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NR 602 MIDTERM EXAM NEWEST
ACTUAL EXAM 2025 COMPLETE 300
QUESTIONS AND DETAILED CORRECT
ANSWERS | A+ GRADE
What would the nurse practitioner do if there is a chemical injury to the eye Correct Answer Initiate irrigation of the affected eye with normal saline, obtain history of chemical and pH if possible. Consult ophthalmology for further evaluation and management. What would the nurse practitioner do if there's a suspected open globe injury based on history? Correct Answer Do not manipulate the eye. Place an eye shield and administer analgesics an anti-medics. Update tetanus in initiate broad-spectrum antibiotics. Do not allow the client to take anything by mouth and place on bedrest. Consult ophthalmology. What is lab work up for a child with bilateral congenital cataracts? Correct Answer Work up, includes titers for toxoplasmosis, rubella, cytomegalovirus, herpes, syphilis, and cerium, calcium and phosphorus levels. Also urine testing for reducing substances. A 12-year-old female is being seen by the primary pediatric nurse practitioner. She states that she has for diabetes control and states that her parents forget to remind her to check her blood sugars. What action is
correct? Correct Answer Help the child develop a strategy to remember without parental prompts 16 - year-old female client is being seen for weight management. The adolescent said I know I need to lose weight but I did not want to give up on my favorite food. When using motivational interviewing techniques, how will the nurse practitioner respond Correct Answer Do you think there are any food you could limit or do without for a while? What is the best antibiotic therapy to use for human bites? Correct Answer Amoxicillin for 7 to 10 days or alternative cephalexin or clindamycin What is the best anabiotic to use for animal bites? Correct Answer Amoxicillin for 7 to 10 days or alternative cefuroxime, fluoroquinolone or trimethoprim- sulfamethoxazole plus clinda or metronidazole If cataracts are detected at birth, when is the best time to take them out for the best outcome? Correct Answer In the first two weeks of life What are the recommendations for children at risk for retinoblastoma's? Correct Answer Children at high risk require cereal, dilated fund disexaminations, binop, theologist, familiar with retinable blastomas monthly for the first 12 months of life, every two months from age 12 to 24 months, every three months from ages 24 to 36 months,
What will patients with middle ear infections often experience Correct Answer Pain and diminished hearing, redness, or bulging of the tympanic membrane. As the ear infection progresses, the eardrum may become perforated, and the patient may experience increased pain and fluid discharge. What is otitis media with effusion? Correct Answer Fluid in middle ear without signs or symptoms of ear infection What are causes of otitis media with effusion? Correct Answer Upper respiratory infection, barotrauma, allergies, recent, acute, otitis media infection. What are symptoms of otitis media with effusion? Correct Answer Mild pain conductive hearing loss may be present. Air bubble seen behind the TM. Acute otitis externa also called swimmers ear Correct Answer This is the infection and inflammation of the auricle, external acoustic meatus or both. This may be spread to surrounding bone and tissue. What is treatment for otitis externa? Correct Answer Ciprodex drops for greater than six months of age. Floxin Otic this has no steroid What is treatment for acute otitis media? Correct Answer First line is amoxicillin. Second line is ceftriaxone.
What is OE (otitis externa)typically caused by Correct Answer Bacterial infection in the skin of the outer ear. Bacteria often invade under moist conditions or is the protective waxy coating of the ear canal has been removed or degraded. What are common symptoms of otitis externa? Correct Answer Redness, inflammation, swelling, itching, pain, and pus discharge as symptoms progress they may include severe pain, hearing loss, fever, and swelling of the cervical lymph nodes Auricle Hematoma Correct Answer cauliflower ear, or collection of blood within the outer ear cartilage. Typically occurs with trauma. tympanic membrane perforation signs and symptoms Correct Answer Whistling sound during sneezing or nose blowing, decreased hearing, ear infections with colds or water entries, copious purulent drainage What does pain indicate on a perforation of a tympanic membrane? Correct Answer Concurrent disease process. Perforations are usually painless. What is a major causes severe chronic lung disease in children Correct Answer Cystic fibrosis. Are children usually born with cystic fibrosis Correct Answer Lungs are typically normal at birth that become inflamed with chronic airway infection shortly after
What is an atrial septal defect? Correct Answer This is a hole in the atrium septum. Wide, splitting of S2, without becoming a single sound on expiration indicates increased pulmonary flow. When might you see a possible mild left anterior chest bulge, or palpable lift at the left sternal border? Correct Answer Atrial septal defect What happens to S1 during atrial septal defect? Correct Answer It is usually normal or split with accentuation of the tricuspid valve closure sound What happens with us to during atrial septal defect Correct Answer Usually split widely and is relatively fixed What is treatment for atrial septal defect? Correct Answer Surgery, aspirin, clopidigrel What is a ventricular septal defect? Correct Answer This is a whole or defect in one of the areas of the ventricular septum When is a murmur usually heard for a atrial septal defect? Correct Answer Usually heard at the age of 2 to 3 years old Is the murmur heard at birth for ventricular septal defect? Correct Answer This is not usually heard at birth
What murmur is herd with ventricular septal defect? Correct Answer Harsh, high-pitched, grade II to IV-VI holosystolic murmur at left sternal border How often should invent to be monitored for ventricular septal defect Correct Answer They should be seen every six months for the first year What is the treatment for ventricular septal defect? Correct Answer Lanoxin, diuretics, ace inhibitors Should treatment be used in children with heart, failure caused by infection, obstruction, or arrhythmias Correct Answer Yes, treatment should be used to ameliorate fluid and electrolyte imbalances, increase contractility, and decrease cardiac afterload A child is seen in the office with a normal physiological murmur, which is a mild case. Parents are asking if the child can still participate in sports Correct Answer Yes, the child can still participate in sports What is considered hypertension in a newborn Correct Answer Systolic blood pressure is greater than 96 What should be done in sickle cell anemia? Correct Answer They should be screened to prevent sepsis and may benefit from anabiotic's.
What cranial nerves should be assessed for secondary or pathological headaches? Correct Answer CN XI - CN XII What is a good test to do on a patient with secondary or pathological headaches Correct Answer Pronator drift test or Romberg What is Osgood-Schlatter disease? Correct Answer Rupture of the growth plate at the tibial tuberosity from stress on patellar tendon What causes Osgood-Schlatter disease? Correct Answer This is caused by microtrauma in deep fibers of the patellar tendon at insertion on tibial tuberosity. This is usually seen after a rapid growth spurt. How can you treat Osgood Schlatter disease? Correct Answer Treatment is rest, wraps, braces, NSAIDS. Education should be provided on limiting weight-bearing for 2 to 3 weeks. Patellofemoral pain syndrome/knee pain Correct Answer This is considered an overuse injury. Treatment is rest, NSAIDS, retraining, and strengthening of the quadriceps muscles. What are treatments for sprains of the knee? Correct Answer NSAIDs, opioid, analgesics if severe fractures or strain, topical NSAIDS give relief to soft tissue trauma, strains, sprains
At which age do children usually become aware of differences in boys and girls? Correct Answer Around age 2 Which age do children usually establish their gender identity? Correct Answer Age 4 What is gender dysphoria? Correct Answer Distress experience by some individuals, who's gender identity does not correspond with their assigned sex at birth What can adrenal insufficiency do to children? Correct Answer This can predispose them to depression or hypothermia What are clinical findings of adrenal insufficiency? Correct Answer Poor appetite, failure to thrive, weight loss, weakness, vomiting, aldosterone deficiency, poor, feeding, common lethargy, dehydration What do nurse practitioners usually found on exam for adrenal insufficiency? Correct Answer Common to find, dehydration, hypotension, excessive pigmentation of the skin What level of serum cortisol would indicate adrenal sufficiency Correct Answer Cortisol value greater than 20 What is treatment for adrenal insufficiency? Correct Answer This includes hormone replacement, and is best managed by pediatric endocrinologist
When treating a school-age child about asthma, the child states it's too much trouble to remember taking an ICS medication twice daily. She states she feels fine in spite of expiratory wheezes. Which action use his health, belief and self efficacy model, to teach this child about asthma management. Correct Answer Obtaining pre-and post treatment spirometry testing An adolescent comes into the office, expressing the desire to lose weight. She states that she wants to lose weight to participate in sports, but does not want to give up sweets and soft drinks. Which stage of change does this represent Correct Answer Contemplation A 17 year old as seen in the clinic who quit smoking almost a year prior to the appointment. Patient reports having renewed cravings, went around friend to smoke. Using knowledge from maintenance stage of change the primary care pediatric nurse practitioner will: Correct Answer Suggest that the teen consider taking up a sport or other physical activity Antibiotics used for plantar wounds Correct Answer Ciprofloxacin for 7 to 20 days. An alternative is to consult infectious disease due to requirement of IV therapy. What should the nurse practitioner do for ingrown toenail? Correct Answer Pat Cotton underneath the nail edge to elevate the nail and educate the patient to repack the cotton daily to prevent infection. Should use warm water with Epsom salt soaks for 20 minutes three times a day. It
is important to use properly fitting shoes. Keep the toe clean and dry. Consider referral to podiatry for recurrent. What is the most common cause of diarrhea globally? Correct Answer Rotavirus. What are most peritonsillar abscess is caused by? Correct Answer Streptococcus and fusobacterium What antibiotics are good for peritonsillar abscesses? Correct Answer Penicillin and clindamycin What is scarlet fever? Correct Answer Is a diffuse erythematous eruption that generally occurs in association with pharyngitis. Abrupt illness with sore throat, vomiting, headache, chills, and malaise. Fever reaches 104. The pharynx is inflamed and can be covered with gray white XU date. The tongue is usually coated and red, also called strawberry tongue. The skin is coarse with a sandpaper feel the rash generally begins on the neck and spreads to the trunk and extremities becoming generalized within 24 hours. The rash fades within 3 to 4 days. The process can take up to six weeks, sore throat and other symptoms resolve approximately 5 to 7 days. Treatment is penicillin. What is asthma step one Correct Answer Saba PRN What is step two of asthma? Correct Answer Low-dose ICS
What is considered severe obstruction on a spirometry Correct Answer Less than 49% When should a child be tested for exercise induced asthma after diagnosis Correct Answer Every one to two years What is allergic rhinitis mediated by? Correct Answer IgE What is treatment for allergic rhinitis? Correct Answer Intranasal corticosteroids are considered first line treatment. Children with allergic rhinitis often exhibit symptoms of asthma. What is pharyngitis? Correct Answer inflammation of the pharynx leading to sore throat. What is the most common bacterial cause of acute pharyngitis? Correct Answer Group A beta-hemolytic Streptococcus (GABHS) (Streptococcus pyogenes) What is the best prevention of upper respiratory infection? Correct Answer Flu vaccine What is Kawasaki disease? Correct Answer Coronary artery vasculitis. The treatment for this disease is IVIG therapy requires Echo and cardiologists. An autoimmune disease involving the inflammation of blood vessels, lymph nodes, skin, and mucosa - initial
symptom is a high fever, later symptoms include conjunctivitis, rash, peeling, and edema. What are symptoms of enterovirus? Correct Answer Fever, runny nose, sneezing, cough, skin, rash, mouth, blisters, and body and muscle aches. This is something that is very contagious. What are clinical findings of downs syndrome? Correct Answer Short stature, brachycephaly, mid face, hyperplasia with flat nasal bridge, Brushfield spots, epicanthal folds with upslanting, Palpebral fissures, smallmouth with protruding tongue, myopia/Cataracs, small ears/narrow, canals, extra skin at nape of neck, lax joints, short, broad hands/feet/digits, single palmar crease, congenital heart disease. What is impetigo? Correct Answer Contagious bacterial infection marked by clusters of small blisters. What is the treatment for impetigo? Correct Answer Topical bacitracin or Mupirocin ointment; Anti-staphloccal antibiotic. What is treatment for contact dermatitis Correct Answer Avoid irritant, cool compress, barrier ointment, hydrocortisone, cream, antihistamined, steroids, oral antibiotics, lukewarm bath.
once daily. Azithromycin one percent ophthalmic solution for four weeks might also be used for posterior blepharitis. What is N. gonorrhoeae treatment Correct Answer Ceftriaxone IM or IV treatment for chlamydia Correct Answer erythromycin or azithromycin Treatment for HSV Correct Answer Antivirals, IV or PO The parent of a newborn has quit smoking cigarettes with in the past month and reports feeling fidgety. Using a reframing technique, how are the primary care pediatric nurse practitioner respond Correct Answer Explore ways that the parent can use the extra energy to do things for the baby Which tall will the nurse practitioner used to estimate reading level? Correct Answer SMOG Zoe is nine months old, which of the following risk assessments are appropriate to conduct during her well child check Correct Answer Vision, led, hearing You would not check, behavioral assessment, anemia, developmental, screening, tuberculosis Corey is 16 years old and presents to the clinic for annual follow up which of the following should be included in his check up Correct Answer Age specific immunizations,
testing for anemia, dyslipidemia, and STI's, depression screening, psychosocial/behavioral assessment, height/weight/BMI, hearing test, if not done at age 15, developmental surveillance, vision testing, tobacco, alcohol, or drug use assessment Primary care pediatric nurse practitioners performing a well-child exam on a four year old child the parent reports that the child snores frequently at night and often awake during the night. Patient seemed cranky during the day. What will the nurse practitioner tell this patient Correct Answer Sleep disorders at this age can have long-term impacts on learning Escalade Childers being seen in the clinic who has overweight. Parent tells primary care nurse practitioner that the child seems to crave high calorie, high carbohydrate foods, even one full the nurse practitioner learned that the child is often irritable and sleepy at school in spite of sleeping 9 to 10 hours of sleep at night what will the nurse practitioner recommend? Correct Answer Referral to a sleep disorder clinic or sleep study Two week old infant has been seen in the clinic. The parent is concerned that the infant sleeps too much. Nurse practitioner asked parent to log. What will the nurse practitioner state is the optimal amount of sleep per day for this infant Correct Answer 15 to 18 hours
