Download 2023 NRNP 6541 MIDTERM EXAM QUESTIONS & CORRECT ANSWERS GRADED A / NRNP 6541 EXAM and more Exams Nursing in PDF only on Docsity!
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2023 NRNP 6541 MIDTERM EXAM QUESTIONS & CORRECT
ANSWERS GRADED A / NRNP 6541 EXAM
Question 1
- When completing this quiz, did you comply with Walden University’s Code of Conductincluding the expectations for academic integrity?
Selected Ye
Answer: s
Which of the following statements regarding adolescent substance use is true?
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Answer:
a.
Tobacco is the most commonly abused substance during adolescence.
You see a 4 - year-old for a well-child visit. He has received four diphtheria, tetanus,
and acellular pertussis vaccines (DTaP); three injected polio vaccines (IPV); one
measles, mumps, and rubella vaccine (MMR); one varicella vaccine; and two
hepatitis B (Hep B) vaccines. What do you order today?
Selected
Answer:
d.
DTaP, IPV, MMR, and Varivax The parents of a 7 - year-old are concerned their son does not want to attend school. Which of the historical findings are not usually associated with the diagnosis of school phobia?
Selected c.
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Answer: Chronic medical
illness Chelsea, age 8, complains that she feels as if something is stuck in her ear. What action is contraindicated?
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Answer:
b.
Flushing the ear with water. You see a 7-year-old with complaints of "having accidents at night." Physical exam and history are unremarkable. Urinalysis, urine culture, and specific gravity are normal. His parents ask about the best treatment for this problem. The best response is
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Answer:
c.
Fluid restriction and voiding prior to the night may be effective. You are doing a kindergarten physical on a 5-year-old girl. Which of the following scenarios would suggest the child is not ready to start kindergarten in the fall?
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Answer:
d.
Counts to 4 and draws a person with three parts. Upon eye examination of a newborn, you note inner canthal folds and Brushfield spots. What do you suspect?
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Answer:
c.
Down syndrome
I like to use my pincer grasp that involves the ablitily to pick up a small object
such as a raisin or piece of cereal with the thumb and forefinger, and that is
mastered around what age?
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Answer:
b.
months
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Answer:
d.
Neurofibromato sis An expected milestone of a 4 - year-old is the ability to
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Answer:
c.
Copy a cross
You receive a phone call from the mother of a 2 - year-old. She states her child has
sleep refusal. You suggest the child should be able to:
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Answer:
a.
Set his own bedtime based on his internal clock. An eye that deviates in when covered but that returns to midline when uncovered is an
Selected
Answer:
a.
esotropi a A 4 - year-old believes there is more juice in a tall, thin glass than a shorter, wider one. The child has not yet achieved which of the principles of Piaget?
Selected
Answer:
b.
Conservati on
A healthy, well-developed 6-year-old child arrives as a new patient to your clinic. His
immunization card reveals that he received an immunization at birth and some when
he was 2 months old, but none sense. Which of the following statements about him
is correct?
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Answer:
b.
He is too old to receive the Haemophilus influenzae Type B vaccine.
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Which of the following issues or concepts is relevant to the school-age child?
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Answer:
b.
Erikson's initiative versus guilt You would be concerned about the language development of a child who:
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Answer:
c.
Stutters when excited or tired at the age of 7 You diagnose a 16-year-old with acute otitis media and need to prescribe an antibiotic with beta-lactamase coverage. What do you choose?
Selected
Answer:
b.
amoxicillin and potassium clavulanate (Augmentin)
A 2 - year-old boy has been slightly less than the 50th percentile for weight, height and
head circumference, but in the last 6 months he has fallen to slightly less than the
25th percentile for weight. The pregnancy was normal, his development is as
expected, and the family reports no psychosocial problems. The mother says that he
is now a finicky eater (wants only macaroni and cheese at all meals), but she insists
that he eat a variety of foods. The meals are marked by much frustration for
everyone. His examination is normal. Which of the following is the best next step in
his care?
Selected
Answer:
b.
Reassurance and counseling for family about childhood normal developmental stage Which of the following characterizes middle adolescence (14 to 16 years old)?
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Answer:
a.
Intense peer group involvement, feelings of immortality, sexual experimentation
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Which of the following signs may indicate a baby is not receiving sufficient breastmilk?
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Answer:
c.
Sleepiness, jaundice, and vomiting Which of the following children should be referred for a comprehensive developmental evaluation?
Selected
Answer:
b.
A 19 - month-old with explosive temper tantrums.
By what age should most children be able to sit well without support?
Selected
Answer:
c.
months
I can roll over, grasp a rattle, and reach for things and have begun feeding myself
finger foods, but I can’t wave bye-bye yet. How old am I?
Selected
Answer:
d.
months
Parents bring their 16-year-old daughter for a “well-child” checkup. She looks normal
on examination. As part of your routine care you plan a urinalysis. The father pulls
you aside and asks you to secretly run a UDS on his daughter. Which of the following
is the most appropriate course of action?
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Answer:
d.
Explore the reasons for the request with the parents and the adolescent and perform a UDS with the adolescent's permission if the history warrants. A teenage female who is overweight has moderate acne on the face and chest, and irregular menses. Elevation of which laboratory test provides the test evidence of
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polycystic ovarian syndrome?
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Answer:
b.
free testosterone Which of the following complication of strep pharyngitis cannot be prevented with antibiotics?
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Answer:
c.
Glomerulonephri tis A fifteen-year-old female makes a statement to you during a well visit. Which of the following statements should not be kept confidential?
Selected
Answer:
d.
"Sometimes I feel like ending my life." Which of the following screenings should adolescents have done annually?
Selected
Answer:
a.
Psychosocial screening, blood pressure, body mass index Which of the following substances is associated with pupillary constriction?
Selected
Answer:
b.
Heroi n The appropriate lab tests in assessment of cervical adenitis include all of the following except:
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Answer:
d.
Blood culture
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Selected d.
Answer: II
Which of the following eye findings would be considered an ophthalmic emergency?
Selected
Answer:
d.
Unilateral vesicular lesions on the upper eyelid in a 3 - week old. Mark is in the exam room. You are concerned he may have epiglottitis. In what position do these patients prefer to sit?
Selected
Answer:
d.
Sitting up and leaning forward
A 14-year-old female comes into the office for an urgent visit after taking 10 valium
tablets. Following the initial emergent care and stailization, the most important part
of the management is:
Selected
Answer:
c.
Assessing the family supports available to the child. Which of the following statements about bullying is true?
Selected
Answer:
d.
It occurs most commonly during unstructured times (lunch, recess, etc.). For adolescent girls, peak height velocity should occur by Tanner Stage (SMR):
Selected c.
Answer: 3
You see a 30-month-old who speaks in mixed Spanish and English. The child’s
vocabulary is normal but at the low end of the normal language spectrum. The parent
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is worried the child’s development will not be normal because she mixes up the two
languages. You respond:
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Answer:
b.
"Your child's speech is normal and bilingual children commonly intermix the words from both languages until about 3 years of age." A 4 - month-old presents with both eyes turning inward. What is this called?
Selected
Answer:
b.
Esotropi a An 8-year-old female has an edematous, mildly erythematous right upper eyelid for 2 days with a fever of 102.9 (F). Which important eye assessment do you need to consider?
Selected
Answer:
d.
Ocular mobility Which of the following strategies would not be appropriate to include as part of your treatment plan of an 8 - year-old boy who is obese?
Selected
Answer:
a.
Referral to nutritionist for weight reduction plan.
A 13-month-old child is noted to be at the 25th percentile for weight, the 10th
percentile for height, and less than the 5 th^ percentile for head circumference. She
was born at term. She was noted to have a small head at birth, to be
developmentally delayed throughout her life, and to have required cataract surgery
shortly after birth. She currently takes phenobarbital for seizures. Which of the
following would most likely explain this child’s small size?
Selected
Answer:
c.
Congenital cytomegalovirus infection Head and chest circumferences should be equal at:
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pharyngitis Sam has an otitis media. He also presents with conjunctivitis. This is due to which organism?
Selected
Answer:
c.
Haemophilus influenza Blood pressure should be measured at well-child visits starting at age:
Selected
Answer:
c.
years Sandy, age 18 months, crosses her legs when lifted from behind rather than pulling them up. Her legs are also hard to separate, making diaper changing difficult. She persistently uses only one hand. What condition do you suspect?
Selected
Answer:
a.
Cerebral palsy A common feature of 2 - year-old behavior is:
Selected
Answer:
b.
Stranger anxiety Appropriate anticipatory guidance for the parents of an 8-year-old girl includes
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Answer:
d.
Information that the child will start to value personal idols and role models. Which of the following statements is true regarding lying and stealing by the school-age
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child?
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Answer:
d.
They represent a common, transient problem. Epiglottitis has decreased due to which immunization?
Selected c.
Answer: Hi
b
A 7-year-old has just been diagnosed with attention deficit hyperactivity disorder
(ADHD). Her parents report that she is doing poorly in school and is disruptive in the
classroom. They ask you what they can do. Your best response is:
Selected
Answer:
b.
"Use a consistent approach with behavioral cues both at home and at school."
You see a 3-year-old for a well-child visit. His mother informs you that potty training
has been very easy because he “has an amazing internal clock. He falls asleep, gets
hungry, and has bowel movements at the same time every day.” This describes
which aspect of temperament?
Selected
Answer:
c.
Rhythmici ty A 2-day-old infant has significant nasal and rectal bleeding. He was delivered by a midwife at home; the pregnancy was without complications. His Apgar scores were 9 at 1 minute and 9 at 5 minutes. He has breastfed well and has not required a health care professional visit since birth. Which of the following vitamin deficiencies might explain his condition?
Selected
Answer:
a.
Vitamin K
A 14 - year old has ataxia. He is brought to the local emergency
department, where he appears euphoric, emotionally labile, and
disoriented. Many notice his abusive language. Which of the following
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Answer: 5
years Which adolescent would be at greatest risk for developing anorexia nervosa?
Selected
Answer:
c.
14 - year-old female gymnast The most common substance used in middle school is
Selected
Answer:
d.
Alcoh ol Sarah, age 15, presents with pain and pressure over her cheeks and discolored nasal discharge. You cannot transilluminate the sinuses. You suspect which common sinus to be affected?
Selected
Answer:
b.
Maxillary sinus What is the most traumatic, yet common form and of child abuse seen in pediatric primary care?
Selected
Answer:
c.
Shaken baby syndrome A 9 - year-old who weighs 70 pounds asks why she can't sit in the front passenger seat of the family car. Your best response is
Selected
Answer:
c.
The safest place for children under 12 years old and 100 pounds is in the backseat of the car.
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During a “well-child” visit, the parents of a healthy 5 - month-old offer a great amount
of information. Which of the following bits of information is of most concern?
Selected
Answer:
b.
Limited eye contact with parents. All of the following are consistent with peritonsillar abscess except:
Selected
Answer:
a.
Trismu s During a domestic health assessment, the CDC recommends screening every refugee child for which of the following diseases?
Selected
Answer:
b.
tuberculos is A Mantoux test in a child with no risk factors is considered positive with a reaction of:
Selected
Answer:
c.
at least 15 mm induration A 2 - day-old newbornwith conjunctivitis is likely due to
Selected
Answer:
d.
Chemical irritation from eye drops
You see a 13-year-old who reports she is learning some basic geometry (areas,
volume etc.). The ability to successfully master these concepts occurs during which
Piaget developmental stage?
Selected
Answer:
b.
Formal operational
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Selected
Answer:
d.
Epiglottit is
Miguel, age 14, was hit in the eye with a baseball and developed eye pain,
decreased visual acuity, and injection of the globe. Upon exam you note blood in the
anterior chamber and confirm diagnosis of hyphema. What treatment do you
recommend while Miguel is waiting to see the ophthalmologist
Selected
Answer:
c.
Apply bilateral eye patches.
Which of the following children has abnormal language development?
Selected
Answer:
c.
Speech is 50% understandable at 36 months of age
The parent of a 2-year-old tells you her daughter recently started having breath-
holding spells. She tells you the older sibling “did the same thing” and asks you for
help. You advise her that after a breath-holding event:
Selected
Answer:
a.
Act as if nothing abnormal happened. You assess a 15 - year-old's visual acuity and note her vision to be 20/50 in the right eye. She asks you what that means and you respond
Selected
Answer:
d.
"You can see at 20 feet with your right eye what most people can see at 50 feet."
You see a 5 - month-old who is fussy, has interrupted sleep, and is drooling. You note
large lower lateral incisor bulges. You recommend:
SelectedAnswer:
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e.
A andD
NRNP 6541 WEEK 3 Test
QUESTION 1
Which of the following vaccines is routinely recommended at 4 months of age?
a. Diphtheria, tetanus, acellular pertussis (DTaP)
b. Oral polio vaccine (OPV)
c. Measles, mumps, rubella (MMR)
d. Varicella
QUESTION 2
The first sign of the onset of female puberty is usually:
a. Sparsely distributed fine, pale pubic hairs
b. Breast buds
c. Menarche
d. Peak height growth velocity
QUESTION 3
You see a 13 - year-old who reports she is learning some basic geometry (areas, volume etc.).
The ability to successfully master these concepts occurs during which Piaget developmental
stage?
a. Sensorimotor
b. Preoperational
c. Concrete operational
d. Formal operational
QUESTION 4
Which of the following injuries is most likely to be caused by abuse of a toddler?
a. Three or four bruises on the shins and knees.
b. Spiral fracture of the tibia.
c. A displaced posterior rib fracture.
d. A forehead laceration.
