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PNCB Pediatric Nurse Practitioner - Primary
Care CPNP-PC Final 2024 Practice Test
Questions and Answers 100% pass
Cystic fibrosis is more commonly seen in which ancenstry? - Answer>> Eastern European Common signs and symptoms of Hodgkin's disease include: - Answer>> - Night sweats
- Weight loss
- Itchy skin
- Enlargement of the spleen and liver
- Swollen lymph nodes Pulmonary hypertension causes: - Answer>> - Increased blood pressure in the pulmonary artery, vein and capillaries
- Causes shortness of breath and dizziness An 18-month old is brought in and her nail beds are softening. What is this a sign of? - Answer>> Clubbing
- Clubbing is a sign of a congenital heart defect For the patient who has recently undergone a kidney transplant, what anticipatory guidance regarding immunosuppressives should be given? - Answer>> - The need for immunosuppressives is lifelong
- Immunosuppressives are required after surgery to prevent organ rejection
- Continue taking immunosuppressives even during illness
- Immunosuppressives should be taken on a strict schedule What is the importance of hydration in treating sickle cell disease?
- Answer>> Adequate hydration promotes hemodilution and circulation of red blood cells
Understanding "no" is expected in the 10-month-old. True or False. - Answer>> True Characteristics of active listening: - Answer>> - Maintaining eye contact
- Asking open-ended questions
- Reflecting back what the speaker has said Signs of pain in an infant: - Answer>> - Grimacing
- Crying
- Restlessness
- Thrashing
- Flailing Classic symptom of scabies: - Answer>> Itching that is worse at night A patient with primary case of scabies was probably infected how long ago? - Answer>> 3 to 4 weeks ago
- 3 to 4 weeks is the incubation period for scabies Management of vulvovaginitis: - Answer>> - Discontinue bubble baths
- Keep perineal area clean
- Have the child wear cotton or cotton-lined underwear Do PPO plan members need authorizations to visit specialists? - Answer>> No Do HMO plan members need authorizations for services and visits to specialists? - Answer>> Yes
HIPAA - Answer>> - Health Information Portability and Accountability Act (1996)
- Governs the privacy and disclosure of health information as well as electronic transfer of information What is the pharmacologic treatment of choice for a 17yo pregnant female with a UTI? - Answer>> Nitrofurantoin (Macrodantin) A child who displays urinary incontinence who has never been dry through the night is said to have: - Answer>> Primary enuresis What is the causative organism of bronchiolitis? - Answer>> Respiratory Syncytial Virus (RSV) Management of a patient with PCOS includes: - Answer>> - Exercise and weight loss
- Metformin (Glucophage) to improve insulin sensitivity, lower LH, androgens and improve fertility
- Monthly provera Excessive estrogen in patients with PCOS leads to: - Answer>> Hyperinsulinemia Ignoring - Answer>> A pattern of behavior in which an adult refuses to interact with or respond to a child Locomotor movement - Answer>> Movement of the body from place to place
- e.g. running, walking, jumping, and skipping A family that consists of a parent, his or her child and their new spouse is: - Answer>> A blended family
Contraindications for administering a Hep B vaccination: - Answer>> Prior anaphylaxis or severe hypersensitivity Omphalocele - Answer>> A condition where infants are born with their liver and intestines outside of the body Signs of cerebral palsy in an infant: - Answer>> - Poor head control after 3 months
- Clenched fists after 3 months
- Stiff or rigid limbs
- Unable to sit unsupported after 8 months
- Persistent neonatal reflexes after 6 months
- Poor suck
- Scissoring of legs
- Apparent early preference for one hand For sickle cell anemia, what is the expected hemoglobin range? - Answer>> 6.5-9.5 g/dL Roy's Adaptation Model - Answer>> Based on stress and adaptation as the framework Potassium can be added to the IV of a child suffering from severe dehydration at which point? - Answer>> After the child's first void -The addition of potassium may speed rehydration
- An unusual-appearing anal dimple
- A newborn that does not pass meconium in 24 hours
- Meconium appearing through a fistula
- Meconium appearing in the urine These are all signs indicating that an infant has: - Answer>> An anorectal malformation
- Recurrent pancreatitis
- Large bulky foul-smelling stools
- Salt loss syndromes Hematuria - Answer>> Blood in the urine
- A common sign of renal failure Increased BUN in a child's urine is indicative of: - Answer>> - Dehydration
- Renal failure
- Increased protein intake What is the purpose of the National Data Bank (NDB)? - Answer>> To improve the quality of healthcare by encouraging state licensing boards, professional societies, and facilities to identify and discipline those who engage in unprofessional behavior. According to HIPAA, you may disclose the patient's health information to whom? - Answer>> Anyone directly involved in the patient's care. What are the two mechanisms causing volvulus symptoms? - Answer>> i. Bowel obstruction ii. Ischemia When the body loses more water than sodium: - Answer>> Hypertonic dehydration Which insurance is purchased by an organization to address employee, job-related injuries: - Answer>> Workers' Compensation injuries
What is the most common source of Hepatitis A virus? - Answer>> Contaminated drinking water After starting B12 therapy, what would be required at the 2-week follow-up visit? - Answer>> Increased hemoglobin/hematocrit and reticulocyte count Malpractice: - Answer>> Negligence by a professional Which vitamin is necessary for normal blood clotting? - Answer>> Vitamin K Authoritative communication is characterized by: - Answer>> - two way communication
- flexibility
- negotiation
- democratic decision making
- Parents often make final decisions based on family rules A child should be expected to pull up to standing position at what age? - Answer>> 9 months A Nurse Practitioner wants to make a change in the state's law concerning the dispensing of prescription medications by certified pediatric nurses. Who would this case need to be taken to? - Answer>> State legislature When taking a history of a patient with known allergies, what is the most important information that needs to be obtained? - Answer>> Reactions associated with each allergen What is the most effective way to communicate health information to a patient with low literacy? - Answer>> Use simple language
What pharmacologic management is used for moderate postsurgical pain in a child? - Answer>> NSAIDs A 6-day old has a mucopurulent eye discharge bilateral. The Pediatric Nurse knows that what historical finding will explain the etiology of this discharge? - Answer>> The mother has chlamydia The shedding of deciduous teeth usually begins at: - Answer>> Age 6
- And continues through age 12 A child will achieve 50% of their adult height at what age? - Answer>> 2 years Terrorizing: - Answer>> Keeping a child in a constant state of fear through threats Acids that build up in the blood of a diabetic patient as a result of the body burning fat due to lack of sufficient insulin are known as which of the following? - Answer>> Ketones Passive immunity is defined as: - Answer>> Defense against disease acquired by the infant from the mother A pregnant patient is concerned about her weight gain. The Pediatric Nurse knows that recommended weight gain during pregnancy for a woman with a healthy body mass index (BMI) is:
- Answer>> 20 to 30 pounds In terms of tooth eruption for a child, the first premolar should normally have a maxillary eruption at what age? - Answer>> 10 to 11 years old
In terms of tooth eruption for a child, the first premolar should normally have a mandibular eruption at what age? - Answer>> 10 to 12 years old A 5-year-old girl (weight 18 kg) is diagnosed with bilateral otitis media. Her last ear infection was 6 months ago, and she had no known drug allergies. An appropriate medication to prescribe would be: - Answer>> Amoxicillin 75-90 mg/kg/day bid x 10 days A child presents with an intermittent bulge in the groin area. What is this suggestive of? - Answer>> An inguinal hernia Moral development becomes conventional and children equate rules with benefits by what age? - Answer>> Age 6 You are working in the emergency department and a woman brings her 3-year-old son in who has ingested a small bottle of baby aspirins. To manage this case, the PN knows that the first priority is to - Answer>> Gastric lavage With SIADH, too much water remaining in the body can cause salt levels to: - Answer>> Decrease What body part does intussusception affect? - Answer>> Intestines What is the least effective route for administering pain medication? - Answer>> Intramuscular What are the most effective routes for administering pain medication? - Answer>> PO or IV
You are counseling a mother who has her 7-month-old infant in the office with the complaint of "spitting up his formula." The PN knows this to be a common thing for infants but the mother conveys she has "put him on goat's milk." The PN is concerned because she knows that goat's milk places the infant at risk of developing: - Answer>> - Folic acid deficiency
- Megaloblastic anemia Failure to thrive: - Answer>> Inadequate growth that occurs as a result of a child not getting enough calories to develop properly Common developmental tasks for the 5-year-old include: - Answer>> - Draw a person with a body, head and arms
- Recognize most letters
- Print some letters
- Know how to skip
- Copy a triangle
- Count on fingers
- Know their colors
- Tie shoe laces A child has pleural effusion that has been confirmed by x-ray. What should be done? - Answer>> Thoracentesis - to remove fluid from the pleural space A patient with which condition is more likely to have a horseshoe kidney? - Answer>> Turner Syndrome You are assessing a 10-year old boy for a sports physical examination. You suspect an innocent murmur is present. The Pediatric Nurse knows that which of the following characteristics is seen with this type of murmur? - Answer>> It becomes softer
and more difficult to hear when the patient goes from a lying position to a standing position. You are providing care for a patient who has a diagnosis of sickle cell anemia. The patient was brought to the ED by his parents with chest pain, a cough, and a fever. His breathing is rapid and it sounds as though he has fluid in his lungs. This patient is experiencing which of the following? - Answer>> Acute chest syndrome - a complication of sickle cell disease that presents like pneumonia; rapid breathing, cough, chest pain and elevated temperature In the treatment of bipolar depressive disorder, the PN may encounter a patient on carbamazepine for mood stabilization. Prescribers who have patients taking carbamazepine should be alert to: - Answer>> Drug-drug interactions Stranger anxiety usually develops around which age? - Answer>> 9 months When discussing weaning from a bottle, when should this anticipatory guidance take place? - Answer>> At 10-months of a age Accountability - Answer>> The ability to answer to one's actions Confidentiality - Answer>> An obligation to protect the patient's identity, personal information, test results, and medical records The Pediatric Nurse assesses an infant and finds a grade 1 or 2 early systolic vibratory murmur that is heard best at the left lower sternal border with little radiation. This murmur subsides or disappears when pressure is applied to the abdomen. What type is it? - Answer>> A newborn murmur
A child who presents with a temperature of 104 °F, inflammation of the throat, and difficulty swallowing is displaying signs consistent with which of the following? - Answer>> Pharyngitis
- A culture of the throat should be done for possible streptococcal infection When should an adolescent female or woman begin cervical cancer screening? - Answer>> Around 3 years after she begins to have sexual intercourse or by age 21 A four year old terminal cancer patient is most likely to fear which of the following? - Answer>> Separation from parents What characteristic marks on the skin indicate immersion burns? - Answer>> - Doughnut-shaped marks
- Glove-shaped marks
- Stocking-shaped marks By 17yo, which cognitive thinking processes should be firmly established? - Answer>> Abstract thought A patient presents with 101F temperature, yellow/white patches on the tonsils, a stomachache and stiff neck. What is the likely diagnosis? - Answer>> Tonsillitis School age children (6-12yo) fall into which stage of Erikson's theory of development? - Answer>> Industry vs. Inferiority What should be suspected in the 2yo who cannot walk steadily? - Answer>> Developmental delay Signs of potential abuse in a pediatric patient include: - Answer>> - Child is fearful of strangers
- Child is fearful of the parent
- Child is disengaged and withdrawn
- Child's injuries do not match the history reported by the child
- The child pleads to stay at the hospital rather than go home
- Delays in seeking medical care
- Child may report injury by the parent According to the CDC, who should get immunized against seasonal influenza? - Answer>> All children 6mos to 18yo Due to frequent urination, patients with diabetes insipidus may become: - Answer>> Dehydrated Signs of respiratory distress in children includes: - Answer>> - Increased pulse rate
- Restlessness
- Diaphoresis What is the most overprescribed medication? - Answer>> Anti- infectives (antimicrobials) A mother brings a 3-year-old child into the office for chronic, recurring diarrhea. A stool for ova and parasites is obtained and is positive for Giardia. What is the most appropriate pharmacologic intervention? - Answer>> Metronidazole (Flagyl) Which of the following may be the ONLY symptom of a urinary tract infection in a child under 2 years old? - Answer>> Fever You are providing care to a patient who has a chest tube. You notice that a clot has made its way into the tube. What is the appropriate way to remedy this situation? - Answer>> Gently milk the tube in order to move the clot out of the tubing and into the receptacle
child's diet. You should advise the parents that they should limit .................. in their child's diet? - Answer>> Potassium Some potassium-rich foods include: Bananas Dark greens Potatoes How long should you take a child's pulse for most accurate results? - Answer>> 1 minute You counsel a patient with allergic rhinitis. The NP knows that the mechanism of Cromolyn is: - Answer>> A mast cell stabilizer
- prevents symptoms of allergic rhinitis
- take about a week to achieve symptom relieve Fidelity - Answer>> The principle that we keep the promises we make to patients and families. It is important to avoid promising more than you can deliver, and to come through on promises made, to foster trust and synergy in the care relationship What is the antidote for coumadin (warfarin) toxicity? - Answer>> Vitamin K Dietary sources of vitamin K include: - Answer>> Green leafy vegetables You are providing care to a patient with sickle cell disease. The patient presented at the ED with pallor, fatigue, and shortness of breath. She indicates that she has recently recovered from strep throat. This patient is displaying signs and symptoms of which of the following? - Answer>> Aplastic crisis
- a temporary cessation of production of red blood cells in a person with sickle cell
A 16 year old girl takes digoxin. She has also been taking ginseng supplements, and now she is vomiting. What is the most likely cause? - Answer>> Drug toxicity The belief that one's own culture is superior to others or is the only "right" way of living is known as: - Answer>> Ethnocentrism When can a woman safely conceive after discontinuing oral contraceptives? - Answer>> Immediately What is the most common symptom of diabetes insipidus? - Answer>> Frequent urination Patients of which type of organization must be assigned to a primary care provider (PCP) and get authorization for services to a specialist from that PCP? - Answer>> Health Maintenance Organization (HMO) Convert 33lbs to kg: - Answer>> 33lb = 15kg You are treating a patient with acute anaphylaxis. What is your priority in this patient's care? - Answer>> Ensure a patent airway You are assessing a 13-year old male with an acute, painless groin swelling. What would be your most useful tool for finding the etiology of this swelling? - Answer>> An ultrasound of the scrotum You are providing care for an infant patient who will need to take iron supplement in her formula when she returns home. In educating her parents about the treatment, which of the following
