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2024 NR 509 CHAPTER 18 FINAL EXAM WITH CORRECT ANSWERS
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2024 NR 509 CHAPTER 18 FINAL EXAM WITH CORRECT ANSWERS
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2024 NR 509 CHAPTER 18 FINALEXAM WITH CORRECT ANSWERS
An infant presents with a heart rate of 180, a respiratory rate of 68, and an
enlarged liver. What diagnosis does this suggest?
A) Pneumonia
B) Heart failure
C) Sepsis
D) Necrotizing enterocolitis - CORRECT-ANSWERSB) Heart failure
You have been unable to hear normal S2 splitting in children up to this point.
What technique will maximize your chances of hearing this phenomenon?
A) Listen with the diaphragm over the left lower sternal border.
B) Listen with the bell over the 2nd left intercostal space.
C) Listen with the bell over the apex.
D) Listen with the diaphragm in the axilla. - CORRECT-ANSWERSB) Listen
with the bell over the 2nd left intercostal space.
A mother is upset because she was told by another provider that her child
has a worrisome murmur. You listen near the clavicle and notice both a
systolic and diastolic sound. You remember that diastolic murmurs are
usually indicative of bad pathology. What would you do next?
A) Cardiology referral
B) Echocardiogram
C) Supine examination
D) Reassure the mother - CORRECT-ANSWERSC) Supine examination
You are having trouble examining the abdomen of a school-aged child due to
ticklishness. What should you do?
A) Have the child press on your hand.
B) Have the parent insist that the child allow you to examine her.
C) Ask the parent to leave the room.
D) Make the child realize that this is part of the examination and must be
done. - CORRECT-ANSWERSA) Have the child press on your hand.
You are examining a 5-year-old before he begins school. You notice a
systolic, grade II/VI vibratory murmur over the LLSB and apex with normal S2
splitting. He has normal pulses as well. Which of the following is most likely?
, A) Tricuspid stenosis
B) Mitral stenosis
C) Still's murmur
D) Venous hum - CORRECT-ANSWERSC) Still's murmur
You are going to obtain a social history on an early adolescent boy. How
should you proceed to obtain the best information?
A) Ask his mother to leave the room.
B) Ask if he would prefer his mother to leave the room.
C) Ask your questions with his mother in the room.
D) Ask his mother how she would like to proceed. - CORRECT-ANSWERSB)
Ask if he would prefer his mother to leave the room.
You are assessing Tanner staging of the breast in a young woman. You
notice projection of the areola and nipple to form a secondary mound above
the level of the breast. Which Tanner stage would this be?
A) I
B) II
C) III
D) IV - CORRECT-ANSWERSC) III
A quiet 3-year-old is brought in for a routine check-up when you notice a
fresh bruise in the axilla and bilateral bruises over the upper back that
appear slightly older. There are brown bruises over his shins as well. His
mother said this happened when he fell off of a couch. What diagnosis should
be considered?
A) Von Willebrand's disease
B) Normal childhood bruises from activity
C) Abuse
D) Seizure disorder - CORRECT-ANSWERSC) Abuse
A 15-month-old is brought to you for a fever of 38.6 degrees Celsius and
fussiness. The ear examination is as follows: external ear, normal
appearance and no tenderness with manipulation; canal, normal diameter
without evidence of inflammation; tympanic membrane, bulging,
erythematous, and opaque. Insufflation is deferred due to pain. What is your
diagnosis?
A) Otitis externa
B) Cholesteatoma
C) Ruptured tympanic membrane
D) Otitis media - CORRECT-ANSWERSD) Otitis media
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