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NU665A (Primary Care of Child II) EXAM 1 2025-
2026|95QUESTIONS&ANSWERS|GRADED A+
For Community-acquired Methyl resistant staph aureus, what are two antibiotics can be given orally in the pediatric population? Clindamycin & TMP/SMX Clindamycin dosage 30 - 40 mg/kg/day PO divided q8h x10 days Bactrim Dosage 5 - 10 mg/kg/day TMP PO divided bid 2-3x/wk; Max: 320 mg/day TMP 18 - month-old with Bronchopulmonary Dysplasia (BPD). To prevent pneumococcal disease, which vaccine will be administered? PCV 13 A child whose family has been camping in a region with endemic Lyme disease suffered several tick bites. The parents report removing the ticks but are not able to verify the type or the length of time the ticks were attached. The child is asymptomatic. Which is the best course of action?
Teach the parents the signs and symptoms to report These factors influence the adherence to taking prescribed pediatric medication Taste, Length of treatment, cost, timing of medication as well as medical condition, belief systems and family/social factors Which lab value is most concerning in an infant with fever and a suspected bacterial infection? C-reactive protein > 10 mg/dL C-reactive protein (CRP) blood test used to measure the level of inflammation in the body; may indicate conditions that lead to cardiovascular disease; also screens for infection Functions of the musculoskeletal system protection, support, motion, storage of minerals, & manufacture of red blood cells This disorders is usually associated with adduction of the forefoot Talipes equinovarus congenita (Club Foot)
3 - week-old with equinovarus of the foot A toddler is receiving long-term antibiotics to treat osteomyelitis. Which laboratory test will the PNP order to measure response to therapy? Erythrocyte sedimentation rate (ESR) Acetaminophen Dosage 10 - 15 mg/kg every 4-6 hours Ibuprofen dosage 10 mg/kg every 6-8 hours The earliest age to give ibuprofen 6 months Neurological system of children complete but immature nervous system; top-heavy; cranial bones-thin, not well-developed; brain highly vascular with small subarachnoid space; excessive spinal mobility; wedge-shaped
cartilaginous vertebral bodies; bones in the neck don't harden and fuse until age 6; risk for injury Spastic cerebral palsy is characterized by Increased deep tendon reflexes and sustained clonus A seven-year-old child whose immunizations are up to date has a fever, headache, stiff neck, and photophobia. What course of treatment is indicated? Hospitalization for diagnosis and treatment with antibiotics symptoms of meningitis rash, stiff neck, dislike of bright lights, confused/delirious, seizures (fits); fever and/or vomiting, severe headache, very sleepy/vacant/very difficult to wake symptoms of septicemia limb, joint, or muscle pain; cold hands and feet/shivering, rash, confused/delirious, fever and/ or vomiting, pale or mottled skin, breathing fast/ breathless, very sleepy/vacant/very difficult to wake
The most common type of brain tumor in children is Medulloblastoma A head injury in which bruising or tearing of the cerebral structures occurs is a: Contusion In working with a child with Tourette syndrome and his family, the PNP should be aware that: Symptoms become more unpredictable during adolescence Cafe al lait spot large, round or oval patch of light brown pigmentation more than 6 is a problem and sizes > than 1.5cm in size is a concern for neurofibromatosis Neurofibromatosis genetic disorder with multiple benign fibrous tumors that grow anywhere in the nervous system including the brain, spinal cord, and peripheral nerves
Headache medications Acetaminophen > Ibuprofen > Naproxen > Zofran Beta-lactam antibiotics, macrolides, and fluroquinolones are all bactericidal. False Macrolides are bacteriostatic The cost and side effects are the only factors to consider when prescribing an antibiotic. Fasle What are some factors you should consider when prescribing antibiotics? The antimicrobial spectrum, the degree of antibiotic exposure, the efficacy, tolerance, toxicity, side effects and the cost are all factors to consider when prescribing an antibiotic. Approved for treatment of inhaled anthrax ciprofloxacin
Clavulanate First generation cephalosporins Cefazolin Cephalexin Cefadroxil A 12 yr old male is being seen for a well-child check. His mother states the child recently tried out for a school play but did not get a part. His mother has not addressed this with him but asks how she will she know if he is adjusting to the rejection. As a PNP what scenario would you share with the mother to demonstrate a growth in mind-set? The importance of effort and practice to succeed and looking for new approaches and strategies during a setback. Advice for parents after a febrile seizure Remember there are ways to avoid infection, such as good handwashing, no sharing of toys or utensils, and avoiding sick people. What do you tell the parents of a 2-year-old child that resists going to sleep easily, asks is it ok to let a that child sleep with them so that they all can get a good night's sleep?
This is common in toddlers and will go away soon as he works through autonomy versus shame and doubt. How should a mother explain to a 9-year-old child about a divorce when he asked what did he do wrong? Explain that he did not cause the breakup and that they both love him. Which neurological disorder is known to stop and may cause regression of developmental milestones? Rett Syndrome What type of therapy is recommended for toddlers and preschoolers? Play Therapy 9 - month-old for well-child visit and mom wants to know if he will be right handed, what should be your response? As I go through the exam, I will be evaluating his physical and developmental milestones and discuss during and at the end of the exam.
§A young adolescent reports chest pain associated with coughing and lifting. Physical examination reveals tenderness over several ribs, radiating to the back. Auscultation of the heart, lungs, and abdomen are normal. Percussion between the ribs elicits pain. There is no history of injury. What will the primary care pediatric nurse practitioner do? §Recommend NSAIDs, stretching exercises and ice packs to the area. §A child who plays soccer is in the clinic reporting pain and swelling in both knees. A physical examination reveals swelling and focal tenderness at the tibial tuberosities, with pain worsening when asked to extend the knees against resistance. What is the treatment for this condition? §Apply ice packs to both knees and avoid activities that cause pain. §During a well-child examination, the primary care pediatric nurse practitioner learns that a five-year-old child has had several episodes of walking out of the bedroom after falling asleep, looking dazed, with open eyes, and saying things that don't make sense. What will the nurse practitioner recommend? §Making sure that stairs are blocked and doors are locked §During a well-baby exam on a nine-month-old infant, the parent reports that the baby always uses the left hand to pick up objects and asks if the baby will be left-handed. What will the primary care pediatric nurse practitioner do? §Perform a careful assessment of fine and gross motor skills
To evaluate brain tissue disorders in infants, which test is useful? Ultrasonography The parent of a preschool-age child reports that the child often appears anxious and nervous and that this is associated occasionally with a rapid heart rate and tremors. What is the best type of referral that the primary care pediatric nurse practitioner could recommend? Play Therapy A 7 year old patient comes in with a unilateral axillary lymphadenopathy that has been present for 1 week. There is surrounding erythema and warmth. He tells you his cat just had kittens. You order this... Bartonella ABS panel (PCR) If your patient has cochlear implants, sickle cell, immunodeficiency, HIV, renal failure, asplenia or chronic lung or heart disease they likely need to receive this vaccine in addition to the usual... PPSV23 or pneumovax 23
The patient with asthma should have these in place prior to sports participation sports management and asthma action plans Your patient was bit by a nonvenomous snake, but appears to have a secondary infection. You treat with this.. Augmentin This screening is often administered at 18 and 24 months as an initial autism screen? MCHAT Comorbidities are frequent with this diagnosis and include sleep disorders, language disorders, reading disorders as well as emotional or behavioral disorders. ADHD This is the first- line medication treatment for uncomplicated ADHD stimulants
This type of therapy may be effective in conjunction with stimulant therapy in your ADHD patient Cognitive-Behavioral Therapy Refusing to go to people other than caregiver, overly sensitive to noise or touch, easily overwhelmed, and inability to calm self are all red flags for this. Sensory Processing Disorder Patients with initial febrile seizure under the age of one are at increased risk for this repeated febrile seizures This is the primary diagnostic tool used in the evaluation of seizure disorder EEG This may appear as altered awareness and a blank stare. It is most common between ages of 4 to 8 and the cause is predominantly genetic absence seizure This type of headache often is associated with an aura and is sometimes relieved with sleep
For an infant with known or suspected herpes, this is the treatment. Acyclovir Brudzinski's sign - or an involuntary flexion of legs when neck is flexed is indicative of this Meningitis Fever and local bone tenderness with refusal to bear weight may be indicative of this. osteomyelitis Reproducible pain with palpation at costosternal junctions costochondritis Sudden acute unilateral paralysis or weakening of facial nerve without sensory loss Bell's Palsy
Johnny's mom comes in and is worried that he is not getting enough sleep. Johnny is 3. years of age and goes to bed at around 8pm and wakes at 7am. Mom reports often he wakes up in the middle of the night screaming, but when she goes in, he seems like he is still asleep. He does not remember these dreams in the morning. You tell mom he is likely suffering from these. Night Terrors
