NR602 Final Exam Peds 100% Correct!!
What will the NP tell the parents about the use of probiotics? - ANSWERThere is no conclusive
evidence about using probiotics to treat colic
Premature infant with poor feeding has a barium study with a normal esophagus what should the NP
consider next to manage the child's nutritional needs? - ANSWERVideo fluoroscopy swallowing study
A toddler is seen in the clinic for 2 days of vomiting & diarrhea. Assessment reveals an irritable child,
with dry mucous membranes, 3 second cap refill, 2 second recoil of skin, mild tachycardia and
tachypnea. Cool hands and feet. The child has had two wet diapers in 24 hours. What will the NP
recommend? - ANSWEROral rehydration solution with follow up in 24 hours
A 9 year old girl has a history of frequent vomiting and her mother has frequent migraines. The child
has begun having more frequent and prolonged episodes accompanied by headaches. An exam
reveals abnormal eye movement and mild ataxia. What is the correct action? - ANSWERRefer to
pediatric gastroenterologist for further workup
The parent of a 3 month old reports that the infant arches and gags while feeding and spits up
undigested formula frequently. The infants weight gain has dropped to 5th percentile from 12th
percentile. What is the best course of treatment for this infant? - ANSWERBegin a trial of extensively
hydrolyzed protein formula for 2 to 4 weeks
A school aged child has a 3 month history of dull, aching, epigastric pain that worsens with eating
and awakens the child from sleep. A CBC shows a hemoglobin of 8mg/dL. What is the next step in
management? - ANSWERReferral for esophagogastroduodenoscopy (EGD)
A 2 month old infant cries up to 4 hours each day and according to the parents is inconsolable during
crying episodes with fists and legs noted to be tense and stiff. The infant is breastfeeding exclusively
and is often fussy during feedings. Physical exam is normal with infant gaining weight normally. What
would the NP recommend? - ANSWEREliminating certain food from the mothers diet
A child is in the clinic after swallowing a metal bead. A xray of the GI tract shows a 6mm cylindrical
object in the child's stomach. The child is able to swallow without difficulty and is not experiencing
pain. What is the correct course of treatment? - ANSWERHave the parents watch for the object in the
child's stool
A 10 year old has had abdominal pain for 2 days which began in the periumbilical area and then
localized to the RLQ. The child vomited once today and then experienced relief from pain followed by
an increased fever. What is the likely diagnosis? - ANSWERAppendicitis with perforation
A 18 month old child has 1 day history of intermittent cramping abdominal pain with nonbilious
vomiting. The child is observed to scream and draw up his legs during pain episodes and becomes
lethargic in between. The NP notes a small amount of bloody, mucous stool in the diaper. What is the
most likely diagnosis? - ANSWERIntussusception
A school age child has had abdominal pain for 3 months that occurs once or twice weekly and is
associated with a headache and occasional difficulty sleeping, often causing the child to stay home
from school. The child has not vomited or had diarrhea and is gaining weight normally. The physical
, exam is normal. What should be included in the initial diagnostic workup? - ANSWERCBC, ESR,
amylase, lipase, UA, and abdominal US
An adolescent is diagnosed with functional abdominal pain. The child's symptoms worsen during
stressful events, especially school anxiety. What will be an important part of treatment for this child?
- ANSWERTeaching about the brain gut interaction causing symptoms
A school age child has recurrent diarrhea with foul smelling stools, excessive flatus, abdominal
distention, and failure to thrive. A 2 week lactose free trial failed to reduce symptoms. What is the
next step in diagnosing the child? - ANSWERSerologic testing for celiac disease
A child is diagnosed with Crohn disease. What are the likely complications for this child? -
ANSWERIntestinal obstruction with scarring and strictures
A 12 month old infant exhibits poor weight gain after previous normal growth patterns. There is no
history of vomiting, diarrhea, or irregular bowel movements and the physical exam is normal. What
is the next step in evaluating these findings? - ANSWERFeeding and stool history and 3 day diet
history
A 2 year old child has an acute diarrheal illness. The child is afebrile and with oral rehydration
measures has remained well hydrated. The parent asks what can be done to help shorten the course
of the illness. What will the NP recommend? - ANSWERLactobacillus
A 30 month old girl who has been toilet trained for 6 months has daytime enuresis and dysuria with a
low grade fever. Dipstick urinalysis is negative for leukocyte esterase and nitrites. What is the next
step? - ANSWERSend the urine to the lab for culture
The clean catch urine specimen of a child with dysuria, frequency, and fever has a colony count
between 50,000 and 100,000 of E.Coli What is the treatment for this child? - ANSWERTreat with
antibiotics for UTI
A dipstick urinalysis is positive for leukocyte esterase and nitrites in a school aged child with dysuria
and foul smelling urine but no fever who has not previously had a UTI. Culture is pending. What will
the NP do to treat this child? - ANSWERPrescribe trimethoprimsulfamethoxazole (TMP) BID for 3-5
days
A preschool 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. Culture is pending. Which is the
correct course of treatment for this child? - ANSWEROrder amoxicillin clavulanate
A 3 year old child has just completed a 7 day course of amoxicillin for a second febrile UTI and
currently has a negative urine culture. What is the next course of action? - ANSWERObtain a renal
and bladder ultrasound
A 9 month old infant with a history of three UTI's is diagnosed with grade II vesicoureteral reflux.
Which medication will be prescribed? - ANSWERTMPSMX; TMP 2mg/kg as a single daily dose
The parent of a toddler diagnosed with grade V vescicoureteral reflux asks the primary care pediatric
NP how the disease will be treated. What with the NP tell the parent? - ANSWERThat surgery to
correct the condition is possible
A healthy 14 year old female has a dipstick urinalysis that is positive for 56 RBCs per hpf but
otherwise normal. What is the first question the NP should ask? - ANSWERWhen was your LMP
What will the NP tell the parents about the use of probiotics? - ANSWERThere is no conclusive
evidence about using probiotics to treat colic
Premature infant with poor feeding has a barium study with a normal esophagus what should the NP
consider next to manage the child's nutritional needs? - ANSWERVideo fluoroscopy swallowing study
A toddler is seen in the clinic for 2 days of vomiting & diarrhea. Assessment reveals an irritable child,
with dry mucous membranes, 3 second cap refill, 2 second recoil of skin, mild tachycardia and
tachypnea. Cool hands and feet. The child has had two wet diapers in 24 hours. What will the NP
recommend? - ANSWEROral rehydration solution with follow up in 24 hours
A 9 year old girl has a history of frequent vomiting and her mother has frequent migraines. The child
has begun having more frequent and prolonged episodes accompanied by headaches. An exam
reveals abnormal eye movement and mild ataxia. What is the correct action? - ANSWERRefer to
pediatric gastroenterologist for further workup
The parent of a 3 month old reports that the infant arches and gags while feeding and spits up
undigested formula frequently. The infants weight gain has dropped to 5th percentile from 12th
percentile. What is the best course of treatment for this infant? - ANSWERBegin a trial of extensively
hydrolyzed protein formula for 2 to 4 weeks
A school aged child has a 3 month history of dull, aching, epigastric pain that worsens with eating
and awakens the child from sleep. A CBC shows a hemoglobin of 8mg/dL. What is the next step in
management? - ANSWERReferral for esophagogastroduodenoscopy (EGD)
A 2 month old infant cries up to 4 hours each day and according to the parents is inconsolable during
crying episodes with fists and legs noted to be tense and stiff. The infant is breastfeeding exclusively
and is often fussy during feedings. Physical exam is normal with infant gaining weight normally. What
would the NP recommend? - ANSWEREliminating certain food from the mothers diet
A child is in the clinic after swallowing a metal bead. A xray of the GI tract shows a 6mm cylindrical
object in the child's stomach. The child is able to swallow without difficulty and is not experiencing
pain. What is the correct course of treatment? - ANSWERHave the parents watch for the object in the
child's stool
A 10 year old has had abdominal pain for 2 days which began in the periumbilical area and then
localized to the RLQ. The child vomited once today and then experienced relief from pain followed by
an increased fever. What is the likely diagnosis? - ANSWERAppendicitis with perforation
A 18 month old child has 1 day history of intermittent cramping abdominal pain with nonbilious
vomiting. The child is observed to scream and draw up his legs during pain episodes and becomes
lethargic in between. The NP notes a small amount of bloody, mucous stool in the diaper. What is the
most likely diagnosis? - ANSWERIntussusception
A school age child has had abdominal pain for 3 months that occurs once or twice weekly and is
associated with a headache and occasional difficulty sleeping, often causing the child to stay home
from school. The child has not vomited or had diarrhea and is gaining weight normally. The physical
, exam is normal. What should be included in the initial diagnostic workup? - ANSWERCBC, ESR,
amylase, lipase, UA, and abdominal US
An adolescent is diagnosed with functional abdominal pain. The child's symptoms worsen during
stressful events, especially school anxiety. What will be an important part of treatment for this child?
- ANSWERTeaching about the brain gut interaction causing symptoms
A school age child has recurrent diarrhea with foul smelling stools, excessive flatus, abdominal
distention, and failure to thrive. A 2 week lactose free trial failed to reduce symptoms. What is the
next step in diagnosing the child? - ANSWERSerologic testing for celiac disease
A child is diagnosed with Crohn disease. What are the likely complications for this child? -
ANSWERIntestinal obstruction with scarring and strictures
A 12 month old infant exhibits poor weight gain after previous normal growth patterns. There is no
history of vomiting, diarrhea, or irregular bowel movements and the physical exam is normal. What
is the next step in evaluating these findings? - ANSWERFeeding and stool history and 3 day diet
history
A 2 year old child has an acute diarrheal illness. The child is afebrile and with oral rehydration
measures has remained well hydrated. The parent asks what can be done to help shorten the course
of the illness. What will the NP recommend? - ANSWERLactobacillus
A 30 month old girl who has been toilet trained for 6 months has daytime enuresis and dysuria with a
low grade fever. Dipstick urinalysis is negative for leukocyte esterase and nitrites. What is the next
step? - ANSWERSend the urine to the lab for culture
The clean catch urine specimen of a child with dysuria, frequency, and fever has a colony count
between 50,000 and 100,000 of E.Coli What is the treatment for this child? - ANSWERTreat with
antibiotics for UTI
A dipstick urinalysis is positive for leukocyte esterase and nitrites in a school aged child with dysuria
and foul smelling urine but no fever who has not previously had a UTI. Culture is pending. What will
the NP do to treat this child? - ANSWERPrescribe trimethoprimsulfamethoxazole (TMP) BID for 3-5
days
A preschool 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. Culture is pending. Which is the
correct course of treatment for this child? - ANSWEROrder amoxicillin clavulanate
A 3 year old child has just completed a 7 day course of amoxicillin for a second febrile UTI and
currently has a negative urine culture. What is the next course of action? - ANSWERObtain a renal
and bladder ultrasound
A 9 month old infant with a history of three UTI's is diagnosed with grade II vesicoureteral reflux.
Which medication will be prescribed? - ANSWERTMPSMX; TMP 2mg/kg as a single daily dose
The parent of a toddler diagnosed with grade V vescicoureteral reflux asks the primary care pediatric
NP how the disease will be treated. What with the NP tell the parent? - ANSWERThat surgery to
correct the condition is possible
A healthy 14 year old female has a dipstick urinalysis that is positive for 56 RBCs per hpf but
otherwise normal. What is the first question the NP should ask? - ANSWERWhen was your LMP
