NR 602 Week 4 Midterm Exam (70-Real Exam Solutions)
1. Role-play with equipment during the course of a physical examination would be most beneficial with which of the following groups?
- Preschoolers/Toddlers
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NR 602 Week 4 Midterm Exam (70-Real Exam Solutions)
1. Role-play with equipment during the course of a physical examination would be most beneficial with which of the following groups?
- Preschoolers/Toddlers
2. What is the Ortolani Sign?
-Assess for congenital hip dysplasia
3. When performing a physical examination of a toddler, which of the following body parts would examine last?
- Ears and throat
4. What are three findings using Jones criteria for Rheumatic Fever?
-Streptococal infection, carditis, and erythema marginatum
5. While examining a 4-month-old boy, you are unable to palpate one of his testes. The next most appropriate step is:
- Refer the child to a urologist
6. Concurrent Otitis media and Conjunctivitis is likely due to which?
- Haemophilus influenza
7. What is the appropriate management of a child with asthma who presents with acute wheezing and/or coughing?
- Administer a short-acting beta agonist
8. Sandra, age 12 years, has several vesicles and honey-colored crusted lesions on her face above the right nares. She has a history of having a bad scratch in the same area several days ago. What condition do you suspect?
-Impetigo
9. The most appropriate management of a 5-year old with a firm nontender nodule in the mid- upper eyelid for 3 weeks would be:
-Topical ophthalmic ointment
10. A 10-month-old child has been diagnosed with gastroenteritis. He attends a child care facility. What is the most likely cause of illness?
-Rotavirus
11. If a child or any patient describes a “pop” in the knee. What is this indicative of?
- Anterior cruciate ligament tear
12. A 7-year-old African American female presents with several hyperkeratotic raised, periungual lesions on the two middle fingers of her left hand. She has a history of nail biting. The most likely diagnosis is:
- Verruca vulgaris
13. Management of scoliosis depends on the severity of curve as well as the age of the child. Which of the following would require surgical intervention?
- Thoracic curve greater than 50 degrees or lumbar curve greater than 40 degrees.
14. Treatment of true central precocious puberty is best achieved with:
- Gonadotropin-releasing hormone agonist
15. Baby Sally was in your office last week for her 6-month checkup. Her weight was 7 kg. Today she presents with diarrhea and vomiting for 4 days. Today her weight is 6.5 kg. What is her percentage of dehydration?
-7%
16. Which of the following would be the most appropriate initial management of a newborn diagnosed with developmental dysplasia of the hip?
-Pavlik harness
17. When considering catch up vaccination in children for IPV vaccinations, it is important to understand one of the following considerations is NOT a consideration when administering the vaccine:
- IPV is can be given routinely beyond the age of 18 years of age in the U.S.
18. An essential test in the evaluation of a 2-year-old being managed for Kawasaki disease is:
- An echocardiogram
19. A 4-week-old presents to your office in mid=January with a 1-week history of nasal congestion and occasional cough. On the evening prior to this visit, the infant developed a temperature of 102, refused to breastfeed, and had proximal coughing and noisy, labored breathing. On exam, you note an ill-appearing infant who is lethargic with tachypnea.
- RSV bronchiolitis
20. What needs to be included when educating parents about a febrile seizure?
- Children may experience repeated seizures
21. A 4-year-old boy is brought in by his mother, who is concerned about the sudden onset of a painful limp in his right leg 2 days ago? Today he has a low-grade fever. Which of the following diagnoses is most likely?
- Transient synovitis of the hip
22. In addition to penicillin, all of the following antibiotics can be used to treat strep pharyngitis except:
- Bactrim
23. Primary dysmenorrhea is due to:
- Elevated prostaglandin level
24. Which behavior would NOT be expected in a two-year old?
- Draws a circle
25. The most common congenital heart defect in children is:
- Ventricular septal defect
26. Michael is a 15-year-old high school student who presents for a school sports physical. He appears to be in good health but is concerned about a bad headache he had a few weeks ago. He is concerned because his mother’s friend dried of a brain tumor. You tell Michael that the most common type of headache with onset in adolescence is:
-Tension headache
27. Treatment for testicular torsion primarily?
- Immediate surgical referral
28. What is important to understand about encopresis?
- The DSM 5 describe the condition as a repeated passage of stool into inappropriate places such as child’s underpants.
28. Newborn W.R. has a vascular lesion that will not fade as she gets older. What is your diagnosis?
- Port-wine stain (nevus flammeus)
29. Vomiting in infancy has a long list of differential diagnosis. Which accompanying symptom would most likely point to pyloric stenosis?
- Acts hungry after vomiting
30. Which malignancy is associated with genitourinary anomalies?
- Wilm’s tumor
31. A child has mild persistent asthma. Appropriate daily medication should include:
- An inhaled low-dose corticosteroid
32. A 3-year-old has an edematous, mildly erythematous right upper eyelid for 1 day with a fever of 103. An important eye assessment would be:
- Ocular mobility
33. What diagnosis should be considered if the infant has not passed meconium in the first 24 hours of life?
- Congenital ganglionic megacolon
34. A child with juvenile idiopathic arthritis (JIA) can present with which asymptomatic condition that warrants close to follow up?
- Uveitus and needs to have routine ophthalmologic screening with slit-lamp every 3 months if the ANA is positive.
35. A 15-month-old failed treatment with amoxicillin for otitis media. At his 2-week recheck, his TM remained red with distorted landmarks, and he persisted with nasal congestion and poor nighttime sleeping, and he has had 101 fever for the past 2 days. The next best step would be to treat with:
- A 10-day course of Augmentin
36. Which of the following is an absolute contraindication for use of combined hormonal contraceptives in adolescent women?
- History of thromboembolism
37. The most common trigger for an acute asthma episode in the very young child is:
- Viral respiratory infections
38. Which of the following findings could be expected to occur in a baby with intussusception?
- Inconsolable screening
39. The appropriate management of Osgood-Schlatter disease includes:
- Decreasing activity, applying ice, and taking prescribing NSAIDS
40. In a healthy, 8-month-old with diarrhea but no dehydration, what would be most appropriate advice to give parents?
- Give bananas and cereal as tolerated
41. The most common rheumatoid disease of childhood is:
- Juvenile idiopathic arthritis
42. When assessing for croup, what is a common finding on xray?
- Subglottic narrowing (steeple sign)
43. Which chromosomal abnormality is associated with short statue in girls?
- Turner syndrome
44. Which activities are common in a 4-5 year-old child?
- Independent toileting (may need help to wipe)
45. A 14-year-old female presents to the clinic and is demonstrating some hesitancy in discussing an important issue regarding her self-identity. What is the appropriate actions on behalf of the clinician?
-The provider should use gender neutral terms to allow the adolescent to feel more comfortable with discussing this issue
46. The most definitive feature or features for a diagnosing of “growing pains” includes:
-Exclusion of other causes of lower extremity pain
47. When examining an adolescent between the ages of 10-13 years of age it is important to remember what characteristic regarding socio-emotional development?
- Feel awkward about their body and self, the examiner should provide privacy for the patient, and this age group tend to test their environment.
48. On exam, an 8 year old being seen at your clinic with complaints of persistent pain to left leg with limp. What is the most likely cause of this condition?
- Legg-Calve Perthes Disease
49. Cara is a 16-year-old adolescent who has been sexually active with… male partner for 6 months. They have used condoms consistently. Cara is interested in a hormonal method as well. Your advice includes all of the following except which one?
- The vaginal contraceptive ring must be changed weekly
50. Role=play with equipment during the course of a physical examination would be most beneficial with which of the following age groups?
-Preschoolers/Toddlers
51. For children 2 to 4 years of age, the most common cause of head injury is:
-Falls
52. In a healthy, 8-month-old with diarrhea but no dehydration, what would be the most appropriate advice to give parents?
- Give bananas and cereal as tolerated
53. The appropriate management of Osgood-Schlatter disease includes:
- Decreasing activity, applying ice, and taking prescribing NSAIDS
54. The organism that causes hand, foot, mouth syndrome is what virus?
- Coxsackle virus
55. Judy has a history of remission and exacerbation of acne that has followed the pattern of menses for 2 years. However, the condition over the last 6 months has worsened to a moderate degree of severity and has been chronic and persistent. You prescribe…
- Hydroquinoa
56. Which malignancy is associated with genitourinary anomalies?
-Wilm’s tumor
57. A 15-month-old failed treatment with amoxicillin for otitis media. AT his 2-week recheck, his TM remained red and distorted…..
-A 10-day course of Augmentin
58. Which of the following is not considered preventative management for iron0deficiency anemia?
-No cow’s milk until 1 year of age
59. In mild to moderate attacks of asthma, albuterol should be given every 4-5 hours PRN and routine medications should be:
-Continued as usual
60. In addition to penicillin, all of the following antibiotics can be used to treat strep pharyngitis except:
-Bactrim
61. The most definitive feature or features for a diagnosis of “growing pains” includes:
- Exclusion of other causes of lower extremity pain
62. Which of the following foods would be appropriate for a child with celiac disease?
- Boiled rice with butter
63. When performing a physical examination of a toddler, which of the following body parts would you examine last?
- Ears and throat
64. Daily eyelid cleaning with diluted baby shampoo and a cotton-tipped applicator would be appropriate in the treatment of which of the following conditions?
- Blepharitis
65. Primary dysmenorrhea is due to:
- Elevated prostaglandin level
66. Management of scoliosis depends on the severity of curve as well as the age of the child. Which of the following would require surgical intervention?
- Thoracic curve greater than 50 degrees or lumbar curve than 40 degrees
67. A 10-year old 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
68. Patients with otitis externa should be instructed to do which of the following?
- Keep ear dry until symptoms improve
69. A 2-year-old female has lymphedema of the hands and feet, with low posterior hairline, cubitus valgus, and a history of intrauterine growth restrictions. Which of the following defects is the most common among the children with these signs?
-Coarctation of the aorta
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