NR 602 Final Exam Chamberlain Spring 2026 questions with 100% correct answers + rationales -Chamberlain

COLIC

Unknown abdominal discomfort;

"cries for more than 3 hours a day, for more than 3 days a week, and more than 3 weeks"

Colic Management

Probiotics may be offered; Consideration of hydrolyzed protein formula

DEHYDRATION Management

Commercially available oral hydration solutions (ORS)

Continue breastfeeding with ORS supplementation

Offer young children 20 ml/kg per hour

Offer older children 100 mL of ORS every 5 minutes

Combine with IV therapy as needed

Reassess after 4 hours; repeat if needed

Avoid juice, soft drinks, and sports drinks

Appendicitis S/S

Presence of involuntary guarding,

RLQ rebound tenderness, maximal pain over McBurney point

Heel-drop jarring test

inability to stand straight or climb stairs; winces when getting off examination table or riding in a car over bumps;

child most comfortable with bent knees.

Positive psoas sign or obturator sign

Rovsing sign or rebound tenderness strongly suggests peritoneal irritation.

Tenderness and possibly a mass (abscess) on the right side on rectal examination.

McBurney point/sign

Pain w/ palpation and release; Rebound tenderness is most reliable.

1.5 to 2 inches in from the right anterior superior iliac crest (on a line toward the umbilicus) on abdominal examination (most reliable finding

positive psoas sign

retract R thigh while on left side; illicit pain consistent with appendicitis

Positive Rovsing Sign

Pain RLQ w/ pressure and release of LLQ; R/O appendicitis

Positive Obturator Sign

Supine; bend R leg and rotate inward; illicit pain in RLQ

Intusscuception

Anterograde intestine into proximal bowel; Most common cause of for Pediatric GI obstruction

S/S of intussusception

S/S of intussuception

intermittent abdominal pain

currant jelly stools

Dance Sign (sausage like mass)

Management of Intussusception

Therapeutic Air Contrast Enema under fluoroscopy

Failure to Thrive (FTT)

The most common cause is nutritional deficiency without an underlying medical condition (greater than 80%).

Asymptomatic bacteriuria

bacteria in the urine without other symptoms, is benign, and does not cause renal injury.

Cystitis

an infection of the bladder that produces lower tract symptoms but does not cause fever or renal injury.

Pyelonephritis

most severe type of UTI involving the renal parenchyma or kidneys and must be readily identified and treated because of the potential irreversible renal damage.

"When was your last menstrual period (LMP)?"

A healthy 14-year-old female has a dipstick urinalysis that is positive for 56RBCs per hpf but otherwise normal. What is the first question the primary care pediatric nursepractitioner will ask this patient?

Monitor for proteinuria at each annual well child examination.

An adolescent has 2+ proteinuria in a random dipstick urinalysis. A subsequent first morning voided specimen is negative. What will the primary care pediatric nurse practitioner do to manage this condition?

Henoch Schönlein purpura

A child has gross hematuria, abdominal pain, and arthralgia as well as a rash. What diagnosis is most likely?

Phenazopyridine (Pyridium)

may be given at 12 mg/kg/day for 6- to 12-year-olds and 200 mg for those older than 12 years old, three times a day for dysuria

Refer the infant to a pediatric urologist or surgeon for possible orchiopexy

A 6-month-old infant has a retractile testis that was noted at the 2-month well baby exam. What will the primary care pediatric nurse practitioner do to manage this condition?

Nitrites

indirect measure of bacteria in the urine and the most specific marker for infection.

Proteinuria

Possible indicative d/t renal disease or orthostactic

Refer immediately to a pediatric surgeon.

A 9-month-old infant is brought to the clinic with scrotal swelling and fussiness. The primary care pediatric nurse practitioner notes a tender mass in the affected scrotum that is difficult to reduce. What is the correct action?

Negative leukocyte esterase and nitrites

reasonably rule out a UTI; however, a culture is still indicated

Obtaining serial measurements to assess patterns over

The primary care pediatric nurse practitioner evaluates children's growth to screen for endocrine and metabolic disorders. Which is a critical component of this screening?

Free Serum T4 and TSH

The primary care pediatric nurse practitioner performs a physical examination on a 9 month old infant with congenital hypothyroidism who takes daily levothyroxine sodium and notes a recent slowing of the infant's growth rate. What will the nurse practitioner order?

first-generation cephalosporin, trimethoprim-sulfamethoxazole (Bactrim), or nitrofurantoin (MacroBid)

Uncomplicated UTIs and bacterial cystitis in afebrile clients can be treated with?

Pancreatic antibodies

A 12 year old child has a recent history of increased thirst and frequent urination. The child's weight has been in the 95th percentile for several years. A dipstick UA is positive for glucose, and random plasma glucose is 350 mg/dL. Which test will the primary care pediatric nurse practitioner order to determine the type of diabetes in this child?

Begin insulin and refer the child to a children's diabetes center.

The primary care pediatric nurse practitioner diagnoses an 8 year old child with type 1 diabetes after a routine urine screen is positive for glucose and negative for ketones and plasma glucose is 350 mg/dL. The child's weight is normal and the parents report a mild increase in thirst and urine output in the past few days. Which course of action is correct?

Continuous glucose monitoring

The primary care pediatric nurse practitioner is reviewing lab work and diabetesmanagement with a school-age child whose HbA1C is 7.6% who reports usual blood sugars before meals as being 80 to 90 mg/dL. The nurse practitioner will consult with the child's endocrinologistto consider which therapy?

The importance of checking blood glucose 3 or 4 times daily

The primary care pediatric nurse practitioner prescribes metformin for a 15 year old adolescent newly diagnosed with type 2 diabetes. What will the nurse practitioner include when teaching the adolescent about this drug?

Polycystic ovary syndrome

A 16year old adolescent female whose BMI is at the 90th percentile reports irregular periods. The primary care pediatric nurse practitioner notes widespread acne on her face and back and an abnormal distribution of facial hair. The nurse practitioner will evaluate her further based on a suspicion of which diagnosis?

20 to 35 mcg dose of ethinyl estradiol and a nonandrogenic progestin component is recommended.

What is the treatment recommendation for women w/ PCOS not intent on conceiving?

Generalized anxiety disorder (GAD)

The parent of a school age child reports that the child becomes frustrated when unable to perform tasks well and often has temper tantrums and difficulty sleeping. Which disorder may be considered in this child?

Cognitive-behavioral therapy (CBT) is the most common psychotherapeutic approach.

First-line pharmacologic treatment is selective serotonin reuptake inhibitors (SSRIs).

What are the treatment modalities for GAD?

Worry, Anxiety

Tantrums

Sleep Difficulties

What are common manifestations of GAD?

Ask the mother about the child's relationship with the father.

A newly divorced mother of a toddler reports that the child began having difficulty sleeping and nightmares along with exhibiting angry outbursts and tantrums 2 months prior. The primary care pediatric nurse practitioner learns that the child refuses to play with usual playmates and often spends time sitting quietly. What will the nurse practitioner do initially?

cyclic mystalgia

occurs in women age 30-50

soreness or aches bilaterally, poorly localized

begins in the luteal phase, stops with menses

is caused by hormonal changes associated with menstruation

Reassurance

Effective for 85% of women who have mild or moderate symptoms of mastalgia, the first line of treatment is

Vaginitis

What is the term for the inflammation of the vagina characterized by an increased vaginal discharge containing numerous white blood cells?

PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) i

small subset of children with OCD, the diagnosis is associated with streptococcal infections.

Psychotherapy alone or in combination w/ SSRI or clomipramine

First-line treatment for mild to moderate OCD are?

Fish-like odor of discharge

What is the most common symptom of bacterial vaginosis?

Candida Albicans

Which organism causes 90% of vulvovaginal candidiasis episodes in women?

Fluconazole (Diflucan)

Most common treatment for Vulvovaginal Candidiasis

Vulvovaginal pruritis

What is the most common symptom of vulvovaginal candidiasis?

Because these symptoms affect the majority of women.

Why shouldn't symptoms such as bloating and breast tenderness be considered disordered premenstrual symptoms?

PMS/PMDD

present with both affective and somatic symptoms during the luteal phase of the menstrual cycle?

PMDD

What is a severe form of PMS that significantly disrupts daily functioning?

(Chadwicks sign)

Cervix color and texture change, becoming cyanotic

(Goodells sign).

softening of the cervix

Hegar Sign

softening of cervix that is a sign of pregnancy, occurring at 10 to 12 weeks' gestation

Ovulatory Dysfunction

Most common cause of Abnormal Uterine Bleeding?

COEIN (coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not yet classified)

Non-Structural Causes of Abnormal Uterine Bleeding?

PALM (polyps, adenomyosis, leiomyoma, malignancy)

Structural Causes of Abnormal Uterine Bleeding?

GnRH (gonadotropin-releasing hormone), Contraceptives, IUD

Medical treatment of Uterine Fibroids can include?

Exclusion of other diagnoses that may better explain the symptoms.

Which of the following is one of the key criteria for a diagnosis of PMS

GnRH (gonadotropin-releasing hormone)

Exercise-induced amenorrhea is probably due to the combination of low body fat and decreased secretion of?

50%

Approximately how many Americans will contract one or more sexually transmitted infections during their lifetime?

Primary amenorrhea

failure of the initiation of menses by age 14 in the absence of puberty or by 16 years of age regardless of the development of secondary sexual characteristics

40

Of the more than 100 known serotypes of human papillomavirus (HPV), approximately how many can infect the genital tract?

3 weeks

An initial or primary genital herpes infection characteristically lasts

Trichomoniasis

Which of the following is caused by an anaerobic one-celled protozoan that commonly lives in the vagina?

Metronidazole; PO Only as intavaginal is not effective

treatment of choice for men and women w/ Trichomoniasis.

Gonorrhea

The second most commonly reported STI after chlamydia?

IM Ceftriaxone

treatment for gonorrhea?

Gonorrhea and Chlamydia Infections

Most common cause of PID?

fever, rash, hypotension, and multisystem organ involvement. Related to

Oxytocin

what hormone is released post child birth that makes the mom feel euphoria?

toxic shock syndrome (TSS)

a severe illness characterized by high fever, rash, vomiting, diarrhea, and myalgia, followed by hypotension and, in severe cases, shock and death; usually affects menstruating women using tampons; caused by Staphylococcus aureus and Streptococcus pyogenes

Appendicitis w/ Perforation

A 10 year old child has had abdominal pain for 2 days, which began in the periumbilical area and then localized to the right lower quadrant. The child vomited once today and then experienced relief from pain followed by an increased fever. What is the likely diagnosis?

Perpetual HPV infection

most important causative agent in cervical carcinogenesis.99.7%

intussusception

An 18 month old child has a 1 day history of intermittent, cramping abdominal pain with nonbilious vomiting. The child is observed to scream and draw up his legs during pain episodes and becomes lethargic in between. The primary care pediatric nurse practitioner notes a small amount of bloody, mucous stool in the diaper. What is the most likely diagnosis?

Prescribe trimethoprim/sulfamethoxazole (TMP) twice daily for 3 to 5 days.

A dipstick urinalysis is positive for leukocyte esterase and nitrites in a school-age

child with dysuria and foul smelling urine but no fever who has not had previous

urinary tract infections. A culture is pending. What will the pediatric nurse practitioner do to treat this child?

Monitor for proteinuria at each annual well child examination

An adolescent has 2+ proteinuria in a random dipstick urinalysis. A subsequent first morning voided specimen is negative. What will the primary care pediatric nurse practitioner do to manage this condition?

polycystic ovary syndrome (PCOS)

A 7yearold female has recently developed pubic and axillary hair without breast development. Her bone age is consistent with her chronological age, and a pediatric endocrinologist has diagnosed idiopathic premature adrenarche. The primary care pediatric nurse practitioner will monitor this child for which condition?

If she has recently begun menstruating

When is a pelvic examination unnecessary for a woman who is experiencing AUB?

massage the fundus

The nurse notes that the fundus of a postpartum patient is boggy, shifted to the left of the midline, and 2 cm above the umbilicus. What is the nurses priority action?

use progesterone-only contraception

Progesterone breakthrough bleeding is sometimes seen in women who

Have the same theoretical efficacy

Compared to COC's, the combined contraceptive patch and vaginal ring

Executive Function

The FNP cares for a preschool-age child who was exposed to drugs prenatally. The child bites other children and has tantrums when asked to stop but is able to state later why this behavior is wrong. This child most likely has a disorder related to what process?

sensory processing

measures tactile sensitivity, taste-smell sensitivity, movement, under-responsiveness, auditory filtering, low energy and weakness, visual and auditory processing.

self-regulation

Ability to recognize and control impulses, manage stress and emotions, and exert self-control

information processing

how information is received, processed, and stored, as well as how it then produces output

Penicillin G (IM injection)

Recommended treatment for syphillis?

Doxycycline PO

Recommended treatment for Chlamydia?

Hormonal Birth Control

ACHES: Abdominal, Chest, Headache, Eye, Speech Deficits...Ask if patient is on what medications?

Negele Rule; Expected Date of Delivery

Add 7 days to first day of last menstrual cycle; subtract 3 months; Add 1 year

Fundal Height at 12 weeks

At the symphysis pubis

Fundal height @ 16 weeks

Between PS and Umbilicus

Fundal height at 20 weeks

At level of the unmbilicus

Fundal height 24-36 weeks

+/- 2cm equal to gestationla age.

Decrease BP; Increase blood volume. Decrease pperipheral vascular resistance

Primary Dysmenorrhea

No physical underlying pathological indication

Almost always associated with ovulatory cycles

Secondary Dysmenorrhea

Pain due to an underlying pelvic pathology

Endometriosis

Most common cause of secondary dysmenorrhea

Follicular Phase

levels of estrogen and progesterone are low during this phase of menstrual cycle; Menstruation occurs during this phase

Ovulatory Phase

surge in luteinizing hormone and follicle-stimulating hormone levels;

Luteal Phase

Surge of Progesterone; Post ovulation prior to menstruation

Estrogen

Surge in this hormone just before ovulation