AC PEDIATRIC NURSE PRACTITIONER (PNP)
– ACUTE CARE MELNIC EXAM NEWEST
ACTUAL EXAM WITH COMPLETE
QUESTIONS AND DETAILED VERIFIED
ANSWERS GRADED A+ | 100% VERIFIED |
2024 UPDATE!!!
What is the antibiotic of choice for a Cystic Fibrosis (CF) patient
admitted with pneumonia?
A. Rocephin
B. Ceftazidime
C. Cefobid
D. Claforan - ✔✔✔ Correct Answer > Explanation: Although all
the answers are 3rd generation cephalosporins, because the
patient has cystic fibrosis, you must remember to cover for
pseudomonas colonization. Ceftazidime is the best choice for
this.
What is the best lab to order to determine whether nephrotic
syndrome is present?
,A. BUN
B. Creatinine
C. Urine sodium
D. Urine Protein quantification - ✔✔✔ Correct Answer >
Explanation: Answer D. Nephrotic syndrome is a constellation
of clinical findings that is the result of massive renal losses of
protein. Nephrotic syndrome is not a disease itself, but the
manifestation of many different glomerular diseases. These
diseases might be:
acute and transient, such as post-infectious glomerulonephritis
which is caused by certain strains of streptococci (group A)
which are nephritogenic
chronic and progressive, such as focal segmental
glomerulosclerosis (FSGS)
Answer A. BUN is a helpful indicator of hydration, protein,
intake and failure
Answer B. Creatinine measures muscle breakdown
Answer C. Urine sodium is seen in SIADH
A 4 week old is brought to the ED by his parents for poor
feeding. His parents report he acts hungry but after a few
minutes sucking his bottle, he screams out and becomes
,diaphoretic. Their PCP has been treating him for GERD. You ask
the parents to feed him and observe the reported behavior. He
has a soft murmur and you order a chest x-ray which shows
cardiomegaly. You order an ECG. What do you expect to find on
the ECG?
A. Atrial tachycardia
B. Deep Q waves in leads V1 and AVL
C. 1st degree AV block
D. Peaked T-waves in all precordial leads - ✔✔✔ Correct
Answer > Explanation: Answerer C. The most likely diagnosis of
this patient is anomalous coronary artery from the left
pulmonary artery.
Remember coronary arteries perfuse the myocardium during
diastole. If an adult has a coronary related issue they
experience chest pain, ischemia and sudden death. Infants will
experience the same thing but usually during or shortly after
starting a feed
Signs of a patient with ALCAPA includes:
Ischemia
Heart failure
Sudden death
ECG - pathologic Q waves lead I and avF = infarction
, Answer A. first degree AV block is exhibited by prolonged PR
interval
Answer B. Atrial Tachycardia is evidenced by rapid atrial rate
Answer D. Peaked T-waves is indicative of hyperkalemia
A 10 year old with Sickle Cell anemia is admitted to your floor
with fever, cough, tachypnea and diminished breath sounds
over both lower lobes. His CXR shows infiltrates and
consolidation in both lower lobes and his lab work shows
leukocytosis and a decreased hemoglobin. Treatment for this
patient includes:
A. Transfusion and antibiotics
B. Splenectomy and analgesics
C. Oxygen and analgesics
D. Chest tube and antibiotics - ✔✔✔ Correct Answer >
Explanation: Answer C. Acute chest syndrome presents with
fever, respiratory symptoms and an infiltrate on chest x-ray.
Bacterial etiology is rarely identified. Patients recover following
treatment with fluids, oxygen, analgesics and antibiotics
Answer A. See above
Answer B. Splenectomy would never be performed during an
episode of acute chest syndrome
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