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

A 5-month-old infant who has a 3-day history of cough and rhinorrhea has developed symptoms of respiratory distress with audible expiratory wheezes and increased coughing. The infant’s immunizations are up-to-date. The physical exam reveals a respiratory rate of 50 breaths per minute, coarse expiratory wheezing, and prolonged expiration. An oxygen saturation is 96% on room air. What is the recommended treatment for this infant? Administer a trial of bronchodilators. Obtain a viral culture of nasal washings. Order an oral corticosteroid medication. Recommend increased fluids and close follow-up. Correct

There is a sample linear regression as follows: 

During the Civil War, soldiers routinely injected themselves with morphine to cope with pain and the tragedies of war.