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NUNP 6541 Midterm Exam – 05 Sets
When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?
Selected Ye
Answer:
s
By what age should most children be able to sit well without support?
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NUNP 6541 Midterm Exam – 05 Sets
Selecte
d
Answer:
a.
months All of the following are consistent with peritonsillar abscess except:
Selecte
d
Answer:
c.
Exudate on tonsils You would be concerned about the language development of a child who:
Selecte
d
Answer:
a.
Stutters when excited or tired at the age of 7
Which of the following is a true contraindication of vaccinating a child?
Selecte
d
Answer:
b.
Previous vaccination reaction that consisted of wheezing and hypotension Which of the following statements about "routine" screening tests is true?
Selecte
d
Answer:
c.
Lead testing is obtained on all 12- and 14-month-old children. You are performing an examination of a 3-year-old who is new to your office. Which finding requires immediate further evaluation?
Selecte
d
Answer:
a.
Can stand briefly on one fit but cannot skip and hop.
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NUNP 6541 Midterm Exam – 05 Sets
Selecte
d
Answer:
a.
10 hours at night and 3-4 hours during the day
You see a healthy 18-month-old for a well-child visit. At the 12-month visit he
received the diphtheria, tetanus, and acellular pertussis (DTaP) third dose;
hepatitis B second dose; measles, mumps, and rubella (MMR) first dose;
injected poliovirus (IPV) second dose; pneumococcal conjugate (PCV13) fourth
dose; and Haemophilus influenzae type B (Hib) fourth dose. Which of the
following do you order today?
Selecte
d
Answer:
a.
DTaP, varicella, hepatitis A, and hepatitis B Which of the following signs may indicate a baby is not receiving sufficient breastmilk?
Selecte
d
Answer:
b.
Sleepiness and excitability 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?
Selecte
d
Answer:
c.
Maxillary sinus An expected milestone of a 4-year-old is the ability to
Selecte
d
Answer:
a.
Copy a cross
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NUNP 6541 Midterm Exam – 05 Sets
A child's head circumference is routinely measured on each well visit until what age?
Selecte
d
Answer:
d.
years
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a. 3
years A 9-year-old who weighs 70 pounds asks why she can't sit in the front passenger seat of
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NUNP 6541 Midterm Exam – 05 Sets
the family car. Your best response is
Selecte
d
Answer:
c.
Air bags are not effective for children at this age and will often not reach the child.
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:
Selecte
d
Answer:
a.
Protest when he goes to bed, but the parents should not pick him up or give him any attention.
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?
Selecte
d
Answer:
a.
Viral pharyngiti s
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?
Selecte
d
Answer:
c.
DTaP, IPV, MMR, and Varivax
A 13-month-old child is noted to be at the 25th percentile for weight, the 10th
percentile for height, and less than the 5 th^ percentile for head circumference.
She was born at term. She was noted to have a small head at birth, to be
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NUNP 6541 Midterm Exam – 05 Sets
infection At what age would a child be expected to remember a string of numbers and repeat them backwards?
Selecte
d
Answer:
a.
years
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?
Selecte
d
Answer:
c.
Oral supplementation with bicarbonate
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:
Selecte
d
Answer:
d.
Obtaining a psychiatric consultation. 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
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NUNP 6541 Midterm Exam – 05 Sets
Selecte
d
Answer:
c.
Epstein' s pearls
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Selecte
d
Answer:
d.
Sitting up and leaning forward
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Which is the correct order for introduction of solid foods to an infant?
Selecte
d
Answer:
a.
Cereal, vegetables, fruits, and meats
Role-play with equipment during the course of the physical exam would be
the most beneficial with which age group?
Selecte
d
Answer:
c.
Toddle r s
A 2-year-old boy has been slightly less than the 50th percentile for weight,
height and head circumference, but in the last 6 months he has fallen to slightly
less than the 25th percentile for weight. The pregnancy was normal, his
development is as expected, and the family reports no psychosocial problems.
The mother says that he is now a finicky eater (wants only macaroni and cheese
at all meals), but she insists that he eat a variety of foods. The meals are marked
by much frustration for everyone. His examination is normal. Which of the
following is the best next step in his care?
Selecte
d
Answer:
e.
Reassurance and counseling for family about childhood normal developmental stage
A 3-year-old (37 months) refuses to have bowel movements on the toilet. He is
bladder trained. He goes and hides and squats when having bowel movements.
Positive encouragement and praise is not working. You advise:
Selecte
d
Answer:
b.
Tell the parent this is normal; the child will eventually train himself, but it is difficult to wait.
You see a 3-year-old for a well-child visit. His mother informs you that potty
training has been very easy because he “has an amazing internal clock. He falls
asleep, gets hungry, and has bowel movements at the same time every day.”
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NUNP 6541 Midterm Exam – 05 Sets
Which adolescent would be at greatest risk for developing anorexia nervosa?
Selecte
d
Answer:
b.
14- year-old female gymnast 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?
Selecte
d
Answer:
b.
Oral Amoxicillin and topical steroids FIRST-LINE therapy for preschoolers (4-5 years of age) diagnosed with attention-deficit hyperactive disorder is:
Selecte
d
Answer:
d.
Behavio r therapy Which of the following screenings should adolescents have done annually?
Selecte
d
Answer:
b.
Blood pressure, hemoglobin, complete physical exam A 12-year-old male states he noticed an enlargement of his testes and scrotum. When counseling him about the next step in pubertal development, you state:
Selecte
d
Answer:
d.
The penis will grow in length and width.
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NUNP 6541 Midterm Exam – 05 Sets
A breastfed infant is expected to have a lower incidence of which of the following?
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c. 12
months A 2-day-old newbornwith conjunctivitis is likely due to
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Selecte
d
Answer:
c.
Chlamy d ia Which of the following strategies would not be appropriate to include as part of your treatment plan of an 8-year-old boy who is obese?
Selecte
d
Answer:
c.
Referral to nutritionist for weight reduction plan. Please interpret the following labs for an adolescent. The adolescent has a history of obesity and acanthosis nigricans.
Selecte
d
Answer:
a.
Normal fasting glucose, impaired glucose tolerance For adolescent girls, peak height velocity should occur by Tanner Stage (SMR):
Selected b.
Answer: 3
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 is worried the child’s development will not be normal because she mixes
up the two languages. You respond:
Selecte
d
Answer:
a.
"Your child's speech is normal and bilingual children commonly intermix the words from both languages until about 3 years of age."
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Results 112 mg/dL Fasting blood glucose 2 hour postprandial
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