Pediatrics Week 4 Study Guide

A toddler is prescribed a liquid oral medication. The parent tells the primary care pediatric nurse practitioner that the child refuses to take medications and usually spits them out. What will the nurse practitioner do? a. Demonstrate oral medication administration with the toddler in the office. b. Instruct the parent to hide the medication in a favorite food or beverage. c. Order the medication to be given via another route if possible. d. Tell the parent to offer the child a reward each time the medication is taken.

a. Demonstrate oral medication administration with the toddler in the office.

An adolescent female reports facial pain and frequent popping of her jaw. An exam reveals unilateral tender facial muscles and a deviation of the mandible to the affected side with opening of the mouth. What will the primary care pediatric nurse practitioner do? a. Recommend ice packs, NSAIDs, and a soft diet. b. Refer to a pediatric mental health specialist. c. Refer to an orthodontist for a surgical intervention. d. Suggest obtaining Botox injection treatments.

a. Recommend ice packs, NSAIDs, and a soft diet.

A 4-year-old child has just been released from the hospital after orthopedic surgery on one leg following a bicycle accident. The child is sitting quietly on the exam table. When asked to rate pain, the child points to the 1 on a faces rating pain scale. What will the PCP do next? a. assess the child's vital signs and ability to walk without pain b. refill the prescription for a narcotic analgesic medication c. suggest that the parents give acetaminophen for mild pain d. teach the parent to give analgesics based on the child's report of pain

a. assess the child's vital signs and ability to walk with out pain

The primary care pediatric nurse practitioner is considering use of a relatively new drug for a 15 month old child. The drug is metabolized by the liver, so the nurse practitioner will consult a pharmacologist to discuss giving the drug: a. less often or at a lower dose. b. more often or at a higher dose. c. via a parenteral route. d. via the oral route.

a. less often or at a lower dose.

A 3 year-old child is recovering from injuries sustained in a motor vehicle accident. How will the PCP evaluate the child's pain? a. Ask the child to rate pain intensity on a 4 to 5 item pain discrimination scale b. Have the child describe pain as "no pain", " a little pain" or a "lot of pain" c. Question the child about the intensity and specific location of any pain d. Rely on non-verbal responses such as facial expressions and limb movements.

b. Have the child describe pain as "no pain", " a little pain" or a "lot of pain"

What will the primary care pediatric nurse practitioner recommend to the parent of an infant who is teething who asks about comfort measures? a. Administer oral ibuprofen or apply topical salicylates. b. Apply a topical anesthetic such a benzocaine to the gums. c. Give the infant a cold teething ring or wet washcloth to chew. d. Try Baby Orajel on the infant's gums several times daily.

c. Give the infant a cold teething ring or wet washcloth to chew.

A 5-year-old child is hit in the face with a baseball bat and is brought to the clinic by a parent. An exam reveals three avulsed front teeth. Radiologic studies are negative for facial fractures. What is the recommended treatment? a. Prescribe tetracycline 4.4 mg/kg twice daily for 7 to 10 days. b. Refer the child to a dentist for reimplantation of the avulsed teeth. c. Refer the child to a dentist immediately for further examination. d. Remove the teeth, place them in saline, and refer the child to a dentist.

c. Refer the child to a dentist immediately for further examination

What intervention should the primary care provider (PCP) encourage all parents to implement to engage in the best management of potential serious child related injuries? a. Being aware of the causes of common childhood injuries b. Actively engaging in attentive parenting practices c. Actively supporting state and federal programs like Safe Kids USA d. Being proficient in basis pediatric life support techniques

d. Being proficient in basis pediatric life support techniques

A pharmaceutical company has developed a new drug that was tested only on adults. The FDA has declared this drug to have potential benefits for ill children. According to the Pediatric Research Equity Act (PREA), what may the pharmaceutical company be required to do? a. Conduct pediatric drug studies to determine whether the drug is safe and effective in children. b. Provide labeling stating that the safety and efficacy of the drug is not established for children. c. Receive a patent extension for conducting pediatric studies to determine use in children. d. Survey existing data about the drug to determine potential use in the pediatric population.

a. Conduct pediatric drug studies to determine whether the drug is safe and effective in children.

An adolescent has localized bleeding of the gums when brushing the teeth. An exam of the mouth reveals the presence of plaque and calculus on the teeth, which are not loose. What will the primary care pediatric nurse practitioner recommend? a. Consistently brushing and flossing the teeth twice daily b. Referral to an oral surgeon for treatment c. Rinsing the mouth daily with chlohexidine gluconate d. Using a xylitol containing gum after meals

a. Consistently brushing and flossing the teeth twice daily

An 18-month-old child has horizontal, bright white lines along the upper gum line of the teeth. What is the most important question the primary care pediatric nurse practitioner will ask the child's parents? a. If the child is still drinking milk from a bottle b. If the child or the parents are brushing the teeth c. If they are brushing the child's teeth twice daily d. If they have taken the child to a dentist

a. If the child is still drinking milk from a bottle

A child with cerebral palsy receives all nutrition via gastrostomy tube. What will the primary care pediatric nurse practitioner recommend to promote dental health in this child? a. Applying topical iodine every month b. Daily chlorhexidine gluconate rinses c. Ordering medications to prevent drooling d. Prescribing prophylactic antibiotics

b. Daily chlorhexidine gluconate rinses

The primary care pediatric nurse practitioner diagnoses a 5 year old child with asthma and prescribes an oral steroid and a short acting beta-adrenergic medication via a metered-dose inhaler to manage acute symptoms. Along with education about the prescribed medications, what information is important to give the child's family at this visit? a. An asthma action plan b. Effects and side effects of current medications c. Information about spirometry testing d. Instructions for medications at school

b. Effects and side effects of current medications

The primary care pediatric nurse practitioner is examining a young child who has cerebral palsy. Which part of the family history raises concerns about potential child maltreatment? a. Child attends day care b. Limited financial resources c. Mother works outside the home d. No membership in a church

b. Limited financial resources

The single mother of a 4 year old who attends day care tells the primary care pediatric nurse practitioner that she had difficulty giving her child a twice daily amoxicillin for 10 days to treat otitis media during a previous episode several months earlier because she works two jobs and is too busy. The child has an ear infection in the clinic today. What will the nurse practitioner do? a. Administer an intramuscular antibiotic. b. Order twice daily amoxicillin for 5 days. c. Prescribe azithromycin once daily for 5 days. d. Reinforce the need to adhere to the plan of care.

c. Prescribe azithromycin once daily for 5 days.

The parent of a 2 month old infant is reluctant to have the baby vaccinated. What is an initial step in responding to these concerns? a. Inform the parent that all vaccines may be given without thimerosol. b. Providing Vaccine Information Statements for the parent to review. c. Question the parent's reasons for concern about immunizations. d. Remind the parent that the infant is exposed to thousands of germs eachday.

c. Question the parent's reasons for concern about immunizations.

An adolescent takes ibuprofen, acetaminophen and a tricyclic antidepressant (TCA) to treat phantom limb pain and reports the medications are no longer effective. What will the PCP do next? a. change to TCA to a SSRI b. evaluate the adolescent for drug-seeking behavior c. increase the TCA dose and reevaluate in 2-3 weeks d. Refer to a pain management clinic

d. Refer to a pain management clinic

The primary care pediatric nurse practitioner is evaluating a 12-year-old girl who reports penile penetration of her vagina by her mother's boyfriend the day before yesterday. The PNP reports this to the local child abuse hotline. What is the PNP's next action? a. Attaining a history of the abuse from the child b. Obtaining urethral specimens for STI testing c. Performing a colposcopic examination to evaluate for trauma d. Referring the child to the ED for forensic specimen collection

d. Referring the child to the ED for forensic specimen collection

The primary care pediatric nurse practitioner is examining a young child who was brought in by a grandmother for evaluation of a partial-thickness burn on one arm. The PNP suspects that this is an intentional injury, but the grandmother states that the parents are "just careless" and that the child is now living with her. What will the PNP do? a. Flag this as a concerning incident in the child's record. b. Reassure the grandmother that she is doing the right thing. c. Refer the child's parents to a parenting resource center. d. Report a suspicion of abuse to child protective services.

d. Report a suspicion of abuse to child protective services.

The parent of a child who has numerous allergies reports using herbal remedies to help treat the child because they are "natural" products. What will the primary care pediatric nurse practitioner suggest to this parent about using these products? a. Brandname herbal products have been tested for efficacy. b. Natural ingredients are usually safe for use in children. c. There are few interactions between drugs and supplements. d. Use single herb supplements whenever possible.

d. Use single herb supplements whenever possible.

The parent of a school-age child who has asthma tells the primary care pediatric nurse practitioner that the child often comes home from school with severe wheezing after gym class and needs to use his metered dose inhaler right away. What will the nurse practitioner do? a. Recommend that the child go to the school nurse when symptoms start. b. Review the child's asthma action plan and possibly increase his steroid dose. c. Suggest asking the school to excuse the child from gym class. d. Write the prescription for two metered dose inhalers with spacers.

d. Write the prescription for two metered dose inhalers with spacers.

A toddler swallowed a coin several days prior. The child's parent has not found the coin in the child's stool. Which imaging test will the primary care pediatric nurse practitioner employ to evaluate this ingestion? a. Abdominal ultrasound b. Computed tomography c. Conventional radiograph d. Magnetic resonance imaging

c. Conventional radiograph

The primary care pediatric nurse practitioner is assessing an ill 2-month-old infant who is febrile and refusing most fluids. The preliminary blood work indicates a viral infection and shows that the infant is hydrated. The infant is alert. The infant's parents are attentive and live close by. What will the nurse practitioner do? a. administer a parenteral antibiotic and antipyretic and send the infant home. b. Admit the infant to an inpatient hospital unit for overnight monitoring. c. Give the parents sick care instructions and follow up in the clinic in the morning d. Send the infant to the urgent care center for intravenous fluids

c. Give the parents sick care instructions and follow up in the clinic in the morning