NU580 Unit 9 Quiz

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Purdue University Globle 

NU580 FNP II – Primary Care of Children and Adolescents’ Health

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Date

NU580 Unit 9 Quiz

Prescribing Medications in Pediatrics

Q1. A pharmaceutical company has developed a new medication that was tested only in adults. The FDA has determined that the drug may provide benefits for children with certain illnesses. Under the Pediatric Research Equity Act (PREA), what may the pharmaceutical company be required to do?

A. Conduct pediatric drug studies to determine whether the drug is safe and effective in children. ✅

B. Market the medication for pediatric use without additional studies.

C. Delay marketing the medication until additional adult studies are completed.

D. Require pediatric providers to determine appropriate pediatric dosing.

Answer: A. Conduct pediatric drug studies to determine whether the drug is safe and effective in children.

Q2. A primary care pediatric nurse practitioner prescribes a new medication for a child who develops a previously unknown adverse reaction. Where should the adverse reaction be reported?

A. Institute for Safe Medication Practices (ISMP)

B. Drug Enforcement Administration (DEA)

C. FDA MedWatch website. ✅

D. Centers for Disease Control and Prevention (CDC)

Answer: C. FDA MedWatch website.

Q3. A pediatric nurse practitioner is considering prescribing a relatively new medication for a 15-month-old child. The medication is metabolized by the liver. The practitioner should consult a pharmacologist about giving the drug:

A. Less often or at a lower dose. ✅

B. More often to maintain therapeutic levels.

C. At the same dose as an older child.

D. Only by intravenous route.

Answer: A. Less often or at a lower dose.

NU580 Unit 9 Quiz

Q4. A pediatric nurse practitioner wants to prescribe a medication for an off-label use in a child. The medication has been reviewed through pharmacology resources and FDA information, and no major contraindications exist. What else should the practitioner do?

A. Discuss recommendations with the parents and document their consent. ✅

B. Avoid prescribing the medication.

C. Obtain approval from the FDA.

D. Consult the pharmacy board before prescribing.

Answer: A. Discuss recommendations with the parents and document their consent.

Q5. An adolescent with asthma frequently forgets to use twice-daily inhaled corticosteroids scheduled at 8 AM and 8 PM. Which strategy may improve medication adherence?

A. Ask the adolescent to identify two times each day that may work better. ✅

B. Tell the adolescent to continue the same schedule.

C. Switch immediately to oral corticosteroids.

D. Ask the parents to administer every dose.

Answer: A. Ask the adolescent to identify two times each day that may work better.

Q6. A toddler has a lower respiratory tract illness with a low-grade fever. The child is eating well, drinking fluids, and has normal oxygen saturation. The nurse practitioner suspects viral pneumonia. What should be done?

A. Begin high-dose antibiotics immediately.

B. Admit the child for IV antibiotics.

C. Teach the parents symptomatic care and order labs to help with the diagnosis. ✅

D. Prescribe oral corticosteroids.

Answer: C. Teach the parents symptomatic care and order labs to help with the diagnosis.

Q7. A single mother of a 4-year-old child reports difficulty giving twice-daily amoxicillin for 10 days during a previous ear infection because of her busy work schedule. The child currently has another ear infection. What should the nurse practitioner do?

A. Prescribe the same amoxicillin regimen.

B. Delay treatment until adherence improves.

C. Prescribe azithromycin once daily for 5 days. ✅

D. Refer the child to an infectious disease specialist.

Answer: C. Prescribe azithromycin once daily for 5 days.

Q8. A school-age child with asthma develops severe wheezing after gym class and needs his inhaler immediately after returning home. What should the nurse practitioner do?

A. Prescribe nebulizer treatments only.

B. Increase the daily inhaled corticosteroid dose.

C. Recommend keeping one inhaler at home only.

D. Write the prescription for two metered-dose inhalers with spacers. ✅

Answer: D. Write the prescription for two metered-dose inhalers with spacers.

Chapter 41: Genitourinary Disorders

Q1. A 30-month-old girl who has been toilet trained for 6 months presents with daytime enuresis, dysuria, and low-grade fever. Urinalysis is negative for leukocyte esterase and nitrites. What is the next step?

A. Begin empiric TMP-SMX.

B. Reassure the parents.

C. Repeat the dipstick in one week.

D. Send the urine to the lab for culture. ✅

Answer: D. Send the urine to the lab for culture.

Q2. A child with dysuria, frequency, and fever has a clean-catch urine culture showing 50,000–100,000 colonies of E. coli. What is the appropriate treatment?

A. Repeat the urine culture.

B. Observe without treatment.

C. Increase fluid intake only.

D. Treat with antibiotics for urinary tract infection. ✅

Answer: D. Treat with antibiotics for urinary tract infection.

Q3. A school-age child has dysuria and foul-smelling urine. Urinalysis is positive for leukocyte esterase and nitrites. A urine culture is pending. What treatment should be started?

A. Amoxicillin.

B. Trimethoprim-sulfamethoxazole (TMP-SMX) twice daily for 3–5 days. ✅

C. Nitrofurantoin for 14 days.

D. Wait for culture results.

Answer: B. Trimethoprim-sulfamethoxazole (TMP-SMX) twice daily for 3–5 days.

Q4. A preschool child has mild flank pain, fever, and urinalysis positive for leukocyte esterase and nitrites. A urine culture is pending. What is the correct treatment?

A. Ciprofloxacin.

B. Amoxicillin-clavulanate. ✅

C. Nitrofurantoin.

D. No antibiotics until culture returns.

Answer: B. Amoxicillin-clavulanate.

Q5. A 3-year-old child has completed a 7-day course of amoxicillin for a second febrile UTI and now has a negative urine culture. What is the next step?

A. Obtain a renal and bladder ultrasound. ✅

B. Begin prophylactic antibiotics.

C. Repeat urine culture monthly.

D. No further evaluation.

Answer: A. Obtain a renal and bladder ultrasound.

Q6. A 9-month-old infant has had three UTIs and is diagnosed with grade II vesicoureteral reflux. Which medication is prescribed?

A. Amoxicillin.

B. Cephalexin.

C. Nitrofurantoin.

D. TMP-SMX (TMP 2 mg/kg once daily). ✅

Answer: D. TMP-SMX (TMP 2 mg/kg once daily).

Q7. A parent asks how grade V vesicoureteral reflux will be treated. What should the nurse practitioner explain?

A. Observation only.

B. Surgery to correct the condition is possible. ✅

C. Long-term steroids.

D. Bed rest until resolved.

Answer: B. Surgery to correct the condition is possible.

Q8. A healthy 14-year-old female has 5–6 RBCs per high-power field on urinalysis but no other abnormalities. What should the nurse practitioner ask first?

A. Family history of kidney disease.

B. Fluid intake.

C. Exercise history.

D. “When was your last menstrual period (LMP)?” ✅

Answer: D. “When was your last menstrual period (LMP)?”

Q9. A child presents with gross hematuria, abdominal pain, arthralgia, and rash. What is the most likely diagnosis?

A. Henoch-Schönlein purpura (IgA vasculitis). ✅

B. Minimal change disease.

C. Nephrolithiasis.

D. Urinary tract infection.

Answer: A. Henoch-Schönlein purpura (IgA vasculitis).

Q10. An adolescent has 2+ proteinuria on random urinalysis, but the first morning urine sample is negative. How should this be managed?

A. Monitor for proteinuria at each annual well-child examination. ✅

B. Refer to nephrology immediately.

C. Begin ACE inhibitor therapy.

D. Order a renal biopsy.

Answer: A. Monitor for proteinuria at each annual well-child examination.

Q11. A child is diagnosed with nephrotic syndrome and responds well after steroid treatment. What should the pediatric nurse practitioner tell the parents about the disease?

A. Steroids are used only once.

B. Steroids will be used when relapses occur. ✅

C. Lifelong antibiotics are required.

D. Surgery is usually necessary.

Answer: B. Steroids will be used when relapses occur.

Q12. A child with nephrotic syndrome is receiving steroids and following a salt-restricted diet during a relapse. Urine protein has decreased from 3+ to 1+. What is the correct management?

A. Stop steroids immediately.

B. Continue steroids and salt restriction until urine is negative for protein. ✅

C. Begin IV albumin.

D. Remove salt restrictions.

Answer: B. Continue steroids and salt restriction until urine is negative for protein.

Q13. A child had a group A beta-hemolytic streptococcal infection 2 weeks ago and now presents with periorbital edema, dyspnea, hypertension, tea-colored urine, hematuria, and mild proteinuria. What should the nurse practitioner do?

A. Begin oral antibiotics.

B. Repeat urinalysis in one week.

C. Start corticosteroids.

D. Refer the child to a pediatric nephrologist for hospitalization. ✅

Answer: D. Refer the child to a pediatric nephrologist for hospitalization.

Q14. An adolescent has right-sided flank pain without fever. Urinalysis shows gross hematuria without infection. The nurse practitioner suspects nephrolithiasis. What is the initial treatment?

A. Immediate surgery.

B. Increase fluid intake up to 2 L daily. ✅

C. Begin antibiotics.

D. Restrict fluids.

Answer: B. Increase fluid intake up to 2 L daily.

Q15. During a well-child examination of a 2-year-old child, the nurse practitioner palpates a unilateral, smooth, firm abdominal mass that does not cross the midline. What is the next step?

A. Repeat examination in one month.

B. Order antibiotics.

C. Schedule routine ultrasound.

D. Refer the child to an oncologist immediately. ✅

Answer: D. Refer the child to an oncologist immediately.

Q16. A 6-month-old infant has a retractile testis noted at a previous examination. What management is appropriate?

A. Observe until adolescence.

B. Refer to a pediatric urologist or surgeon for possible orchiopexy. ✅

C. Begin antibiotics.

D. Manual reduction.

Answer: B. Refer to a pediatric urologist or surgeon for possible orchiopexy.

Q17. A 9-month-old infant presents with scrotal swelling and fussiness. The nurse practitioner finds a tender scrotal mass that is difficult to reduce. What should be done?

A. Apply ice packs.

B. Refer immediately to a pediatric surgeon. ✅

C. Prescribe pain medication only.

D. Observe for 24 hours.

Answer: B. Refer immediately to a pediatric surgeon.

Q18. The mother of a 12-month-old uncircumcised male reports painful urination. Examination reveals a tight pinpoint foreskin opening with thickening and inflammation. What is the correct action?

A. Reassure the parents.

B. Prescribe antibiotics only.

C. Refer the child to a pediatric urologist. ✅

D. Forcefully retract the foreskin.

Answer: C. Refer the child to a pediatric urologist.

Q19. An adolescent male presents with sudden unilateral scrotal pain, nausea, and vomiting. Examination reveals a swollen painful testis and a negative Phren sign. What should the nurse practitioner do?

A. Prescribe NSAIDs.

B. Order routine ultrasound.

C. Observe for improvement.

D. Refer immediately to a pediatric urologist or surgeon. ✅

Answer: D. Refer immediately to a pediatric urologist or surgeon.

Chapter 42: Gynecologic Disorders

Q1. A pediatric nurse practitioner needs to assess a possible hymenal tear in a prepubertal female who is anxious about examination. Which approach should be used?

A. Lithotomy position.

B. Knee-chest position. ✅

C. Standing examination.

D. Prone position.

Answer: B. Knee-chest position.

Q2. A pediatric nurse practitioner is prescribing contraception for an adolescent who has never used birth control. The adolescent has a normal examination and no cardiovascular risk factors. Which preparation should be used initially?

A. Combination oral contraceptive pill with 30–35 mcg estrogen and low progestin. ✅

B. Progestin-only pill.

C. Depot medroxyprogesterone.

D. Copper IUD.

Answer: A. Combination oral contraceptive pill with 30–35 mcg estrogen and low progestin.

Q3. An adolescent female reports unprotected intercourse 4 days ago and is worried about pregnancy. What should the nurse practitioner prescribe?

A. Ulipristal acetate (Ella). ✅

B. Levonorgestrel after 7 days.

C. Combined oral contraceptives.

D. No treatment.

Answer: A. Ulipristal acetate (Ella).

Q4. A 4-year-old girl has recurrent UTIs, persistent dysuria, and genital redness. Examination reveals a thin membrane extending from the posterior fourchette toward the clitoris. What treatment is indicated?

A. Oral antibiotics.

B. Sitz baths only.

C. Topical steroids.

D. Estrogen-containing cream. ✅

Answer: D. Estrogen-containing cream.

Q5. A school-age female has vulvovaginitis for 2 months. Cultures are negative, and symptoms persist despite antibiotics. What is the next treatment?

A. Estrogen cream at bedtime for 2–3 weeks. ✅

B. Oral fluconazole.

C. Repeat antibiotics.

D. Surgical intervention.

Answer: A. Estrogen cream at bedtime for 2–3 weeks.

Q6. A 16-year-old female reports dull, achy cramping pain in the lower abdomen lasting 2–3 hours between menstrual periods every month. She is not sexually active. What is the treatment?

A. Oral contraceptives.

B. Surgery.

C. Prostaglandin inhibitor analgesics and a heating pad. ✅

D. Antibiotics.

Answer: C. Prostaglandin inhibitor analgesics and a heating pad.

Q7. A 17-year-old sexually active female reports new-onset moderate to severe lower abdominal pain associated with menstruation and occurring at other times. Pregnancy test is negative. What is the priority action?

A. Perform a full diagnostic workup. ✅

B. Prescribe NSAIDs only.

C. Reassure the patient.

D. Start oral contraceptives immediately.

Answer: A. Perform a full diagnostic workup.

Q8. A 15-year-old female has a positive pregnancy test and asks the nurse practitioner not to tell her parents. She is unsure about keeping the pregnancy. What should the nurse practitioner do first?

A. Determine the state-mandated reporting laws. ✅

B. Notify the parents immediately.

C. Refer for adoption counseling.

D. Schedule prenatal care.

Answer: A. Determine the state-mandated reporting laws.

Q9. A 16-year-old female reports breast tenderness and a lump. Examination reveals a small fluid-filled mass. Pregnancy test is negative. What action is appropriate?

A. Mammography.

B. Order an ultrasound of the mass. ✅

C. Surgical excision.

D. Reassure and discharge.

Answer: B. Order an ultrasound of the mass.

Q10. A 16-year-old female has not started menstruating but has normal sexual maturity development. She denies sexual activity. Which laboratory test should be ordered first?

A. Thyroid function tests.

B. FSH.

C. Pregnancy test. ✅

D. Prolactin level.

Answer: C. Pregnancy test.

Q11. An adolescent female has menstrual periods every 30 days that are consistently heavy and last 5–8 days. What is the diagnosis?

A. Metrorrhagia.

B. Menorrhagia. ✅

C. Dysmenorrhea.

D. Amenorrhea.

Answer: B. Menorrhagia.

Q12. An adolescent female has heavy and irregular menstrual periods. Physical examination is normal. A complete blood count shows hemoglobin of 8.9 g/dL. What test should the nurse practitioner order next?

A. Coagulation studies. ✅

B. Pelvic ultrasound.

C. Pregnancy test.

D. Pap smear.

Answer: A. Coagulation studies.

Q13. A 14-year-old female has menometrorrhagia with moderately increased menstrual flow and irregular periods. Her hemoglobin level is 13.1 g/dL. How should this condition be managed?

A. Iron supplementation and prostaglandin inhibitors. ✅

B. Blood transfusion.

C. Hysterectomy.

D. Antibiotics.

Answer: A. Iron supplementation and prostaglandin inhibitors.

Q14. A sexually active adolescent female tests positive for Neisseria gonorrhoeae and Chlamydia trachomatis. She wants treatment immediately because she is moving away the next day. What should the nurse practitioner prescribe?

A. Doxycycline only.

B. Ceftriaxone 250 mg IM and azithromycin 1 g PO one time each. ✅

C. Ceftriaxone only.

D. Metronidazole only.

Answer: B. Ceftriaxone 250 mg IM and azithromycin 1 g PO one time each.

Q15. A 16-year-old sexually active female presents with fever, bilateral lower abdominal pain, and malaise. Pelvic examination reveals adnexal tenderness. Urinalysis is normal, and cervical cultures are pending. What medications should the nurse practitioner prescribe?

A. Azithromycin only.

B. Ceftriaxone only.

C. Ceftriaxone, doxycycline, and metronidazole. ✅

D. Metronidazole only.

Answer: C. Ceftriaxone, doxycycline, and metronidazole.