Final Exam NR 602
Study online at https://quizlet.com/_fwb1b3
The parent of an infant asks about using
a probiotic medication. What will the pri-
mary care pediatric nurse practitioner tell
this parent?
a. Probiotic medications have demon-
strated efficacy in treating colic. d. There is no conclusive evidence about
b. Probiotics are not safe to use to treat using probiotics to treat colic.
infants who have colic.
c. There are no studies showing useful-
ness of probiotics to manage colic.
d. There is no conclusive evidence about
using probiotics to treat colic.
A toddler who was born prematurely re-
fuses most solid foods and has poor
weight gain. A barium swallow study re-
veals a normal esophagus. What will the
primary care pediatric nurse practitioner
consider next to manage this child's nu- d. Video fluoroscopy swallowing study.
tritional needs?
a. Consultation with a dietician
b. Fiberoptic endoscopy evaluation
c. Magnetic resonance imaging
d. 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 irri-
table child with dry mucous membranes,
3 second capillary refill, 2 second re-
coil of skin, mild tachycardia and tachyp-
nea, and cool hands and feet. The child
d. Oral rehydration solution with follow-up
has had two wet diapers in the past 24
in 24 hours.
hours. What will the primary care pedi-
atric nurse practitioner recommend?
a. Antidiarrheal medication and clear flu-
ids for 24 hours
b. Bolus of IV normal saline in the clinic
until improvement
c. Hospital admission for IV rehydration
, Final Exam NR 602
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and oral fluids
d. Oral rehydration solution with fol-
low-up in 24 hours.
A 9-year-old girl has a history of fre-
quent vomiting, and her mother has fre-
quent migraine headaches. The child
has recently begun having more fre-
quent and prolonged episodes accom-
panied by headaches. An exam reveals
abnormal eye movements and mild atax-
ia. What is the correct action? b. Refer to a pediatric gastroenterologist
a. Begin using an antimigraine medica- for further workup. Correct
tion to prevent headaches.
b. Refer to a pediatric gastroenterologist
for further workup.
c. Prescribe ondansetron and lorazepam
to help manage symptoms.
d. Reassure the parent that this is ex-
pected with cyclic vomiting syndrome.
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
a. Begin a trial of extensively hydrolyzed
protein formula for 2 to 4 weeks.
protein formula for 2 to 4 weeks.
b. Institute an empiric trial of acid sup-
pression with a proton pump inhibitor
(PPI).
c. Perform esophageal pH monitoring to
determine the degree of reflux.
d. Reassure the parent that these symp-
toms will likely resolve by 12 to 24
months.
A school-age child has a 3 month his-
tory of dull, a ching epigastric pain that
, Final Exam NR 602
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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. Administration of H2RA or PPI med- d. Referral for esophagogastroduo-
ications denoscopy (EGD) Correct
b. Empiric therapy for H. pylori (HP)
c. Ordering an upper GI series
d. Referral for esophagogastroduo-
denoscopy (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 frequent-
ly but is often fussy during feedings. The
physical exam is normal, and the infant
is gaining weight normally. What will the
primary care pediatric nurse practitioner b. Eliminating certain foods from the
recommend? mother's diet
a. A complete workup, including labora-
tory and radiologic tests
b. Eliminating certain foods from the
mother's diet
c. Empiric treatment with a proton pump
inhibitor medication
d. Stopping breastfeeding and beginning
a hydrolyzed formula
A child is in the clinic after swallowing
a metal bead. A radiograph of the GI
tract shows 6 mm cylindrical object in the
child's stomach. The child can swallow
without difficulty and is not experiencing b. Have the parents watch for the object
pain. What is the correct course of treat- in the child's stool.
ment?
a. Administer ipecac to induce vomiting.
b. Have the parents watch for the object
in the child's stool.
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