NURS 6541 Midterm Exam 1 – Posting

  1. When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?
  2. Which of the following would not suggest an eating disorder with a purging component?
  3. Which of the following screenings should adolescents have done annually?
  4. A healthy, well-developed 6-year-old child arrives as a new patient to your clinic. His immunization card reveals that he received an immunization at birth and some when he was 2 months old, but none sense. Which of the following statements about him is correct?
  5. You see a young child who has tripled her birth weight and looks for hidden objects. When given blocks, she places one in each hand. She has a fine pincer grasp. On the floor, she walks around holding objects and is trying to take independent steps. This child is most likely how old?
  6. You see a 30-month-old who speaks in mixed Spanish and English. The child’s vocabulary is normal but at the low end of the normal language spectrum. The parent is worried the child’s development will not be normal because she mixes up the two languages. You respond:
  7. A breastfed infant is expected to have a lower incidence of which of the following?
  8. An 8-year-old female is brought into the office by her mother. She has complaints of fever and sore throat for the past 2 days. She denies difficulty swallowing but has loss of appetite and mild diarrhea. A few classmates have similar symptoms. A review of systems reveals clear nasal drainage, dry cough, and hoarseness. On exam she has a 101.5 temperature, 3+ erythematous tonsils, and anterior cervical lymphadenopathy. What is the likely diagnosis?
  9. Acute otitis media can be diagnosed when there is
  10. A 4-month-old presents with both eyes turning inward. What is this called?
  11. Which of the following represents normal sequencing of development in a toddler?
  12. Which of the following foreign body in the nose requires immediate removal?
  13. During a “well-child” visit, the parents of a healthy 5-month-old offer a great amount of information. Which of the following bits of information is of most concern?
  14. Which of the following children should be referred for a comprehensive developmental evaluation?
  15. Which of the following is a true contraindication of vaccinating a child?
  16. A 2-year-old boy has been slightly less than the 50th percentile for weight, height and head circumference, but in the last 6 months he has fallen to slightly less than the 25th percentile for weight. The pregnancy was normal, his development is as expected, and the family reports no psychosocial problems. The mother says that he is now a finicky eater (wants only macaroni and cheese at all meals), but she insists that he eat a variety of foods. The meals are marked by much frustration for everyone. His examination is normal. Which of the following is the best next step in his care?
  17. Which is the correct order for introduction of solid foods to an infant?
  18. At what age would a child be expected to remember a string of numbers and repeat them backwards?
  19. Epiglottitis has decreased due to which immunization?
  20. Sarah, 7 years old, is in the office today. All of the following are acceptable management options for allergic rhinitis, except
  21. Josh, age 13, has some enlargement of the scrotum and testes, a reddened scrotal sac, and some hair texture alteration. His penis is not enlarged. He is in Tanner stage
  22. Which of the following issues or concepts is relevant to the school-age child?
  23. Hannah, age 4, is brought into the office by her father. She complains of a sore throat, difficulty swallowing, copious oral secretions, stridor, and a temperature of 102F. She does not have pharyngeal erythema or cough. What do you suspect?
  24. Sally, age 4, presents to the office with her mother for a well-child visit. To assess for age-appropriate fine motor skills, what activity would you ask her to perform?
  25. Which of the following eye findings would be considered an ophthalmic emergency?
  26. Which of the following signs may indicate a baby is not receiving sufficient breastmilk?
  27. Which of the following statements is true regarding lying and stealing by the school-age child?
  28. Upon eye examination of a newborn, you note inner canthal folds and Brushfield spots. What do you suspect?
  29. Miguel, age 14, was hit in the eye with a baseball and developed eye pain, decreased visual acuity, and injection of the globe. Upon exam you note blood in the anterior chamber and confirm diagnosis of hyphema. What treatment do you recommend while Miguel is waiting to see the ophthalmologist
  30. A 4-month-old child has poor weight gain. Her current weight is less than the 5th percentile, height about the 10th percentile, and head circumference at the 50th percentile. The planned pregnancy resulted in a normal, spontaneous, vaginal delivery; mother and child were discharged after a 48-hour hospitalization. Feeding is via breast and bottle; the quantity seems sufficient. The child has had no illness. The examination is unremarkable except for the child’s small size. Screening laboratory shows the hemoglobin and hematocrit are 11 mg/dL and 33% respectively, with a platelet count of 198,000/mm3. Serum electrolyte levels are sodium 140, chloride 105, potassium 3.5, bicarbonate 17, blood urea nitrogen 15, and creatinine 0.3. Liver function tests are normal. Urinalysis reveals a pH of 8 with occasional epithelial cells but no white blood cells, bacteria, protein, ketones, or reducing substances. Which of the following is the most appropriate therapy for this child?
  31. Mark, a 10-year-old, has a lot of ear pain. He does not want anyone to touch it and is crying in pain. The ear canal is swollen and exudate is present. The TM is normal. Mark should be instructed to do which of the following?
  32. Appropriate advice for a mother of a 2-week-old child here for a “well child” visit includes which of the following?
  33. A 9-year-old who weighs 70 pounds asks why she can’t sit in the front passenger seat of the family car. Your best response is
  34. Which of the following statements about bullying is true?
  35. The parent of a 2-year-old tells you her daughter recently started having breath-holding spells. She tells you the older sibling “did the same thing” and asks you for help. You advise her that after a breath-holding event: 
  36. Which adolescent would be at greatest risk for developing anorexia nervosa?
  37. An 11-year-old girl has dizziness, pupillary dilation, nausea, fever, techycardia, and facial flushing. She says she can “see” sound and “hear” colors. The agent likely to be responsible is which of the following?
  38. You see a 13-year-old who reports she is learning some basic geometry (areas, volume etc.). The ability to successfully master these concepts occurs during which Piaget developmental stage? 
  39. The nurse practitioner role was initially established to
  40. You would be concerned about the language development of a child who:
  41. Which of the following are important considerations when screening child refugees for tuberculosis? SELECT TWO (2)
  42. You diagnose a 16-year-old with acute otitis media and need to prescribe an antibiotic with beta-lactamase coverage. What do you choose?
  43. A 12-year-old male states he noticed an enlargement of his testes and scrotum. When counseling him about the next step in pubertal development, you state:
  44. A differential diagnosis for child abuse would include all of the following except.
  45. Which of the following complication of strep pharyngitis cannot be prevented with antibiotics?
  46. A 4-year-old believes there is more juice in a tall, thin glass than a shorter, wider one. The child has not yet achieved which of the principles of Piaget?
  47. The first sign of the onset of female puberty is usually:
  48. Which of the following injuries is most likely to be caused by abuse of a toddler?
  49. During a domestic health assessment, the CDC recommends screening every refugee child for which of the following diseases?
  50. Conductive hearing loss can be caused by
  51. A 2-day-old infant has significant nasal and rectal bleeding. He was delivered by a midwife at home; the pregnancy was without complications. His Apgar scores were 9 at 1 minute and 9 at 5 minutes. He has breastfed well and has not required a health care professional visit since birth. Which of the following vitamin deficiencies might explain his condition?
  52. The mother of a 4-year-old tells you he likes to “play with himself” while playing and watching television. You advise the mother to
  53. Which of the following children has abnormal language development? 
  54. Which of the following strategies would not be appropriate to include as part of your treatment plan of an 8-year-old boy who is obese?
  55. Luke, a 17-month-old, failed treatment with amoxicillin for otitis media. At the two-week recheck, his TM was still erythematous and you cannot see the landmarks. He has persistent nasal congestion, he is not sleeping at night, and he has a 101°F fever. What is the next best step for Luke?
  56. The appropriate lab tests in assessment of cervical adenitis include all of the following except:
  57. What method can be safely used to remove cerumen in a 15-month-old child’s ear?
  58. The most common substance used in middle school is
  59. Role-play with equipment during the course of the physical exam would be the most beneficial with which age group?
  60. An 8-year-old female has an edematous, mildly erythematous right upper eyelid for 2 days with a fever of 102.9 (F). Which important eye assessment do you need to consider?
  61. A 7-year-old has just been diagnosed with attention deficit hyperactivity disorder (ADHD). Her parents report that she is doing poorly in school and is disruptive in the classroom. They ask you what they can do. Your best response is:
  62. Which of the following is a priority nurse practitioner role to help children and adolescents to have healthy sexual development?
  63. Initial screening tests for an 11-year-old with a family history of hyperlipidemia and weight at the 97th percentile include:
  64. You see a 6-month-old for a well-child visit and the mother tells you the child’s grandmother recommends that she give the infant whole milk and eggs when he starts solids. What should you tell the mother?
  65. Early reflexive responses that are not related to survival include all but:
  66. The father of a 3-year-old is concerned because the child stutters. What should your approach be?
  67. A common feature of 2-year-old behavior is:
  68. A child’s head circumference is routinely measured on each well visit until what age?
  69. A teenage female who is overweight has moderate acne on the face and chest, and irregular menses. Elevation of which laboratory test provides the test evidence of polycystic ovarian syndrome?
  70. Parents bring their 6-month-old son to see you. He is symmetrically less than the 5th percentile for height, weight and head circumference. He was born at 30 weeks’ gestation and weighed 1000g. He was a planned pregnancy, and his mother’s prenatal course was uneventful until an automobile accident initiated the labor. He was ventilated for 3 days in the intensive care unit but otherwise did well without ongoing problems. He was discharged at 8 weeks of life. Which of the following is the most likely explanation for his small size?
  71. For adolescent girls, peak height velocity should occur by Tanner Stage (SMR):
  72. A 2-year-old child weighs 34 lb. What type of car seat should the child use?
  73. Head and chest circumferences should be equal at:
  74. You see a healthy 18-month-old for a well-child visit. At the 12-month visit he received the diphtheria, tetanus, and acellular pertussis (DTaP) third dose; hepatitis B second dose; measles, mumps, and rubella (MMR) first dose; injected poliovirus (IPV) second dose; pneumococcal conjugate (PCV13) fourth dose; and Haemophilus influenzae type B (Hib) fourth dose. Which of the following do you order today?
  75. A 14-year old has ataxia. He is brought to the local emergency department, where he appears euphoric, emotionally labile, and a bit disoriented. He has nystagmus and hypersalivation. Many notice his abusive language. Which of the following agents is most likely responsible for his condition?
  76. FIRST-LINE therapy for preschoolers (4-5 years of age) diagnosed with attention-deficit hyperactive disorder is:
  77. You see a 5-month-old who is fussy, has interrupted sleep, and is drooling. You note large lower lateral incisor bulges. You recommend:
  78. A new mom calls the NP on postpartum day 5. She reports her newborn wants to nurse for 30 minutes every 1-1/2 to 2 hours. Which of these is the best response?
  79. Sandy, age 18 months, crosses her legs when lifted from behind rather than pulling them up. Her legs are also hard to separate, making diaper changing difficult. She persistently uses only one hand. What condition do you suspect?
  80. By what age should most children be able to sit well without support?
  81. Flourescein staining of the eye is used to detect a
  82. An eye that deviates in when covered but that returns to midline when uncovered is an
  83. You are doing a kindergarten physical on a 5-year-old girl. Which of the following scenarios would suggest the child is not ready to start kindergarten in the fall?
  84. The diagnostic criteria for autism spectrum disorder include all of the following except
  85. A 14-year-old female comes into the office for an urgent visit after taking 10 valium tablets.  Following the initial emergent care and stailization, the most important part of the management is:
  86. A 19-month-old says “mama” and “dada,” points and gestures if he wants things, and follows simple one-step commands. Your best response is which of the following?
  87. Which of the following substances is associated with pupillary constriction?
  88. Blood pressure should be measured at well-child visits starting at age:
  89. Which of the following statements about “routine” screening tests is true?
  90. You see a 3-year-old for a well-child visit. His mother informs you that potty training has been very easy because he “has an amazing internal clock. He falls asleep, gets hungry, and has bowel movements at the same time every day.” This describes which aspect of temperament?
  91. Chelsea, age 8, complains that she feels as if something is stuck in her ear. What action is contraindicated?
  92. A Mantoux test in a child with no risk factors is considered positive with a reaction of:
  93. Please interpret the following labs for an adolescent. The adolescent has a history of obesity and acanthosis nigricans.
  94. A mother states that her 4-year-old son constantly grinds his teeth at night. You document this as:
  95. Max, a 9-year-old boy, is a very active child with limited self-control. He is easily distracted and has difficulty staying on task. You determine that he should have a neurodevelopmental evaluation because he is showing signs of
  96. A 6-month-old infant has been growing poorly. His parents have changed his formula three times without success. His examination is remarkable for a pale, emaciated child with little subcutaneous fat and anterior fontanelle fullness. His laboratory test results are notable for a hemolytic anemia and prolonged bleeding times. Which of the following is the most appropriate next step?
  97. The parents of a 7-year-old are concerned their son does not want to attend school. Which of the historical findings are not usually associated with the diagnosis of school phobia?
  98. Mark is in the exam room. You are concerned he may have epiglottitis. In what position do these patients prefer to sit?
  99. Which of the following statements regarding adolescent substance use is true?
  100. I like to use my pincer grasp that involves the ablitily to pick up a small object such as a raisin or piece of cereal with the thumb and forefinger, and that is mastered around what age?
  101. A mother brings her 4-week-old infant into the office because she noticed small yellow-white glistening bumps on her infant’s gums. She says they look like teeth but is concerned that they may be cancer. You diagnose these bumps as