NR 602 EXAM WITH WELL VERIFIED
QUESTIONS AND ANSWERS|| GUARANTEED
PASS|| ALREADY GRADED A+|| LATEST
VERSION 2026
A school-age child has had nasal discharge and daytime cough but no fever for
12 days without improvement in symptoms. The child has not had antibiotics
recently and there is no significant antibiotic resistance in the local community.
What is the appropriate treatment for this child?
A. Amoxicillin 45 mg/kg/day
B. Amoxicillin 80-90 mg/kg/day
C. Amoxicillin-clavulanate 80-90 mg/kg/day
D. Saline irrigation for symptomatic relief - ANSWER-ANS: A
This child meets criteria for treatment of acute rhinosinusitis (ARS) based on
duration of symptoms without clinical improvement. The initial treatment is
amoxicillin 45 mg/kg/day. The higher dose is used to treat ARS in communities
with resistant S. pneumonia. If antibiotics have been used previously,
amoxicillin-clavulanate is used. The use of buffered isotonic saline into the
nasal cavity by squeeze bottle or neti pot (in late childhood and adolescence)
may be helpful, but the clinical guidelines do not support or negate the use of
saline.
The primary care pediatric nurse practitioner manages care in conjunction with
a pediatric pulmonologist for a child with cystic fibrosis. Which medication
regimen is used to facilitate airway clearance for this child?
A. Ibuprofen and azithromycin
B. Inhaled dornase alfa
,C. Ivacaftor
D. Prophylactic clindamycin - ANSWER-ANS: B
Inhaled dornase alfa is given to promote airway clearance by reducing mucus
viscosity. Ibuprofen and azithromycin is given to reduce chronic airway
inflammation. Ivacaftor is given to patients with specific gene mutations.
Antibiotic therapy is based on regular sputum cultures.
A 2-year-old child is brought to the clinic after developing a hoarse, bark-like
cough during the night with "trouble catching his breath" according to the
parent. The history reveals a 2 day history of low-grade fever and upper
respiratory symptoms. On exam, the child has a respiratory rate of 40 breaths
per minute, occasional stridor when crying, and a temperature of 101.3°F. What
is the next step in treatment for this child?
A. Administer intramuscular dexamethasone.
B. Admit the child for inpatient hospitalization.
C. Give the child a racemic epinephrine treatment in the office.
D. Prescribe oral dexamethasone for 2 days. - ANSWER-ANS: D
This child has croup with milder symptoms and may be managed at home with
oral steroids. IM steroids are given to children who are vomiting. Inpatient
admission is considered for children with respiratory distress (rates between 70
and 90 breaths per minute, severe retractions, and stridor at rest). Racemic
epinephrine is useful for more severe symptoms, especially for stridor, but is
done in the ED or hospital and should always be combined with a steroid.
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?
A. Administer a broad-spectrum intravenous antibiotic.
B. Obtain blood and throat cultures and start antibiotic therapy.
C. Send the child to radiology for a lateral neck radiograph.
,D. Transport the child to the hospital via emergency medical services. -
ANSWER-ANS: D
The child has symptoms of epiglottitis and should be transported immediately
for emergency treatment via ambulance. All of the other options may be
initiated at the hospital once the diagnosis is more certain. If the possibility of
epiglottitis is thought to be remote, a lateral neck radiograph may be obtained
prior to visualizing the throat. If epiglottitis is suspected, visualizing the throat
is contraindicated.
A child who had GABHS 2 weeks prior is in the clinic with periorbital edema,
dyspnea, and elevated blood pressure. A urinalysis reveals tea-colored urine
with hematuria and mild proteinuria. What will the primary care pediatric nurse
practitioner do to manage this condition?
A. Prescribe a 10- to 14-day course of high-dose amoxicillin.
B. Prescribe high-dose steroids in consultation with a nephrologist.
C. Reassure the parents that this condition will resolve spontaneously.
D. Refer the child to a pediatric nephrologist for hospitalization. - ANSWER-
ANS: D
This child has symptoms of post-streptococcal glomerulonephritis and signs
indicating a need for hospitalization: elevated BP, edema, and dyspnea. The
PNP should refer the child to a nephrologist for hospital admission and care.
Amoxicillin is not indicated; this condition is an immunologic response to
GABHS and not an infection. Steroids are not effective in treating this disease.
Although the condition usually does self-resolve, the child needs hospitalization
for close monitoring and follow-up.
An adolescent has right-sided flank pain without fever. A dipstick urinalysis
reveals gross hematuria without signs of infection or bacteriuria, and the
primary care pediatric nurse practitioner diagnoses possible nephrolithiasis.
What is the initial treatment for this condition?
A. Extracorporeal shockwave lithotripsy (ESWL)
B. Increasing fluid intake up to 2 L daily
C. Percutaneous removal of renal calculi
, D. Referral to a pediatric nephrologist - ANSWER-ANS: B
The first line of therapy for all stone types is increasing fluids. ESWL may be
indicated if symptoms worsen and stones are not passed. Percutaneous removal
of renal calculi and referral to nephrology may be indicated with worsening
symptoms.
A 9-month-old infant with a history of three urinary tract infections is diagnosed
with grade II vesicoureteral reflux. Which medication will be prescribed?
A. Amoxicillin 10 mg/kg as a single daily dose
B. Ceftriaxone IM 50 mg/kg as a single daily dose
C. Nitrofurantoin 1-2 mg/kg as a single daily dose
D. TMP-SMX; TMP 2 mg/kg as a single daily dose - ANSWER-ANS: D
TMP-SMX is a first-line medication for grade II VUR prophylaxis. TMP-SMX:
TMP 2 mg/kg as a single daily dose or 5 mg/kg twice/wk (based on TMP
component) if older than 1 month.Amoxicillin is a first-line treatment in infants
younger than 2 months. It is not necessary to give IM medications.
Nitrofurantoin is expensive and poorly tolerated.
A 16-year-old female reports dull, achy cramping pain in her lower abdomen
lasting 2 or 3 hours that occurs between her menstrual periods each month. The
adolescent is not sexually active. What is the treatment for this condition?
A. Abdominal ultrasound to rule out ovarian cyst
B. Oral contraceptives to suppress ovulation
C. Prostaglandin inhibitor analgesics and a heating pad
D. Referral to a pediatric gynecologist - ANSWER-ANS: C
The adolescent is experiencing mittelschmerz pain, which is thought to occur
when the follicle ruptures at the time of ovulation. Unless the pain is severe, the
adolescent should be reassured and offered strategies to relieve discomfort, such
as a heating pad and NSAIDs. The pain is intermittent and occurs between
periods; if it were persistent and severe, abdominal US would be indicated. Oral
contraceptives are rarely used to suppress ovulation when symptoms are severe.
Referral to a pediatric gynecologist is not indicated.
QUESTIONS AND ANSWERS|| GUARANTEED
PASS|| ALREADY GRADED A+|| LATEST
VERSION 2026
A school-age child has had nasal discharge and daytime cough but no fever for
12 days without improvement in symptoms. The child has not had antibiotics
recently and there is no significant antibiotic resistance in the local community.
What is the appropriate treatment for this child?
A. Amoxicillin 45 mg/kg/day
B. Amoxicillin 80-90 mg/kg/day
C. Amoxicillin-clavulanate 80-90 mg/kg/day
D. Saline irrigation for symptomatic relief - ANSWER-ANS: A
This child meets criteria for treatment of acute rhinosinusitis (ARS) based on
duration of symptoms without clinical improvement. The initial treatment is
amoxicillin 45 mg/kg/day. The higher dose is used to treat ARS in communities
with resistant S. pneumonia. If antibiotics have been used previously,
amoxicillin-clavulanate is used. The use of buffered isotonic saline into the
nasal cavity by squeeze bottle or neti pot (in late childhood and adolescence)
may be helpful, but the clinical guidelines do not support or negate the use of
saline.
The primary care pediatric nurse practitioner manages care in conjunction with
a pediatric pulmonologist for a child with cystic fibrosis. Which medication
regimen is used to facilitate airway clearance for this child?
A. Ibuprofen and azithromycin
B. Inhaled dornase alfa
,C. Ivacaftor
D. Prophylactic clindamycin - ANSWER-ANS: B
Inhaled dornase alfa is given to promote airway clearance by reducing mucus
viscosity. Ibuprofen and azithromycin is given to reduce chronic airway
inflammation. Ivacaftor is given to patients with specific gene mutations.
Antibiotic therapy is based on regular sputum cultures.
A 2-year-old child is brought to the clinic after developing a hoarse, bark-like
cough during the night with "trouble catching his breath" according to the
parent. The history reveals a 2 day history of low-grade fever and upper
respiratory symptoms. On exam, the child has a respiratory rate of 40 breaths
per minute, occasional stridor when crying, and a temperature of 101.3°F. What
is the next step in treatment for this child?
A. Administer intramuscular dexamethasone.
B. Admit the child for inpatient hospitalization.
C. Give the child a racemic epinephrine treatment in the office.
D. Prescribe oral dexamethasone for 2 days. - ANSWER-ANS: D
This child has croup with milder symptoms and may be managed at home with
oral steroids. IM steroids are given to children who are vomiting. Inpatient
admission is considered for children with respiratory distress (rates between 70
and 90 breaths per minute, severe retractions, and stridor at rest). Racemic
epinephrine is useful for more severe symptoms, especially for stridor, but is
done in the ED or hospital and should always be combined with a steroid.
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?
A. Administer a broad-spectrum intravenous antibiotic.
B. Obtain blood and throat cultures and start antibiotic therapy.
C. Send the child to radiology for a lateral neck radiograph.
,D. Transport the child to the hospital via emergency medical services. -
ANSWER-ANS: D
The child has symptoms of epiglottitis and should be transported immediately
for emergency treatment via ambulance. All of the other options may be
initiated at the hospital once the diagnosis is more certain. If the possibility of
epiglottitis is thought to be remote, a lateral neck radiograph may be obtained
prior to visualizing the throat. If epiglottitis is suspected, visualizing the throat
is contraindicated.
A child who had GABHS 2 weeks prior is in the clinic with periorbital edema,
dyspnea, and elevated blood pressure. A urinalysis reveals tea-colored urine
with hematuria and mild proteinuria. What will the primary care pediatric nurse
practitioner do to manage this condition?
A. Prescribe a 10- to 14-day course of high-dose amoxicillin.
B. Prescribe high-dose steroids in consultation with a nephrologist.
C. Reassure the parents that this condition will resolve spontaneously.
D. Refer the child to a pediatric nephrologist for hospitalization. - ANSWER-
ANS: D
This child has symptoms of post-streptococcal glomerulonephritis and signs
indicating a need for hospitalization: elevated BP, edema, and dyspnea. The
PNP should refer the child to a nephrologist for hospital admission and care.
Amoxicillin is not indicated; this condition is an immunologic response to
GABHS and not an infection. Steroids are not effective in treating this disease.
Although the condition usually does self-resolve, the child needs hospitalization
for close monitoring and follow-up.
An adolescent has right-sided flank pain without fever. A dipstick urinalysis
reveals gross hematuria without signs of infection or bacteriuria, and the
primary care pediatric nurse practitioner diagnoses possible nephrolithiasis.
What is the initial treatment for this condition?
A. Extracorporeal shockwave lithotripsy (ESWL)
B. Increasing fluid intake up to 2 L daily
C. Percutaneous removal of renal calculi
, D. Referral to a pediatric nephrologist - ANSWER-ANS: B
The first line of therapy for all stone types is increasing fluids. ESWL may be
indicated if symptoms worsen and stones are not passed. Percutaneous removal
of renal calculi and referral to nephrology may be indicated with worsening
symptoms.
A 9-month-old infant with a history of three urinary tract infections is diagnosed
with grade II vesicoureteral reflux. Which medication will be prescribed?
A. Amoxicillin 10 mg/kg as a single daily dose
B. Ceftriaxone IM 50 mg/kg as a single daily dose
C. Nitrofurantoin 1-2 mg/kg as a single daily dose
D. TMP-SMX; TMP 2 mg/kg as a single daily dose - ANSWER-ANS: D
TMP-SMX is a first-line medication for grade II VUR prophylaxis. TMP-SMX:
TMP 2 mg/kg as a single daily dose or 5 mg/kg twice/wk (based on TMP
component) if older than 1 month.Amoxicillin is a first-line treatment in infants
younger than 2 months. It is not necessary to give IM medications.
Nitrofurantoin is expensive and poorly tolerated.
A 16-year-old female reports dull, achy cramping pain in her lower abdomen
lasting 2 or 3 hours that occurs between her menstrual periods each month. The
adolescent is not sexually active. What is the treatment for this condition?
A. Abdominal ultrasound to rule out ovarian cyst
B. Oral contraceptives to suppress ovulation
C. Prostaglandin inhibitor analgesics and a heating pad
D. Referral to a pediatric gynecologist - ANSWER-ANS: C
The adolescent is experiencing mittelschmerz pain, which is thought to occur
when the follicle ruptures at the time of ovulation. Unless the pain is severe, the
adolescent should be reassured and offered strategies to relieve discomfort, such
as a heating pad and NSAIDs. The pain is intermittent and occurs between
periods; if it were persistent and severe, abdominal US would be indicated. Oral
contraceptives are rarely used to suppress ovulation when symptoms are severe.
Referral to a pediatric gynecologist is not indicated.
