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NU664 FINAL EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS LATEST UPDATE (2025/2026), Exams of Nursing

Regis CollegeNursing

Bossing - ANS ✓-Fullness of the frontal area-Bulging of the newborn skull, in the frontal areas associated with prematurity or rickets - Cephalhematoma - ANS ✓-Does not cross suture lines -A deep collection of blood in the subperiosteal area of the scalp -The swelling appears hours to days after delivery -No treatment is indicated because of the condition resolving in a few weeks to months -Monitor for hyperbilirubinemia Macrocephaly - ANS ✓-Evaluate with CT of the head -Referral to a neurology provider should be made for diagnostic purposes and a brain MRI should be done as a baseline at some point Plagiocephaly - ANS ✓-Flattening or asymmetry of the head -Risk - sleeping supine -Education - tummy time 30-60 minutes/day; alternative babies head position, helmet 23 hrs/day for 4-6 months when repositioning and helmets are not successful

Typology: Exams

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Available from 04/07/2025

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NU664
NU664 FINAL
NU664 FINAL EXAM QUESTIONS WITH
CORRECT VERIFIED ANSWERS LATEST UPDATE
(2025/2026) GUARANTEED PASS
Bossing - ANS ✓-Fullness of the frontal area-Bulging of the newborn skull, in the
frontal areas associated with prematurity or rickets
-
Cephalhematoma - ANS ✓-Does not cross suture lines
-A deep collection of blood in the subperiosteal area of the scalp
-The swelling appears hours to days after delivery
-No treatment is indicated because of the condition resolving in a few weeks to
months
-Monitor for hyperbilirubinemia
Macrocephaly - ANS ✓-Evaluate with CT of the head
-Referral to a neurology provider should be made for diagnostic purposes and a
brain MRI should be done as a baseline at some point
Plagiocephaly - ANS ✓-Flattening or asymmetry of the head
-Risk - sleeping supine
-Education - tummy time 30-60 minutes/day; alternative babies head position,
helmet 23 hrs/day for 4-6 months when repositioning and helmets are not
successful
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Partial preview of the text

Download NU664 FINAL EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS LATEST UPDATE (2025/2026) and more Exams Nursing in PDF only on Docsity!

NU

NU664 FINAL EXAM QUESTIONS WITH

CORRECT VERIFIED ANSWERS LATEST UPDATE

(202 5 /202 6 ) GUARANTEED PASS

Bossing - ANS ✓-Fullness of the frontal area-Bulging of the newborn skull, in the frontal areas associated with prematurity or rickets

Cephalhematoma - ANS ✓-Does not cross suture lines

  • A deep collection of blood in the subperiosteal area of the scalp
  • The swelling appears hours to days after delivery
  • No treatment is indicated because of the condition resolving in a few weeks to months
  • Monitor for hyperbilirubinemia Macrocephaly - ANS ✓-Evaluate with CT of the head
  • Referral to a neurology provider should be made for diagnostic purposes and a brain MRI should be done as a baseline at some point Plagiocephaly - ANS ✓-Flattening or asymmetry of the head
  • Risk - sleeping supine
  • Education - tummy time 30-60 minutes/day; alternative babies head position, helmet 23 hrs/day for 4-6 months when repositioning and helmets are not successful

NU

  • Improvement should occur in 2-3 months if all these are done Primary evaluation tool in toddler growth - ANS ✓-WHO charts from birth to 23 months
  • CDC growth chart from 2 years of age and older Normal weight gain in toddlers - ANS ✓-Most triple birth weight by 12 months
  • Will gain 6-8 pounds in next year and gain 12 inches in length Transition to milk - ANS ✓-Milk should be limited to <24 ounces/day (16 is good) due to lack of iron and interference with intake of other nutrients
  • Whole milk and no skim
  • Whole milk until 2 years
  • Discuss at 12 months Temper tantrums - ANS ✓-Reassure it's normal and nothing is wrong Toddlers - identification of red flags - ANS ✓-Speech concerns Otitis Externa - treatment - ANS ✓-Diffuse inflammation of the EAC and can involve the pinna or TM
  • Edema, discharge, and erythema
  • OE results when the protective barrier in the EAC are damaged by mechanical or chemical mechanisms
  • Eardrops - Ciprodex - ciprofloxacin and dexamethasone; usually containing acetic acid or antibiotic with and without corticosteroid drops are the treatment of choice
  • Should improve within 7 days, but resolution may take two weeks

NU

  • Must be conjunctival scraping and they must contain epithelial cells; isolate the organism by tissue culture; direct fluorescence antibody test; also test for gonorrhea Dacryostenosis - ANS ✓-Abnormal obstruction of the nasolacrimal duct that prevents tears from flowing into an opening in the nasal mucosa
  • Continuous or intermittent tearing, stickiness, and mucoid discharge at the inner canthus that can become purulent, with possible expression of purulent material; blepharitis; nasal obstruction and drainage; tenderness and swelling over the lacrimal duct; eyelids closed with dried mucous on awakening; edema and erythema of the tear sac
  • Treatment - daily massage of the lacrimal sac may be performed to facilitate canalization of the duct; bacterial conjunctivitis or excessive exudate (erythromycin ophthalmic ointment or a fluoroquinolone); saline drops into the nose, followed by aspiration before feeding and at bedtime
  • Referral - if exudate persists for 1-2 weeks despite interventions; refer to ophthalmologist; probing Chalazion - ANS ✓-A chronic sterile inflammation of the eyelid resulting from a lipogranuloma of the meibomian glands, which line the posterior margins of the eyelids
  • Hot compresses
  • Refer to a ophthalmologist for surgical incision or topical intralesional corticosteroid injections if the condition is unresolved or the lesion causes cosmetic concerns
  • Can cause astigmatism as a result of pressure on the orbit Hordeolum - ANS ✓-A stye, is an infection of either the sebaceous glands, the eyelids (external hordeolum), or the meibomian glands (internal hordeolum)
  • Signs - tender, swollen, red furuncle is seen
  • Interventions - rupture often occurs spontaneously wen the furuncle becomes large and a point develops; removal of an eyelash promotes rupture; warm, moist

NU

compresses 3-4 times a day, 10-15 minutes each time, hygiene for the eye with a cotton-tipped applicator or clean washcloth with no-tears shampoo once or twice a day; antistaphylococcal ointment; no steroids

  • Refer to an ophthalmologist for incision and drainage if it does not rupture on its own after coming to a point or for multiple or recurrent hordeolum Blepharitis - ANS ✓-An acute or chronic inflammation of the eyelash follicles or meibomian sebaceous glands of the eyelids (or both)
    • Usually bilateral
  • Swelling, erythema of the eyelid margins and palpebral conjunctiva, flaky, scaly debris over eyelid margins on awakening, gritty, burning feeling in eyes,
  • Scrub eyelashes and eyelids with a cotton tipped applicator or clean washcloth with no-tears shampoo; warm compresses; massage the lids 2-4 times a day; sometimes an antistaphylococcal antibiotic (bacitracin or erythromycin) is used once daily at bedtime until symptoms subside and for at least one week Retinoblastoma - ANS ✓-Intraocular tumor that develops in the retina
    • Most common tumor in childhood
  • All infants have a red reflex exam before discharge from the newborn nursery and thereafter at every health maintenance visit
  • Strabismus, decreased visual acuity, uni or bilateral white pupil described as an intermittent glow, glint, gleam, or glare
  • Diagnosis via ophthalmic exam, US, or MRI
  • Need multidisciplinary team - may need cryotherapy, laser photocoagulopathy, chemotherapy, or enculeation
  • Frequent follow-up to assess treatment and monitor for recurrence is critical to optimizing vision Retinopathy of prematurity - ANS ✓-A multifactorial retinal vascular pathologic disease primarily caused by early gestational age with low birth weight

NU

  • Round or breakable objects can be removed using a wire loop, a curette, or right-angle hook slowly advanced beyond the object and withdrawn carefully
  • Disk, coin-shaped, or button batteries must be removed emergently
  • Spherical objects are the most difficult to remove and require referral to an otolaryngologist
  • If the object is made of iron, nickel, or cobalt, a magnet may be used for retrieval
  • Insects should be suffocated with mineral oil, then ear can be irrigated, or the child can be referred to ENT for removal
  • If the foreign body cannot be extracted on the first few attempts or cannot be removed without risking damage to the external canal or TM, or if there is worsening pain, then refer the child to an ENT Epiglottitis - ANS ✓-A life-threatening illness characterized by inflammation of the epiglottis the aryepiglottic folds, and the ventricular bands at the base of the epiglottis
  • If this is suspected - do not examine the throat
  • Signs - inspiratory and sometimes expiratory stridor, drooling, aphonia, and high fever, rapidly progressive respiratory obstruction and prostration, flaring of the ala nasi and retraction of the supraclavicular, intercostal, and subcostal spaces, child assumes a hyperextension of the neck
  • In older children - sore throat, dysphagia, stridor, irritability, restlessness, and brassy cough; airway obstruction follows within 2-24 hour; the child sits with arms back, trunk forward, neck hyperextended, and chin thrust forward (tripod position)
  • Interventions - airway management ASAP; early consultation with a pediatric otolaryngologist and anesthesiologist is key; establish airway and start antimicrobials; do not place in supine position, immediately transport to the ER
  • Diagnosed in the OR by depressing the tongue to view the swollen cherry-red epiglottis
  • Nasotracheal intubation, IV broad-spectrum antibiotics, which can include ampicillin/sulbactam, cefotaxime, ceftriaxone, or clindamycin of penicillin allergy with the addition of vancomycin if MRSA is suspected; oxygen and respiratory support

NU

Community acquired pneumonia - ANS ✓-Drug of choice - Azithromycin 10 mg/kg/day once on day 1 and then 5 mg/kg/day for the next 4 days Appendicitis - ANS ✓-Inflammation of the appendix the leads to distention and ischemia that can result in necrosis, perforation, and peritonitis or abscess formation

  • Poorly defined periumbilical pain; acute onset of severe pain is not typical of acute appendicitis; a shifting of pain to the RLQ may occur after a few hours and become more intense, continuous, and localized; nausea and vomiting, anorexia, stool with mucus, fever may or may not occur
  • Physical exam - involuntary guarding, RLQ rebound tenderness, pain over McBurney point, positive psoas sign or obturator sign, rovsing sign or rebound tenderness Colic - ANS ✓-An infant who is younger than 5 months old when symptoms start and stop
  • Recurrent and prolonged periods of infant crying, fussing, or irritability reported by caregivers that occur without obvious cause and cannot be prevented or resolved by caregivers
  • No FTT, fever, or illness
  • PE - inconsolable bouts of crying, which occur without obvious cause, often clustering in afternoon or evening, grimacing, clenched fists, flatus, drawing legs up, crying more intense
  • Two week trial of hypoallergenic formula or removing cow's milk from mom's diet if BFing; avoid sorbitol; encourage BFing, trial of caffeine elimination, swaddling infant, white noise, do not overstimulate, no exposure to tobacco smoke, reassure parents, no evidence to support probiotics
  • May need follow-up frequently, see baby 2 weeks after diagnosis Cyclic vomiting syndrome - ANS ✓-Uncommon, idiopathic disorder that is characterized by recurrent, sudden-onset attacks of repeated retching and vomiting that are separated by symptom-free intervals of weeks to months
  • Presenting signs - Episodes occur on awakening or 3-4 am; a brief prodromal period and/or a recovery period; episodes begin and end abruptly; intense

NU

Celiac disease - ANS ✓-An immune-mediated systemic disorder triggered by wheat gluten and related proteins in barley and rye

  • Signs - diarrhea, steatorrhea, weight loss, growth failure, abdominal pain, constipation, extraintestinal symptoms
  • Interventions - gluten free diet for life ; enzyme therapy, correcting intestinal barrier defects
  • Testing - serologic testing if first degree relative, associated disorder or a suspicion; gluten must be eaten in more than one meal for 6 weeks every day; IGA; if positive, endoscopy with biopsy Dehydration - ANS ✓1. Minimal to none (<3% loss of body weight) - well, alert, drinks normally, normal vital signs, tears present, moist mouth and tongue, skinfold with instant recoil; warm extremities, urine output normal
  • Interventions - maintenance hydration (100 ml/kg/24 hr for 0-10 kg; 1000 ml plus 50 ml/kg for each kg over 10 for 10-20 kg; if over 20 kg - 1500 ml plus 20 ml/kg for each kg over 20 kg)-If less than 10 kg - 60 - 120 ml ORS for each diarrheal stool or vomiting episode
  • If greater than 10 kg - 120 - 240 ml ORS for each diarrheal stool or vomiting episode
  1. Mild to moderate dehydration (3%-9% loss of body weight) - normal, fatigued or restless, irritable; thirsty, eager to drink, normal to increased HR and normal to decreased quality of pulses; normal or fast breathing; slightly sunken eyes; decreased tears; mouth and tongue dry; skinfold recoil in <2 seconds; prolonged cap refill, cool extremities, decreased urine output
  • Interventions - ORS 50-100 ml/kg body weight over 3-4 hours or 10- 20 ml/kg/hour
  • Maintenance - same as above
  • Ongoing losses - same as ORS above
  1. Severe (>9% of body weight) - apathetic, lethargic, unconscious; drinks poorly, unable to drink; tachycardia, bradycardia in severe cases; weak, thready, or impalpable pulses; deep breathing, deeply sunken eyes; absent tears; parched mouth and tongue; recoil skin in >2 seconds; prolonged cap refill; extremities are cold, mottled; cyanotic; minimal urine output

NU

  • Interventions - LR or NS IV in boluses of 20 ml/kg body weight until perfusion and mental status improve; if after 60-80 ml/kg given then other causes of of shock should be considered; then administer 100 ml/kg body weight ORS over 4 hours or 5% dextrose in 1/2 NS IV at twice the maintenance rate
  • Maintenance - same-Ongoing losses - in unable to drink, administer through NG or administer 5% dextrose in Intussusception - ANS ✓-Involves a section of intestine being pulled antegrade into adjacent intestine with the proximal bowel trapped in the distal segment
  • Signs - intermittent, colicky abdominal pain, vomiting, and bloody mucous stools; screaming with drawing up the legs with periods of calm, sleeping, or lethargy between episodes; fever may or may not be present
  • Intervention - emergency management and consultation with a pediatric radiologist and and a pediatric surgeon; rehydration, gastric decompression, surgery if perforation, peritonitis, or hypovolemic shock is suspected or radiologic reduction fails; IV antibiotics to cover perforation; observation followed radiologic reduction is recommended
  • Return with any recurrence of symptoms are required, and close phone follow- up for up to 72 hours is prudent Recurrent abdominal pain - ANS ✓-Recurrent abdominal pain with no specific cause
  • Diagnosis - The following must occur at least 4 times per month for at least 2 months before diagnosis - episodic or continuous abdominal pain that does not occur solely during eating or menses; insufficient criteria for IBS, functional dyspepsia, or abdominal migraine; the pain cannot be explained by another medical condition
  • Treatment - therapeutic relationship, explain the brain-gut interaction; medications judiciously (H2 blockers should not be used unless dyspepsia is present): encourage return to lifestyle; CAM approaches; a blander diet may be helpful; explore triggers; identify and treat any psychological issues; discuss red flag symptoms

NU

  1. APRNs reduce health care costs, improve health outcomes, and produce health care savings Social determinants - ANS ✓1. Resources
  2. Homelessness
  3. Teen mothers Newborn feeding schedule - ANS ✓-To the breast 8-12 times a day, every 2- 3 hours for 20-45 minutes at each feeding
  • Successful - 0.5-1 oz a day or 4-7 oz a week Growth and development - ANS ✓-NICU vs. full term - Infant normal growth rate - ANS ✓-Full term weight gain rule of thumb
  • Double birth weight by 6 months and triple birth weight by 12 months of age Infant - appropriate screening tools - ANS ✓-Hearing test - should have before one month of age; any infant with abnormal findings should be referred for additional evaluation and EI Infant Anticipatory Guidance - ANS ✓-Sleep position -
  • When to start solids - may begin at 4 months; preference is 6 months; introduce when tongue thrust diminishes, infant has good head control; avoid high allergens until end of first year if high risk for allergens Infants - first lead check - ANS ✓- Nine months old
  • All children at risk should be screened at 1-2 years of age for lead Immunizations - newborn and infants - ANS ✓1. Newborn - Hepatitis B

NU

  1. Two week - Hep B only if didn't get in hospital
  2. Two month - Hep B #2, RV, DTaP, Hib, PCV13, IPV
  3. Four month - RV, DTaP, Hib, PCV13, IPV
  4. Six month - DTaP, Hib, IPV, PCV, RV (not if got at 2 and 4 months), influenza
  5. Twelve month - Hib between 12-18 months, MMR between 12-15 month, Varicella at 12 months, PCV at 12-15 months, influenza ; also Hepatitis A
  6. 15-18 months - IPV, DTaP, influenza
  7. Two year visit - none Anterior fontanelle closure - ANS ✓18 months
  • Posterior - 2 - 3 months Head lag - ANS ✓-Holds head erect when sitting at 3 months, minimal to none at 4 months & completely gone at 6 months Caput Succedaneum - ANS ✓-Crosses the suture lines
  • It is a diffuse superficial swelling of the soft tissue of the scalp with possible underlying bruising
  • Swelling will resolve spontaneously over the first few days after birth; If there is bruising, observe the baby for the development of jaundice as the blood from bruising is reabsorbed Substance abuse - ANS ✓-Advice - talk about it at every visit; annually
  • Treatment - keep the child from starting to use (primary prevention) and secondary prevention with a goal of cessation; behavioral interventions for a mild nicotine dependence; cognitive-behavioral strategies, motivational strategies, and examining the effects of social influence on smoking; tailor to the adolescents readiness for change; if moderate to severe dependence - medications; address secondhand smoke; parental modeling; outpatient or day

NU

  • Sexual education - body parts, concepts of privacy and choice, masturbation, sexual abuse prevention, menstruation, homosexuality, marriage, sexual interaction, dating and intimacy, appropriate social behaviors, birth control, pregnancy, attitudes and values, sexual responsibility, privileges, and consent
  • Encourage parent to make sure they make age appropriate friends-Risky behavior increases with older friends Normal sexual behavior - ANS ✓-Masturbation Allergic reaction - ANS ✓-Rash description - morbilliform, or exanthematous rash; usually within 1-2 weeks of starting a new medication and can occur after it has been stopped
  • Varying degrees of itching
  • Also urticaria typified by erythematous wheels
  • Urticaria is seen as mildly erythematous, annular, raised wheels or welts with pale centers from 2 mm to several centimeters in diameter; can be various shapes
  • Scattered but generalized, can appear and then fade, blanch with pressure, intensified with fear Molluscum contagiosum - ANS ✓-Don't share towels
  • Flesh colored papules, mildly pruritic
  • Self-limiting - resolves without treatment, provide reassurance Acne treatment - ANS ✓1. First line treatment
  • Mild - benzoyl peroxide or topical retinoid or topical combination therapy (BP plus antibiotic, or retinoid plus BP, or retinoid plus BP plus antibiotic

NU

  • Moderate - topical combination therapy (like above) or oral antibiotic pls topical retinoid plus BP plus topical antibiotic
  • Severe - oral antibiotic plus topical combination therapy (above) or oral isotretinoin
  1. Alternative treatment
  • Mild - add topical retinoid or BP (if not on) or consider alternative retinoid or consider topical dapsone
  • Moderate - consider alternate combination therapy or consider change in oral antibiotic or add combined oral contraceptive or oral spironolactone (females) or consider oral isotretinoin
  • Severe - Consider change in oral antibiotic or add combined oral contraceptive or oral spironolactone (females) or consider oral isotretinoin Pediculosis capitis - ANS ✓-Aka lice
  • Can usually visualize live lice and itching of the scalp, excoriation to back of head
  • Can be treated with OTC lice treatments, but can be resistant, so usually permethrin 5%
  • All over the scalp, shower cap, sleep over night, then wash and remove it all
  • Must remove nits Tinea Corporis - ANS ✓-Annular lesions, central clearing, scaly and flaky
  • Treat with antifungal cream like miconazole or clotrimazole
  • Don't have to scrape, typically we treat based on visual diagnosis unless not improved
  • Aka ringworm Tinea Capitis - ANS ✓-Same annular lesion as corporis, flaking to the scalp
  • Cannot be treated topically
  • First line is griseofulvin
  • Taste bad so educate parents on this

NU

  • Need urinalysis, C-peptide concentrations, glutamic acid decarboxylase and tyrosine phosphatase to determine DM1 to DM2, androgen levels, serum testosterone levels
  • Can also be related to obesity, hereditary, thyroid issues, drug administration, malignancy Toxic epidermal necrolysis - ANS ✓-Caused by medication
  • Fever, sore throat, malaise, and generalized sun-burn like erythema
  • This rash has rapidly coalescing target lesions and widepread bullae that become full-thickness epidermal peeling or sloughing within 24 hours
  • Nikolsky sign - peeling of the skin with a light rub that reveals a moist red surface
  • Conjunctivea, urethra, rectum, oral and nasal mucosa, larynx, and traceobronchial mucosa may or may not be involved
  • This can be life threatening
  • PICU or burn unit for wound care, management of hydration and electrolytes, nutritional support, and pain
  • IVIG to reverse blistering and sloughing
  • SJS treatment is the same Tinea versicolor - ANS ✓-Superficial fungal infection that tends to be persistent and occurs on the trunk
  • Caused by yeast like organism, M. furfur and occurs more commonly in adolescents
  • Selenium sulfide 2.5% lotion or 1% shampoo applied in a thin layer several hand widths beyond lesions for 30 minutes twice a week for 2-4 weeks followed by monthly applications for 3 months to help prevent recurrences
  • Older adolescents can use ketoconazole 2%

NU

  • Oral antifungal treatments for severe or resistant cases - fluconazole Psoriasis - ANS ✓-A chronic, papulosquamous skin disorder with spontaneous remissions and exacerbations, is characterized by thick silvery scales, varied distribution patterns, and isomorphic response
  • The scalp, elbows, knees, buttocks
  • Sun exposure, prevent sunburn; emollient creams (Eucerin, Aquaphor), topical steroids 2-3 times a day for 2-3 weeks
  • Referral to dermatology - sulfur or salicylic acid; anthralin ointment, calcipotriol, UV light therapy, Pityriasis rosea - ANS ✓-Self-limiting papulosquamous disease
  • Herald spot or patch - solitary, ovoid, slightly erythematous lesion with a finely scaled slightly elevated border that enlarges quickly with central clearing; trunk, upper arm, neck, or thigh
  • Secondary generalized lesions appear that are symmetric, small macular to papular, thin and round to oval; christmas tree pattern Impetigo - ANS ✓-Common contagious bacterial infection of the superficial layers of the skin
  • Nonbullous, classic, or common - 1 - 2 mm erythematous papules or pustules that progress to vesicles or bullae, which rupture, leaving moist, honey-colored, crusty lesions on mildly erythematous, eroded skin
  • Common face, hands, neck, extremities, or perineum
  • Treatment - topical antibiotics if superficial, nonbullous, or localized to a limited area; bacitracin, polymyxin B, neomycin; mupirocin and retapamulin are considered better due to resistance
  • Widespread infection - oral antibiotics - Cephalexin, Augmentin
  • S aureus or S. pyogenes
  • Moisturize skin, cleanse and break in skin