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NR 602 final Study set Questions and Answers
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NR 602 final Study set Questions and Answers
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NR 602 final Study set Questions andAnswers
A 15yearold n female has a positive pregnancy test and asks the primary care
pediatric nurse practitioner not to tell her parents. She is tearful and says she isn't sure she wants to
keep the baby. What will the nurse practitioner do first? Correct Ans-Determine the state mandated
reporting laws.
Rationale- Each state has different laws on reporting to parents about STIs and Pregnancy.
A 17yearold sexually active female who began having periods at age 14 reports having moderate to
severe dull lower abdominal pain associated
predominantly with periods but that occurs at other times as well. The history reveals a recent onset of
these symptoms. A pregnancy test is negative. Which course of action is most important? Correct
Ans-Perform a full diagnostic workup to evaluate potential causes.
Rationale- This is not normal and needs more workup to determine the reason for it. She is sexually
active so this raises more concerns for other things that might be going on such as PID or an STI
A 16yearold female reports dull, achy cramping pa in in her lower abdomen
lasting 2 or 3 hours that occurs between her menstrual periods each month.
The adolescent is not sexually active. What is the treatment for this condition? Correct Ans-
Prostaglandin inhibitor analgesics and a heating pad
Rationale -This is signs of normal period and the 1st line treatment is Prostoglandin and heating pad.
A schoolage female has had vulvovaginitis for 2 months. All cultures and tests .are negative, but the
symptoms persist after treatment with both topical antibiotics and oral amoxicillin. What is the next
course of action to treat this condition? Correct Ans-Estrogen cream at bedtime for 2 to 3 weeks
,A 4yearold female who has had two urinary tract infections has persistent dysuria and genital redness.
The physical exam reveals a thin, flat membrane from the posterior fourchette almost to the clitoris.
Which treatment is indicated? Correct Ans-Use of estrogencontaining cream
An adolescent female tells the primary care pediatric nurse practitioner
that shehad unprotected sexual intercourse 4 days prior and is worried she might become pregnant.
What will the nurse practitioner do? Correct Ans-Prescribe ulipristal acetate (Ella).
Rationale- ella emergency contraception prevents pregnancy up to 5 days after unprotected sex.
The primary care pediatric nurse practitioner is prescribing contraception
for an adolescent who has not used birth control previously. The adolescent has a normal exam and has
no family history of cardiovascular and peripheral
vascular disease or diabetes. Which preparation is used initially? Correct Ans-A combination oral
contraceptive pills (OCP) with 30 to 35
mcg of estrogen and low progestin
Rationale- Pt does not have history of cardiovascular, thrombosis, stroke of diabetes use this method
first. Remember to start low then increase.
The primary care pediatric nurse practitioner needs to assess a potential
hymenal tear in a prepubertal female who is apprehensive about the exam. Which approach will the
nurse practitioner use? Correct Ans-Place the child in the kneechest position on the exam table.
The mother of a 12monthold uncircumcised male infant reports that the child
seems to have pain associated with voiding. A physical examination reveals a tight, pinpoint opening of
the foreskin, which thickened and inflamed. What will the primary care pediatric nurse practitioner do?
Correct Ans-Refer to urologist
A 6monthold infant has a retractile testis that was noted at the 2month
well baby exam. What will the primary care pediatric nurse practitioner do to
, manage this condition? Correct Ans-Refer the infant to a pediatric urologist or surgeon for possible
orchiopexy.
During a well child examination of a 2yearold child, t he primary care pediatric
nurse practitioner palpates a unilateral, smooth, firm abdominal mass which does not cross the midline.
What is the next course of action that? Correct Ans-Refer the child to an oncologist immediately.
An adolescent has right sided flank pain without fever. A dipstick urinalysis reveals gross hematuria
without signs of infection or bacteriuria, and the primary care pediatric nurse practitioner diagnoses
possible nephrolithiasis. What is the initial treatment or this condition? Correct Ans-increasing fluid
intake up to 2 L daily
Rationale- This is another name for a kidney stone, there is hematuria but no bacteriuria which is
indication for kidney stones. It is also on the R side or L side or lower back depending on which side the
stone is at and not fever associated with it.Usually described as Sharp
A child who had GABHS 2 weeks prior is in the clinic with periorbital
edema, dyspnea, and elevated blood pressure. A urinalysis reveals teacolored
urine with hematuria and mild proteinuria. What will the primary care pediatric nurse practitioner do to
manage this condition? Correct Ans-Refer the child to a pediatric nephrologist for hospitalization
Rationalle- This can be signs of glommeripheritis. When someone has a strep infection previous it can go
the kidneys and cause this. The tea color urine is indication of kidney failure
A child who has nephrotic syndrome is on a steroids and a saltrestricted
diet for a relapse of symptoms. A dipstick urinalysis shows 1+ protein, down from 3+ at the beginning of
the episode. In consultation with the child's nephrologist, what is the correct course of treatment
considering this finding? Correct Ans-Continue with steroids and salt restrictions until the urine is
negative for protein.
Rationelle- Happens with the body does not filture out protein the body.
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