NUR 6130 Final Exam V2 | NUR 6130
Advanced Practice Nursing III | Q&A with
Rationale (NUR6130 Final Exam) | William
Paterson University
1. A 4-year-old child is brought to the clinic for a routine check-up. The nurse practitioner
notes that the child is unable to hop on one foot or copy a square. Which of the following is
the most appropriate next step?
A. Refer the child immediately to a pediatric neurologist for a developmental delay
evaluation.
B. Reassure the parents that these skills are typically mastered by age 5 or 6.
C. Perform a standardized developmental screening tool such as the Denver II.
D. Diagnose the child with gross and fine motor delay and initiate physical therapy.
Answer: C
Rationale: At age 4, children are expected to hop on one foot and copy a square. While a
delay is suspected, the clinician must first use a validated, standardized tool to quantify the
delay before making referrals. This ensures that the assessment is objective and follows
evidence-based practice guidelines for developmental surveillance.
,2. A 24-year-old female patient presents with a complaint of a thin, grayish-white vaginal
discharge with a ‘fishy’ odor that is more noticeable after intercourse. Microscopic
examination reveals clue cells. What is the first-line treatment for this condition?
A. Metronidazole 500 mg orally twice daily for 7 days.
B. Fluconazole 150 mg orally in a single dose.
C. Azithromycin 1g orally in a single dose.
D. Ceftriaxone 250 mg intramuscularly once.
Answer: A
Rationale: The clinical presentation and presence of clue cells are diagnostic of Bacterial
Vaginosis (BV). According to the CDC, the preferred treatment is oral Metronidazole for
seven days or topical clindamycin. Fluconazole is used for yeast infections, while
Azithromycin and Ceftriaxone are used for STIs like Chlamydia and Gonorrhea.
3. A 15-month-old infant is seen for a well-child visit. The mother expresses concern about
the child’s diet and iron intake. Which of the following findings would most likely suggest
iron-deficiency anemia in this toddler?
A. A history of exclusive breastfeeding until 4 months of age.
B. High intake of leafy green vegetables and lean meats.
C. Consumption of more than 24 ounces of whole cow’s milk per day.
D. The presence of a systolic murmur at the left upper sternal border.
,Answer: C
Rationale: Excessive intake of cow’s milk (more than 24 oz/day) is a major risk factor for
iron-deficiency anemia in toddlers because it displaces iron-rich foods and can cause occult
intestinal bleeding. Toddlers should be limited to 16-24 ounces of milk per day to ensure a
balanced diet. Identifying dietary patterns is a critical component of pediatric nutritional
assessment in advanced practice nursing.
4. A 32-year-old pregnant woman at 28 weeks gestation presents for a routine prenatal visit.
Her glucose challenge test (GCT) result is 155 mg/dL. What is the appropriate management
for this patient?
A. Diagnose her with Gestational Diabetes Mellitus (GDM) and start insulin.
B. Repeat the 1-hour glucose challenge test in one week.
C. Advise the patient to reduce carbohydrate intake and recheck at 32 weeks.
D. Schedule a 3-hour oral glucose tolerance test (OGTT).
Answer: D
Rationale: A 1-hour glucose challenge test result above 130-140 mg/dL is considered
abnormal and requires a follow-up 3-hour OGTT for a definitive diagnosis of GDM. The 3-
hour test involves fasting and multiple blood draws to assess how the body handles a
higher glucose load. Early diagnosis of GDM is vital to prevent maternal and neonatal
complications such as macrosomia.
, 5. An 8-year-old boy presents with a sudden onset of high fever, sore throat, and a
‘sandpaper’ rash that began on his chest and spread to his extremities. On examination, he
has a ‘strawberry tongue.’ What is the most likely diagnosis?
A. Measles (Rubeola)
B. Scarlet Fever
C. Roseola Infantum
D. Kawasaki Disease
Answer: B
Rationale: Scarlet fever is caused by Group A Streptococcus and is characterized by a sore
throat, fever, and a distinctive sandpaper-like rash. The strawberry tongue is a classic
physical finding associated with this infection. Treatment with antibiotics like Penicillin is
necessary to prevent complications such as rheumatic fever.
6. Which of the following is a contraindication for the administration of the Live Attenuated
Influenza Vaccine (LAIV) in a pediatric patient?
A. A 3-year-old child receiving long-term aspirin therapy.
B. Current diagnosis of well-controlled asthma in a 6-year-old.
C. A history of mild egg allergy manifesting only as hives.
D. Living in a household with a pregnant woman.
Answer: A
Advanced Practice Nursing III | Q&A with
Rationale (NUR6130 Final Exam) | William
Paterson University
1. A 4-year-old child is brought to the clinic for a routine check-up. The nurse practitioner
notes that the child is unable to hop on one foot or copy a square. Which of the following is
the most appropriate next step?
A. Refer the child immediately to a pediatric neurologist for a developmental delay
evaluation.
B. Reassure the parents that these skills are typically mastered by age 5 or 6.
C. Perform a standardized developmental screening tool such as the Denver II.
D. Diagnose the child with gross and fine motor delay and initiate physical therapy.
Answer: C
Rationale: At age 4, children are expected to hop on one foot and copy a square. While a
delay is suspected, the clinician must first use a validated, standardized tool to quantify the
delay before making referrals. This ensures that the assessment is objective and follows
evidence-based practice guidelines for developmental surveillance.
,2. A 24-year-old female patient presents with a complaint of a thin, grayish-white vaginal
discharge with a ‘fishy’ odor that is more noticeable after intercourse. Microscopic
examination reveals clue cells. What is the first-line treatment for this condition?
A. Metronidazole 500 mg orally twice daily for 7 days.
B. Fluconazole 150 mg orally in a single dose.
C. Azithromycin 1g orally in a single dose.
D. Ceftriaxone 250 mg intramuscularly once.
Answer: A
Rationale: The clinical presentation and presence of clue cells are diagnostic of Bacterial
Vaginosis (BV). According to the CDC, the preferred treatment is oral Metronidazole for
seven days or topical clindamycin. Fluconazole is used for yeast infections, while
Azithromycin and Ceftriaxone are used for STIs like Chlamydia and Gonorrhea.
3. A 15-month-old infant is seen for a well-child visit. The mother expresses concern about
the child’s diet and iron intake. Which of the following findings would most likely suggest
iron-deficiency anemia in this toddler?
A. A history of exclusive breastfeeding until 4 months of age.
B. High intake of leafy green vegetables and lean meats.
C. Consumption of more than 24 ounces of whole cow’s milk per day.
D. The presence of a systolic murmur at the left upper sternal border.
,Answer: C
Rationale: Excessive intake of cow’s milk (more than 24 oz/day) is a major risk factor for
iron-deficiency anemia in toddlers because it displaces iron-rich foods and can cause occult
intestinal bleeding. Toddlers should be limited to 16-24 ounces of milk per day to ensure a
balanced diet. Identifying dietary patterns is a critical component of pediatric nutritional
assessment in advanced practice nursing.
4. A 32-year-old pregnant woman at 28 weeks gestation presents for a routine prenatal visit.
Her glucose challenge test (GCT) result is 155 mg/dL. What is the appropriate management
for this patient?
A. Diagnose her with Gestational Diabetes Mellitus (GDM) and start insulin.
B. Repeat the 1-hour glucose challenge test in one week.
C. Advise the patient to reduce carbohydrate intake and recheck at 32 weeks.
D. Schedule a 3-hour oral glucose tolerance test (OGTT).
Answer: D
Rationale: A 1-hour glucose challenge test result above 130-140 mg/dL is considered
abnormal and requires a follow-up 3-hour OGTT for a definitive diagnosis of GDM. The 3-
hour test involves fasting and multiple blood draws to assess how the body handles a
higher glucose load. Early diagnosis of GDM is vital to prevent maternal and neonatal
complications such as macrosomia.
, 5. An 8-year-old boy presents with a sudden onset of high fever, sore throat, and a
‘sandpaper’ rash that began on his chest and spread to his extremities. On examination, he
has a ‘strawberry tongue.’ What is the most likely diagnosis?
A. Measles (Rubeola)
B. Scarlet Fever
C. Roseola Infantum
D. Kawasaki Disease
Answer: B
Rationale: Scarlet fever is caused by Group A Streptococcus and is characterized by a sore
throat, fever, and a distinctive sandpaper-like rash. The strawberry tongue is a classic
physical finding associated with this infection. Treatment with antibiotics like Penicillin is
necessary to prevent complications such as rheumatic fever.
6. Which of the following is a contraindication for the administration of the Live Attenuated
Influenza Vaccine (LAIV) in a pediatric patient?
A. A 3-year-old child receiving long-term aspirin therapy.
B. Current diagnosis of well-controlled asthma in a 6-year-old.
C. A history of mild egg allergy manifesting only as hives.
D. Living in a household with a pregnant woman.
Answer: A
