Download Final Exam: NU664A/ NU 664A (New 2025/ 2026 Update) Review| Qs & As| 100% Correct- Regis and more Exams Nursing in PDF only on Docsity!
Final l Exam: l NU664A/ l NU l 664 A l (New l
2025/ l 2026 l Update) l Primary l Care l of l
Child l I l Review| l Qs l & l As l | l Grade l A| l
100% l Correct l (Verified l Answers)- l Regis
QUESTION
Al 4 l yearl oldl childl withl PEl tubesl inl bothl earsl hasl otalgial inl onel ear.l Thel PNPl isl ablel tol visualizel thel tubel andl doesl notl seel exudatel inl thel earl canall andl obtainsl al typel Al tympanogram.l Whatl willl thel NPl do? Answer: Orderl ototopicall corticosteroid/antibioticl drops.
QUESTION
Al twol monthl oldl infantl willl receivel initiall vaccines,l andl thel parentl asksl aboutl givingl medicationl tol increasel thel infantsl comfortl andl minimizel fever.l Whatl willl thel PNPl recommend? Answer: Administerl acetaminophenl asl needed.
QUESTION
Al toddlerl exhibitsl exotropial ofl thel rightl eyel duringl al cover-uncoverl screen.l Thel PNPl willl referl tol pediatricl ophthalmologistl tol initiatel whichl treatment? Answer: Patchingl thel unaffectedl eyel forl 2 l hrs./day
QUESTION
Al 10 l yearl oldl childl hasl hadl abdominall painl forl 2 l daysl whichl beganl inl thel periumbilicall arel andl thenl localizedl tol thel rightl lowerl quadrant.l Thel childl vomitedl oncel todayl andl thenl experiencedl reliefl froml painl followedl byl anl increasedl fever.l Whatl isl thel likelyl diagnosis? Answer: Appendicitisl withl perforation
QUESTION
Al 16 - year-oldl femalel reportsl breastl tendernessl andl "lump".l Thel PNPl palpatesl al smalll fluid-filledl massl inl herl rightl breast.l Al pregnancyl testl isl negative.l Whichl actionl isl correct? Answer: Orderl anl ultrasoundl ofl thel mass.
QUESTION
Sincel adolescentsl andl youngl adultsl betweenl 16 l andl 23 l yearsl ofl agel havel thel highestl incidencel ofl meningococcall disease,l thel recommendationl forl vaccinationl is: Answer: Firstl dosel atl 11 - 12 l yearsl ofl age,l followedl byl al boosterl atl 16 l yearsl ofl age.
QUESTION
Al 5 - year-oldl whol hadl al repairl forl transpositionl ofl thel greatl arteriesl shortlyl afterl birthl isl growingl normallyl andl hasl beenl asymptomaticl sincel thel surgery.l Thel PNPl notesl mildl shortnessl ofl breathl withl exertionl andl uponl questioningl learnsl thatl thel childl hasl recentlyl complainedl ofl dizziness.l Whatl willl thel NPl do?
QUESTION
Classificationl ofl asthmal severityl forl al childl whol isl 6 l yearsl oldl whol hasl symptomsl 3 l daysl al week,l usesl hisl inhalerl dailyl forl exercise,l butl notl otherwise,l hasl minorl limitationl tol activityl andl wakesl 3 l timesl al monthl withl cough Answer: mildl persistentl asthma
QUESTION
Shouldl notl bel usedl tol treatl asthmal inl childrenl underl thel agel ofl 4? Answer: dryl powderl inhalers
QUESTION
Bruising,l Nosebleeds,l Bleedingl ofl gumsl andl Lips,l petechiae,l butl otherwise,l well- appearingl childl arel alll concerningl forl this Answer: ITP
QUESTION
Presencel ofl blastl cellsl onl peripherall bloodl smearl isl highlyl suggestivel ofl this Answer: leukemia
QUESTION
Inl additionl tol thel routinel PCVl 13 l vaccinel series,l sicklel celll anemial patientsl olderl thanl 2 l yearsl ofl agel shouldl receivel thisl oncel andl thenl al boosterl inl 5 l years. Answer: PPSV
QUESTION
Prophylacticl penicillinl shouldl bel initiatedl inl childrenl withl sicklel celll anemial byl thisl age. Answer: 2 l tol 3 l monthsl ofl age
QUESTION
Whatl typel ofl hemorrhagel wouldl bel expectedl withl severel factorl VIIIl deficiency? Answer: spontaneousl hemarthrosis orl spontaneousl hemorrhage
QUESTION
PCPl shouldl screenl forl thisl atl sportsl physicalsl orl withl al complaintl ofl syncope,l chestl painl orl palpitations? Answer: suddenl cardiacl death
QUESTION
Yourl nextl patientl isl al 6 - year-oldl malel herel forl al rashl underl hisl nosel forl aboutl threel days.l Hel remembersl scratchingl hisl naresl andl causingl theml tol bleedl al littlel aboutl onel weekl ago.l Whenl assessed,l thel PNPl notesl severall vesiclesl andl honey-coloredl crustedl lesions.l Whatl isl thel diagnosis? Answer: Impetigo
QUESTION
Yourl nextl patientl isl al six-month-oldl infantl whol justl completedl amoxicillinl forl otitisl media.l Thel motherl statesl herl childl isl betterl exceptl forl al diaperl rash.l Uponl examination,l youl notel redl scalyl plaquesl inl thel diaperl areal withl satellitel lesionsl tol hisl upperl thighs.l Whatl wouldl youl dol nextl asl thel PNP? Answer: Yourl childl hasl al rashl thatl isl likelyl duel tol al fungus,l Candida,l andl commonlyl occursl afterl takingl antibiotics.l Il willl prescribel nystatinl tol bel appliedl tol thel diaperl area.
QUESTION
Epidermis Answer: Thinnerl outerl layer-protectivel barrierl betweenl bodyl andl environment
QUESTION
Dermis Answer:
§Thickerl middlel layer-contributesl strength,l supportl andl elasticityl tol skin §Underlyingl subcutaneousl tissue-adiposel tissue §Skinl appendages-hair,l nails,l sweatl glands,l andl sebaceousl glands.
QUESTION
Normall variationsl ofl thel skin Answer: §Skinl colorl andl texture §Pigmentationl ofl gingiva §Increasedl melaninl inl elbowsl orl knees §Futcher/Itol line §Cafél aul laitl spots §Colorl alteration
QUESTION
12 l y.o.l femalel presentsl tol thel clinicl afterl beingl bitl byl al dogl onl thel face.l Abrasionl withl 2 l puncturel woundsl onl thel upperl rightl cheek,l approximatelyl 1 l inchl belowl thel eye. Thel areal isl slightlyl erythematous,l withl al smalll amountl ofl bruisingl andl raisedl areal alongl thel cheekbone. Cleansel thel areal withl what?l Treatl withl what? Answer: Usingl normall saline,l irrigatel thel woundsl usingl highl pressurel (greaterl thanl 4 l poundsl perl squarel inch)l andl highl volumel (greaterl thanl 1 l L).l Isolatedl puncturel woundsl shouldl notl bel irrigated,l insteadl soakl thel woundl inl al dilutedl solutionl ofl tapl waterl andl povidone- iodinel forl 15 l .minutesl • l Prescribel al 3 - l tol 5 - dayl coursel ofl prophylacticl antibiotics
QUESTION
Al 4 l yol childl hasl clustersl ofl small,l clear,l tensel vesiclesl withl anl erythematousl basel onl onel sidel ofl thel mouthl alongl thel vermillionl border,l whichl arel causingl discomfortl andl difficultyl eating.l Whatl willl thel PNPl recommendl asl treatment?
Al school-agel childl hasl severall annularl lesionsl onl thel abdomenl withl centrall clearingl withl scalyl redl borders.l Whatl isl thel firstl stepl inl managingl thisl condition? Answer: Treatl empiricallyl withl anti-fungall cream.
QUESTION
Al PNPl workingl inl al communityl healthl centerl wishesl tol developl al programl tol assistl impoverishedl childrenl andl familiesl tol havel accessl tol healthyl foods.l Whichl strategyl willl thel PNPl employl tol ensurel thel successl ofl suchl al program? Answer: Askingl communityl membersl tol assistl inl researchingl andl implementingl al program
QUESTION
Al childl hasl al leadl levell ofl 25 l mcg/dL.l Oncel leadl abatementl measuresl arel instituted,l whatl isl anl importantl interventionl tol helpl preventl permanentl damagel inl thisl child? Answer: Followl upl testing
QUESTION
Thel parentl ofl al 1 - weekl oldl isl concernedl aboutl thel unusuall shapel ofl theirl child'sl head.l Inl thel physicall exam,l whichl ofl thel followingl signsl wouldl notl supportl thel diagnosisl ofl craniosynostosis? Answer: Al palpablel lesionl atl thel occipitall region.
QUESTION
Stagel ofl hypertensionl inl al childl withl al bloodl pressurel abovel thel 99thl percentilel forl age,l sexl andl height Answer: Stagel IIl Hypertension
QUESTION
diagnosticl studiesl forl syncope Answer: Orthostaticl Vitall Signs,l Hgb,l 12 l leadl EKG,l Echo,l Possiblel Exercisel Testing
QUESTION
Stills,l innocent,l functionall orl physiologicl murmur Answer: Midsystolicl murmur,l louderl inl supinel positionl orl withl inspiration
QUESTION
Tetralogyl ofl Fallot Answer: Al gradel IIIl tol Vl harshl systolicl ejectionl murmurl atl thel leftl midl tol upperl sternall border.l Therel mayl bel al palpablel thrilll andl al holosystolicl murmurl atl thel LLSB.
QUESTION
Oftenl treatedl withl Selsunl bluel shampoo.
Answer: Bilaterall conjunctivall injection,l 5 l daysl ofl fever,l cervicall lymphadenopathy,l polymorphousl exanthema,l changesl inl peripherall extremities
QUESTION
6 l orl morel cafél aul laitl spotsl arel concerningl for Answer: neurofibromatosis
QUESTION
Childl betweenl 4 l tol 6 l withl al pinkishl maculopapularl rashl thatl progressesl froml redl tol purplel tol brown,l arthritis,l abdominall pain,l edemal andl hypertension Answer: HSP
QUESTION
ASD
Answer: Murmurl mayl notl bel noticedl untill agel 2 l orl 3,l gradel 1 - 3 l wildlyl radiating,l mediuml pitchedl notl harshl crescendo-decrescendol murmur.
QUESTION
Coarctationl ofl thel Aorta Answer:
Thisl isl notl alwaysl apparentl inl newbornsl untill thel ductusl closesl andl decreasesl bloodl flowl tol thel lowerl body.l Youl mayl seel al differencel inl upperl andl lowerl extremityl bloodl pressures
QUESTION
Juvenilel Idiopathicl Arthritis(JIA) Answer: Thisl isl thel mostl commonl rheumatologicl diseasel ofl childhood.l Itl hasl anl onsetl ofl symptomsl atl orl youngerl thanl 16 l yearsl ofl agel andl typicallyl causesl chronicl inflammationl ofl atl leastl onel synoviall jointl forl 6 l weeksl orl more.
QUESTION
Firstl linel treatmentl forl comedonall acne Answer: benzoyll peroxidel 5%l orl tretinoinl 0.025%l orl Adapalenel 0.1%l gel
QUESTION
treatmentl forl tineal capitis Answer: griseofulvinl forl 6 l tol 8 l weeks
QUESTION
Firstl linel treatmentl forl allergicl rhinitis Answer: Orall H1l antihistaminesl and/orl intranasall steroids
QUESTION
Whatl isl thel nextl stepl ifl youl havel al 13 l yearl oldl patientl withl al highl bloodl pressure? Answer: Repeatl bloodl pressurel atl thel endl ofl thel visit. Havel patientl comel inl justl tol takel bloodl pressurel onl twol subsequentl accounts. Havel bloodl pressurel takenl inl anotherl environment.
QUESTION
Whatl isl neededl tol diagnosisl hypertension? Answer: Havel tol havel 3 l elevatedl bloodl pressurel readings
QUESTION
Subacutel bacteriall endocarditisl (SBE) Answer: al slowlyl developingl typel ofl infectivel endocarditisl —l anl infectionl ofl thel liningl ofl yourl heartl (l endocardiuml )
QUESTION
Whol dol youl treatl forl SBEl prophylactically? Answer: Childrenl withl cardiacl valves Childrenl withl jointl surgeries
QUESTION
Redl flagsl forl murmurs Answer: Gradel 3 l orl higher
QUESTION
Youl canl reassurel al parentl aboutl al murmurl if Answer: youl canl suppressl thel sound
QUESTION
Patientl thatl isl dehydrated,l hasl al Gradel Il murmur,l andl febrilel whatl wouldl youl telll thel parent? Answer: Murmurl canl bel louderl s/tl stressl onl thel bodyl becausel ofl increasedl bloodl viscosityl whichl makesl thel bloodl louderl whenl travelingl throughl thel vessels
QUESTION
Whatl wouldl makel murmurl louder? Answer: Squattingl orl vasleuarl maneuver
QUESTION
2 l conditionsl withl s/sl ofl newl Murmur,l fever,l malaise,l rash
Viruses
QUESTION
Thel characteristicl thatl isl mostl concerningl inl thel school-agedl childl withl al cardiacl murmur. Answer: Progressivel exercisel intolerance
QUESTION
Al parentl ofl al childl withl al historyl ofl al benignl cardiacl murmurl statesl shel readl thatl childrenl withl heartl diseasel needl tol havel anl antibioticl beforel dentall procedures.l Howl wouldl youl answerl thel motherl asl thel PNP? Answer: Certainl childrenl dol needl anl antibioticl tol preventl somethingl calledl bacteriall endocarditis,l butl thesel arel childrenl whol havel hadl al surgicall repairl done.
QUESTION
Yourl nextl patientl isl al 12 - year-oldl malel herel forl hisl well-childl exam.l Whenl reviewingl hisl height,l weight,l andl BMI,l itl isl notedl thatl hisl BMIl isl inl thel 90thl percentile.l Thel motherl statesl thatl herl childl isl "big-boned"l andl isl notl concernedl ofl anyl cardiovascularl diseasel risk.l Whatl wouldl youl discussl withl thel mother? Answer: Althoughl al riskl ofl cardiovascularl diseasel exists,l withl al healthyl dietl andl regularl exercise,l yourl sonl likelyl willl bel ablel tol reducel hisl BMIl andl reducel hisl risk.
QUESTION
Yourl nextl patientl isl al 5 - year-oldl childl withl al historyl ofl moderatel persistentl asthma.l Hel hasl beenl wheezingl andl coughingl forl thel pastl twol days,l andl hisl motherl bringsl himl inl todayl forl evaluation.l Hel hasl beenl usingl albuteroll everyl fourl hours.l Hisl respiratoryl ratel isl 13 l breathsl perl minute;l hisl lungsl arel clearl tol auscultation;l andl nol retractionsl arel noted.l Whatl mayl bel yourl assessmentl andl interventionl basedl onl thisl information? Answer: Yourl childl isl breathingl slowerl thanl normall forl hisl age.l Wel needl tol sendl himl tol thel ERl forl furtherl intervention.
QUESTION
Yourl nextl patientl isl al 6 - year-oldl malel herel forl hisl annuall influenzal vaccine.l Hel hasl al historyl ofl mildl persistentl asthma.l Whatl wouldl youl discussl forl medicationsl whenl reviewingl hisl asthmal actionl plan? Answer: Yourl childl shouldl continuel hisl low-dosel inhaledl corticosteroidl dailyl andl addl albuteroll asl neededl forl anl exacerbation.
QUESTION
Whichl ofl thel followingl isl al commonl causel ofl acquiredl coronaryl arteryl diseasel inl children? Answer: Kawasakil disease
QUESTION
Yourl nextl patientl isl al 14 - year-oldl femalel whol presentsl tol yourl officel withl al complaintl ofl syncopel atl school.l Shel hadl justl stoodl upl froml herl chairl atl thel endl ofl thel day,l feltl dizzyl andl nauseous,l andl thenl wokel upl onl thel floor.l Shel didl notl hitl herl headl andl wokel upl withinl 30 l seconds.l Whatl isl yourl impression,l andl whatl wouldl youl dol next?
