NUR 6130 Exam 4 V1 | NUR 6130
Advanced Practice Nursing III | Q&A with
Rationale (NUR6130 Exam 4) | William
Paterson University
1. A 2-year-old child presents with a ‘barky’ cough and inspiratory stridor that worsens at
night. Which of the following is the most likely diagnosis?
A. Epiglottitis
B. Croup (Laryngotracheobronchitis)
C. Bacterial Tracheitis
D. Foreign Body Aspiration
Answer: B
Rationale: Croup is most commonly caused by the parainfluenza virus and typically
presents with a hallmark barking cough. The subglottic narrowing leads to the
characteristic inspiratory stridor seen in young children. Treatment usually involves a
single dose of dexamethasone and monitoring for respiratory distress.
2. When assessing a 4-month-old infant, the nurse practitioner notes that the infant cannot
yet sit with support. What is the appropriate interpretation of this finding?
A. This is a normal finding as sitting with support typically develops around 6 months.
B. This is a significant developmental delay requiring immediate referral.
,C. The infant should be screened for cerebral palsy immediately.
D. The mother should be instructed to start intensive physical therapy exercises.
Answer: A
Rationale: Infants typically begin to sit with support between 4 and 6 months of age, with
independent sitting occurring closer to 6-8 months. A 4-month-old not sitting is generally
considered within the normal range of development. The NP should continue to monitor
milestones at the next well-child visit.
3. Which of the following physical exam findings is most suggestive of Developmental
Dysplasia of the Hip (DDH) in a 2-month-old?
A. Positive Trendelenburg sign
B. Negative Barlow maneuver
C. Asymmetric gluteal folds
D. Symmetrical thigh creases
Answer: C
Rationale: Asymmetric gluteal or thigh folds are a clinical red flag for Developmental
Dysplasia of the Hip (DDH) in infants. In infants under 3 months, the Ortolani and Barlow
maneuvers are the primary screening tools used by providers. If these signs are present, an
ultrasound of the hips is indicated for further evaluation.
, 4. A 6-year-old presents with a high fever, ‘sandpaper’ rash that began on the trunk, and a
‘strawberry tongue’. What is the most likely diagnosis?
A. Measles
B. Roseola
C. Scarlet Fever
D. Kawasaki Disease
Answer: C
Rationale: Scarlet Fever is caused by Group A Streptococcus and is characterized by a
diffuse erythematous rash that feels like sandpaper. The presence of a strawberry tongue
and circumoral pallor are also classic clinical markers. Treatment involves a full course of
antibiotics, typically penicillin or amoxicillin.
5. According to the CDC immunization schedule, which vaccines should a healthy 12-month-
old receive?
A. MMR, Varicella, and Hep A
B. DTaP, IPV, and Rotavirus
C. HPV and Meningococcal
D. Tdap and Meningococcal B
Answer: A
Advanced Practice Nursing III | Q&A with
Rationale (NUR6130 Exam 4) | William
Paterson University
1. A 2-year-old child presents with a ‘barky’ cough and inspiratory stridor that worsens at
night. Which of the following is the most likely diagnosis?
A. Epiglottitis
B. Croup (Laryngotracheobronchitis)
C. Bacterial Tracheitis
D. Foreign Body Aspiration
Answer: B
Rationale: Croup is most commonly caused by the parainfluenza virus and typically
presents with a hallmark barking cough. The subglottic narrowing leads to the
characteristic inspiratory stridor seen in young children. Treatment usually involves a
single dose of dexamethasone and monitoring for respiratory distress.
2. When assessing a 4-month-old infant, the nurse practitioner notes that the infant cannot
yet sit with support. What is the appropriate interpretation of this finding?
A. This is a normal finding as sitting with support typically develops around 6 months.
B. This is a significant developmental delay requiring immediate referral.
,C. The infant should be screened for cerebral palsy immediately.
D. The mother should be instructed to start intensive physical therapy exercises.
Answer: A
Rationale: Infants typically begin to sit with support between 4 and 6 months of age, with
independent sitting occurring closer to 6-8 months. A 4-month-old not sitting is generally
considered within the normal range of development. The NP should continue to monitor
milestones at the next well-child visit.
3. Which of the following physical exam findings is most suggestive of Developmental
Dysplasia of the Hip (DDH) in a 2-month-old?
A. Positive Trendelenburg sign
B. Negative Barlow maneuver
C. Asymmetric gluteal folds
D. Symmetrical thigh creases
Answer: C
Rationale: Asymmetric gluteal or thigh folds are a clinical red flag for Developmental
Dysplasia of the Hip (DDH) in infants. In infants under 3 months, the Ortolani and Barlow
maneuvers are the primary screening tools used by providers. If these signs are present, an
ultrasound of the hips is indicated for further evaluation.
, 4. A 6-year-old presents with a high fever, ‘sandpaper’ rash that began on the trunk, and a
‘strawberry tongue’. What is the most likely diagnosis?
A. Measles
B. Roseola
C. Scarlet Fever
D. Kawasaki Disease
Answer: C
Rationale: Scarlet Fever is caused by Group A Streptococcus and is characterized by a
diffuse erythematous rash that feels like sandpaper. The presence of a strawberry tongue
and circumoral pallor are also classic clinical markers. Treatment involves a full course of
antibiotics, typically penicillin or amoxicillin.
5. According to the CDC immunization schedule, which vaccines should a healthy 12-month-
old receive?
A. MMR, Varicella, and Hep A
B. DTaP, IPV, and Rotavirus
C. HPV and Meningococcal
D. Tdap and Meningococcal B
Answer: A
