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Exam 1: NU664C/ NU 664C (Latest 2025/ 2026 Update)
Family Psychiatric Mental Health I | Questions & Verified
Answers| Graded A| 100% Correct (Verified Solutions)-
Regis.
Question:
Gold standard for CAP diagnosis:
Answer:
Chest x-ray
Question:
If CAP symptoms present but no obvious signs of infection on CXR treatment is...
Answer:
Same as if CXR was positive
Question:
Immunizations for people over 65 or younger people with comorbidities such as asthma, CHF COPD:
Answer:
Pneumonia and flu vaccines
Question:
Who is at risk for CAP?
Answer:
Extremes of age, smokers, alcoholics, GERD, chronic disease, institutionalization
Question:
CAP presentation in adults:
Answer:
Cough (may be nonproductive), dyspnea, fever, hemoptysis, chest pain, fatigue, tachycardia
Question:
If lymphocytes are elevated?
Answer:
Indicative of viral process
Question:
If monocytes are elevated?
Answer:
Indicative of chronic process
Question:
If eosinophils are elevated?
Question:
Your next patient is a 5-year-old child with a history of moderate persistent asthma. He has been wheezing and coughing for the past two days, and his mother brings him in today for evaluation. He has been using albuterol every four hours. His respiratory rate is 13 breaths per minute; his lungs are clear to auscultation; and no retractions are noted. What may be your assessment and intervention based on this information?
Answer:
Your child is breathing slower than normal for his age. We need to send him to the ER for further intervention.
Question:
Your next patient is a 6-year-old male here for his annual influenza vaccine. He has a history of mild persistent asthma. What would you discuss for medications when reviewing his asthma action plan?
Answer:
Your child should continue his low-dose inhaled corticosteroid daily and add albuterol as needed for an exacerbation.
Question:
A child who has been diagnosed with asthma for several years has been using a short-acting Beta-agonist (SABA) to control symptoms. The PNP learns that the child has recently begun using the SABA 2-3 times each week to prevent wheezing and shortness of breath. The child currently has clear breath sounds and an FEV1 of 75% of personal best. What will the NP do?
Answer:
Add an inhaled corticosteroid.
Question:
Your next patient is a six-month-old infant who just completed amoxicillin for otitis media. The mother states her child is better except for a diaper rash. Upon examination, you note red scaly plaques in the diaper area with satellite lesions to his upper thighs. What would you do next as the PNP?
Answer:
Your child has a rash that is likely due to a fungus, Candida, and commonly occurs after taking antibiotics. I will prescribe nystatin to be applied to the diaper area.
Question:
A 12 y.o. female presents to the clinic after being bit by a dog on the face. Abrasion with 2 puncture wounds on the upper right cheek, approximately 1 inch below the eye. The area is slightly erythematous, with a small amount of bruising and raised area along the cheekbone.
Answer:
Using normal saline, irrigate the wounds using high pressure (greater than 4 pounds per square inch) and high volume (greater than 1 L). Isolated puncture wounds should not be irrigated, instead soak the wound in a diluted solution of tap water and povidone-iodine for 15 .minutes • Prescribe a 3- to 5-day course of prophylactic antibiotics
Question:
A 4 yo child has clusters of small, clear, tense vesicles with an erythematous base on one side of the mouth along the vermillion border, which are causing discomfort and difficulty eating. What will the PNP recommend as treatment?
Answer:
Topical diphenhydramine and magnesium hydroxide.
Question:
Question:
Nasal mucosa pale, boggy and edematous with allergic shiners
Answer:
Allergic rhinitis
Question:
The category on your asthma action plan when you have had exposure to a known trigger, are coughing with wheezing, have a tight chest and are coughing at night.
Answer:
Yellow or cautious phase
Question:
Classification of asthma severity for a child who is 6 years old who has symptoms 3 days a week, uses his inhaler daily for exercise, but not otherwise, has minor limitation to activity and wakes 3 times a month with cough
Answer:
mild persistent asthma
Question:
Should not be used to treat asthma in children under the age of 4?
Answer:
dry powder inhalers
Question:
In addition to the routine PCV 13 vaccine series, sickle cell anemia patients older than 2 years of age should receive this once and then a booster in 5 years.
Answer:
PPSV
Question:
cradle cap or seborrheic dermatitis
Answer:
Often treated with Selsun blue shampoo.
Question:
Bilateral conjunctival injection, 5 days of fever, cervical lymphadenopathy, polymorphous exanthema, changes in peripheral extremities
Answer:
Kawasaki Disease
Question:
First line treatment for allergic rhinitis
Answer:
Oral H1 antihistamines and/or intranasal steroids
Question:
A 2 week old infant with complaint of rash near left upper eyelid several vesicular lesions on his left upper eyelid. What would you discuss with the mother as the PNP?
Answer:
It is important that you go to the children's hospital emergency department now because your child needs an immediate referral to a pediatric ophthalmologist.
Question:
A 3 year old w/ hx of blepharitis and his mother asks whether there is anything she can do to prevent this from occurring again. What would you suggest as the PNP?
Answer:
Good handwashing and daily eye lid and lash scrub with diluted baby shampoo should prevent this from reoccurring.
Question:
A 5 year old feeling like something might be in his eye. No visual changes had occurred, normal EOM, no known injury. You decide to complete fluorescein staining to the affected eye because you suspect
Answer:
Corneal abrasion
Question:
A 4-month-old w/1-week hx of nasal congestion and occasional cough. Prior evening Temp 102F refused to breastfeed and had coughing and noisy labored breathing. On exam ill-appearing infant who is lethargic w/ tachypnea, wheezing, and intercostal retractions. Does not attend daycare but has a 3-year-old sibling who is in daycare and who recently had a "cold". Considering the clinical presentation what is the most likely cause of the infant's illness?
Answer:
RSV bronchiolitis
Question:
A 6 year old hx of cough for 10 days, Fever 101.5 F in the past 24 hrs. Decrease appetite and complain of abdominal pain. Breathing faster than normal. Given the information, what is the most likely dx?
Answer:
Pneumonia
Question:
A 12 day old concerned about breathing. Feeding stops breathing for 10 seconds. Eats well never appeared pale/cyanotic, and has never become limp during any of these episodes. What would the PNP discuss w/ the parents?
Answer:
I know this can be concerning. This can be a normal variant for infants.
Question:
A child is diagnosed with community acquired pneumonia and will be treated as an outpatient. Which antibiotic will the PNP choose?
Answer:
Amoxicillin
Question:
A school-aged child has had nasal discharge and a daytime cough but no fever for 12 days without improvement in symptoms. The child has not had antibiotics recently and there is no
Question:
A school-age child who has an abrupt onset of sore throat, nausea, headache, and a temperature of 102.3 F. An examination reveals petechiae on the soft palate, beefy-red tonsils with yellow exudate, and scarlatiniform rash. A rapid antigen detection test (RADT) is negative, what is the next step in the management for this child?
Answer:
Perform a follow-up throat culture
Question:
Fluorescein staining could be used to detect this.
Answer:
Corneal abrasion
Question:
Confirming the diagnosis that newborn chlamydia conjunctivitis would be best done by obtaining this.
Answer:
Culture of conjunctival scrapings
Question:
Acute sudden onset high fever, severe sore throat, muffled voice drooling, choking sensation restless with hyper extension of neck.
Answer:
Epiglottitis
Question:
Helps with the prevention of epiglottitis
Answer:
Hib Vaccine
Question:
What is the drug of choice for treating pertussis?
Answer:
Azithromycin 10mg/kg x 5days
Question:
Sneezing, discomfort and unilateral purulent it malodorous or bloody nasal discharge is a sign of. nasal foreign body
Answer:
Question:
This can occur in patients with an untreated streptococcal infection of the upper respiratory tract.
Answer:
acute rheumatic fever
Sensorineural hearing loss
Answer:
hearing loss caused by damage to the cochlea's receptor cells or to the auditory nerves; also called nerve deafness
Question:
Treatment of otitis externa
Answer:
Withdraw any foreign bodies or debri by gentle irrigation Topical abx drops (ofloxacin) Insert cotton wick if significant swelling Analgesics Avoid getting ear wet
Question:
Etiology of AOM
Answer:
After viral URI Highest incidence 6-36 months Winter/spring males
Question:
First line therapy for AOM
Answer:
Amoxicillin (cefdinir if allergy)
Question:
Second line therapy for AOM
Answer:
Augmentin (no improvement 48-72 hrs, recurrence within 1 month, concomitant conjunctivitis)
Question:
Third line therapy for AOM
Answer:
Ceftriaxone
Question:
If allergic to penicillin what do you treat the AOM with
Answer:
Cephalosporin
Question:
If a child is being treated for an AOM and is vomiting or unable to tolerate oral medication what do you prescribe
Answer:
Rocephin IV or IM
Question:
Otitis media with effusion what is the most common organism
Answer:
H. influenzae
Question:
Chlamydia conjunctiva symptoms
Answer:
Begins 5-14 days of life up to 6 weeks; moderate eyelid swelling and palpebral or bulbar conjunctival injection and moderate, thick, purulent discharge, assess for systemic infection (pharyngitis, ear infection, pneumonia)
Question:
At 12 months of age the head and chest circumference should be
Answer:
Equal
Question:
Mastoiditis
Answer:
suppurative infection of the mastoid cells that may occur with AOM or follow an AOM, mucoperiosteal lining of the mastoid air cells becomes inflamed with subsequent progressive swelling and obstruction caused by drainage from the mastoid
Question:
What vaccines decrease the incidence of mastoiditis and what are the two most common causes?
Answer:
Hib and S. pneumoniae are the 2 common causes Pneumococcal vaccine decreases incidence
Question:
Mastoiditis management and treatment
Answer:
Urgent ENT referral, hospitalization, abx, myringotomy, tube placement, mastoidectomy
Question:
What is the most common cause of otitis media
Answer:
Streptococcus pneumoniae
Question:
What groups are at risk for AOM
Answer:
children younger than 24 months, recent beta-lactam drugs, exposed to large number of other children, immune deficiency, smoke exposure in household, bottle fed
Question:
With otitis media with effusion when should a myringotomy or tympanostomy tubes be considered
Answer:
children 6 month to 12 years who have had bilateral effusion for a total of 3 months or longer with documented hearing deficiency or for children with recurrent AOM who have evidence of middle ear effusion at the time of assessment for tubes
