The parent of an infant asks about using a probiotic medication. What will the primary care pediatric nurse practitioner tell this parent?
A. Probiotic medications have demonstrated efficacy in treating colic.
B. Probiotics are not safe to use to treat infants who have colic. C. There are no stu...
The parent of an infant asks about using a probiotic medication. What will the primary care pediatric
nurse practitioner tell this parent?
A. Probiotic medications have demonstrated efficacy in treating colic.
B. Probiotics are not safe to use to treat infants who have colic. C. There are no studies showing
usefulness of probiotics to manage colic. D. There is no conclusive evidence about using probiotics to
treat colic - ANSWERD. There is no conclusive evidence about using probiotics to treat colic
A toddler who was born prematurely refuses most solid foods and has poor weight gain. A barium
swallow study reveals a normal esophagus. What will the primary care pediatric nurse practitioner
consider next to manage this child's nutritional needs?
A. Consultation with a dietician B. Fiberoptic endoscopy evaluation
C. Magnetic resonance imaging
D. Video fluoroscopy swallowing study - ANSWERD. Video fluoroscopy swallowing study
A toddler is seen in the clinic after a 2 day history of intermittent vomiting and diarrhea. An
assessment reveals an irritable child with dry mucous membranes, 3 second capillary refill, 2 second
recoil of skin, mild tachycardia and tachypnea, and cool hands and feet. The child has had two wet
diapers in the past 24 hours. What will the primary care pediatric nurse practitioner recommend?
A. Antidiarrheal medication and clear fluids for 24 hours B. Bolus of IV normal saline in the clinic
until improvement C. Hospital admission for IV rehydration and oral fluids D. Oral rehydration
solution with follow-up in 24 hours - ANSWERD. Oral rehydration solution with follow-up in 24 hours
A 9 year old girl has a history of frequent vomiting and her mother has frequent migraine headaches.
The child has recently begun having more frequent and prolonged episodes accompanied by
headaches. An exam reveals abnormal eye movements and mild ataxia. What is the correct action?
A. Begin using an antimigraine medication to prevent headaches. B. Prescribe ondansetron and
lorazepam to help manage symptoms.
C. Reassure the parent that this is expected with cyclic vomiting syndrome. D. Refer to a pediatric
gastroenterologist for further workup - ANSWERD. Refer to a 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 infant's weight gain has dropped to the 5th percentile from the
12th percentile. What is the best course of treatment for this infant?
A. Begin a trial of extensively hydrolyzed protein formula for 2 to 4 weeks. B. Institute an empiric
trial of acid suppression with a proton pump inhibitor (PPI). C. Perform esophageal pH monitoring to
determine the degree of reflux. D. Reassure the parent that these symptoms will likely resolve by 12
to 24 months. - ANSWERA. Begin a trial of extensively hydrolyzed protein formula for 2 to 4 weeks.
, A school age child has a 3 month history of dull, aching epigastric pain that worsens with eating and
awakens the child from sleep. A complete blood count shows a hemoglobin of 8 mg/dL. What is the
next step in management?
A 10 year old child has had abdominal pain for 2 days, which began in the periumbilical area and
then localized to the right lower quadrant. The child vomited once today and then experienced relief
from pain followed by an increased fever. What is the likely diagnosis?
A. Appendicitis with perforation B. Gastroenteritis C. Pelvic inflammatory disease (PID) D. Urinary
tract infection (UTI) - ANSWERA. Appendicitis with perforation
An 18 month old child has a 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 primary care pediatric nurse practitioner notes a small amount of bloody,
mucous stool in the diaper. What is the most likely diagnosis?
A. Appendicitis B. Gastroenteritis C. Intussusception D. Testicular torsion - ANSWERC.
Intussusception
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 does not have vomiting or diarrhea and is gaining weight normally. The
physical exam is normal. According to Bishop, what is included in the initial diagnostic workup for this
child?
A. CBC, ESR, amylase, lipase, UA, and abdominal ultrasound
B. CBC, ESR, CRP, and fecal calprotectin C. CBC, ESR, CRP, UA, stool for ova, parasites, and culture D.
Stool for H. pylori antigen and serum IgA, IgG, tTg - ANSWERA. CBC, ESR, amylase, lipase, UA, and
abdominal ultrasound
An adolescent is diagnosed with functional abdominal pain (FAP). The child's symptoms worsen
during stressful events, especially with school anxiety. What will be an important part of treatment
for this child?
A. Informing the parents that the pain is most likely not real
B. Instituting a lactose free diet along with lactobacillus supplements
C. Teaching about the brain gut interaction causing symptoms D. Using histamine 2 blockers to help
alleviate symptoms - ANSWERC. Teaching about the brain gut interaction causing symptoms
A school age child has recurrent diarrhea with foul smelling stools, excessive flatus, abdominal
distension, and failure to thrive. A 2 week lactose free trial failed to reduce symptoms. What is the
next step in diagnosing this condition?
A. Lactose hydrogen breath test B. Serologic testing for celiac disease C. Stool for ova and parasites D.
Sweat chloride test for cystic fibrosis - ANSWERB. Serologic testing for celiac disease
A child is diagnosed with Crohn disease. What are likely complications for this child? A. Cancer of the
colon and possible colectomy
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