NU 664 Exam 1/129 Answered
Questions/A+ Graded
Gold standard for CAP diagnosis: - -Chest x-ray
-If CAP symptoms present but no obvious signs of infection on CXR
treatment is... - -Same as if CXR was positive
-Immunizations for people over 65 or younger people with comorbidities
such as asthma, CHF COPD: - -Pneumonia and flu vaccines
-Who is at risk for CAP? - -Extremes of age, smokers, alcoholics, GERD,
chronic disease, institutionalization
-CAP presentation in adults: - -Cough (may be nonproductive), dyspnea,
fever, hemoptysis, chest pain, fatigue, tachycardia
-If lymphocytes are elevated? - -Indicative of viral process
-If monocytes are elevated? - -Indicative of chronic process
-If eosinophils are elevated? - -Indicative of asthma, allergic reaction
-If basophils are elevated? - -Indicative of chronic process
-If neutrophils are elevated? - -Indicative of acute bacterial process
-CAP: patient present with symptoms of chills, fever, chest pain, productive
cough with purulent sputum, positive chest x-ray, and patient had URI last
week? - -Streptococcus pneumonia: gram +
-In the United States, the most common cause of myocarditis in children is: -
-Viruses
-Your next patient is a 5-year-old child with a history of moderate persistent
asthma. He has been wheezing and coughing for the past two days, and his
mother brings him in today for evaluation. He has been using albuterol every
four hours. His respiratory rate is 13 breaths per minute; his lungs are clear
to auscultation; and no retractions are noted. What may be your assessment
and intervention based on this information? - -Your child is breathing slower
than normal for his age. We need to send him to the ER for further
intervention.
, -Your next patient is a 6-year-old male here for his annual influenza vaccine.
He has a history of mild persistent asthma. What would you discuss for
medications when reviewing his asthma action plan? - -Your child should
continue his low-dose inhaled corticosteroid daily and add albuterol as
needed for an exacerbation.
-A child who has been diagnosed with asthma for several years has been
using a short-acting Beta-agonist (SABA) to control symptoms. The PNP
learns that the child has recently begun using the SABA 2-3 times each week
to prevent wheezing and shortness of breath. The child currently has clear
breath sounds and an FEV1 of 75% of personal best. What will the NP do? - -
Add an inhaled corticosteroid.
-Your next patient is a six-month-old infant who just completed amoxicillin
for otitis media. The mother states her child is better except for a diaper
rash. Upon examination, you note red scaly plaques in the diaper area with
satellite lesions to his upper thighs. What would you do next as the PNP? - -
Your child has a rash that is likely due to a fungus, Candida, and commonly
occurs after taking antibiotics. I will prescribe nystatin to be applied to the
diaper area.
-A 12 y.o. female presents to the clinic after being bit by a dog on the face.
Abrasion with 2 puncture wounds on the upper right cheek, approximately 1
inch below the eye. The area is slightly erythematous, with a small amount
of bruising and raised area along the cheekbone. - -Using normal saline,
irrigate the wounds using high pressure (greater than 4 pounds per square
inch) and high volume (greater than 1 L). Isolated puncture wounds should
not be irrigated, instead soak the wound in a diluted solution of tap water
and povidone-iodine for 15 .minutes • Prescribe a 3- to 5-day course of
prophylactic antibiotics
-A 4 yo child has clusters of small, clear, tense vesicles with an
erythematous base on one side of the mouth along the vermillion border,
which are causing discomfort and difficulty eating. What will the PNP
recommend as treatment? - -Topical diphenhydramine and magnesium
hydroxide.
-A 4 year old child with PE tubes in both ears has otalgia in one ear. The PNP
is able to visualize the tube and does not see exudate in the ear canal and
obtains a type A tympanogram. What will the NP do? - -Order ototopical
corticosteroid/antibiotic drops.
-The parent of a 1-week old is concerned about the unusual shape of their
child's head. In the physical exam, which of the following signs would not
support the diagnosis of craniosynostosis? - -A palpable lesion at the
occipital region.
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