The parent of an infant asks about using a probiotic medication. What will the primary care pediatric nurse practitioner tell this parent?
A. Probiotic medications have demonstrated efficacy in treating colic.
B. Probiotics are not safe to use to treat infants who have colic. C. There are no stu...
The parent of an infant asks about using a probiotic medication. What will the primary care pediatric
nurse practitioner tell this parent?
A. Probiotic medications have demonstrated efficacy in treating colic.
B. Probiotics are not safe to use to treat infants who have colic. C. There are no studies showing
usefulness of probiotics to manage colic. D. There is no conclusive evidence about using probiotics to
treat colic - ANSWER D. There is no conclusive evidence about using probiotics to treat colic
A toddler who was born prematurely refuses most solid foods and has poor weight gain. A barium
swallow study reveals a normal esophagus. What will the primary care pediatric nurse practitioner
consider next to manage this child's nutritional needs?
A. Consultation with a dietician B. Fiberoptic endoscopy evaluation
C. Magnetic resonance imaging
D. Video fluoroscopy swallowing study - ANSWER 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 irritable child with dry mucous membranes, 3 second capillary refill, 2 second recoil of skin,
mild tachycardia and tachypnea, and cool hands and feet. The child has had two wet diapers in the past
24 hours. What will the primary care pediatric nurse practitioner recommend?
A. Antidiarrheal medication and clear fluids for 24 hours B. Bolus of IV normal saline in the clinic until
improvement C. Hospital admission for IV rehydration and oral fluids D. Oral rehydration solution with
follow-up in 24 hours - ANSWER D. Oral rehydration solution with follow-up in 24 hours
A 9 year old girl has a history of frequent vomiting and her mother has frequent migraine headaches.
The child has recently begun having more frequent and prolonged episodes accompanied by headaches.
An exam reveals abnormal eye movements and mild ataxia. What is the correct action?
A. Begin using an antimigraine medication to prevent headaches. B. Prescribe ondansetron and
lorazepam to help manage symptoms.
C. Reassure the parent that this is expected with cyclic vomiting syndrome. D. Refer to a pediatric
gastroenterologist for further workup - ANSWER D. Refer to a pediatric gastroenterologist for further
workup
, 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 protein formula for 2 to 4 weeks. B. Institute an empiric trial of
acid suppression with a proton pump inhibitor (PPI). C. Perform esophageal pH monitoring to determine
the degree of reflux. D. Reassure the parent that these symptoms will likely resolve by 12 to 24 months. -
ANSWER A. Begin a trial of extensively hydrolyzed protein formula for 2 to 4 weeks.
A school age child has a 3 month history of dull, aching epigastric pain that 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 medications B. Empiric therapy for H. pylori (HP) C. Ordering an upper
GI series D. Referral for esophagogastroduodenoscopy (EGD) - ANSWER D. Referral for
esophagogastroduodenoscopy (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 frequently 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 recommend?
A. A complete workup, including laboratory 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 - ANSWER B. Eliminating certain foods from the mother's diet
.A child is in the clinic after swallowing a metal bead. A radiograph of the GI tract shows a 6 mm
cylindrical object in the child's stomach. The child is able to swallow without difficulty and is not
experiencing pain. What is the correct course of treatment?
A. Administer ipecac to induce vomiting. B. Have the parents watch for the object in the child's stool.
C. Insert a nasogastric tube to flush out the object.
D. Refer the child for endoscopic removal of the object. - ANSWER B. Have the parents watch for the
object in the child's stool.
A 10 year old child has had abdominal pain for 2 days, which began in the periumbilical area and then
localized to the right lower quadrant. The child vomited once today and then experienced relief from
pain followed by an increased fever. What is the likely diagnosis?
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