NR602 / NR-602: Primary Care of the Childbearing and Childrearing Family Practicum Midterm Exam (Fall 2020) Chamberlain College of Nursing

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NR-602 Primary Care of the Childbearing and Childrearing Family Practicum NR 602 Midterm 1. The most appropriate management of a 5-year-old with a firm, nontender nodule in the mid-upper eye... lid for 3 weeks would be: - topical ophthalmic ointment 2. Daily eyelid cleansing with diluted baby shampoo and a cotton-tipped applicator would be appropriate in the treatment of which one of the following conditions? - 3. Concurrent otitis media and conjunctivitis is likely due to which organism? - 4. 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? - 5. Patients with otitis externa should be instructed to do which one of the following? - 6. All but which one of the following patients are at an increased risk of developing otitis media? - 7. A 15-month-old failed treatment with amoxicillin for an otitis media. At his 2-week recheck, his TM remained red with distorted landmarks and he persisted with nasal congestion, poor nighttime sleeping, and with a 101°F fever for the past 2 days. The next best step would be to treat with: - 1 8. A 2-year-old male with a history of chronic serous otitis media is noted to have a pearly white opacity in the upper outer quadrantof his TM. He currently has no symptoms and appears to hear "okay." The most likely diagnosis and appropriate management would be: - 9. A 9-month-old is noted to have a bifed uvula. This would increase his risk of developing which disorder? - 10. The organism that causes hand, foot, mouth syndrome is what virus? - 11. Which one of the following complications of strep pharyngitis cannot be prevented with antibiotics? - 12. In addition to penicillin, all of the following antibiotics can be used to treat strep pharyngitis except: - 13. Confirming the diagnosis of chlamydia conjunctivitis in a newborn would best be done by obtaining which one of the following? - 14. Chalazion - 15. Shelby, a 4-week-old, presents to your office in mid-January with a one-week history of nasal congestion and occasional cough. On the evening prior to this visit Shelby developed a temperature of 102°F, refused to breastfeed, had paroxysmal coughing, and noisy, labored breathing. On exam, you note an ill-appearing infant who is lethargic with tachypnea and intercostal retractions. Shelby does not attend daycare but has a 3-year-old sibling who is in daycare and who recently had a "cold." Considering the clinical presentation, what is the most likely cause of Shelby's illness? - 16. RSV bronchiolitis treatment - 17. In addition to airway hyper-responsiveness and reversible airway obstruction, asthma is a chronic lung disease characterized by: - 18. The most common trigger for an acute asthma episode in the very young child is: - 19. Luke has mild persistent asthma. Appropriate daily medication should include: - 20. Which of the following is not a goal of appropriate asthma management? - 21. Deon is a 4-year-old male with a history of atopic dermatitis and recurrent pneumonias, according to his mother. He presents with a persistent nighttime cough. His most likely diagnosis is: - 22. The most typical chest radiographic finding consistent with the diagnosis of asthma is: - 23. When providing asthma education regarding the use of a long-acting beta2 agonist, it is important to stress: - 24. Claire is an 8-year-old with moderate persistent asthma who is still having a daily cough. She reports three times a day use of a short-acting inhaled beta2 agonist and cromolyn sodium at her clinic visit. Your management plan should be altered to include: - 25. Ben is a 10-year-old who has recently been diagnosed with mild intermittent asthma. Which of the following is not a routine part of his clinic management? - 26. You examine C.C., a newborn, and observe numerous white papular lesions on the cheeks, forehead, and nose. You suspect either milia or neonatal acne. Which physical finding helps to confirm a diagnosis of milia? - 27. Newborn W.R. has a vascular lesion that will not fade as she gets older. What is your diagnosis - 28. You notice 10 macular tan lesions of varying sizes on D.D. and refer him for a medical evaluation to rule out neurofibromatosis or Albright's syndrome. What kind of lesion does D.D. have? - 29. What is characteristic of the lesion that D.D. has? - 30. Sandra, age twelve years, has several vesicles and honey-colored crusted lesions on her face above the right nares. She has a history of having had a scratch in the same area several days ago. What condition do you suspect? - 31. K.C., age thirteen years, has several firm, small (2 mm), white or skin-colored umbilicated papules on her neck. The lesions have been present for three months and have increased in number. What is your diagnosis? - 32. A wide pulse pressure that results from a high systolic blood pressure is usually not due to which of the following? - 33. Which of the following is not characteristic of innocent heart murmurs in children? - 34. Kawasaki disease is most common in: - 35. A principal clinical feature of Kawasaki disease includes: - 36. An essential test in the evaluation of a 2-year - old being managed for Kawasaki disease is: - 37. The most common congenital heart defect in children is: - 38. The mother of a 4-month-old infant reports that he turned "blue" and seemed to have fast, labored breathing after vigorous crying soon after awakening. He "fell asleep" and his color and breathing seemed to improve. On physical examination, the mucous membranes of the lips and mouth appear mildly cyanotic. A systolic murmur is heard best at the left sternal border. Vital signs are normal with normal peripheral pulses. There is no hepatomegaly. A likely diagnosis is: - 39. A 9 year old boy with fever 102 and complaints of leg pains. His mother reports that he had an upper respiratory infection with a sore throat approximately two weeks ago, which subsided without therapy. On physical examination, he has tender, swollen knees bilaterally. His heart rate is 120/min and a blowing systolic murmur is heard at the apex. No murmur was noted at a previous well-child visit. The most likely diagnosis is: - 40. The most useful test for evaluation of suspected acute rheumatic fever is - 41. The initial attack of acute rheumatic fever is preceded by: - 42. Salmon patch/nevus simplex - 43. You see B.D. for the first time at age six weeks. B.D. has a bright red, raised, rubbery lesion of irregular shape and 2 cm in diameter on the occiput. What condition do you suspect B.D. has? - 44. Verruca Vulgaris (Warts) - 45. Herpetic whitlow - 46. A ten-month-old child has been diagnosed with gastroenteritis. He attends a child-care facility. What is the most likely cause of his illness? - 47. In a healthy, eight-month-old with diarrhea but no dehydration, what would be the most appropriate advice to give parents? - 48. Vomiting in infancy has a long list of differential diagnoses. Which accompanying symptom would most likely point to pyloric stenosis? - 49. You see Jack, a 20-month-old toddler with normal growth and development in your office for diarrhea. His mother tells you that he is passing up to three loose stools a day and that he drinks 20 ounces of apple juice a day. What is the most likely diagnosis? - 50. Which of the following findings could be expected to occur in a baby with intussusception? - 51. Steatorrhea is not consistent with which of the following? - 52. Which of the following foods would be appropriate for a child with celiac disease? - 53. Cryptosporidium parvum - 54. Salmonella - 55. The most common rheumatoid disease of child- hood is: - 56. Radiographic findings of disease progression and sphericity of femoral head is helpful in the diagnosis and follow-up of: - 57. A 4-year-old boy is brought in by his mother, 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? - 58. A characteristic feature of polyarticular JIA disease is: - 59. ANA seropositivity for antibodies is: - 60. 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? - 61. A 6-year-old child presents with a limp and knee pain. The PNP finds limited passive internal rotation and abduction of the hip joint on physical examination. The most likely diagnosis is: - 62. Which of the following statements is true about acute osteomyelitis? - 63. Systemic-onset JIA is most commonly associated with: - 64. Which of the following is an appropriate goal for a child being treated for osteomyelitis? - 65. In Legg-Calvé-Perthes disease, which of the following signs and symptoms are seen? - 66. Which of the following is true for idiopathic scoliosis, which occurs primarily in adolescents? - 67. A 4-year-old boy is brought in by his mother, 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? - 68. Which of the following would be the most appropriate initial management of a newborn diagnosed with developmental dysplasia of the hip? - 69. Dislocation in the hip of a child six months or older may typically present with: - 70. For a newborn, the correct management of hip dislocation should include: - 71. Tibial torsion is commonly associated with: - 72. Osgood-Schlatter disease - 73. A typical febrile seizure is most likely to be the problem in which of the following children? - 74. Which of the following is an appropriate strategy to instruct the parents of an 18-month-old child who has just been diagnosed with a febrile seizure and who has a fever of 104oF? - 75. Which of the following contraceptive methods would be least suitable for adolescents? - 76. Which of the following is not an absolute contraindication for oral contraceptives? - 77. During a track meet, a 14-year-old male pole- vaulter falls to the ground screaming in pain. He complains of intense, searing pain in his right scrotum. He vomits twice while waiting for the ambulance. He most likely has: - 78. Treatment for this disorder is primarily: - 79. Which of the following is not considered preventive management for iron deficiency anemia? - 80. Which malignancy is associated with genitourinary anomalies? - 81. Down Syndrome (Trisomy 21) - 82. Which of the following is not true of dysmenorrhea? - 83. Precocious puberty - 84. Puberty - 85. menarche - 86. coarctation of the aorta - 87. Supravalvular aortic stenosis - 88. mitral valve prolapse - 89. Dissecting Aortic Aneurysm - 90. Which of the following factors is not usually present in a 4-year-old with migraine headaches? - 91. Aplastic crisis (is associated with parvovirus B19) - 92. pityriasis rosea - 93. An 11-year-old girl is brought in by her mother complaining of severe headaches associated with nausea and vomiting. Which of the following signs and symptoms would lead you to consider a brain tumor as part of your differential diagnoses? - [Show More]

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