A 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:
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.
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