NRNP 6541 WEEK 11 FINAL EXAM 3 LATEST VERSIONS 2024/2025 ACTUAL EXAM EACH VERSION CONTAINS 60 QUESTIONS AND CORRECT DETAILED ANSWERS
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Course
NRNP 6541
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NRNP 6541
NRNP 6541 WEEK 11 FINAL EXAM 3 LATEST VERSIONS 2024/2025 ACTUAL EXAM EACH VERSION CONTAINS 60 QUESTIONS AND CORRECT DETAILED ANSWERS/NRNP 6541 WEEK 11 FINAL EXAM 3 LATEST VERSIONS 2024/2025 ACTUAL EXAM EACH VERSION CONTAINS 60 QUESTIONS AND CORRECT DETAILED ANSWERS
NRNP 6541 WEEK 11 FINAL EXAM 3 LATEST VERSIONS 2024/2025 ACTUAL EXAM EACH VERSION
CONTAINS 60 QUESTIONS AND CORRECT DETAILED ANSWERS
Recommended treatment for RSV in a 7 month old (outpatient) - correct answer Use of saline
drops and suctioning of the nares. Indications of when to use antipyretics. Signs of respiratory
distress or dehydration. Guidelines for feeding an infant with signs of mild respiratory distress
which includes smaller more frequent feedings; monitoring of the respiratory rate; and
guarding against vomiting. The parents should be educated that the child may have the
symptoms over the course of 2-3 weeks
Epiglottitis s/s - correct answer Acute and rapid onset of high fever, chills, and toxicity. Severe
sore throat and drooling saliva. Will not eat or drink, muffled (hot potato) voice, and anxiety.
Sitting posture with hyperextended neck with open-mouth breathing. Stridor, tachycardia, and
tachypnea
Epiglottitis prevention - correct answer Haemophilus influenzae type B (Hib) vaccine
Steeple sign - correct answer a radiologic sign found on radiograph where the subglottic
tracheal narrowing produces a shape of a church steeple which supports a diagnosis of croup
Foreign body aspiration antibiotic? - correct answer Depends on the nature of the material
aspirated, plus the location and degree of obstruction. Bronchial or laryngeal foreign body
aspiration, a bronchoscopy must be performed for removal of the foreign body
Antibiotics for bronchiolitis? - correct answer Use of saline drops and suctioning of the nares.
There is no evidence to support the routine use of antibiotics
Antibiotics for croup? - correct answer Nebulized epinephrine, corticosteroids (dexamethasone
oral or IM), blow by oxygen or heliox in severe croup. Racemic epinephrine with the use of
corticosteroids to limit rebound swelling
Antibiotics for epiglottitis? - correct answer Establish an airway preferably by nasotracheal
intubation. Administer IV antibiotics such as rocephin to cover H.influenzae. Administer oxygen
and respiratory support. Antibiotics should be continued for 10 days. Rifampin prophylaxis 20
mg/kg in a single dose (maximum of 600 mg) for 4 days for infants and children, 600 mg once a
day for adults for 4 days. Should be provided for household contacts who are at risk (Younger
than 4 years old who is non-immunized or incompletely immunized, children less than 12
months who have not received primary series of Hib, and immunocompromised children.
Asthma treatment - correct answer The pharmacological management of asthma in children is
based on the severity of asthma and the child's age. After initial control, decrease treatment to
the least amount of medication needed to maintain control. Systemic corticosteroids may be
needed at any time and stepped up if there is a major flare-up of symptoms.
Step 1 Asthma management for children 0-4 years old - correct answer Step 1: SABA (Short
acting beta2-agonist) PRN: With viral respiratory symptoms short acting beta 2-agonist should
be used every 4-6 hours up to 24 hours (longer with a physician consult). Consider short course
,NRNP 6541 WEEK 11 FINAL EXAM 3 LATEST VERSIONS 2024/2025 ACTUAL EXAM EACH VERSION
CONTAINS 60 QUESTIONS AND CORRECT DETAILED ANSWERS
of oral systemic corticosteroids if severe exacerbation. Frequent use of SABA may indicate the
need to step up treatment
Step 2 Asthma management for children 0-4 years old - correct answer Step 2: Consider
consultation with asthma specialist. Low dose of inhaled corticosteroids.
Step 3 asthma mgmt for children 0-4 yrs - correct answer Step 3: Medium-dose of inhaled
corticosteroids
Steps 4-6 asthma mgmt for children 0-4 yrs - correct answer Step 4: Medium-dose ICS and
Long acting beta2-agonist or montelukast.
Step 5: High dose ICS and Long acting beta 2-agonist or montelukast.
Step 6: High dose of ICS and LABA or montelukast and oral corticosteroids
Steps 1-3 asthma mgmt for children 5-11 yrs - correct answer Step 1: SABA (Short acting beta
2-agonist) PRN: Increasing the use of short-acting beta 2-agonist or use greater than 2 days a
week for symptom relief generally indicates inadequate control and the need to step up
treatment.
Step 2: Consider consultation with asthma specialist. Low dose of inhaled corticosteroids.
Step 3: Low dose of inhaled corticosteroid and LABA. Or medium dose of inhaled
corticosteroids.
Steps 4-6 asthma mgmt for children 5-11 yrs - correct answer Step 4: Medium-dose ICS and
LABA or medium dose of inhaled corticosteroid and leukotriene receptor antagonist or
theophylline. .
Step 5: High dose ICS and LABA or high dose of inhaled corticosteroid and leukotriene receptor
antagonist or theophylline. .
Step 6: High dose of ICS and LABA and oral corticosteroids or high dose of inhaled
corticosteroids and leukotriene receptor antagonist or theophylline and oral corticosteroids.
,NRNP 6541 WEEK 11 FINAL EXAM 3 LATEST VERSIONS 2024/2025 ACTUAL EXAM EACH VERSION
CONTAINS 60 QUESTIONS AND CORRECT DETAILED ANSWERS
** Theophylline levels must be monitored.
Differentials for patient with sore throat - correct answer Strep pharyngitis
Peritonsillar abscess
Viral pharyngitis
Infectious mononucleosis
Epiglottitis
small-for-gestational-age infants: which type of chromosomal analysis should be included? -
correct answer Trisomy 18
Holt-Olram
Trisomy 13
Turner Syndrome
Trisomy 21
Prader-Willi Syndrome
heart defects associated with Down syndrome - correct answer Atrioventricular Septal Defect
Ventricular Septal Defect
Persistant Ductus Arteriosus
Tetrology of Fallot
Contact sports with Down's Syndrome - correct answer Do not recommend due to atlantoaxial
instability
Diagnosing Down Syndrome - correct answer Usually identified at birth by the presence of
certain physical traits: low muscle tone, a single deep crease across the palm of the hand, a
slightly flattened facial profile and an upward slant to the eyes. Because these features may be
present in other babies, a chromosomal analysis called a karyotype is done to confirm the
diagnosis. To obtain a karyotype, doctors draw a blood sample to examine the baby's cells. They
photograph the chromosomes and then group them by size, number, and shape. By examining
the karyotype, doctors can diagnose. Another genetic test called FISH can apply similar
principles and confirm a diagnosis in a shorter amount of time
Diagnosing Trisomy 18 (Edwards Syndrome) - correct answer A sample of the baby's dna is
extracted from a blood sample or other bodily cells or tissue and is cultured to examine a
picture of the chromosomes called a karyotype. In order to get this picture, the chromosomes
are isolated, stained, and examined under the microscope. Most often, this is done using the
, NRNP 6541 WEEK 11 FINAL EXAM 3 LATEST VERSIONS 2024/2025 ACTUAL EXAM EACH VERSION
CONTAINS 60 QUESTIONS AND CORRECT DETAILED ANSWERS
chromosomes in the white blood cells. A picture of the chromosomes is taken through the
microscope. A visible extra 18th chromosome confirms a Trisomy 18 diagnosis
Diagnosing Holt-Oram Syndrome - correct answer A diagnosis may be suspected when a
person is found to have changes in the way the bones of the wrist and other bones of the upper
limb are formed. The diagnosis can be confirmed if a person has specific bone changes and a
personal or family history of an atrial septal defect, ventricular septal defect, or cardiac
conduction disease. In order to establish the diagnosis, a doctor may order tests including an x-
ray of the hands, wrists, and arms, a echocardiogram, and an electrocardiogram. The diagnosis
may also be confirmed with genetic testing of the TBX5 gene
Diagnosing Trisomy 13 - correct answer Parents who are at risk to have a translocation due to
their family history can have a blood test called a karyotype, which can determine if a
translocation is present.
Prenatal testing or screening is also available to determine if a current pregnancy is at risk for
chromosome disorders.
People with a family history who are interested in learning about genetic screening or testing
for themselves or family members are encouraged speak with a genetic counselor or other
genetics professional.
Diagnosing Turner Syndrome - correct answer A diagnosis may be suspected when there are a
number of typical physical features observed such as webbed neck, a broad chest and widely
spaced nipples. Sometimes diagnosis is made at birth because of heart problems, an unusually
wide neck or swelling of the hands and feet.
This can be confirmed by prenatal testing to obtain cells from the unborn baby for
chromosomal analysis. If a diagnosis is confirmed prenatally, the baby may be under the care of
a specialist pediatrician immediately after birth
Diagnosis is confirmed by a blood test, called a karyotype. This is used to analyze the
chromosomal composition of the female
Fragile X Syndrome (Martin-Bell Syndrome) - correct answer a genetic condition that causes a
range of developmental problems including learning disabilities and cognitive impairment.
Usually, males are more severely affected by this disorder than females.
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