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MN580 FNP II – Primary Care of Children and Adolescents Health
Unit 10 Final Exam
Question 1                          2 / 2 points
A 10-day-old child presents with multiple raised lesions resembling flea bites over the trunk and nape of the neck. The infant is nursing well and has no fever or exposure to animals. These lesions likely represent:
Question options:
erythema toxicum neonatorum.
acne neonatorum.
staphylococcal skin infection.
Question 2                          2 / 2 points
A risk factor for mitral valve prolapse (MVP) includes a history of:
Question options:
rheumatic fever.
rheumatoid arthritis.
Kawasaki disease.
Marfan syndrome.
Question 3                          2 / 2 points
The most important aspect of skin care for individuals with atopic dermatitis is:
Question options:
frequent bathing with antibacterial soap.
consistent use of medium-potency to high-potency topical steroids.
application of lubricants.
treatment of dermatophytes.
Question 4                          2 / 2 points
What advice should you give to the parents of a toddler with gastroenteritis?
Question options:
Give the child sips of room temperature cola.
Give the child sips of an oral rehydration solution.
Give the child sips of a sports drink such as Gatorade®.
Try sips of apple juice mixed 1:1 with tap water.
Question 5                          2 / 2 points
When billing Medicaid, NPs get the authority to bill for their services from:
Question options:
state law only.
federal law only.
state and federal law.
neither state nor federal law.
Question 6                          0 / 2 points
The anticipated average daily weight gain during the first 3 months of life is approximately:
Question options:
15 g or 0.53 oz.
20 g or 0.7 oz.
25 g or 0.88 oz.
30 g or 1 oz.
Question 7                          2 / 2 points
The most common type of injury causing a sport-related meniscal tear involves:
Question options:
twisting of the knee.
hyperextension of the knee.
repetitive hard impact on the knee (i.e., running on hard surface).
an unknown origin in most cases.
Question 8                          2 / 2 points
The clinician anticipates that a child with mongolian spots will cry out because of discomfort when the area is pressed or palpated.
Question options:
Question 9                          2 / 2 points
Which of the following is appropriate advice to give to a mother who is breastfeeding her 12-hour-old infant?
Question options:
“You will likely have enough milk to feed the baby within a few hours of birth.”
“The baby might need to be awakened to be fed.”
“Supplemental feeding is needed unless the baby has at least four wet diapers in the first day of life.”
“The baby will likely have a seedy yellow bowel movement today.”
Question 10                        2 / 2 points
First-line therapy for acne vulgaris with closed comedones includes:
Question options:
oral antibiotics.
benzoyl peroxide.
hydrocortisone cream.
Question 11                        0 / 2 points
Kawasaki disease most commonly occurs in what age group?
Question options:
Children aged 2–3 years.
Children approaching puberty.
Children aged 1–8 years.
Question 12                        2 / 2 points
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 13                        2 / 2 points
Characteristics of onychomycosis include all of the following except:
Question options:
it is readily diagnosed by clinical examination.
nail hypertrophy.
brittle nails.
fingernails respond more readily to therapy than toenails.
Question 14                        2 / 2 points
The following chromosomal syndrome is a common etiology of social and verbal developmental delays in boys:
Question options:
Tay-Sachs disease.
cystic fibrosis.
fragile X.
trisomy 18.
Question 15                        2 / 2 points
An important part of the treatment of Kawasaki disease includes the use of:
Question options:
immune globulin.
Question 16                        2 / 2 points
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 17                        2 / 2 points
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:
Native American ancestry.
family history of type 1 DM.
personal history of polycystic ovary syndrome.
Question 18                        2 / 2 points
You examine a newborn with a capillary hemangioma on her thigh. You advise her parents that this lesion:
Question options:
is likely to increase in size over the first year of life.
should be treated to avoid malignancy.
usually resolves within the first months of life.
is likely to develop a superimposed lichenification.
Question 19                        2 / 2 points
Girls typically grow to their adult height by:
Question options:
1 year before menarche.
1 year after onset of menstruation.
age 16.
Question 20                        2 / 2 points
Of the following, the most common route of hepatitis A virus (HAV) transmission is:
Question options:
needle sharing.
raw shellfish ingestion.
ingestion of contaminated food or water.
exposure to blood and body fluids.
Question 21                        2 / 2 points
In children, which of the following conditions can contribute to bladder instability and increase the risk of a UTI?
Question options:
Upper respiratory tract infection.
Chronic diarrhea.
Efficient bladder emptying.
Question 22                        2 / 2 points
Hemoglobin A1c best provides information on glucose control over the past:
Question options:
1–29 days.
21–47 days.
48–63 days.
64–90 days.
Question 23                        2 / 2 points
An 18-year-old college freshman is brought to the student health center with a chief complaint of a 3-day history of progressive headache and intermittent fever. On physical examination, he has positive Kernig and Brudzinski signs. The most likely diagnosis is:
Question options:
viral encephalitis.
bacterial meningitis.
acute subarachnoid hemorrhage.
epidural hematoma.
Question 24                        2 / 2 points
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 25                        2 / 2 points
A cutaneous reaction nearly always occurs with the use of amoxicillin in the presence of infection with:
Question options:
human herpes virus type 1.
human papillomavirus type 11.
adenovirus type 20
Epstein-Barr virus.
Question 26                        2 / 2 points
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 27                        2 / 2 points
Type I hypersensitivity reactions, such as atopic dermatitis, involve the action of which antibodies binding to receptor sites on mast cells?
Question options:
Question 28                        2 / 2 points
Which of the following do you expect to find in the assessment of the person with urticaria?
Question options:
Low erythrocyte sedimentation rate.
Elevated thyroid-stimulating hormone level.
Question 29                        2 / 2 points
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 30                        2 / 2 points
Poststreptococcal glomerulonephritis typically occurs how long following a bacterial pharyngitis infection?
Question options:
4–6 days.
1–2 weeks.
3–4 weeks.
2 months.
Question 31                        2 / 2 points
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 32                        2 / 2 points
The most common reason for precocious puberty in girls is:
Question options:
ovarian tumor.
adrenal tumor.
exogenous estrogen.
early onset of normal puberty.
Question 33                        2 / 2 points
Which of the following is most consistent with iron-deficiency anemia?
Question options:
Low mean corpuscular volume (MCV), normal mean corpuscular hemoglobin (MCH).
Low MCV, low MCH.
Low MCV, elevated MCH.
Normal MCV, normal MCH.
Question 34                        2 / 2 points
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 35                        2 / 2 points
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 36                        2 / 2 points
Leonard is an 18-year-old man who has been taking isotretinoin (Accutane) for the treatment of acne for the past 2 months. Which of the following is the most important question for the clinician to ask at his follow-up office visit?
Question options:
Are you having any problems remembering to take your medication?
Have you noticed any dry skin around your mouth since you started using Accutane?
Do you notice any improvement in your skin?
Have you noticed any recent changes in your mood?
Question 37                        2 / 2 points
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 38                        2 / 2 points
At 3 weeks of age, the average weight, formula-fed infant should be expected to take:
Question options:
2–3 oz., or 60–90 mL, every 2–3 hours.
2–3 oz., or 60–90 mL, every 3–4 hours.
3–4 oz., or 90–118 mL, every 2–3 hours.
3–4 oz., or 90–118 mL, every 3–4 hours.
Question 39                        2 / 2 points
Compared with albuterol, levalbuterol (Xopenex) has:
Question options:
a different mechanism of action.
the ability potentially to provide greater bronchodilation with a lower dose.
an anti-inflammatory effect similar to that of an inhaled corticosteroid.
a contraindication to use in pediatric patients.
Question 40                        2 / 2 points
Diagnostic criteria for generalized anxiety disorder include all of the following except:
Question options:
difficulty concentrating.
consistent early morning wakening.
Question 41                        2 / 2 points
Regarding physiologic jaundice in the newborn, which of the following is the correct statement?
Question options:
It occurs between the first 12 and 24 hours of life.
It progresses from the abdomen toward the head of the infant.
Unconjugated bilirubin is elevated.
It can be avoided by supplemental water and dextrose feedings between breastfeeding in the first 3–4 days of life to increase infant hydration while awaiting mother’s milk to come in.
Question 42                        2 / 2 points
Serious allergic reactions caused by the use of TMP-SMX include all of the following except:
Question options:
Stevens-Johnson syndrome.
toxic epidermal necrolysis.
fixed drug eruptions.
Question 43                        2 / 2 points
Which of the following represents the most accurate patient information when using permethrin (Elimite) for treating scabies?
Question options:
To avoid systemic absorption, the medication should be applied over the body and rinsed off within 1 hour.
The patient should notice a marked reduction in pruritus within 48 hours of using the product.
Itch often persists for a few weeks after successful treatment.
It is a second-line product in the treatment of scabies.
Question 44                        2 / 2 points
What percentage of patients with infectious mononucleosis has splenomegaly during the acute phase of the illness?
Question options:
At least 10%.
About 25%.
At least 50%.
Nearly 100%.
Question 45                        2 / 2 points
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.
Question 46                        2 / 2 points
Skin lesions infected by community-acquired MRSA (CA-MRSA) often occur spontaneously on intact skin.
Question options:
Question 47                        2 / 2 points
In a malpractice case involving the NP care of a 4-year-old previously well boy with acute otitis media who is seen in a family practice primary care setting, the most appropriate expert the plaintiff may use to establish standard of care would be:
Question options:
a pediatrician.
a family nurse practitioner.
an infectious disease physician specialist.
an NP specializing in ethical and legal dilemmas.
Question 48                        0 / 2 points
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 49                        2 / 2 points
A 6-year-old boy presents with a 1-day history of a fiery red, maculopapular facial rash concentrated on the cheeks. He has had mild headache and myalgia for the past week. The most likely diagnosis is:
Question options:
erythema infectiosum.
scarlet fever.
Question 50                        2 / 2 points
A child needs to demonstrate more than one developmental red flag to warrant further evaluation.
Question options:

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