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MN 580: Final Exam
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Exam of 18 pages for the course MN 580 at MN 580 (MN 580: Final Exam)
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MN 580: Final ExamThe mother of a 16yearold male was recently divorced after several years of an
abusive relationship and tells the primary care pediatric nurse practitioner that the
adolescent has begun skipping school and hanging out with friends at the local
shopping mall. When she confronts her child, he responds by saying that he hates
her. What will the nurse practitioner tell this mother?
a. Adolescence is marked by an inability to comprehend complex situations
.b. Adolescence is typically marked by tempestuous and transient episodes.
c. Adolescents normally have extreme, disruptive conflicts with parents.
d. Adolescents often need counseling to help them cope with life events - ANSWER
d
The primary care pediatric nurse practitioner performs a well baby examination on a
7-day-old infant who is nursing well, according to the mother. The nurse practitioner
notes that the infant weighed 3250 grams at birth and 2990 grams when discharged
on the second day of life. The infant weighs 3080 grams at this visit. Which action is
correct?
a. Follow up at the 2-month checkup.
b. Refer to a lactation consultant.
c. Schedule a weight check in 1 week.
d. Suggest supplementing with formula. - ANSWER C
This infant lost about 8% of its birth weight, which is normal and, since discharge
home, has gained at least 15 grams per day, which is also normal. The PNP should
schedule a weight check in a week to make sure the infant regains its birth weight,
since most should regain this in 10 to 14 days and since this loss of birth weight is at
the high end of normal. It is not necessary to refer to a lactation consultant or
supplement with formula, since the infant is gaining weight adequately.
The parent of a newborn infant asks the primary care pediatric nurse practitioner
when to intervene to help the infant's future intellectual growth. What will the nurse
practitioner tell the parent?
a. Cognitive learning begins during the toddler years.
b. Intellectual growth begin when speech develops.
c. Language and literacy skills begin at birth.
d. Preschool is an optimal time to begin general learning. - ANSWER c. Language
and literacy skills begin at birth.
General learning and acquisition of skills for later reading and writing begin at birth,
not in kindergarten or first grade, and these skills grow with everyday loving
interactions between infants and caregivers. Cognitive learning changes during
toddler years but begins at birth. Intellectual growth is not tied to speech alone.
,The parent of a 10 yearold boy tells the primary care pediatric nurse practitioner that
the child doesn't appear to have any interest in girls and spends most of his time with
a couple of other boys. The parent is worried about the child's sexual identity. The
nurse practitioner will tell the parent:
A. children at this age who prefer interactions with same gender peers usually have
a homosexual orientation.
B. children experiment with sexuality at this age as a means of deciding later sexual
orientation.
C.this attachment to other same gender children is how the child learns to interact
with others.
D. to encourage mixed gender interactions in order to promote development of
sexual values - ANSWER C.this attachment to other same gender children is how
the child learns to interact with others.
The parent of a 2weekold
infant reports that the infant was diagnosed with
transient tachypnea of the newborn shortly after birth. The primary carepediatric
nurse
practitioner understands that, in this condition,
A. antibiotic therapy is generally necessary to prevent severeinfection.
B. home oxygen therapy is needed until the infant grows out of thecondition.
C. recovery is usually complete with minimal intervention and
treatments.
D. treatment with exogenous surfactant and mechanical ventilation isneeded -
ANSWER C. recovery is usually complete with minimal intervention and
treatments
An infant has congenital adrenal hyperplasia. At a routine well baby
checkup, the
primary care pediatric nurse practitioner notes vomiting, poor feeding, lethargy, and
dehydration. Which action is correct?
A Administer an intramuscular stress dose of hydrocortisone succinate.
B Administer intravenous fluids in the clinic and reassess hydration status.
C Prescribe an oral hydrocortisone in a replacement dose of 8 to 10mg/M2.
D Refer the infant to the emergency department for fluids, dextrose,
and steroids. - ANSWER D Refer the infant to the emergency department for fluids,
dextrose, and steroids.
The parent of a 4-day-old infant tells the primary care pediatric nurse
practitioner that the infant was diagnosed with hydronephrosis while in utero and
asks what will be done. What will the nurse practitioner tell this parent?
A.Renal function will be abnormal and will require lifetime treatment.
B. Spontaneous resolution often occurs within 6 months to a yearof
age.
C. The affected kidney will be nonfunctionalbut the
other kidney will
compensate.
, D The infant will eventually require renal transplantation for that kidney. - ANSWER
B. Spontaneous resolution often occurs within 6 months to a year of age.
An initial key part of management of a child suspected of having an inborn error of
metabolism is
a. consulting a metabolic specialist
b. obtaining a complete family history
.c. ordering metabolic screening tests.
d. referring the family to a dietician. - ANSWER a. consulting a metabolic specialist
The primary care pediatric nurse practitioner notes a musty odor when
examining a newborn at a 2 week checkup. What will the nurse practitioner suspect?
A.Galactosemia
B. Glucose6phosphatase
deficiency
C. Phenylketonuria
D. Urea cycle disorder - ANSWER C. Phenylketonuria
A 16-year-old adolescent female whose BMI is at the 90th percentile reports irregular
periods. The primary care pediatric nurse practitioner notes widespread acne on her
face and back and an abnormal distribution of facial hair. The nurse practitioner will
evaluate her further based on a suspicion of which diagnosis?
A. Dyslipidemia
B. Hypothyroidism
C. Nonalcoholic steatohepatitis
D. Polycystic ovary syndrome - ANSWER D. Polycystic ovary syndrome
The primary care pediatric nurse practitioner prescribes metformin for a 15yearold
adolescent newly diagnosed with type 2 diabetes. What will the nurse practitioner
include when teaching the adolescent about this drug?
A. That insulin therapy will be necessary in the future
B. The importance of checking blood glucose 3 or 4 times daily
C To consume a diet with foods that are high in vitamin B12
D To use a stool softener to prevent gastrointestinal side effects - ANSWER B. The
importance of checking blood glucose 3 or 4 times daily
The primary care pediatric nurse practitioner notes the presence of a
hyperpigmented velvet like rash in skin folds. The child denies polydipsia,
polyphagia, and polyuria. The nurse practitioner will
A counsel the child to lose weight to prevent type 2 diabetes.
B. diagnose type 2 diabetes if the child has a random glucose of 180mg/dL.
C. order a fasting blood sample for a metabolic screen for type 2 diabetes.
D. refer the child to a pediatric endocrinologist - ANSWER C. order a fasting blood
sample for a metabolic screen for type 2 diabetes.
The mother of a female infant is concerned that her daughter is
developing breasts. The primary care pediatric nurse practitioner notes mild breast
development but no pubic or axillary hair. What is the likely diagnosis?
A Congenital adrenal hyperplasia causing breast development
B. Precocious puberty needing endocrinology management
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