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NR 602 final week 7 GI GU Endocrine MC questions and answers
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NR 602 final week 7 GI GU Endocrine MC questions and answers
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NR 602 final week 7 GI/GU/EndocrineMC questions and answers
A 3yearold child has just completed a 7day course of amoxicillin for a
second febrile urinary tract infection and currently has a negative urine
culture. What is the next course of action?
Obtain a renal and bladder ultrasound.
Goal of fluid replacement:
Providing maintenance
Replenish prior losses
Replace persisting losses.
Goal of TBW: 50-75% of total body mass.
What is Wilms Tumor (Nephroblastoma):
A malignancy of urogenital tract. Presents as abdominal mass with or
without associated abdominal pain or hematuria.
According to the American Academy of Pediatrics (AAP) recommendations,
what age should urinalysis screening begin in asymptomatic children and
how often should it be performed?
The AAP does not recommend screening urinalysis for asymptomatic
children.
Which of the following would raise concerns for renal disease in a 2-year-
old, asymptomatic child with proteinuria or UA?
Hypertension
The FNP is performing a well child exam on a 4monthold infant who is
nursing exclusively. The mother reports that the infant has had a marked
decrease in the number of stools each day, from 3 to 5 stools each day to
only one stool every other day. How will the nurse practitioner respond?
Ask the mother to describe the color and consistency of the stools
The FNP is performing a well child exam on a 12monthold infant. The
parent tells the nurse practitioner that the infant has predictable bowel
and bladder habits and asks about toilet training. What will the nurse
practitioner tell this parent?
Placing the child on a “potty” chair helps the child associate elimination
cues with the toilet.
,The FNP is performing a well child exam on a 24monthold child. The
parent tells the nurse practitioner that the child is being toilet trained and
expresses frustration that on some days the child uses the toilet every
time and on other days not at all. What will the nurse practitioner do?
Ask the parent about the child’s toilet habits and understanding of toilet
training.
The FNP is discussing toileting issues with the parent of a 3yearold
toddler who reports that the child has been toilet trained for several
months but has recently been refusing to have bowel movements and is
becoming constipated. What will the nurse practitioner do?
Ask the parent about bathroom facilities in the child’s day care.
The FNP is evaluating a 5yearold child who has frequent soiling of stool
associated with stomach aches and decreased appetite for the past 2
months. The parent states that the child has two or fewer formed bowel
movements each week and has been toilet trained for about 2 years.
Which initial assessment will the nurse practitioner make?
Recent illnesses, fluid intake, changes in diet
The FNP is managing a 6yearold child who has chronic constipation and
encopresis. The nurse practitioner has ruled out neurogenic etiology. The
parents report that the child was difficult to toilet train as a toddler. What
is key to managing this child's condition?
Encouraging use of maintenance medications for at least 2 months after
resolution of constipation
The parent of a 5yearold child tells the FNP that the child has been using
the toilet to urinate for since age 3 but continues to defecate in "pullups."
The nurse practitioner learns that the child has predictable bowel
movements and a physical examination is normal. What will the nurse
practitioner recommend?
Putting the child on the toilet for 5 to 10 minutes at the usual time of
defecation
The FNP evaluates a 4yearold girl whose parent reports frequent urination
in the evenings on weekdays, incontinence after voiding. The parent
reports that the child has soft formed stools 5 or 6 times weekly. Which
assessment will the nurse practitioner make initially?
Examination for labial adhesions
The FNP is concerned that a toddler may have vesicoureteral reflux based
on a history of dysfunctional voiding patterns and a series of urinary tract
infections. Which intervention is appropriate?
Referral to a urologist for evaluation
, The FNP is evaluating a 4yearold female child for enuresis. The parents
reports that the child has never been dry at night and has recently begun
having daytime incontinence, usually when at preschool. The nurse
practitioner learns that the child does not appear to have an abnormal
urine stream. What will the nurse practitioner do next?
Examine the urethral meatus and labia and obtain a dipstick clean catch
urinalysis.
The FNP is counseling the parent of an 8yearold child who has primary
nocturnal enuresis. The nurse practitioner recommends an enuresis alarm,
but the parent wishes to use medication. What will the nurse practitioner
tell the parent?
The combination of alarm therapy and intermittent drug therapy is best
The parent of an infant asks about using a probiotic medication. What will
the FNP tell this parent?
There is no conclusive evidence about using probiotics to treat colic.
A toddler who was born prematurely refuses most solid foods and has
poor weight gain. A barium swallow study reveals a normal esophagus.
What will the FNP consider next to manage this child's nutritional needs?
Videofluoroscopy swallowing study
A toddler is seen in the clinic after a 2day history of intermittent vomiting
and diarrhea. An assessment reveals an irritable child with dry mucous
membranes, 3second capillary refill, 2second recoil of skin, mild
tachycardia and tachypnea, and cool hands and feet. The child has had
two wet diapers in the past 24 hours. What will the FNP recommend?
Oral rehydration solution with followup in 24 hours
A 9yearold girl has a history of frequent vomiting and her mother has
frequent migraine headaches. The child has recently begun having more
frequent and prolonged episodes accompanied by headaches. An exam
reveals abnormal eye movements and mild ataxia. What is the correct
action?
Refer to a pediatric gastroenterologist for further workup.
The parent of a 3monthold reports that the infant arches and gags while
feeding and spits up undigested formula frequently. The infant's weight
gain has dropped to the 5th percentile from the 12th percentile. What is
the best course of treatment for this infant?
Begin a trial of extensively hydrolyzed protein formula for 2 to 4 weeks
A school-age child has a 3month history of dull, aching epigastric pain that
worsens with eating and awakens the child from sleep. A complete blood
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