your baby back into the hospital. |
B
A woman who loses a small amount of urine involuntarily every time she sneezes is experiencing what type of incontinence?
Functional incontinence | ||
Overflow incontinence | ||
Stress incontinence | ||
Urge incontinence |
C
A patient’s urinalysis came back positive for glucose. What does the healthcare professional expect the patient’s blood glucose to be at a minimum?
126 mg/dL | ||
150 mg/dL | ||
180 mg/dL | ||
200 mg/dL |
C
According to Freud’s theory, during the phallic stage of early childhood (5 to 7 years old), the child attaches to:
A. | The parent of the same sex | |
B. | The parent of the opposite sex | |
C. | The oldest sibling | |
D. | None of the family members; this is a time of isolation |
b
A fungal infection of the nails is called:
A. | Onychomycosis | |
B. | Herpetic whitlow | |
C. | Paronychia | |
D. | Tinea cruris |
A Grade VI heart murmur is:
A. | Barely audible. | |
B. | Moderately loud; no thrill. | |
C. | Loud and present over a widespread area; no thrill. | |
D. | Heard without a stethoscope. |
A
The National Heart, Lung, and Blood Institute (NHLBI) recommends measuring blood pressures annually and at every health care episode at:
A. | Birth | |
B. | Age 1 year | |
C. | Age 3 years | |
D. | Age 5 years |
c
The following are the five stages of change:
A. | Contemplation, inaction, action, post-contemplation, maintenance | |
B. | Precontemplation, contemplation, preparation, action, maintenance | |
C. | Contemplation, preparation, forward thinking, action, continuation | |
D. | Preparation, contemplation, action, post-contemplation, maintenance |
B
The mode of transmission for shigella is:
A. | Respiratory | |
B. | Fecal-oral | |
C. | Skin contact | |
D. | Contact with blood, urine, or saliva |
In a child, the normal heart sounds are:
A. | S1 and S2 | |
B. | S1, S2, aortic closure | |
C. | S1, S2, S3, and S4 | |
D. | Mitral, aortic, pulmonic |
A
t has been found that children who participate in after-school activities have:
A. | Decreased self esteem | |
B. | Better school grades | |
C. | Poorer emotional skills | |
D. | Higher incidence of depression |
A medication that can be used for children with monosymptomatic nocturnal enuresis is:
A. | Trazodone | |
B. | Ritalin | |
C. | Benadryl | |
D. | Desmopressin |
The guidelines for indication of a tonsillectomy are:
A. | At least one serious throat infection a year for five years in a row | |
B. | At least three throat infections in the past year | |
C. | More than seven episodes of throat infections in the past year, or more than five episodes of throat infection in the past two years, or at least three episodes per year for the past three years | |
D. | One episode in the past six months of Strep throat |
A child should be excluded from the childcare setting if he/she:
A. | Is HIV positive | |
B. | Has an exanthem but no fever or behavioral changes | |
C. | Has diarrhea that is not contained by diapers or toilet use | |
D. | Has nits that are being treated |
In Erikson’s Developmental theory, the first stage (0-12 months) which is the stage of:
A. | Trust vs. mistrust | |
B. | Autonomy vs shame | |
C. | Intimacy vs isolation | |
D. | Initiative vs guilt |
For a patient with a corneal abrasion, it is important to:
A. | Have the patient return the following day for a recheck. | |
B. | Have the patient wear an eye patch over the affected eye while it is healing. | |
C. | Prescribe topical anesthetics for the patient for comfort. | |
D. | A and B |
Most children become toilet-trained between the ages of:
A. | 12-24 months | |
B. | 18 months-2 ½ years | |
C. | 2 ½-3 ½ years | |
D. | 4-5 years |
B
A respiratory rate greater than _____ in a young child who is quiet, resting, and afebrile warrants further evaluation.
A. | 16 | |
B. | 24 | |
C. | 40 | |
D. | 60 |
C
Mastoiditis is most common in:
A. | Children younger than 2 years | |
B. | School-aged children | |
C. | Teenagers | |
D. | Elderly individuals |
A
In fetal circulation, the oxygenation of the blood occurs in:
A. | The lungs | |
B. | The placenta | |
C. | The umbilical vein | |
D. | The portal vein |
Trisomy 21 is also known as:
A. | Klinefelter syndrome | |
B. | Turner syndrome | |
C. | Down syndrome | |
D. | Fragile X syndrome |
Jonathan comes in with a wart on his finger. In discussing this with his parent, a decision is made to proceed with cryotherapy. When discussing the procedure with Jonathan and his mother, you tell them:
A. | When I complete the procedure, the wart will be gone but you will need to keep the area covered for 48 hours to reduce the risk of infection. | |
B. | There is a chance that one treatment may not completely resolve the wart and it may need to be retreated. | |
C. | When you leave, the wart will not be gone. A blister will form over the next 1-2 days and it should gradually resolve. | |
D. | B and C |
D
A common term for strabismus is:
A. | Lazy eye | |
B. | Monovision | |
C. | Nystagmus | |
D. | Astigmatism |
atients with CF have an 85% rate of:
A. | Pancreatic insufficiency | |||||||||||||||||||||||||||||||||||||||||||||||||
B. | Hepatomegaly | |||||||||||||||||||||||||||||||||||||||||||||||||
C. | Gastritis | |||||||||||||||||||||||||||||||||||||||||||||||||
D. | Ulcerative colitis | |||||||||||||||||||||||||||||||||||||||||||||||||
The most effective means of preventing the spread of infection is:
90% of allergic conjunctivitis in the United States is caused by:
The CDC recommends initial universal screening for congenital or birth-related hearing loss:
The Patient Protection and Affordable Care Act of 2010 (ACA) made it so that:
|
When a perforation of the tympanic membrane occurs,
A. | The patient will have intense pain until intervention occurs | |
B. | The patient may have bleeding from the ear | |
C. | The pain may improve | |
D. | A and C | |
E. | B and C |
The clinical findings of retinal detachment include:
The assessment tool often used to assess for hyperactivity is:
A. | The PHQ-9 | |
B. | The Columbia Impairment Scale | |
C. | The Vanderbilt Assessment Scale | |
D. | The Eyberg Child Inventory |
C
A hordeolum is also known as a:
A. | Stye | |
B. | Wen | |
C. | Sebaceous cyst | |
D. | Chalazion |
Nonpharmacologic strategies for management of a fever in a child include:
A. | Adequate hydration, ice-water baths, appropriate clothing | |
B. | Alcohol sponging, adequate hydration, and reassurance to the parents | |
C. | Adequate hydration, ambient environment temperatures around 72 degrees F, reassurance to the parents | |
D. | Ambient environment temperatures around 68 degrees F, acetaminophen, and adequate hydration |
Nonpharmacologic strategies for management of a fever in a child include:
A. | Adequate hydration, ice-water baths, appropriate clothing | |
B. | Alcohol sponging, adequate hydration, and reassurance to the parents | |
C. | Adequate hydration, ambient environment temperatures around 72 degrees F, reassurance to the parents | |
D. | Ambient environment temperatures around 68 degrees F, acetaminophen, and adequate hydration |
he following is/are characteristics of children with fetal alcohol syndrome:
A. | Microcephaly | |
B. | Large upper jaw | |
C. | Large epicanthal folds | |
D. | A and C | |
E. | A, B, and C |
The transmission of HIV to infants can occur in the following way(s):
A. | In utero transmission | |
B. | Intrapartum transmission | |
C. | Breastfeeding | |
D. | B and C | |
E. | A, B, and C |
Candidiasis is a:
A. | Fungal infection | |
B. | Bacterial infection | |
C. | Viral infection | |
D. | A combination of A, B, and C |
A commonly used term for Herpes Zoster is:
A. | Chicken pox | |
B. | Shingles | |
C. | Impetigo | |
D. | Cellulitis |
The complete history usually needs to be completed:
A. | Only once for new patients | |
B. | At every visit | |
C. | Once a year | |
D. | Every five years |
A herald patch is present in 70% of the presentation of:
A. | Tinea corporis | |
B. | Roseola | |
C. | Pityriasis rosea | |
D. | Psoriasis |
Hepatitis B is highly contagious and causes:
A. | Blindness | |
B. | Severe renal disease | |
C. | Severe liver disease | |
D. | Thyroid cancer |
A teratogen is:
A. | A chromosomal disorder | |
B. | A genetic disorder | |
C. | An agent that results in, or increases the incidence of, a congenital malformation * (pg. 1151) | |
D. | A term meaning a hand with only four fingers |
Regarding sexual development, a five-year old should:
A. | Not yet have any idea where babies come from. | |
B. | Use slang words for sexual body parts. | |
C. | Not yet understand about saying no to unwanted touch. | |
D. | Know that “sex talk” is for private times at home. |
Regarding sexual development, a five-year old should:
A. | Not yet have any idea where babies come from. | |
B. | Use slang words for sexual body parts. | |
C. | Not yet understand about saying no to unwanted touch. | |
D. | Know that “sex talk” is for private times at home. |
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