Chapter 18 NR 509 Final Questions and Answers with Verified Solutions

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Chapter 18 NR 509 Final Questions and Answers with Verified Solutions A 6-month-old infant is brought in for a well check. It is noted his head circumference is off the chart and at a much higher p... ercentile than was previously measured. What should you do next? A) Recommend a neurology consult. B) Order a CT of the head. C) Remeasure the circumference. D) Admit the child to the hospital for further workup. Correct Answer- C) Remeasure the circumference. A 15-month-old is brought to you for a fever of 38.6 degrees Celsius and fussiness. The ear examination is as follows: external ear, normal appearance and no tenderness with manipulation; canal, normal diameter without evidence of inflammation; tympanic membrane, bulging, erythematous, and opaque. Insufflation is deferred due to pain. What is your diagnosis? A) Otitis externa B) Cholesteatoma C) Ruptured tympanic membrane D) Otitis media Correct Answer- D) Otitis media A 24-year-old mother who is a smoker and cocaine addict gave birth at 39 weeks to a 2,000- gram female infant who is in the neonatal intensive care unit. Using the Intrauterine Growth Curve chart, you determine whether the infant's weight is appropriate for her gestational age. In which category does the infant best fit? A) Large for gestational ageB) Normal for gestational age C) Small for gestational age Correct Answer- C) Small for gestational age A 32-year-old white female presents to labor and delivery fully effaced and delivers a 5.8-lb (2,500-gram) infant female with Apgar scores of 6 and 8. The mother has had no prenatal care and in the nursery you perform the newborn examination. With the Ballard scoring system, the neuromuscular examination score is 15. Looking at physical maturity, you see superficial peeling and few veins on the skin. The lanugo hair has bald areas and the plantar surface of the foot has creases on two thirds of it. The areola is stippled with a 2-mm bud. The pinna is well curved, is firm, and has instant recoil. The labia majora and minora are equally prominent. Add the score of the neuromuscular components to your score of physical maturity to determine weeks of gestation. How many weeks of gestation has this child had? A) 34 weeks B) 36 weeks C) 40 weeks Correct Answer- B) 36 weeks A 38-week gestation, 2500-gram infant is placed on your service. How would she be described? A) Term, normal birth weight B) Term, low birth weight C) Preterm, normal birth weight D) Preterm, low birth weight Correct Answer- A) Term, normal birth weight A foster mother brings a 4-year-old child to see you for an evaluation. She has had custody of the girl for 2 weeks. She knows that the child was born in your state and that her maternal grandmother had custody for 6 months. She received good medical care during that time, but after her biologic mother obtained custody the child was abused and has had no further medical care. She says the child has had many behavioral problems and seems to be very behind on her developmental tasks. When you examine the child you notice short palpebral fissures, a wide nasal philtrum, and thin lips. Her cardiac, pulmonary, musculoskeletal, andabdominal examinations are normal. Her Denver Developmental Screening Test shows most of her milestones have occurred only through the 24th month. What form of congenital retardation is she most likely to have? A) Fetal alcohol syndrome B) Congenital hypothyroidism C) Down syndrome Correct Answer- A) Fetal alcohol syndrome A mother brings her 4-year-old daughter to your office because of fever and decreased eating and drinking. When you ask the little girl what is wrong, she says her mouth and throat hurt. On examination her temperature is 101 degrees. Her ears and nose examinations are unremarkable. Her mouth has ulcerations on the buccal mucosa and the tongue. She also has cervical lymphadenopathy. Her cardiac and pulmonary examinations are normal. She is up to date on her childhood vaccinations. What mouth abnormality does she most likely have? A) Strep throat B) Herpetic stomatitis C) Oral candidiasis (thrush) D) Diphtheria Correct Answer- B) Herpetic stomatitis A mother brings her 15-month-old daughter to your office for evaluation of a rash and fever. She says the rash started one day and the fever developed the next day. Her daughter has had all of her vaccinations up to 10 months. The mother sheepishly admits that she hasn't had time to bring her daughter in since her 10-month check-up. On examination you see a mildly sickappearing toddler with a 102-degree temperature. Looking at her skin you see at least 100 of a variety of papules, vesicles, and ulcers in different stages of development. What illness prevented by proper vaccination does this toddler have? A) Varicella (chickenpox) B) MeaslesC) Smallpox Correct Answer- A) Varicella (chickenpox) [Show More]

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