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NR 602 My final Study set CORRECT 100%
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A 16yearold sexually active female has a fever, bilateral lower abdominal pain,and malaise. A speculum and bimanual exam reveals adnexal tenderness. The urinalysis is normal and cervical cultures are pending. What medications will the primary care pediatric nurse practitioner prescribe for this p...

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  • October 17, 2024
  • 27
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • nr 602
  • nr 602 my final study set correct 100
  • a 16yearold sexually active female has a fever bi
  • rational this is pid the treatment is ceftriaxone

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NR 602 My final Study set CORRECT 100%
A 16yearold sexually active female has a fever, bilateral lower abdominal

pain,and malaise. A speculum and bimanual exam reveals adnexal tenderness.

The urinalysis is normal and cervical cultures are pending. What medications will the primary care
pediatric nurse practitioner prescribe for this patient? - ANSWER PID- she is Sexually active+Adnexal
Tenderness and negative for UTI.

Ceftriaxone, doxycycline, and metronidazole



Rational- This is PID the treatment is Ceftriaxone 250 mg IM plus Doxyclicline 100 mg BID for 14 days plus
with or without Metronidazole 500 mg PO bid for 14 days.



4. A sexually active adolescent female tests positive for N. gonorrhea

and Chalmydia. She tells the primary care pediatric nurse practitioner that she

wants to be treated today since she is moving out of town the next day. What will the nurse practitioner
order?What is the treatment for her - ANSWER Ceftriaxone 250 mg IM and azithromycin 1 g PO one time
each



Rational- Remember the G in Gonorehea for or Ceftriaxone and Chlamydia you can give either
Doxycycline 100 mg for 7 days or Azithromycin 1 g PO x1 because she is moving she are giving this
combination.



A 14yearold female has menometrorrhagia with moderate increase in menstrual flow and irregular
periods. Her hemoglobin is 13.1 g/dL. How will this be managed? - ANSWER Iron supplementation and
prostaglandin inhibitors



Rationale: Her hemoglobin level is at 13.1 and the normal range for this age group is 11.9-15. It is better
to give Iron because of the bleeding and for pain reliefe Prostoglandins such as Ibuprofen.



An adolescent female has heavy periods that are also irregular. The physical exam is normal. A complete
blood count reveals a hemoglobin of 8.9 g/dL. What test will the primary care pediatric nurse
practitioner order next? - ANSWER Coagulation studies

, Rational-The normal Hemoglobin range is 11.9-13.1 and she is outside the range. We need to look for
reasons of this.



An adolescent female has periods every 30 days that are consistently

heavy and last from 5 to 8 days. What is her diagnosis? - ANSWER Menorrhagia-



Rationale- The diagnosis for this is periods lasting longer than 7 days. Hers are lasting 8 days. She is
consistant with when her periods start so it won't be menometrorrhagia because that is irregular
periods.



A 16yearold female has not had a menstrual period yet and is concerned. She

denies sexual activity. An exam reveals an adult sexual maturity rating.

Which laboratory test will the primary care pediatric nurse practitioner order initially? - ANSWER
Pregnancy Test



Rationale- All people lie and the number one reason for Ammenorrhea is pregnancy. After I rule out that
then I can look at other things such as nutrition, is she an athlete and is it Primary Amenorrhea which is
failure to have a period for 3 years or creast development or by age 15. or Secondary Anemia which is no
menstrual periods for 3 months or absent of period for 6 months for those on irregular periods.



A 16yearold female reports breast tenderness and a "lump." The primary care pediatric nurse
practitioner palpates a small fluidfilled mass in her right breast. - ANSWER Order an Ultra Sound of
Breast



Rationale- First thing you always do is order an ultra sound first to determine reason. Most girls this age
do not have breast cancer.



A 15yearold n female has a positive pregnancy test and asks the primary care

pediatric nurse practitioner not to tell her parents. She is tearful and says she isn't sure she wants to
keep the baby. What will the nurse practitioner do first? - ANSWER Determine the state mandated
reporting laws.

, Rationale- Each state has different laws on reporting to parents about STIs and Pregnancy.




Rationalle- This can be signs of glommeripheritis. When someone has a strep infection previous it can go
the kidneys and cause this. The tea color urine is indication of kidney failure



A child who has nephrotic syndrome is on a steroids and a saltrestricted

diet for a relapse of symptoms. A dipstick urinalysis shows 1+ protein, down from 3+ at the beginning of
the episode. In consultation with the child's nephrologist, what is the correct course of treatment
considering this finding? - ANSWER Continue with steroids and salt restrictions until the urine is

negative for protein.



Rationelle- Happens with the body does not filture out protein the body.



An adolescent has 2+ proteinuria in a random dipstick urinalysis. A

subsequent first morning voided specimen is negative. What will the primary care pediatric nurse
practitioner do to manage this condition? - ANSWER Monitor for proteinuria at each annual well child

examination



A child has gross hematuria, abdominal pain, and arthralgia as well as a

rash. What diagnosis is most likely? - ANSWER HenochSchönlein purpura



Rationale-most common in children under 10



A preschoolage child with no previous history has mild flank pain and fever but no abdominal pain or
vomiting. A urinalysis is positive for leukocyte esterase and nitrites. A culture is pending. Which is the
correct course of treatment for this child? - ANSWER amoxicillin clavulanate



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? - ANSWER Obtain a renal and bladder ultrasound.

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