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    Exam Review

    1. A 4-year-old child diagnosed with otitis media continues to experience persistent ear pain after being treated with an antibiotic for 24 hours. The nurse practitioner should:
      A)
      change the antibiotic.
      B)
      increase the dose and frequency of acetaminophen (Tylenol) administration.
      C)
      alternate ibuprofen (Advil) with acetaminophen (Tylenol) for pain.
      D)
      re-evaluate the child after completing 48-72 hours of antibiotic therapy.
    2. When considering medications for an 8-year-old diagnosed with hyperthyroidism, the initial recommended treatment in this patient is:
      A)
      radioactive iodine.
      B)
      propylthiouracil (PTU).
      C)
      methimazole (Tapazole).
      D)
      levothyroxine (Synthroid).
    3. A sexually active 18-year-old female presents to the nurse practitioner for abnormal uterine bleeding. A finding that does not usually suggest cervical cancer is:
      A)
      infection with HPV.
      B)
      hardening of the cervix.
      C)
      an irregular, cauliflower-like cervical growth.
      D)
      a cervical polyp.
    4. The first and most obvious sign of precocious puberty in a 7-year-old female is:
      A)
      pubarche.
      B)
      leukorrhea.
      C)
      rapid onset acne.
      D)
      breast enlargement.
    Page 1 of 37

    Exam Review

    1. An 18-month-old patient was recently diagnosed with atopic dermatitis on the trunk and extensor surface of the arms and legs. The nurse practitioner initiated treatment with emollients, dietary precautions, and environmental control. The caregiver reports today that the child has been scratching the affected areas more frequently during the day and has been restless at night. The lesions appear erythematous without excoriation. The nurse practitioner should:
      A)
      prescribe an oral corticosteroid daily for 7 days and a topical antihistamine cream three times daily.
      B)
      prescribe a low-potency topical steroid three times a day and an oral antihistamine at bedtime.
      C)
      prescribe a medium-potency topical steroid three times a day and a topical antihistamine at bedtime.
      D)
      prescribe a topical antibiotic and an oral antihistamine three times a day.
    2. A 5-year-old patient is diagnosed with an uncomplicated urinary tract infection for the first time. The nurse practitioner should order:
      A)
      cephalexin (Keflex) orally for 10 days
      B)
      ciprofloxacin (Cipro) orally for 7 days.
      C)
      ceftriaxone (Rocephin) IM every 24 hours for 5 days.
      D)
      nitrofurantoin (Furadantin) orally for 7 days.
    3. An 18-year-old pregnant adolescent in her third trimester has dyspepsia despite previous treatment with Maalox. A safe choice for the nurse practitioner to prescribe is:
      A)
      ranitidine HC (Zantac).
      B)
      sodium bicarbonate.
      C)
      sodium citrate and citric acid (Bicitra).
      D)
      aluminum, magnesium and simethicone (Gelusil).
    4. A 10-year-old child presents to the outpatient clinic with dehydration. The nurse practitioner administers a bolus of IV fluids. Before adding potassium to the fluids, the nurse practitioner should first assess:
      A)
      recent fluid intake.
      B)
      urinary output.
      C)
      capillary refill.
      D)
      last bowel movement.
    Page 2 of 37

    Exam Review

    1. A 2-year-old patient has been diagnosed with acute bronchiolitis. In the home instructions, the nurse practitioner specifies that the child:
      A)
      should stay home from daycare for 7 days.
      B)
      should be given antipyretics every 4 hours for the next 5 days.
      C)
      will be free of acute symptoms within 1 to 3 days, and complete resolution of symptoms should occur within 10-14 days.
      D)
      should be given an antibiotic if the nasal discharge becomes purulent.
    2. Lymphatic fluid that accumulates in the pleural cavity is:
      A)
      pericardial effusion.
      B)
      parapneumonic pleural effusion.
      C)
      pleural empyema.
      D)
      chylothorax.
    3. Auscultation of a 3 year-old child's heart reveals a pansystolic, harsh murmur. It is heard loudest over the lower left sternal border. This finding is consistent with a:
      A)
      pericardial friction rub.
      B)
      venous hum.
      C)
      patent ductus arteriosus.
      D)
      ventricular septal defect.
    4. A 16-year-old pregnant female exercises at the gym 3 times a week. Which choice should not deter her from exercising?
      A)
      Nausea prior to exercising
      B)
      Calf pain
      C)
      Pain in the back, hips or pubic area
      D)
      Chest pain
    Page 3 of 37

    Exam Review

    1. Seborrheic dermatitis in infants is referred to as:
      A)
      erythema multiforme.
      B)
      cradle cap.
      C)
      hives.
      D)
      impetigo.
    2. The symptom that suggests human papillomavirus (HPV) infection in males is:
      A)
      testicular swelling.
      B)
      penile warts.
      C)
      testicular pain.
      D)
      erectile dysfunction
    3. The nurse practitioner suspects congenital hypothyroidism because a 3-week-old infant presents with:
      A)
      a micropenis, jitterness, and a large posterior fontanel.
      B)
      vomiting, lethargy, and poor feeding.
      C)
      decreased activity, a large anterior fontanel, and poor feeding
      D)
      a rapid heart rate, irritability, and frequent stools.
    4. A 16-year-old patient has been diagnosed and treated for genital warts. The LEAST important action at this time is to:
      A)
      screen the patient for other sexually transmitted diseases (STDs).
      B)
      perform a Pap test.
      C)
      test the patient's sexual partners for sexually transmitted diseases.
      D)
      prescribe another course of imiquimod (Aldara) 5% topical cream.
    Page 4 of 37

    Exam Review

    1. Nonpharmacologic measures have been ineffective in a 7-year-old diagnosed with enuresis. When planning treatment, the nurse practitioner would consider which medication as third-line treatment?
      A)
      oxybutynin (Ditropan XL).
      B)
      desmopressin acetate (DDAVP).
      C)
      tolterodine (Detrol).
      D)
      imipramine (Tofranil).
    2. Initial pharmacologic treatment for pain in an adolescent recently diagnosed with epicondylitis is:
      A)
      an intra-articular corticosteroid injection.
      B)
      a cox-2 inhibitor.
      C)
      oral nonsteroidal anti-inflammatory drug (NSAID).
      D)
      oral acetaminophen with codeine.
    3. The nurse practitioner is unable to palpate the right testicle of a 4-month-old male. This finding could be suggestive of:
      A)
      a hydrocele.
      B)
      epispadias.
      C)
      phimosis.
      D)
      cryptorchidism.
    4. The enlargement of both nasal openings during inspiration is known as:
      A)
      nasal grunting
      B)
      nasal stridor.
      C)
      nasal flaring.
      D)
      nasal obstruction.
    Page 5 of 37

    Exam Review

    1. By the time a child is 3 years old, they are expected to:
      A)
      distinguish between real and make believe.
      B)
      cooperate with other children.
      C)
      take turns when playing games.
      D)
      prefer playing with others rather than alone.
    2. A 12-month-old child has a capillary lead level reading of 15 μg/dL. Based on this finding, the nurse practitioner should:
      A)
      consider this a normal capillary lead level and rescreen in a year.
      B)
      confirm the results with a venous blood sample.
      C)
      refer the child for chelation therapy.
      D)
      recommend an inspection of the patient's home for lead contamination.
    3. A 10-year-old patient is diagnosed with scabies. Appropriate treatment should include:
      A)
      retapamulin topically twice a day for 5 days.
      B)
      one dose of permethrin cream 5% topically.
      C)
      topical clotrimazole 3 times a day for 7 days.
      D)
      hydrocortisone cream 1% topically three times a day for 10 days.
    4. After performing a physical examination on a 4-year-old patient, the nurse practitioner suspects physical abuse. The nurse practitioner's primary legal responsibility is to:
      A)
      discuss the physical assessment findings with the caregivers.
      B)
      report the suspected abuse to child protective services.
      C)
      refer the family to the appropriate support group.
      D)
      assist the family in identifying resources and support systems.
    Page 6 of 37