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NU 665 final questions with certified
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Qs A school-age child has a fractured wrist with a Salter Harris Type II fracture, according to the radiologist. What is true about this type of fracture? - n ANS✔ There is a metaphyseal fragment on the compression side of fracture. Qs What will the primary care pediatric nurse practitioner elicit when obtaining a positive Barlow maneuver when screening for developmental dysplasia of the hip? - n ANS✔ Dislocation of an unstable hip Qs A 3-year-old child is brought to the clinic by a parent who reports that the child refuses to use the right arm after being swung by both arms while playing. The child is sitting with the right arm held slightly flexed and close to the body. There is no swelling or ecchymosis present. What will the primary care pediatric nurse practitioner do? - n ANS✔ Gently attempt a supination and flexion technique.
Qs A school-age child falls off a swing and suffers a closed fracture of the right clavicle. How will this be managed? - n ANS✔ Immobilization with a sling to support the affected extremity Qs 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. There is no history of injury. What will the primary care pediatric nurse practitioner do? - n ANS✔ Recommend NSAIDs, stretching exercises, and ice packs to the area. Qs A young adolescent female is observed to have mild unequal scapula prominences on gross examination while standing. In the Adams forward bending position, this inequality disappears. What will the primary care pediatric nurse practitioner do? - n ANS✔ Discuss posture and exercise and ask about backpacks and books.
Qs A child who plays soccer is in the clinic reporting pa in 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? - n ANS✔ Apply ice packs to both knees and avoid activities that cause pain. Qs During a well baby examination of a newborn, the primary care pediatric nurse practitioner notes adduction of the right forefoot, with normal position of the mid and hindfoot, along with a convex shaped lateral border of the foot. What will the nurse practitioner do to evaluate this deformity? - n ANS✔ Grasp the heel with one hand and abduct the forefoot with the other hand. Qs During a well child examination on a 4-month-old infant, the primary care pediatric nurse practitioner evaluates mental health issues. Which statement by the parent indicates a potential problem with the parent- infant relationship? - n
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"I let my baby cry a while to learn to be patient." Qs A child has a difficult temperament. What will the primary care pediatric nurse practitioner tell the parent about managing this child's behavior? - n ANS✔ It is important for the parent to learn to manage criticism and power struggles. Qs During a well child assessment of a preschool-age child, the parent voices concerns that because the child has behavior problems at school, the child may have a mental health disorder. Which initial approach will provide the best information? JJJJ. Ask the parent whether other caregivers have voiced similar concerns. - n ANS✔ Take time to actively listen to the parent's and child's perceptions of the problem. Qs The primary care pediatric nurse practitioner attempts to learn more about the emotional health of an 18-month-old child through which assessment strategy? - n
occurred when the child was a toddler. What will the primary care pediatric nurse practitioner tell the parent? - n ANS✔ The significance of this loss must be reworked at each developmental level. Qs The parent of a school-age child reports that the child doesn't like being alone in rooms because of a fear of aliens hiding in closets. What will the primary care pediatric nurse practitioner tell the parent? - n ANS✔ "Fear of imaginary creatures does not usually occur at this age." Qs 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? - n ANS✔ Play therapy Qs A 9-year-old child exhibits school refusal and a reluctance to attend sleepovers with classmates. The parent is concerned because the child
has recently begun sleeping in the parents' bed. Which initial action by the primary care pediatric nurse practitioner is appropriate? - n ANS✔ Assess for environmental stress, parental dysfunction, and maternal depression. Qs The parent of a school-age child reports that the child becomes frustrated when unable to perform tasks well and often has temper tantrums and difficulty sleeping. Which disorder may be considered in this child? - n ANS✔ Generalized anxiety disorder (GAD) Qs The parent of a school-age girl reports that the child has difficulty getting ready for school and is often late because of a need to check and recheck whether her teeth are clean and her room light has been turned off. What will the primary care pediatric nurse practitioner recommend to this parent? - n ANS✔ Cognitive behavioral therapy Qs
Determining suicidal ideation and risk of suicide Qs An adolescent is diagnosed with major depression, and the mental health specialist has prescribed fluoxetine. What other treatment is important to protect against suicide risk? - n ANS✔ Cognitive behavioral therapy Qs A 13-year-old child has exhibited symptoms of mild depression for several weeks. The parent reports feeling relieved that the symptoms have passed but concerned that the child now seems to have boundless energy and an inability to sit still. What will the primary care pediatric nurse practitioner do? - n ANS✔ Refer the child to a child psychiatrist for evaluation of bipolar disorder. Qs A toddler has begun hitting and biting other children at a day care center and is exhibiting temper tantrums and bad language at home. The parent reports that these behaviors began shortly after a sibling was born. What will the primary care pediatric nurse practitioner do? - n ANS✔
Engage the parent in positive parenting strategies to facilitate appropriate child coping. Qs A 14-year-old female comes to the clinic with amenorrhea for 3 months. A pregnancy test is negative. The adolescent's body weight is at 82% of expected for height and age. The mother reports that her daughter often throws up and refuses to eat most foods. Which condition does the primary care pediatric nurse practitioner suspect? - n ANS✔ Anorexia nervosa Qs Which type of heat-related illness involves a core body temperature of at least 104.9°F, acute mental status changes, absent sweat, and tachypnea? - n ANS✔ Heat stroke Qs What percentage of burns is involved using the rule of nines if both front legs are burned? - n ANS✔
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Qs Which diagnostic test is the best to diagnose a subdural hematoma? - n ANS✔ Magnetic resonance imaging (MRI) Qs Patients with a spontaneous pneumothorax should be counseled that up to what percentage may experience a reoccurrence at some point? - n ANS✔ 30% Qs Most adult poisonings are: - n ANS✔ Intentional and self-inflicted Qs Which method is used to remove heavy metals, such as lead, that are ingested as poisons? - n
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Chelation Qs If a previously frostbitten area becomes frostbitten again after it has healed, what might occur? - n ANS✔ Permanent tissue damage may occur, resulting in necrosis to that body part. Qs What percentage of all visits to the emergency department (ED) are related to wounds? - n ANS✔ 12% Qs Which solution should be used when irrigating lacerated tissue over a wound on the arm? - n ANS✔ Saline irrigation or soapy water Qs
Qs Which of the following characteristics separates anaphylaxis from a vasovagal reaction? - n ANS✔ Severe bronchoconstriction Qs Delayed serum sickness-type reactions in response to multiple bee, wasp, or fire ant stings can be managed with which of the following? - n ANS✔ A corticosteroid such as prednisone (Deltasone), 60 to 100 mg, tapered over 2 weeks Qs After a head injury, what is it called when air enters into the cerebrospinal fluid (CSF)-filled spaces within the head? - n ANS✔ Pneumocephalus Qs
Cerebrospinal fluid (CSF) may leak through the cribriform plate region of the skull following a head injury and cause which of the following? - n ANS✔ Nasal CSF rhinorrhea Qs Which classic feature of an epidural hematoma may distinguish it from other skull hematomas? - n ANS✔ A brief loss of consciousness, then a brief "lucid" moment, followed by momentary unconsciousness minutes after the injury Qs A patient with a basilar skull fracture may experience an impaired downward gaze or diplopia from which affected cranial nerve? - n ANS✔ CN IV Qs A history of overuse or excessive force, as opposed to a fall, hyperextension, or the twisting of a joint, is more likely related to which musculoskeletal injury? - n ANS✔
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Acetaminophen Qs Pink, cherry red tissues and skin may result from which type of poisoning? - n ANS✔ Carbon monoxide Qs In which type of burn is the injury more extensive than it appears, and the cardiac conduction system may be affected, leading to sudden death or arrhythmias? - n ANS✔ Electrical burns Qs Eddie, age 4, presents to the ED with a live insect trapped in his ear canal causing a lot of distress. What should be your first step? - n ANS✔ Immobilize the insect with 2% lidocaine. Qs
When giving discharge instructions to a patient with a laceration injury to his lower leg, which is the most important one? - n ANS✔ Recommend cleansing the wound every 4 hours to prevent an infection. Qs Cerebellar function may be assessed by performing which examination/test? - n ANS✔ Romberg's test Qs In the epithelialization phase of wound healing, the wound will have only what percent of its normal tensile strength at 3 weeks? - n ANS✔ 15% to 20% Qs Which of the following statements is true about antibiotic prophylaxis for most wounds? - n ANS✔
