27 Dec Reaching for a desired object.
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When advising a patient about the influenza nasal spray vaccine, the NP considers the following:
1) Its use is acceptable during pregnancy.
2) Its use is limited to children younger than 6 years.
3) It contains live, attenuated virus.
4) This is the preferred method of influenza protection in the presence of airway disease.
Which of the following is true about the MMR vaccine?
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.
4) One dose is recommended for young adults who have not been previously immunized.
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?
The most common causative organism of bronchiolitis is:
1) haemophilus influenzae.
2) parainfluenza virus.
3) respiratory syncytial virus.
At which of the following ages in an infant’s life is parental anticipatory guidance about teething most helpful?
1) 1–2 months.
2) 2–4 months.
3) 4–6 months.
4) 8–10 months.
A young child should use a rear-facing car seat until at least age:
1) 12 months.
2) 18 months.
3) 24 months.
4) 30 months.
Question 7 1 / 2 points
Risk factors for dyslipidemia in children include which of the following? Select all that apply.
1) Blood pressure at the 70th to 80th percentile for age.
2) Breastfeeding into the toddler years.
3) Family history of lipid abnormalities.
4) Family history of type 2 diabetes mellitus.
Which of the following laboratory tests can identify the causative organism of bronchiolitis?
1) Nasal washing antigen test.
2) Antibody test via blood sample.
3) Urine culture.
4) A laboratory test is not available.
Physical examination findings in otitis externa include:
1) tympanic membrane immobility.
2) increased ear pain with tragus palpation.
3) tympanic membrane erythema.
4) tympanic membrane bullae.
Which of the following findings is most consistent with the diagnosis of acute bacterial rhinosinusitis (ABRS)?
1) Upper respiratory tract infection symptoms persisting beyond 7 to 10 days.
2) Mild midfacial fullness and tenderness.
3) Preauricular lymphadenopathy.
4) Marked eyelid edema.
Aortic stenosis in a 15-year-old male is most likely:
1) a sequela of rheumatic fever.
2) a result of a congenital defect.
3) calcific in nature.
4) found with atrial septal defect.
Which of the following do you expect to find in an examination of a 2-week-old infant?
1) A visual preference for the human face.
2) A preference for low-pitched voices.
3) Indifference to the cry of other neonates.
4) Poorly developed sense of smell.
An 18-year-old woman has a chief complaint of a “sore throat and swollen glands” for the past 3 days. Her physical examination includes a temperature of 101° F (38. 3° C), exudative pharyngitis, and tender anterior cervical lymphadenopathy. Right and left upper quadrant abdominal tenderness is absent. The most likely diagnosis is:
1) streptococcus pyogenes pharyngitis.
2) infectious mononucleosis.
3) viral pharyngitis.
4) vincent angina.
At which of the following ages in a young child’s life is parental anticipatory guidance about infant sleep position most helpful?
2) 2 weeks.
3) 2 months.
4) 4 months.
With regard to seasonal influenza prevention in well children, the NP considers that:
1) compared with school-aged children, younger children (? 24 months old) have an increased risk of seasonal influenza-related hospitalization.
2) a full adult dose of seasonal influenza vaccine should be given starting at age 4 years.
3) the use of the seasonal influenza vaccine in well children is discouraged.
4) widespread use of the vaccine is likely to increase the risk of eczema and antibiotic allergies.
Rebound tenderness is best described as abdominal pain that worsens with:
1) light palpation at the site of the discomfort.
2) release of deep palpation at the site of the discomfort.
3) palpation on the contralateral side of the abdomen.
4) deep palpation at the site of the discomfort.
A Still murmur:
1) is heard in the presence of cardiac pathology.
2) has a humming or vibratory quality.
3) is a reason for denying sports participation clearance.
4) can become louder when the patient is standing.
Common causative organisms of acute suppurative conjunctivitis include all of the following except:
1) staphylococcus aureus.
2) haemophilus influenzae.
3) streptococcus pneumoniae.
4) pseudomonas aeruginosa.
Which of the following imaging studies potentially exposes the patient being evaluated for abdominal pain to the lowest ionizing radiation burden?
2) Barium enema.
3) CT scan.
4) Abdominal flat plate.
At which age is a child at greatest risk of death from pertussis?
1) <1 year. 2) 2–4 years. 3) 5–10 years. 4) >10 years.
A healthy 3-year-old child is in your office for well-child care. You expect this child to be able to:
1) name five colors.
2) alternate feet when climbing stairs.
3) speak in two-word phrases.
4) tie shoelaces.
Treatment options in acute and recurrent allergic conjunctivitis include all of the following except:
1) cromolyn ophthalmic drops.
2) oral antihistamines.
3) ophthalmological antihistamines.
4) corticosteroid ophthalmic drops.
Rectal bleeding associated with anal fissure is usually described by the patient as:
1) drops of blood noticed when wiping.
2) dark brown to black in color and mixed in with normal-appearing stool.
3) a large amount of brisk red bleeding.
4) significant blood clots and mucus mixed with stool.
Concerning the MMR vaccine, which of the following is true?
1) The link between use of MMR vaccine and childhood autism has been firmly established.
2) There is no credible scientific evidence that MMR use increases the risk of autism.
3) The use of the combined vaccine is associated with increased autism risk, but giving the vaccine’s three components as separate vaccines minimizes this risk.
4) The vaccine contains thimerosal, a mercury derivative.
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:
1) aortic stenosis.
2) hypertrophic cardiomyopathy.
3) a physiologic murmur.
4) a Still’s murmur.
Which of the following statements is correct about the varicella vaccine?
1) This vaccine contains killed varicella-zoster virus (VZV).
2) A short febrile illness is common during the first days after vaccination.
3) Children should have a varicella titer drawn before receiving the vaccine.
4) Rarely, mild cases of chickenpox have been reported in immunized patients.
A healthy 6-year-old girl presents for care. Her parents request that she receive vaccination for influenza and report that she has not received this vaccine in the past. How many doses of influenza vaccine should she receive this flu season?
At which of the following ages in a young child’s life is parental anticipatory guidance about toilet-training readiness most helpful?
1) 12 months.
2) 15 months.
3) 18 months.
4) 24 months.
The murmur of atrial septal defect is usually:
1) found in children with symptoms of cardiac disease.
2) first found on a 2–6-month well-baby examination.
3) found with mitral valve prolapse.
4) presystolic in timing.
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:
1) encourage the mother to enroll her son in daycare to increase his socialization.
2) conduct further evaluation of milestone attainment.
3) reassure the parent that delayed speech is common in boys.
4) order audiogram and tympanometry.
Treatment options for streptococcal pharyngitis for a patient with penicillin allergy include all of the following except:
Which of the following is one of the more common sources of hepatitis A infection in the United States?
1) Receiving blood products.
2) Ingestion of raw shellfish.
3) Drinking municipally sourced tap water drinking water.
4) Exposure to fecally contaminated food.
Juice intake is acceptable in children 6 months and older per which of the following recommendations? Select all that apply.
1) The juice is mixed in small amounts to flavor water.
2) Only 100% juice is used.
3) Juice replaces no more than one serving of milk.
4) The juice is consumed in the morning with breakfast.
5) No more than 6 oz. (177 mL) per day is recommended for children 6 months to 5 years.
Treatment of viral conjunctivitis can include:
1) moxifloxacin ophthalmic drops.
2) polymyxin B ophthalmic drops.
3) oral acyclovir.
4) no antibiotic therapy needed.
Question 35 1 / 2 points
Which of the following benchmarks indicate normal development by a healthy child born at term who is now 12 months of age? Select all that apply.
Talking in two-word sentences.
Pointing to a desired object.
Reaching for a desired object.
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