NRNP 6541 Midterm Exam: Questions and Answers, Exams of Nursing

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NRNP 6541 Midterm Exam /

NRNP6541 Midterm Exam (

Version Q & A):Walden university

Test Week 6 - Midterm Exam Started 7/12/20 6:29 PM Submitted 7/12/20 7:24 PM Due Date 7/13/20 1:59 AM Status Completed Attempt Score 96 out of 100 points Time Elapsed 54 minutes out of 3 hours and 20 minutes Results Displayed Submitted Answers

 Question 1

0 out of 0 points When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Selected Answer: Ye s

 Question 2

1 out of 1 points Which of the following statements regarding adolescent substance use is true? Selected Answer: a. Tobacco is the most commonly abused substance during adolescence.

 Question 3

1 out of 1 points You see a 4-year-old for a well-child visit. He has received four diphtheria, tetanus, and acellular pertussis vaccines (DTaP); three injected polio vaccines (IPV); one measles, mumps, and rubella vaccine (MMR); one varicella vaccine; and two hepatitis B (Hep B) vaccines. What do you order today? Selected Answer: d. DTaP, IPV, MMR, and Varivax

 Question 4

1 out of 1 points The parents of a 7-year-old are concerned their son does not want to attend school. Which of the historical findings are not usually associated with the diagnosis of school phobia? Selected c.

 Question 10

1 out of 1 points Mark, a 10-year-old, has a lot of ear pain. He does not want anyone to touch it and is crying in pain. The ear canal is swollen and exudate is preswent. The TM is normal. What is the proper management for his patient? Selected Answer: b. Topical Fluoroquiolone

 Question 11

1 out of 1 points The diagnostic criteria for autism spectrum disorder include all of the following except Selected Answer: d. Tolerance of flexibility with routines

 Question 12

1 out of 1 points Luke, a 17-month-old, failed treatment with amoxicillin for otitis media. At the two- week recheck, his TM was still erythematous and you cannot see the landmarks. He has persistent nasal congestion, he is not sleeping at night, and he has a 101°F fever. What is the next best step for Luke? Selected Answer: d. A 10 day course of Augmentin

 Question 13

1 out of 1 points Which of the following would not suggest an eating disorder with a purging component? Selected Answer: d. Diarrhe a

 Question 14

1 out of 1 points Role-play with equipment during the course of the physical exam would be the most beneficial with which age group? Selected Answer: d. Preschoole rs

 Question 15

1 out of 1 points While assessing the skin of an infant, you note cafe-au-lait spots. Which disease should be ruled out?

Selected Answer: d. Neurofibromato sis

 Question 16

1 out of 1 points An expected milestone of a 4-year-old is the ability to Selected Answer: c. Copy a cross

 Question 17

1 out of 1 points You receive a phone call from the mother of a 2-year-old. She states her child has sleep refusal. You suggest the child should be able to: Selected Answer: a. Set his own bedtime based on his internal clock.

 Question 18

0 out of 1 points An eye that deviates in when covered but that returns to midline when uncovered is an Selected Answer: a. esotropi a

 Question 19

1 out of 1 points A 4-year-old believes there is more juice in a tall, thin glass than a shorter, wider one. The child has not yet achieved which of the principles of Piaget? Selected Answer: b. Conservati on

 Question 20

1 out of 1 points A healthy, well-developed 6-year-old child arrives as a new patient to your clinic. His immunization card reveals that he received an immunization at birth and some when he was 2 months old, but none sense. Which of the following statements about him is correct? Selected Answer: b. He is too old to receive the Haemophilus influenzae Type B vaccine.

 Question 21

Which of the following foreign body in the nose requires immediate removal? Selected Answer: c. batter y

 Question 27

1 out of 1 points Which is the correct order for introduction of solid foods to an infant? Selected Answer: d. Cereal, vegetables, fruits, and meats

 Question 28

1 out of 1 points FIRST-LINE therapy for preschoolers (4-5 years of age) diagnosed with attention-deficit hyperactive disorder is: Selected Answer: d. Behavior therapy

 Question 29

1 out of 1 points A 15-month-old boy says “mama” and “dada,” points and gestures if he wants things, and follows simple one-step commands. Your best response is which of the following? Selected Answer: c. Tell parent, "Your child's language development is normal."

 Question 30

1 out of 1 points A 4-month-old child has poor weight gain. Her current weight is less than the 5th percentile, height about the 10th percentile, and head circumference at the 50th percentile. The planned pregnancy resulted in a normal, spontaneous, vaginal delivery; mother and child were discharged after a 48-hour hospitalization. Feeding is via breast and bottle; the quantity seems sufficient. The child has had no illness. The examination is unremarkable except for the child’s small size. Screening laboratory shows the hemoglobin and hematocrit are 11 mg/dL and 33% respectively, with a platelet count of 198,000/mm3. Serum electrolyte levels are sodium 140, chloride 105, potassium 3.5, bicarbonate 17, blood urea nitrogen 15, and creatinine 0.3. Liver function tests are normal. Urinalysis reveals a pH of 8 with occasional epithelial cells but no white blood cells, bacteria, protein, ketones, or reducing substances. Which of the following is the most appropriate therapy for this child? Selected Answer: e. Oral supplementation with bicarbonate

 Question 31

1 out of 1 points Which of the following signs may indicate a baby is not receiving sufficient breastmilk? Selected Answer: c. Sleepiness, jaundice, and vomiting

 Question 32

0 out of 1 points Which of the following children should be referred for a comprehensive developmental evaluation? Selected Answer: b. A 19-month-old with explosive temper tantrums.

 Question 33

1 out of 1 points By what age should most children be able to sit well without support? Selected Answer: c. 9 months

 Question 34

1 out of 1 points I can roll over, grasp a rattle, and reach for things and have begun feeding myself finger foods, but I can’t wave bye-bye yet. How old am I? Selected Answer: d. 6 months

 Question 35

1 out of 1 points Parents bring their 16-year-old daughter for a “well-child” checkup. She looks normal on examination. As part of your routine care you plan a urinalysis. The father pulls you aside and asks you to secretly run a UDS on his daughter. Which of the following is the most appropriate course of action? Selected Answer: d. Explore the reasons for the request with the parents and the adolescent and perform a UDS with the adolescent's permission if the history warrants.

 Question 36

1 out of 1 points A teenage female who is overweight has moderate acne on the face and chest, and irregular menses. Elevation of which laboratory test provides the test evidence of

What method can be safely used to remove cerumen in a 15-month-old child's ear? Selected Answer: b. Irrigation using warm water from a soft bulb syringe

 Question 43

1 out of 1 points Max, a 9-year-old boy, is a very active child with limited self-control. He is easily distracted and has difficulty staying on task. You determine that he should have a neurodevelopmental evaluation because he is showing signs of Selected Answer: b. ADH D

 Question 44

1 out of 1 points A mother states that her 4-year-old son constantly grinds his teeth at night. You document this as: Selected Answer: c. Bruxis m

 Question 45

1 out of 1 points The father of a 3-year-old is concerned because the child stutters. What should your approach be? Selected Answer: d. Explain that this can be normal until 4 years of age.

 Question 46

1 out of 1 points A mother of a 6-month-old asks you about normal sleep patterns for an infant this age. The best response is: Selected Answer: b. 10 hours at night and 3-4 hours during the day

 Question 47

1 out of 1 points Josh, age 13, has some enlargement of the scrotum and testes, a reddened scrotal sac, and some hair texture alteration. His penis is not enlarged. He is in Tanner stage

Selected Answer: d. II

 Question 48

1 out of 1 points Which of the following eye findings would be considered an ophthalmic emergency? Selected Answer: d. Unilateral vesicular lesions on the upper eyelid in a 3-week old.

 Question 49

1 out of 1 points Mark is in the exam room. You are concerned he may have epiglottitis. In what position do these patients prefer to sit? Selected Answer: d. Sitting up and leaning forward

 Question 50

1 out of 1 points A 14-year-old female comes into the office for an urgent visit after taking 10 valium tablets. Following the initial emergent care and stailization, the most important part of the management is: Selected Answer: c. Assessing the family supports available to the child.

 Question 51

1 out of 1 points Which of the following statements about bullying is true? Selected Answer: d. It occurs most commonly during unstructured times (lunch, recess, etc.).

 Question 52

1 out of 1 points For adolescent girls, peak height velocity should occur by Tanner Stage (SMR): Selected Answer: c. 3

 Question 53

1 out of 1 points You see a 30-month-old who speaks in mixed Spanish and English. The child’s vocabulary is normal but at the low end of the normal language spectrum. The parent

Selected Answer: b. 3 years of age

 Question 59

1 out of 1 points Which of the following represents normal sequencing of development in a toddler? Selected Answer: a. Feeds self, can undress self with help, washes hands, imitates housework.

 Question 60

1 out of 1 points A 7-year-old boy with mental retardation was born at home at 26 weeks gestation to a 28- year-old mother who had received no prenatal care. An evaluation is likely to suggest his MR is related to which of the following? Selected Answer: e. Complications of prematurity

 Question 61

1 out of 1 points A child's head circumference is routinely measured on each well visit until what age? Selected Answer: b. 2 years

 Question 62

1 out of 1 points I can walk well on tiptoes, my speech is 50% understandable, I know six body parts, but I cannot balance on one foot for 1 second. I am: Selected Answer: b. 2-1/2 years old ( months)

 Question 63

1 out of 1 points An 8-year-old female is brought into the office by her mother. She has complaints of fever and sore throat for the past 2 days. She denies difficulty swallowing but has loss of appetite and mild diarrhea. A few classmates have similar symptoms. A review of systems reveals clear nasal drainage, dry cough, and hoarseness. On exam she has a 101.5 temperature, 3+ erythematous tonsils, and anterior cervical lymphadenopathy. What is the likely diagnosis? Selected Answer: a. Viral

pharyngitis

 Question 64

1 out of 1 points Sam has an otitis media. He also presents with conjunctivitis. This is due to which organism? Selected Answer: c. Haemophilus influenza

 Question 65

1 out of 1 points Blood pressure should be measured at well-child visits starting at age: Selected Answer: c. 3 years

 Question 66

1 out of 1 points Sandy, age 18 months, crosses her legs when lifted from behind rather than pulling them up. Her legs are also hard to separate, making diaper changing difficult. She persistently uses only one hand. What condition do you suspect? Selected Answer: a. Cerebral palsy

 Question 67

0 out of 1 points A common feature of 2-year-old behavior is: Selected Answer: b. Stranger anxiety

 Question 68

1 out of 1 points Appropriate anticipatory guidance for the parents of an 8-year-old girl includes Selected Answer: d. Information that the child will start to value personal idols and role models.

 Question 69

1 out of 1 points Which of the following statements is true regarding lying and stealing by the school-age

agents is most likely responsible for his condition? Selected Answer: d. Alcoh ol

 Question 75

1 out of 1 points An 11-year-old girl has dizziness, pupillary dilation, nausea, fever, techycardia, and facial flushing. She says she can "see" sound and "hear" colors. The agent likely to be responsible is which of the following? Selected Answer: e. Lysergic acid diethylamide (LSD)

 Question 76

1 out of 1 points You are performing an examination of a 3-year-old who is new to your office. Which finding requires immediate further evaluation? Selected Answer: d. An equal A-P and transverse chest diameter.

 Question 77

1 out of 1 points Please interpret the following labs for an adolescent. The adolescent has a history of obesity and acanthosis nigricans. Results Fasting blood glucose 112 mg/dL 2 hour postprandial glucose 138 mg/dL Selected Answer: d. Impaired fasting glucose, postprandial glucose within normal limits

 Question 78

1 out of 1 points A 2-year-old child weighs 34 lb. What type of car seat should the child use? Selected Answer: a. A forward-facing car seat in the back of the vehicle.

 Question 79

1 out of 1 points Most children can independently get dressed by themselves by age: Selected d.

Answer: 5 years

 Question 80

1 out of 1 points Which adolescent would be at greatest risk for developing anorexia nervosa? Selected Answer: c. 14-year-old female gymnast

 Question 81

1 out of 1 points The most common substance used in middle school is Selected Answer: d. Alcoh ol

 Question 82

1 out of 1 points Sarah, age 15, presents with pain and pressure over her cheeks and discolored nasal discharge. You cannot transilluminate the sinuses. You suspect which common sinus to be affected? Selected Answer: b. Maxillary sinus

 Question 83

1 out of 1 points What is the most traumatic, yet common form and of child abuse seen in pediatric primary care? Selected Answer: c. Shaken baby syndrome

 Question 84

1 out of 1 points A 9-year-old who weighs 70 pounds asks why she can't sit in the front passenger seat of the family car. Your best response is Selected Answer: c. The safest place for children under 12 years old and 100 pounds is in the backseat of the car.

 Question 85

1 out of 1 points

1 out of 1 points A mother brings her 4-week-old infant into the office because she noticed small yellow- white glistening bumps on her infant's gums. She says they look like teeth but is concerned that they may be cancer. You diagnose these bumps as Selected Answer: b. Epstein's pearls

 Question 92

1 out of 1 points Flourescein staining of the eye is used to detect a Selected Answer: a. Corneal abrasion

 Question 93

1 out of 1 points A new mom calls the NP on postpartum day 5. She reports her newborn wants to nurse for 30 minutes every 1-1/2 to 2 hours. Which of these is the best response? Selected Answer: b. "This is a very healthy breastfeeding pattern. Be sure to rest when you can. You are doing a great job."

 Question 94

1 out of 1 points Tammy, age 3, is at the office for her well-child visit. She has trouble removing her own shirt as requested. Her mother yanks off her shirt after smacking her wrist and saying, "you must do as you're told quickly." Which action is indicated? Selected Answer: d. Observe Tammy for signs of child abuse.

 Question 95

1 out of 1 points Which of the following injuries is most likely to be caused by abuse of a toddler? Selected Answer: c. A displaced posterior rib fracture.

 Question 96

1 out of 1 points Hannah, age 4, is brought into the office by her father. She complains of a sore throat, difficulty swallowing, copious oral secretions, stridor, and a temperature of 102F. She does not have pharyngeal erythema or cough. What do you suspect?

Selected Answer: d. Epiglottit is

 Question 97

1 out of 1 points Miguel, age 14, was hit in the eye with a baseball and developed eye pain, decreased visual acuity, and injection of the globe. Upon exam you note blood in the anterior chamber and confirm diagnosis of hyphema. What treatment do you recommend while Miguel is waiting to see the ophthalmologist Selected Answer: c. Apply bilateral eye patches.

 Question 98

1 out of 1 points Which of the following children has abnormal language development? Selected Answer: c. Speech is 50% understandable at 36 months of age

 Question 99

1 out of 1 points The parent of a 2-year-old tells you her daughter recently started having breath- holding spells. She tells you the older sibling “did the same thing” and asks you for help. You advise her that after a breath-holding event: Selected Answer: a. Act as if nothing abnormal happened.

 Question 100

1 out of 1 points You assess a 15-year-old's visual acuity and note her vision to be 20/50 in the right eye. She asks you what that means and you respond Selected Answer: d. "You can see at 20 feet with your right eye what most people can see at 50 feet."

 Question 101

1 out of 1 points You see a 5-month-old who is fussy, has interrupted sleep, and is drooling. You note large lower lateral incisor bulges. You recommend: Selected Answer: e. A and D