Author: Anonymous

A 9-month-old presents to the clinic with their parent. The chief complaint is the baby’s temperature which has been up to 103.6º for the past 24 hours. The parent states that they have given the baby tylenol, but it takes at least an hour for the fever to go away and it comes back five (5) to six (6) hours later. A thorough history reveals no other symptoms and no travel out of town for the past 2 months. The child does attend daycare, but the mother reports that no one who cares for the child has been ill. The mother states that the child is nursing and sleeping well. The child’s temperature is 102.ºF at the time of the visit. The assessment reveals a happy, playful baby with no abnormal findings, except the fever.  What might you say to the parent to ease their fear about the fever? (Please list at least two (2) things you might say? What are some ways you could tell the parent to help reduce the fever without medication? Please list at least two (2) ways to reduce fever without medication. BONUS…What might this illness be and what would you warn the parent about that may occur when the fever resolves?

A 10-year-old presents to the clinic complaining of a sore throat. Further history taking reveals a temperature up to 102ºF for the past 2 days, bad breath and difficulty opening their mouth.  The nurse practitioner’s assessment reveals an area of pus-filled tissue in front of the patient’s right tonsil and cervical lymphadenopathy. What should the treatment plan be for this patient?

The parents of a formula-fed newborn report that they get their drinking water from a well. What will the primary care pediatric nurse practitioner recommend to provide adequate fluoride for this infant? (Remember our talk on fluorosis!)

The primary care pediatric nurse practitioner is examining a 5-year-old child who has had recurrent fevers, bone pain, and a recent loss of weight. The physical exam reveals scattered petechiae, lymphadenopathy, and bruising. A complete blood count shows thrombocytopenia, anemia, and an elevated white cell blood count. The nurse practitioner will refer this child to a specialist for what diagnostic testing?

A 13-year-old female with sickle cell anemia presents in the clinic for a wellness examination. Upon completion of a normal physical examination, the patient asks the nurse practitioner if they will sign the sports physical form for high school. The patient states that they would like to join the high school swim team. What should the nurse practitioner do?

An 11-year-old presents to the clinic complaining of itchy eyelids. The nurse practitioner notes swelling and erythema of the eyelid margins and conjunctiva, as well as flaky, scaly debris over the eyelid margins. The patient has had no fever, no runny nose and no discharge from the eyes. Further examination of the patient record reveals a history of seborrhea. The MOST appropriate treatment for this patient is:

A 7-year-old presents to the clinic complaining of a swollen eye. The child has had a temperature at or above 102.5ºF for the past 2 days that has been controlled with ibuprofen. The parent states that the child complained that something stung him about a 4-5 days ago. The child has been rubbing his eye for the past 4 days and continues to say that it “burns and itches”.  An examination reveals a child who is not septic, but has an eye that looks like this.. What is the BEST treatment plan for this patient?

The parent of a 6-month-old infant calls to ask about teething? What would you recommend to the parent as comfort measures for this infant? (Please list at least 2 things you would advise the parent to do to comfort the baby who is teething.)

The nurse practitioner is reviewing the hematology report on a child with beta-thalassemia minor and notes a hemoglobin level of 8 g/dL. What should the nurse practitioner do next?

During a wellness examination an adolescent explains to the nurse practitioner that they have had some localized bleeding of the gums when brushing the teeth. An examination of the mouth reveals the presence of plaque and calculus on the teeth, which are not loose. What should the nurse practitioner recommend?