MN580 MIDTERM EXAM
1. Cyclic vomiting may:
1. Last for days.
2. Require SSRIs to stop hurting.
3. Not be associated with a headache.
4. Requires pain medication and Zofran.
ANS: 3
2. A 5-day old infant comes in for a newborn checkup. On assessment of the newborn, you note
that the skin is jaundice in color. The anterior fontanel is slightly sunken. Per mom, the infant has
only had 2 diapers today. The infant is strictly breastfed, and this is moms first child. She states
baby is having trouble latching on. A bilirubin level is sent and comes back at 18. You identify
this newborn to be dehydrated and is most likely to have breast milk jaundice. Which nursing
intervention(s) will be required for this baby?
1. Phototherapy
2. Providing support and education for the lactating mother
3. Strict monitoring of intake and output
4. All of the above
ANS 4
3. You are taking care of an infant who was admitted with dehydration. His weight is 6kg. You
have been watching his I & Os. What would you expect the infants urinary output to be in order
to maintain adequate hydration?
1. 0.52 ml/kg/hr
2. 0.52.5 ml/kg/hr
3. 13 ml/kg/hr
4. As long as he is having wet diapers it does not matter
ANS: 3
4. The primary care pediatric nurse practitioner diagnoses a 5yearold child with asthma and
prescribes an oral steroid and a short acting beta-adrenergic medication via a metered dose
inhaler to manage acute symptoms. Along with education about the prescribed medications, what
information is important to give the child’s family at this visit?
A. An asthma action plan
B. Effects and side effects of current medications Correct
C. Information about spirometry testing

D. Instructions for medications at school
5. The primary care pediatric nurse practitioner orders a pulmonology consult for a child who has
severe asthma. The nurse practitioner writes “child with asthma refractory to conventional
treatments needs suggestions for alternative treatments.” The nurse practitioner expects the
pulmonologist to
A. confirm the medical diagnosis for the child’s parents.
B. make recommendations for disease management. Correct
C. stress the importance of adherence to the medication regimen.
D. take over management of this child’s chronic illness.
6. The parent of an 18monthold child calls the clinic to report that the child has a rectal
temperature of 100.4°F (38°C). The child is playing normally, taking fluids well, and has a
slightly reduced appetite. What will the primary care pediatric nurse practitioner recommend?
A. Administering an antipyretic medication
B. Bringing the child to the clinic for evaluation
C. Offering extra fluids and calling if symptoms change Correct
D. Ordering outpatient lab work such as a CBC
7. The primary care pediatric nurse practitioner is evaluating a 10yearold child who is describing
shooting pain in both legs associated with aching, tingling, and burning. The child is unable to
pinpoint specific locations for this pain. Which type of pain does the nurse practitioner suspect?
A. Chronic pain
B. Neuropathic pain Correct
C. Somatic pain
D Visceral pain
8. A 3yearold child is recovering from injuries sustained in a motor vehicle accident. How will
the primary care pediatric nurse practitioner evaluate this child’s pain?
A. Ask the child to rate pain intensity on a 4 to 5 item pain discrimination scale.

B. Have the child describe any pain as “no pain, a little pain, or a lot of pain.” Correct
C. Question the child about the intensity and specific location of any pain.
D. Rely on nonverbal responses such as facial expressions and limb movements.
9. A 4yearold child has just been released from the hospital after orthopedic surgery on one leg
following a bicycle accident. The child is sitting quietly on the exam table. When asked to rate
pain, the child points to the “1” on a faces rating pain scale. What will the primary care pediatric
nurse practitioner do next?
A. Assess the child’s vital signs and ability to walk without pain. Correct
B. Refill the prescription for a narcotic analgesic medication.
C. Suggest that the parents give acetaminophen for mild pain.
D. Teach the parent to give analgesics based on the child’s report of pain.
10. A developmentally and cognitively disabled 10yearold child who is unable to communicate
must undergo a series of surgeries, and the child’s parent asks how to know if the child is in pain
and when to give pain medication. What will the primary care pediatric nurse practitioner teach
this parent to use to assess this child’s pain?
A. Comfort scale
B. FLACC scale
C. NCCPCR Correct
D. Nonverbal observations
11. The primary care pediatric nurse practitioner is preparing to perform a painful procedure on a
4monthold infant. Besides providing local anesthesia, what other pain control method provides
analgesic effects?
A. Providing toys
B. Singing or music
C. Sucrose solution Correct
D. Swaddling or cuddling

12. An adolescent female reports moderate dysmenorrhea with periods and tells the primary care
pediatric nurse practitioner that 400 mg ibuprofen every 6 to 8 completely control her pain. What
will the nurse practitioner recommend?
A. Increasing the ibuprofen dose to 600 to 800 mg every 6 to 8 hours
B. Taking extra strength acetaminophen 1000 mg every 4 to 6 hours
C. Taking naproxen 500 mg initially and then 250 mg every 6 to 8 hours correct
D. Using extended release naproxen 500 mg every 12 hours
13. What is the most important dose limiting factor when prescribing acetaminophen with
hydrocodone?
A. Acetaminophen dose Correct
B. Gastrointestinal side effects
C. Pruritis symptoms
D. Urinary retention
14. An adolescent takes ibuprofen, acetaminophen, and a tricyclic antidepressant (TCA) to treat
phantom limb pain and reports that the medications are no longer effective. What will the
primary care pediatric nurse practitioner do?
A. Change the TCA to a selective serotonin reuptake inhibitor.
B. Evaluate the adolescent for drug seeking behavior.
C. Increase the TCA dose and reevaluate in 2 to 3 weeks.
D. Refer the adolescent to a pain management specialist. Correct
15. The parent of a school age child with a chronic pain condition tells the primary care pediatric
nurse practitioner that the child has requested to stay home from school more often in the past
few months. The child’s exam does not reveal any significant change in pathology, and a review
of the child’s medications indicates appropriate dosing of analgesic medications. What will the
nurse practitioner recommend?
A. Assessing the child’s pain every day to determine changes
B. Ensuring the child stays quiet in bed with videos when having pain
C. Having the child do homework when staying home from school Correct

D. Requiring the child to go to school even during pain episodes
16. The parent of a 2weekold infant reports that the infant was diagnosed with transient
tachypnea of the newborn shortly after birth. The primary care pediatric nurse practitioner
understands that, in this condition,
A. antibiotic therapy is generally necessary to prevent severe infection.
B. home oxygen therapy is needed until the infant grows out of the condition.
C. recovery is usually complete with minimal intervention and treatments. Correct
D. treatment with exogenous surfactant and mechanical ventilation is needed.
17. A 2monthold infant has a staccato cough and fever. Which aspect of the history is most
important in determining the diagnosis?
A. Day care attendance
B. Immunization history Correct
C. Medication history
D. Past medical history
18. According to recent research, which populations may have higher rates of under
immunization than others?
A. Those with higher rates of Asians
B. Those with higher rates of graduate degrees Correct
C. Those with lower rates of poverty
D. Those with lower rates of primary providers
19. The parent of a 2monthold infant is reluctant to have the baby vaccinated. What is
an initial step in responding to these concerns.
A. Inform the parent that all vaccines may be given without thimerosol.
B. Providing Vaccine Information Statements for the parent to review.
C. Question the parent’s reasons for concern about immunizations. Correct
D. Remind the parent that the infant is exposed to thousands of germs each
day.

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MN580 Child Care Midterm Exam With Answers (61 Solved Questions)

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