Name
Purdue University Globle
NU580 FNP II – Primary Care of Children and Adolescents’ Health
Prof. Name
Date
Question: Which statement about Cyclic Vomiting Syndrome (CVS) is correct?
A. Episodes last for days.
B. SSRIs are required to stop symptoms.
C. CVS is not associated with headaches.
D. Treatment requires pain medication and Zofran.
Correct Answer: C. CVS is not associated with headaches.
Question: A 5-day-old infant presents with jaundice, a slightly sunken anterior fontanel, decreased wet diapers, and breastfeeding difficulties. The bilirubin level is 18 mg/dL. Which nursing interventions are appropriate?
A. Initiate phototherapy.
B. Provide breastfeeding support and education.
C. Closely monitor intake and output.
D. All of the above.
Correct Answer: D. All of the above.
Question: An infant weighing 6 kg is admitted with dehydration. Which urinary output indicates adequate hydration?
A. 0.5 mL/kg/hr
B. 0.5–2.5 mL/kg/hr
C. 1–3 mL/kg/hr
D. Wet diapers alone are sufficient to assess hydration.
Correct Answer: C. 1–3 mL/kg/hr.
Question: A 5-year-old child with asthma is prescribed an oral corticosteroid and a short-acting beta-adrenergic medication through a metered-dose inhaler for acute symptoms. Which education is most important?
A. Provide an asthma action plan.
B. Explain medication effects and potential side effects.
C. Provide information about spirometry testing.
D. Explain medication administration at school.
Correct Answer: A. Provide an asthma action plan.
Question: A child with severe asthma does not respond adequately to conventional treatments. A pulmonology referral is ordered. What should the pulmonologist provide?
A. Confirm the diagnosis for the parents.
B. Recommend alternative disease management strategies.
C. Emphasize medication adherence only.
D. Take over all chronic illness management.
Correct Answer: B. Recommend alternative disease management strategies.
Question: An 18-month-old child has a rectal temperature of 100.4°F (38°C). The child is playful, drinking fluids, and has a slightly decreased appetite. What should the nurse practitioner recommend?
A. Administer antipyretic medication.
B. Bring the child to the clinic immediately.
C. Offer additional fluids and call if symptoms change.
D. Order laboratory testing.
Correct Answer: C. Offer additional fluids and call if symptoms change.
Question: A 10-year-old child reports shooting pain in both legs, accompanied by aching, tingling, and burning sensations. The child cannot identify specific pain locations. Which type of pain is suspected?
A. Chronic pain
B. Neuropathic pain
C. Somatic pain
D. Visceral pain
Correct Answer: B. Neuropathic pain.
Question: A 3-year-old child recovering from injuries sustained in a motor vehicle accident requires pain assessment. Which method is most appropriate?
A. Use a detailed pain discrimination scale.
B. Ask the child to describe pain as no pain, a little pain, or a lot of pain.
C. Ask about exact pain intensity and location.
D. Rely only on nonverbal behaviors.
Correct Answer: B. Ask the child to describe pain as no pain, a little pain, or a lot of pain.
Question: A 4-year-old child recovering from orthopedic surgery points to “1” on a faces pain scale. What should the nurse practitioner do next?
A. Assess vital signs and mobility without pain.
B. Refill narcotic medication.
C. Recommend acetaminophen only.
D. Teach parents to administer medication based only on pain reports.
Correct Answer: A. Assess vital signs and mobility without pain.
Question: A developmentally and cognitively disabled 10-year-old child cannot communicate pain before undergoing multiple surgeries. Which pain assessment tool should the parent be taught to use?
A. Comfort Scale
B. FLACC Scale
C. NCCPCR
D. Nonverbal observations
Correct Answer: C. NCCPCR.
Question: A 4-month-old infant is undergoing a painful procedure. In addition to local anesthesia, which intervention provides additional analgesic effects?
A. Providing toys
B. Singing or playing music
C. Administering a sucrose solution
D. Swaddling or cuddling
Correct Answer: C. Administering a sucrose solution.
Question: An adolescent female reports moderate dysmenorrhea. Ibuprofen 400 mg every 6–8 hours controls her pain. Which recommendation is appropriate?
A. Increase ibuprofen to 600–800 mg every 6–8 hours.
B. Use acetaminophen 1000 mg every 4–6 hours.
C. Use naproxen 500 mg initially, followed by 250 mg every 6–8 hours.
D. Use extended-release naproxen 500 mg every 12 hours.
Correct Answer: C. Use naproxen 500 mg initially, followed by 250 mg every 6–8 hours.
Question: When prescribing acetaminophen with hydrocodone, which factor is most important in limiting the dose?
A. Total acetaminophen dose
B. Gastrointestinal side effects
C. Pruritus symptoms
D. Urinary retention
Correct Answer: A. Total acetaminophen dose.
Question: An adolescent takes ibuprofen, acetaminophen, and a tricyclic antidepressant for phantom limb pain. The medications are no longer effective. What should the nurse practitioner do?
A. Change the tricyclic antidepressant to an SSRI.
B. Evaluate for drug-seeking behavior.
C. Increase the tricyclic antidepressant dose.
D. Refer the patient to a pain management specialist.
Correct Answer: D. Refer the patient to a pain management specialist.
Question: A school-age child with chronic pain wants to stay home from school more often. The physical examination and medication review remain unchanged. What should the nurse practitioner recommend?
A. Assess pain daily.
B. Keep the child in bed during pain episodes.
C. Have the child complete homework when staying home.
D. Require school attendance despite pain.
Correct Answer: C. Have the child complete homework when staying home.
Question: A 2-week-old infant was diagnosed with transient tachypnea of the newborn shortly after birth. What should the nurse practitioner understand about this condition?
A. Antibiotics are usually required.
B. Home oxygen is always needed.
C. Recovery is usually complete with minimal intervention.
D. Mechanical ventilation and surfactant are required.
Correct Answer: C. Recovery is usually complete with minimal intervention.
Question: A 2-month-old infant presents with a staccato cough and fever. Which history finding is most important?
A. Daycare attendance
B. Immunization history
C. Medication history
D. Past medical history
Correct Answer: B. Immunization history.
Question: Research suggests which population may have higher rates of under-immunization?
A. Communities with higher Asian populations
B. Communities with higher graduate degree rates
C. Communities with lower poverty rates
D. Communities with fewer primary care providers
Correct Answer: B. Communities with higher graduate degree rates.
Question: A parent of a 2-month-old infant expresses hesitancy about vaccines. What is the best initial response?
A. Explain that vaccines contain no thimerosal.
B. Provide Vaccine Information Statements only.
C. Ask about the parent’s concerns regarding vaccines.
D. Remind the parent about exposure to germs.
Correct Answer: C. Ask about the parent’s concerns regarding vaccines.
Question: According to Institute of Medicine findings, which information should parents receive about vaccine risks?
A. Multiple vaccines cause type 1 diabetes.
B. MMR may be associated with febrile seizures.
C. Hepatitis B vaccine causes central nervous system disorders.
D. Thimerosal-containing vaccines cause developmental disorders.
Correct Answer: B. MMR may be associated with febrile seizures.
Question: A 2-month-old infant receives initial immunizations. What should the nurse practitioner recommend for comfort?
A. Give ibuprofen or acetaminophen as needed.
B. Avoid all antipyretic medications.
C. Give medication only after vaccination.
D. Give both medications before vaccination.
Correct Answer: A. Give ibuprofen or acetaminophen as needed.
Question: An 18-month-old child received the MMR vaccine two days before the first birthday. What should the nurse practitioner do?
A. Give a reduced MMR dose.
B. Obtain antibody titers.
C. Recommend the next dose at 4–5 years.
D. Repeat the MMR vaccine.
Correct Answer: D. Repeat the MMR vaccine.
Question: A 5-year-old child with a previous pertussis infection needs kindergarten immunizations. Which vaccine is recommended?
A. DTaP
B. DTP
C. Td
D. Tdap
Correct Answer: A. DTaP.
Question: Which statement best describes thelarche in female puberty?
A. Appearance of pubic hair
B. Appearance and maturation of breast tissue
C. Beginning of the first menstrual period
D. All of the above
Correct Answer: B. Appearance and maturation of breast tissue.
Question: Congenital hypothyroidism is more common in infants with Down syndrome. After initial thyroid screening, thyroid studies should be performed at least:
A. Every 2 months
B. Every month
C. Every 6 months
D. Yearly
Correct Answer: D. Yearly.
Question: Children with Down syndrome have an increased risk of which malignancy?
A. Colon cancer
B. Leukemia
C. Pancreatic cancer
D. Bladder cancer
Correct Answer: B. Leukemia.
Question: Children with Down syndrome may develop cervical spine instability. Which symptoms should caregivers monitor?
A. Changes in reflexes
B. Changes in bowel function
C. All of the above
D. None of the above
Correct Answer: C. All of the above.
Question: An 18-month-old child has ear pain, fever, an erythematous bulging tympanic membrane, and no history of ear infections. What is the recommended treatment?
A. Amoxicillin 80–90 mg/kg/day
B. Analgesic medication and watchful waiting
C. Ceftriaxone injection
D. Antibiotic ear drops
Correct Answer: B. Analgesic medication and watchful waiting.
Question: A 7-month-old infant has persistent otitis media despite treatment with amoxicillin and amoxicillin-clavulanate. What is the next step?
A. Repeat amoxicillin-clavulanate.
B. Perform tympanocentesis.
C. Prescribe clindamycin.
D. Refer to an otolaryngologist.
Correct Answer: D. Refer to an otolaryngologist.
Question: A child with pressure equalizing tubes has ear pain but no drainage. The tube is visualized normally, and the tympanogram is type A. What should the nurse practitioner do?
A. Prescribe antibiotic/steroid ear drops.
B. Give prophylactic antibiotics.
C. Reassure the parent that this is a normal examination.
D. Refer immediately to ENT.
Correct Answer: A. Prescribe antibiotic/steroid ear drops.
Question: What should parents expect after placement of pressure equalizing tubes?
A. Improved hearing
B. Complete prevention of ear infections
C. Need for earplugs during every bath
D. Tubes remain in place for 3–4 years.
Correct Answer: A. Improved hearing.
Question: A child with recurrent otitis externa asks how to prevent future episodes. What should the nurse practitioner recommend?
A. Clean the ear canals after swimming.
B. Dry the ear canal with a hair dryer.
C. Swim only in chlorinated pools.
D. Use cerumenolytic agents daily.
Correct Answer: B. Dry the ear canal with a hair dryer.
Question: A child presents with itching, hearing difficulty, ear canal swelling, and severe pain when the ear is manipulated. What is the appropriate treatment?
A. Culture the ear canal.
B. Order antibiotic/corticosteroid ear drops.
C. Prescribe oral amoxicillin-clavulanate.
D. Refer to ENT.
Correct Answer: B. Order antibiotic/corticosteroid ear drops.
Question: A child with otitis externa develops severe ear canal swelling after two days of topical therapy. What is the next treatment step?
A. Insert an ear wick.
B. Irrigate the ear canal.
C. Give systemic corticosteroids.
D. Prescribe oral antibiotics.
Correct Answer: A. Insert an ear wick.
Question: A small foreign object is located near the tympanic membrane in a child’s ear canal. What should the nurse practitioner do?
A. Irrigate the ear.
B. Refer to an otolaryngologist.
C. Remove the object with a wire loop.
D. Use forceps.
Correct Answer: B. Refer to an otolaryngologist.
Question: A 3-year-old child develops recurrent acute otitis media after previous amoxicillin treatment. Tympanogram shows middle ear fluid, and the child has a fever. Which medication should be ordered?
A. Tympanocentesis referral
B. Amoxicillin alone
C. Amoxicillin-clavulanate
D. Intramuscular ceftriaxone
Correct Answer: C. Amoxicillin-clavulanate.
Question: A 2-year-old child has acute otitis media with a history of frequent ear infections. What is the recommended treatment?
A. Amoxicillin for 10 days
B. Analgesics and watchful waiting
C. Antibiotic ear drops
D. Ceftriaxone injection
Correct Answer: B. Analgesics and watchful waiting.
Question: A child treated for otitis media has persistent middle ear fluid but no fever or pain. What is the next step?
A. Ceftriaxone injection
B. Oral clindamycin
C. Monitor ear fluid for 3 months.
D. Begin immediate antibiotic treatment.
Correct Answer: C. Monitor ear fluid for 3 months.
Question: A school-age child with chronic ear disease presents with vertigo, purulent drainage, and a pearly white lesion on the tympanic membrane. Which condition is suspected?
A. Cholesteatoma
B. Mastoiditis
C. Otitis externa
D. Otitis media with effusion
Correct Answer: A. Cholesteatoma.
These pediatric nursing practice questions cover:
Pediatric dehydration and neonatal conditions
Asthma management and respiratory disorders
Pediatric pain assessment and pharmacological treatment
Childhood immunizations and vaccine counseling
Down syndrome and associated health risks
Otitis media, otitis externa, and other ear conditions
