NU580 Unit 9 Quiz

NU580 Unit 9 Quiz

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Purdue University Global

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

Prof. Name:

Date

Prescribing Medications in Pediatrics — Questions & Answers

Question 1:

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?

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

Explanation:
PREA requires manufacturers to study certain new drugs in pediatric populations when the medication may be used in children. These studies help establish appropriate safety, effectiveness, and dosing information.

Question 2:

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?

Answer:
C. Log onto the FDA MedWatch website.

Explanation:
FDA MedWatch is the reporting system used for healthcare professionals and consumers to report adverse drug reactions and safety concerns.

Question 3:

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:

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

Explanation:
Young children may have immature liver enzyme systems, which can affect drug metabolism. Reduced frequency or lower dosing may be needed to prevent toxicity.

NU580 Unit 9 Quiz

Question 4:

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?

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

Explanation:
When prescribing off-label medications, providers should discuss the risks, benefits, alternatives, and available evidence with parents or caregivers and document informed consent.

Question 5:

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?

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

Explanation:
Involving adolescents in creating a realistic medication schedule improves adherence by matching treatment routines with their daily habits.

Question 6:

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?

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

Explanation:
Most viral respiratory infections do not require antibiotics. Supportive care and appropriate evaluation are recommended.

Question 7:

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?

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

Explanation:
A shorter, once-daily antibiotic regimen may improve adherence when medication administration is challenging.

Question 8:

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?

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

Explanation:
Children with asthma should have access to rescue medication in appropriate locations, such as home and school. A spacer improves medication delivery.

Chapter 41: Genitourinary Disorders — Questions & Answers

Question 1:

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?

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

Explanation:
A negative dipstick does not completely rule out urinary tract infection (UTI). Culture confirms diagnosis.

Question 2:

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?

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

Explanation:
A significant colony count with symptoms indicates a UTI requiring antibiotic therapy.

Question 3:

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?

Answer:
B. Prescribe trimethoprim-sulfamethoxazole (TMP-SMX) twice daily for 3 to 5 days.

Explanation:
Children with symptoms and positive urine screening tests should begin empiric treatment while awaiting culture results.

Question 4:

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?

Answer:
B. Order amoxicillin-clavulanate.

Explanation:
Flank pain and fever suggest possible upper urinary tract involvement, requiring appropriate antibiotic coverage.

Question 5:

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?

Answer:
A. Obtain a renal and bladder ultrasound.

Explanation:
Children with recurrent febrile UTIs should be evaluated for structural abnormalities of the urinary tract.

Question 6:

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

Answer:
D. TMP-SMX: TMP 2 mg/kg as a single daily dose.

Explanation:
Low-dose antibiotic prophylaxis helps prevent recurrent UTIs in children with vesicoureteral reflux.

Question 7:

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

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

Explanation:
Severe reflux may require surgical correction to prevent kidney damage.

Question 8:

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?

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

Explanation:
Menstrual contamination is a common cause of microscopic hematuria in adolescent females.

Question 9:

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

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

Explanation:
IgA vasculitis commonly causes purpuric rash, joint pain, abdominal symptoms, and renal involvement.

Question 10:

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

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

Explanation:
This pattern suggests orthostatic proteinuria, a benign condition commonly seen in adolescents.

Chapter 41: Genitourinary Disorders — Questions & Answers (Continued)

Question 11:

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?

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

Explanation:
Children with nephrotic syndrome often experience relapses. Corticosteroids are commonly used again during relapse episodes to control symptoms.

Question 12:

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?

Answer:
B. Continue with steroids and salt restrictions until the urine is negative for protein.

Explanation:
Treatment should continue until proteinuria resolves. Stopping therapy too early may lead to relapse.

Question 13:

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?

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

Explanation:
These findings suggest acute post-streptococcal glomerulonephritis, which may require specialist evaluation and monitoring.

Question 14:

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?

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

Explanation:
Increasing hydration helps promote passage of small kidney stones and prevents further stone formation.

Question 15:

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?

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

Explanation:
A firm abdominal mass in a young child may indicate a renal tumor such as Wilms tumor and requires urgent evaluation.

Question 16:

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

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

Explanation:
A testis that does not remain in the scrotum requires specialist evaluation to prevent complications.

Question 17:

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?

Answer:
B. Refer immediately to a pediatric surgeon.

Explanation:
A painful, non-reducible scrotal mass may indicate an incarcerated inguinal hernia, which requires urgent surgical evaluation.

Question 18:

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?

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

Explanation:
These findings suggest pathologic phimosis, which may require specialist management.

Question 19:

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?

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

Explanation:
These findings are consistent with testicular torsion, a surgical emergency requiring immediate intervention.

Chapter 42: Gynecologic Disorders — Questions & Answers

Question 1:

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?

Answer:
B. Place the child in the knee-chest position on the examination table.

Explanation:
The knee-chest position provides the best visualization while minimizing discomfort and anxiety.

Question 2:

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?

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

Explanation:
Combined oral contraceptives are commonly used as an initial contraceptive option in healthy adolescents.

Question 3:

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

Answer:
A. Prescribe ulipristal acetate (Ella).

Explanation:
Ulipristal acetate is effective for emergency contraception up to 5 days after unprotected intercourse.

Question 4:

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?

Answer:
D. Use of estrogen-containing cream.

Explanation:
This presentation suggests labial adhesions, which may improve with topical estrogen therapy.

Question 5:

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

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

Explanation:
Persistent vulvovaginal symptoms may be related to hypoestrogenic tissue, which can respond to topical estrogen therapy.

NU580 Unit 9 Quiz

Question 6:

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?

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

Explanation:
This is consistent with mittelschmerz (ovulatory pain), which is managed conservatively with NSAIDs and heat.

Question 7:

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?

Answer:
A. Perform a full diagnostic workup to evaluate potential causes.

Explanation:
New pelvic pain in a sexually active adolescent requires evaluation for conditions such as pelvic inflammatory disease, ovarian pathology, or endometriosis.

Question 8:

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?

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

Explanation:
Confidentiality rules vary by location. The provider must first understand legal requirements before proceeding.

Question 9:

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?

Answer:
B. Order an ultrasound of the mass.

Explanation:
Breast ultrasound is the preferred imaging method for evaluating breast masses in adolescents.

Question 10:

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?

Answer:
C. Pregnancy test.

Explanation:
Pregnancy should always be ruled out first in an adolescent with delayed menstruation, regardless of reported sexual activity.

Chapter 42: Gynecologic Disorders — Questions & Answers (Continued)

Question 11:

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

Answer:
B. Menorrhagia

Explanation:
Menorrhagia refers to excessive menstrual bleeding that occurs at regular intervals. It involves heavy or prolonged menstrual flow during otherwise predictable cycles.

Question 12:

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?

Answer:
A. Coagulation studies

Explanation:
Heavy menstrual bleeding with anemia in adolescents may indicate an underlying bleeding disorder, such as von Willebrand disease. Coagulation studies help evaluate for clotting abnormalities.

Question 13:

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?

Answer:
A. Iron supplementation and prostaglandin inhibitors

Explanation:
For adolescents with mild abnormal uterine bleeding and normal hemoglobin levels, NSAIDs can reduce menstrual bleeding, and iron supplementation helps maintain iron stores.

Question 14:

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?

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

Explanation:
When both gonorrhea and chlamydia are suspected or confirmed, treatment should cover both infections. Immediate treatment is important to prevent complications and transmission.

Question 15:

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?

Answer:
C. Ceftriaxone, doxycycline, and metronidazole

Explanation:
The symptoms suggest pelvic inflammatory disease (PID). Empiric broad-spectrum antibiotic therapy should be started promptly to cover gonorrhea, chlamydia, and anaerobic organisms.

Summary of Correct Answers

Prescribing Medications in Pediatrics

1. A

2. C

3. A

4. A

5. A

6. C

7. C

8. D

Genitourinary Disorders

1. D

2. D

3. B

4. B

5. A

6. D

7. B

8. D

9. A

10. A

11. B

12. B

13. D

14. B

15. D

16. B

17. B

18. C

19. D

Gynecologic Disorders

1. B

2. A

3. A

4. D

5. A

6. C

7. A

8. A

9. B

10. C

11. B

12. A

13. A

14. B

15. C