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NURS 6541 Midterm Exam / NURS6541 Midterm Exam   (Latest): Primary Care of Adolescents and Children: Walden University


· Question 1



When completing this   quiz, did you comply with Walden University’s Code of Conduct including the   expectations for academic integrity?


· Question 2


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


· Question 3


The father of a   3-year-old is concerned because the child stutters. What should your approach   be?


· Question 4


A 2-day-old   newbornwith conjunctivitis is likely due to


· Question 5


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?


· Question 6


For adolescent   girls, peak height velocity should occur by Tanner Stage (SMR):


· Question 7


Which is the correct   order for introduction of solid foods to an infant?


· Question 8


I can walk well on tiptoes,   my speech is 50% understandable, I know six body parts, but I cannot balance   on one foot for 1 second. I am:


· Question 9


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:


· Question 10


A   15-month-old  boy says “mama” and “dada,” points and gestures if he   wants things, and follows simple one-step commands. Your best response is   which of the following?


· Question 11


At what age would a child   be expected to remember a string of numbers and repeat them backwards?


· Question 12


A 13-month-old child is noted   to be at the 25th percentile for weight, the 10th percentile for height, and   less than the 5th 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?


· Question 13


A child’s head   circumference is routinely measured on each well visit until what age?


· Question 14


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:


· Question 15


All of the   following are consistent with peritonsillar abscess except:




· Question 16


Which of the   following complication of strep pharyngitis cannot be prevented with   antibiotics?




· Question 17


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?




· Question 18


Josh, age 13, has   some enlargement of the scrotum and testes, a reddened scrotal sac, and some   hair texture alteration. His penis is not enlarged. He is in Tanner stage




· Question 19


A breastfed infant   is expected to have a lower incidence of which of the following?




· Question 20


A 12-year-old male   states he noticed an enlargement of his testes and scrotum. When counseling   him about the next step in pubertal development, you state:



The penis will grow in length and width.

· Question 21


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



Fluid restriction and voiding prior to the night may be effective.

· Question 22


Chelsea, age 8,   complains that she feels as if something is stuck in her ear. What action is   contraindicated?



Flushing the ear with water.

· Question 23


By what age should most   children be able to sit well without support?



9 months

· Question 24


A typically   developing 8-year-old girl will have which of the following genital   development?



No pubic hair at all

· Question 25


John is diagnosed   with allergic conjunctivitis. What type of discharge do you expect to see   upon exam?



Serous and clear

· Question 26


Which of the following   vaccines is routinely recommended at 4 months of age?



Diphtheria, tetanus, acellular pertussis (DTaP)

· Question 27


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?



Ocular mobility

· Question 28


Role-play with equipment during the course of the physical exam   would be the most beneficial with which age group?




· Question 29


Conductive hearing   loss can be caused by



Serous otitis

· Question 30


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 is worried the   child’s development will not be normal because she mixes up the two   languages. You respond:



“Your child’s speech is normal and bilingual children commonly     intermix the words from both languages until about 3 years of age.”

· Question 31


Mark is in the exam   room. You are concerned he may have epiglottitis. In what position do these   patients prefer to sit?



Sitting up and leaning forward

· Question 32


The mother of a   4-year-old tells you he likes to “play with himself” while playing   and watching television. You advise the mother to



Explain to the child that masturbation is something that should be     done in private.

· Question 33


Parents bring their   6-month-old son to see you. He is symmetrically less than the 5th   percentile for height, weight and head circumference. He was born at 30   weeks’ gestation and weighed 1000g. He was a planned pregnancy, and his   mother’s prenatal course was uneventful until an automobile accident   initiated the labor. He was ventilated for 3 days in the intensive care unit   but otherwise did well without ongoing problems. He was discharged at 8 weeks   of life. Which of the following is the most likely explanation for his small   size?



Normal ex-preemie infant growth

· Question 34


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



“You can see at 20 feet with your right eye what most people can     see at 50 feet.”

· Question 35


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?



Limited eye contact with parents.

· Question 36


You are performing   an examination of a 3-year-old who is new to your office. Which finding   requires immediate further evaluation?



Heart rate     increases during inspiration and decreases during expiration

· Question 37


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



The safest place for children under 12 years old and 100 pounds is in     the backseat of the car.

· Question 38


Which of the   following would not suggest an eating disorder with a   purging component?



Finger calluses

· Question 39


A fifteen-year-old   female makes a statement to you during a well visit. Which of the following   statements should not be kept confidential?



“Sometimes I feel like ending my life.”

· Question 40


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?



Maxillary sinus

· Question 41


A 6-month-old infant has been   growing poorly. His parents have changed his formula three times without   success. His examination is remarkable for a pale, emaciated child with   little subcutaneous fat and anterior fontanelle fullness. His laboratory test   results are notable for a hemolytic anemia and prolonged bleeding times.   Which of the following is the most appropriate next step?


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