NRNP 6541 Week 6 Midterm Exam (100%
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NRNP 6541 Week 6
... [Show More] Midterm Exam (100%
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• Question 1
1 out of 1 points
• Question 2
1 out of 1 points
2022
When completing this quiz, did you comply with Walden University’s Code of Conduct
including the expectations for academic integrity?
Selected answer; no
Which of the following statements regarding adolescent substance use is true?
Selected
Answer:
a.
Tobacco is the most commonly abused substance during
adolescence.
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?
Selected
Answer:
d.
DTaP, IPV, MMR, and
Varivax
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?
Selected c.
• Question 4
1 out of 1 points
• Question 3
1 out of 1 points
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• Question 5 1 out of 1 points
Answer: Chronic medical
illness
Chelsea, age 8, complains that she feels as if something is stuck in her ear. What action
is contraindicated?
Selected
Answer:
b.
Flushing the ear with
water.
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
Selected
Answer:
c.
Fluid restriction and voiding prior to the night may be
effective.
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?
Selected
Answer:
d.
Counts to 4 and draws a person with
three parts.
Upon eye examination of a newborn, you note inner canthal folds and Brushfield spots.
What do you suspect?
Selected
Answer:
c.
Down
syndrome
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?
Selected
Answer:
b.
9
months
• Question 9
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• Question 8
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• Question 7
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• Question 6 1 out of 1 points
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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?
Selected
Answer:
b.
Topical
Fluoroquiolone
The diagnostic criteria for autism spectrum disorder include all of the following except
Selected
Answer:
d.
Tolerance of flexibility with
routines
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?
Selected
Answer:
d.
A 10 day course of
Augmentin
Which of the following would not suggest an eating disorder with a purging component?
Selected
Answer:
d.
Diarrhe
a
Role-play with equipment during the course of the physical exam would be the
most beneficial with which age group?
Selected
Answer:
d.
Preschoole
rs
While assessing the skin of an infant, you note cafe-au-lait spots. Which disease should
be ruled out?
• Question 15
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• Question 14
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• Question 13
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• Question 12
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• Question 11
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• Question 10
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Selected
Answer:
d.
Neurofibromato
sis
An expected milestone of a 4-year-old is the ability to
Selected
Answer:
c.
Copy a
cross
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:
Selected
Answer:
a.
Set his own bedtime based on his
internal clock.
An eye that deviates in when covered but that returns to midline when uncovered is an
Selected
Answer:
a.
esotropi
a
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?
Selected
Answer:
b.
Conservati
on
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?
Selected
Answer:
b.
He is too old to receive the Haemophilus
influenzae Type B vaccine.
• Question 21
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• Question 16
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Which of the following issues or concepts is relevant to the school-age child?
Selected
Answer:
b.
Erikson's initiative versus
guilt
You would be concerned about the language development of a child who:
Selected
Answer:
c.
Stutters when excited or tired at the
age of 7
You diagnose a 16-year-old with acute otitis media and need to prescribe an antibiotic
with beta-lactamase coverage. What do you choose?
Selected
Answer:
b.
amoxicillin and potassium clavulanate
(Augmentin)
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?
Selected
Answer:
b.
Reassurance and counseling for family about childhood normal
developmental stage
Which of the following characterizes middle adolescence (14 to 16 years old)?
Selected
Answer:
a.
Intense peer group involvement, feelings of immortality, sexual
experimentation
• Question 26
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Which of the following foreign body in the nose requires immediate removal?
Selected
Answer:
c.
batter
y
Which is the correct order for introduction of solid foods to an infant?
Selected
Answer:
d.
Cereal, vegetables, fruits, and
meats
FIRST-LINE therapy for preschoolers (4-5 years of age) diagnosed with attention-deficit
hyperactive disorder is:
Selected
Answer:
d.
Behavior
therapy
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?
Selected
Answer:
c.
Tell parent, "Your child's language development is
normal."
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?
Selected
Answer:
e.
Oral supplementation with
bicarbonate
• Question 30
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1 out of 1 points
Question 29•
• Question 28
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• Question 27
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Which of the following signs may indicate a baby is not receiving sufficient breastmilk?
Selected
Answer:
c.
Sleepiness, jaundice, and
vomiting
Which of the following children should be referred for a comprehensive developmental
evaluation?
Selected
Answer:
b.
A 19-month-old with explosive temper
tantrums.
By what age should most children be able to sit well without support?
Selected
Answer:
c.
9
months
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?
Selected
Answer:
d.
6
months
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?
Selected
Answer:
d.
Explore the reasons for the request with the parents and the adolescent
and perform a UDS with the adolescent's permission if the history
warrants.
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
• Question 36
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polycystic ovarian syndrome?
Selected
Answer:
b.
free
testosterone
Which of the following complication of strep pharyngitis cannot be prevented with
antibiotics?
Selected
Answer:
c.
Glomerulonephri
tis
A fifteen-year-old female makes a statement to you during a well visit. Which of the
following statements should not be kept confidential?
Selected
Answer:
d.
"Sometimes I feel like ending
my life."
Which of the following screenings should adolescents have done annually?
Selected
Answer:
a.
Psychosocial screening, blood pressure, body
mass index
Which of the following substances is associated with pupillary constriction?
Selected
Answer:
b.
Heroi
n
The appropriate lab tests in assessment of cervical adenitis include all of the
following except:
Selected
Answer:
d.
Blood
culture
• Question 42
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• Question 40
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• Question 37
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What method can be safely used to remove cerumen in a 15-month-old child's ear?
Selected
Answer:
b.
Irrigation using warm water from a soft bulb
syringe
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
Selected
Answer:
b.
ADH
D
A mother states that her 4-year-old son constantly grinds his teeth at night. You
document this as:
Selected
Answer:
c.
Bruxis
m
The father of a 3-year-old is concerned because the child stutters. What should your
approach be?
Selected
Answer:
d.
Explain that this can be normal until 4
years of age.
A mother of a 6-month-old asks you about normal sleep patterns for an infant this age.
The best response is:
Selected
Answer:
b.
10 hours at night and 3-4 hours during
the day
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
• Question 47
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Selected d.
Answer: II
Which of the following eye findings would be considered an ophthalmic emergency?
Selected
Answer:
d.
Unilateral vesicular lesions on the upper eyelid in a
3-week old.
Mark is in the exam room. You are concerned he may have epiglottitis. In what position
do these patients prefer to sit?
Selected
Answer:
d.
Sitting up and leaning
forward
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:
Selected
Answer:
c.
Assessing the family supports available to
the child.
Which of the following statements about bullying is true?
Selected
Answer:
d.
It occurs most commonly during unstructured times (lunch,
recess, etc.).
For adolescent girls, peak height velocity should occur by Tanner Stage (SMR):
Selected c.
Answer: 3
You see a 30-month-old who speaks in mixed Spanish and English. The child’s
• Question 48
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vocabulary is normal but at the low end of the normal language spectrum. The parent
NRNP 6541 Week 6 Midterm Exam (100%
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is worried the child’s development will not be normal because she mixes up the two
languages. You respond:
Selected
Answer:
b.
"Your child's speech is normal and bilingual children commonly intermix
the words from both languages until about 3 years of age."
A 4-month-old presents with both eyes turning inward. What is this called?
Selected
Answer:
b.
Esotropi
a
An 8-year-old female has an edematous, mildly erythematous right upper eyelid for 2
days with a fever of 102.9 (F). Which important eye assessment do you need to consider?
Selected
Answer:
d.
Ocular
mobility
Which of the following strategies would not be appropriate to include as part of your
treatment plan of an 8-year-old boy who is obese?
Selected
Answer:
a.
Referral to nutritionist for weight
reduction plan.
A 13-month-old child is noted to be at the 25th percentile for weight, the 10th
percent ile f or height, and less t han t he 5th percent ile f or head circumf erence. S he
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?
Selected
Answer:
c.
Congenital cytomegalovirus
infection
Head and chest circumferences should be equal at:
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• Question 54
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Selected
Answer:
b.
3 years of
age
Which of the following represents normal sequencing of development in a toddler?
Selected
Answer:
a.
Feeds self, can undress self with help, washes hands, imitates
housework.
A 7-year-old boy with mental retardation was born at home at 26 weeks gestation to a 28-
year-old mother who had received no prenatal care. An evaluation is likely to suggest his MR
is related to which of the following?
Selected
Answer:
e. Complications
of prematurity
A child's head circumference is routinely measured on each well visit until what age?
Selected
Answer:
b.
2
years
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:
Selected
Answer:
b.
2-1/2 years old (30
months)
An 8-year-old female is brought into the office by her mother. She has complaints of
fever and sore throat for the past 2 days. She denies difficulty swallowing but has
loss of appetite and mild diarrhea. A few classmates have similar symptoms. A
review of systems reveals clear nasal drainage, dry cough, and hoarseness. On
exam she has a 101.5 temperature, 3+ erythematous tonsils, and anterior cervical
lymphadenopathy. What is the likely diagnosis?
Selected
Answer:
a.
Viral
• Question 63
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• Question 64 1 out of 1 points
pharyngitis
Sam has an otitis media. He also presents with conjunctivitis. This is due to which
organism?
Selected
Answer:
c.
Haemophilus
influenza
Blood pressure should be measured at well-child visits starting at age:
Selected
Answer:
c.
3
years
Sandy, age 18 months, crosses her legs when lifted from behind rather than pulling them
up. Her legs are also hard to separate, making diaper changing difficult. She persistently
uses only one hand. What condition do you suspect?
Selected
Answer:
a.
Cerebral
palsy
A common feature of 2-year-old behavior is:
Selected
Answer:
b.
Stranger
anxiety
Appropriate anticipatory guidance for the parents of an 8-year-old girl includes
Selected
Answer:
d.
Information that the child will start to value personal idols and
role models.
Which of the following statements is true regarding lying and stealing by the school-age
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• Question 71
1 out of 1 points
child?
Selected
Answer:
d.
They represent a common, transient
problem.
Epiglottitis has decreased due to which immunization?
Selected c.
Answer: Hi
b
A 7-year-old has just been diagnosed with attention deficit hyperactivity disorder
(ADHD). Her parents report that she is doing poorly in school and is disruptive in the
classroom. They ask you what they can do. Your best response is:
Selected
Answer:
b.
"Use a consistent approach with behavioral cues both at home
and at school."
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?
Selected
Answer:
c.
Rhythmici
ty
A 2-day-old infant has significant nasal and rectal bleeding. He was delivered by a midwife at home;
the pregnancy was without complications. His Apgar scores were 9 at 1 minute and 9 at 5 minutes. He
has breastfed well and has not required a health care professional visit since birth. Which of the
following vitamin deficiencies might explain his condition?
Selected
Answer:
a.
Vitamin
K
A 14-year old has ataxia. He is brought to the local emergency
department, where he appears euphoric, emotionally labile, and
disoriented. Many notice his abusive language. Which of the following
1 out of 1 points
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agents is most likely responsible for his condition?
Selected
Answer:
d.
Alcoh
ol
An 11-year-old girl has dizziness, pupillary dilation, nausea, fever, techycardia, and facial
flushing. She says she can "see" sound and "hear" colors. The agent likely to be
responsible is which of the following?
Selected
Answer:
e.
Lysergic acid diethylamide
(LSD)
You are performing an examination of a 3-year-old who is new to your office. Which
finding requires immediate further evaluation?
Selected
Answer:
d.
An equal A-P and transverse chest
diameter.
Please interpret the following labs for an adolescent. The adolescent has a history of
obesity and acanthosis nigricans.
Selected
Answer:
d.
Impaired fasting glucose, postprandial glucose within
normal limits
A 2-year-old child weighs 34 lb. What type of car seat should the child use?
Selected
Answer:
a.
A forward-facing car seat in the back of the vehicle.
Most children can independently get dressed by themselves by age:
Selected d.
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Fasting blood glucose
2 hour postprandial glucose
Results
112 mg/dL
138 mg/dL
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Answer: 5
years
Which adolescent would be at greatest risk for developing anorexia nervosa?
Selected
Answer:
c.
14-year-old female
gymnast
The most common substance used in middle school is
Selected
Answer:
d.
Alcoh
ol
Sarah, age 15, presents with pain and pressure over her cheeks and discolored nasal
discharge. You cannot transilluminate the sinuses. You suspect which common sinus to be
affected?
Selected
Answer:
b.
Maxillary
sinus
What is the most traumatic, yet common form and of child abuse seen in pediatric
primary care?
Selected
Answer:
c.
Shaken baby
syndrome
A 9-year-old who weighs 70 pounds asks why she can't sit in the front passenger seat of
the family car. Your best response is
Selected
Answer:
c.
The safest place for children under 12 years old and 100 pounds is in
the backseat of the car.
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During a “well-child” visit, the parents of a healthy 5-month-old offer a great amount
of information. Which of the following bits of information is of most concern?
Selected
Answer:
b.
Limited eye contact with
parents.
All of the following are consistent with peritonsillar abscess except:
Selected
Answer:
a.
Trismu
s
During a domestic health assessment, the CDC recommends screening every refugee
child for which of the following diseases?
Selected
Answer:
b.
tuberculos
is
A Mantoux test in a child with no risk factors is considered positive with a reaction of:
Selected
Answer:
c.
at least 15 mm
induration
A 2-day-old newbornwith conjunctivitis is likely due to
Selected
Answer:
d.
Chemical irritation from eye
drops
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?
Selected
Answer:
b.
Formal
operational
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A mother brings her 4-week-old infant into the office because she noticed small yellow-
white glistening bumps on her infant's gums. She says they look like teeth but is
concerned that they may be cancer. You diagnose these bumps as
Selected
Answer:
b.
Epstein's
pearls
Flourescein staining of the eye is used to detect a
Selected
Answer:
a.
Corneal
abrasion
A new mom calls the NP on postpartum day 5. She reports her newborn wants to nurse
for 30 minutes every 1-1/2 to 2 hours. Which of these is the best response?
Selected
Answer:
b.
"This is a very healthy breastfeeding pattern. Be sure to rest when you
can. You are doing a great job."
Tammy, age 3, is at the office for her well-child visit. She has trouble removing her own
shirt as requested. Her mother yanks off her shirt after smacking her wrist and saying,
"you must do as you're told quickly." Which action is indicated?
Selected
Answer:
d.
Observe Tammy for signs of child
abuse.
Which of the following injuries is most likely to be caused by abuse of a toddler?
Selected
Answer:
c.
A displaced posterior rib
fracture.
Hannah, age 4, is brought into the office by her father. She complains of a sore
throat, difficulty swallowing, copious oral secretions, stridor, and a temperature of
102F. She does not have pharyngeal erythema or cough. What do you suspect?
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Selected
Answer:
d.
Epiglottit
is
Miguel, age 14, was hit in the eye with a baseball and developed eye pain,
decreased visual acuity, and injection of the globe. Upon exam you note blood in the
anterior chamber and confirm diagnosis of hyphema. What treatment do you
recommend while Miguel is waiting to see the ophthalmologist
Selected
Answer:
c.
Apply bilateral eye
patches.
Which of the following children has abnormal language development?
Selected
Answer:
c.
Speech is 50% understandable at 36
months of age
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:
Selected
Answer:
a.
Act as if nothing abnormal
happened.
You assess a 15-year-old's visual acuity and note her vision to be 20/50 in the right eye.
She asks you what that means and you respond
Selected
Answer:
d.
"You can see at 20 feet with your right eye what most people can
see at 50 feet."
You see a 5-month-old who is fussy, has interrupted sleep, and is drooling. You note
large lower lateral incisor bulges. You recommend:
Selected
Answer:
e.
A and
D
• Question 101
1 out of 1 points
• Question 100
1 out of 1 points
• Question 99
1 out of 1 points
• Question 98
1 out of 1 points
• Question 97
1 out of 1 points
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