NURS 629 EXAM 4 MARYVILLE ACTUAL TEST
SCRIPT 2026 COMPLETE QUESTIONS AND
ANSWERS GRADED A+
◉ The parent of an infant asks about using a probiotic medication.
What will the primary care pediatric nurse practitioner tell this
parent? Answer: there is no conclusive evidence about using
probiotics to treat colic.
◉ 2. A toddler who was born prematurely refuses most solid foods
and has poor weight gain. A barium swallow study reveals a normal
esophagus. What will the primary care pediatric nurse practitioner
consider next to manage this child's nutritional needs? Answer:
Video fluoroscopy swallowing study
◉ 3. A toddler is seen in the clinic after a 2day history of
intermittent vomiting and diarrhea. An assessment reveals an
irritable child with dry mucous membranes, 3second capillary refill,
2 second recoil of skin, mild tachycardia and tachypnea, and cool
hands and feet.
The child has had two wet diapers in the past 24 hours. What will
the primary care pediatric nurse practitioner recommend? Answer:
Oral rehydration solution with followup in 24 hours
,◉ 4. A 9yearold girl has a history of frequent vomiting and her
mother has frequent migraine headaches. The child has recently
begun having more frequent and prolonged episodes accompanied
by headaches. An exam reveals abnormal eye movements and mild
ataxia. What is the correct action? Answer: Refer to a pediatric
gastroenterologist for further workup.
◉ 5. The parent of a 3monthold reports that the infant arches and
gags while feeding Answer: Begin a trial of extensively hydrolyzed
protein formula for 2 to 4 weeks.
◉ A schoolage child has a 3month history of dull, aching epigastric
pain that worsens with eating and awakens the child from sleep. A
complete blood count shows a
hemoglobin of 8 mg/dL. What is the next step in management?
Answer: Referral for esophagogastroduodenoscopy (EGD)
◉ 7. A 2monthold infant cries up to 4 hours each day and, according
to the parents, is inconsolable during crying episodes with fists and
legs noted to be tense and stiff. The infant is breastfeeding
frequently but is often fussy during feedings. The physical exam is
normal and the infant is gaining weight normally. What will the
primary care pediatric nurse practitioner recommend? Answer:
Eliminating certain foods from the mother's diet
,◉ 8. A child is in the clinic after swallowing a metal bead. A
radiograph of the GI tract shows a 6 mm cylindrical object in the
child's stomach. The child is able to swallow without difficulty and is
not experiencing pain. What is the correct course of treatment?
Answer: Have the parents watch for the object in the child's stool
◉ 9. A 10yearold child has had abdominal pain for 2 days, which
began in the periumbilical area and then localized to the right lower
quadrant. The child vomited once today and then experienced relief
from pain followed by an increased fever. What is the likely
diagnosis? Answer: Appendicitis with perforation
◉ An 18monthold child has a 1day history of intermittent, cramping
abdominal pain with nonbilious vomiting. The child is observed to
scream and draw up his legs during pain episodes and becomes
lethargic in between. The primary care pediatric nurse practitioner
notes a small amount of bloody, mucous stool in the diaper. What is
the most likely diagnosis? Answer: Intussusception
◉ 13. A schoolage child has recurrent diarrhea with foulsmelling
stools, excessive flatus, abdominal distension, and failuretothrive. A
2week lactosefree trial failed to reduce symptoms. What is the next
step in diagnosing this condition? Answer: Serologic testing for
celiac disease
◉ 12. An adolescent is diagnosed with functional abdominal pain
(FAP). The child's
, symptoms worsen during stressful events, especially with school
anxiety. What will be an important
part of treatment for this child? Answer: Teaching about the
braingut interaction causing symptoms
◉ 11. A schoolage child has had abdominal pain for 3 months that
occurs once or twice weekly and is associated with a headache and
occasional difficulty sleeping, often causing the child to
stay home from school. The child does not have vomiting or diarrhea
and is gaining weight normally.
The physical exam is normal. According to Bishop, what is included
in the initial diagnostic workup for
this child? Answer: CBC, ESR, amylase, lipase, UA, and abdominal
ultrasound
◉ A 30monthold girl who has been toilet trained for 6 months has
daytime enuresis and dysuria and a lowgrade fever. A dipstick
urinalysis is negative for leukocyte esterase and nitrites. What is the
next step? Answer: Send the urine to the lab for culture.
◉ 2. The clean catch urine specimen of a child with dysuria,
frequency, and fever has
a colony count between 50,000 and 100,000 of E. coli. What is the
treatment for this child? Answer: Treat with antibiotics for urinary
tract infection
SCRIPT 2026 COMPLETE QUESTIONS AND
ANSWERS GRADED A+
◉ The parent of an infant asks about using a probiotic medication.
What will the primary care pediatric nurse practitioner tell this
parent? Answer: there is no conclusive evidence about using
probiotics to treat colic.
◉ 2. A toddler who was born prematurely refuses most solid foods
and has poor weight gain. A barium swallow study reveals a normal
esophagus. What will the primary care pediatric nurse practitioner
consider next to manage this child's nutritional needs? Answer:
Video fluoroscopy swallowing study
◉ 3. A toddler is seen in the clinic after a 2day history of
intermittent vomiting and diarrhea. An assessment reveals an
irritable child with dry mucous membranes, 3second capillary refill,
2 second recoil of skin, mild tachycardia and tachypnea, and cool
hands and feet.
The child has had two wet diapers in the past 24 hours. What will
the primary care pediatric nurse practitioner recommend? Answer:
Oral rehydration solution with followup in 24 hours
,◉ 4. A 9yearold girl has a history of frequent vomiting and her
mother has frequent migraine headaches. The child has recently
begun having more frequent and prolonged episodes accompanied
by headaches. An exam reveals abnormal eye movements and mild
ataxia. What is the correct action? Answer: Refer to a pediatric
gastroenterologist for further workup.
◉ 5. The parent of a 3monthold reports that the infant arches and
gags while feeding Answer: Begin a trial of extensively hydrolyzed
protein formula for 2 to 4 weeks.
◉ A schoolage child has a 3month history of dull, aching epigastric
pain that worsens with eating and awakens the child from sleep. A
complete blood count shows a
hemoglobin of 8 mg/dL. What is the next step in management?
Answer: Referral for esophagogastroduodenoscopy (EGD)
◉ 7. A 2monthold infant cries up to 4 hours each day and, according
to the parents, is inconsolable during crying episodes with fists and
legs noted to be tense and stiff. The infant is breastfeeding
frequently but is often fussy during feedings. The physical exam is
normal and the infant is gaining weight normally. What will the
primary care pediatric nurse practitioner recommend? Answer:
Eliminating certain foods from the mother's diet
,◉ 8. A child is in the clinic after swallowing a metal bead. A
radiograph of the GI tract shows a 6 mm cylindrical object in the
child's stomach. The child is able to swallow without difficulty and is
not experiencing pain. What is the correct course of treatment?
Answer: Have the parents watch for the object in the child's stool
◉ 9. A 10yearold child has had abdominal pain for 2 days, which
began in the periumbilical area and then localized to the right lower
quadrant. The child vomited once today and then experienced relief
from pain followed by an increased fever. What is the likely
diagnosis? Answer: Appendicitis with perforation
◉ An 18monthold child has a 1day history of intermittent, cramping
abdominal pain with nonbilious vomiting. The child is observed to
scream and draw up his legs during pain episodes and becomes
lethargic in between. The primary care pediatric nurse practitioner
notes a small amount of bloody, mucous stool in the diaper. What is
the most likely diagnosis? Answer: Intussusception
◉ 13. A schoolage child has recurrent diarrhea with foulsmelling
stools, excessive flatus, abdominal distension, and failuretothrive. A
2week lactosefree trial failed to reduce symptoms. What is the next
step in diagnosing this condition? Answer: Serologic testing for
celiac disease
◉ 12. An adolescent is diagnosed with functional abdominal pain
(FAP). The child's
, symptoms worsen during stressful events, especially with school
anxiety. What will be an important
part of treatment for this child? Answer: Teaching about the
braingut interaction causing symptoms
◉ 11. A schoolage child has had abdominal pain for 3 months that
occurs once or twice weekly and is associated with a headache and
occasional difficulty sleeping, often causing the child to
stay home from school. The child does not have vomiting or diarrhea
and is gaining weight normally.
The physical exam is normal. According to Bishop, what is included
in the initial diagnostic workup for
this child? Answer: CBC, ESR, amylase, lipase, UA, and abdominal
ultrasound
◉ A 30monthold girl who has been toilet trained for 6 months has
daytime enuresis and dysuria and a lowgrade fever. A dipstick
urinalysis is negative for leukocyte esterase and nitrites. What is the
next step? Answer: Send the urine to the lab for culture.
◉ 2. The clean catch urine specimen of a child with dysuria,
frequency, and fever has
a colony count between 50,000 and 100,000 of E. coli. What is the
treatment for this child? Answer: Treat with antibiotics for urinary
tract infection
