CMN568/ CMN 568 Intro to Family NP Final Exam
Questions and Verified Answers 2025
QUESTION
Are these 1. and 2. statements TRUE or FALSE?
Strabismus is noted on an eye exam where the left eye is deviated outward and the right eye
seems to be fixated on an object you are holding in front of the patient. You perform a cover test.
1. When covering the left eye, you would see no movement in the uncovered eye.
2. When covering the right eye, you would see the left uncovered eye move toward fixation on
the object.
An alternating cover test is mentioned in Hay, but not explained. This test can be performed on a
patient whose eyes seem to be well aligned. Move the cover laterally back and forth between the
eyes. If the eyes remain fixated on the object, this would be considered a normal test. If you see
movement of the eyes, this is an abnormal test and should be referred.
(MODULE 1)
Answer:
Exotropia is a type of strabismus in which the eye is deviated outward.
1. True, when covering the left eye, you would see no movement in the uncovered eye
(unaffected eye).
2. True, the eye will move toward fixation on the object in exotropia (Hay p. 456)
QUESTION
A child has AOM and weighs 27#.You choose to give high dose Amoxicillin as a first line
antibiotic. Your prescription would read:
Joe Doe
Amoxicillin 500mg/5ml
Give ml BID x 10 days for ear infection (MODULE 1)
Answer:
patient 27lbs/2.2= 12.27kg Amoxicillin 90mg/kg/day
90mg x 12.27kg = 1,104mg
1,104mg x 5ml =5,520/500mg=11ml/2 doses=5.5ml per dose
,Joe Doe
Amoxicillin 500mg/5ml
Give 5.5ml BID x 10 days for ear infection
QUESTION
What are risk factors for developing squamous cell carcinoma of the "throat"? (MODULE 1)
Answer:
SCC of the larynx is most commonly seen in men 50-70 years old and with a significant tobacco
use history (McPhee p. 236) HPV 16 or 18 has an association with laryngeal cancer in
nonsmokers (McPhee p. 236)
QUESTION
How would you dose each of the following medications for a diagnosis of AOM in adults and
children? Amoxicillin? Trimethoprim/Sulfamethoxazole ? Ceftriaxone ? (MODULE 1)
Answer:
Peds dosing for AOM:
Amoxicillin (FIRST LINE CHOICE!): 80-90 mg/kg/day divided Q12H
Trimethoprim/Sulfamethoxazole: 8-12 mg TMP/kg/day (divided Q21H (Sanford p.
241)
Ceftriaxone: 50-100 mg/kg Q24H (Sanford p.241)-IV/IM Adult dosing for AOM
Amoxicillin: 1 gm PO Q8H for 5-7 days (McPhee p. 206)
Trimethoprim/Sulfamethoxazole: Standard dose: 1 DS tab PO BID (160
TMP/800SMX) (Sanford p. 131)
Ceftriaxone: 1-2 gm once daily (IM/IV) (Sanford p. 120)
Notes: Dosage of Trimethoprim/Sulfamethoxazole, for children the dosage is 8-12mg (of the
TMP component)/kg/day divided q12hours x 10 days. Not recommended for children < 2mo.
Used when severe allergy to PCN for susceptible S. pneumonia and H. flu infections. Another
obvious choice for a child with a severe allergy to PCN would be a Macrolide antibiotic which
has more coverage for common organisms causing AOM than Trimethoprim/Sulfamethoxazole.
QUESTION
Fever causes by age in infants? (MODULE 1)
Answer:
, Causes: Less than 1month: Group B Strep, E. Coli
1 mo-3 mo: strep pneumoniae, H. Influenzae, N. Meningitidis
Fever without source of infection: most common cause - H.Influenza Type B & Strep
Pneumoniae
QUESTION
Fever appearance in infants for non toxic vs toxic? (MODULE 1)
Answer:
Non-toxic appearance: consolable
Toxic appearance: weak, high pitched cry, inconsolable
Seen Immediately: neck stiff, fever >40.6 C, <3mo + fever >38C, petechiae, drooling saliva and
unable to swallow anything, child has sickle cell disease/ splenectomy/ HIV/ chemotherapy/
organ transplant/ chronic steroids
Tympanic route is not accurate in infants <3mo. RED FLAGS FOR SERIOUS ILLNESS:
<1mo: >40C temp, petechial rash, meningeal irritation, resp signs (tachypnea,
stridor, increased WOB, crackles, decreased breath sounds, cyanosis), hypotension. In neonates,
meningeal irritation can present as labile temperature.
Any infant less than 1 month old with fever should be hospitalized and have full sepsis work up
QUESTION
Define fever temperature in infants? (MODULE 1)
Answer:
Rectal temp: 38 degrees
Celsius
or 100.4 degrees Fahrenheit.
Determine treatment based on presentation, whether they are non-toxic or toxic appearing
QUESTION
Acetaminophen dosing in children? (MODULE 1)
Answer:
Acetaminophen (Tylenol)
10-15mg/kg q4 to 6 hours
MAX daily dose: 5 doses in 24 hours
, QUESTION
Ibuprofen dosing in children? (MODULE 1)
Answer:
Ibuprofen (Motrin/Advil)
5-10mg/kg q6 to 8 hrs.
MAX: 40mg/kg per day TOTAL
6 months or older
QUESTION
Fever treatment for .... Infants less than 4 weeks? Infants 4 weeks to 3 months? Infants 3 months
to preschool?
(MODULE 1)
Answer:
Infants less than 4 weeks:
risk of sepsis!!
Full septic work-up - blood culture, CXR if indicated, stool culture. AVOID CEFTRI- AXONE
(Rocephin). Refer to ED. Ampicillin, cefotaxime, acyclovir.
Infants 4 weeks - 3 months:
Toxic appearance (risks for SBI [systemic bacterial infection]): full septic work up. CXR if
indicated, stool cultures. Refer to ED. Empiric IV abx pending culture.
Non-toxic appearance (no risk for SBI): full septic work-up. CXR. Outpatient if pt has reliable
caregiver. Rocephin 50mg/kg/day (empiric abx).
Infants 3 months - preschool:
Toxic appearance: septic workup. Lumbar puncture, CXR, stool culture, rapid viral testing.
Empiric abx (pending culture results)
Non-toxic appearance: lab work-up guided by H&P. Empiric abx (pending culture results)
QUESTION
Acute Otitis Media (AOM) (MODULE 1)
Answer:
Moderate - severe bulging of TM. MUST
have bulging TM and MEE (middle ear effusion)