PEDIATRICS EXAM I - FNP YEAR 2
(SPRING SEMESTER) QUESTIONS AND
ANSWERS LATEST TOP SCORE.
Respiratory rates
INFANT 0-12 mo
TODDLER 1-3y
PRESCHOOL 4-5y
SCHOOL AGE 6-12y - correct answer. Infant: 30-60
Toddler: 24-40
Preschool: 22-34
School age: 18-30
Viral URI
Etiology
Dx
Tx
Duration - correct answer. Etiology: rhinovirus, paraflu, adenovirus, RSV, coxsackie,
flu
Dx: clinical, nasopharyngeal swab indicated in cases with significant fever, myalgia,
malaise, sore throat
Tx: symptom management (no honey <1 y, no cough/cold meds <4)
Duration: 5-7 days (if longer, consider acute bacterial sinusitis)
,Honey - correct answer. Not before 1 year old
Who can't have cough/cold meds - correct answer. <4 y/o
Brochiolitis
Etiology
Very common in...
S/s
Dx
Tx
Duration - correct answer. Etiology: usually RSV
Very common <24 months old (infants)
S/s: rhinnorhea, cough, wheeze, tachypnea, increased WOB
Dx: no labs/imaging, CXR only if atypical presentation (no viral s/s, severe distress,
recurrence, lack of improvement)
Tx: NO ANTIBIOTICS, ALBUTEROL, EPI, STEROIDS, LOWER AIRWAY
SUCTIONING
--Nasal suctioning is mainstay of treatment
--Self-limiting
Duration: worsens at 3-5 days, then improves
Pneumonia - etiologies, who gets each kind more, pathogens - correct answer.
Etiology:
-BACTERIAL: more in school-aged/AYA -- child appears TOXIC looking (strep
pneumo**, staph aureus, mycoplasma pneumo)
-VIRAL: more in preschool/infants -- child doesn't look as ill as in bacterial
-FUNGAL/PARASITIC
What kind of pneumonia appears more toxic? - correct answer. Bacterial -- normally
strep pneumo, normally school aged/AYA
Pneumonia - presentation (infants, children/AYA, all kids) - correct answer.
INFANTS: difficulty feeding, irritability
CHILDREN/AYA: pleuritic chest pain
ALL KIDS: fever, leukocytosis, cough, tachypnea, lethargy/low energy, hypoxemia,
increased WOB, decreased appetite, crackles, wheeze
Pneumonia
, Dx
Tx - correct answer. DX:
-CLINICAL PICTURE
-CXR if clinical findings are inconclusive, hx of recurrent pneumonia, disease is severe
-CBC and blood cultures (usually only once hospitalized)
Tx:
-Antibiotics if you suspect bacterial etiology (Amox, Cefdinir, Zithromax)
What is the drug of choice for bacterial pneumonia? - correct answer. Amoxicillin
Pneumonia - when to hospitalize
-Appearance
-Vitals
-AEs
-Duration - correct answer. Toxic appearing (normally bacterial etiology)
O2 sat <90%
RR >70 in infants and >50 in older kids
Dehydration
No improvement/worsening within 48-72 hours
Sinusitis timeline
-Acute
-Recurrent acute
-Chronic - correct answer. Acute: <30 days
Recurrent acute (RABS): episodes of bacterial sinusitis lasting <30 days and separated
by intervals of >10 days during which the patient is asymptomatic
Chronic: 90+ uninterrupted symptomatic days
Sinusitis - presentation (3) - correct answer. Child with acute URI presents with...
Nasal discharge of any kind OR daytime cough >10 days without improvement
Worsening course of nasal discharge, daytime cough, or fever after initial improvement
Severe onset (fever >102.2 and purulent nasal discharge for 3+ days)
In sinusitis, young kids do NOT get...? - correct answer. Sinus tenderness
Sinusitis
