NR 602 questions with correct answers
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? Correct 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
Correct 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? Correct 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? Correct 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? Correct 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? Correct 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. Correct 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? Correct Answer-Determine the state mandated
reporting laws.
, Rationale- Each state has different laws on reporting to parents about
STIs and Pregnancy.
A 17yearold sexually active female who began having periods at age 14
reports having moderate to severe dull lower abdominal pain associated
predominantly with periods but that occurs at other times as well. The
history reveals a recent onset of these symptoms. A pregnancy test is
negative. Which course of action is most important? Correct Answer-
Perform a full diagnostic workup to evaluate potential causes.
Rationale- This is not normal and needs more workup to determine the
reason for it. She is sexually active so this raises more concerns for other
things that might be going on such as PID or an STI
A 16yearold female reports dull, achy cramping pa in in her lower
abdomen
lasting 2 or 3 hours that occurs between her menstrual periods each
month.
The adolescent is not sexually active. What is the treatment for this
condition? Correct Answer-Prostaglandin inhibitor analgesics and a
heating pad
Rationale -This is signs of normal period and the 1st line treatment is
Prostoglandin and heating pad.
A schoolage female has had vulvovaginitis for 2 months. All cultures
and tests .are negative, but the symptoms persist after treatment with
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