NURS 629 Exam 3 V1 | NURS 629 Peds |
Actual Q&A with Rationale (NURS629
Exam 3) | Maryville University
1. A 7-year-old child presents with symptoms of asthma including coughing and wheezing
more than twice a week but not daily, and nighttime awakenings 3 to 4 times per month.
How would the nurse practitioner classify this level of asthma severity?
A. Intermittent
B. Severe Persistent
C. Moderate Persistent
D. Mild Persistent
Correct Answer: D
Mild persistent asthma is characterized by symptoms occurring more than twice weekly
but not daily. Nighttime awakenings for this age group at this level occur 3 to 4 times per
month. Recognizing these clinical markers is essential for initiating the appropriate step-
wise pharmacological management.
2. Which of the following are appropriate non-pharmacological and pharmacological
interventions for a toddler diagnosed with moderate atopic dermatitis? (Select all that apply)
A. Daily hot baths to open pores
B. Use of fragrance-free emollients twice daily
,C. Application of low-potency topical corticosteroids to affected areas
D. Oral antibiotics for all flare-ups
E. Maintaining a cool environment to prevent sweating
F. Keeping fingernails short to prevent secondary infection
Correct Answer: B, C, E, F
Atopic dermatitis management focuses on skin hydration and the reduction of
inflammatory triggers. Using lukewarm baths followed by heavy emollients helps restore
the skin barrier. Topical steroids are used for active flares, while oral antibiotics are
reserved only for evidence of secondary bacterial infection like impetiginization.
3. A 14-year-old female is screened for scoliosis using the Adams forward bend test, and a
scoliometer reading of 7 degrees is noted. What is the most appropriate next step for the
nurse practitioner?
A. Order a standing PA and lateral spinal X-ray to measure the Cobb angle
B. Initiate bracing immediately
C. Recheck in 12 months
D. Refer directly to physical therapy
Correct Answer: A
A scoliometer reading of 5 to 7 degrees or greater is generally the threshold for ordering
formal imaging to determine the Cobb angle. Scoliosis is defined as a Cobb angle of 10
, degrees or more on a standing radiograph. Monitoring or referral depends on the degree of
curvature and the skeletal maturity of the patient.
4. During a well-child exam of a 2-month-old, the nurse practitioner performs the Ortolani
maneuver. What is the purpose of this specific physical exam technique?
A. To assess for knee stability
B. To check for femoral shortening
C. To reduce a dislocated hip back into the acetabulum
D. To provoke hip dislocation
Correct Answer: C
The Ortolani maneuver is used to confirm the presence of a dislocated hip by attempting
to reduce it. The practitioner abducts the hip while applying upward pressure on the
greater trochanter. A positive sign is a palpable ‘clunk’ as the femoral head relocates into
the socket.
5. A father brings his 3-year-old to the clinic because the child is refusing to move her left
arm. The child was playing ‘airplane’ with her older brother earlier in the day. On exam, the
arm is held in a pronated and slightly flexed position. What is the likely diagnosis?
A. Supracondylar fracture
B. Clavicle fracture
C. Septic arthritis of the elbow
Actual Q&A with Rationale (NURS629
Exam 3) | Maryville University
1. A 7-year-old child presents with symptoms of asthma including coughing and wheezing
more than twice a week but not daily, and nighttime awakenings 3 to 4 times per month.
How would the nurse practitioner classify this level of asthma severity?
A. Intermittent
B. Severe Persistent
C. Moderate Persistent
D. Mild Persistent
Correct Answer: D
Mild persistent asthma is characterized by symptoms occurring more than twice weekly
but not daily. Nighttime awakenings for this age group at this level occur 3 to 4 times per
month. Recognizing these clinical markers is essential for initiating the appropriate step-
wise pharmacological management.
2. Which of the following are appropriate non-pharmacological and pharmacological
interventions for a toddler diagnosed with moderate atopic dermatitis? (Select all that apply)
A. Daily hot baths to open pores
B. Use of fragrance-free emollients twice daily
,C. Application of low-potency topical corticosteroids to affected areas
D. Oral antibiotics for all flare-ups
E. Maintaining a cool environment to prevent sweating
F. Keeping fingernails short to prevent secondary infection
Correct Answer: B, C, E, F
Atopic dermatitis management focuses on skin hydration and the reduction of
inflammatory triggers. Using lukewarm baths followed by heavy emollients helps restore
the skin barrier. Topical steroids are used for active flares, while oral antibiotics are
reserved only for evidence of secondary bacterial infection like impetiginization.
3. A 14-year-old female is screened for scoliosis using the Adams forward bend test, and a
scoliometer reading of 7 degrees is noted. What is the most appropriate next step for the
nurse practitioner?
A. Order a standing PA and lateral spinal X-ray to measure the Cobb angle
B. Initiate bracing immediately
C. Recheck in 12 months
D. Refer directly to physical therapy
Correct Answer: A
A scoliometer reading of 5 to 7 degrees or greater is generally the threshold for ordering
formal imaging to determine the Cobb angle. Scoliosis is defined as a Cobb angle of 10
, degrees or more on a standing radiograph. Monitoring or referral depends on the degree of
curvature and the skeletal maturity of the patient.
4. During a well-child exam of a 2-month-old, the nurse practitioner performs the Ortolani
maneuver. What is the purpose of this specific physical exam technique?
A. To assess for knee stability
B. To check for femoral shortening
C. To reduce a dislocated hip back into the acetabulum
D. To provoke hip dislocation
Correct Answer: C
The Ortolani maneuver is used to confirm the presence of a dislocated hip by attempting
to reduce it. The practitioner abducts the hip while applying upward pressure on the
greater trochanter. A positive sign is a palpable ‘clunk’ as the femoral head relocates into
the socket.
5. A father brings his 3-year-old to the clinic because the child is refusing to move her left
arm. The child was playing ‘airplane’ with her older brother earlier in the day. On exam, the
arm is held in a pronated and slightly flexed position. What is the likely diagnosis?
A. Supracondylar fracture
B. Clavicle fracture
C. Septic arthritis of the elbow
