NR 602 Midterm Study Guide
NR 602 Midterm Study Guide – Topics 26-30
Juvenile Idiopathic Arthritis (Page 551-554)
Questions for Thought with Answers & Rationale
1. The most common rheumatoid disease of childhood is:
Systemic lupus erythematosus
Juvenile idiopathic arthritis
Legg-Calve Perthes disease
2. A 14-year-old boy os brought In by his mother who reports that her son has been complaining for several months of recurrent bloating, stomach upset, and occasional lose stools. She reports that he has difficulty gaining weight and is short for his age. … ahs noticed that his symptoms are worse after eating large amounts of crackers, cookies, and breads. She denies seeing blood in the boy’s stool. Which of the following conditions is most likely?
3. A common cause of acute abdominal pain in children under 5 years old?
4. An 18 -month old child is brought to the clinic by her mother and is c/o abrupt onset of vomiting, followed by more than 10 liquid stools with mucus for the past 48 hours. Temp is 100 degrees F orally. The stool smear obtained is negative for WBCs. What is the most likely etiologic pathogen for this young child’s gastroenteritis?
5. The viral gastroenteritis seen in older children and adults has a short incubation (18-72 hours) and short incubation (24-48 hours), is characterized by abrupt onset of nausea and abdominal cramps, followed by vomiting and diarrhea, and is often accompanied by headache and myalgia. What causes this disorder?
Enteric calicivirus (Norwalk)
6. The family nurse practitioner is interpreting the notation of “string sign” on an upper GI series performed on an infant. This is associated with the dx of:
7. What question by the FNP would be appropriate to ask the parents of an infant suspected of intussusception?
“Does the infant have clay colored stools?”
“Doe.s the infant have projectile vomiting?”
Does the infant have constant abdominal pain?”
Doe.s the infant have red currant jelly stools?”
8. A 6 year old patient with sore throat has coryza, hoarseness, and diarrhea. What is the likely etiology?
Group A Strep
9. Which of the following findings could be expected to occur in a baby with intussusception?
Olive- shaped mass
Left to right peristaltic waves
10. Vomiting in infancy has a long list of differential diagnoses. Which accompanying symptom would likely point to pyloric stenosis?
Acts hungry after vomiting
Sausage-shaped mass in abdomen
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D&M 3 NDNP 864
Midterm Study Guide
Week 1: Early child development notes (chapter 6):
Gross Motor Development
School Age Children
Growth and Development
Conceptual vs perceptual thinking:
Communication and language development:
Symptoms of stress / fear:
WEEK 2 : Chapter 8
Physiologic Changes of the Adolescent
Egocentrism of adolescents:
Principles and approaches to assessment:
Phases of adolescence:
• Early adolescence (11-14 years old): most difficult period
• Middle Adolescence (15-17 years old): stand out for their unique appearance
• Late Adolescence (18 to 21 years old): autonomy
Risk behavior assessment:
• Adolescent interviewing
Week 5: Pediatric Orthopedics 3/1/2018
Age and likelihood of disorder
Treatment of sprains:
Diagnosis plan for CP
Problems associated with CP
Signs of possible CP
Goals for CP
CP and IQ
Muscular dystrophies (MD)
Duchenne Muscular Dystrophy
Case Study: 15 yr old male, Dx with DMD at age 5, Wheelchair bound since age 9, Bipap at night, 5kg wt loss in 3 mths, now with complaints of difficulty swallowing,
• What diagnostic work-up is indicated? Swallow study (condition may cause aspiration), EMG (electromyography) to check muscles
• What is the prognosis for this condition (life span mid 20s)
• Wha.t tx/therapies are needed (thicken feeds, slow softer foods, feeding tube, speech, PT)
• What consult/referrals should be placed?
Guillian-Barre syndrome (GBS)
Case Study: 17 year old male, Hx influenza 2 wks ago, Ataxia, HA, blurred vision, Limping unable to stand on 1 foot, Denies fever, Labs norm CBC and electrolytes, What other studies would you do Laboratory Imaging: MRI or CT scan
Myasthenia Gravis (MG)
Case study (recommended reading): 2 y.o. girl presents with refusal to walk, symptoms started 3 wks ago with fever of 104 and difficulty bearing weight on both lower extremities. xray unremarkable at the time but was positive for AOM which was tx’d with amoxicillin. 1 wk later limp worsened, tx at a community clinic was NSAIDs and heating pads. Further progression brings her to the hospital; no hx of trauma or resp. s/s but 3 mths prior had bloody diarrhea +ve for E. coli and Shigella. Immunizations UTD.
PE: Afebrile, HR 100, RR 24 BP 84/60. full ROM bil. at hips and knees, no deep tendon reflexes in LE at both knees and ankles, limited dorsoflexion of the R foot, no swelling, erythema at any joints. other exam was normal.
Labs: CBC, CMP, CK, CRP, antinuclear antibodies WNL but ESR slightly elevated at 25mm/hr. LE xray and bone scan are -ve
What further test would you do? MRI and CSF
Week 4 (3/22) Mental Health
Common Pediatric Psych Diagnoses
Treating Depression & SSRI use from readings
ADHD Medication Management – from readings
Pediatric Surgery 2/22/18
Post consolidation immunotherapy
Bone Marrow Transplant
Fever and Neutropenia
Superior Vena Cava Syndrome
Spinal Cord Compression
Cancer Treatment Side effects
Guidelines for management of cancer survivors
Participation for MSN
The weekly case study discussion is worth up to 100 points. Students are expected to participate a minimum of four times (once in Part One by Tuesday, 11:59 p.m. MT, once in Part Two by Thursday, 11:59 p.m. MT, provide a written summary in SOAP format to the Dropbox by Sunday, 11:59 p.m. MT, and one post to a student peer as required in the interactive dialogue criterion). The student must provide answers to the graded case study questions from Part One, post a treatment plan for Part Two and provide a written summation of their case in SOAP format to the Dropbox for Part Three. The written summation must be submitted in a Word document and the following file naming convention be used: Last name.week#.SOAP For example: if your last name is Smith then your Week 1 SOAP note would be saved as Smith.Week1.SOAP
Outstanding or highest level of performance
Very good or high level of performance
Satisfactory level of performance
Poor or failing level of performance
Unsatisfactory level of performance
|Total Points Possible= 100|
|30 Points||26 Points||24 Points||11 Points||0 Points|
|Application of Course Knowledge||Post contributes unique perspectives/insights applicable to the results from the physical exam and diagnosis (es).Part One: Initial post includes at least three (3) appropriate differential diagnoses with rationale and answers all questions presented in the case. Demonstrates course knowledge/assigned readings by: linking questions and tests/interventions to diagnoses,linking diseases by identifying symptoms and patient information.
Parts Two and Three: Primary and secondary diagnoses and treatment plan supported with rationale from the literature. Differential diagnoses are eliminated.
All five (5) parts of the treatment plan are thorough, specific and evidence-based.
|Post contributes unique perspectives or insights, but may lack some applicability to presented case study patients.Part One: Initial post includes at least two (2) appropriate differential diagnoses with rationale and answers most of the questions presented in the case. One to two (1-2) elements of specificity identified in course expectations not met
Parts Two and Three: Confirmed diagnosis (es) and treatment plan partially applicable and evidence-based for each case study patient.
|Post has limited perspective, insights and/or applicability to presented case study patients.Part One: Initial post does not address each patient or does not include at least two (2) differential diagnoses for each patient. Some evidence-based rationale may be missing. Does not answer questions presented in the case. Two (2) or more elements of specificity from course expectations not met.
Parts Two and Three: Confirmed diagnosis and treatment plan are not applicable to specific case study or some sections may not be evidence-based.
|Post perspectives are not consistent with current practice. Three (3) or more elements from course expectations missing from parts two and/or three, differential diagnoses not eliminated from Part Two and/or Three.||Post offers no insight or application to the case study presentation.|
|30 Points||26 Points||24 Points||11 Points||0 Points|
|Support from Evidence-Based Practice (EBP)||Initial discussion posts in Parts One, Two and SOAP note are supported by evidence from appropriate sources published within the last 5 years. In-text citations and full references are provided.||Initial discussion posts for Parts One, Two, and SOAP note are partially supported by evidence from appropriate sources published within the last 5 years.
In-text citations and full references are provided.
Evidence-based reference( s) used but may not fully support the treatment plan.
|Initial discussion posts for Parts One, Two, and SOAP note are partially supported by evidence.Sources may not be scholarly in nature or may be older than 5 years.
In-text citations and/or full references may be incomplete or missing.
|Citations to non-scholarly websites given as rationale to support differential diagnoses and/or treatment plan.||Discussion posts contain no evidence-based practice reference or citation.
*Students should note that factitious sources, sources that are clearly not read by the student and used, or sources that have incorrect dates will result in an automatic zero (0) for this section for the week.
|10 Points||9 Points||8 Points||4 Points||0 Points|
|Organization||Discussion posts and SOAP notes presents case study findings in a logical, meaningful, and understandable sequence. Each problem-based learning case study patient is presented individually in all discussion posts and SOAP notes.
Part One: Discussion questions addressed individually for each patient.
|Discussion posts and SOAP notes are relevant to the topic but may be unclear or difficult to follow in places.
Part One: Discussion questions may not be addressed individually for each patient.
Part Two or SOAP note contains all elements but may not be written following SOAP note format.
|Discussion posts and SOAP notes not fully relevant to the topic. May be unclear or difficult to follow in places.
Part Two and SOAP note do not contain all components and/or may be missing data.
|Discussion post presents case findings and plan or intervention that are sometimes unclear to follow and may not always be relevant to topic.||Discussion post is not relevant to case study.|
|Interactive Dialogue||Presents case study findings and responds substantively to at least one topic-related post of a peer including evidence from appropriate sources, and all direct faculty questions posted in Parts One and Two.
|Presents case study findings and responds substantively to at least one topic-related post of a peer. Does include evidence from appropriate sources.
Responds to some direct faculty questions posted in Parts One and Two.
|Responds to a student peer and faculty questions but the posts adds limited content or insights to the discussion.
Does include evidence from appropriate sources.
|Responds to a student peer and/or faculty, but the nature of the response is not substantive.
Does not include evidence from any sources.
|Does not respond to a topic-related peer post and/or does not respond to faculty questions posted by Sunday.|
|Grammar, Syntax, APA||APA format, grammar, spelling, and/or punctuation are accurate, or with zero to one errors.||Two to four errors in APA format, grammar, spelling, and syntax noted.||Five to seven errors in APA format, grammar, spelling, and syntax noted.||Eight to nine errors in APA format, grammar, spelling, and syntax noted.||Post contains greater than ten errors in APA format, grammar, spelling, and/or punctuation or repeatedly makes the same errors after faculty feedback.|
|0 Points Deducted||Points Deducted for Late or Missing Posts|
Enters first post to part one by 11:59 p.m. MT on Tuesday; First post to part two by 11:59 p.m. MT on Thursday; and submits written summation by Sunday 11:59 p.m. MT. Written submission (SOAP notes) will NOT be accepted after Sunday 11:59 p.m. MT.
|Enters first post to Part One by 11:59 p.m. MT on Tuesday; first post to Part Two by 11:59 p.m. MT on Thursday; and enters peer response/faculty responses and written summation (SOAP) by Sunday 11:59 p.m. MT.||Ten percent (10%) per day for each late discussion post.
*See Calculating Late Posting Penalty Document
Written submissions including SOAPs will not be accepted after Sunday 11:59 p.m. MT of the week they are due.
33 points deducted per part if Part One, Part Two or SOAP note is/are not submitted by Sunday by 11:59 p.m. MT of the week they are due.