MN580 midterm exam 2021

Question 1          2 / 2 points

An 18-year-old man presents with periumbilical pain, vomiting, and abdominal cramping over the past 48 hours. Physical examination reveals rebound tenderness and laboratory analysis shows the presence of bandemia and a total WBC of 28,000 mm3. To support the diagnosis of acute appendicitis with suspected appendiceal rupture, you consider obtaining the following abdominal imaging study:

Question options:

 

1) Magnetic resonance image (MRI).

 

 

3)            Ultrasound.

 

 

4)            Flat plate.

 

 

Question 2

 

 

2 / 2 points

 

 

Gina is 2 years old and presents with a 3-day history of fever, crankiness, and congested cough. Her respiratory rate is more than 50% of the upper limits of normal for age. Tubular breath sounds are noted at the right lung base. Skin turgor is normal, and she is wearing a wet diaper. She is alert, resisting the examination as age appropriate, and engages in eye contact. Temperature is 38.3° C (101° F). Gina's diagnostic evaluation should include:

Question options:

 

 

2)            urine culture and sensitivity measurement.

 

 

3)            lumbar puncture.

 

 

4)            sputum culture.

 

 

Question 3

 

2 / 2 points

 

 

Aortic stenosis in a 15-year-old male is most likely: Question options:

 

1)            a sequela of rheumatic fever.

 

 

3)            calcific in nature.

 

 

4)            found with atrial septal defect.

 

 

Question 4

 

 

2 / 2 points

 

 

Which of the following laboratory tests can identify the causative organism of bronchiolitis? Question options:

 

2)            Antibody test via blood sample.

 

 

3)            Urine culture.

 

 

4)            A laboratory test is not available.

 

 

Question 5

 

2 / 2 points

 

 

A Still murmur:

Question options:

 

1)            is heard in the presence of cardiac pathology.

 

 

3)            is a reason for denying sports participation clearance.

 

 

4)            can become louder when the patient is standing.

 

Question 6

 

2 / 2 points

 

 

A physiological murmur has which of the following characteristics? Question options:

1)            Occurs late in systole.

 

 

2)            Is noted in a localized area of auscultation.

 

 

4) Frequently obliterates S2.

 

 

Question 7

 

2 / 2 points

 

You anticipate that adult car seat belts fit correctly when a child is approximately               tall and is              old.

Question options:

 

1)            51 inches (129.5 cm), 6 to 8 years

 

 

2)            53 inches (134.6 cm), 5 to 7 years

 

 

4) 59 inches (150 cm), 12 to 14 years

 

 

Question 8

 

 

2 / 2 points

 

 

Physical examination findings in otitis externa include: Question options:

1)            tympanic membrane immobility.

 

 

3)            tympanic membrane erythema.

 

 

4)            tympanic membrane bullae.

 

 

Question 9

 

2 / 2 points

 

 

In infants, solid foods are best introduced no earlier than: Question options:

1)            1–3 months.

 

 

2)            3–5 months.

 

 

4) 6–8 months.

 

 

Question 10

 

2 / 2 points

 

 

When advising a patient about injectable influenza immunization, the nurse practitioner (NP) considers the following about the use of this vaccine:

Question options:

 

1)            Its use is not recommended in sickle cell anemia.

 

 

2)            Its use is limited to children older than 2 years.

 

 

3)            Its use is limited due to containing live virus.

 

 

 

Question

11

 

2 / 2 points

 

 

A healthy 2-year-old child is able to: Question options:

 

 

 

2)            throw a ball at a target.

 

 

3)            scribble spontaneously.

 

 

4)            ride a tricycle.

 

 

Question 12

 

2 / 2 points

 

 

The preferred treatment option for a 6-year-old boy with pertussis is: Question options:

1)            amoxicillin.

 

 

2)            ceftriaxone.

 

 

4) levofloxacin.

 

 

Question 13

 

2 / 2 points

 

 

At which of the following ages in a young child's life is parental anticipatory guidance about using “time out” as a discipline method most helpful?

Question options:

 

1)            12–18 months.

 

 

3)            24–30 months.

 

 

4)            30–36 months.

 

Question             2 / 2 points

 

14

Common causative organisms of acute suppurative conjunctivitis include all of the following except: Question options:

1)            staphylococcus aureus.

 

 

2)            haemophilus influenzae.

 

 

3)            streptococcus pneumoniae.

 

 

 

Question

15

 

2 / 2 points

 

 

At which of the following ages in a young child's life is parental anticipatory guidance about protection from falls most helpful?

Question options:

 

 

2)            2 months.

 

 

3)            4 months.

 

 

4)            6 months.

 

 

Question 16

 

2 / 2 points

 

 

Which of the following statements is true about inactivated poliovirus vaccine (IPV)? Question options:

1)            It contains live virus.

 

 

3)            Two doses should be administered by a child's fourth birthday.

 

 

4)            After administration of IPV, live poliovirus is usually shed from the stool.

 

 

Question 17

 

2 / 2 points

 

 

Problems after tetanus immunization typically include: Question options:

 

2)            myalgia and malaise.

 

 

3)            low-grade fever.

 

 

4)            diffuse rash.

 

 

Question 18

 

 

0 / 2 points

 

 

Which of the following is true about the MMR vaccine? Question options:

1)            This vaccine contains live virus.

 

 

2)            Its use is contraindicated in persons with a history of egg allergy.

 

 

3)            Revaccination of an immune person is associated with risk of allergic reaction.

 

 

 

Question

19

 

2 / 2 points

 

 

Treatment of viral conjunctivitis can include: Question options:

 

1)            moxifloxacin ophthalmic drops.

 

 

2)            polymyxin B ophthalmic drops.

 

 

3)            oral acyclovir.

 

 

 

Question

20

 

2 / 2 points

 

 

A healthy 6–7-month-old infant is able to: Question options:

 

2)            confidently feed self a cracker.

 

 

3)            reach for an object.

 

 

4)            crawl on abdomen.

 

 

Question 21

 

 

2 / 2 points

 

 

At which of the following ages in a young child's life is parental anticipatory guidance about temper tantrums most helpful?

Question options:

 

1)            8–10 months.

 

 

3)            12–14 months.

 

 

4)            14–16 months.

 

Question             2 / 2 points

 

22

Which of the following findings is most consistent with the diagnosis of acute bacterial rhinosinusitis (ABRS)?

Question options:

 

 

2)            Mild midfacial fullness and tenderness.

 

 

3)            Preauricular lymphadenopathy.

 

 

4)            Marked eyelid edema.

 

 

Question 23

 

2 / 2 points

 

 

Which of the following is the most prudent first-line treatment choice for an otherwise well toddler with acute otitis media (AOM) who requires antimicrobial therapy?

Question options:

 

1)            Ceftibuten.

 

 

3)            Cefuroxime.

 

 

4)            Azithromycin.

 

 

Question 24

 

 

2 / 2 points

 

 

Which of the following is one of the more common sources of hepatitis A infection in the United States? Question options:

1)            Receiving blood products.

 

 

2)            Ingestion of raw shellfish.

 

3)            Drinking municipally sourced tap water drinking water.

 

 

 

Question

25

 

2 / 2 points

 

 

Juice intake is acceptable in children 6 months and older per which of the following recommendations? Select all that apply.

Question options:

 

 

3)            Juice replaces no more than one serving of milk.

 

 

4)            The juice is consumed in the morning with breakfast.

 

 

 

Question

26

 

2 / 2 points

 

 

You are examining an 18-year-old man who is seeking a sports clearance physical examination. You note a mid-systolic murmur that gets louder when he stands. This may represent:

Question options:

 

1)            aortic stenosis.

 

 

3)            a physiologic murmur.

 

 

4)            a Still's murmur.

 

 

Question 27

 

 

2 / 2 points

 

A healthy infant at age 9–11 months is expected to: Question options:

1)            roll from back to stomach.

 

 

2)            imitate “bye-bye.”

 

 

4) hand toy on request.

 

 

Question 28

 

2 / 2 points

 

 

You examine a 10-year-old boy with suspected streptococcal pharyngitis. His mother asks if he can get a “shot of penicillin.” Which of the following statements is/are true regarding the use of intramuscular (IM) penicillin? Select all that apply.

Question options:

 

 

 

 

 

 

 

 

 

Question 29

 

3)            The risk of severe allergic reaction with IM products is similar to that of oral preparations.

 

4)            Injectable penicillin has a superior spectrum of antimicrobial coverage compared with the oral form of the drug.

 

2 / 2 points

 

 

At which of the following ages in an infant's life is parental anticipatory guidance about teething most helpful?

Question options:

 

1)            1–2 months.

 

 

2)            2–4 months.

 

 

 

4) 8–10 months.

 

 

Question 30

 

2 / 2 points

 

 

First-line treatment for uncomplicated hordeolum is: Question options:

1)            topical corticosteroid.

 

 

3)            incision and drainage.

 

 

4)            oral antimicrobial therapy.

 

 

Question 31

 

 

2 / 2 points

 

 

Which of the following imaging studies potentially exposes the patient being evaluated for abdominal pain to the lowest ionizing radiation burden?

Question options:

 

 

2)            Barium enema.

 

 

3)            CT scan.

 

 

4)            Abdominal flat plate.

 

 

Question 32

 

 

2 / 2 points

 

 

You are examining an 18-month-old boy who is not speaking any discernible words. Mom tells you he has not said “mama or dada” yet or babbled or smiled responsively. You:

Question options:

 

1)            encourage the mother to enroll her son in daycare to increase his socialization.

 

 

3)            reassure the parent that delayed speech is common in boys.

 

 

4)            order audiogram and tympanometry.

 

 

Question 33

 

 

2 / 2 points

 

 

The gastric parietal cells produce: Question options:

 

2)            a protective mucosal layer.

 

 

3)            prostaglandins.

 

 

4)            prokinetic hormones.

 

 

Question 34

 

2 / 2 points

 

 

The most common causative organism of bronchiolitis is: Question options:

1)            haemophilus influenzae.

 

 

2)            parainfluenza virus.

 

 

4) coxsackievirus.

 

Question 35

 

2 / 2 points

 

 

Which of the following would not be found in newborns? Question options:

1)            Best vision at a range of 8–12 inches.

 

 

2)            Presence of red reflex.

 

 

3)            Light-sensitive eyes.