NURS 6541 final may 2020

Question 1

1 out of 1 points

A small-for-gestational-age, dysmorphic newborn infant has microcephaly and sloping forehead,

cutis aplasia (missing portion of the skin and hair) of the scalp, polydactyly, microphthalmia, and

omphalocele. Which of these is the most likely diagnosis?

Selected Answer: a.

Patau syndrome (trisomy 13)

• Question 2

• 1 out of 1 points

A 16-year-old girl has enuresis, frequent urination, a white vaginal discharge, and a dark

rash around her neck. Her serum glucose level is 250 mg/dL, and her urinalysis is positive

for 2+ glucose but is otherwise negative. Which of the following is the most likely diagnosis?

Selected Answer: c.

Type II diabetes

• Question 3

• 1 out of 1 points

Mark, age 15, is 5 feet tall andn weighs 85 pounds. You suspect anorexia and know that the best

initial approach is to

Selected Answer: d.

Confront Mark with the fact that you suspect an eating

disorder.

• Question 4

• 1 out of 1 points

Which of the following is not a sign or symptom of congenital hypothyroidism?

Selected Answer: d.

Frequent stooling

• Question 5

• 0 out of 1 points

While doing a 5-year-old well child exam, you notice two small patches of hair loss. Broken hair is

present, as is erythema and scaling. On the basis of this information, which of these is the likely

diagnosis?

Selected Answer: c.

Alopecia areata

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• Question 6

• 1 out of 1 points

Hope is a 7-month-old who presents in January with a 1-day history of cough, yellow nasal

discharge, and low-grade temp (T max 100°F). She was previously healthy. She does have

2+ edema of the nasal turbinates and cloudy rhinorrhea. She is afebrile in the office. Her

chest, mouth, and ears are clear. You prescribe:

Selected Answer: d.

Saline drops, bulb suction, humidified air, and increased PO

fluids

• Question 7

• 1 out of 1 points

The parents of an 8-year-old Down Syndrome boy arrive for his annual well-child visit. He wants to

participate in sports, including the Special Olympics. Until further examination can be completed,

which of the following sports would you suggest as being safe?

Selected Answer: a.

Tennis

• Question 8

• 1 out of 1 points

Jason, age 14, appears with tender discoid breast tissue enlargement (2-3 cm in diameter) beneath

the areola. Your next action would be to

Selected Answer: a.

Perform watchful waiting for 1 year.

• Question 9

• 1 out of 1 points

You see a 7-year-old boy a day after he was bitten by his pet dog. According to the mother,

the dog bit the child after he snuck up on the dog and grabbed his tail. The dog has had all

its vaccinations, including rabies. The child has had no fever, has full movement of the

injured limb, and has no sign of neurologic or vascular injury. The wound is on the child’s

forearm, is not deep, and is not bleeding, but has developed about 2 cm of erythema

surrounding the site. Which of the following is the most appropriate treatment?

Selected Answer: c.

Oral amoxicillin-clavulanate for 7-14 days

• Question 10

• 1 out of 1 points

A head injury in which bruising or tearing of the cerebral structures occurs is a

Selected Answer: d.

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Contusion

• Question 11

• 1 out of 1 points

A 14-year-old has a 3-week history of fever, anorexia, and abdominal pain. What additional

symptom would cause the NP to suspect Crohn's disease?

Selected Answer: b.

Blood, mucous diarrhea

• Question 12

• 1 out of 1 points

Which of the following should be done annually after 1 year of age in a child with Down syndrome?

Selected Answer: a.

Thyroid screenings

• Question 13

• 1 out of 1 points

A previously healthy male has a 3-month history of increasing headaches, blurred vision,

and personality changes. Previously he admitted to marijuana experimentation more than 1

year ago. On examination he is a healthy, athletic-appearing 17-year-old with decreased

extraocular range of motion and left eye visual acuity. Which of the following is the best next

step in his management?

Selected Answer: c.

Neuroimaging

• Question 14

• 1 out of 1 points

Kelly, your 11-year-old well visit patient, presents to the office with weight loss, polyuria, and

polydipsia. Which of the following do you need to rule out?

Selected Answer: d.

Diabetes mellitus

• Question 15

• 1 out of 1 points

A 3-week old presents to the office in January with a 1-week history of nasal congestion and

occastional cough. On the night prior to the visit in infant developed a fever 102ºF rectally, was

difficult to breastfeed, and had paroxysmal coughing and noisy, labored breathing. On exam, you

note an ill-appearing infant who is lethergic with wheezing, tachypnea, and intercostal retractions.

The infant is home with the mom at this time; however, has a sibling who is 4-years-old and is in

daycare and recently had cold symptoms. If the patient has been diagnosed with RSV bronchiolitis,

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