STU 25SUM1 Pediatric Competency Exam
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Free STU 25SUM1 Pediatric Competency Exam Questions
The most important factor used to determine the rate of fluid replacement in a child after establishing the degree of dehydration should be the:
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hourly urine output
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percentage of weight loss
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clinical signs of dehydration
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type of dehydration, based on serum sodium concentrations
Explanation
The Correct Answer is:
B. percentage of weight loss.
Detailed Explanation:
The percentage of weight loss is the most accurate indicator for determining the degree of dehydration and guiding fluid replacement therapy in children. It reflects the proportion of body water lost relative to baseline weight. Mild dehydration corresponds to 3–5% weight loss, moderate to 6–9%, and severe to ≥10%. Fluid replacement plans are then tailored to replace both ongoing and deficit losses based on this percentage. Weight-based calculations provide an objective and quantifiable approach to restoring hydration safely and effectively.
The CDC’s recommendation for the initial administration of HPV vaccine in males is:
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age 11–12 years
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between 13 and 16 years
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between 13 and 26 years
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8–9 years of age
Explanation
The Correct Answer is:
A. age 11–12 years.
Detailed Explanation:
The Centers for Disease Control and Prevention (CDC) recommends routine administration of the human papillomavirus (HPV) vaccine at ages 11–12 years for both males and females. Vaccination can begin as early as age 9, but 11–12 is the preferred age because the immune response is strongest and protection is established before potential exposure to HPV through sexual activity. For those who start later (ages 13–26), catch-up vaccination is advised if they have not been previously vaccinated.
Initial pharmacologic treatment for pain in an adolescent recently diagnosed with epicondylitis is:
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an intra-articular corticosteroid injection
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a COX-2 inhibitor
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oral nonsteroidal anti-inflammatory drug (NSAID)
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oral acetaminophen with codeine
Explanation
The Correct Answer is:
C. oral nonsteroidal anti-inflammatory drug (NSAID).
Detailed Explanation:
Epicondylitis, commonly known as “tennis elbow” or “golfer’s elbow,” is an overuse injury causing inflammation at the tendon insertion near the elbow. The initial pharmacologic treatment for pain is oral NSAIDs such as ibuprofen or naproxen, which reduce inflammation and provide effective pain relief. These are preferred as first-line therapy in adolescents due to their safety and anti-inflammatory properties. Nonpharmacologic measures, including rest, ice, and activity modification, should also be continued alongside medication.
The pharmacologic management of cryptorchidism is:
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not recommended
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low-dose testosterone
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human chorionic gonadotropin (HCG)
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somatotropin
Explanation
The Correct Answer is:
A. not recommended.
Detailed Explanation:
Cryptorchidism (undescended testis) is a condition where one or both testes fail to descend into the scrotum by birth. While hormonal therapy using human chorionic gonadotropin (hCG) or gonadotropin-releasing hormone (GnRH) was previously used to induce testicular descent, it is no longer recommended because of low success rates, high recurrence rates, and potential adverse effects. The standard of care is surgical correction (orchiopexy), typically performed between 6 and 12 months of age. Early intervention optimizes fertility potential and reduces the risk of testicular malignancy later in life.
The child in end-stage renal disease is receiving recombinant erythropoietin to treat:
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Renal osteodystrophy
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Hyperkalemia
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Hypertension
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Anemia
Explanation
The Correct Answer is:
D. Anemia.
Detailed Explanation:
Children with end-stage renal disease (ESRD) often develop anemia due to a deficiency of erythropoietin, a hormone produced by the kidneys that stimulates red blood cell production in the bone marrow. In renal failure, the kidneys cannot produce adequate erythropoietin, leading to decreased RBC production and normocytic, normochromic anemia.
Recombinant erythropoietin (Epoetin alfa) replaces this hormone, stimulating erythropoiesis and improving oxygen-carrying capacity, energy, and growth.
Which one of the following sexually transmitted diseases (STDs) is NOT required to be reported to the Centers for Disease Control and Prevention (CDC)?
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Syphilis
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Gonorrhea
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Hepatitis B
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Human papillomavirus (HPV)
Explanation
The Correct Answer is:
D. Human papillomavirus (HPV).
Detailed Explanation:
Human papillomavirus (HPV) infection is not a nationally reportable disease to the CDC. Although HPV is the most common sexually transmitted infection in the United States, it is often asymptomatic, self-limiting, and difficult to track accurately. However, HPV-related conditions—such as cervical cancer and high-grade cervical dysplasia—are monitored through cancer registries and screening programs rather than case reporting.
The nurse practitioner suspects congenital hypothyroidism because a 3-week-old infant presents with:
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a micropenis, jitteriness, and a large posterior fontanel
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vomiting, lethargy, and poor feeding
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decreased activity, a large anterior fontanel, and poor feeding
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a rapid heart rate, irritability, and frequent stools
Explanation
The Correct Answer is:
C. decreased activity, a large anterior fontanel, and poor feeding.
Detailed Explanation:
Congenital hypothyroidism is caused by insufficient thyroid hormone production in newborns and can result in irreversible cognitive and growth delays if untreated. Early symptoms are often subtle but include decreased activity, lethargy, hypotonia, poor feeding, prolonged jaundice, constipation, and a large anterior fontanel due to delayed bone growth. Early detection through newborn screening is critical, and treatment with levothyroxine should begin immediately upon confirmation to promote normal development.
A 16-year-old adolescent female reports amenorrhea for 8 weeks. The most appropriate intervention by the nurse practitioner would be to:
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ask the adolescent if she is sexually active
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order a urine pregnancy test
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order a serum human chorionic gonadotropin (HCG) test
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order a pelvic ultrasound
Explanation
The Correct Answer is:
B. order a urine pregnancy test.
Detailed Explanation:
For any female of reproductive age presenting with amenorrhea (absence of menstruation), the first and most appropriate step is to rule out pregnancy, regardless of the reported sexual history. A urine pregnancy test is quick, noninvasive, inexpensive, and highly sensitive for detecting human chorionic gonadotropin (hCG). If the urine test is positive, further evaluation is needed to confirm intrauterine pregnancy and assess gestational age. If negative and amenorrhea persists, further diagnostic workup (serum hCG, hormone levels, or imaging) can follow based on findings.
Seborrheic dermatitis in infants is referred to as:
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erythema multiforme
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cradle cap
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hives
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impetigo
Explanation
The Correct Answer is:
B. cradle cap.
Detailed Explanation:
Cradle cap is the common term for seborrheic dermatitis in infants. It presents as greasy, yellowish scales on the scalp, sometimes extending to the face, behind the ears, or diaper area. It results from overactive sebaceous glands influenced by maternal hormones and the presence of Malassezia yeast. Treatment includes gentle washing with mild shampoo and the application of mineral oil or medicated shampoos to soften and remove scales. The condition is benign and self-limiting.
A newborns are classified according to their gestational age and weight. A newborn delivered at less than 34 weeks’ gestation is considered:
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preterm
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late preterm
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term
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postterm
Explanation
The Correct Answer is:
A. preterm.
Detailed Explanation:
Gestational-age categories are based on completed weeks. Any birth before 37 weeks is preterm. Within preterm, clinically important subgroups are: extremely preterm (<28 weeks), very preterm (28 w 0 d–31 w 6 d), and moderate (32 w 0 d–33 w 6 d). Thus, a baby born at <34 weeks is unequivocally preterm (specifically very or moderate preterm). These infants are at higher risk for respiratory distress (surfactant deficiency), apnea, thermoregulatory instability, feeding immaturity, hypoglycemia, sepsis, jaundice, and longer NICU stays. Management focuses on thermoregulation, respiratory support, early but cautious nutrition (often with parenteral support/fortification), infection prevention, and screening for complications (e.g., IVH, ROP).
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