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NR 602 Final exam questions and answers.
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NR 602 Final exam questions and answers.
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NR 602 Final exam questionsand answers
Step 1 Asthma approach-Intermittent - answer symptoms 2x or less per
week
asymptomatic and normal PED
requires SABA 2 days/week
no interference with normal activities
brief exacerbations
nighttime symptoms 2x or less a month
lung fx- FEV>80% predicted
Step 2 Asthma Approach-Mild persistent - answer Symptoms >2 x a
week, less than once per day
requires SABA more than 2days/week, no more than once a day
exacerbations may affect activity
nighttime symptoms 3-4x a month
FEV> 80% predicted
Step 3 Asthma Approach-Moderate Persistant - answer daily symptoms
daily use of SABA
some limitations
2x or more per week exacerbations
nighttime symptoms more than 1x per week, not nightly
FEV >60% but <80%
Step 4 Asthma Approach-Severe Persistent - answer continual symptoms
requires SABA multiple x a day
,extremely limited activity
nighttime symptoms 7x a week
FEV <60%
Tx of asthma - answer Stepwise approach
step 1: SABA PRN
step 2: low dose ICS
Step 3: low dose ICS+ LABA or medium dose ICS
step 4: Medium dose ICS+LABA
Step 5: high dose ICS+ LABA
Step 6: High dose ICS+LABA + corticosteroid
Step 6 Asthma Approach - answer
Bulbar/palpebral conjunctival infection - answer May be unilateral or
bilateral
Leukocoria - answer abnormal appearance of a white film in the pupil;
immediate referral to pediatric ophthalmologist warranted
Causes: retinal detachment, cataract, retinal dysplasia, newborn
retinoblastoma
Visual screening in children - answer At least once between ages 3-5 y/o
according to USPSTF
AOM - answer RF: genetics, males, Native American, siblings, low
economic status, ages 6mo-3y, winter, supine bottle feeding, daycare,
tobacco smoke
S/S of AOM - answer erythema, otalgia, bulging TM, absent cone of light
, Dx of AOM - answer Audiometry, tympanometry, possible lateral neck
xray to r/o mass
TX of AOM - answer uncomplicated: supportive with tylenol/ibuprofen;
watchful waiting 48-72 in 6m-2y/o; <5 benzocaine otic drops
1st line antx: amoxicillin 80-90mg/kg/day Q12 x 10days
if allergy to PCN- augmentin, cefuroxime
Bacterial rhinosinusitis - answer Preceded by URI-typically worsens after
5-7 days- not resolved in 2 weeks
Sx of bacterial rhinosinusitis - answer Purulant nasal congestion,
drainage, facial pain, headache, fever
No imaging required- if no improvement refer to ENT
Bronchiolitis - answer Usually caused by RSV
wheezing present
<2 y/o
other causes; influenza, adenovirus, rhinovirus
S/s of bronchiolitis - answer Increased work of breathing, prolonged
expiration, grunting, retractions, nasal flaring
Croup sx - answer Low grade fever, URI symptoms, barking cough,
inspiratory stridor can occur
Croup dx - answer Made from symptoms
Croup tx - answer Glucocorticoids possibly
0.6mg/kg-1mg/kg
humidified air
bronchodilators
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