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NURS 6541
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NURS 6541 Week 8 Quiz Questions and Answers (Graded A)
NURS 6541 Week 8 Quiz Questions and Answers (Graded A) QUESTION 1 Which of the following scenarios is suspicious for the development of neonatal jaun... [Show More] dice with potential for kernicterus? a. A 7-day-old breastfed infant with yellowing of the sclera b. A 7-day-old infant with AB+ blood whose mother has B+ blood c. A 7-hour-old infant who is breastfed, is alert, and has normal skin tone d. A 7-hour-old infant who is Rh positive and whose mother is Rh negative 1 points Saved QUESTION 2 Which of the following statements regarding infants with PKU is true? a. They require special infant formulas. b. They are seriously ill in the newborn period. c. Breastfeeding is contraindicated. d. Aspartame (NutraSweet) is a preferred sugar substitute for these children. 1 points Saved QUESTION 3 Abdominal pain and vomiting are troublesome in children with type 1 diabetes because these symptoms can occur in which of the following dangerous conditions? a. Ketoacidosis b. Parasitic gastroenteritis c. Hyperglycemia d. Autoimmune response in the pancreas 1 points Saved QUESTION 4 A 2-year-old with sickle-cell anemia presents to your office with a fever of 103.4°F, lethargy, and malaise. The mother tells you she stopped giving the child the amoxicillin prescribed by his hematologist because she is concerned about antimicrobial resistance. Which of the following diagnoses should be considered in this scenario? a. Acute chest syndrome b. Pneumococcal bacteremia c. Vasocclusive crisis d. Hemarthrosis 1 points Saved QUESTION 5 Children and adolescents with acquired hypothyroidism often have: a. Decreased linear growth b. Third fontanelles c. Soft, silky hair d. Advanced bone age 1 points Saved QUESTION 6 Iron deficiency anemia is most common in what age group? a. 6 to 9 months b. 9 to 24 months c. 18 to 36 months d. 4 to 5 years 1 points Saved QUESTION 7 Which of the following is NOT a standard of care for children with sickle-cell anemia? a. Annual complete blood count (CBC) b. Bimonthly liver and kidney function testing c. Collaboration with a pediatric hematologist d. Routine wellness care with special attention to immunization status 1 points Saved QUESTION 8 Which of the following children is at risk for lead poisoning? a. A child who lives in a home with copper water pipes b. A child whose sibling has an elevated lead level c. A child who lives in public housing built in 1999 d. A child whose father is a hunter 1 points Saved QUESTION 9 Which of the following statements regarding galactosemia is true? a. The disease is X-linked. b. Infants with galactosemia are ill at birth. c. The disease is due to a buildup of an amino acid. d. Vomiting, seizures, and lethargy start in the second and third weeks of life. 1 points Saved QUESTION 10 A 14-month-old is diagnosed with iron deficiency secondary to poor iron intake. Her hemoglobin is 8.7 g/dl. You counsel regarding the sources of dietary iron. The most appropriate next step is: a. Give intramuscular ferrous sulfate. b. Administer oral ferrous sulfate 3–6 mg/kg divided three times daily. c. Measure Hgb again in 1 month after dietary changes. d. Refer for a hematology consult. 1 points Saved [Show Less]
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NURS 6541 WEEK 5 Quiz – Question and Answers 2 Sets (Graded A).
NURS 6541 WEEK 5 Quiz – Question and Answers 2 Sets (Graded A). QUESTION 1 A 7-year-old presents to your office with several linear, curved lines app... [Show More] roximately 4 millimeters in length that end in a papule. The lines are near the umbilicus and waist area. He complains about severe itching that is worse at night. You suspect: a. Scabies b. Hives c. Fleas d. Ticks 1 points QUESTION 2 You see a 10-year-old with warts on the hand. This is best treated with: a. Topical salicylic acid applied twice daily b. Podophyllum resin c. Referral to dermatology for removal d. Topical freezing of the warts and referral to dermatology if they do not respond 1 points QUESTION 3 Which of the following treatments is indicated for tinea versicolor? a. Mupirocin (Bactroban) topical ointment b. Cephalexin (Keflex) oral for 10 days c. Selenium sulfide 2.5% lotion (Selsun) d. Griseofulvin microsize oral until clear 1 points QUESTION 4 Jaime presents with lesions on his forearms. He was bit by mosquitos and he “just wouldn’t stop scratching them.” You notice two crusted lesions with erythematous bases on the lower portion of both arms. He also has two pustular lesions around his nose. What is the preferred therapy for this child? a. Topical neomycin-based antibiotic like Neosporin b. Topical antibiotic therapy with mupirocin (Bactroban) c. Oral antibiotic therapy with penicillin VK d. Oral antibiotic therapy with cephalexin (Keflex) 1 points QUESTION 5 A new mother is concerned about a strawberry hemangioma that her infant daughter has on the back of her neck. What is the treatment of choice for the majority of infants with hemangiomas? a. Cryosurgery b. Interlesional steroid injections c. Oral steroids d. Observation 1 points QUESTION 6 Michael is a 10-month-old with erythematous papular dermatitis on the face, scalp, and neck. His mother says he is constantly rubbing the skin. There is a strong family history of asthma and allergies. The most likely diagnosis is: a. Contact dermatitis b. Atopic dermatitis c. Seborrheic dermatitis d. Scabies infestation 1 points QUESTION 7 You see a 6-year-old who obtained a cut on his foot while walking barefoot. You diagnose cellulitis. He is up to date on his DTaP vaccine. There is a low-grade temperature and appears nontoxic. There is considerable pain when you palpate the foot. Which of the following treatments is best? a. Apply cool, moist compresses to the area to decrease pruritis and begin oral amoxicillin at 80 mg/kg/day. b. 2 c. Advise rest and immobilization, begin cephalexin (Keflex) or sulfamethoxazole/trimethoprim (Bactrim), and use warm moist compresses. d. Give acetaminophen for pain or fever and begin oral azithromycin (Zithromax). 1 points QUESTION 8 You receive a phone call from a mother of a 3-year-old who was diagnosed yesterday with molluscum contagiosum at a well-child visit. The mother was not at the visit and has questions about what type of treatment the child will need. Your best response is: a. There is low risk of communicability to others and the rash is self-limiting, so no treatment is necessary. b. The rash is highly contagious and the child should avoid contact with other children until the rash clears. c. Systemic involvement is common, so the child must be treated with oral antivirals like acyclovir. d. The child should be evaluated by a dermatologist because this disorder can cause long-term sequelae. 1 points QUESTION 9 You diagnose a 2-month-old with atopic dermatitis. She has an erythematous pruritic rash on her cheeks and scalp with ovoid patches on her trunk. What is the most important intervention at this time? a. Educate the parents this is a chronic disease she will likely have for the rest of her life. b. Discuss potential food triggers that should be avoided. c. Prescribe a medium potency topical corticosteroid. d. Emphasize the importance of consistent daily skin care with frequent bathing and emollient lotions. 1 points QUESTION 10 You diagnose a 14-year-old with tinea capitis. Which of the following treatments do you recommend? a. b. c. d. Quiz 2 Question 1 0 out of 1 points You see a 6-year-old who obtained a cut on his foot while walking barefoot. You diagnose cellulitis. He is up to date on his DTaP vaccine. There is a low-grade temperature and appears nontoxic. There is considerable pain when you palpate the foot. Which of the following treatments is best? Question 2 0 out of 1 points You diagnose a 2-month-old with atopic dermatitis. She has an erythematous pruritic rash on her cheeks and scalp with ovoid patches on her trunk. What is the most important intervention at this time? Question 3 0 out of 1 points Jaime presents with lesions on his forearms. He was bit by mosquitos and he “just wouldn’t stop scratching them.” You notice two crusted lesions with erythematous bases on the lower portion of both arms. He also has two pustular lesions around his nose. What is the preferred therapy for this child? Question 4 1 out of 1 points You diagnose a 14-year-old with tinea capitis. Which of the following treatments do you recommend? Question 5 1 out of 1 points A new mother is concerned about a strawberry hemangioma that her infant daughter has on the back of her neck. What is the treatment of choice for the majority of infants with hemangiomas? Question 6 0 out of 1 points You receive a phone call from a mother of a 3-year-old who was diagnosed yesterday with molluscum contagiosum at a well-child visit. The mother was not at the visit and has questions about what type of treatment the child will need. Your best response is: Question 7 1 out of 1 points A 7-year-old presents to your office with several linear, curved lines approximately 4 millimeters in length that end in a papule. The lines are near the umbilicus and waist area. He complains about severe itching that is worse at night. You suspect: Question 8 1 out of 1 points Which of the following treatments is indicated for tinea versicolor? Question 9 1 out of 1 points You see a 10-year-old with warts on the hand. This is best treated with: Question 10 0 out of 1 points Michael is a 10-month-old with erythematous papular dermatitis on the face, scalp, and neck. His mother says he is constantly rubbing the skin. There is a strong family history of asthma and allergies. The most likely diagnosis is: [Show Less]
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Walden University NURS 6541 Week 1 Quiz – Question & Answers
Walden University NURS 6541 Week 1 Quiz – Question & Answers Question 1 I can roll over, grasp a rattle, and reach for things and have begun feeding my... [Show More] self finger foods, but I can’t wave bye-bye yet. How old am I? a. 5 months b. 6 months c. 9 months d. 12 months 1 points Question 2 Which of the following children has abnormal language development? a. Repeats simple phrases at 32 months b. Stutters when excited or tired at 4 years of age c. Has a 10-word vocabulary at 12 months d. Speech is 50% understandable at 36 months of age 1 points Question 3 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 1 points Question 4 I can walk well on tiptoes, my speech is 50% understandable, I know six body parts, but I can’t balance on one foot for 1 second. I am: a. 2 years old (24 months) b. 2½ years old (30 months) c. 3 years old (36 months) d. 4 years old (48 months) 1 points Question 5 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 1 point Question 6 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 1 points Question 7 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? a. It is okay to begin weaning to whole milk between 9 and 12 months of age. b. The most important thing to add at this time is table foods; discussion of other dietary issues will happen at 9 months of age. c. The baby should remain on infant formula and stage 2 and 3 baby foods for now. d. It is a good idea to introduce whole eggs to the diet of 5- to 6-month-olds. 1 points Question 8 A typically developing 8-year-old girl will have which of the following genital development? a. No pubic hair at all b. Small amount of long, downy pubic hair along the labia majora c. Coarse, curly pubic hair that extends laterally from the labia majora d. Adult-like pubic hair that extends along the mons pubis but does not include the medial thighs 1 points Question 9 Most children can independently get dressed by themselves by age: a. 2 years b. 3 years c. 4 years d. 5 years 1 points Question 10 The most likely weight of a 1-year-old whose birth weight was 6½ pounds would be: a. 13 to 14 pounds b. 19 to 20 pounds c. 25 to 25 pounds d. Impossible to estimate 1 points Question 11 When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Yes [Show Less]
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WALDEN UNIVERSITY NURS 6541 WEEK 3 QUIZ – QUESTION WITH ANSWERS
WALDEN UNIVERSITY NURS 6541 WEEK 3 QUIZ – QUESTION WITH ANSWERS QUESTION 1 A 9-year-old who weighs 70 pounds asks why she can’t sit in the front pa... [Show More] ssenger seat of the family car. Your best response is: a. The safest place for children under 12 years old and 100 pounds is the backseat of the car. b. Air bags are not effective for children this age and will often not reach the child. c. It’s okay to sit in the front seat as long as air bags are not present or are turned off. d. Booster seats should never be used after 8 years of age. 1 points QUESTION 2 Which of the following is a priority nurse practitioner role to help children and adolescents to have healthy sexual development? a. Begin anticipatory guidance related to sexuality and normal pubertal development in the early school-age visits. b. Inform parents about a child’s risky sexual behaviors. c. Ask teenage girls if they have a boyfriend. d. Assessing parental beliefs regarding sexual education. 1 points QUESTION 3 For adolescent girls, peak height velocity should occur by Tanner Stage (SMR): a. 1 b. 2 c. 3 d. 4 1 points QUESTION 4 Which of the following statements regarding adolescent substance use is true? a. A negative drug screen effectively rules out drug use. b. Taking drug screen samples from adolescents without their assent is acceptable in pediatrics. c. Tobacco is the most commonly abused substance during adolescence. d. Most teen alcohol abusers are not “functional” alcoholics. 1 points QUESTION 5 Which of the following statements about bullying is true? a. About 35% of second graders report having been bullied. b. It occurs most commonly during unstructured times (lunch, recess, etc.). c. Boys are more likely to indirectly bully while girls usually directly bully. d. Victims rarely have physical symptoms. 1 points QUESTION 6 Which of the following screenings should adolescents have done annually? a. Psychosocial screening, blood pressure, body mass index b. Blood pressure, hemoglobin, complete physical exam c. Complete physical exam, psychosocial screening, drug testing d. Psychosocial screening, cholesterol screening, blood pressure 1 points QUESTION 7 The mother of a 5-year-old informs you 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. 1 points QUESTION 8 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: a. The penis will grow in length and width b. The penis will grow in width. c. Facial hair will appear. d. Changes in your voice will occur. 1 points QUESTION 9 Which of the following issues or concepts is relevant to the school-age child? a. Operational thinking b. Erikson’s initiative versus guilt c. Formal operational thinking d. Conservation, classification, and seriation 1 points QUESTION 10 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 1 points QUESTION 11 When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Yes [Show Less]
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Walden University NURS 6541 Week 2 Quiz – Question & Answers
Walden University NURS 6541 Week 2 Quiz – Question & Answers QUESTION 1 You see a healthy 18-month-old for a well-child visit. At the 12-month visit ... [Show More] 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? a. Varicella and DTaP b. DTaP, varicella, hepatitis A, and hepatitis B c. DTaP, IPV, varicella, PCV13, and hepatitis B d. Hib, PCV 13, IPV, and hepatitis A 1 points QUESTION 2 A common feature of 2-year-old behavior is: a. Negativism b. Stranger anxiety c. Nonparallel play d. a and b ???? 1 points QUESTION 3 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: a. “Your child’s speech is normal and bilingual children commonly intermix the words from both languages until about 3 years of age.” b. “Don’t be concerned because your child’s speech is normal and young childhood is the best time to learn languages.” c. “Stop speaking English at home to avoid confusion. She can always learn English outside the home.” d. “The child may confuse the words now, but that will change by second grade.” 1 points QUESTION 4 A mother of a 6-month-old asks you about normal sleep patterns for an infant this age. The best response is: a. 10 hours at night and 1 to 2 hours during the day b. 10 hours at night and 3 to 4 hours during the day c. 10 hours at night and 5 to 6 hours during the day d. 8 hours at night and 4 to 5 hours during the day 1 points QUESTION 5 You see a 6-month-old who is fussy, has interrupted sleep, and is drooling. You note large lower lateral incisor bulges. You recommend: a. Acetaminophen 10-15 mg/kg/dose every 4 to 6 hours as needed b. Ibuprofen 20 mg/kg/dose every 6 to 8 hours as needed c. Over-the-counter topical anesthetic gels d. Gum massage with a cold washcloth e. A and D 1 points QUESTION 6 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 1 points QUESTION 7 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: a. Act as if nothing abnormal happened. b. Stand and watch, but do nothing while she is holding her breath. c. Splash the child’s face to stimulate her breathing. d. Place her in a timeout as soon as the breath-holding spell is over. 1 points QUESTION 8 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. Tetanus and diphtheria toxoid with acellular pertussis (TdaP), MMR, hepatitis B, and IPV c. DTaP, IPV, MMR, and Varivax d. PCV13, DTaP, IPV, MMR, and Varivax 1 points QUESTION 9 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? a. Tell parent, “Your child’s language development is normal ” b. Tell parent, “Boys typically have delayed speech compared with girls at this age.” c. Encourage early intervention services for speech d. Reevaluate the child at the 24-month visit. 1 points QUESTION 10 Which of the following represents normal sequencing of development in a toddler? a. Feeds self, can undress self with help, washes hands, imitates housework b. Uses spoon without difficulty, uses parallel play, dresses and undresses self independently, washes hands c. Feeds self, dresses and undresses self independently, washes hands and feet d. Washes hands, dresses self independently, uses nonparallel play, uses fork without difficulty 1 points QUESTION 11 When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Yes [Show Less]
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NURS 6541 Week 6 Quiz 1 Questions and Answers (Graded A)
NURS 6541 Week 6 Quiz 1 Questions and Answers (Graded A) Question 1 1. A 3-year-old has a history of upper respiratory tract infection 2 weeks ago. She ... [Show More] recently started awakening at night. Physical exam reveals a normothermic child. She is smiling, playful, and sitting on the father’s lap. The TMs are gray with scattered bubbles and good motility. What is the best treatment? 2. a. Amoxicillin at 80 mg/kg/day in two divided doses for 10 days b. Observation without therapy; recheck in 1 month c. Nasal corticosteroids daily d. Referral to an otolaryngologist 1 points Question 2 1. The mother of a 5-year-old wants to know what to do to decrease the discomfort of her daughter who has a URI. The mother should be instructed to: 2. a. Administer topical decongestant for 3 days and use normal saline nose drops b. Administer dextromethorphan and saline nose drops c. Place a warm-mist vaporizer in the child’s bedroom d. Start zinc nasal spray to decrease the symptoms 1 points Question 3 1. A 7-year-old presents with a complaint of ear pain with purulent discharge. He states it hurts when he is lying on the affected side and when anyone touches his pinna. The most likely diagnosis is: 2. a. Otitis media with effusion b. Acute otitis media c. Otitis interna d. Otitis externa 1 points Question 4 1. Mikayla is a 15-month-old female who has had recurrent bouts of acute otitis media. Her mother is concerned about future school performance. Which of the following statements regarding otitis media is true? 2. a. The incidence of acute otitis media is highest from 18 to 24 months of age. b. Bilateral otitis media with effusion does not cause hearing deficits. c. Potential aggravating factors for Mikayla include pacifier use, bottle use, and cigarette smoke exposure. d. There is a correlation between the number of school days missed due to acute otitis media and IQ measurement. 1 points Question 5 1. TJ is a 12-year-old with a significantly swollen eye. His mom states he was stung by a bee next to his eye 3 days ago. The swelling started last night and has progressively worsened. He has a fever of 101.9°F, has erythematous edema around his left eye, and is able to move his eye through all visual fields. After consulting with your MD, you prescribe: 2. a. Use of cold compresses and diphenhydramine (Benadryl) b. Use of amoxicillin/clavulanic acid (Augmentin), possibly after intramuscular cefriaxone (Rocephin) or an inpatient course of IV cefriaxone c. Use of low-potency topical corticosteroids and systemic low-dose prednisone for 3 days d. Use of cold compresses and opthalmalogic antibiotic drops 1 points Question 6 1. A 10-year-old comes to your school-based clinic with complaint of a painful sore on the upper lip for 5 days. The sore is getting better since yesterday, but today the right eyelid is swelling and there are blisters on the eye. The best management is to: 2. a. Suggest warm compresses three times a day b. Start topical antibiotic drops like polymixin B (Polytrim) c. Immediately refer to ophthalmology d. Start oral antiviral treatment like acyclovir 1 points Question 7 1. Therapeutic treatment for Coxsackie infections include: 2. a. Antiviral treatment like acyclovir b. Immunoglobulin c. Supportive care d. Antimicrobial treatment like amoxicillin or cephalexin 1 points Question 8 1. You see a 9-year-old after he was hit in the eye with a foreign body. Flourescein staining reveals a vertical line abrasion lateral to the iris. The pupils are equal in size and reactive; a positive red reflex is present bilaterally. There are no abnormal extraocular movements. Visual acuity is normal. An appropriate plan of care includes follow-up in 48 to 72 hours and: 2. a. Prescribing ophthalmic steroid drops three times a day but not applying an eye patch b. Prescribing ophthalmic antibiotic drops three to four times daily and placing a patch over the eye for 24 to 48 hours c. Prescribing topical ophthalmic steroid drops three times a day and placing a patch over the eye for 24 to 48 hours d. Prescribing ophthalmic antibiotic drops three to four times daily but not applying an eye patch 1 points Question 9 1. Each of the following is a risk factor for the development of acute otitis media EXCEPT: 2. a. Breastfeeding ? b. Group child care attendance c. Respiratory viral infection d. Ambient tobacco smoke 1 points Question 10 1. You see a 6-month-old with a diagnosis of dacryocystitis. The mother states “her left eye tears all the time and it has since birth.” The infant was seen in urgent care last week and was prescribed antibiotic eye drops that “don’t seem to help.” You confirm the diagnosis of dacryocystitis without evidence of infection. What education and counseling do you provide? 2. a. The infant should see an ophthalmologist since the condition has persisted for 6 months. b. The infant should get another course of antibiotic eye drops to prevent secondary infection. c. The blockage in the tear duct is probably the result of a neonatal eye infection. d. Spontaneous resolution usually occurs by 9 to 12 months. • Question 1 1 out of 1 points You see a 9-year-old after he was hit in the eye with a foreign body. Flourescein staining reveals a vertical line abrasion lateral to the iris. The pupils are equal in size and reactive; a positive red reflex is present bilaterally. There are no abnormal extraocular movements. Visual acuity is normal. An appropriate plan of care includes follow-up in 48 to 72 hours and: • Question 2 1 out of 1 points A 3-year-old has a history of upper respiratory tract infection 2 weeks ago. She recently started awakening at night. Physical exam reveals a normothermic child. She is smiling, playful, and sitting on the father’s lap. The TMs are gray with scattered bubbles and good motility. What is the best treatment? • Question 3 1 out of 1 points Each of the following is a risk factor for the development of acute otitis media EXCEPT: • Question 4 0 out of 1 points You see a 6-month-old with a diagnosis of dacryocystitis. The mother states “her left eye tears all the time and it has since birth.” The infant was seen in urgent care last week and was prescribed antibiotic eye drops that “don’t seem to help.” You confirm the diagnosis of dacryocystitis without evidence of infection. What education and counseling do you provide? • Question 5 1 out of 1 points Kelly is a 9-year-old who presents to your office with complaint of nasal congestion, nasal obstruction, and facial pain with radiation to her teeth and jaw for the last 14 days. The pain is described as throbbing and is worsened by abrupt movements, walking, or bending over. Her temperature is currently 100.4°F. Your most likely diagnosis is: • Question 6 1 out of 1 points TJ is a 12-year-old with a significantly swollen eye. His mom states he was stung by a bee next to his eye 3 days ago. The swelling started last night and has progressively worsened. He has a fever of 101.9°F, has erythematous edema around his left eye, and is able to move his eye through all visual fields. After consulting with your MD, you prescribe: • Question 7 1 out of 1 points Therapeutic treatment for Coxsackie infections include: • Question 8 1 out of 1 points A 10-year-old comes to your school-based clinic with complaint of a painful sore on the upper lip for 5 days. The sore is getting better since yesterday, but today the right eyelid is swelling and there are blisters on the eye. The best management is to: • Question 9 1 out of 1 points Mikayla is a 15-month-old female who has had recurrent bouts of acute otitis media. Her mother is concerned about future school performance. Which of the following statements regarding otitis media is true? • Question 10 0 out of 1 points John, age 5, was diagnosed with a ruptured tympanic membrane as a result of acute otitis media 2 weeks ago. He was treated with oral antibiotics at the time of diagnosis and has finished his course. He has no purulent drainage, but he still has a TM perforation. His plan of care should include: • Question 11 0 out of 0 points When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Monday, April 9, 2018 1:02:31 AM EDT [Show Less]
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NURS 6541 Week 6 Quiz 1 – Question and Answers.
NURS 6541 Week 6 Quiz 1 – Question and Answers. Results Displayed: Selected Answers and Correct Answers • Question 1 1 out of 1 points A 65... [Show More] -year-old male recently had a cerebrovascular accident that resulted in dysphagia. He now has aspiration of gastric contents. The nurse assesses the patient for which complication? Selected Answer: a. Pneumonia Correct Answer: a. Pneumonia • Question 2 1 out of 1 points A nurse is preparing to teach the staff about asthma. Which information should the nurse include? Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by: Selected Answer: c. Mucus secretion, bronchoconstriction, and airway edema Correct Answer: c. Mucus secretion, bronchoconstriction, and airway edema • Question 3 1 out of 1 points A 50-year-old male presents with hypotension, hypoxemia, and tracheal deviation to the left. Tests reveal that the air pressure in the pleural cavity exceeds barometric pressure in the atmosphere. Based upon these assessment findings, what does the nurse suspect the patient is experiencing? Selected Answer: b. Tension pneumothorax Correct Answer: b. Tension pneumothorax • Question 4 1 out of 1 points A 45-year-old male undergoes lung transplantation. He now suffers from airway occlusion secondary to fibrosis. Which diagnosis will the nurse see on the chart? Selected Answer: d. Bronchiolitis obliterans Correct Answer: d. Bronchiolitis obliterans • Question 5 1 out of 1 points When the nurse is asked what causes asthma, how should the nurse respond? Asthma is thought to be caused by: Selected Answer: d. Interactions between genetic and environmental factors Correct Answer: d. Interactions between genetic and environmental factors • Question 6 1 out of 1 points A 25-year-old male presents with chronic bronchitis of 5 months’ duration. When obtaining the patient’s history, which of the following findings is most likely to cause this condition? Selected Answer: c. Cigarette smoke Correct Answer: c. Cigarette smoke • Question 7 1 out of 1 points A 22-year-old female presents with chronic bronchitis. Tests reveal closure of the airway during expiration. While planning care, a nurse recalls this condition is most likely caused by: Selected Answer: a. Thick mucus from hypertrophied glands Correct Answer: a. Thick mucus from hypertrophied glands • Question 8 1 out of 1 points Individuals with a recent diagnosis of emphysema should be assessed for which most common presenting factor? Selected Answer: c. Dyspnea Correct Answer: c. Dyspnea • Question 9 1 out of 1 points A 28-year-old male reports to his primary care provider that he has had a cold for a week and is coughing up bloody secretions. When giving report, what term should the nurse use to describe this condition? Selected Answer: d. Hemoptysis Correct Answer: d. Hemoptysis • Question 10 1 out of 1 points A nurse recalls asthma is classified by: Selected Answer: b. Clinical severity Correct Answer: b. Clinical severity • Question 11 1 out of 1 points While planning care for a child with asthma, which of the following is characteristic of asthma? Selected Answer: b. Prolonged expirations Correct Answer: b. Prolonged expirations • Question 12 1 out of 1 points A nurse is preparing to teach the staff about asthma. Which information should the nurse include? Airway hyper-responsiveness in asthma is related to: Selected Answer: c. Exposure to an allergen causing mast cell degranulation Correct Answer: c. Exposure to an allergen causing mast cell degranulation • Question 13 1 out of 1 points A 47-year-old male is diagnosed with pulmonary edema. Which assessment findings will the nurse observe? Selected Answer: b. Pink, frothy sputum Correct Answer: b. Pink, frothy sputum • Question 14 1 out of 1 points A nurse is teaching staff about pulmonary edema. Which information should the nurse include? The most common cause of pulmonary edema is: Selected Answer: b. Left heart failure Correct Answer: b. Left heart failure • Question 15 1 out of 1 points A 7-month-old male presents with cystic fibrosis (CF) accompanied by failure to thrive and frequent, loose, and oily stools. Sweat testing reveals increased chloride. Which of the following should the nurse observe for that would accompany this disease? Selected Answer: b. A thick mucus Correct Answer: b. A thick mucus • Question 16 1 out of 1 points A geneticist is discussing cystic fibrosis (CF). Which information should be included? CF is an _____ disease. Selected Answer: a. Autosomal recessive Correct Answer: a. Autosomal recessive • Question 17 1 out of 1 points A 10-year-old male is brought to the ER with prolonged bronchospasm and severe hypoxemia. The most likely diagnosis on the chart is: Selected Answer: c. Status asthmaticus Correct Answer: c. Status asthmaticus • Question 18 1 out of 1 points A 50-year-old diabetic male did not take his medication and is now in metabolic acidosis. He is experiencing Kussmaul respirations. What type of breathing will the nurse observe upon assessment? Selected Answer: b. A slightly increased ventilatory rate, large tidal volumes, and no expiratory pause Correct Answer: b. A slightly increased ventilatory rate, large tidal volumes, and no expiratory pause • Question 19 1 out of 1 points A 60-year-old female with a 25-year history of smoking is diagnosed with emphysema. She has an increased anterior-posterior chest diameter. The nurse attributes this finding to: Selected Answer: a. Air trapping Correct Answer: a. Air trapping • Question 20 1 out of 1 points A 57-year-old male presents with cough, sputum production, dyspnea, and decreased lung volume. He is diagnosed with pneumoconiosis. When taking the patient’s history, which finding is the most probable cause of his illness? Selected Answer: a. Inhalation of silica, asbestos, mica Correct Answer: a. Inhalation of silica, asbestos, mica • Question 21 1 out of 1 points Which of the following shows a correct cause and effect sequence in the development of acute respiratory distress syndrome (ARDS)? Selected Answer: b. Alveolocapillary membrane injury causing a massive inflammatory response Correct Answer: b. Alveolocapillary membrane injury causing a massive inflammatory response • Question 22 1 out of 1 points A 53-year-old male with a 20-year history of smoking is diagnosed with emphysema. When a staff member asks why the patient’s airways are obstructed, how should the nurse respond? The airways are obstructed because of: Selected Answer: b. Loss of elastic recoil Correct Answer: b. Loss of elastic recoil • Question 23 1 out of 1 points A 13-year-old female is diagnosed with asthma. Which of the following should the nurse teach the patient to recognize as part of an asthmatic attack? Selected Answer: c. Wheezing Correct Answer: c. Wheezing • Question 24 1 out of 1 points A 10-year-old female develops pneumonia. Physical exam reveals subcostal and intercostal retractions. She reports that breathing is difficult and she feels she cannot get enough air. What term should the nurse use to document this condition? Selected Answer: b. Dyspnea Correct Answer: b. Dyspnea • Question 25 1 out of 1 points An 11-year-old female presents with a low-grade fever and cough. She is diagnosed with atypical pneumonia. What type of pneumonia does the nurse suspect the patient is experiencing? Selected Answer: c. Mycoplasma pneumonia Correct Answer: c. Mycoplasma pneumonia • Question 26 1 out of 1 points An 80-year-old female develops pneumonia in the hospital. She becomes cyanotic, tachycardic, and develops a fever and cough. Chest x-ray reveals pus in the pleural space. Which of the following is the most likely diagnosis documented on the chart? Selected Answer: a. Empyema Correct Answer: a. Empyema • Question 27 1 out of 1 points If an individual with respiratory difficulty were retaining too much carbon dioxide, which of the following compensatory responses would the nurse expect to be initiated? Selected Answer: a. Increase in respiratory rate Correct Answer: a. Increase in respiratory rate • Question 28 1 out of 1 points A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon dioxide (CO2) levels. Which of the following does the nurse suspect is the most likely cause? Selected Answer: a. Hyperventilation Correct Answer: a. Hyperventilation • Question 29 1 out of 1 points When the pulmonologist discusses the condition in which a series of alveoli in the left lower lobe receive adequate ventilation but do not have adequate perfusion, which statement indicates the nurse understands this condition? When this occurs in a patient it is called: Selected Answer: b. Alveolar dead space Correct Answer: b. Alveolar dead space • Question 30 1 out of 1 points When the nurse observes a diagnosis of nosocomial pneumonia, the patient generally acquires this pneumonia: Selected Answer: c. During hospitalization Correct Answer: c. During hospitalization [Show Less]
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NURS 6541 Midterm Exam Review (Week 1-6)
NURS 6541 Midterm Exam Review (Week 1-6) Week 1: Growth and Development • Safety with Car Seats – remain rear facing for as long as possible until ... [Show More] they reach weight or height of seat. https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Updates-Recommendations-on-Car-Seats-for-Children.aspx • Vaccination Schedules and contraindications – o Hepatitis B – 3 dose series o Rotavirus – 2 dose series o Diphtheria, tetanus, & acellular pertussis (DTaP) – 5 dose series o Haemophilus influenzae type b (HIB) o Pneumococcal conjugate (PCV13) o Inactivated poliovirus (IPV) o Measles, mumps, rubella (MMR) o Varicella o Hepatitis A o Meningococcal o Tetanus, diphtheria, & acellular pertussis (Tdap) o Human papillomavirus (HPV) o Meningococcal B o Pneumococcal polysaccharide (PPSV23) • Child Abuse mandatory reporting – any reason to believe that there is abuse or neglect, you do not have to have burden of proof, • Failure to thrive causes o Childs environment (loss of emotional bond between parent and child, poverty, problems with child-caregiver relationship, diet, exposure to infections, parasites, or toxins, poor eating habits), abuse, neglect, genes such as Down syndrome, organ problems, hormone problems, damage to the brain or CNS may cause feeding difficulties, heart or lung problems, anemia, GI problems making it hard to absorb nutrients or cause a lack of digestive enzymes, long-term infections, metabolism problems, • Breastfed baby’s possible health problems o Lowers risk of asthma or allergies • Normal birth weights and growth – birth to 6 months growth ½ - 1 inch a month and gain 5-7 ounces a week. Double birth weight by 5 months • Normal reflexes in newborns o Rooting – goes away at 4 months - check stroked head turns to that side o Suck – when roof of mouth touch baby starts to suck begins 32 weeks and not fully developed until 36 weeks. o Moro – goes away at 3-4 months – startled o Step – goes away 2 months - appears to be taking steps o Tonic neck – goes away 5-7 months old. head relaxed and laying face up is moved to the side, the arm reaches away from body with had partially open o Grasp – goes away 5-6 months – stroke palm of hand and fingers grasp • Language development issues o Always check hearing • Fine motor skills o • Signs of puberty o Tanner stages 1 hair development, papilla above level of chest 2 sparse, long, pigmented, downy hair – hair seen along the labia and base of penis, small mounds and increased diameter of the areolae, enlargement of Scutum and testes and change in texture of scrotal skin 3 considerably darker, coarser, and curlier, hair is spread over pubes, breast and areolae cont to enlarge, length of penis some circumference, and increase growth in testes and scrotum 4 hair is adult like but decreased in total quantity, areolae and papillae elevate above breast, penis is larger in length and circumference, further development of glans penis, distinct darkening of scrotal skin 5 hair is in triangle and down thighs, mature breast, genitals are adult size o • Piaget developmental stages o Sensorimotor o Preoperational o Concrete o formal • Normal vital signs for various age groups o Infant (1-12mo)– RR 20-30 – HR 80-140 o Toddler (1-3 y.o) – RR 20-30 – HR 80-130 o Preschooler (3-5) – RR 20-30 – HR 80-120 o School Age (6-12) – RR 20-30 – HR 70-110 • Congenital infection with cytomegalovirus, complications of prematurity o Most common congenital viral infection o IUGR, prematurity, microcephaly, jaundice, petechiae, hepatosplenomegaly, periventricular calcifications, chorioretinitits, pneumonitis, hepatitis, and sensorineural hearing loss • Crawling (7-10 months), sitting (4-7 months without support 8 months), rolling over (tummy to back early as 4 months – 5-6 months back to front), walking milestones (9-12 months) Week 2: Infants, Toddlers, and Preschoolers • Normal premature infant growth • Protein calorie malnutrition • Small size differentials • Poor weight gain differentials • Well Child Visit standards for these age groups • Normal sequencing of development in a toddler • Treatment for teething • Early interventions services for speech • Sleep refusal • Bowel training issues • Breath holding • Bilingual children and expectations • Vaccination schedule • Normal sleep patterns • Correct order for introduction of food • Screening for TB • Normal breastfeeding schedules Week 3: School-Age Children and Adolescents • Drug Screening adolescents o Emergent clinical care for altered mental status, assessment of behavioral or mental health symptoms • Vaccination catch up schedule • Routine lab screenings • Anticipatory guidance for each age group • Bedwetting • Erickson’s stages of development o One – trust vs mistrust – Hope 0-1.5 o Autonomy vs shame and doubt – Will 1.5-3 o Three – initiative vs guilt – Purpose 3-5 o Four – industry vs inferiority – competency 5-12 o Five – identity vs role confusion – Fidelity 12-18 o Six – intimacy vs isolation – Love 18-40 o Seven – generativity vs stagnation – Care 40-65 o Eight – ego integrity vs despair – wisdom 65+ • Safety concerns • Bullying • Puberty • Adolescent substance abuse • Lab screenings in adolescents • Female peak height velocity Week 4: HEENT • Differential diagnoses for patients with HEENT disorders • Various treatment options for common HEENT disorders • Evaluate pattern recognition in patient diagnoses o Cobblestone appearance in throat and eyelids Polygonal cells bulge out from mucosal surface; can be caused by postnasal drip, laryngopharyngeal reflux (LPR) o Otitis media Otalgia with fever, N/V/D, hearing loss, difficulty sleeping Increase risk with smoking in house, bottle feeding, and daycare Bulging, erythematous TM, displacement of light reflex Oral analgesics, Amoxicillin, Cefdinir o Conjunctivitis, all types Viral, bacterial, and allergic Blurred vision, crust overnight, visual acuity should be unaffected, itching and watery discharge (allergic), foreign body sensation, photophobia, and discharge (viral), purulent (bacterial), severe eye pain (scleritis) o Corneal abrasion Foreign body sensation, tearing, redness, and discharge, vision is rarely affected Slit-lamp exam with fluorescein staining Remove foreign object, ATB ointment (bacitracin/polymyxin B or ciprofloxacin) and pupillary dilation o Keratitis Inflammation of the cornea o Hyphema o Nasal and eye foreign body o Allergic rhinitis Itching, sneezing, rhinorrhea, nasal congestion, conjunctivitis, caused by exposure to pollens or other allergens Antihistamines, decongestants, nasal corticosteroids o Hand, foot and mouth syndrome Caused by coxsackievirus A16, enterovirus 71, enteroviruses Can have sore throat or mouth pain, refuse to eat, fever, vesicles over buccal mucosa and tongue, palms of hands and soles of feet. Sometimes the butt and genitals o Strep pharyngitis Sore throat, fever, beefy red pharynx, purulent tonsillar exudate, cervical and submaxillary nodes o Glomerulonephritis Inflammation of the glomeruli blood vessels in the kidneys o Peritonsillar abscess Fever, throat pain, and trismus Ultrasongraphy and computed tomographic scanning to confirm diagnosis, needle aspiration is the gold standard with pcn, clinda, cephalosporins or metronidazole for ATB therapy o Epiglottitis Bacterial can rapidly progress Severe sore throat, dysphagia, high fever, drooling, and inspiratory stidor Protect the airway o Cervical adenitis Acute symptomatic enlargement of lymph nodes with spontaneous resolution over four to six weeks o Orbital cellulitis Caused by extension of adjacent sinuses, especially the ethmoid sinus Swelling and redness of the eyelid and surrounding soft tissues, conjunctival hyperemia and chemosisi, decreased ocular motility, pain with eye movements, decreased visual acutity, and proptosis ATB (clinda, vanc, doxy) o Visual acuity by ages Distance done by Snellen letters, numbers, picture test Ocular alignment done by unilateral cover test at 10 ft o Exotropia Form of strabismus where eyes deviate outward Transient intermittent seen in 4-6 week olds and spontaneously resolve. Constant is congenital o Esotropia Strabismus in which one or both eyes turns inward “cross eyed” o Strabismus Misalignment of the eyes that causes deviation from parallelism of normal gaze Risk factors – downs and crouzon, prenatal drug exposure, prematurity, low birth wt, congenital eye defects, and cerebral palsy Diagnosis with cover test Treatment – patching an corrective lenses, alignment by corrective lenses and surgical repair o Foreign body in ear o TMJ malocclusion Trauma, arthritis, bad bite where teeth do not fit together, muscles are not in right position when mouth is closed and it puts stress on the hard and soft tissues in the jaw o Bruxism Clenching or grinding of teeth o Excessive cerumen Causes hearing loss, irritation, pain, dizziness, and ringing o Epstein’s pearls Benign retention cyst resembling small pearls often seen in the palate Disappear within 1-2 weeks of birth o Exostosis Bone spur formation of new bone on the surface of bone Causes chronic pain, can be seen in the ribs, ankles, knees, shoulders, elbows and hips Week 5: Respiratory, Cardiovascular and Genetic Disorders o RSV RNA virus, pneumovirus, outbreaks occur mainly in winter and spring, most common cause of lower resp tract illness Begin URI, fever, dyspnea, cough, wheezing, crackles, apnea in infants <6 mo Supportive care, O2 and hydration, corticosteroids and bronchodilators, ribavirin o Pneumonia – bacterial, mycobacterial, viral, fungal, or parasitic o Bronchitis o Asthma o Croup – acute inflammation, caused by parainfluenza virus type 1 infection Barking couch and hoarseness, commonly at night, inspiratory stridor, Awaken at night with resp distress, tachypnea, and retrations Cool humidified air, single dose of long-acting corticosteroid, racemic epinephrine (5-10mg in 3 ml of saline q2h), dexamethasone 0.6mg/kg IM or PO o Bronchiolitis – acute viral infection of lower resp tract <24 mo peak incidence btwn 2mo-6mo Tachypnea, fever, retractions, and wheezy or hacking cough Premature infants’ recurrent apneic spells, typical symptoms over 24-48 hrs s/s of distress circumoral cyanosis, deepening retractions, and audible wheezing treatment supportive therapy, O2 needed, Iv hydration o Foreign body aspiration o Epiglottitis Inflammation and swelling of epiglottis Life threatening when it swells it can block the airway Hib – Haemophilus influenzae type b common cause o Tonsillectomy and adenoidectomy o Down syndrome - Trisomy 21 Intellectual disability, microcephaly, short stature, and characteristic facies, increased risk of obesity Gross motor and language delays, congenital heart disease, ventricular septal defects and atrioventricular canal, diabetes, celiac disease, hypothyroidism, Hirschsprung disease (delay of meconium of 48 hrs) o Edwards syndrome – Trisomy 18 Intellectual disability, small birth size, and various congenital anomalies, include severe microcephaly, heart defects, prominent occiput, low-set malformed ears, and characteristic pinched facial appearance. Prenatal history of feeble fetal activity, poly, small placenta, and single umbilical artery Clenched fist index finger overlaps 3rd and 4th fingers, redundant skinfolds over back f neck, clubfeet and rocker-bottom feet, congenital heart disease, patent ductus arteriosus, ventricular septal defects o Turner syndrome Girls are born with one of their two X partly or completely missing Coarctation of the aorta and bicuspid aortic valve, hypertension, development dysplasia of the hip Marked dorsal lymphedema of hands and feet, skin folds over back of neck, webbed neck and broad chest, wide spaced inverted nipples, short stature Management of comorbid conditions, possible surgical repair of cardiac abnormalities, growth hormone and estrogen o Fragile x syndrome – genetic abnormality of the X chromosome that causes intellectual disability and behavioral disorders. Abnormality of FMR1 gene unstable triplet repeat expansion; Fragile X syndrome is not a chromosome abnormality Physical, cognitive (autism, perseverative speech, poor eye contact, social anxiety), and behavioral abnormalities Large, protuberant ears, prominent chin and forehead, a high arched palate and postpubertal males macroorchidism, joints hyperextensible, mitral valve prolapse Early intervention, speech and language therapy and occupational therapy, stimulants, antidepressants, and antianxiety o XYY male Males have an extra Y chromosome Taller than average, acne, and an increased risk of learning problems, speech delay, low muscle tone (hypotonia), low-set ears, malar flattening (zygomatic flattening), o Klinefelter syndrome Male with an extra X chromosome Infertility and small testicles, weaker muscles, greater height, poor coordination, less body hair, breast growth, and less interest in sex Anxiety, impaired social skills, short attention span, and limited problem-solving skills, increase of DM2, blood clots, involuntary trembling, breast cancer, thinning and weakening of bones, systemic lupus, erythematosus, and RA o Cystic fibrosis Inherited disease with thick, sticky mucus buildup, mostly in resp and GI Sweat to be very salty, frequent sinusitis, bronchitis, pneumonia Intestines can’t fully absorb fats and proteins, diarrhea or bulky, foul smelling, greasy stools – poor wt gain and growth Treatment is preventing lung infections, loosening and removing mucus, preventing blockage in intestines, nutrition, hydration Week 6: Behavioral and Mental Health Issues o Child abuse o Adhd – symptoms can appear btwn 3-6 and continue Inattention – can’t keep on task, lacks persistence, has difficulty focusing and is disorganized Hyperactivity – moves constantly fidgets, taps, or talks Impulsivity – may have high potential for harm, desire immediate reward Treatments include stimulants to increase brain chemicals dopamine and norepinephrine they may decrease appetite, cause sleep problems, tics, personality changes, increase anxiety and irritability, HA and stomachaches – Amphetamines (dextroamphetamine, Adderal, and Vyvanse) – Methylphenidates (concerta, metadata, Ritalin, focalin) Other meds include Strattera, Wellbutrin, guanfacine, clonidine o Autism Repetitive patterns of behavior and difficulties with social communication and interaction Rarely make eye contact, fail to engage in typical babbling Diagnosed with no babbling or pointing by age 1, no single words by age 16 months or 2-word phrases by age 2, no response to name, loss of language or social skills acquired, poor eye contact, excessive lining up of toys or objects, no smiling or social responsiveness Behavioral/educational interventions early - o Dyslexia – learning disorder involving problems in reading, mathematics, spelling, written expression or handwriting Delayed language production, speech articulation difficulties, remembering names of letters, numbers, and colors, difficulties with word problems despite normal math computation skills Diagnosed with reading evaluation, speech, language, and auditory evals, psych eval Educational interventions, direct and indirect instruction in word recognition and component skills o Fetal alcohol syndrome – alcohol exposure in utero increases risk for Spontaneous AB, decrease birth weight, Small IUGR at birth, microcephaly, microphthalmia, short palpebral fissures, epicanthal folds, small or flat midface, flat elongated philtrum, thin upper lip, small chin, abnormal palmer creases, cardiac defects, joint contractures After birth cognitive deficits Treatments supportive care o Depression Antidepressants plus psychotherapy (>8 fluoxetine) • SSRI first line [Show Less]
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NURS 6541 Week 6 Quiz 2 Questions and Answers (Graded A)
NURS 6541 Week 6 Quiz 2 Questions and Answers (Graded A) NURS 6541 Week 6 Quiz 2 Questions and Answers (Graded A) Question 1 You see a 9-year-old af... [Show More] ter he was hit in the eye with a foreign body. Flourescein staining reveals a vertical line abrasion lateral to the iris. The pupils are equal in size and reactive; a positive red reflex is present bilaterally. There are no abnormal extraocular movements. Visual acuity is normal. An appropriate plan of care includes follow-up in 48 to 72 hours and: a. Prescribing ophthalmic steroid drops three times a day but not applying an eye patch b. Prescribing ophthalmic antibiotic drops three to four times daily and placing a patch over the eye for 24 to 48 hours c. Prescribing topical ophthalmic steroid drops three times a day and placing a patch over the eye for 24 to 48 hours d. Prescribing ophthalmic antibiotic drops three to four times daily but not applying an eye patch 1 points QUESTION 2 A 3-year-old has a history of upper respiratory tract infection 2 weeks ago. She recently started awakening at night. Physical exam reveals a normothermic child. She is smiling, playful, and sitting on the father’s lap. The TMs are gray with scattered bubbles and good motility. What is the best treatment? a. Amoxicillin at 80 mg/kg/day in two divided doses for 10 days b. Observation without therapy; recheck in 1 month c. Nasal corticosteroids daily d. Referral to an otolaryngologist 1 points QUESTION 3 Therapeutic treatment for Coxsackie infections include: a. Antiviral treatment like acyclovir b. Immunoglobulin c. Supportive care d. Antimicrobial treatment like amoxicillin or cephalexin 1 points QUESTION 4 A 10-year-old comes to your school-based clinic with complaint of a painful sore on the upper lip for 5 days. The sore is getting better since yesterday, but today the right eyelid is swelling and there are blisters on the eye. The best management is to: a. Suggest warm compresses three times a day b. Start topical antibiotic drops like polymixin B (Polytrim) c. Immediately refer to ophthalmology d. Start oral antiviral treatment like acyclovir 1 points QUESTION 5 John, age 5, was diagnosed with a ruptured tympanic membrane as a result of acute otitis media 2 weeks ago. He was treated with oral antibiotics at the time of diagnosis and has finished his course. He has no purulent drainage, but he still has a TM perforation. His plan of care should include: a. Refer child to an ENT for evaluation and treatment. b. Educate the parents about strategies to prevent water from entering the middle ear. c. Continue the oral antibiotics to prevent infection until the tympanic membrane heals. d. Use topical antibiotic drops to prevent infection until the tympanic membrane heals. 1 points QUESTION 6 Each of the following is a risk factor for the development of acute otitis media EXCEPT: a. Breastfeeding b. Group child care attendance c. Respiratory viral infection d. Ambient tobacco smoke 1 points QUESTION 7 Mikayla is a 15-month-old female who has had recurrent bouts of acute otitis media. Her mother is concerned about future school performance. Which of the following statements regarding otitis media is true? a. The incidence of acute otitis media is highest from 18 to 24 months of age. b. Bilateral otitis media with effusion does not cause hearing deficits. c. Potential aggravating factors for Mikayla include pacifier use, bottle use, and cigarette smoke exposure. d. There is a correlation between the number of school days missed due to acute otitis media and IQ measurement. 1 points QUESTION 8 You see a 6-month-old with a diagnosis of dacryocystitis. The mother states “her left eye tears all the time and it has since birth.” The infant was seen in urgent care last week and was prescribed antibiotic eye drops that “don’t seem to help.” You confirm the diagnosis of dacryocystitis without evidence of infection. What education and counseling do you provide? a. The infant should see an ophthalmologist since the condition has persisted for 6 months. b. The infant should get another course of antibiotic eye drops to prevent secondary infection. c. The blockage in the tear duct is probably the result of a neonatal eye infection. d. Spontaneous resolution usually occurs by 9 to 12 months. 1 points QUESTION 9 Kelly is a 9-year-old who presents to your office with complaint of nasal congestion, nasal obstruction, and facial pain with radiation to her teeth and jaw for the last 14 days. The pain is described as throbbing and is worsened by abrupt movements, walking, or bending over. Her temperature is currently 100.4°F. Your most likely diagnosis is: a. Dental infection b. Chronic rhinitis c. Maxillary sinusitis d. Allergic rhinitis 1 points QUESTION 10 A 7-year-old presents with a complaint of ear pain with purulent discharge. He states it hurts when he is lying on the affected side and when anyone touches his pinna. The most likely diagnosis is: a. Otitis media with effusion b. Acute otitis media c. Otitis interna d. Otitis externa 1 points Click Save and Submit to save and submit. Click Save All Answers to save all answers. [Show Less]
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NURS 6541 WEEK 7 Quiz 2 Questions and Answers.
NURS 6541 WEEK 7 Quiz 2 Questions and Answers. NURS 6541 WEEK 7 Quiz 2 Questions and Answers. QUESTION 1 Shelby is a healthy 4-week-old who presents... [Show More] to your office in mid-January with a 3-day history of nasal congestion with occasional cough. She started running a low-grade fever last night (T max 101.5°F). Now she is refusing to nurse and has paroxysmal coughing and noisy/labored breathing. Physical exam reveals an ill-appearing infant with lethargy and tachypnea, intercostal retractions, expiratory wheezes, and occasional rales. She does not attend day care but has a 3-year-old sibling who does and who recently had a “cold.” What is the MOST LIKELY cause of Shelby’s illness? a. Mycoplasma pneumonia b. Bronchitis c. RSV bronchiolitis d. Upper respiratory tract infection 1 points QUESTION 2 You are on call and receive a phone call from the parents of a 13-year-old known asthmatic. She has been having chest tightness and a worsening cough for 48 hours. She has significant nasal discharge that began 14 days ago and intermittent complaint of headache. She is now running a low-grade fever. Her peak flow the last 48 hours is 70–80% of personal best. Her temperature right now is 101.7°F. She is on salmeterol with corticosteroid (Advair) and PRN albuterol. Which of the following is most appropriate? a. Continue home management with the use of inhaled beta agonists and inhaled corticosteroids, and add the use of oral antihistamine/decongestant combinations. b. See her in the office in the morning and prescribe a 14-day course of amoxicillin plus the addition of a short course of oral steroids. c. See her in the office in the morning and prescribe a short course of oral steroids. d. Continue home management and add inhaled cromolyn sulfate. 1 points QUESTION 3 A 3-year-old presents to your office with a history of wheezing over the last 3 months and has only been moderately responsive to therapy. Which of the following diagnostic tests would be appropriate? a. Sweat chloride testing b. Pulmonary function testing c. Bronchoscopy d. All of the above 1 points QUESTION 4 Which of the following symptoms are most suggestive of pneumonia in a young child? a. Headache, fever, malaise, congestion, scattered rhonchi b. Fever, tachypnea, coryza, cough, scattered rales c. Fever, vomiting, coryza, cough, scattered rales d. Irritability, fever, decreased appetite, scattered rhonchi 1 points QUESTION 5 Hope is a 7-month-old who presents in January with a 1-day history of cough, yellow nasal discharge, and low-grade temp (T max 100°F). She was previously healthy. She does have 2+ edema of the nasal turbinates and cloudy rhinorrhea. She is afebrile in the office. Her chest, mouth, and ears are clear. You prescribe: a. Guaifenesin liquid suspension b. Amoxicillin 80 mg/kg/day in two divided doses for 10 day c. Neo-Synephrine half-strength drops three times a day for 5 to 6 days d. Saline drops, bulb suction, humidified air, and increased PO fluids 1 points QUESTION 6 A 7-year-old presents with abrupt fever, stridor, drooling, and hyperextension of the neck. You examine the nose and throat and notice one tonsil is enlarged and there is marked erythema of the pharynx with uvular deviation. Which is most appropriate? a. Start amoxicillin at the appropriate dose for weight after obtaining a throat culture. b. Place on a 5-day course of oral steroids after obtaining a monospot, EBV titers, and a CBC. c. Refer to otolaryngology for management of a peritonsillar abscess and possible hospital admission. d. Start cephalexin (Keflex) at the appropriate dose for weight after obtaining a throat culture. 1 points QUESTION 7 Anthony is a known asthmatic. He has symptoms three times a week but never more than once a day. Exacerbations affect his normal activities occasionally. He awakens with cough three to four times a month. You classify his asthma as: a. Mild intermittent b. Mild persistent c. Moderate persistent d. Severe persistent 1 points QUESTION 8 In children who have not received antibiotics in the past month, which antibiotic is recommended by the Centers for Disease Control and Prevention for the management of acute bacterial respiratory infection? a. Azithromycin (Zithromax) b. Amoxicillin (Amoxil) c. Amoxicillin plus clavulanic acid (Augmentin) d. Sulfamethoxasole (Bactrim) 1 points QUESTION 9 A 2-year-old presents with a history of wheezing and persistent cough. The father reports the child had a coughing/choking episode about a week ago that was spontaneously resolved. A few days later she began to cough and wheeze. This scenario is most consistent with: a. Restrictive airway disease b. Sinusitis c. Bronchiolitis d. Foreign body aspiration 1 points QUESTION 10 A 2-year-old presents to your office with the following symptoms: nasal congestion and rhinorrhea for 48 hours, low-grade fever, and a harsh/barky cough that is significantly worse at night. Inspiratory stridor is present and she has clear but slightly decreased breath sounds. Which of the following treatments is best? a. Albuterol sulfate solution via nebulizer every 4 to 6 hours b. Azithromycin (Zithromax) treatment for 5 days c. One dose of oral dexamethasone d. Oral dextromethorphan extended release at night only 1 points Click Save and Submit to save and submit. Click Save All Answers to save all answers. [Show Less]
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