Kaplan MN 580 Unit 2 Discussion Primary Care of Children and Adolescents Health

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 1 Discussion

Growth and Development

This week’s Discussion will address the growth and development of the child from neonate to adolescents, cultural considerations, and the importance of communication with the child and family in respect to age and developmental considerations. This will build a solid knowledge base for the provider when caring for the child.

Your professor will assign you a case to present and, in return, you will reply to your classmates in the other cases in order to promote a robust discussion.

Please complete each initial post in APA format following the Discussion Board grading rubric to include, but not limited to the following:

Apply a principle of human growth and development related to appropriate age group

Apply developmental theory related to age group

Discuss developmental milestones related to the age

Discuss developmental assessment tool related to the age

Apply cultural consideration and cultural assessment to presentation

Case 1: A 6-month-old Haitian male, both parents present at the appointment and the third child for both parents. Child was born at 40 weeks, last seen at 4-month visit and no concerns at that time. Child is smiling, babbling, rolls both from abdomen to back and back to abdomen and sits with support.

Case 2: A 2-year-old Hispanic female, mother and grandmother present at the appointment, first child for mother, sixth grandchild for grandmother. Mother speaks English as primary language; grandmother speaks Spanish as primary language. Last well visit was at 18 months of age and was speaking 20 words total, about 10 in English and 10 in Spanish. Now, mother states that child has about 50 words, with some in English and some in Spanish.

Case 3: A 4-year-old African American male, with mother, father, and paternal grandmother present. Child is here for well check for school entry. Child speaks approximately 100 words and only 50% intelligible.

Case 4: A 7-year-old Mexican American male with mother and maternal grandmother present. Mother has no concerns except grandmother feels the child is “too skinny.”

Case 5: A 14-year-old Caucasian female from single-parent family with father present. Father states that “she has always been healthy but I am worried that something is wrong because she doesn’t talk to me anymore.”

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 2 Discussion

Topic 1: Pediatric Health Maintenance Exam and PPE

The foundation of pediatric healthcare visits, both sick and well, starts with a thorough health history; from the data collected, an accurate physical examination and diagnosis can be made. Primary care healthcare visits are an integral part of ensuring the health and well-being of the child. In children that participate in sports, a preparticipation physical examination (PPE) is required and may be the only contact the healthy child has with their healthcare provider. This week’s Discussion will focus on these key topics.

Your professor will assign a topic to present and, in return, you will reply to your classmates in the other topics in order to promote a robust discussion.

Please complete each post in APA format following the Discussion Board grading rubric.

Topic 1: What are the different types of pediatric health histories? When would you use each specific type?

Topic 2: What is the review of systems (ROS)? In a SOAP note, where does the ROS belong? What is the relationship between the ROS and the physical exam?

Topic 3: Shelby is a 5-year-old female, brought to the clinic by her parents and will be starting kindergarten in the fall. The parents state that she needs her physical and shot record to register her for school. The parents state that she has been healthy and voice no concerns although Shelby is “scared” about the exam and vaccines. How would you address Shelby’s fear of the exam and vaccines? What age-appropriate screenings and lab tests are recommended for Shelby? What immunizations will Shelby require, if any?

Topic 4: Peyton is a 2-month-old female brought to the clinic by her 18-year-old mother for her health maintenance exam. What should the physical examination focus on for this child? What immunizations are due, if any? What age-appropriate anticipatory guidance topics should be discussed with mom?

Topic 5: George is a 12-year-old male brought to the clinic by his father and wants to start playing football and needs a preparticipation physical examination (PPE). He is an established patient in your practice and his last health maintenance exam was at 11 years of age. In reviewing his health history, you note that he has sickle cell trait but otherwise healthy. During his exam, you auscultate a Grade I murmur, and the remaining exam is normal. Dad asks if you will clear George to start football practice tomorrow. Would you clear George? Why or why not? Are there any specialists George needs to see before clearance? What are some of the preventive measures you would discuss with George and his father related to playing sports, specifically football?

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 3 Discussion

Topic 1: Pediatric Conditions Affecting the Eyes, Ears, Mouth, and Gastrointestinal System

This week, there will be a variety of conditions assigned to you by your instructor pertaining to the eyes, ears, mouth, and gastrointestinal system. You are expected to present your initial topic including, but not limited to, the following items:

Pathophysiology

Epidemiology

Physical exam findings

Differential diagnoses and rationale

Management plan to include diagnostic testing, medications if applicable, follow-up plans and referrals if needed

In addition, you are required to follow the Discussion Board grading rubric and respond to at least three of your classmates. Topics may include:

1. Sensorineural and conductive hearing loss

2. Otitis media (all types)

3. Conjunctivitis (all types) and nystagmus

4. Amblyopia and strabismus

5. Retinopathy of prematurity

6. Dental caries, candidiasis, aphthous ulcers

7. Retinoblastoma

8. Gastroesophageal reflux disease in pediatrics

9. Peptic ulcer disease in pediatrics

10. Appendicitis and functional abdominal pain syndrome

11. Intussusception and pyloric stenosis

12. Malabsorption syndromes: Celiac disease, lactose intolerance, cow’s milk protein intolerance or allergy

13. Failure to thrive

14. Acute gastroenteritis and intestinal parasites

15. Constipation and encopresis

16. Periorbital cellulitis and orbital cellulitis

17. Otitis externa and mastoiditis

18. Glaucoma and cataracts in pediatrics

19. Corneal ulcers and hordeolum

20. Cyclic vomiting syndrome

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 4 Discussion

Topic 1: Cardiac and Pulmonic Pediatric Conditions

This week, cardiac and pulmonic conditions will be assigned to you by your instructor. You are expected to present your initial topic including, but not limited to, the following items:

Pathophysiology

Epidemiology

Physical exam findings

Differential diagnoses and rationale

Management plan to include diagnostic testing, medications if applicable, follow-up plans and referrals if needed

In addition, you are required to follow the Discussion Board grading rubric and respond to at least three of your classmates. Topics may include:

Murmurs (innocent and pathologic)

Congestive heart disease in children

Left to right shunting: ASD, VSD

Left to right shunting: Atrioventricular septal defect, PDA

Right to left shunting: Transposition of the great arteries (TGA), tetralogy of fallot, hypoplastic left heart syndrome

Hypertension in children

Kawasaki Disease, acute rheumatic fever

Infective endocarditis, pericarditis

Myocarditis, cardiomyopathy

Syncope

Cardiac dysrhythmias

Upper respiratory disorders: The common cold, rhinosinusitis

Pharyngitis, tonsillitis

Diphtheria, pertussis

Recurrent epistaxis, nasal foreign body

Croup, epiglottitis

Foreign body aspiration (laryngeal, tracheal, bronchial)

Nonbacterial and bacterial pneumonia

Cystic fibrosis

Pectus deformity

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 5 Discussion

Topic 1: Pain Management, Palliative Care, Metabolic, Endocrine, Genetic, and Chronic Conditions and Management Plans

This week, there will be a variety of conditions assigned to you by your instructor pertaining to metabolic, endocrine, genetic, and chronic conditions. You are expected to present your initial topic including, but not limited to, the following items:

Pathophysiology

Epidemiology

Physical exam findings

Differential diagnoses and rationale

Management plan to include diagnostic testing, medications if applicable, follow-up plans and referrals if needed

In addition, you are required to follow the Discussion Board grading rubric and respond to at least three of your classmates. Topics may include:

Precocious puberty

Pediatric obesity

Hypothyroidism

Hyperthyroidism

Growth hormone deficiency

Constitutional growth delay

Adrenal Insufficiency

Type 1 diabetes

Type 2 diabetes

Inborn errors of metabolism

Phenylketonuria

Dyslipidemia

Trisomy 21

Trisomy 18

Turner syndrome

Fragile X syndrome

Klinefelter syndrome

Neurofibromatosis

Fever in children

Pain in children

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 6 Discussion

Topic 1: Pediatric Atopic, Immunologic, Infectious Disease, and Integumentary Conditions and Management Plans

This week, there will be a variety of conditions assigned to you by your instructor pertaining to atopic, immunologic, infectious disease, and integumentary conditions. You are expected to present your initial topic including, but not limited to, the following items:

Pathophysiology

Epidemiology

Physical exam findings

Differential diagnoses and rationale

Management plan to include diagnostic testing, medications if applicable, follow-up plans and referrals if needed

In addition, you are required to follow the Discussion Board grading rubric and respond to at least three of your classmates. Topics may include:

1. Pediatric asthma (0–4 years of age)

2. Allergic rhinitis

3. Atopic dermatitis, contact dermatitis

4. Juvenile idiopathic arthritis

5. Systemic lupus erythematosus

6. Acute rheumatic fever

7. Henoch-Schonlein purpura

8. Pediatric asthma (5–11 years of age)

9. Pediatric asthma (>12 years of age)

10. Impetigo

11. Cellulitis

12. Candidiasis, all types

13. Tinea capitis, tinea corporis

14. Tinea versicolor, pityriasis rosea

15. Scabies, pediculosis

16. Acne vulgaris

17. Stevens-Johnson syndrome

18. Herpes simplex virus

19. Infectious mononucleosis

20. Fever of unknown origin

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 7 Discussion

Topic 1: Musculoskeletal, Hematologic, and Oncologic Conditions in Children and Management Plans

This week, there will be a variety of conditions assigned to you by your instructor pertaining to musculoskeletal, hematologic, and oncologic conditions. You are expected to present your initial topic including, but not limited to, the following items:

Pathophysiology

Epidemiology

Physical exam findings

Differential diagnoses and rationale

Management plan to include diagnostic testing, medications if applicable, follow-up plans and referrals if needed

In addition, you are required to follow the Discussion Board grading rubric and respond to at least three of your classmates. Topics may include:

Microcytic anemia

Thalassemias

Hemolytic anemia

Sickle cell anemia and trait

Hereditary spherocytosis

Idiopathic thrombocytopenic purpura

Hemophilias

Leukemia

Non-Hodgkin lymphoma

Hodgkin lymphoma

Brachial plexus injury

Clavicle fracture

Costochondritis

Scoliosis

Developmental dysplasia of the hip

Legg-Calve-Perthes disease

Slipped capital femoral epiphysis

Genu varum, genu valgum

Osgood-Schlatter disease

Subluxation of the radial head

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 8 Discussion

Topic 1: Neurologic and Mental Health Conditions and Management Plans

This week, there will be a variety of conditions assigned to you by your instructor pertaining to neurologic and mental health conditions. You are expected to present your initial topic including, but not limited to, the following items:

Pathophysiology

Epidemiology

Physical exam findings

Differential diagnoses and rationale

Management plan to include diagnostic testing, medications if applicable, follow-up plans and referrals if needed

In addition, you are required to follow the Discussion Board grading rubric and respond to at least three of your classmates. Topics may include:

Night terrors, nightmares

Attention-deficit/hyperactivity disorder

Learning disorders

Sensory processing disorder

Autistic spectrum disorders

Anxiety disorder (separation and generalized)

Obsessive-compulsive disorder

Tic disorders

Posttraumatic stress disorder

Depression

Bipolar disorder

Oppositional defiant disorder

Eating disorders

Cerebral palsy

Epilepsy and seizure disorder

Headaches in children

Disturbances of head growth

Guillain-Barre syndrome

Head injury

CNS infection

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 9 Discussion

Topic 1: Genitourinary, Gynecologic, and Adolescent Health and Management Plans

This week, there will be a variety of conditions assigned to you by your instructor pertaining to genitourinary, gynecologic, and adolescent health conditions. You are expected to present your initial topic including, but not limited to, the following items:

Pathophysiology

Epidemiology

Physical exam findings

Differential diagnoses and rationale

Management plan to include diagnostic testing, medications if applicable, follow-up plans and referrals if needed

In addition, you are required to follow the Discussion Board grading rubric and respond to at least three of your classmates. Topics may include:

Urinary tract infection, pyelonephritis

Vesicoureteral reflux

Hematuria

Proteinuria

Hypospadias

Cryptorchidism

Hydrocele

Varicocele

Inguinal hernia

Labial adhesions

Vulvovaginitis

Dysmenorrhea

Amenorrhea

Dysfunctional uterine bleeding

Vaginitis

Polycystic ovary syndrome

Gynecomastia in adolescent males

Adolescent pregnancy

Suicidality in adolescents

Substance abuse in adolescents

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 10 Discussion

Topic 1: Assessment of the Neonate, Child Abuse and Neglect, Environmental Health, and Complementary Therapies in Pediatrics

This week, there will be a variety of conditions assigned to you by your instructor pertaining to the neonate, child abuse, child neglect, and environmental health conditions. You are expected to present your initial topic including, but not limited to, the following items:

Pathophysiology

Epidemiology

Physical exam findings

Differential diagnoses and rationale

Management plan to include diagnostic testing, medications if applicable, follow-up plans and referrals if needed

In addition, you are required to follow the Discussion Board grading rubric and respond to at least three of your classmates. Topics may include:

Milia, erythema toxicum, cutis marmorata

Branchial cleft, thyroglossal cyst

Caput succedaneum, cephalhematoma

Cleft lip and palate

Pyloric stenosis

Neonatal jaundice

Sudden infant death syndrome, apparent life-threatening events

Mercury poisoning

Lead poisoning

Environmental tobacco smoke exposure

Carbon monoxide poisoning

Pesticide exposure

Noise pollution

Child neglect

Physical abuse

Sexual abuse

Emotional abuse

Verbal abuse

Mold exposure

Burns

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 2 Assignment

Anticipatory Guidance for Neonates to Adolescents Table

Anticipatory guidance helps family, caregivers, and others know what to expect according to the child’s growth and development. The guidance is done through collaboration between the healthcare provider and the caregiver. It is sometimes thought of as a type of counseling. Nurse practitioners working in pediatric primary care need to be experts on anticipatory guidance. There are excellent resources available and these are being updated as technologies and environments change.

This Assignment will demonstrate your ability to describe age-specific anticipatory guidance for the child and the family. Additionally, you will then have a reference table for quick glance created by you for future encounters with pediatric individuals and their families.

This assignment has a template that you will use to fill in the relevant elements of the anticipatory guidance per age group. The columns provide guidance to the specific areas such as safety and immunizations. If there is an area that is not applicable, such as oral health in infancy-newborn group, then place N/A in the box.

Submit your assignment to the Unit 2 Dropbox.

AGE GROUP	PHYSICAL DEVELOPMENT AND MENTAL HEALTH	NUTRITION AND PHYSICAL ACTIVITY	ORAL HEALTH	SAFETY CONCERNS	IMMUNIZATIONS
Infancy- Newborn Visit
Infancy-First Week Visit
Infancy-1 Month Visit
Infancy-2 Month Visit
Infancy-4 Month Visit
Infancy-6 Month Visit
Infancy-9 Month Visit
Early Childhood-12 Month Visit
Early Childhood-15 Month Visit
Early Childhood-18 Month Visit
Early Childhood-2 Year Visit
Early Childhood-2.5 Year Visit
Early Childhood-3 Year Visit
Early Childhood-4 Year Visit
Middle Childhood-5 and 6 Year Visits
Middle Childhood-7 and 8 Year Visits
Middle Childhood-9 and 10 Year Visits
Early Adolescence-11 to 14 Year Visits
Middle Adolescence-15 to 17 Year Visits
Late Adolescence-18 to 21 Year Visits

Assignment Requirements:

Before finalizing your work, you should:

be sure to read the Assignment description carefully;

consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and

utilize spelling and grammar check to minimize errors.

Your writing Assignment should:

follow the conventions of Standard English (correct grammar, punctuation, etc.);

be well ordered, logical, and unified, as well as original and insightful;

display superior content, organization, style, and mechanics; and

use APA 6th Edition format.

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 3 Assignment

The i-Human® scenario below is designed to help you move through a simulated clinical patient scenario. Your work will be scored by i-HUMAN rubric below and transferred to a grade in the gradebook by faculty. This assignment is worth 100 points.

Grading criteria for assignment are:

History = 30

Physical Exam = 30

Differential Diagnosis = 15

Rank Diff Dx = 5

Must not Miss Diagnoses = 5

Test Selection = 15

The follow up review i-Human Seminar will be held in Unit 4 and is mandatory either by live attendance or review of recording and alternative assignment. This is worth 20 points.

For this activity, you will need to login to your i-Human account. Instructions for logging-in are as follows:

Go to https://ih2.i-human.com/.

Log in with your credentials (username and password).

Select “Assignments” from the menu options on the top left of the screen.

Press the green play button next to the I Human Testing Mode Ryan for the case study.

The case study will open; click Start to begin.

Complete all elements of the case study (history, physical exam, assessment, etc.)

Once you have successfully completed the Assignment, take a screenshot of the last screen of the activity, paste it into a Microsoft Word document, save your document, and Submit your Assignment to the unit Dropbox before midnight on the last day of the unit.

For help creating a screenshot, visit the website below.

Take a Screenshot. Retrieved from http://www.take-a-screenshot.org

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 5 Assignment

i-Human Case

The i-Human® scenario below is designed to help you move through a simulated clinical patient scenario. Your work will be scored by i-HUMAN rubric below and transferred to a grade in the gradebook by faculty. This assignment is worth 100 points.

Grading criteria for assignment are:

History = 30

Physical Exam = 30

Differential Diagnosis = 15

Rank Differential Diagnosis = 5

Rank Differential Diagnosis (must not miss) = 5

Lab Tests Ordered = 15

The follow up review i-Human Seminar will be held in Unit 6 and is mandatory either by live attendance or review of recording and alternative assignment. These Seminar is worth 20 points.

For this activity, you will need to login to your i-Human account. Instructions for logging-in are as follows:

Go to https://ih2.i-human.com/.

Log in with your credentials (username and password).

Select “Assignments” from the menu options on the top left of the screen.

Press the green play button next to the Johnson for Kaplan University case study.

The case study will open; click Start to begin.

Complete all elements of the case study (history, physical exam, assessment, etc.)

Once you have successfully completed the Assignment, take a screenshot of the last screen of the activity, paste it into a Microsoft Word document, save your document, and Submit your Assignment to the unit Dropbox before midnight on the last day of the unit.

For help creating a screenshot, visit the website below.

Take a Screenshot. Retrieved from http://www.take-a-screenshot.org

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 6 Assignment

Applying Current Evidence Based Practice Guidelines for the Diagnosis and Treatment of Acute Bacterial Sinusitis in Pediatric Patients Using Healthcare Informatics.

This assignment will demonstrate your ability to use healthcare informatics to apply current evidence-based practice guidelines to the management of a pediatric patient diagnosed with acute bacterial sinusitis.

The guidelines that you are to use are in the following article available in the online Purdue Global library.

Hauk, L. (2014). AAP releases guideline on diagnosis and management of acute bacterial sinusitis in children one to 18 years of age. American Family Physician, 89(8), 676-681.

This assignment has a template that you will use to fill in the requested information.

Please submit to the Dropbox when you have completed your assignment.

	Pediatric Client with Acute Bacterial Sinusitis
List the clinical criteria that must be present to support this diagnosis in pediatric patients from newborn to 21 years of age. Categorize clinical signs and symptoms by: Persistent Symptoms, Severe Onset, or Worsening Symptoms.	List Criteria for Persistent Symptoms.	List Criteria for Severe Onset of Symptoms.	List Criteria for Worsening Symptoms.
When would imaging studies be indicated?
What is the recommended Antibiotic for Child with No Known Allergies? Provide dose, frequency, mg., ml., length of treatment, number of dosing units (i.e. prescription information).
What is the second line Recommended Antibiotic for Child with allergy to PCN Provide dose, frequency, mg., ml., length of treatment, number of dosing units (i.e. prescription information).
When is Referral indicated?
What additional medications and or treatment strategies are recommended for treatment or symptomatic control
What is the treatment change in a child with worsening symptoms at 72 hours after initiation of antibiotic
When is outpatient 72 hour “observation” acceptable?
What modifications would be needed for the following children: Four year old who is otherwise healthy
Child with immune deficiency
Child with two prior sinus infections
Child with cystic fibrosis
What other conditions would modify these treatment recommendations?

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 7 Assignment

Collaboration Paper

This assignment is a formal paper. This includes: APA format, title page, headings, literature review, proper citation per APA, logical sequence, conclusions, clarity, understanding of the topic, and reference list. The paper should be 3-5 pages in length excluding the title page and reference page.  The paper must demonstrate independent ideas and conclusions.  At a minimum, the following topics must be well articulated in the paper. Remember that discussion of each topic requires citations that are current (less than 5 years old) and relevant.  Please refer to the grading rubric for how your paper will be graded.

Explain how multidisciplinary collaboration can affect clinical decision making.

Discuss how collaboration can lead to improved patient outcomes.

Discuss how lack of collaboration can lead to poor patient outcomes.

Identify three barriers to professional collaboration among healthcare professionals and patients?

What are the five best ways to promote professional collaboration in pediatric primary care?

How can the nurse practitioner encourage and support collaboration among the patient, family, caregivers, and healthcare professionals?

Assignment Requirements:

Before finalizing your work, you should:

be sure to read the Assignment description carefully (as displayed above);

consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and

utilize spelling and grammar check to minimize errors.

Your writing Assignment should:

follow the conventions of Standard English (correct grammar, punctuation, etc.);

be well ordered, logical, and unified, as well as original and insightful;

display superior content, organization, style, and mechanics; and

use APA 6th Edition format.

Submit your Assignment to the unit Dropbox before midnight on the last day of the unit.

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 3 Seminar

Attending live Seminars is important to your academic success, and attendance is highly recommended. The Seminar allows you to review the important concepts presented in each unit, discuss work issues in your lives that pertain to these concepts, ask your instructor questions, and allow you to come together in real time with your fellow classmates.

There will be a graded Seminar in three units in this course. You must attend the live Seminar or listen to the archived transcript.

All students must complete the Seminar Quiz to earn points for the Seminar.

Unit three Seminar will include an overview of the class and chance for you to ask questions. The Seminar will also include assessment, diagnosis, and treatment plan of upper respiratory infections in the pediatric patient.

Seminar Quiz

After attending the live Seminar or listening to the transcript, complete the Seminar Quiz to earn points for the Seminar. The Seminar Quiz will consist of multiple choice and/or true or false questions based on the topics that were covered in the live Seminar.

The Unit 3 Seminar Quiz questions are worth 5 points for a total of 20.

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 4 Seminar

Discussion and Review of i-Human Assignment

The follow up review i-Human Seminar is mandatory either by live attendance or review of recording and alternative assignment. The Seminar is worth 20 points.

Alternate Seminar Assignment

If you are unable to attend the live Seminar, there will be a written paper option (100 words or less) about the overall content of the Seminar. For this written assignment, you will need to view the archived version before writing the paper. This assignment is worth 20 points.

When you have completed the Alternate Seminar Assignment submit to the Dropbox.

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 6 Seminar

Review of Unit 5 i-Human Assignment

The follow up review i-Human Seminar will be held in Unit 6 and is mandatory either by live attendance or review of recording and alternative assignment. The Seminar is worth 20 points.

Alternate Seminar Assignment

If you are unable to attend the live Seminar, there will be a written paper option (100 words or less) about the overall content of the Seminar. For this written assignment you will need to view the archived version before writing the paper. This assignment is worth 20 points.

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 3 Quiz

Question 1

In the U.S., the average child has between six and eight URIs a year.

Question options:

True

False

Question 2

Correct handwashing does not make a significant difference in preventing the spread of common URI viruses.

Question options:

True

False

Question 3

Fever is not a common sign of URI.

Question options:

True

False

Question 4

The Food and Drug Administration (FDA) has issued a warning advisement against administering any over the counter medications for URI symptomatic relief to children under two years of age.

Question options:

True

False

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 4 Quiz

Question 1Usual treatment option for a child with hepatitis A includes:

Question options:

1)  interferon alpha.

2) ribavirin.

3) acyclovir.

4) supportive care.

Question 2Rectal bleeding associated with anal fissure is usually described by the patient as:

Question options:

1) drops of blood noticed when wiping.

2) dark brown to black in color and mixed in with normal-appearing stool.

3) a large amount of brisk red bleeding.

4) significant blood clots and mucus mixed with stool.

Question 3Which of the following do you expect to find in an examination of a 2-week-old infant?

Question options:

1) A visual preference for the human face.

2) A preference for low-pitched voices.

3) Indifference to the cry of other neonates.

4) Poorly developed sense of smell.

Question 4Problems after tetanus immunization typically include:

Question options:

1) localized reaction at site of injection.

2) myalgia and malaise.

3) low-grade fever.

4) diffuse rash.

Question 5Treatment options in acute and recurrent allergic conjunctivitis include all of the following except:

Question options:

1) cromolyn ophthalmic drops.

2) oral antihistamines.

3) ophthalmological antihistamines.

4) corticosteroid ophthalmic drops.

Question 6The most common causative organism of bronchiolitis is:

Question options:

1) haemophilus influenzae.

2) parainfluenza virus.

3) respiratory syncytial virus.

4) coxsackievirus.

Question 7Which of the following must be present for the diagnosis of AOM? Select all that apply.

Question options:

1) Bulging of the tympanic membrane (TM).

2) TM retraction.

3) Otalgia.

4) Anterior cervical lymphadenopathy.

Question 8When advising a patient about the influenza nasal spray vaccine, the NP considers the following:

Question options:

1) Its use is acceptable during pregnancy.

2) Its use is limited to children younger than 6 years.

3) It contains live, attenuated virus.

4) This is the preferred method of influenza protection in the presence of airway disease.

Question 9Which of the following is the most prudent first-line treatment choice for an otherwise well toddler with acute otitis media (AOM) who requires antimicrobial therapy?

Question options:

1) Ceftibuten.

2) Amoxicillin.

3) Cefuroxime.

4) Azithromycin.

Question 10First-line treatment for uncomplicated hordeolum is:

Question options:

1) topical corticosteroid.

2) warm compresses to the affected area.

3) incision and drainage.

4) oral antimicrobial therapy.

Question 11Anterior epistaxis is usually caused by:

Question options:

1) hypertension.

2) bleeding disorders.

3) localized nasal mucosa trauma.

4) a foreign body.

Question 12Which of the following is one of the more common sources of hepatitis A infection in the United States?

Question options:

1) Receiving blood products.

2) Ingestion of raw shellfish.

3) Drinking municipally sourced tap water drinking water.

4) Exposure to fecally contaminated food.

Question 13        A 7-year-old child with type 1 diabetes mellitus is about to receive injectable influenza vaccine. His parents and he should be advised that:

Question options:

1) the vaccine is more than 90% effective in preventing influenza.

2) use of the vaccine is contraindicated during antibiotic therapy.

3) localized immunization reactions are common.

4) a short, intense, flu-like syndrome typically occurs after immunization.

Question 14        Rebound tenderness is best described as abdominal pain that worsens with:

Question options:

1) light palpation at the site of the discomfort.

2) release of deep palpation at the site of the discomfort.

3) palpation on the contralateral side of the abdomen.

4) deep palpation at the site of the discomfort.

Question 15An 18-year-old man presents with periumbilical pain, vomiting, and abdominal cramping over the past 48 hours. Physical examination reveals rebound tenderness and laboratory analysis shows the presence of bandemia and a total WBC of 28,000 mm3. To support the diagnosis of acute appendicitis with suspected appendiceal rupture, you consider obtaining the following abdominal imaging study:

Question options:

1) Magnetic resonance image (MRI).

2) Computed tomography (CT) scan.

3) Ultrasound.

4) Flat plate.

Question 16        Risk factors for dyslipidemia in children include which of the following? Select all that apply.

Question options:

1) Blood pressure at the 70th to 80th percentile for age.

2) Breastfeeding into the toddler years.

3) Family history of lipid abnormalities.

4) Family history of type 2 diabetes mellitus.

Question 17In caring for a patient with symptomatic gastroesophageal reflux, you prescribe a PPI to:

Question options:

1) enhance motility.

2) increase the pH of the stomach.

3) reduce lower esophageal pressure.

4) help limit H. pylori growth.

Question 18Which of the following criteria should be met for a child to be treated for AOM with observation and analgesia but no antimicrobial therapy? Select all that apply.

Question options:

1) Age greater than 6 months.

2) Bilateral infection.

3) Moderate illness.

4) Presumptively caused by bacterial infection.

Question 19Gina is 2 years old and presents with a 3-day history of fever, crankiness, and congested cough. Her respiratory rate is more than 50% of the upper limits of normal for age. Tubular breath sounds are noted at the right lung base. Skin turgor is normal, and she is wearing a wet diaper. She is alert, resisting the examination as age appropriate, and engages in eye contact. Temperature is 38.3° C (101° F). Gina’s diagnostic evaluation should include:

Question options:

1) chest x-ray.

2) urine culture and sensitivity measurement.

3) lumbar puncture.

4) sputum culture.

Question 20All of the following are components of the classic ophthalmological emergency except:

Question options:

1) eye pain.

2) purulent discharge.

3) red eye.

4) new onset change in visual acuity.

Question 21        At which of the following ages in an infant’s life is parental anticipatory guidance about teething most helpful?

Question options:

1) 1–2 months.

2) 2–4 months.

3) 4–6 months.

4) 8–10 months.

Question 22Aortic stenosis in a 15-year-old male is most likely:

Question options:

1)

a sequela of rheumatic fever.

2) a result of a congenital defect.

3) calcific in nature.

4) found with atrial septal defect.

Question 23        The gastric parietal cells produce:

Question options:

1) hydrochloric acid.

2) a protective mucosal layer.

3) prostaglandins.

4) prokinetic hormones.

Question 24 A healthy infant at age 9–11 months is expected to:

Question options:

1) roll from back to stomach.

2) imitate “bye-bye.”

3) play peek-a-boo.

4) hand toy on request.

Question 25When advising a patient about injectable influenza immunization, the nurse practitioner (NP) considers the following about the use of this vaccine:

Question options:

1) Its use is not recommended in sickle cell anemia.

2) Its use is limited to children older than 2 years.

3) Its use is limited due to containing live virus.

4) Its use is recommended for virtually all members of the population.

MN580 FNP II – Primary Care of Children and Adolescents Health

Unit 10 Final Exam

Question 1A 10-day-old child presents with multiple raised lesions resembling flea bites over the trunk and nape of the neck. The infant is nursing well and has no fever or exposure to animals. These lesions likely represent:

Question options:

erythema toxicum neonatorum.

milia.

acne neonatorum.

staphylococcal skin infection.

Question 2          A risk factor for mitral valve prolapse (MVP) includes a history of:

Question options:

rheumatic fever.

rheumatoid arthritis.

Kawasaki disease.

Marfan syndrome.

Question 3The most important aspect of skin care for individuals with atopic dermatitis is:

Question options:

frequent bathing with antibacterial soap.

consistent use of medium-potency to high-potency topical steroids.

application of lubricants.

treatment of dermatophytes.

Question 4What advice should you give to the parents of a toddler with gastroenteritis?

Question options:

Give the child sips of room temperature cola.

Give the child sips of an oral rehydration solution.

Give the child sips of a sports drink such as Gatorade®.

Try sips of apple juice mixed 1:1 with tap water.

Question 5          When billing Medicaid, NPs get the authority to bill for their services from:

Question options:

state law only.

federal law only.

state and federal law.

neither state nor federal law.

Question 6The anticipated average daily weight gain during the first 3 months of life is approximately:

Question options:

15 g or 0.53 oz.

20 g or 0.7 oz.

25 g or 0.88 oz.

30 g or 1 oz.

Question 7The most common type of injury causing a sport-related meniscal tear involves:

Question options

twisting of the knee.

hyperextension of the knee.

repetitive hard impact on the knee (i.e., running on hard surface).

an unknown origin in most cases.

Question 8The clinician anticipates that a child with mongolian spots will cry out because of discomfort when the area is pressed or palpated.

Question options:

True

False

Question 9

Which of the following is appropriate advice to give to a mother who is breastfeeding her 12-hour-old infant?

Question options:

“You will likely have enough milk to feed the baby within a few hours of birth.”

“The baby might need to be awakened to be fed.”

“Supplemental feeding is needed unless the baby has at least four wet diapers in the first day of life.”

“The baby will likely have a seedy yellow bowel movement today.”

Question 10First-line therapy for acne vulgaris with closed comedones includes:

Question options:

oral antibiotics.

isotretinoin.

benzoyl peroxide.

hydrocortisone cream.

Question 11        Kawasaki disease most commonly occurs in what age group?

Question options:

Infants.

Children aged 2–3 years.

Children approaching puberty.

Children aged 1–8 years.

Question 12At which of the following ages should screening begin for a child who has significant risk of lead poisoning?

Question options:

3 months.

6 months.

1 year.

2 years.

Question 13Characteristics of onychomycosis include all of the following except:

Question options:

it is readily diagnosed by clinical examination.

nail hypertrophy.

brittle nails.

fingernails respond more readily to therapy than toenails.

Question 14The following chromosomal syndrome is a common etiology of social and verbal developmental delays in boys:

Question options:

Tay-Sachs disease.

cystic fibrosis.

fragile X.

trisomy 18.

Question 15An important part of the treatment of Kawasaki disease includes the use of:

Question options:

antibiotics.

antivirals.

immune globulin.

antifungals.

Question 16        In counseling a patient with scabies, the NP recommends all of the following methods to eliminate the mite from bedclothes and other items except:

Question options:

wash items in hot water.

run items through the clothes dryer for a normal cycle.

soak items in cold water for at least 1 hour.

place items in a plastic storage bag for at least 1 week.

Question 17You are seeing 17-year-old Cynthia. As part of the visit, you consider her risk factors for type 2 DM would likely include all of the following except:

Question options:

obesity.

Native American ancestry.

family history of type 1 DM.

personal history of polycystic ovary syndrome.

Question 18You examine a newborn with a capillary hemangioma on her thigh. You advise her parents that this lesion:

Question options:

is likely to increase in size over the first year of life.

should be treated to avoid malignancy.

usually resolves within the first months of life.

is likely to develop a superimposed lichenification.

Question 19Girls typically grow to their adult height by:

Question options:

menarche.

1 year before menarche.

1 year after onset of menstruation.

age 16.

Question 20Of the following, the most common route of hepatitis A virus (HAV) transmission is:

Question options:

needle sharing.

raw shellfish ingestion.

ingestion of contaminated food or water.

exposure to blood and body fluids.

Question 21In children, which of the following conditions can contribute to bladder instability and increase the risk of a UTI?

Question options:

Constipation.

Upper respiratory tract infection.

Chronic diarrhea.

Efficient bladder emptying.

Question 22Hemoglobin A1c best provides information on glucose control over the past:

Question options:

1–29 days.

21–47 days.

48–63 days.

64–90 days.

Question 23An 18-year-old college freshman is brought to the student health center with a chief complaint of a 3-day history of progressive headache and intermittent fever. On physical examination, he has positive Kernig and Brudzinski signs. The most likely diagnosis is:

Question options:

viral encephalitis.

bacterial meningitis.

acute subarachnoid hemorrhage.

epidural hematoma.

Question 24In medical coding, the abbreviation ICD stands for:

Question options:

insurance code for diagnoses.

integrated clinical dilemmas.

international classification of diseases.

initial classification of the diagnosis.

Question 25A cutaneous reaction nearly always occurs with the use of amoxicillin in the presence of infection with:

Question options:

human herpes virus type 1.

human papillomavirus type 11.

adenovirus type 20