The most common reason for precocious puberty in girls is: - ANSWER Early onset
of normal puberty
When billing Medicaid, NPs get the authority to bill their services from: - ANSWER
State and federal law
You have initiated therapy for an 18 yom with acne vulgaris and have prescribed
doxycycline. He returns in 3 weeks, complaining that his skin is no better. Your next
action is to: - ANSWER Counsel him that 6-8 weeks of treatment is often needed
before significant improvement is achieved
For a Grade I ankle sprain, weight-bearing should be avoided for at least: -
ANSWER 24 hours
Hemoglobin A1c best provides information on glucose control over the past: -
ANSWER 21-47 days
18 yom presents with periumbilical pain, vomiting, and abdominal cramping over the
past 48 hours. Physical examination reveals rebound tenderness and laboratory
analysis shows the presence of bandemia and a total WBC of 28,000. To support the
diagnosis of acute appendicitis with suspected appendiceal rupture, you consider
obtaining the following: - ANSWER CT scan
2 yof presents with a 3-day history of fever, crankiness, and congested cough. Her
respiratory rate is more than 50% of the upper limits of normal for age. Tubular
breath sounds are noted at the right lung base. Skin turgur and normal, and she is
wearing a wet diaper. She is alert, resisting the examination as age appropriate, and
engages in eye contact. Temperature is 38.3. Her diagnostic evaluation should
include: - ANSWER Chest x-ray
Aortic stenosis in a 15 yom is: - ANSWER A result of a congenital defect
Which of the following laboratory tests can identify the causative organism of
bronchiolitis? - ANSWER Nasal washing antigen test
A Still murmur: - ANSWER Has a humming or vibratory quality
A physiological murmur has which of the following characteristics? - ANSWER
Becomes softer when the patient moves from supine to standing
Cyclic vomiting may: - ANSWER Not be associated with a headache
5 day old infant, jaundice, sunken anterior fontanel, difficulty latching, bilirubin 18,
dehydrated and drinks breast milk, jaundice. Interventions? - ANSWER
Interventions: all of the above (phototherapy, providing support, strict I/O)
, Infant with dehydration. Weight 6kg, watching I/O, adequate hydration, urinary
output. How much fluid would you give? - ANSWER 13 ml/kg/hour
PCP diagnosed 5 year old with asthma. Prescribes PO steroid and SABA via
metered-dose inhaler. What information is important to give? - ANSWER Make
recommendations for disease mamagement
18 month old presents with rectal temperature of 100.4, acting normal. NP would
recommend: - ANSWER Offering extra fluids and calling if symptoms change
10 year old child with shooting pain in both legs, aching, tingling, burning, unable to
pin point specific location. What type of pain is this? - ANSWER Neuropathic pain
Parent concerned about vaccine reaction. What should NP tell them? - ANSWER
MMR may be linked to febrile seizures in immunocompromised children
2 month old in the office to receive immunization, having fevers after. What would
the NP recommend? - ANSWER Ibuprofen and Tylenol as needed
PCP has an 18 month old patient who received MMR 2 days prior to 1st birthday.
What should the NP do? - ANSWER Recommend next dose of MMR at 4-5 years
5 year old with a history of pertussis. What immunizations do they need prior to
starting kindergarten? - ANSWER DTaP
Trelarche stage in females? - ANSWER All of the above (pubic hair, breast tissue,
1st period)
How often should thyroid studies be performed? - ANSWER Yearly
Down Syndrome 18x greater in what population than that of the general population?
- ANSWER Leukemia
Down syndrome spinal cord changes? - ANSWER All of the above
Patient presents with chronic otitis media, profuse purulent otorrhea, pearly white
lesion on one tympanic membrane - ANSWER Cholestatoma
2 week old presents with wide spitting, S2 expiration - ANSWER Atrial septal defect
New grade II vibratory, midsystolic murmur, louder when patient is supine -
ANSWER Stills murmur
Harsh, blowing, grade IV/VI murmur at 6 month old. What should the NP do? -
ANSWER Refer to cardiology
What should the NP prescribe for a 12 month old who had a heart defect at 8
months? - ANSWER Amoxicillin
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