Walden NRNP6541 2021 September Week 3 Quiz Latest

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NRNP6541 Primary Care of Adolescents and Children

Week 3 Quiz  

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:

a.Set his own bedtime based on his internal clock.

b.Protest when he goes to bed, but the parents should not pick him up or give him any attention.

c.Put himself to sleep somewhere other than his own bed and the parents should move him to the bed once he is asleep.

d.Make multiple requests, but the parents should only respond to every third request.

A 13-month-old child is noted to be at the 25th percentile for weight, the 10th percentile for height, and less than the 5th percentile for head circumference. She was born at term. She was noted to have a small head at birth, to be developmentally delayed throughout her life, and to have required cataract surgery shortly after birth. She currently takes phenobarbital for seizures. Which of the following would most likely explain this child’s small size?

a.Congenital cytomegalovirus infection

b.Down syndrome

c.Glycogen storage disease type II

d.Congenital

e.Craniopharyngioma

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?

a.4months

b.6months

c.9months

d.15months

 

 I can walk well on tiptoes, my speech is 50% understandable, I know six body parts, but I cannot balance on one foot for 1 second. I am:

a.2          years old (24 months)

b.            /2 years old (30 months)

c.3          years old (36 months)

d.4          years old (48 months)

Appropriate anticipatory guidance for the parents of an 8-year-old girl includes

a.Preparation for an increase in nervous mannerisms and activity

b.Preparation for decreased needs for parental guidance and supervision

c.Information that the child will start to value personal idols and role models.

d.Information on menstrual hygiene practices

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

a.Copy a cross

 b.Copy a circle

c.Copy a vertical line

d.Draw a person in six parts

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?

a.Pneumococcal conjugate vaccine (PCV13), IPV, varicella, and DTaP

b.DTaP, IPV, MMR, and Varivax

c.Tetanus and diphtheria toxoid with acellular pertussis (TdaP), MMR, hepatitus B, and IPV

d.PVC 13, DTaP, IPV, MMR, and Varivax

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.Object permanence

b.Formal operations

c. Abstract reasoning

 d.Conservation

The first sign of the onset of female puberty is usually:

a.Sparsely distributed fine, pale pubic hairs

b.Breast buds

c.Menarche

d.Peak height growth velocity

A 7-month-old male is found to have a spiral fracture of the femur that his father says he got by climbing onto a chair and then jumping off. Which of the following statements is true regarding this situation?

a.You cannot report this to child protective services because the history provides a legitimate possible mechanism of injury other than abuse.

b.The father can sue you if you report this to the authorities and they determine that no abuse occurred.

c.You should anonymously report the abuse to the authorities.

d.You can be held legally liable for failing to report child abuse.

A breastfed infant is expected to have a lower incidence of which of the following?

a.Asthma

b.Conjunctivitis

c.Diarrhea

d.Impetigo

e.Urinary tract infections

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?

a.Activity

b.Rhythmicity

c.Adaptability

d. Threshold of response

The nurse practitioner role was initially established to

a.Reduce the nursing shortage and improve access to care.

b.Improve access to care and partially solve physician shortage.

 c.Improve working condition of nurses while improving access to care.

d.Improving nursing’s image through expansion of the role.

The mother of a 5-year-old informs you that her daughter cheats when playing board games. What is the best response?

a.Encourage the parents to use timeouts when cheating occurs.

b.Explain that this is developmentally normal until the child is old enough to understand complex game rules.

c.Tell the mother to spend time clarifying board game rules before starting games.

d.Have the mother explain to her daughter that cheating, like lying, is unacceptable behavior and make her stop playing.

Most children can independently get dressed by themselves by age:

a.18months

b.2          years

c.3          years

d.5 years

 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?

a.Sensorimotor

b.Preoperational

c. Concrete operational

d.Formal operational

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

a.Fluid restriction and voiding prior to the night may be effective.

b.Maturation of the urinary tract is still incomplete at this age and they just need to give it more time.

c.Conditioning devices like bed-wetting alarms are not the best option at this time because of the child’s age.

d.Medications like desmopressin acetate (DDAVP) provide the best long- term resolution.

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?

a.Chromosomal abnormality

b.Protein-calorie malnutrition

c.Normal ex-preemie infant growth

d.Malabsorption secondary to short gut syndrome

e.Congenital hypothyroidism

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

a.Toddlers

b.Preschoolers

c.Young school-aged children

d.Older school-aged children

Medicaid provides health insurance coverage to

a.Anyone whose personal income falls below federal poverty level.

 b.Certain categories of people whose personal income falls below a certain percentage of the federal poverty level.

c.Newborn, pregnant women, and those older than 65 whose personal income falls below the federal poverty level.

d.Those who are elderly.

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