A school-age child has frequent nosebleeds. Nasal visualization reveals fresh clots and excoriated nasal mucosa but no visible site of bleeding. Coagulation studies are normal. In spite of symptomatic measures, the child continues to have nosebleeds. What is the next course of action? Recommend use of dehumidifier. Order a topical vasoconstrictor medication. Prescribe a barrier agent such as petrolatum jelly. Refer to an otolaryngologist for further evaluation. Correct

A 12-year-old child whose weight and body mass index (BMI) are in the 75th percentile has a diastolic blood pressure that is between the 95th and 99th percentiles for age, sex, and height on three separate occasions. Which test will be prescribed for this child initially? Complete blood count Erythrocyte sedimentation rate Renal function Correct Urinalysis and electrolytes

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 12-year-old child is brought to the clinic with joint pain, a 3-week history of low-grade fever, and a facial rash. The primary care pediatric nurse practitioner palpates an enlarged liver 2 cm below the subcostal margin along with diffuse lymphadenopathy. An antinuclear antibody (ANA) test is positive. Which follow up tests should be ordered? (Select all that apply.) Double stranded DNA Correct C reactive protein procalcitonin Extractable nuclear antigen panel Correct

The primary care pediatric nurse practitioner auscultates a new grade II vibratory, mid-systolic murmur at the mid sternal border in a 4-year-old child that is louder when the child is supine. What type of murmur is most likely? Pathologic murmur Pulmonary flow murmur Still’s murmur Correct Venous hum

Which of the following mechanisms contributes to beta-cell dysfunction in type II diabetes?

This study, which was planned to be a 50 year longitudinal study, was the world’s first large prospective study of the effects of smoking to establish a convincing linkage between tobacco smoking and lung cancer.

A 12-month-old infant who had cardiopulmonary bypass with red blood cell (RBC) and plasma infusions during surgery at 8 months is seen for a well child examination. Which vaccine may be administered at this visit? Measles, mumps, and rubella (MMR) oral polio vaccine (OPV) Pneumococcal vaccine Correct Varicella vaccine

The primary care pediatric nurse practitioner evaluates a child who awoke with a sore throat and high fever after a nap. The child appears anxious and is sitting on the parent’s lap with the neck hyperextended. The physical exam reveals stridor, drooling, nasal flaring, and retractions. What will the nurse practitioner do next? Administer a broad-spectrum intravenous antibiotic. Obtain blood and throat cultures and start antibiotic therapy. Send the child to radiology for a lateral neck radiograph. Transport the child to the hospital via emergency medical services. Correct

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