FNP Pediatric Exam Test Bank; 2022.
The concept of health promotion consists of efforts to prevent rather than to cure disease or disability. This description best describes:
a. tertiary prevention
b. secondary prevention
c. primary prevention
d. morbidity prevention ✅- c
Standards for well child care and health promotion are set forth by the:
a. Task Force on Preventative Services, US Department of Health and Human services
b. American Academy of Family Physicians
c. American Academy of pediatrics
d. Healthy People 2010 and 2020 ✅- c
A 15 yo female comes to the clinic for a health maintenance visit. The patient reports no complaints. She does well in school, has many friends, and gets along well with her parents and two siblings. She has recently become sexually active with her boyfriend of 6mo. The physical exam is normal for her age. What screening, lab tests, and/or immunizations should the PNP order?
a. Vision, hearing, urinalysis, STD screen, pelvic exam, and immunizations as needed
b. STD screen, pneumococcal vaccine, pelvic exam, and cholesterol screening as indicated
c. vision, hearing, STD screen, pelvic exam, and hemoglobin if indicated.
d. Measles vaccine, vision, hearing, STD screen, pelvic exam exam, and cholesterol screen if indicated. ✅- a
Which of the following is the best written chief complaint?
a. 5yo asian female with itchy red rash
b. 1 mo with difficulty feeding
c. 15yo african american female complaining of lower abdominal pain for 3 days
d. 12yo caucasian with itchy eye for 1 week ✅- c
The past history should include
a. family history
b. social hx
c. symptom analysis
d. hospitalization ✅- d The family history should include:
a. the health status of the paternal grandparents
b. the living conditions of the family
c. the work status of the parents
d. school information ✅- a
Which of the following statements would be considered subjective data obtained from the client during the review of systems for the skin?
a. the skin appears dry & excoriated
b. a lesion is noted on the lateral aspect of the right leg
c. there is moderate acne on the forehead and back
d. the patient denies changes in skin texture ✅- d
The PNP is completing the ROS on a 4mo. What response from the mother might indicate a cardiac problem in the infant & require a more thorough history? a. the baby gets the hiccups often.
b. it takes the baby over 30min to complete a bottle
c. the baby's heart seems to beat rapidly sometimes
d. sometimes the baby sounds congested ✅- b
The PNP is obtaining a review of systems on a healthy 8yo girl. It would be important to include:
a. the date of last breast self-exam.
b. any limitations related to sports participation.
c. the last hematocrit and hemoglobin
d. the last lead screen ✅- b
The mother of a 3yo states that her son was completely toilet trained at 18mo. The PNP explores further, asking:
a. how the mother did the toilet training
b. if the child is dry at night and fully trained for urine and stool day and night
c. at what age did the mother begin toilet training the other child.
d. if the child gets up at night to use the bathroom ✅- b
Jasmine, a 5-month-old infant is in the clinic for a well child visit and is sleeping in her mother's arms. What should the PNP do first? a. Examine the ears, since this is uncomfortable for the infant.
b. Quickly give any needed immunizations.
c. Begin with assessment of the head and proceed from head to toe. d. auscultate the heart & lungs while the infant is sleeping. ✅- d
The mother of a newborn brings the baby to the clinic because she is afraid something is wrong with her baby ("his head is so big"). The PNP responds that:
a. "this is normal. The head of a newborn is proportionately large to the rest of the body"
b. "Yes, this does appear abnormal. I will make an appointment for the baby to be seen by a neurologist."
d. "your head appears large so it is probably genetic." ✅- a
A healthy 12yo female is at the clinic for a well checkup. On physical examination, a marked elevation of the right scapula and right thoracic hump and spinal curve abnormally are noted. Spinal films indicate 20 degree curve. The PNP should:
a. refer the patient to an orthopedist
b. monitor the patient every 3 mo until menarche
c. refer the patient for physical therapy
d. recommend bedrest and back brace ✅- a
What is the % of risk an autosomal dominant gene is being passed on to each offspring? a. 25
b. 50
c. 100
d. none ✅- b
A 13yo female is at the clinic for a routine check up. What presenting symptoms might alert the PNP to the presence of a possible genetic disorder?
a. <10% on growth chart, Tanner I, and learning difficulties
b. Precocious puberty, developmental delays, gifted piano player
c. Lactose intolerance, frequent ear infections, speech delays
d. Peanut allergy, right-sided weakness, and exhibits bullying behavior ✅- a
The parents of a child with cystic fibrosis are considering another pregnancy. They want to know what their chances are of having another child with cystic fibrosis. The PNP explains that cystic fibrosis is an autosomal recessive disorder and that each conception of carrier parents has a:
a. 25% chance of being affected
b. 50% chance of being affected
c. 75% chance of being affected
d. 100% chance of being affected ✅- a The parents of a son with hemophilia are considering another pregnancy. The mother has been identified as a carrier of the hemophilia gene. What chance does each female offspring have of having hemophilia. a. 100%
b. 50%
c. 25%
d. none ✅- d
A male with Vitamin D-resistant rickets asks what his chances are of passing his disease to his parents. The PNP answers:
a. all sons will be affected by only 25% daughters
b. all daughters are affected by only 25% sons
c. 50% of all offspring will have the disease
d. all daughters will be affected but no sons. ✅- d
The PNP is following a 15-year-old male adolescent with consistent blood pressure readings of 132 to 138/84 to 86 mm Hg, which is classified as significant hypertension. After performing a workup, the PNP determines that the adolescent has primary hypertension. The most judicious recommendation for therapy is:
A) Diet and exercise counseling and referral to a specialist
B) A diuretic, low-salt diet, exercise, and counseling by a dietician
C) Perform an extensive family history to determine other risk factors
D) A vasodilator, restricted activity, and a low-fat diet ✅- a
The PNP is examining a neonate with a heart murmur. The S2 sound is loudest at the apex. The respiratory rate is 65 breaths per minute, and the heart rate is 180 beats per minute. Which of the following would be an appropriate action by the PNP?
A) Reevaluate the neonate in 24 hours
B) Increase the number of oral feedings
C) Order cardiac catheterization
D) Refer the neonate to a cardiologist ✅- d
A 2-week-old neonate is brought to the clinic with excessive lacrimation of both eyes. The eyes are clear, with no areas of redness, but the corneas appear hazy. The PNP explains to the parents the possible diagnosis and treatment as follows:
A) Congenital glaucoma requiring an ophthalmology referral
B) Corneal foreign body requiring fluorescein staining and removal
