MN580 FNP II - Primary Care of
Children and Adolescents Health
Unit 1 discussion
Growth and
Development
This week’s
Discussion will address the growth and development of the child from neonate to
adolescents, cultural considerations, and the importance of communication with
the child and family in respect to age and developmental considerations. This
will build a solid knowledge base for the provider when caring for the child.
Your
professor will assign you a case to present and, in return, you will reply to
your classmates in the other cases in order to promote a robust discussion.
Please
complete each initial post in APA format following the Discussion Board grading
rubric to include, but not limited to the following:
Apply a
principle of human growth and development related to appropriate age group
Apply
developmental theory related to age group
Discuss
developmental milestones related to the age
Discuss
developmental assessment tool related to the age
Apply
cultural consideration and cultural assessment to presentation
Case 1: A
6-month-old Haitian male, both parents present at the appointment and the third
child for both parents. Child was born at 40 weeks, last seen at 4-month visit
and no concerns at that time. Child is smiling, babbling, rolls both from
abdomen to back and back to abdomen and sits with support.
Case 2: A
2-year-old Hispanic female, mother and grandmother present at the appointment,
first child for mother, sixth grandchild for grandmother. Mother speaks English
as primary language; grandmother speaks Spanish as primary language. Last well
visit was at 18 months of age and was speaking 20 words total, about 10 in
English and 10 in Spanish. Now, mother states that child has about 50 words,
with some in English and some in Spanish.
Case 3: A
4-year-old African American male, with mother, father, and paternal grandmother
present. Child is here for well check for school entry. Child speaks
approximately 100 words and only 50% intelligible.
Case 4: A
7-year-old Mexican American male with mother and maternal grandmother present.
Mother has no concerns except grandmother feels the child is “too skinny.”
Case 5: A
14-year-old Caucasian female from single-parent family with father present.
Father states that “she has always been healthy but I am worried that something
is wrong because she doesn’t talk to me anymore.”
MN580 FNP II - Primary Care of
Children and Adolescents Health
Unit 2 discussion
Pediatric
Health Maintenance Exam and PPE
The
foundation of pediatric healthcare visits, both sick and well, starts with a
thorough health history; from the data collected, an accurate physical
examination and diagnosis can be made. Primary care healthcare visits are an
integral part of ensuring the health and well-being of the child. In children
that participate in sports, a preparticipation physical examination (PPE) is
required and may be the only contact the healthy child has with their
healthcare provider. This week’s Discussion will focus on these key topics.
Your
professor will assign a topic to present and, in return, you will reply to your
classmates in the other topics in order to promote a robust discussion.
Please
complete each post in APA format following the Discussion Board grading rubric.
Topic 1:
What are the different types of pediatric health histories? When would you use
each specific type?
Topic 2:
What is the review of systems (ROS)? In a SOAP note, where does the ROS belong?
What is the relationship between the ROS and the physical exam?
Topic 3:
Shelby is a 5-year-old female, brought to the clinic by her parents and will be
starting kindergarten in the fall. The parents state that she needs her
physical and shot record to register her for school. The parents state that she
has been healthy and voice no concerns although Shelby is “scared” about the
exam and vaccines. How would you address Shelby’s fear of the exam and
vaccines? What age-appropriate screenings and lab tests are recommended for
Shelby? What immunizations will Shelby require, if any?
Topic 4:
Peyton is a 2-month-old female brought to the clinic by her 18-year-old mother
for her health maintenance exam. What should the physical examination focus on
for this child? What immunizations are due, if any? What age-appropriate
anticipatory guidance topics should be discussed with mom?
Topic 5:
George is a 12-year-old male brought to the clinic by his father and wants to
start playing football and needs a preparticipation physical examination (PPE).
He is an established patient in your practice and his last health maintenance
exam was at 11 years of age. In reviewing his health history, you note that he
has sickle cell trait but otherwise healthy. During his exam, you auscultate a
Grade I murmur, and the remaining exam is normal. Dad asks if you will clear
George to start football practice tomorrow. Would you clear George? Why or why
not? Are there any specialists George needs to see before clearance? What are
some of the preventive measures you would discuss with George and his father
related to playing sports, specifically football?
MN580 FNP II - Primary Care of
Children and Adolescents Health
Unit 3 discussion
Topic 1:
Pediatric Conditions Affecting the Eyes, Ears, Mouth, and Gastrointestinal
System
This week,
there will be a variety of conditions assigned to you by your instructor
pertaining to the eyes, ears, mouth, and gastrointestinal system. You are
expected to present your initial topic including, but not limited to, the
following items:
Pathophysiology
Epidemiology
Physical
exam findings
Differential
diagnoses and rationale
Management
plan to include diagnostic testing, medications if applicable, follow-up plans
and referrals if needed
In addition,
you are required to follow the Discussion Board grading rubric and respond to
at least three of your classmates. Topics may include:
1.
Sensorineural and conductive hearing loss
2. Otitis
media (all types)
3.
Conjunctivitis (all types) and nystagmus
4. Amblyopia
and strabismus
5.
Retinopathy of prematurity
6. Dental
caries, candidiasis, aphthous ulcers
7.
Retinoblastoma
8. Gastroesophageal
reflux disease in pediatrics
9. Peptic
ulcer disease in pediatrics
10.
Appendicitis and functional abdominal pain syndrome
11.
Intussusception and pyloric stenosis
12.
Malabsorption syndromes: Celiac disease, lactose intolerance, cow’s milk
protein intolerance or allergy
13. Failure
to thrive
14. Acute
gastroenteritis and intestinal parasites
15.
Constipation and encopresis
16.
Periorbital cellulitis and orbital cellulitis
17. Otitis
externa and mastoiditis
18. Glaucoma
and cataracts in pediatrics
19. Corneal
ulcers and hordeolum
20. Cyclic
vomiting syndrome
MN580 FNP II - Primary Care of
Children and Adolescents Health
Unit 4 discussion
Topic 1:
Cardiac and Pulmonic Pediatric Conditions
This week,
cardiac and pulmonic conditions will be assigned to you by your instructor. You
are expected to present your initial topic including, but not limited to, the
following items:
Pathophysiology
Epidemiology
Physical
exam findings
Differential
diagnoses and rationale
Management
plan to include diagnostic testing, medications if applicable, follow-up plans
and referrals if needed
In addition,
you are required to follow the Discussion Board grading rubric and respond to
at least three of your classmates. Topics may include:
Murmurs
(innocent and pathologic)
Congestive
heart disease in children
Left to
right shunting: ASD, VSD
Left to
right shunting: Atrioventricular septal defect, PDA
Right to
left shunting: Transposition of the great arteries (TGA), tetralogy of fallot,
hypoplastic left heart syndrome
Hypertension
in children
Kawasaki
Disease, acute rheumatic fever
Infective
endocarditis, pericarditis
Myocarditis,
cardiomyopathy
Syncope
Cardiac
dysrhythmias
Upper
respiratory disorders: The common cold, rhinosinusitis
Pharyngitis,
tonsillitis
Diphtheria,
pertussis
Recurrent
epistaxis, nasal foreign body
Croup,
epiglottitis
Foreign body
aspiration (laryngeal, tracheal, bronchial)
Nonbacterial
and bacterial pneumonia
Cystic
fibrosis
Pectus
deformity
MN580 FNP II - Primary Care of
Children and Adolescents Health
Unit 5 discussion
Topic 1:
Pain Management, Palliative Care, Metabolic, Endocrine, Genetic, and Chronic
Conditions and Management Plans
This week,
there will be a variety of conditions assigned to you by your instructor
pertaining to metabolic, endocrine, genetic, and chronic conditions. You are
expected to present your initial topic including, but not limited to, the
following items:
Pathophysiology
Epidemiology
Physical
exam findings
Differential
diagnoses and rationale
Management
plan to include diagnostic testing, medications if applicable, follow-up plans
and referrals if needed
In addition,
you are required to follow the Discussion Board grading rubric and respond to
at least three of your classmates. Topics may include:
Precocious
puberty
Pediatric
obesity
Hypothyroidism
Hyperthyroidism
Growth
hormone deficiency
Constitutional
growth delay
Adrenal
Insufficiency
Type 1
diabetes
Type 2
diabetes
Inborn
errors of metabolism
Phenylketonuria
Dyslipidemia
Trisomy 21
Trisomy 18
Turner
syndrome
Fragile X
syndrome
Klinefelter
syndrome
Neurofibromatosis
Fever in
children
Pain in
children
MN580 FNP II - Primary Care of
Children and Adolescents Health
Unit 6 discussion
Topic 1:
Pediatric Atopic, Immunologic, Infectious Disease, and Integumentary Conditions
and Management Plans
This week,
there will be a variety of conditions assigned to you by your instructor
pertaining to atopic, immunologic, infectious disease, and integumentary
conditions. You are expected to present your initial topic including, but not
limited to, the following items:
Pathophysiology
Epidemiology
Physical
exam findings
Differential
diagnoses and rationale
Management
plan to include diagnostic testing, medications if applicable, follow-up plans
and referrals if needed
In addition,
you are required to follow the Discussion Board grading rubric and respond to
at least three of your classmates. Topics may include:
1. Pediatric
asthma (0–4 years of age)
2. Allergic
rhinitis
3. Atopic
dermatitis, contact dermatitis
4. Juvenile
idiopathic arthritis
5. Systemic
lupus erythematosus
6. Acute
rheumatic fever
7.
Henoch-Schonlein purpura
8. Pediatric
asthma (5–11 years of age)
9. Pediatric
asthma (>12 years of age)
10. Impetigo
11.
Cellulitis
12.
Candidiasis, all types
13. Tinea
capitis, tinea corporis
14. Tinea versicolor,
pityriasis rosea
15. Scabies,
pediculosis
16. Acne
vulgaris
17.
Stevens-Johnson syndrome
18. Herpes
simplex virus
19.
Infectious mononucleosis
20. Fever of
unknown origin
MN580 FNP II - Primary Care of
Children and Adolescents Health
Unit 7 discussion
Topic 1:
Musculoskeletal, Hematologic, and Oncologic Conditions in Children and
Management Plans
This week,
there will be a variety of conditions assigned to you by your instructor
pertaining to musculoskeletal, hematologic, and oncologic conditions. You are
expected to present your initial topic including, but not limited to, the
following items:
Pathophysiology
Epidemiology
Physical
exam findings
Differential
diagnoses and rationale
Management
plan to include diagnostic testing, medications if applicable, follow-up plans
and referrals if needed
In addition,
you are required to follow the Discussion Board grading rubric and respond to
at least three of your classmates. Topics may include:
Microcytic
anemia
Thalassemias
Hemolytic
anemia
Sickle cell
anemia and trait
Hereditary
spherocytosis
Idiopathic
thrombocytopenic purpura
Hemophilias
Leukemia
Non-Hodgkin
lymphoma
Hodgkin
lymphoma
Brachial
plexus injury
Clavicle
fracture
Costochondritis
Scoliosis
Developmental
dysplasia of the hip
Legg-Calve-Perthes
disease
Slipped
capital femoral epiphysis
Genu varum,
genu valgum
Osgood-Schlatter
disease
Subluxation
of the radial head
MN580 FNP II - Primary Care of
Children and Adolescents Health
Unit 8 discussion
Topic 1:
Neurologic and Mental Health Conditions and Management Plans
This week,
there will be a variety of conditions assigned to you by your instructor
pertaining to neurologic and mental health conditions. You are expected to
present your initial topic including, but not limited to, the following items:
Pathophysiology
Epidemiology
Physical
exam findings
Differential
diagnoses and rationale
Management
plan to include diagnostic testing, medications if applicable, follow-up plans
and referrals if needed
In addition,
you are required to follow the Discussion Board grading rubric and respond to
at least three of your classmates. Topics may include:
Night
terrors, nightmares
Attention-deficit/hyperactivity
disorder
Learning
disorders
Sensory
processing disorder
Autistic
spectrum disorders
Anxiety
disorder (separation and generalized)
Obsessive-compulsive
disorder
Tic
disorders
Posttraumatic
stress disorder
Depression
Bipolar
disorder
Oppositional
defiant disorder
Eating
disorders
Cerebral
palsy
Epilepsy and
seizure disorder
Headaches in
children
Disturbances
of head growth
Guillain-Barre
syndrome
Head injury
CNS
infection
MN580 FNP II - Primary Care of
Children and Adolescents Health
Unit 9 discussion
Topic 1:
Genitourinary, Gynecologic, and Adolescent Health and Management Plans
This week,
there will be a variety of conditions assigned to you by your instructor
pertaining to genitourinary, gynecologic, and adolescent health conditions. You
are expected to present your initial topic including, but not limited to, the
following items:
Pathophysiology
Epidemiology
Physical
exam findings
Differential
diagnoses and rationale
Management
plan to include diagnostic testing, medications if applicable, follow-up plans
and referrals if needed
In addition,
you are required to follow the Discussion Board grading rubric and respond to
at least three of your classmates. Topics may include:
Urinary
tract infection, pyelonephritis
Vesicoureteral
reflux
Hematuria
Proteinuria
Hypospadias
Cryptorchidism
Hydrocele
Varicocele
Inguinal
hernia
Labial
adhesions
Vulvovaginitis
Dysmenorrhea
Amenorrhea
Dysfunctional
uterine bleeding
Vaginitis
Polycystic
ovary syndrome
Gynecomastia
in adolescent males
Adolescent
pregnancy
Suicidality
in adolescents
Substance
abuse in adolescents
MN580 FNP II - Primary Care of
Children and Adolescents Health
Unit 10 discussion
Topic 1:
Assessment of the Neonate, Child Abuse and Neglect, Environmental Health, and
Complementary Therapies in Pediatrics
This week,
there will be a variety of conditions assigned to you by your instructor
pertaining to the neonate, child abuse, child neglect, and environmental health
conditions. You are expected to present your initial topic including, but not
limited to, the following items:
Pathophysiology
Epidemiology
Physical
exam findings
Differential
diagnoses and rationale
Management
plan to include diagnostic testing, medications if applicable, follow-up plans
and referrals if needed
In addition,
you are required to follow the Discussion Board grading rubric and respond to
at least three of your classmates. Topics may include:
Milia,
erythema toxicum, cutis marmorata
Branchial
cleft, thyroglossal cyst
Caput
succedaneum, cephalhematoma
Cleft lip
and palate
Pyloric
stenosis
Neonatal
jaundice
Sudden
infant death syndrome, apparent life-threatening events
Mercury
poisoning
Lead
poisoning
Environmental
tobacco smoke exposure
Carbon
monoxide poisoning
Pesticide
exposure
Noise
pollution
Child
neglect
Physical
abuse
Sexual abuse
Emotional
abuse
Verbal abuse
Mold
exposure
Burns
MN580 FNP II - Primary Care of
Children and Adolescents Health
Unit 2 assignment
Anticipatory Guidance for Neonates to Adolescents
Table
Anticipatory guidance helps family, caregivers, and
others know what to expect according to the child’s growth and development. The
guidance is done through collaboration between the healthcare provider and the
caregiver. It is sometimes thought of as a type of counseling. Nurse
practitioners working in pediatric primary care need to be experts on
anticipatory guidance. There are excellent resources available and these are being
updated as technologies and environments change.
This Assignment will demonstrate your ability to
describe age-specific anticipatory guidance for the child and the family.
Additionally, you will then have a reference table for quick glance created by
you for future encounters with pediatric individuals and their families.
This assignment has a template that you will use to
fill in the relevant elements of the anticipatory guidance per age group. The
columns provide guidance to the specific areas such as safety and
immunizations. If there is an area that is not applicable, such as oral health
in infancy-newborn group, then place N/A in the box.
Submit your assignment to the Unit 2 Dropbox.
|
AGE GROUP
|
PHYSICAL DEVELOPMENT AND MENTAL HEALTH
|
NUTRITION AND PHYSICAL ACTIVITY
|
ORAL HEALTH
|
SAFETY CONCERNS
|
IMMUNIZATIONS
|
|
Infancy- Newborn Visit
|
|
|
|
|
|
|
Infancy-First Week Visit
|
|
|
|
|
|
|
Infancy-1 Month Visit
|
|
|
|
|
|
|
Infancy-2 Month Visit
|
|
|
|
|
|
|
Infancy-4 Month Visit
|
|
|
|
|
|
|
Infancy-6 Month Visit
|
|
|
|
|
|
|
Infancy-9 Month Visit
|
|
|
|
|
|
|
Early Childhood-12 Month Visit
|
|
|
|
|
|
|
Early Childhood-15 Month Visit
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Early Childhood-18 Month Visit
|
|
|
|
|
|
|
Early Childhood-2 Year Visit
|
|
|
|
|
|
|
Early Childhood-2.5 Year Visit
|
|
|
|
|
|
|
Early Childhood-3 Year Visit
|
|
|
|
|
|
|
Early Childhood-4 Year Visit
|
|
|
|
|
|
|
Middle Childhood-5 and 6 Year Visits
|
|
|
|
|
|
|
Middle Childhood-7 and 8 Year Visits
|
|
|
|
|
|
|
Middle Childhood-9 and 10 Year Visits
|
|
|
|
|
|
|
Early Adolescence-11 to 14 Year Visits
|
|
|
|
|
|
|
Middle Adolescence-15 to 17 Year Visits
|
|
|
|
|
|
|
Late Adolescence-18 to 21 Year Visits
|
|
|
|
|
|
Assignment Requirements:
Before finalizing your work, you should:
be sure to read the Assignment description carefully;
consult the Grading Rubric (under the Course
Resources) to make sure you have included everything necessary; and
utilize spelling and grammar check to minimize errors.
Your writing Assignment should:
follow the conventions of Standard English (correct
grammar, punctuation, etc.);
be well ordered, logical, and unified, as well as
original and insightful;
display superior content, organization, style, and
mechanics; and
use APA 6th Edition format.
MN580 FNP II - Primary
Care of Children and Adolescents Health
Unit 3 assignment
The i-Human® scenario below is designed to help you
move through a simulated clinical patient scenario. Your work will be scored by
i-HUMAN rubric below and transferred to a grade in the gradebook by faculty.
This assignment is worth 100 points.
Grading criteria for assignment are:
History = 30
Physical Exam = 30
Differential Diagnosis = 15
Rank Diff Dx = 5
Must not Miss Diagnoses = 5
Test Selection = 15
The follow up review i-Human Seminar will be held in
Unit 4 and is mandatory either by live attendance or review of recording and
alternative assignment. This is worth 20 points.
For this activity, you will need to login to your
i-Human account. Instructions for logging-in are as follows:
Go to https://ih2.i-human.com/.
Log in with your credentials (username and password).
Select “Assignments” from the menu options on the top
left of the screen.
Press the green play button next to the I Human
Testing Mode Ryan for the case study.
The case study will open; click Start to begin.
Complete all elements of the case study (history,
physical exam, assessment, etc.)
Once you have successfully completed the Assignment,
take a screenshot of the last screen of the activity, paste it into a Microsoft
Word document, save your document, and Submit your Assignment to the unit
Dropbox before midnight on the last day of the unit.
For help creating a screenshot, visit the website
below.
Take a Screenshot. Retrieved from
http://www.take-a-screenshot.org
MN580 FNP II - Primary
Care of Children and Adolescents Health
Unit 5 assignment
i-Human Case
The i-Human® scenario below is designed to help you
move through a simulated clinical patient scenario. Your work will be scored by
i-HUMAN rubric below and transferred to a grade in the gradebook by faculty.
This assignment is worth 100 points.
Grading criteria for assignment are:
History = 30
Physical Exam = 30
Differential Diagnosis = 15
Rank Differential Diagnosis = 5
Rank Differential Diagnosis (must not miss) = 5
Lab Tests Ordered = 15
The follow up review i-Human Seminar will be held in
Unit 6 and is mandatory either by live attendance or review of recording and
alternative assignment. These Seminar is worth 20 points.
For this activity, you will need to login to your
i-Human account. Instructions for logging-in are as follows:
Go to https://ih2.i-human.com/.
Log in with your credentials (username and password).
Select “Assignments” from the menu options on the top
left of the screen.
Press the green play button next to the Johnson for
Kaplan University case study.
The case study will open; click Start to begin.
Complete all elements of the case study (history,
physical exam, assessment, etc.)
Once you have successfully completed the Assignment,
take a screenshot of the last screen of the activity, paste it into a Microsoft
Word document, save your document, and Submit your Assignment to the unit
Dropbox before midnight on the last day of the unit.
For help creating a screenshot, visit the website
below.
Take a Screenshot. Retrieved from
http://www.take-a-screenshot.org
MN580 FNP II - Primary
Care of Children and Adolescents Health
Unit 6 assignment
Applying Current Evidence Based Practice Guidelines
for the Diagnosis and Treatment of Acute Bacterial Sinusitis in Pediatric
Patients Using Healthcare Informatics.
This assignment will demonstrate your ability to use
healthcare informatics to apply current evidence-based practice guidelines to
the management of a pediatric patient diagnosed with acute bacterial sinusitis.
The guidelines that you are to use are in the
following article available in the online Purdue Global library.
Hauk, L. (2014). AAP releases guideline on diagnosis
and management of acute bacterial sinusitis in children one to 18 years of age.
American Family Physician, 89(8), 676-681.
This assignment has a template that you will use to
fill in the requested information.
Please submit to the Dropbox when you have completed
your assignment.
|
|
Pediatric
Client with Acute Bacterial Sinusitis
|
|
List the
clinical criteria that must be present to support this diagnosis in pediatric
patients from newborn to 21 years of age. Categorize clinical signs and
symptoms by: Persistent Symptoms, Severe Onset, or Worsening Symptoms.
|
List Criteria
for Persistent Symptoms.
|
List Criteria
for Severe Onset of Symptoms.
|
List Criteria
for Worsening Symptoms.
|
|
When
would imaging studies be indicated?
|
|
|
What is the
recommended Antibiotic for Child with No Known Allergies?
Provide dose,
frequency, mg., ml., length of treatment, number of dosing units (i.e.
prescription information).
|
|
|
What is the
second line Recommended Antibiotic for Child with allergy to PCN
Provide dose,
frequency, mg., ml., length of treatment, number of dosing units (i.e.
prescription information).
|
|
|
When is
Referral indicated?
|
|
|
What
additional medications and or treatment strategies are recommended for
treatment or symptomatic control
|
|
|
What is the
treatment change in a child with worsening symptoms at 72 hours after
initiation of antibiotic
|
|
|
When is
outpatient 72 hour “observation” acceptable?
|
|
|
What modifications
would be needed for the following children:
Four year old
who is otherwise healthy
|
|
|
Child with
immune deficiency
|
|
|
Child with
two prior sinus infections
|
|
|
Child with
cystic fibrosis
|
|
|
What other
conditions would modify these treatment recommendations?
|
|
MN580 FNP II - Primary
Care of Children and Adolescents Health
Unit 7 assignment
Collaboration Paper
This assignment is a formal paper. This includes: APA
format, title page, headings, literature review, proper citation per APA,
logical sequence, conclusions, clarity, understanding of the topic, and
reference list. The paper should be 3-5 pages in length excluding the title
page and reference page. The paper must
demonstrate independent ideas and conclusions.
At a minimum, the following topics must be well articulated in the
paper. Remember that discussion of each topic requires citations that are
current (less than 5 years old) and relevant.
Please refer to the grading rubric for how your paper will be graded.
Explain how multidisciplinary collaboration can affect
clinical decision making.
Discuss how collaboration can lead to improved patient
outcomes.
Discuss how lack of collaboration can lead to poor
patient outcomes.
Identify three barriers to professional collaboration
among healthcare professionals and patients?
What are the five best ways to promote professional
collaboration in pediatric primary care?
How can the nurse practitioner encourage and support
collaboration among the patient, family, caregivers, and healthcare
professionals?
Assignment Requirements:
Before finalizing your work, you should:
be sure to read the Assignment description carefully
(as displayed above);
consult the Grading Rubric (under the Course
Resources) to make sure you have included everything necessary; and
utilize spelling and grammar check to minimize errors.
Your writing Assignment should:
follow the conventions of Standard English (correct
grammar, punctuation, etc.);
be well ordered, logical, and unified, as well as
original and insightful;
display superior content, organization, style, and
mechanics; and
use APA 6th Edition format.
Submit your Assignment to the unit Dropbox before
midnight on the last day of the unit.
Unit 3 Quiz
Question 1
In the U.S.,
the average child has between six and eight URIs a year.
Question
options:
True
False
Question 2
Correct
handwashing does not make a significant difference in preventing the spread of
common URI viruses.
Question
options:
True
False
Question 3
Fever is not
a common sign of URI.
Question options:
True
False
Question 4
The Food and
Drug Administration (FDA) has issued a warning advisement against administering
any over the counter medications for URI symptomatic relief to children under
two years of age.
Question
options:
True
False
MIDTERM
EXAM
Random
Section 1
Question 1
When
advising a patient about the influenza nasal spray vaccine, the NP considers
the following:
Question
options:
1)
Its use is
acceptable during pregnancy.
2)
Its use is
limited to children younger than 6 years.
3)
It contains
live, attenuated virus.
4)
This is the
preferred method of influenza protection in the presence of airway disease.
Question 2
Which of the
following is true about the MMR vaccine?
Question
options:
1)
This vaccine
contains live virus.
2)
Its use is
contraindicated in persons with a history of egg allergy.
3)
Revaccination
of an immune person is associated with risk of allergic reaction.
4)
One dose is
recommended for young adults who have not been previously immunized.
Question 3
Which of the
following is the most prudent first-line treatment choice for an otherwise well
toddler with acute otitis media (AOM) who requires antimicrobial therapy?
Question
options:
1)
Ceftibuten.
2)
Amoxicillin.
3)
Cefuroxime.
4)
Azithromycin.
Question 4
The most
common causative organism of bronchiolitis is:
Question
options:
1)
haemophilus
influenzae.
2)
parainfluenza
virus.
3)
respiratory
syncytial virus.
4)
coxsackievirus.
Question 5
At which of
the following ages in an infant's life is parental anticipatory guidance about
teething most helpful?
Question
options:
1)
1–2 months.
2)
2–4 months.
3)
4–6 months.
4)
8–10 months.
Question 6
A young
child should use a rear-facing car seat until at least age:
Question
options:
1)
12 months.
2)
18 months.
3)
24 months.
4)
30 months.
Question 7
Risk factors
for dyslipidemia in children include which of the following? Select all that
apply.
Question
options:
1)
Blood
pressure at the 70th to 80th percentile for age.
2)
Breastfeeding
into the toddler years.
3)
Family
history of lipid abnormalities.
4)
Family
history of type 2 diabetes mellitus.
Question 8
Which of the
following laboratory tests can identify the causative organism of
bronchiolitis?
Question
options:
1)
Nasal
washing antigen test.
2)
Antibody
test via blood sample.
3)
Urine
culture.
4)
A laboratory
test is not available.
Question 9
Physical
examination findings in otitis externa include:
Question
options:
1)
tympanic
membrane immobility.
2)
increased
ear pain with tragus palpation.
3)
tympanic
membrane erythema.
4)
tympanic
membrane bullae.
Question 10
Which of the
following findings is most consistent with the diagnosis of acute bacterial
rhinosinusitis (ABRS)?
Question
options:
1)
Upper
respiratory tract infection symptoms persisting beyond 7 to 10 days.
2)
Mild
midfacial fullness and tenderness.
3)
Preauricular
lymphadenopathy.
4)
Marked
eyelid edema.
Question 11
Aortic stenosis
in a 15-year-old male is most likely:
Question
options:
1)
a sequela of
rheumatic fever.
2)
a result of
a congenital defect.
3)
calcific in
nature.
4)
found with
atrial septal defect.
Question 12
Which of the
following do you expect to find in an examination of a 2-week-old infant?
Question
options:
1)
A visual
preference for the human face.
2)
A preference
for low-pitched voices.
3)
Indifference
to the cry of other neonates.
4)
Poorly
developed sense of smell.
Question 13
An
18-year-old woman has a chief complaint of a “sore throat and swollen glands”
for the past 3 days. Her physical examination includes a temperature of 101° F
(38. 3° C), exudative pharyngitis, and tender anterior cervical
lymphadenopathy. Right and left upper quadrant abdominal tenderness is absent.
The most likely diagnosis is:
Question
options:
1)
streptococcus
pyogenes pharyngitis.
2)
infectious
mononucleosis.
3)
viral
pharyngitis.
4)
vincent
angina.
Question 14
At which of
the following ages in a young child's life is parental anticipatory guidance
about infant sleep position most helpful?
Question
options:
1)
Birth.
2)
2 weeks.
3)
2 months.
4)
4 months.
Question 15
With regard
to seasonal influenza prevention in well children, the NP considers that:
Question
options:
1)
compared
with school-aged children, younger children (? 24 months old) have an increased
risk of seasonal influenza-related hospitalization.
2)
a full adult
dose of seasonal influenza vaccine should be given starting at age 4 years.
3)
the use of
the seasonal influenza vaccine in well children is discouraged.
4)
widespread
use of the vaccine is likely to increase the risk of eczema and antibiotic
allergies.
Question 16
Rebound
tenderness is best described as abdominal pain that worsens with:
Question
options:
1)
light
palpation at the site of the discomfort.
2)
release of
deep palpation at the site of the discomfort.
3)
palpation on
the contralateral side of the abdomen.
4)
deep
palpation at the site of the discomfort.
Question 17
A Still
murmur:
Question
options:
1)
is heard in
the presence of cardiac pathology.
2)
has a
humming or vibratory quality.
3)
is a reason
for denying sports participation clearance.
4)
can become
louder when the patient is standing.
Question 18
Common
causative organisms of acute suppurative conjunctivitis include all of the
following except:
Question
options:
1)
staphylococcus
aureus.
2)
haemophilus
influenzae.
3)
streptococcus
pneumoniae.
4)
pseudomonas
aeruginosa.
Question 19
Which of the
following imaging studies potentially exposes the patient being evaluated for
abdominal pain to the lowest ionizing radiation burden?
Question
options:
1)
Ultrasound.
2)
Barium
enema.
3)
CT scan.
4)
Abdominal
flat plate.
Question 20
At which age
is a child at greatest risk of death from pertussis?
Question
options:
1)
<1 year.
2)
2–4 years.
3)
5–10 years.
4)
>10
years.
Question 21
A healthy
3-year-old child is in your office for well-child care. You expect this child to
be able to:
Question
options:
1)
name five
colors.
2)
alternate
feet when climbing stairs.
3)
speak in
two-word phrases.
4)
tie
shoelaces.
Question 22
Treatment
options in acute and recurrent allergic conjunctivitis include all of the following
except:
Question
options:
1)
cromolyn
ophthalmic drops.
2)
oral
antihistamines.
3)
ophthalmological
antihistamines.
4)
corticosteroid
ophthalmic drops.
Question 23
Rectal
bleeding associated with anal fissure is usually described by the patient as:
Question
options:
1)
drops of
blood noticed when wiping.
2)
dark brown
to black in color and mixed in with normal-appearing stool.
3)
a large
amount of brisk red bleeding.
4)
significant
blood clots and mucus mixed with stool.
Question 24
Concerning
the MMR vaccine, which of the following is true?
Question
options:
1)
The link
between use of MMR vaccine and childhood autism has been firmly established.
2)
There is no
credible scientific evidence that MMR use increases the risk of autism.
3)
The use of
the combined vaccine is associated with increased autism risk, but giving the
vaccine's three components as separate vaccines minimizes this risk.
4)
The vaccine
contains thimerosal, a mercury derivative.
Question 25
You are
examining an 18-year-old man who is seeking a sports clearance physical
examination. You note a mid-systolic murmur that gets louder when he stands.
This may represent:
Question
options:
1)
aortic
stenosis.
2)
hypertrophic
cardiomyopathy.
3)
a
physiologic murmur.
4)
a Still's
murmur.
Final Exam
Question 1
Which of the
following is an oral antimicrobial option for the treatment of a
community-acquired methicillin-resistant S. aureus cutaneous infection?
Question
options:
Amoxicillin.
Dicloxacillin.
Cephalexin.
Trimethoprim-sulfamethoxazole.
Question 2
The most
common renal stones are composed of:
Question
options:
calcium.
uric acid.
sodium.
iron.
Question 3
At which of
the following ages should screening begin for a child who has significant risk
of lead poisoning?
Question
options:
3 months.
6 months.
1 year.
2 years.
Question 4
An 18-year-old
high school senior presents, asking for a letter stating that he should not
participate in gym class because he has asthma. The most appropriate action is
to:
Question
options:
write the
note because gym class participation could trigger asthma symptoms.
excuse him
from outdoor activities only to avoid pollen exposure.
assess his
level of asthma control and make changes in his treatment plan if needed so he
can participate.
write a note
excusing him from gym until his follow-up exam in 2 months.
Question 5
Sam is a
4-year-old boy who presents with a 1-week history of intermittent fever, rash,
and watery, red eyes. Clinical presentation is of an alert child who is
cooperative with examination but irritable, with a temperature of 38° C(100.4°
F), pulse rate of 132 bpm, and respiratory rate of 38/min. Physical examination
findings include nasal crusting; dry, erythematous, cracked lips; red, enlarged
tonsils without exudate; and elevated tongue papillae. The diagnosis of
Kawasaki disease is being considered. Additional findings are likely to
include:
Question
options:
vesicular-form
rash.
purulent
conjunctivitis.
peeling
hands.
occipital
lymphadenopathy.
Question 6
Acanthosis
nigricans is commonly noted in all of the following areas except:
Question
options:
groin folds.
axilla.
nape of the
neck.
face.
Question 7
To obtain
the most accurate hydration status in a child with acute gastroenteritis, the
NP should ask about:
Question
options:
the time of
last urination.
thirst.
quantity of
liquids taken.
number of
episodes of vomiting and diarrhea.
Question 8
In a
13-year-old female patient with mild acne and who experiences an inadequate
response to benzoyl peroxide treatment, an appropriate treatment option would
be to:
Question
options:
add a
topical retinoid.
add an oral
antibiotic.
consider
isotretinoin.
consider
hormonal therapy.
Question 9
A mother
brings to the clinic her 3-year-old daughter, who presents with dry red patches
on her face around the eyes. The mother has observed her daughter constantly
rubbing the area, which has caused swelling around the eyes. Physical
examination is consistent with atopic dermatitis. The NP considers this is a
diagnosis that:
Question
options:
requires a
skin culture to confirm contributing bacterial organisms.
should be
supported by a biopsy of the affected area.
necessitates
obtaining peripheral blood eosinophil level
is usually
made by clinical assessment alone.
Question 10
A 6-year-old
boy has a 1-year history of moderate persistent asthma that is normally well
controlled with budesonide via dry powder inhaler (DPI) twice a day and the use
of albuterol once or twice a week as needed for wheezing. Three days ago, he
developed a sore throat, clear nasal discharge, and a dry cough. In the past 24
hours, he has had intermittent wheezing, necessitating the use of albuterol two
puffs with use of an age-appropriate spacer every 3 hours, with partial relief.
Your next most appropriate action is to obtain:
Question
options:
a chest
radiograph.
an oxygen
saturation measurement.
a peak
expiratory flow (PEF) measurement.
a sputum
smear for WBCs.
Question 11
Worldwide,
which of the following is the most common type of anemia?
Question
options:
Pernicious
anemia.
Folate-deficiency
anemia.
Anemia of
chronic disease.
Iron-deficiency
anemia.
Question 12
Celeste is a
9-year-old girl with moderate persistent asthma. She is not taking a prescribed
inhaled corticosteroid but is using albuterol PRN to relieve her cough and
wheeze. According to her mother, she currently uses about six albuterol doses
per day, in particular for cough and wheeze after active play. You consider
that:
Question
options:
albuterol
use can continue at this level.
excessive
albuterol use is a risk factor for asthma death.
she should
also use salmeterol (Serevent) to reduce her albuterol use.
active play
should be limited to avoid triggering cough and wheeze
Question 13
In medical
coding, the abbreviation CPT stands for:
Question
options:
current
pricing tier.
current
procedural terminology.
clinical
practice terminology.
compendium
of procedures and therapy.
Question 14
First-line
treatment of impetigo with less than 5 lesions of 1–2 centimeters in diameter
on the legs in a 9-year-old girl is:
Question
options:
topical
mupirocin.
topical
neomycin.
oral
cefixime.
oral
doxycycline.
Question 15
After
inhaled corticosteroid is initiated, improvement in control is usually seen:
Question
options:
on the first
day of use.
within 2–8
days.
in about 3–4
weeks.
in about 1–2
months.
Question 16
Which
precursor of vitamin D is the form that is commonly measured in laboratory
tests to determine vitamin D status?
Question
options:
Vitamin D2.
25-hydroxyvitamin
D.
Vitamin D3.
1,
25-dihydroxyvitamin D.
Question 17
When
compared with children with private insurance, those with Medicaid and CHIP
are:
Question
options:
comparable
in access to health care and meeting several core measures in preventive care.
more
deficient in several core measures of preventive care.
less likely
to see primary care providers.
more likely
to receive mandatory immunizations.
Question 18
Which of the
following best describes asthma?
Question
options:
Intermittent
airway inflammation with occasional bronchospasm.
A disease of
bronchospasm that leads to airway inflammation.
Chronic
airway inflammation with superimposed bronchospasm.
Relatively
fixed airway constriction.
Question 19
During an
outbreak of meningococcal meningitis, all of the following can be used as
chemoprophylaxis except:
Question
options:
a single
dose of ceftriaxone.
multiple
doses of rifampin.
multiple
doses of amoxicillin.
a single
dose of meningococcal conjugate vaccine (MCV4 or Menactra).
Question 20
The
clinician anticipates that a child with mongolian spots will cry out because of
discomfort when the area is pressed or palpated.
Question
options:
True
False
Question 21
A
14-year-old male presents with acne consisting of 25 comedones and 20
inflammatory lesions with no nodules. This patient can be classified as having:
Question
options:
mild acne.
moderate
acne.
severe acne.
very severe
acne.
Question 22
Which of the
following is consistent with the NAEPP comment on the use of inhaled
corticosteroids (ICS) for a child with asthma?
Question options:
The
potential but small risk of delayed growth with ICS is well balanced by their
effectiveness.
ICS should
be used only if leukotriene modifiers fail to control asthma.
Permanent
growth stunting is consistently noted in children using ICS.
Leukotriene
modifiers are equal in therapeutic effect to the use of a long-acting
beta2-agonist.
Question 23
A potential
adverse effect from ICS use is:
Question
options:
oral
candidiasis.
tachycardia.
gastrointestinal
upset.
insomnia.
Question 24
A Still
murmur:
Question
options:
is an
indication to restrict sports participation selectively.
has a
buzzing quality.
is usually
heard in patients who experience dizziness when exercising.
is a sign of
cardiac structural abnormality.
Question 25
In medical
coding, the abbreviation ICD stands for:
Question
options:
insurance
code for diagnoses.
integrated
clinical dilemmas.
international
classification of diseases.
initial
classification of the diagnosis.
Question 26
A common
site for atopic dermatitis in an infant is:
Question
options:
the diaper
area.
the face.
the neck.
the
posterior trunk.
Question 27
When
counseling the family of an otherwise healthy 2-year-old child who just had a
febrile seizure, you consider which of the following regarding whether the
child is at risk for future febrile seizures?
Question
options:
The
occurrence of one febrile seizure is predictive of having another.
Intermittent
depakote can be used prophylactically during febrile illness to reduce risk of
recurrence.
A milder
temperature elevation in a child with a history of a febrile seizure poses
significant risk for future recurrent febrile and nonfebrile seizures.
Consistent
use of antipyretics during a febrile illness will significantly reduce the risk
of a future febrile seizure.
Question 28
In
counseling a patient with scabies, the NP recommends all of the following
methods to eliminate the mite from bedclothes and other items except:
Question
options:
wash items
in hot water.
run items
through the clothes dryer for a normal cycle.
soak items
in cold water for at least 1 hour.
place items
in a plastic storage bag for at least 1 week.
Question 29
You are
seeing 17-year-old Cynthia. As part of the visit, you consider her risk factors
for type 2 DM would likely include all of the following except:
Question
options:
obesity.
Native
American ancestry.
family
history of type 1 DM.
personal
history of polycystic ovary syndrome.
Question 30
When billing
commercial insurance, NPs get the authority to bill for their services from:
Question
options:
state law
only.
federal law
only.
state law
and/or the commercial payers.
federal law
and/or commercial payers.
