NUR 588 / N588 Quiz 4 Attempt review | American Sentinel Classroom

The primary care family nurse practitioner (FNP) is examining a 2-year-old infant and auscultates a wide fixed split S . What condition may this finding represent? Coarctation of the aorta (COA) Ventricular septal defe ...

The primary care family nurse practitioner (FNP) is examining a 2-year-old infant and auscultates a wide fixed split S . What condition may this finding represent? Coarctation of the aorta (COA) Ventricular septal defect (VSD) Patent ductus arteriosus (PDA) Atrial septal defect (ASD)  Atrial septal defect (ASD) The primary care family nurse practitioner auscultates a new grade II vibratory, mid-systolic murmur at the mid sternal border in a 4-year-old child that is louder when the child is supine. What type of murmur is most likely? Venous hum Still’s murmur  Pathologic murmur Pulmonary flow murmur Still’s murmur Question 3 Incorrect 0.00 points out of 1.00 Question 4 Correct 1.00 points out of 1.00 During a well child assessment, the primary care family nurse practitioner (FNP) auscultates a harsh, blowing grade IV/VI murmur in a 6- month-old infant. What will the nurse practitioner do next? Order a chest radiograph to evaluate for cardiomegaly. Obtain an electrocardiogram to assess for arrhythmia. Refer to a pediatric cardiologist for further evaluation.  Get a complete blood count to rule out severe anemia. Your answer is incorrect. Obtain an electrocardiogram to assess for arrhythmia. A 12-month-old infant who had cardiopulmonary bypass with red blood cell (RBC) and plasma infusions during surgery at 8 months is seen for a well child examination. Which vaccine may be administered at this visit? Pneumococcal vaccine  Varicella vaccine oral polio vaccine (OPV) Measles, mumps, and rubella (MMR) Pneumococcal vaccine Question 5 Correct 1.00 points out of 1.00 Question 6 Incorrect 0.00 points out of 1.00 During a well-baby examination of a 6-week-old infant, the family nurse practitioner notes poor weight gain, acrocyanosis of the hands and feet, thready peripheral pulses, and a respiratory rate of 60 breaths per minute. Oxygen saturation on room air is 93%. The remainder of the exam is unremarkable. Which action is correct? Reassure the parents that the exam is within normal limits. Order a chest radiograph and an electrocardiogram. Refer the infant to a pediatric cardiologist immediately.  Follow-up in 1 week to assess the infant’s weight. Refer the infant to a pediatric cardiologist immediately. The primary care family nurse practitioner (FNP) is performing a well child examination on a school-age child who had complete repair of a tetralogy of Fallot (TOF) defect in infancy. What is important in this child’s health maintenance regime? Teaching about management of hypercyanotic episodes.  Cardiology clearance for sports participation. Restriction of physical activity to avoid pulmonary complications. Sub-acute bacterial endocarditis prophylaxis precautions. Your answer is incorrect. Cardiology clearance for sports participation. Question 7 Correct 1.00 points out of 1.00 Question 8 Correct 1.00 points out of 1.00 The primary care family nurse practitioner (FNP) is performing a sports physical on an adolescent whose history reveals mild aortic stenosis (AS). What will the nurse practitioner recommend? Low-intensity sports, such as golf or bowling. Clearance for any sports since this is mild. Evaluation by a cardiologist prior to participation.  Avoidance of all sports to prevent sudden death. Evaluation by a cardiologist prior to participation. A 10-year-old child has had abdominal pain for 2 days, which began in the periumbilical area and then localized to the right lower quadrant. The child vomited once today and then experienced relief from pain followed by an increased fever. What is the likely diagnosis? Appendicitis with perforation  Urinary tract infection (UTI) Gastroenteritis Pelvic inflammatory disease (PID) Appendicitis with perforation Question 9 Correct 1.00 points out of 1.00 Question 10 Correct 1.00 points out of 1.00 An 18-month-old child has a 1-day history of intermittent, cramping abdominal pain with non-bilious vomiting. The child is observed to scream and draw up his legs during pain episodes and becomes lethargic in between. The primary care family nurse practitioner notes a small amount of bloody, mucous stool in the diaper. What is the most likely diagnosis? Gastroenteritis Testicular torsion Appendicitis Intussusception  Intussusception An adolescent is diagnosed with functional abdominal pain (FAP). The child’s symptoms worsen during stressful events, especially with school anxiety. What will be an important part of treatment for this child? Instituting a lactose-free diet along with lactobacillus supplements. Informing the parents that the pain is most likely not real. Using histamine2-blockers to help alleviate symptoms. Teaching about the brain-gut interaction causing symptoms.  Teaching about the brain-gut interaction causing symptoms. Question 11 Correct 1.00 points out of 1.00 Question 12 Correct 1.00 points out of 1.00 A 12-month-old infant exhibits poor weight gain after previously normal growth patterns. There is no history of vomiting, diarrhea, or irregular bowel movements, and the physical exam is normal. What is the next step in evaluating these findings? Feeding and stooling history and 3-day diet history  Swallow study with video fluoroscopy Stool cultures for ova and parasites Complete blood count and electrolytes Feeding and stooling history and 3-day diet history A toddler who was born prematurely refuses most solid foods and has poor weight gain. A barium swallow study reveals a normal esophagus. What will the primary care family nurse practitioner consider next to manage this child’s needs? (Select all that apply.) Gastric biopsy Video fluoroscopy swallowing study  Food allergy testing  Fiberoptic endoscopy evaluation  The correct answers are: Fiberoptic endoscopy evaluation, Video fluoroscopy swallowing study Question 13 Correct 1.00 points out of 1.00 Question 14 Correct 1.00 points out of 1.00 A 2-year-old child has an acute diarrheal illness. The child is afebrile and, with oral rehydration measures, has remained well hydrated. The parent asks what can be done to help shorten the course of this illness. What will the primary care family nurse practitioner recommend? Clear liquids only Lactobacillus  Loperamide Peppermint oil Lactobacillus The parent of a 3-month-old reports that the infant arches and gags while feeding and spits up undigested formula frequently. The infant’s weight gain has dropped to the 5th percentile from the 12th percentile. What is the best course of treatment for this infant? Reassure the parent that these symptoms will likely resolve by 12 to 24 months. Begin a trial of extensively hydrolyzed protein formula for 2 to 4 weeks.  Perform upper GI series to determine the degree of reflux. Prescribe motility agent such as erythromycin. Begin a trial of extensively hydrolyzed protein formula for 2 to 4 weeks. Question 15 Correct 1.00 points out of 1.00 Question 16 Correct 1.00 points out of 1.00 A child is in the clinic after swallowing a metal bead. A radiograph of the GI tract shows a 3 mm cylindrical object in the child’s stomach. The child can swallow without difficulty and is not experiencing pain. What is the correct course of treatment? Insert a nasogastric tube to flush out the object. Refer the child for endoscopic removal of the object. Have the parents watch for the object in the child’s stool.  Administer ipecac to induce vomiting. Have the parents watch for the object in the child’s stool. A 6-year-old female has had a recent growth spurt and an exam reveals breast and pubic hair development. Her bone age is determined to be 8 years. What will the primary care family nurse practitioner do next? Order LH and FSH levels and a long-acting GnRH agonist. Refer the child to a pediatric endocrinologist for management.  Order thyroid function tests to exclude primary hypothyroidism. Reassure the parent that this is most likely idiopathic. Refer the child to a pediatric endocrinologist for management. Question 17 Incorrect 0.00 points out of 1.00 Question 18 Correct 1.00 points out of 1.00 The mother of a female infant is concerned that her daughter is developing breasts. The primary care family nurse practitioner notes mild breast development but no pubic or axillary hair. What is the likely diagnosis? Premature adrenarche which will lead to pubic hair onset.  Congenital adrenal hyperplasia causing breast development. Premature thelarche which will resolve over time. Precocious puberty needing endocrinology management. Your answer is incorrect. Premature thelarche which will resolve over time. A 12-year-old child has a recent history of increased thirst and frequent urination. The child’s weight has been in the 95th percentile for several years. A dipstick UA is positive for glucose, and random plasma glucose is 350 mg/dL. Which test will the primary care family nurse practitioner order to determine the type of diabetes in this child? Fasting plasma glucose Hemoglobin A1C levels Pancreatic autoantibodies  Thyroid function tests Pancreatic autoantibodies Question 19 Correct 1.00 points out of 1.00 Question 20 Correct 1.00 points out of 1.00 A 13-year-old Native American female has a body mass index (BMI) at the 90th percentile for age. The primary care family nurse practitioner notes the presence of a hyperpigmented velvet-like rash in skin folds. The child denies polydipsia, polyphagia, and polyuria. The nurse practitioner will take what action? Diagnose type 2 diabetes if the child has a random glucose of 180 mg/dL. Order a fasting blood sample for a metabolic screen for type 2 diabetes.  Counsel the child to lose weight to prevent type 2 diabetes. Refer the child to a pediatric endocrinologist. Order a fasting blood sample for a metabolic screen for type 2 diabetes. The primary care family nurse practitioner prescribes metformin for a 15-year-old adolescent newly diagnosed with type 2 diabetes. What will the nurse practitioner include when teaching the adolescent about this drug? The importance of checking blood glucose 3 or 4 times daily. To use a stool softener to prevent gastrointestinal side effects. To consume a diet with foods that are high in vitamin B .  That insulin therapy will be necessary in the future. 12 To consume a diet with foods that are high in vitamin B12. Question 21 Correct 1.00 points out of 1.00 Question 22 Correct 1.00 points out of 1.00 A 16-year-old adolescent female whose body mass index (BMI) is at the 90th percentile reports irregular periods. The primary care family nurse practitioner notes widespread acne on her face and back and an abnormal distribution of facial hair. The nurse practitioner will evaluate her further based on a suspicion of which diagnosis? Dyslipidemia Polycystic ovary syndrome  Nonalcoholic steatohepatitis Hypothyroidism Polycystic ovary syndrome The mother of a 1-month-old recently diagnosed with phenylketonuria (PKU) inquires why the baby will need a special diet for life. The nurse practitioner knows the diet is to prevent: CNS damage and intellectual disability.  hypoglycemia. congestive heart failure. kidney failure. CNS damage and intellectual disability. Question 23 Correct 1.00 points out of 1.00 Question 24 Correct 1.00 points out of 1.00 A child is diagnosed with community-acquired pneumonia and will be treated as an outpatient. Which antibiotic will the primary care family nurse practitioner prescribe? Amoxicillin  Ceftriaxone Azithromycin Oseltamivir Amoxicillin A 5-month-old infant who has a 3-day history of cough and rhinorrhea has developed symptoms of respiratory distress with audible expiratory wheezes and increased coughing. The infant’s immunizations are up-to-date. The physical exam reveals a respiratory rate of 50 breaths per minute, coarse expiratory wheezing, and prolonged expiration. An oxygen saturation is 96% on room air. What is the recommended treatment for this infant? Recommend increased fluids and close follow-up.  Order an oral corticosteroid medication. Administer a trial of bronchodilators. Obtain a viral culture of nasal washings. Recommend increased fluids and close follow-up. Question 25 Correct 1.00 points out of 1.00 Question 26 Correct 1.00 points out of 1.00 The primary care family nurse practitioner evaluates a child who awoke with a sore throat and high fever after a nap. The child appears anxious and is sitting on the parent’s lap with the neck hyperextended. The physical exam reveals stridor, drooling, nasal flaring, and retractions. What will the nurse practitioner do next? Transport the child to the hospital via emergency medical services.  Administer a broad-spectrum intravenous antibiotic. Send the child to radiology for a lateral neck radiograph. Obtain blood and throat cultures and start antibiotic therapy. Transport the child to the hospital via emergency medical services. The parent of a toddler and a 4-week-old infant tells the primary care family nurse practitioner that the toddler has just been diagnosed with pertussis. What will the nurse practitioner do to prevent disease transmission to the infant? Instruct the parent to limit contact between the toddler and the infant. Prescribe erythromycin 10 mg/kg/dose four times daily for 14 days. Order azithromycin 10 mg/kg/day in a single dose daily for 5 days.  Administer the initial diphtheria, pertussis, and tetanus vaccine. Order azithromycin 10 mg/kg/day in a single dose daily for 5 days. Question 27 Correct 1.00 points out of 1.00 Question 28 Correct 1.00 points out of 1.00 A newborn with a history of meconium ileus should also be evaluated for congenital diaphragmatic hernia cystic fibrosis  congenital pulmonary airway malformation congenital heart disease cystic fibrosis A 5-year-old presents with fever of 103 degrees, toxic appearance, crackles in right lower lobe. Oxygen saturation is 89% and respiratory rate is 55. What is the most appropriate intervention? Send to the ED for evaluation and possible admission.  Administer albuterol in the office. Perform respiratory viral testing. Prescribe high dose oral amoxicillin. Send to the ED for evaluation and possible admission. Question 29 Correct 1.00 points out of 1.00 Question 30 Correct 1.00 points out of 1.00 A school age child is in the clinic because of symptoms of purulent, foul-smelling nasal discharge from the right nostril. Nasal visualization reveals something shiny in a mass of mucous in the nasal cavity. What will the primary care family nurse practitioner (FNP) do? Suction the mucoid mass using a bulb syringe. Refer the child to a pediatric otolaryngologist. Attempt to remove the mass gently using alligator forceps.  Perform a saline nasal rinse using a water jet device. Attempt to remove the mass gently using alligator forceps. The family nurse practitioner (FNP) is evaluating a 3-year-old patient who presents to the primary clinic after acute onset wheezing and difficulty breathing. On exam, the patient is tachypneic, auscultation reveals expiratory wheezing with prolonged expiratory phase is heard in all lobes. Which family history is most relevant in determining a diagnosis of asthma? History of frequent antibiotic use during infancy. Patient history of prior albuterol use with improvement of symptoms with prior illnesses. History of atopy in any 1st or 2nd generation family member.  History of immunocompromise in household family members. History of atopy in any 1st or 2nd generation family member. ◄ Simulation 2 Submission Jump to... Module 4 Overview ►