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During a routine well child exam on a 5-year-old child, the primary care pediatric nurse practitioner auscultates a grade II/VI, harsh, late systolic ejection murmur at the upper left sternal border that transmits to both lung fields. The child has normal growth and development. What will the nurse practitioner suspect? Aortic stenosis (AS) Patent ductus arteriosus (PDA) Pulmonic stenosis Correct Tricuspid atresia

A 6-year-old child has a systolic blood pressure between the 95th and 99th percentile for age, sex, and height and a diastolic blood pressure between the 90th and the 95th percentile on three separate clinic visits. This child’s blood pressure is placed in which classification? Normotensive Pre-hypertensive Stage 1 hypertensive Correct Stage 2 hypertensive

The primary care pediatric nurse practitioner (PNP) is performing a sports physical on an adolescent whose history reveals mild aortic stenosis (AS). What will the nurse practitioner recommend? Avoidance of all sports to prevent sudden death Clearance for any sports since this is mild Evaluation by a cardiologist prior to participation Correct Low-intensity sports, such as golf or bowling

A child who has been diagnosed with asthma for several years has been using a short-acting B2-agonist (SABA) to control symptoms. The primary care pediatric nurse practitioner learns that the child has recently begun using the SABA two or three times each week to treat wheezing and shortness of breath. The child currently has clear breath sounds and an FEV1 of 75% of personal best. What will the nurse practitioner do next? Add a daily inhaled corticosteroid. Correct Administer 3 SABA treatments. Continue the current treatment. Order an oral corticosteroid.

A 9-month-old infant has a grade III/VI, harsh, rumbling, continuous murmur in the left infraclavicular fossa and pulmonic area. A chest radiograph reveals cardiac enlargement. The primary care pediatric nurse practitioner will refer the infant to a pediatric cardiologist and prepare the parents for which intervention to repair this defect? Cardiopulmonary bypass surgery Coil insertion in the catheterization laboratory Correct Indomethacin administration Observation for spontaneous closure

A school-age child who uses a short-acting beta2-agonist (SABA) and an inhaled corticosteroid medication is seen in the clinic for an acute asthma exacerbation. After 4 puffs of an inhaled short-acting B2-agonist (SABA) every 20 minutes for three treatments, spirometry testing shows an FEV1 of 60% of the child’s personal best. What will the primary care pediatric nurse practitioner do next? Administer an oral corticosteroid and repeat the three treatments of the inhaled SABA. Admit the child to the hospital for every 2 hour inhaled SABA and intravenous steroids. Give the child 2 mg/kg of an oral corticosteroid and have the child taken to the emergency department. Order an oral corticosteroid, continue the SABA every 3 to 4 hours, and follow closely. Correct

VI. Proof A DON’T FORGET TO SHOW completely ripped up scrap paper to camera BEFORE submitting exam, OR LOSE minimum 10 points! NO excuses. A. 1. X + Z)  >  (P + ~O)   2. (W > T)  >  (~Z v X)3. ~(P v ~T)          / ~(T > Z)

A 2 yo who has a sudden onset of cough and stridor, has no h/o viral illness, no  fever or vomiting. The mother states the child was well this morning and was playing at home when symptoms suddenly started. What is the highest on your list  differential diagnoses?

A previously healthy school-age child develops a cough and a low-grade fever. The primary care pediatric nurse practitioner auscultates wheezes in all lung fields. Which diagnosis will the nurse practitioner suspect? Atypical pneumonia Correct Bacterial pneumonia Bronchiolitis Epiglottitis

A school-age child has had nasal discharge and daytime cough but no fever for 12 days without improvement in symptoms. The child has not had antibiotics recently and there is no significant antibiotic resistance in the local community. What is the appropriate treatment for this child? Amoxicillin 45 mg/kg/day Correct Amoxicillin 80-90 mg/kg/day Amoxicillin-clavulanate 80-90 mg/kg/day Saline irrigation for symptomatic relief