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Course NUNP-6541N-10,Primary Care Adolescnt & Child.2020 Spring
Qtr 02/24-05/17-PT
Test Week 6 - Midterm Exam
Started 3/31/20 2:
AM Submitted 3/31/20 5:
AM Due Date 4/6/20 1:59 AM
Status Completed
Attempt Score 84 out of 100 points
Time Elapsed 2 hours, 18 minutes out of 3 hours and 20 minutes
Results
Displaye
d
Submitted Answers
When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?
Selected Ye
Answer: s
Miguel, age 14, was hit in the eye with a baseball and developed eye pain,
decreased visual acuity, and injection of the globe. Upon exam you note blood in
the anterior chamber and confirm diagnosis of hyphema. What treatment do
you recommend while Miguel is waiting to see the ophthalmologist
Selected
Answer:
a.
Apply bilateral eye patches. The father of a 3-year-old is concerned because the child stutters. What should your approach be?
Selected
Answer:
a.
Explain that this can be normal until 4 years of age. A 2-day-old newbornwith conjunctivitis is likely due to
Selected
Answer:
b.
Gonorr h ea
You see a 13-year-old who reports she is learning some basic geometry (areas,
volume etc.). The ability to successfully master these concepts occurs during
which Piaget developmental stage?
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Selected
Answer:
b.
Sensorimo tor
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developmentally delayed throughout her life, and to have required cataract
surgery shortly after birth. She currently takes phenobarbital for seizures. Which
of the following would most likely explain this child’s small size?
Selected
Answer:
e.
Congenital cytomegalovirus infection A child's head circumference is routinely measured on each well visit until what age?
Selected
Answer:
a.
years
A 14-year-old female comes into the office for an urgent visit after taking 10
valium tablets. Following the initial emergent care and stailization, the most
important part of the management is:
Selected
Answer:
a.
Assessing the family supports available to the child. All of the following are consistent with peritonsillar abscess except:
Selected
Answer:
b.
Exudate on tonsils Which of the following complication of strep pharyngitis cannot be prevented with antibiotics?
Selected
Answer:
b.
Glomeruloneph ritis A 4-year-old believes there is more juice in a tall, thin glass than a shorter, wider one. The child has not yet achieved which of the principles of Piaget?
Selected
Answer:
b.
Conservat ion Josh, age 13 , has some enlargement of the scrotum and testes, a reddened scrotal sac, and some hair texture alteration. His penis is not enlarged. He is in Tanner stage
Selected d.
Answer: II
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Answer:
Diarr h (^) ea A 12-year-old male states he noticed an enlargement of his testes and scrotum. When counseling him about the next step in pubertal development, you state:
Selected
Answer:
d.
The penis will grow in length and width. You see a 7-year-old with complaints of "having accidents at night." Physical exam and history are unremarkable. Urinalysis, urine culture, and specific gravity are normal. His parents ask about the best treatment for this problem. The best response is
Selected
Answer:
a.
Fluid restriction and voiding prior to the night may be effective. Chelsea, age 8, complains that she feels as if something is stuck in her ear. What action is contraindicated?
Selected
Answer:
c.
Flushing the ear with water.
By what age should most children be able to sit well without support?
Selected
Answer:
a.
mont h s A typically developing 8-year-old girl will have which of the following genital development?
Selected
Answer:
a.
No pubic hair at all John is diagnosed with allergic conjunctivitis. What type of discharge do you expect to see upon exam?
Selected
Answer:
c.
Serous and clear
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Which of the following vaccines is routinely recommended at 4 months of age?
Selected a.
Answer:
Parents bring their 6-month-old son to see you. He is symmetrically less than the 5th percentile for height, weight and head
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circumference. He was born at 30 weeks’ gestation and weighed 1000g. He was a planned pregnancy, and his mother’s prenatal course was uneventful until an automobile accident initiated the labor. He was ventilated for 3 days in the intensive care unit but otherwise did well without ongoing problems. He was discharged at 8 weeks of life. Which of the following is the most likely explanation for his small size?
Selected
Answer:
e.
Normal ex-preemie infant growth You assess a 15-year-old's visual acuity and note her vision to be 20/50 in the right eye. She asks you what that means and you respond
Selected
Answer:
d.
"You can see at 20 feet with your right eye what most people can see at 50 feet."
During a “well-child” visit, the parents of a healthy 5-month-old offer a great amount
of information. Which of the following bits of information is of most concern?
Selected
Answer:
a.
Limited eye contact with parents. You are performing an examination of a 3-year-old who is new to your office. Which finding requires immediate further evaluation?
Selected
Answer:
d.
Weight plots in the 50th percentile, while height plots at the 75th percentile. A 9-year-old who weighs 70 pounds asks why she can't sit in the front passenger seat of the family car. Your best response is
Selected
Answer:
c.
The safest place for children under 12 years old and 100 pounds is in the backseat of the car. Which of the following would not suggest an eating disorder with a purging component?
Selected
Answer:
d.
Sore throa t A fifteen-year-old female makes a statement to you during a well visit. Which of the following statements should not be kept confidential?
Selected Answer:
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Sarah, age 15, presents with pain and pressure over her cheeks and discolored nasal discharge. You cannot transilluminate the sinuses. You suspect which common sinus to be affected?
Selected
Answer:
d.
Maxillar y sinus A 6-month-old infant has been growing poorly. His parents have changed his formula three times without success. His examination is remarkable for a pale, emaciated child with little subcutaneous fat and anterior fontanelle fullness. His laboratory test results are notable for a hemolytic anemia and prolonged bleeding times. Which of the following is the most appropriate next step?
Selected
Answer:
d.
Obtain a sweat chloride concentration Medicaid provides health insurance coverage to
Selected
Answer:
a.
Certain categories of people whose personal income falls below a certain percentage of the federal poverty level. The mother of a 5-year-old informs you that her daughter cheats when playing board games. What is the best response?
Selected
Answer:
b.
Tell the mother to spend time clarifying board game rules before starting games. Which of the following substances is associated with pupillary constriction?
Selected
Answer:
b.
Hero i n
A 7-year-old has just been diagnosed with attention deficit hyperactivity
disorder (ADHD). Her parents report that she is doing poorly in school and is
disruptive in the classroom. They ask you what they can do. Your best response
is:
Selected
Answer:
a.
"Use a consistent approach with behavioral cues both at home and at school." Flourescein staining of the eye is used to detect a
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Selected
Answer:
c.
Foreig n body
• Question 47
c
. esopho
ria
A 7-year-old boy with mental retardation was born at home at 26 weeks gestation to a 28-
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year-old mother who had received no prenatal care. An evaluation is likely to suggest
his MR is related to which of the following?
Selected
Answer:
e.
Complications of prematurity The most common substance used in middle school is
Selected
Answer:
a.
Alcoh ol A 2-day-old infant has significant nasal and rectal bleeding. He was delivered by a midwife at home; the pregnancy was without complications. His Apgar scores were 9 at 1 minute and 9 at 5 minutes. He has breastfed well and has not required a health care professional visit since birth. Which of the following vitamin deficiencies might explain his condition?
Selected
Answer:
a.
Vitami n K Tammy, age 3, is at the office for her well-child visit. She has trouble removing her own shirt as requested. Her mother yanks off her shirt after smacking her wrist and saying, "you must do as you're told quickly." Which action is indicated?
Selected
Answer:
d.
Observe Tammy for signs of child abuse.
A 4-month-old child has poor weight gain. Her current weight is less than the 5th
percentile, height about the 10th percentile, and head circumference at the 50th
percentile. The planned pregnancy resulted in a normal, spontaneous, vaginal delivery;
mother and child were discharged after a 48-hour hospitalization. Feeding is via breast
and bottle; the quantity seems sufficient. The child has had no illness. The examination
is unremarkable except for the child’s small size. Screening laboratory shows the
hemoglobin and hematocrit are 11 mg/dL and 33% respectively, with a platelet count of
198,000/mm3. Serum electrolyte levels are sodium 140, chloride 105, potassium 3.5,
bicarbonate 17, blood urea nitrogen 15, and creatinine 0.3. Liver function tests are
normal. Urinalysis reveals a pH of 8 with occasional epithelial cells but no white blood
cells, bacteria, protein, ketones, or reducing substances.
Which of the following is the most appropriate therapy for this child?
Selected
Answer:
d.
Oral supplementation with bicarbonate
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testosterone
A 2-year-old boy has been slightly less than the 50th percentile for weight,
height and head circumference, but in the last 6 months he has fallen to slightly
less than the 25th percentile for weight. The pregnancy was normal, his
development is as expected, and the family reports no psychosocial problems.
The mother says that he is now a finicky eater (wants only macaroni and cheese
at all meals), but she insists that he eat a variety of foods. The meals are marked
by much frustration for everyone. His examination is normal. Which of the
following is the best next step in his care?
Selected
Answer:
c.
Reassurance and counseling for family about childhood normal developmental stage
I like to use my pincer grasp that involves the ablitily to pick up a small object
such as a raisin or piece of cereal with the thumb and forefinger, and that is
mastered around what age?
Selected
Answer:
b.
mont h s An 11-year-old girl has dizziness, pupillary dilation, nausea, fever, techycardia, and facial flushing. She says she can "see" sound and "hear" colors. The agent likely to be responsible is which of the following?
Selected
Answer:
d.
Lysergic acid diethylamide (LSD)
An 8-year-old female is brought into the office by her mother. She has
complaints of fever and sore throat for the past 2 days. She denies difficulty
swallowing but has loss of appetite and mild diarrhea. A few classmates have
similar symptoms. A review of systems reveals clear nasal drainage, dry cough,
and hoarseness. On exam she has a 101.5 temperature, 3+ erythematous
tonsils, and anterior cervical lymphadenopathy. What is the likely diagnosis?
Selected
Answer:
c.
Viral pharyngiti s
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Appropriate advice for a mother of a 2-week-old child here for a “well child” visit
includes which of the following?
Selected
Answer:
c.
Sleep in the supine position is recommended
