Pncb Core Q 3 - Diagnostics, Meds, & Education (Ch 52-58)

Front 1

The PNP’s role in the office emergency preparedness planning includes all of the following EXCEPT:

A. Having access to the proper emergency equipment per sample emergency drug and equipment lists in AAP Blue Book
B. Receiving ongoing education and training in identification and treatment of selected emergencies
C. Knowing the community resources for referral and to confidently render care under such circumstances
D. PNPs are required to complete pediatric advanced life support (PALS) certification prior to practicing in a clinic or outpatient setting

Back 1

D. PNPs are required to complete pediatric advanced life support (PALS) certification prior to practicing in a clinic or outpatient setting

This is not a standard requirement for PNPs in outpatient settings.

Front 2

While pediatric emergencies in the office setting are an infrequent event, the type of emergency that is most frequently reported is:

A. Poisoning
B. Respiratory
C. Major trauma
D. Orthopedic

Back 2

B. Respiratory

Respiratory-related conditions are the most frequently reported emergencies in the pediatric office setting. This finding coincides with respiratory emergencies being the most common medical emergency, overall, in pediatric emergency care.

Front 3

In an emergency, the PNP trained in pediatric advanced life support should be prepared to:

A. Maintain and stabilize the child’s airway, with or without airway adjuncts
B. Perform a venous cut-down
C. Perform chest decompression
D. Administer intracardiac epinephrine

Back 3

A. Maintain and stabilize the child’s airway, with or without airway adjuncts

The other choices are unlikely to be performed in an office setting

Front 4

What system allows for quick reference to determine appropriate equipment size, fluid volumes, and medication doses?

A. Pediatric advanced life support (PALS)
B. Emergency medical system (EMS)
C. Basic life support (BLS)
D. Broselow-Luten system

Back 4

D. Broselow-Luten system

The Broselow-Luten system is a COLOR-CODED MEASURING TAPE that offers QUICK REFERENCE for equipment size, supplies, and medication doses based on the child’s HEIGHT.

PALS is training in pediatric advanced life support and includes CPR, entotracheal tube intubation, intraosseuous access, ad medication calculation.

BLS is basic life support training which includes adult, child, and infant CPR.

EMS is activated in the event of an emergency.

Front 5

PNPs should collaborate with EMS to accomplish all of the following EXCEPT:

A. Improve their response time to their office
B. Enhance professional communications
C. Teach them about pediatric care
D. Participate in their mock codes

Back 5

A. Improve their response time to their office

EMS may not have control in their response times to the primary care office due to its location, availability of the EMS crew, and other factors that PNPs are unable to control.

Front 6

What is the best way to determine the practical value of a diagnostic test?

A. Ordering the test will appease the parents of the child
B. The subsequent health outcomes of the child have been considered
C. The test will narrow the differential diagnosis, but not guide treatment
D. The test will confirm a diagnosis that will be treated regardless of the results

Back 6

B. The subsequent health outcomes of the child have been considered

Front 7

What are defining characteristics of point-of-care diagnostic tests?

A. Specific, simple to conduct, inexpensive
B. Accurate, simple to conduct, disposable
C. Specific, disposable, inexpensive
D. Simple to conduct, specific, difficult to interpret

Back 7

A. Specific, simple to conduct, inexpensive

Point-of-care tests are NOT required to be disposable, and they should NOT be difficult to interpret.

Front 8

It is important to use the proper collection tubes for venous blood specimens because:

A. All tubes have additives
B. All samples are collected in the same manner
C. The tubes are all the same size
D. The samples may be whole blood, serum, or plasma

Back 8

D. The samples may be whole blood, serum, or plasma

Not all tubes have additives or are the same size.

Front 9

Common sites for a capillary blood specimen in infants and children include:

A. Abdomen, heels, earlobes
B. Fingertips, toes, heels
C. Heels, elbows, earlobes
D. Fingertips, heels, earlobes

Back 9

D. Fingertips, heels, earlobes

These are often used b/c these sites are ACCESSIBLE and they have CAPILLARY BEDS CLOSE TO THE SKIN’S SURFACE.

Front 10

You ordered a chemistry panel for your patient that includes a sodium, potassium, chloride, bicarbonates, BUN, creatinine, and glucose. The results are sodium 138, potassium 6.1, chloride 99, bicarbonate 22, BUN 36, creatinine 0.4, glucose 102. You learn that the specimen was a capillary blood sample. What is a possible explanation for this result?

A. The lab has a new technician
B. The sample was hemolyzed during the collection process
C. The specimen was labeled incorrectly
D. The specimen was not sent on ice

Back 10

B. The sample was hemolyzed during the collection process

The value that is not in the normal range is potassium of 6.1. This value may have occurred because of hemolysis. Hemolysis can occur if the technician drawing the sample had to SQUEEZE the site to obtain blood or used a scraping motion to collect the blood in the tube.

Front 11

A 12 year old female presents to the clinic with frequency and pain when urinating. She has had symptoms for several days and reports the use of a medicine “to help the pain” that her mother bought over the counter. A clean-catch specimen is obtained for urinalysis and culture. The color of the urine is noted to be dark orange. What is the most likely reason for the color of the urine?

A. Blood
B. Lotrimin
C. Pyridium
D. Melanin

Back 11

C. Pyridium

Blood usually presents as RED urine.

Melanin would present as BLACK urine.

Pyridium can cause the urine to be dark orange or brown.

Front 12

What diagnostic tests require a larger than normal stool sample?

A. Microscopy for ova and parasites, fat content
B. Occult blood, microscopy for ova and parasites
C. Fat content, gram stain
D. Trypsin, rotavirus antigen

Back 12

A. Microscopy for ova and parasites, fat content

Microscopy for ova and parasites usually requires 3 specimens to identify the organism. To determine the fat content of stool, a 72-hour sample is required. Other tests only require a small amount of stool.

Front 13

A sputum specimen can be obtained by the following method:

A. Having the patient spit into a cup
B. Having the patient suck on a cotton pledget
C. Suctioning the patient’s trachea
D. Swabbing the tonsillar area

Back 13

C. Suctioning the patient’s trachea

The other 3 choices will provider a sample of saliva. A patient may be able to cough up a specimen, or the trachea can be suctioned to obtain sputum.

Front 14

A wet mount microscopy is performed on vaginal fluids obtained during a pelvic exam. The presence of pseudohyphae is noted. What does this finding suggest?

A. This finding is normal
B. Bacterial vaginosis
C. Candida infection
D. Precancerous cells

Back 14

C. Candida infection

The presence of pseudohyphae or yeast buds suggest a Candida infection. Clue cells that look like ground black pepper would suggest a bacterial vaginosis.

Front 15

When using a Wood’s lamp to observe fluorescence on the skin of a patient, you note the color to be pale yellow. What is this most likely indicative of?

A. Tinea capitis
B. Pityriasis versicolor
C. Candida
D. Corynebacterium minutissmum

Back 15

B. Pityriasis versicolor

Tinea capitis – blue-green

Corynebacterium minutissimum – coral red color

Candida – no fluorescence

Front 16

Which dermatophyte has a characteristic “spaghetti-and-meatballs” appearance under the microscope?

A. Candida
B. PItyriasis versicolor
C. Tinea cruris
D. Tinea versicolor

Back 16

D. Tinea versicolor

Candida cells are round/oval.

Front 17

A skin culture can be considered negative after how many days?

A. 5
B. 7
C. 10
D. 21

Back 17

D. 21

While a skin culture can be positive after 7-10 days, a full 21 days must past before the culture is determined to be negative.

Front 18

Adult body water is 60% of total weight. A full-term neonate’s body water is approximately what percentage of total weight?

A. 45% - 55%
B. 55% - 60%
C. 70% - 75%
D. 75% - 80%

Back 18

D. 75% - 80%

Extracellular fluid (interstitial and intravascular) in an infant is much greater than that of an adult; this totals to 45% of an infant’s body weight.

Front 19

In the neonate, the proportion of body water varies from the adult in which of the following ways?

A. The proportion of intracellular fluid increases as the infant matures
B. The neonate exchanges extracellular fluid more rapidly than an adult
C. A larger milligram per kilogram dosage of water-soluble drug is needed
D. A smaller milligram per kilogram dosage of water-soluble drug is needed

Back 19

C. A larger milligram per kilogram dosage of water-soluble drug is needed

Since they have more water, a larger milligram per kilogram dose of water-soluble meds is needed.

Front 20

A 1 month old is given medication which is dependent on protein binding for drug distribution. As the PNP, you are aware that it may be necessary to:

A. Decrease the amount of drug and shorten the dosage interval
B. Increase the amount of drug and give at longer intervals
C. Decrease the amount of drug and give at longer intervals
D. Increase the amount of drug and shorten the dosage intervals

Back 20

A. Decrease the amount of drug and shorten the dosage interval

Infants have less circulating albumin than adults; thus, there is a decreased affinity for protein binding during the neonatal period. More drug amount is needed.