Kelly presents for her 6-month well visit. Her mother is worried because you found a positive Babinski reflex. You explain that a positive Babinski usually disappears by:

Question 1Kelly presents for her 6-month well visit. Her mother is worried because you found a positive Babinski reflex. You explain that a positive Babinski usually disappears by:

 

1 year

 

2 months

 

2 years

 

5 years

 

Question 2A 1-month-old male infant presents with mother for a well visit. When asked about birth history, mom reports that this is her first baby and he was breech presentation at birth, born by cesarean section. All of the following should be included in your exam and screening EXCEPT:

 

Order a hip ultrasound to complete at 6 weeks of age

 

Order a hip radiograph at 6 weeks of age

 

Check for a positive Galeazzi sign

 

Perform Barlow and Ortolani maneuvers

 

Question 3All of the following describe the Period of PURPLE crying EXCEPT:

 

Babies may resist soothing and have bouts of inconsolable crying.

 

The infant may turn blue or purple when crying.

 

It explains crying as a normal part of an infant’s development.

 

Begins at 2 weeks and continues until 3-4 months of age.

 

Question 4The following is considered to be a normal lead level and is managed by routine testing and patient education and risk assessment:

 

< 10 ug/dl

 

10-14 ug/dl

 

< 5 ug/dl

 

< 25 ug/dl

 

Question 5Which test will help you to detect strabismus in a preschooler?

 

Red reflex

 

Snellen

 

Fluorescein strip with woods lamp

 

Cover-uncover

 

Question 6A mother of a 2-week-old newborn comes to you for the first well-child exam. The infant takes only breast milk, urinates every 1-2 hours and has several soft yellow bowel movements per day. Your anticipatory guidance for this patient will include all EXCEPT:

 

Breast milk is the best milk for your baby, continue to breast feed for at least the entire first year if possible.

 

Mother should continue to take a prenatal or multivitamin daily.

 

Give baby Tylenol if he has a rectal temperature of 100.0 F or greater.

 

Baby should sleep face up in a crib or bassinette only, avoid sharing the adult bed with baby.

 

Question 7You are performing a physical exam on a 6-month-old girl. Mom is concerned about her baby’s growth. How will you determine if her concern is valid?

 

Look at the BMI growth chart.

 

Compare the weight since the last visit.

 

Evaluate the weight and height on the growth chart.

 

Evaluate the weight, length, and head circumference on the 0-36 month-old female growth chart.

 

Question 8Which is the best prescription of amoxicillin for a 6-month-old with otitis media who weighs 16 pounds, dosed at 80 mg/kg?

 

Amox 250mg/5ml; 4.5ml po BID x 10 days

 

Amox 400mg/5ml; 9ml po BID x w10 days

 

Amox 250mg/5ml; 9.5ml po TID x 10 days

 

Amox 400mg/5ml; 4ml po BID x 10 days

 

Question 9A 12-month-old child should be able to do all of the following EXCEPT:

 

Walk up steps.

 

Say Mama or Dada specifically.

 

Clap hands.

 

Indicate wants without crying.

 

Question 10A white instead of a red reflex upon eye exam of a 1-year-old child would suggest:

 

An accommodative error

 

Retinoblastoma

 

Papilledema

 

Retinal detachment

 

 

 

 

 

NRP543 Management Of Pediatric And Adolescent Populations

 

Week 2 Quiz

 

Question 1Which of the following would be helpful in distinguishing obesity vs. laree body frame in an adolescent who is concerned with her weight?

 

Triceps skinfold measurement

 

Assessing family history of body type

 

Body mass index

 

Percent of ideal body weight

 

Question 2Carlos is here for his 12-year-old physical. His BMI falls in the 97% percentile. His diagnosis today is:

 

Overweight

 

Metabolic syndrome

 

Obesity

 

Normal weight for age because he is very tall

 

Question 3The primary care pediatric nurse practitioner is examining a 15-year-old female who reports having her first period at age 13. She states that she has had five periods in the last year, with the last one 2 months prior. She participates in basketball at school. Which action is correct?

 

Perform biometric screening to determine lean body mass.

 

Prescribe oral contraceptives pills to regulate her periods.

 

Reassure her that this is perfectly normal at her age.

 

Refer her to an endocrinologist for hormonal evaluation.

 

Question 4The primary care pediatric nurse practitioner is performing a well child exam on a 17-year-old female whose mother is present during the history. The mother expresses concern that her daughter wishes to have an eyebrow piercing and states that she is opposed to the idea. What will the nurse practitioner do?

 

Provide information about piercings and encourage continued discussion.

 

Remind the adolescent that her mother is responsible for her health.

 

State that piercings are relatively harmless and are an expression of individuality.

 

Suggest that she wait until she is 18 years old and can make her own decisions.

 

Question 5The parent of an adolescent reports noting cutting marks on the teen’s arms and asks the primary care pediatric nurse practitioner what it means. What will the nurse practitioner tell this parent?

 

Cutting is a way of dealing with emotional distress.

 

It is a method of fitting in with other adolescents.

 

The behavior is common and will usually stop.

 

This type of behavior is a type of suicide attempt.

 

Question 6The primary care pediatric nurse practitioner is performing a well child assessment on a 13-year-old female whose mother asks when her daughter’s periods may start. Which information will the nurse practitioner use to help estimate the onset of periods?

 

The age of the mother’s menarche

 

The patient’s age at thelarche

 

When adrenarche occurred

 

Whether linear growth has stopped

 

Question 7The parent of an adolescent female tells the primary care pediatric nurse practitioner that the child may be the victim of cyber-bullying at school but won’t talk about it with her parents. What is the nurse practitioner’s initial response?

 

Ask about the adolescent’s school performance and friends.

 

Interview the adolescent separately from the parent.

 

Reassure the parent that suicide is a rare response to bullying.

 

Suggest that the parent discuss this with the school counselor.

 

Question 8The primary care pediatric nurse practitioner sees a 10-year-old child whose parent describes as a “class clown.” The child denies having problems at school, but acknowledges poor grades by saying, “I’m not very smart, I guess.” When counseling the parent about helping this child deal with this self-perception issue, the nurse practitioner will recommend which strategy?

 

Empower the child to make decisions and assume more responsibilities.

 

Help the child identify skills and activities that he is good at.

 

Spend time each evening helping the child with homework to improve grades.

 

Work with the teacher to set appropriate limits on school behavior.

 

Question 9The primary care pediatric nurse practitioner (PNP) prescribes a twice daily inhaled corticosteroid for a 12-year-old child. At a well child visit, the child reports not using the medication on a regular basis. Which response by the pediatric nurse practitioner demonstrates an understanding of client-centered care?

 

Asking the child to describe usual daily routines and schedules

 

Referring the family to a social worker to help with medication compliance

 

Reviewing the asthma action plan with the parent and the child

 

Teaching the child how the medication will help to control asthma symptoms

 

Question 10The primary care pediatric nurse practitioner is performing an exam on an adolescent male who asks about sexual orientation. He states he is asking this question because he is concerned that a friend is worried about being labeled as “gay.” Which response will the nurse practitioner make in this situation?

 

Provide the teen with a questionnaire to gain information about his sexuality.

 

Remind the adolescent that mandatory reporting requires disclosure to parents.

 

Suggest that the adolescent discuss sexual concerns with his parents.

 

Tell the adolescent that, unless he is in physical or mental danger, what he says will be confidential.

 

 

 

NRP543 Management Of Pediatric And Adolescent Populations

 

Week 3 Quiz

 

Question 1The vaccinations due at two months of age include:

 

IPV, DTaP, Hib, HepB, PCV13, RV

 

IPV, DTaP, Hib, PCV13

 

IPV, HepB, DTaP, Hib, PCV13

 

Question 2The vaccinations due at six months of age include:

 

DTaP, IPV, PCV13

 

HepB, DTaP, PCV13

 

IPV, DTaP, Hib, HepB, PCV13

 

Question 3The vaccinations due at 12 months of age include:

 

DTaP, MMR, VAR, PCV13. HepA

 

MMR, VAR, PCV13, HepA, Hib

 

HepB, Hib, PCV13, HepA, MMR, VAR

 

Question 4The vaccinations due at four years of age include:

 

MMR, VAR, IPV, DTaP

 

MMR, VAR

 

MMR, VAR, IPV, DTaP, LAIV

 

Question 5The vaccinations due at 11 years of age include:

 

DTaP, HPV, MenB

 

Tdap, HPV, MenACWY

 

Tdap, HPV, MenB, MenACWY, PPSV23

 

Question 6The vaccinations due at 16 years of age include:

 

MenACWY

 

MEnB

 

MenACWY, HPV, Tdap

 

Question 7Which of the following are true of the HPV vaccine?

 

Recommended at 11-12 years but can be given as early as 9 years.

 

The 3-dose series is given at 0, 1-2 months, and 6-month intervals.

 

2 doses are recommended if < 15 years old and 3 doses recommended if 15 years or older.

 

All of the above are true.

 

A and B are true.

 

Question 8If a 7-month-old never received the rotavirus vaccine, they can start it now.

 

True

 

False

 

Question 9MMR vaccine causes autism, so give each component separately.

 

True

 

False

 

Question 10Which tetanus preparation is used in a child under 7 years of age?

 

DT

 

Tdap

 

DTaP

 

 

 

NRP543 Management Of Pediatric And Adolescent Populations

 

Week 4 Quiz

 

Question 1A 4-year-old child comes into your office with complaints of cough and wheezing. In evaluating the child, the most appropriate first step would be:

 

Give an albuterol breathing treatment

 

Do a TB skin test

 

Order a chest x-ray and CBC

 

Obtain a brief history including allergies then examine the child’s respiratory system

 

Question 2On physical exam of this child with asthma, the most significant physical finding in a diagnosis of asthma would be:

 

Dark circles under the eyes

 

Bluish, boggy, nasal turbinates

 

Expiratory wheezing and rales

 

Decreased breath sounds in the LLL

 

Question 3After the diagnosis of asthma is established the appropriate management of this patient might include all of the following EXCEPT:

 

Pharmaceutical treatments

 

Referral to a Pediatric Allergist

 

Reassurance to the parents that he will outgrow it

 

Education involving the nature of the disease and identification and avoidance of triggers

 

Question 4Well controlled asthma is classified by all of the following EXCEPT:

 

Rescue medication is used 2x or less per week

 

Nighttime symptoms occur 1 or less times per month

 

Daytime symptoms occur2 time or less per week

 

Some limitations to activities

 

Question 5The differential diagnoses for this child with cough and wheezing would include all of the following EXCEPT:

 

Pneumonia

 

Bronchiolitis

 

Asthma

 

Foreign body

 

Question 6The following are true about bronchiolitis EXCEPT:

 

It is primarily a disease of infancy.

 

The most common cause is respiratory syncytial virus.

 

Blood and sputum cultures are positive for bacteria.

 

A chest x-ray will show characteristic hyperinflation.

 

Question 7The treatment for bronchiolitis may include all of the following EXCEPT:

 

Careful observation for increased respiratory distress

 

Antibiotic therapy

 

Increased liquid intake

 

Vaporize use

 

Question 8Headaches in children that wake them from sleep and are followed by vomiting are indicative of:

 

Migraine headaches

 

Sinusitis headaches

 

Cluster headaches

 

Tumors

 

Question 9A mother presents with her 4-year-old child with report that child feels like there is something in her right eye x 1-2 days. On exam, you note a small bump on her right eyelid that is red, tender, swollen and there is no discharge present. The child does not have a fever.

 

Corneal abrasion

 

Blepharitis

 

Hordeolum

 

Chalazion

 

Question 10A 13-year-old boy and his mother visit the clinic with complaints of headache for 1 day. The boy fell and hit his head while riding his skateboard without a helmet yesterday. Today he developed red eyes with a surrounding bruise. The nurse practitioner noted a small amount of clear fluid from the nose. The nurse practitioner should

 

Restrict physical activity for 2 weeks and notify the school nurse.

 

Suspect viral infection and recommend Tylenol, rest, and extra fluids.

 

Refer patient to the hospital.

 

Reassure the mother. Explain that boys of that age always have bruises. Educate on the importance of wearing a helmet while riding a skateboard.

 

 

 

NRP543 Management Of Pediatric And Adolescent Populations

 

Week 5 Quiz                                                                 

 

Question 1One of the most common causes of viral gastroenteritis is:

 

Norwalk virus

 

Rotavirus

 

Campylobacter

 

Shigella

 

Question 2The most serious case related to gastroenteritis would be:

 

Sunken fontanel in a 4-month-old, parched lips, and decreased urine output

 

A weight loss of 8 oz in a 22lb 6-month-old, pulse of 100, normal urine output

 

Pulse of 100 in a 4-year-old, altered specific gravity or urine and moist mucus membranes

 

Good oral intake, fever of 101 F, pale color and slight increase in fussiness in a 2-year-old

 

Question 3Contributing factors in cases of constipation include all of the following EXCEPT:

 

Too little fiber in diet

 

Disrupted routines

 

Psychosocial factors

 

Too little protein

 

Question 4A 7-year-old male brought to you by mother who is concerned about an itchy rash that has been getting worse on his feet and legs for the last 3 weeks. Mother states no one else has a rash at home. On exam you note a pale pink, pinpoint rash with scattered vesicles and several scabbed excoriations. The rash is linear and begins in the webs of the toes on the left foot but at ankle height on the right leg. He says it really itches and that sometimes wakes him up from sleep at night, itching intensely. You decide:

 

The diagnosis is atopic dermatitis, and the treatment is 1% hydrocortisone bid.

 

The diagnosis is varicella, and the rash will subside without treatment.

 

The diagnosis is scabies, and the treatment is Elimite cream in one application left on for 8 hours.

 

The diagnosis is roseola, no treatment because it is self-limiting.

 

Question 5The most likely organism to cause a UTI in the pediatric population is:

 

Staphylococcus Saprophyticus

 

Klebsiella

 

Chlamydiab

 

E Coli

 

Question 6One of the most commonly suggested reasons for primary enuresis is:

 

Medications such as theophylline

 

Genitourinary abnormalities

 

Family disruptions and stress

 

Delayed maturation of voiding inhibitory reflex

 

Question 7For a 6-year-old child with primary nocturnal enuresis, the first recommendation is:

 

Avoid criticism or punishment

 

Remove privileges

 

Treat with medication

 

Purchase an enuresis alarm

 

Question 8The best treatment for pediatric viral gastroenteritis would include all of the following EXCEPT:

 

An antidiarrheal agent

 

Increase fluids

 

Rest

 

Probiotic rich diet

 

Question 9You know that an adolescent male with a unilateral, red, painful scrotum has signs of:

 

Testicular torsion

 

Phimosis

 

Hydrocele

 

Glomerulonephritis

 

Question 10A mother presents with her 10-year son with complaint of a rash on his back x 1 week. Mom mentions that he has been itching his back after returning home from baseball practice. Denies fever. On exam you note 3 annular lesions up to 2cm in diameter with red scaly borders and central clearing on his low back. The best diagnosis for this child is:

 

Tinea corporis

 

Impetigo

 

Pityriasis Rosea

 

Tinea cruris

 

 

 

NRP543 Management Of Pediatric And Adolescent Populations

 

Week 6 Quiz

 

Question 1A father brings his 3-year-old son to the clinic with complaints of high fever, sore throat, and seems to have pain with swallowing because child doesn’t want to eat. His symptoms started in the last 24 hours. On exam you note the child seems anxious, is drooling, sitting in a tripod position, and has mild inspiratory stridor. The best diagnosis for this child is:

 

Retropharyngeal abscess

 

Foreign body aspiration

 

Croup

 

Epiglottitis

 

Question 2All of the following are true of Still’s murmurs EXCEPT:

 

They are usually Grade I-II/IV

 

Heard best in the lower left sternal border

 

Intensity increased when standing up or sitting

 

Intensity increases with laying supine

 

Question 3Etiologic agents responsible for 95% of the cases of meningitis in children >2 months of age have been Streptococcus pneumoniae, Neisseria meningitis and

 

Haemophilus influenzae type b

 

Escherichia coli

 

Mycococcus meningitides

 

Fluvoricoccus type c

 

Question 4Hand, foot, and mouth disease is a viral disease characterized by fever and vesicular lesions of the mouth, palms, and soles. It is caused by

 

Kawasaki’s

 

Coxsackie virus

 

Herpes virus

 

Candida albicans

 

Question 5A 10-year-old child manifests symptoms of fever, sore throat, and swollen lymph nodes. Spleen tip is palpable. Throat culture and rapid strep test results are negative. The next logical diagnostic test would involve

 

Repeat throat culture

 

Chest x-ray

 

Bone marrow aspiration

 

Epstein-Barr antibody test

 

Question 6Which of the following is TRUE regarding innocent murmurs?

 

 

 

The murmur is often holosystolic

 

Prompt referral to a cardiologist is indicated

 

A precordial thrill is present

 

Tends to disappear during later childhood

 

Question 7A 12-year-old boy seen at a routine visit has a BP of 150/96. He denies symptoms. The initial management would include

 

IV pyelogram

 

Return in 2 weeks for repeat BP measurements and keep a BP diary at home

 

No follow up needed – BP related to anxiety

 

Diuretic therapy

 

Question 8Which of the following is a common cause of acquired heart disease during childhood?

 

Lyme disease

 

Down syndrome

 

Systemic lupus

 

Kawasaki disease

 

Question 9A 5-year-old child who had a repair for transposition of the great arteries shortly after birth is growing normally and has been asymptomatic since the surgery. The primary care nurse practitioner (PNP)notes mild shortness of breath with exertion and, upon questioning, learns that the child has recently reported dizziness. What will the nurse practitioner do?

 

Order an echocardiogram and chest radiograph.

 

Perform pulmonary function testing.

 

Reassure the parent that these symptoms are common.

 

Refer the child to the cardiologist immediately.

 

Question 10A school-age child has fever of 104°F, sore throat, vomiting and malaise. The primary care pediatric nurse practitioner observes that the tonsils, oropharynx, and palate are erythematous and covered with exudate; the tongue is coated and red; and there is a red, sandpaper-like rash on the child’s neck, trunk, and extremities. A rapid strep test is positive. What will the nurse practitioner do to manage this child’s illness?

 

Administer intramuscular ceftriaxone.

 

Hospitalize for further diagnostic tests.

 

Prescribe oral amoxicillin.

 

Refer to a pediatric infectious disease specialist.

 

 

 

 

 

NRP543 Management Of Pediatric And Adolescent Populations

 

Week 7 Quiz

 

Question 1All of the following are elements of red blood cells (RBC) EXCEPT:

 

Young RBCs are referred to as erythrocytes and mature RBCs are reticulocytes.

 

RBCs live 120 days before being destroyed through phagocytosis.

 

Hemoglobin is the oxygen-carrying protein molecule in RBC.

 

They carry oxygen from the lungs to body tissues and transfer carbon dioxide from the tissue to the lungs.

 

Question 2The following are associated with which disease?

 

More commonly occurs in African descent; is a type chronic hemolytic anemia; can cause unpredictable acute complications that can become life threatening; is often identified in neonatal screening; and can be associated with a ‘pain crisis’.

 

Idiopathic thyrobocytopenic purpura (ITP)

 

Thormbophilia

 

Iron deficiency anemia

 

Sickle cell disease

 

Question 3Starr comes for her 2-year-old physical; she still drinks from a bottle and mom complains that she is a very picky eater. Her hemoglobin result is 10.1. You repeat it and it is 10.0. Your diagnosis is

 

Well child exam

 

Sickle cell anemia

 

Iron deficiency anemia

 

Thalassemia

 

Question 4Starr weighs 24 pounds, which prescription for FeSo4 dosed at 5mg/kg would be right for her?

 

None, this prescription would be inappropriate at this time

 

FeSO4 drops 75 mg (15 mg elemental FE)/ml; 1.7ml po BID x 30 days

 

FeSO4 elixir 220 mg (44 mg elemental Fe)/5 ml; 1.2ml po BID x 30 days

 

FeSO4 drops 75 mg (15 mg elemental Fe)/ml; 0.6 ml po QD x 30 days

 

Question 5Septic arthritis is most commonly caused by:

 

Group B streptococcus

 

Pseudomonas

 

Staphylococcus aureus

 

Haemophilus influenzae

 

Question 6All of the following are true of the Mentzer index EXCEPT:

 

It differentiates between iron deficiency and thalassemia.

 

It is calculated by MCV divided by RBC.

 

A ratio of less than 13 indicates thalassemia

 

It is used to differentiate between beta thalassemia major and minor.

 

Question 7A mother presents with her 4 year old daughter, Emma, with concern of left arm or shoulder pain. She denies any history of injury or trauma, but noticed Emma seems to be protecting her left arm and won’t extend it. This started after Emma was playing outside with her teenage brother who built an obstacle course and was pulling Emma by her arms over the larger obstacles. On exam, Emma is holding her left arm with her other hand, and resists any movement of her elbow, wrist, or fingers. She seems anxious. There is no erythema, warmth, edema, or signs of injury with tenderness over the radial head. The most likely diagnosis is:

 

Left clavicle fracture

 

Osteomyelitis

 

Salter Harris fracture

 

Nursemaid elbow

 

Question 8Six-year-old Jeana is brought to the clinic by her dad complaining of pain in her legs. Dad states Jeana can’t sleep at night crying due to pain in her thighs. This has been happening off and on for 3 months. Your exam is negative. Jeana is most likely to be suffering from

 

Osteosarcoma

 

Juvenile rheumatoid arthritis

 

Growing pains

 

Slipped femoral capital epiphysis

 

Question 9The primary care pediatric nurse practitioner sees a 12-month-old infant who is being fed goat’s milk and a vegetarian diet. The child is pale and has a beefy-red, sore tongue and oral mucous membranes. Which tests will the nurse practitioner order to evaluate this child’s condition?

 

Hemoglobin electrophoresis

 

RBC folate, iron, and B12 levels

 

Reticulocyte levels

 

Serum lead levels

 

Question 10A 15-year-old female reports fainting at school in class on two occasions. The adolescent’s orthostatic blood pressures are normal. The primary care pediatric nurse practitioner suspects a cardiac cause for these episodes and will order which tests before referring her to a pediatric cardiologist?

 

12-lead electrocardiogram

 

Echocardiogram

 

Tilt table testing

 

Treadmill exercise testing

 

 

 

NRP543 Management Of Pediatric And Adolescent Populations

 

Week 8 Quiz

 

Question 1All of the following are true of Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM) EXCEPT:

 

T1DM is characterized by insulin deficiency while T2DM is characterized by insulin resistance with relative insulin deficiency.

 

Patients with T1DM are not commonly overweight while patients with T2DM commonly have a BMI > 95th percentile.

 

T1DM commonly presents after onset of puberty while T2DM commonly presents at a younger age, often before age 10.

 

Aconthosis nigricans is more commonly seen in pateints with T2DM.

 

Question 2Sleep problems common in preschool years are all of the following EXCEPT:

 

Nightmares

 

Night terrors

 

Insomnia

 

Bedtime fears

 

Question 3All of the following are ways that a child is screened for type 1 diabetes during routine care EXCEPT:

 

Urinalysis

 

Growth chart evaluation

 

Finger stick blood glucose testing

 

Assessment of eating, drinking, and urinating pattern

 

Question 4The diagnostic criteria for autistic disorders include which of the following:

 

Speech delay, ataxia, mental retardation

 

Impairments in social interactions, interpersonal communication and staring spells

 

Mental retardation, impairment of social interactions and stereotypical restricted pattern of interests and activities

 

Impairment of social interactions, impairment of interpersonal communication and stereotypical restricted pattern of interests and activities

 

Question 5Which of the following is not a common sign or symptom of hypothyroidism in children?

 

Delayed growth

 

Frequent stools

 

Constipation

 

Lethargy

 

Question 6The 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?

 

Free serum T4 and TSH levels

 

Serum levothyroxine level

 

Total T4 and free T4 levels

 

TSH and total T4 levels

 

Question 7A 6-year-old female has had a recent growth spurt and an exam reveals breast and pubic hair development. Her bone age is determined to be 8 years. What will the primary care pediatric nurse practitioner do next?

 

Order LH and FSH levels and a long-acting GnRH agonist.

 

Order thyroid function tests to exclude primary hypothyroidism.

 

Reassure the parent that this is most likely idiopathic.

 

Refer the child to a pediatric endocrinologist for management.

 

Question 8A 13-year-old Native American female has a body mass index (BMI) at the 90th percentile for age. The primary care pediatric nurse practitioner notes the presence of a hyperpigmented velvet-like rash in skin folds. The child denies polydipsia, polyphagia, and polyuria. The nurse practitioner will take what action?

 

Counsel the child to lose weight to prevent type 2 diabetes.

 

Diagnose type 2 diabetes if the child has a random glucose of 180 mg/dL.

 

Order a fasting blood sample for a metabolic screen for type 2 diabetes.

 

Refer the child to a pediatric endocrinologist.

 

Question 9A 16-year-old adolescent female whose body mass index (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?

 

Dyslipidemia

 

Hypothyroidism

 

Nonalcoholic steatohepatitis

 

Polycystic ovary syndrome

 

Question 10A 14-year-old female comes to the clinic with amenorrhea for 3 months. A pregnancy test is negative. The adolescent’s body weight is at 82% of expected for height and age. The mother reports that her daughter often throws up and refuses to eat most foods. Which condition does the primary care pediatric nurse practitioner suspect?

 

Anorexia nervosa

 

Bulimia nervosa

 

Depression

 

Substance abuse

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