NUNP 6541 Pediatric Final Exam-Walden U 1
Latest Update 2024-2025 180 Questions and
100% Verified Correct Answers Actual Exam
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2-year-old girl with increased work of breathing had a fever, abdominal pain, post-
tussive emesis and no diarrhea. What lab test would be beneficial? - CORRECT
ANSWER: Rapid flu test, respiratory viral panel
3-week-old male infant with projective vomiting and constant feeding: what would be the
most likely diagnosis? - CORRECT ANSWER: Pyloric stenosis
4 year old being treated with chemotherapy; which immunizations should he avoid? -
CORRECT ANSWER: MMR and Varicella because they are live-attenuated vaccines
5 year old has mild leg bowing, what labs would you order? - CORRECT ANSWER:
Vitamin D, Phosphorus
6-month-old with newly diagnosed sickle cell disease, what should you do on the visit of
a well-baby visit? - CORRECT ANSWER: Educate regarding risk of infection due to
asplenia and need to seek medical attention promptly for eval of febrile illness. If febrile,
immediate referral for blood culture and empiric abx against s.pneumo and Hib.
Prevention is key! Factors that may precipitate events: dehydration, hypoxia, fever,
exposure to extreme temps; how to manage pain; how to recognize signs of serious
prob.
Anticipatory guidance regarding developmental issues such as toilet training, school
attendance, delayed growth & development
A 11-year-old who presents with weight loss, polyuria, and polydipsia. What do you
need to rule out ? - CORRECT ANSWER: Diabetes
,A 14-month-old that has lower extremity bowing. Lab values what would be the most
likely diagnosis? - CORRECT ANSWER: Vitamin D, Phosphorus, Calcium
A 14-year-old who has not started menstrual cycle - CORRECT ANSWER:
Chromosomal or genetic abnormalities can cause the ovaries to stop functioning
normally. Turner syndrome, a condition caused by a partially or completely missing X
chromosome, and androgen insensitivity syndrome, often characterized by high levels
of testosterone
Problems with the hypothalamus or pituitary gland in the brain can cause an imbalance
of hormones that can prevent periods from starting
A 2-year-old who was brought in with fever, poor feeding, getting worse since yesterday,
appears ill, temp 101, tachycardic, x-ray of left hip shows widen joint space but no
fractures what would you do at this point? - CORRECT ANSWER: Oral antibiotics
(cephalosporin or clindamycin) and recheck in 2 days
A 3 yr old presents with wheezing for past 3 months, what tests would you order? -
CORRECT ANSWER: Spirometry
A 5-year-old with acute lymphocytic leukemia. What is he at risk for developing? -
CORRECT ANSWER: Bleeding febrile neutropenia
A 5-year-old with encopresis what would your next action be after diagnosis? -
CORRECT ANSWER: Goal is to establish a regular bowel routine.
Bowel evacuation using oral PEG solutions (if problem is constipation)
If not constipation, establish a structured toileting pattern
A 5-year-old with type 1 diabetes and management of the insulin requirement -
CORRECT ANSWER: Children with newly diagnosed type 1 diabetes usually require an
initial total daily dose of ∼0.5-1.0 units/kg. In general, younger (and prepubertal)
children require lower doses while the presence of ketoacidosis, use of steroids, and the
hormonal changes of puberty all dictate higher doses
,It is common for a newly diagnosed child's diabetes to enter a honeymoon phase with
an increase in insulin production within several weeks after the initiation of insulin
therapy. During this phase of diabetes, insulin requirements may fall well below the
initial dose of 0.5-1.0 units/kg per day needed to maintain blood glucose targets.
Children may require only minimal amounts of intermediate- or long-acting insulin,
possibly combined with small amounts of rapid- or short-acting insulin. β-cell destruction
continues during this honeymoon phase, and with the progressive loss of β-cell function,
there is need for increased exogenous insulin to avoid elevated blood glucose levels
A 7-month old presents with 1-day cough, yellow sinus drainage and a low grade temp,
treatment options? - CORRECT ANSWER: Tylenol and monitor
A 9-year-old who has dyspepsia without occult blood what would your steps be? -
CORRECT ANSWER: Endoscopy
A child developed her 2nd perirectal abscess in 6 months. What should she be
evaluated for? - CORRECT ANSWER: Crohn's disease or sexual abuse
A child has not received abx for a bacterial respiratory infection, what would you treat
them with? - CORRECT ANSWER: Amoxicillin
A child who stopped walking at 18 months old what would you be concerned about? -
CORRECT ANSWER: Cerebral palsy
A healthy male with headaches blurred vision and personally changes what would you
do? - CORRECT ANSWER: Head CT, possibly MRI
A male who is complaining of breast tissue enlargement, how would you treat that? -
CORRECT ANSWER: Usually, no treatment is needed. Most cases of gynecomastia
lessen with time. However, if a medical condition is causing gynecomastia, medications
may need to be given. If a medication is the cause, your doctor may tell you to stop
taking it or may prescribe a different medication. Your doctor may suggest seeing an
endocrinologist. Surgery is usually not recommended unless the gynecomastia is
causing severe pain and tenderness or embarrassment
, Antibiotics for bronchiolitis? - CORRECT ANSWER: Use of saline drops and suctioning
of the nares. There is no evidence to support the routine use of antibiotics
Antibiotics for croup? - CORRECT ANSWER: Nebulized epinephrine, corticosteroids
(dexamethasone oral or IM), blow by oxygen or heliox in severe croup. Racemic
epinephrine with the use of corticosteroids to limit rebound swelling
Antibiotics for epiglottitis? - CORRECT ANSWER: Establish an airway preferably by
nasotracheal intubation. Administer IV antibiotics such as rocephin to cover
H.influenzae. Administer oxygen and respiratory support. Antibiotics should be
continued for 10 days. Rifampin prophylaxis 20 mg/kg in a single dose (maximum of
600 mg) for 4 days for infants and children, 600 mg once a day for adults for 4 days.
Should be provided for household contacts who are at risk (Younger than 4 years old
who is non-immunized or incompletely immunized, children less than 12 months who
have not received primary series of Hib, and immunocompromised children.
Appendicitis: What would the findings be? - CORRECT ANSWER: Pain in the belly
(abdomen) is the most common symptom. This pain:
May start in the area around the bellybutton, and move to the lower right-hand side of
the belly. Or it may start in the lower right-hand side of the belly.
Often gets worse as time passes
May be worse when the child is moving, taking deep breaths, being touched, or
coughing and sneezing
May be felt all over the belly if the appendix bursts
Other common symptoms include:
Upset stomach (nausea) and vomiting
Loss of appetite
Fever and chills
Changes in behavior
Trouble having a bowel movement (constipation)
Loose stool (diarrhea)
Swollen belly in younger children
