NRP543 Management Of Pediatric And Adolescent Populations
Week 1 Discussion
Child Morbidity and Mortality
Select a child morbidity or mortality topic from the Child Morbidity and Mortality Presentation document (breastfeeding, SIDS, immunizations, early childhood caries, bully behavior, fall prevention, obesity, passenger/young driver safety, safe sex, sports participation) and respond in a minimum of 175 words:
Summarize the topic you selected, including your findings from the research.
Define the relevance of the topic as it relates to children's health and clinical NP practice.
Discuss treatment options, including any involved risks and benefits.
Discuss controversies surrounding the topic by responding to opposing viewpoints.
Cite your refences according to APA guidelines.
NRP543 Management Of Pediatric And Adolescent Populations
Week 2 Discussion
Theory of Human Caring
Review "Core Concepts of Jean Watson's Theory of Human Caring/Caring Science."
Respond to the following in a minimum of 175 words:
Define key family-centered care concepts specific to caring for children.
Evaluate issues and ethical scenarios in today's society that place children and their families at risk.
How can you apply examples of Jean Watson's theory of caring during clinicals?
NRP543 Management Of Pediatric And Adolescent Populations
Week 3 Discussion
Immunization
Pick one of the following immunizations:
Hepatitis B
Rotavirus
DTaP/Tdap
Hib
PCV13
IPV
Influenza
MMR
Varicella
Hepatitis A
HPV
Meningococcal/Meningococcal B
In a minimum of 175 words, summarize:
The purpose of the vaccine (what is it protecting against)
The routine series with age recommendations
The catch-up schedule
Any special considerations or concerns related to the immunization
NRP543 Management Of Pediatric And Adolescent Populations
Week 4 Discussion
Pediatric Diagnosis and Treatment
Pick one of the following topics:
Recurrent otitis media
RSV
Pharyngitis
Pediatric sinusitis
Febrile seizure
Pediatric headache
Respond in a minimum of 175 words:
How is the chosen topic diagnosed?
Which national organizations could you go to for treatment?guidelines?
Discuss first-line treatment using evidence-based practice support.
Does this diagnosis require a referral?
NRP543 Management Of Pediatric And Adolescent Populations
Week 5 Discussion
Gastrointestinal, Genitourinary, and Dermatology Disorders
Pick one of the following topics:
Diaper dermatitis
Atopic dermatitis
Molluscum contagiosum
Constipation
Viral gastroenteritis
Pediatric UTI
Respond to the following in a minimum of 175 words:
How would you diagnose your chosen topic?
Which national organizations could you go to for treatment?guidelines?
Discuss first-line treatment using evidence-based practice support.
NRP543 Management Of Pediatric And Adolescent Populations
Week 6 Discussion
Cardiovascular and Infectious Disease
Pick one of the following topics:
Still’s murmur
Ventricular septal defect
Multisystem inflammatory syndrome (MIS-C)
Varicella
Pneumonia
Scarlatina
Respond to the following in a minimum of 175 words:
How would you diagnose your chosen topic?
Which national organizations could you go to for treatment guidelines?
Discuss first-line treatment using evidence-based practice support.
NRP543 Management Of Pediatric And Adolescent Populations
Week 7 Discussion
Hematologic and Orthopedic Disorders
Pick one of the following topics:
Newborn jaundice/hyperbilirubinemia
Sickle cell disease
Iron deficiency anemia
Hip dysplasia
Scoliosis
Osgood-Schlatter disease
Respond to the following in a minimum of 175 words:
How would you diagnose your chosen topic?
Which national organizations could you go to for treatment guidelines?
Discuss first-line treatment using evidence-based practice support.
NRP543 Management Of Pediatric And Adolescent Populations
Week 8 Discussion
Endocrine, Developmental, and Behavioral Disorders
Pick one of the following topics:
Hypothyroidism
ADHD
Autism spectrum disorder
Fetal alcohol syndrome
Diabetes type 1
Pediatric diabetes type II
Respond to the following in a minimum of 175 words:
How would you screen for your chosen disorder?
Which national organizations could you go to for treatment guidelines?
Discuss first-line treatment using evidence-based practice support.
What referral would you need to make for your chosen disorder?
NRP543 Management Of Pediatric And Adolescent Populations
Week 1 Assignment
Dosage Calculations and Pediatric Scenarios Worksheet
Part 1
Instructions: Calculate the correct dosage for each of following children and write the prescription following the provided format if indicated. Please make up the patient’s name and DOB but do not change the age of the patient provided.
1.A 4-month-old weighing 12 pounds needs amoxicillin (400mg/5ml) for otitis media (dosed at 80 mg/kg). Calculate the dose.
Patient Name:
Date of Birth (DOB):
Drug:
Sig:
Dispense amount:
Refills:
Signature: (can type out signature)
Date:
2.A 1-year-old who weighs 22 pounds needs amoxicillin clavulanate (dosed at 80 mg/kg) for otitis media. Amoxicillin Clavulanate strength is 600mg/42.9mg/5ml. Calculate the dose.
Patient Name:
Date of Birth (DOB):
Drug:
Sig:
Dispense amount:
Refills:
Signature: (can type out signature)
Date:
3.A 32-pound 3-year-old needs cefdinir (250mg/5ml) for otitis media. Calculate the dose.
Patient Name:
Date of Birth (DOB):
Drug:
Sig:
Dispense amount:
Refills:
Signature: (can type out signature)
Date:
4.A 9-month-old who weighs 18 pounds has a fever of 103ºF. What dose of acetaminophen (160mg/5ml – dose at 10mg/kg/dose) would you recommend?
Drug:
Sig:
5.What dose of ibuprofen (100mg/5ml – dose at 5mg/kg/dose) would you recommend for the same child?
Drug:
Sig:
6.A 20-pound 1-year-old needs sulfa trim (200mg/40mg/5ml) for UTI. Base your dosing on 10mg/kg/day. Calculate the dose.
Patient Name:
Date of Birth (DOB):
Drug:
Sig:
Dispense amount:
Refills:
Signature: (can type out signature)
Date:
7.A 5-year-old asthmatic child who weighs 40 pounds needs prednisolone (Prelone) for an exacerbation of his asthma. Recommended dose is 1-2mg/kg/day daily or BID x3-10 days (Epocrates, 2020). Prednisolone strength: 25mg/5ml Dose at 2mg/kg/day not to exceed 60 mg/day Calculate the dose.
Patient Name:
Date of Birth (DOB):
Drug:
Sig:
Dispense amount:
Refills:
Signature: (can type out signature)
Date:
Part 2
Instructions: Read the scenarios and answer the corresponding questions.
Scenario 1
Jimmy is a 6-month-old boy who has been vomiting and having diarrhea for 3 days. He is seen in your office today and weighs 16 pounds (7.27kg) and is 24 inches in length. His head circumference is 44.5 cm. Last week, he was in your office for a well-child visit and weighed 17.5 pounds (7.95kg).
1.How much weight, in grams, has Jimmy lost?
2.What percentage of dehydration does this represent?
3.What signs and symptoms would you expect to see?
4.What type of oral fluids would you suggest?
5.What instructions would you give Jimmy’s mom about offering fluids and calling the office, or taking the child to the emergency room?
6.Plot his measurements on the appropriate growth charts and document his percentiles for weight, length, and head circumference here:
Scenario 2
Janice is a 3-year-old who has been vomiting and has had diarrhea for 3 days. She weighed 33 pounds and was 35-inches tall at a well-child check-up 2 weeks ago. Today, she weighs 26.5 pounds.
1.Calculate Janice's degree of dehydration.
2.What do you expect Janice to look like?
3What would be your first fluid treatment?
4.Janice responds well to your therapy. What would your next step be?
5.Plot her height, weight, and BMI on the appropriate growth chart and document the percentiles here. What is your assessment of her overall growth?
NRP543 Management Of Pediatric And Adolescent Populations
Week 2 Assignment
Child Morbidity and Mortality Presentation
Assignment Content
Develop a 10- to 15-slide Microsoft® PowerPoint® presentation with detailed speaker notes for each slide that addresses the child morbidity or mortality issue chosen in Week 1 (breastfeeding, SIDS, immunizations, early childhood caries, bully behavior, fall prevention, obesity, passenger/young driver safety, safe sex, sports participation).
Refer to the the Child Morbidity and Mortality assignment.
Address the following in your presentation:
Summarize the topic you selected, including your findings from the research.
Define the relevance of the topic as it relates to children's health and clinical FNP practice.
Discuss treatment options, including any involved risks and benefits.
Consider potential financial barriers or benefits related to the recommended treatment options. How will you address these barriers?
What community resources are available in your state of practice to help with financial barriers, including services for uninsured and underinsured pediatric patients?
Provide your recommended patient education plan addressing and managing the issue.
Include a minimum of 2 academic resources that support your findings.
NRP543 Management Of Pediatric And Adolescent Populations
Week 3 Assignment
Immunization Counseling Paper
Assignment Content
Controversy has always existed surrounding the concept of required immunizations. In practice, you may frequently engage in conversations with parents and guardians who are trying to better understand their options with the goal of choosing the safest treatment plan for their child. Confusion exists regarding what is required for entry into public school and what is recommended by the CDC.
Respond to the following scenario by creating a 750-word summary:
Mrs. Clara Baker comes to you with her son Isaac, a five-year-old who is preparing to enter public school. Isaac has never been vaccinated before, and she knows he will need some vaccines for school, but she has been hesitant to have him vaccinated in the past. Isaac is a healthy five-year-old without any significant past medical history. He was born full-term via vaginal delivery in the hospital, where he did receive his first hepatitis B vaccine before being discharged the next day. He has had regular well child checks since birth, but until now Clara has refused all vaccinations.
Address the following:
How will you, as the FNP, counsel Mom about immunization recommendations and safety?
What immunizations would you recommend for Isaac today?
What education would you provide Mom regarding common reactions and unexpected adverse events?
What would your recommendation for follow-up be?
NRP543 Management Of Pediatric And Adolescent Populations
Week 4 Assignment
i-Human Emma Ryan Lab and Reflection
Assignment Content
i-Human simulates a patient situation you may encounter in a clinical setting. This is an opportunity to practice your skills in taking a history, performing a physical exam, and developing a diagnosis and treatment plan.
Access i-Human Patients using the link in the Course Content section.
Part I
Complete the health history assessment available at the beginning of the Emma Ryan case.
Part II
Complete the patient encounter for Emma Ryan by completing the following steps:
Interview Emma Ryan to obtain her complete patient history.
Document your findings in i-Human.
Complete a health assessment and focused physical exam based on current evidence.
Document your health assessment and focused physical exam findings and develop a problem list and diagnosis for Emma Ryan.
Review the i-Human Patients Case Player Instructions, which includes helpful tips for completing the patient simulation.
Note: Scores will be recorded in I-Human Patients; there is nothing to submit in the classroom for this portion of the assignment. Your I-Human Patients Lab score will be determined strictly based on completion. Use the lab to complete the patient stimulation to the best of your ability since you will use this experience to complete the associated Reflection assignment. The detailed summary of your lab is an excellent opportunity to review techniques that will help advance best practices associated with health assessments.
Read 1 of the recommended evidence-based practice academic articles provided at the end of the case or locate and read an academic article from the University Library that relates to the conditions presented in the Emma Ryan case.
Write a 350-word summary of how you can utilize the findings from the article to improve your clinical decision-making skills.
Include the following in your analysis:
Are there techniques identified in the article that can be used to improve your clinical skills? If so, explain.
Now that the final diagnosis has been revealed, identify, and provide the rationale for your top 3 differential diagnoses for Emma. How would you rule each in/out?
Explain how you can apply the information you learned from your patient encounter and the evidence-based practice article in the clinical setting.
Format your summary using APA guidelines.
NRP543 Management Of Pediatric And Adolescent Populations
Week 5 Assignment
Dermatology
Dermatology Assignment
Part I: Name that Rash
Rash options
A. Tinea Capitis
B. Candidiasis rash
C. Scalp psoriasis
D. Tinea Versicolor
E. Pityriasis Rosea
F. Impetigo
G. Urticaria
H. Tinea Corporis
I. Tinea pedis
J. Pityriasis Alba
K. Seborrhea Capitis
L. Roseola Infantum
M. Atopic dermatitis
N. Tinea Manuum
O. Fifth Disease
P. Seborrhea Dermatitis
Q. Alopecia
R. Measles
S. Molluscum contagiosum
T. Verruca (viral warts)
U. Diaper dermatitis
1.Numerous pale pink, macular and papular oval lesions presenting in a Christmas tree pattern on the back of an adolescent
2. Multiple discrete, poorly outlined, hypopigmented patches on the face
3.Honey colored crusts on erythematous base to nose, philtrum, and cheek
4. Scaly, hypopigmented discrete oval macules and patches on the upper back
5. Patchy hair loss and scaly lesions with raised borders on the scalp
6. Small, firm, pink to flesh colored discrete papules to upper chest and left axilla; some papules are umbilicated
7. Erythematous, dry-scaling papules and plaques to bilateral popliteal fossae of adolescent
8. Moist, bright red diaper rash with sharp borders and satellite lesions
9.Erythematous, flaky, thick, yellow greasy scales on scalp of infant
10.Intense red eruption on bilateral cheeks with circumoral pallor; with lacy maculopapular eruption on the trunk of a toddler
Part 2: Diagnosis and Treatment/Management Plan
List your diagnosis from the corresponding image above and list the treatment / management plan for that diagnosis.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Part 1: Name that Rash
In this part of the assignment, you will identify 10 rashes from pictures.
Part 2: Diagnosis and Treatment/Management Plan
In this part of the assignment, you will list your diagnosis from the corresponding image you identified in Part 1, then list the treatment/management plan for that diagnosis in a minimum of 50 words each.
NRP543 Management Of Pediatric And Adolescent Populations
Week 6 Assignment
Clinical Management Presentation
Develop a 15- to 20-slide presentation, using Microsoft® PowerPoint® with detailed speaker notes, on the clinical management of the pediatric condition, problem, or disease selected from the approved list and approved by your faculty.
Refer to the Clinical Management Presentations instructions document.
Include the following in your presentation:
Analyze the etiology, pathophysiology, and general clinical manifestation of symptoms of the disease based on relevant literature.
How might age or overall health status alter the normal clinical manifestation of the disease?
Evaluate the patient’s overall social and medical history, clinical symptoms, and clinical assessment from the perspective of the previously cited literature.
Evaluate the diagnostic work-up and clinical findings, which include the rationale for each diagnostic test and expected findings, and recommend a diagnosis based on the findings.
Develop a plan of care based on the diagnosis, including age-appropriate modifications of the proposed therapy and dose modifications based on clinical guidelines.
Create a patient/parent education plan that shows an understanding of the recommended anticipatory guidance and the patient’s developmental age, parental role, health literacy of the patient/family, cultural sensitivity, and health belief models.
Analyze the current condition and how it may relate to underlying health issues, the proposed plan of care, and possible side effects or complications.
Include an example of patient/family engagement in the plan of care (for example, utilization of the teach-back method).
Analyze how the principles of Watson’s theory of human caring are integrated into the patient/parent education.
NRP543 Management Of Pediatric And Adolescent Populations
Week 7 Assignment
Polly Davis Lawful Practice Case Study
DOB: 9/7/2016
Polly Davis is a 5-year-old, Caucasian female who is brought to you by her father Jeremiah today for concerns of crying with urination and repeated complaints of “pain down there,” which seems to be getting worse. Jeremiah is a single father who works nights at a local warehouse. Polly’s grandmother used to babysit Polly each night while her dad worked, but she passed away two months ago. Since that time, Polly’s uncle has been watching Polly overnight. Jeremiah has noticed that Polly has become unusually clingy, crying when he leaves for work. He reports that recently she has been soiling herself, which is a new finding. On exam, you notice significant vulvovaginitis with some purulent vaginal discharge; there also appears to be some hymenal tearing along with some suspicious bruising on her buttocks. You suspect Polly is being sexually abused.
Prepare a 700- to 1,000-word case summary discussing the following:
What are your immediate concerns for Polly? How would you address these concerns?
What are the reporting requirements for pediatric abuse in your state? If you are required to report suspected pediatric abuse, who do you report your suspicions to? What is the required timeline for reporting?
How would you conclude this visit? In addition to referring Polly to the ER, what other types of referrals might you need to consider as her primary care provider?
How would you document this visit?
NRP543 Management Of Pediatric And Adolescent Populations
Week 8 Assignment
Comprehensive SOAP Note for Two-Year-Old Well Child Check
Write a comprehensive SOAP note for a two-year-old well child check. Use the PEDS comprehensive written SOAP note template provided. Assume all findings are within normal limits.
Complete the SOAP Note for Two-Year-Old Well Child Check Template.
Ensure you include the following:
A full subjective and objective assessment
Appropriate Ht/Wt percentiles
Developmental history and current developmental state (milestones)
At least 3 differential diagnoses to consider (think about why we recommend well child checks)
A final diagnosis indicating normal findings
Your assessment and plan, including education and anticipatory guidance.
NRP543 Management Of Pediatric And Adolescent Populations
Week 1 Quiz
Question 1Kelly presents for her 6-month well visit. Her mother is worried because you found a positive Babinski reflex. You explain that a positive Babinski usually disappears by:
1 year
2 months
2 years
5 years
Question 2A 1-month-old male infant presents with mother for a well visit. When asked about birth history, mom reports that this is her first baby and he was breech presentation at birth, born by cesarean section. All of the following should be included in your exam and screening EXCEPT:
Order a hip ultrasound to complete at 6 weeks of age
Order a hip radiograph at 6 weeks of age
Check for a positive Galeazzi sign
Perform Barlow and Ortolani maneuvers
Question 3All of the following describe the Period of PURPLE crying EXCEPT:
Babies may resist soothing and have bouts of inconsolable crying.
The infant may turn blue or purple when crying.
It explains crying as a normal part of an infant’s development.
Begins at 2 weeks and continues until 3-4 months of age.
Question 4The following is considered to be a normal lead level and is managed by routine testing and patient education and risk assessment:
< 10 ug/dl
10-14 ug/dl
< 5 ug/dl
< 25 ug/dl
Question 5Which test will help you to detect strabismus in a preschooler?
Red reflex
Snellen
Fluorescein strip with woods lamp
Cover-uncover
Question 6A mother of a 2-week-old newborn comes to you for the first well-child exam. The infant takes only breast milk, urinates every 1-2 hours and has several soft yellow bowel movements per day. Your anticipatory guidance for this patient will include all EXCEPT:
Breast milk is the best milk for your baby, continue to breast feed for at least the entire first year if possible.
Mother should continue to take a prenatal or multivitamin daily.
Give baby Tylenol if he has a rectal temperature of 100.0 F or greater.
Baby should sleep face up in a crib or bassinette only, avoid sharing the adult bed with baby.
Question 7You are performing a physical exam on a 6-month-old girl. Mom is concerned about her baby’s growth. How will you determine if her concern is valid?
Look at the BMI growth chart.
Compare the weight since the last visit.
Evaluate the weight and height on the growth chart.
Evaluate the weight, length, and head circumference on the 0-36 month-old female growth chart.
Question 8Which is the best prescription of amoxicillin for a 6-month-old with otitis media who weighs 16 pounds, dosed at 80 mg/kg?
Amox 250mg/5ml; 4.5ml po BID x 10 days
Amox 400mg/5ml; 9ml po BID x w10 days
Amox 250mg/5ml; 9.5ml po TID x 10 days
Amox 400mg/5ml; 4ml po BID x 10 days
Question 9A 12-month-old child should be able to do all of the following EXCEPT:
Walk up steps.
Say Mama or Dada specifically.
Clap hands.
Indicate wants without crying.
Question 10A white instead of a red reflex upon eye exam of a 1-year-old child would suggest:
An accommodative error
Retinoblastoma
Papilledema
Retinal detachment
NRP543 Management Of Pediatric And Adolescent Populations
Week 2 Quiz
Question 1Which of the following would be helpful in distinguishing obesity vs. laree body frame in an adolescent who is concerned with her weight?
Triceps skinfold measurement
Assessing family history of body type
Body mass index
Percent of ideal body weight
Question 2Carlos is here for his 12-year-old physical. His BMI falls in the 97% percentile. His diagnosis today is:
Overweight
Metabolic syndrome
Obesity
Normal weight for age because he is very tall
Question 3The primary care pediatric nurse practitioner is examining a 15-year-old female who reports having her first period at age 13. She states that she has had five periods in the last year, with the last one 2 months prior. She participates in basketball at school. Which action is correct?
Perform biometric screening to determine lean body mass.
Prescribe oral contraceptives pills to regulate her periods.
Reassure her that this is perfectly normal at her age.
Refer her to an endocrinologist for hormonal evaluation.
Question 4The primary care pediatric nurse practitioner is performing a well child exam on a 17-year-old female whose mother is present during the history. The mother expresses concern that her daughter wishes to have an eyebrow piercing and states that she is opposed to the idea. What will the nurse practitioner do?
Provide information about piercings and encourage continued discussion.
Remind the adolescent that her mother is responsible for her health.
State that piercings are relatively harmless and are an expression of individuality.
Suggest that she wait until she is 18 years old and can make her own decisions.
Question 5The parent of an adolescent reports noting cutting marks on the teen’s arms and asks the primary care pediatric nurse practitioner what it means. What will the nurse practitioner tell this parent?
Cutting is a way of dealing with emotional distress.
It is a method of fitting in with other adolescents.
The behavior is common and will usually stop.
This type of behavior is a type of suicide attempt.
Question 6The primary care pediatric nurse practitioner is performing a well child assessment on a 13-year-old female whose mother asks when her daughter’s periods may start. Which information will the nurse practitioner use to help estimate the onset of periods?
The age of the mother’s menarche
The patient’s age at thelarche
When adrenarche occurred
Whether linear growth has stopped
Question 7The parent of an adolescent female tells the primary care pediatric nurse practitioner that the child may be the victim of cyber-bullying at school but won’t talk about it with her parents. What is the nurse practitioner’s initial response?
Ask about the adolescent’s school performance and friends.
Interview the adolescent separately from the parent.
Reassure the parent that suicide is a rare response to bullying.
Suggest that the parent discuss this with the school counselor.
Question 8The primary care pediatric nurse practitioner sees a 10-year-old child whose parent describes as a “class clown.” The child denies having problems at school, but acknowledges poor grades by saying, “I’m not very smart, I guess.” When counseling the parent about helping this child deal with this self-perception issue, the nurse practitioner will recommend which strategy?
Empower the child to make decisions and assume more responsibilities.
Help the child identify skills and activities that he is good at.
Spend time each evening helping the child with homework to improve grades.
Work with the teacher to set appropriate limits on school behavior.
Question 9The primary care pediatric nurse practitioner (PNP) prescribes a twice daily inhaled corticosteroid for a 12-year-old child. At a well child visit, the child reports not using the medication on a regular basis. Which response by the pediatric nurse practitioner demonstrates an understanding of client-centered care?
Asking the child to describe usual daily routines and schedules
Referring the family to a social worker to help with medication compliance
Reviewing the asthma action plan with the parent and the child
Teaching the child how the medication will help to control asthma symptoms
Question 10The primary care pediatric nurse practitioner is performing an exam on an adolescent male who asks about sexual orientation. He states he is asking this question because he is concerned that a friend is worried about being labeled as “gay." Which response will the nurse practitioner make in this situation?
Provide the teen with a questionnaire to gain information about his sexuality.
Remind the adolescent that mandatory reporting requires disclosure to parents.
Suggest that the adolescent discuss sexual concerns with his parents.
Tell the adolescent that, unless he is in physical or mental danger, what he says will be confidential.
NRP543 Management Of Pediatric And Adolescent Populations
Week 3 Quiz
Question 1The vaccinations due at two months of age include:
IPV, DTaP, Hib, HepB, PCV13, RV
IPV, DTaP, Hib, PCV13
IPV, HepB, DTaP, Hib, PCV13
Question 2The vaccinations due at six months of age include:
DTaP, IPV, PCV13
HepB, DTaP, PCV13
IPV, DTaP, Hib, HepB, PCV13
Question 3The vaccinations due at 12 months of age include:
DTaP, MMR, VAR, PCV13. HepA
MMR, VAR, PCV13, HepA, Hib
HepB, Hib, PCV13, HepA, MMR, VAR
Question 4The vaccinations due at four years of age include:
MMR, VAR, IPV, DTaP
MMR, VAR
MMR, VAR, IPV, DTaP, LAIV
Question 5The vaccinations due at 11 years of age include:
DTaP, HPV, MenB
Tdap, HPV, MenACWY
Tdap, HPV, MenB, MenACWY, PPSV23
Question 6The vaccinations due at 16 years of age include:
MenACWY
MEnB
MenACWY, HPV, Tdap
Question 7Which of the following are true of the HPV vaccine?
Recommended at 11-12 years but can be given as early as 9 years.
The 3-dose series is given at 0, 1-2 months, and 6-month intervals.
2 doses are recommended if < 15 years old and 3 doses recommended if 15 years or older.
All of the above are true.
A and B are true.
Question 8If a 7-month-old never received the rotavirus vaccine, they can start it now.
True
False
Question 9MMR vaccine causes autism, so give each component separately.
True
False
Question 10Which tetanus preparation is used in a child under 7 years of age?
DT
Tdap
DTaP
NRP543 Management Of Pediatric And Adolescent Populations
Week 4 Quiz
Question 1A 4-year-old child comes into your office with complaints of cough and wheezing. In evaluating the child, the most appropriate first step would be:
Give an albuterol breathing treatment
Do a TB skin test
Order a chest x-ray and CBC
Obtain a brief history including allergies then examine the child’s respiratory system
Question 2On physical exam of this child with asthma, the most significant physical finding in a diagnosis of asthma would be:
Dark circles under the eyes
Bluish, boggy, nasal turbinates
Expiratory wheezing and rales
Decreased breath sounds in the LLL
Question 3After the diagnosis of asthma is established the appropriate management of this patient might include all of the following EXCEPT:
Pharmaceutical treatments
Referral to a Pediatric Allergist
Reassurance to the parents that he will outgrow it
Education involving the nature of the disease and identification and avoidance of triggers
Question 4Well controlled asthma is classified by all of the following EXCEPT:
Rescue medication is used 2x or less per week
Nighttime symptoms occur 1 or less times per month
Daytime symptoms occur2 time or less per week
Some limitations to activities
Question 5The differential diagnoses for this child with cough and wheezing would include all of the following EXCEPT:
Pneumonia
Bronchiolitis
Asthma
Foreign body
Question 6The following are true about bronchiolitis EXCEPT:
It is primarily a disease of infancy.
The most common cause is respiratory syncytial virus.
Blood and sputum cultures are positive for bacteria.
A chest x-ray will show characteristic hyperinflation.
Question 7The treatment for bronchiolitis may include all of the following EXCEPT:
Careful observation for increased respiratory distress
Antibiotic therapy
Increased liquid intake
Vaporize use
Question 8Headaches in children that wake them from sleep and are followed by vomiting are indicative of:
Migraine headaches
Sinusitis headaches
Cluster headaches
Tumors
Question 9A mother presents with her 4-year-old child with report that child feels like there is something in her right eye x 1-2 days. On exam, you note a small bump on her right eyelid that is red, tender, swollen and there is no discharge present. The child does not have a fever.
Corneal abrasion
Blepharitis
Hordeolum
Chalazion
Question 10A 13-year-old boy and his mother visit the clinic with complaints of headache for 1 day. The boy fell and hit his head while riding his skateboard without a helmet yesterday. Today he developed red eyes with a surrounding bruise. The nurse practitioner noted a small amount of clear fluid from the nose. The nurse practitioner should
Restrict physical activity for 2 weeks and notify the school nurse.
Suspect viral infection and recommend Tylenol, rest, and extra fluids.
Refer patient to the hospital.
Reassure the mother. Explain that boys of that age always have bruises. Educate on the importance of wearing a helmet while riding a skateboard.
NRP543 Management Of Pediatric And Adolescent Populations
Week 5 Quiz
Question 1One of the most common causes of viral gastroenteritis is:
Norwalk virus
Rotavirus
Campylobacter
Shigella
Question 2The most serious case related to gastroenteritis would be:
Sunken fontanel in a 4-month-old, parched lips, and decreased urine output
A weight loss of 8 oz in a 22lb 6-month-old, pulse of 100, normal urine output
Pulse of 100 in a 4-year-old, altered specific gravity or urine and moist mucus membranes
Good oral intake, fever of 101 F, pale color and slight increase in fussiness in a 2-year-old
Question 3Contributing factors in cases of constipation include all of the following EXCEPT:
Too little fiber in diet
Disrupted routines
Psychosocial factors
Too little protein
Question 4A 7-year-old male brought to you by mother who is concerned about an itchy rash that has been getting worse on his feet and legs for the last 3 weeks. Mother states no one else has a rash at home. On exam you note a pale pink, pinpoint rash with scattered vesicles and several scabbed excoriations. The rash is linear and begins in the webs of the toes on the left foot but at ankle height on the right leg. He says it really itches and that sometimes wakes him up from sleep at night, itching intensely. You decide:
The diagnosis is atopic dermatitis, and the treatment is 1% hydrocortisone bid.
The diagnosis is varicella, and the rash will subside without treatment.
The diagnosis is scabies, and the treatment is Elimite cream in one application left on for 8 hours.
The diagnosis is roseola, no treatment because it is self-limiting.
Question 5The most likely organism to cause a UTI in the pediatric population is:
Staphylococcus Saprophyticus
Klebsiella
Chlamydiab
E Coli
Question 6One of the most commonly suggested reasons for primary enuresis is:
Medications such as theophylline
Genitourinary abnormalities
Family disruptions and stress
Delayed maturation of voiding inhibitory reflex
Question 7For a 6-year-old child with primary nocturnal enuresis, the first recommendation is:
Avoid criticism or punishment
Remove privileges
Treat with medication
Purchase an enuresis alarm
Question 8The best treatment for pediatric viral gastroenteritis would include all of the following EXCEPT:
An antidiarrheal agent
Increase fluids
Rest
Probiotic rich diet
Question 9You know that an adolescent male with a unilateral, red, painful scrotum has signs of:
Testicular torsion
Phimosis
Hydrocele
Glomerulonephritis
Question 10A mother presents with her 10-year son with complaint of a rash on his back x 1 week. Mom mentions that he has been itching his back after returning home from baseball practice. Denies fever. On exam you note 3 annular lesions up to 2cm in diameter with red scaly borders and central clearing on his low back. The best diagnosis for this child is:
Tinea corporis
Impetigo
Pityriasis Rosea
Tinea cruris
NRP543 Management Of Pediatric And Adolescent Populations
Week 6 Quiz
Question 1A father brings his 3-year-old son to the clinic with complaints of high fever, sore throat, and seems to have pain with swallowing because child doesn't want to eat. His symptoms started in the last 24 hours. On exam you note the child seems anxious, is drooling, sitting in a tripod position, and has mild inspiratory stridor. The best diagnosis for this child is:
Retropharyngeal abscess
Foreign body aspiration
Croup
Epiglottitis
Question 2All of the following are true of Still's murmurs EXCEPT:
They are usually Grade I-II/IV
Heard best in the lower left sternal border
Intensity increased when standing up or sitting
Intensity increases with laying supine
Question 3Etiologic agents responsible for 95% of the cases of meningitis in children >2 months of age have been Streptococcus pneumoniae, Neisseria meningitis and
Haemophilus influenzae type b
Escherichia coli
Mycococcus meningitides
Fluvoricoccus type c
Question 4Hand, foot, and mouth disease is a viral disease characterized by fever and vesicular lesions of the mouth, palms, and soles. It is caused by
Kawasaki’s
Coxsackie virus
Herpes virus
Candida albicans
Question 5A 10-year-old child manifests symptoms of fever, sore throat, and swollen lymph nodes. Spleen tip is palpable. Throat culture and rapid strep test results are negative. The next logical diagnostic test would involve
Repeat throat culture
Chest x-ray
Bone marrow aspiration
Epstein-Barr antibody test
Question 6Which of the following is TRUE regarding innocent murmurs?
The murmur is often holosystolic
Prompt referral to a cardiologist is indicated
A precordial thrill is present
Tends to disappear during later childhood
Question 7A 12-year-old boy seen at a routine visit has a BP of 150/96. He denies symptoms. The initial management would include
IV pyelogram
Return in 2 weeks for repeat BP measurements and keep a BP diary at home
No follow up needed – BP related to anxiety
Diuretic therapy
Question 8Which of the following is a common cause of acquired heart disease during childhood?
Lyme disease
Down syndrome
Systemic lupus
Kawasaki disease
Question 9A 5-year-old child who had a repair for transposition of the great arteries shortly after birth is growing normally and has been asymptomatic since the surgery. The primary care nurse practitioner (PNP)notes mild shortness of breath with exertion and, upon questioning, learns that the child has recently reported dizziness. What will the nurse practitioner do?
Order an echocardiogram and chest radiograph.
Perform pulmonary function testing.
Reassure the parent that these symptoms are common.
Refer the child to the cardiologist immediately.
Question 10A school-age child has fever of 104°F, sore throat, vomiting and malaise. The primary care pediatric nurse practitioner observes that the tonsils, oropharynx, and palate are erythematous and covered with exudate; the tongue is coated and red; and there is a red, sandpaper-like rash on the child’s neck, trunk, and extremities. A rapid strep test is positive. What will the nurse practitioner do to manage this child’s illness?
Administer intramuscular ceftriaxone.
Hospitalize for further diagnostic tests.
Prescribe oral amoxicillin.
Refer to a pediatric infectious disease specialist.
NRP543 Management Of Pediatric And Adolescent Populations
Week 7 Quiz
Question 1All of the following are elements of red blood cells (RBC) EXCEPT:
Young RBCs are referred to as erythrocytes and mature RBCs are reticulocytes.
RBCs live 120 days before being destroyed through phagocytosis.
Hemoglobin is the oxygen-carrying protein molecule in RBC.
They carry oxygen from the lungs to body tissues and transfer carbon dioxide from the tissue to the lungs.
Question 2The following are associated with which disease?
More commonly occurs in African descent; is a type chronic hemolytic anemia; can cause unpredictable acute complications that can become life threatening; is often identified in neonatal screening; and can be associated with a 'pain crisis'.
Idiopathic thyrobocytopenic purpura (ITP)
Thormbophilia
Iron deficiency anemia
Sickle cell disease
Question 3Starr comes for her 2-year-old physical; she still drinks from a bottle and mom complains that she is a very picky eater. Her hemoglobin result is 10.1. You repeat it and it is 10.0. Your diagnosis is
Well child exam
Sickle cell anemia
Iron deficiency anemia
Thalassemia
Question 4Starr weighs 24 pounds, which prescription for FeSo4 dosed at 5mg/kg would be right for her?
None, this prescription would be inappropriate at this time
FeSO4 drops 75 mg (15 mg elemental FE)/ml; 1.7ml po BID x 30 days
FeSO4 elixir 220 mg (44 mg elemental Fe)/5 ml; 1.2ml po BID x 30 days
FeSO4 drops 75 mg (15 mg elemental Fe)/ml; 0.6 ml po QD x 30 days
Question 5Septic arthritis is most commonly caused by:
Group B streptococcus
Pseudomonas
Staphylococcus aureus
Haemophilus influenzae
Question 6All of the following are true of the Mentzer index EXCEPT:
It differentiates between iron deficiency and thalassemia.
It is calculated by MCV divided by RBC.
A ratio of less than 13 indicates thalassemia
It is used to differentiate between beta thalassemia major and minor.
Question 7A mother presents with her 4 year old daughter, Emma, with concern of left arm or shoulder pain. She denies any history of injury or trauma, but noticed Emma seems to be protecting her left arm and won't extend it. This started after Emma was playing outside with her teenage brother who built an obstacle course and was pulling Emma by her arms over the larger obstacles. On exam, Emma is holding her left arm with her other hand, and resists any movement of her elbow, wrist, or fingers. She seems anxious. There is no erythema, warmth, edema, or signs of injury with tenderness over the radial head. The most likely diagnosis is:
Left clavicle fracture
Osteomyelitis
Salter Harris fracture
Nursemaid elbow
Question 8Six-year-old Jeana is brought to the clinic by her dad complaining of pain in her legs. Dad states Jeana can’t sleep at night crying due to pain in her thighs. This has been happening off and on for 3 months. Your exam is negative. Jeana is most likely to be suffering from
Osteosarcoma
Juvenile rheumatoid arthritis
Growing pains
Slipped femoral capital epiphysis
Question 9The primary care pediatric nurse practitioner sees a 12-month-old infant who is being fed goat’s milk and a vegetarian diet. The child is pale and has a beefy-red, sore tongue and oral mucous membranes. Which tests will the nurse practitioner order to evaluate this child’s condition?
Hemoglobin electrophoresis
RBC folate, iron, and B12 levels
Reticulocyte levels
Serum lead levels
Question 10A 15-year-old female reports fainting at school in class on two occasions. The adolescent’s orthostatic blood pressures are normal. The primary care pediatric nurse practitioner suspects a cardiac cause for these episodes and will order which tests before referring her to a pediatric cardiologist?
12-lead electrocardiogram
Echocardiogram
Tilt table testing
Treadmill exercise testing
NRP543 Management Of Pediatric And Adolescent Populations
Week 8 Quiz
Question 1All of the following are true of Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM) EXCEPT:
T1DM is characterized by insulin deficiency while T2DM is characterized by insulin resistance with relative insulin deficiency.
Patients with T1DM are not commonly overweight while patients with T2DM commonly have a BMI > 95th percentile.
T1DM commonly presents after onset of puberty while T2DM commonly presents at a younger age, often before age 10.
Aconthosis nigricans is more commonly seen in pateints with T2DM.
Question 2Sleep problems common in preschool years are all of the following EXCEPT:
Nightmares
Night terrors
Insomnia
Bedtime fears
Question 3All of the following are ways that a child is screened for type 1 diabetes during routine care EXCEPT:
Urinalysis
Growth chart evaluation
Finger stick blood glucose testing
Assessment of eating, drinking, and urinating pattern
Question 4The diagnostic criteria for autistic disorders include which of the following:
Speech delay, ataxia, mental retardation
Impairments in social interactions, interpersonal communication and staring spells
Mental retardation, impairment of social interactions and stereotypical restricted pattern of interests and activities
Impairment of social interactions, impairment of interpersonal communication and stereotypical restricted pattern of interests and activities
Question 5Which of the following is not a common sign or symptom of hypothyroidism in children?
Delayed growth
Frequent stools
Constipation
Lethargy
Question 6The primary care pediatric nurse practitioner performs a physical examination on a 9-month-old infant with congenital hypothyroidism who takes daily levothyroxine sodium and notes a recent slowing of the infant’s growth rate. What will the nurse practitioner order?
Free serum T4 and TSH levels
Serum levothyroxine level
Total T4 and free T4 levels
TSH and total T4 levels
Question 7A 6-year-old female has had a recent growth spurt and an exam reveals breast and pubic hair development. Her bone age is determined to be 8 years. What will the primary care pediatric nurse practitioner do next?
Order LH and FSH levels and a long-acting GnRH agonist.
Order thyroid function tests to exclude primary hypothyroidism.
Reassure the parent that this is most likely idiopathic.
Refer the child to a pediatric endocrinologist for management.
Question 8A 13-year-old Native American female has a body mass index (BMI) at the 90th percentile for age. The primary care pediatric nurse practitioner notes the presence of a hyperpigmented velvet-like rash in skin folds. The child denies polydipsia, polyphagia, and polyuria. The nurse practitioner will take what action?
Counsel the child to lose weight to prevent type 2 diabetes.
Diagnose type 2 diabetes if the child has a random glucose of 180 mg/dL.
Order a fasting blood sample for a metabolic screen for type 2 diabetes.
Refer the child to a pediatric endocrinologist.
Question 9A 16-year-old adolescent female whose body mass index (BMI) is at the 90th percentile reports irregular periods. The primary care pediatric nurse practitioner notes widespread acne on her face and back and an abnormal distribution of facial hair. The nurse practitioner will evaluate her further based on a suspicion of which diagnosis?
Dyslipidemia
Hypothyroidism
Nonalcoholic steatohepatitis
Polycystic ovary syndrome
Question 10A 14-year-old female comes to the clinic with amenorrhea for 3 months. A pregnancy test is negative. The adolescent’s body weight is at 82% of expected for height and age. The mother reports that her daughter often throws up and refuses to eat most foods. Which condition does the primary care pediatric nurse practitioner suspect?
Anorexia nervosa
Bulimia nervosa
Depression
Substance abuse
