NRNP6541 MIDTERM Exam A graded Latest 2022

Test       Week 6 – Midterm Exam

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Which of the following statements regarding adolescent substance use is true?

You see a 4-year-old for a well-child visit. He has received four diphtheria, tetanus, and acellular pertussis vaccines (DTaP); three injected polio vaccines (IPV); one measles, mumps, and rubella vaccine (MMR); one varicella vaccine; and two hepatitis B (Hep B) vaccines. What do you order today?

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?

Chelsea, age 8, complains that she feels as if something is stuck in her ear. What action is contraindicated?

You see a 7-year-old with complaints of “having accidents at night.” Physical exam and history are unremarkable. Urinalysis, urine culture, and specific gravity are normal. His parents ask about the best treatment for this problem. The best response is

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?

Upon eye examination of a newborn, you note inner canthal folds and Brushfield spots. What do you suspect?

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?

 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 preswent. The TM is normal. What is the proper management for his patient?

The diagnostic criteria for autism spectrum disorder include all of the following except

 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?

Which of the following would not suggest an eating disorder with a purging component?

 Role-play with equipment during the course of the physical exam would be the most beneficial with which age group?

 While assessing the skin of an infant, you note cafe-au-lait spots. Which disease should be ruled out?

 An expected milestone of a 4-year-old is the ability to

You receive a phone call from the mother of a 2-year-old. She states her child has sleep refusal. You suggest the child should be able to:

 An eye that deviates in when covered but that returns to midline when uncovered is an

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?

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?

 Which of the following issues or concepts is relevant to the school-age child?

You would be concerned about the language development of a child who:

You diagnose a 16-year-old with acute otitis media and need to prescribe an antibiotic with beta-lactamase coverage. What do you choose?

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?

 Which of the following characterizes middle adolescence (14 to 16 years old)?

Which of the following foreign body in the nose requires immediate removal?

Which is the correct order for introduction of solid foods to an infant?

FIRST-LINE therapy for preschoolers (4-5 years of age) diagnosed with attention-deficit hyperactive disorder is:

A 15-month-old boy 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?

 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?

Which of the following signs may indicate a baby is not receiving sufficient breastmilk?

Which of the following children should be referred for a comprehensive developmental evaluation?

By what age should most children be able to sit well without support?

 I can roll over, grasp a rattle, and reach for things and have begun feeding myself finger foods, but I can’t wave bye-bye yet. How old am I?

Parents bring their 16-year-old daughter for a “well-child” checkup. She looks normal on examination. As part of your routine care you plan a urinalysis. The father pulls you aside and asks you to secretly run a UDS on his daughter. Which of the following is the most appropriate course of action?

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?

Which of the following complication of strep pharyngitis cannot be prevented with antibiotics?

fifteen-year-old female makes a statement to you during a well visit. Which of the following statements should not be kept confidential?

 Which of the following screenings should adolescents have done annually?

Which of the following substances is associated with pupillary constriction?

The appropriate lab tests in assessment of cervical adenitis include all of the following except:

 What method can be safely used to remove cerumen in a 15-month-old child’s ear?

 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

A mother states that her 4-year-old son constantly grinds his teeth at night. You document this as:

 The father of a 3-year-old is concerned because the child stutters. What should your approach be?

A mother of a 6-month-old asks you about normal sleep patterns for an infant this age. The best response is:

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

Which of the following eye findings would be considered an ophthalmic emergency?

Mark is in the exam room. You are concerned he may have epiglottitis. In what position do these patients prefer to sit?

 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:

Which of the following statements about bullying is true?

 For adolescent girls, peak height velocity should occur by Tanner Stage (SMR):

is worried the child’s development will not be normal because she mixes up the two languages. You respond:

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