NSG 5442 PEDIATRIC NP EXAM 2 RATIONALE
STUDY GUIDE QUESTIONS AND ANSWERS
2026 UPDATE 100% CORRECT - SC.
200 QUESTIONS
TABLE OF CONTENTS
Differentiate complex pediatric Select and justify evidence-based
presentations using advanced clinical management plans for pediatric conditions
Q1 - previously healthy school-age child presents Q26 - assessment finding would most effectively
Q2 - managing a child with moderate Q27 - a child with newly diagnosed
Q3 - 4-year-old presents with a 3-day Q28 - of the following is the
Q4 - of the following best explains Q29 - toddler presents with a 2-day
Q5 - 2-month-old infant presents with poor Q30 - of the following is the
Q6 - of the following best describes Q31 - a child with suspected acute
Q7 - 6-year-old with a history of Q32 - 4-year-old presents with acute-onset stri...
Q8 - of the following is the Q33 - of the following best differentiates
Q9 - 3-year-old presents with a 2-day Q34 - of the following findings is
Q10 - a child with suspected intussusception, Q35 - child with sickle cell disease
Q11 - a school-based asthma program, a Q36 - of the following findings on
Q12 - 14-year-old with type 1 diabetes Q37 - 6-month-old infant presents with poor
Q13 - combination of findings is most Q38 - of the following findings is
Q14 - 16-year-old female presents with a Q39 - of the following is the
Q15 - 3-year-old presents with a 2-day Q40 - child with asthma is on
Q16 - NP is evaluating a 2-year-old Q41 - a child with suspected acute
Q17 - 7-year-old with asthma is well-controlled Q42 - child with a history of
Q18 - 12-year-old with a history of Q43 - the management of a child
Q19 - 4-year-old with a history of Q44 - of the following best explains
Q20 - 15-year-old presents with a 5-day Q45 - child with cystic fibrosis has
Q21 - a child with suspected acute Q46 - a child with suspected intussusception,
Q22 - school-age child presents with acute-onset Q47 - of the following findings in
Q23 - finding on a newborn's screening Q48 - child with a ventriculoperitoneal shunt
Q24 - managing an infant with bronchiolitis, Q49 - of the following best explains
Q25 - 6-year-old presents with fever, cough, Q50 - a child with suspected appendicitis,
Page 1
,Interpret diagnostic data to guide safe and NSG 5442 Pediatric NP Exam 2 Rationale
effective pharmacologic and Study Guide Questions and Answers 2026
Q51 - clinician is evaluating a child Q76 - 4-year-old with type 1 diabetes
Q52 - managing a child with severe Q77 - child with sickle cell disease
Q53 - school-age child presents with a Q78 - 2-year-old has a 3-day history
Q54 - of the following best explains Q79 - 5-year-old with a history of
Q55 - a child with type 1 Q80 - of the following best reflects
Q56 - prescribing an antibiotic for a Q81 - a school-based asthma program, a
Q57 - child with asthma is being Q82 - 14-year-old with type 1 diabetes
Q58 - of the following findings is Q83 - 6-year-old is brought in with
Q59 - assessing a child for suspected Q84 - 3-year-old with a history of
Q60 - of the following immunization recommendat... Q85 - 16-year-old with moderate persistent asthma
Q61 - child with severe asthma is Q86 - 4-year-old with type 1 diabetes
Q62 - a term infant with suspected Q87 - 9-year-old with asthma is being
Q63 - 4-year-old presents with a 2-day Q88 - 12-year-old with type 1 diabetes
Q64 - school-age child with a history Q89 - 7-year-old with mild intermittent asthma
Q65 - 6-month-old infant with bronchiolitis is Q90 - 5-year-old with type 1 diabetes
Q66 - a child with acute rheumatic Q91 - a child with suspected appendicitis,
Q67 - 10-year-old with a history of Q92 - school-age child presents with acute-onset
Q68 - 14-year-old female presents with acute Q93 - previously healthy child presents with
Q69 - 2-month-old infant with poor weight Q94 - of the following represents the
Q70 - 5-year-old with a history of Q95 - child with a history of
Q71 - school-age child with asthma has Q96 - child with suspected bacterial meningitis
Q72 - a child with suspected growth Q97 - child with a history of
Q73 - 3-year-old presents with acute-onset stri... Q98 - 10-year-old child is diagnosed with
Q74 - 6-month-old infant with bronchiolitis has Q99 - child with a ventriculoperitoneal shunt
Q75 - clinical scenario most strongly suggests Q100 - child with a history of
Page 2
,Foundations of Pediatric Nurse Practitioner Applied Pediatric Nurse Practitioner (PNP) -
(PNP) - Advanced Clinical Reasoning Advanced Clinical Reasoning
Q101 - previously healthy adolescent presents with Q126 - finding on a newborn metabolic
Q102 - child with a history of Q127 - 6-year-old presents with recurrent abdominal
Q103 - According to the 2026 AAP Q128 - combination of clinical findings most
Q104 - 2-year-old with a history of Q129 - an infant with bronchiolitis, which
Q105 - school-age child presents with a Q130 - of the following is the
Q106 - pediatric patient with cystic fibrosis Q131 - a pediatric clinic, a 4-year-old
Q107 - 4-year-old presents with a 2-day Q132 - child with moderate persistent asthma
Q108 - 6-year-old with a history of Q133 - 6-year-old is diagnosed with uncomplicated
Q109 - neonate is noted to have Q134 - of the following best explains
Q110 - 14-year-old female presents with weight Q135 - 7-year-old with ADHD is being
Q111 - 4-year-old presents with a 3-day Q136 - managing a pediatric migraine, which
Q112 - of the following best describes Q137 - laboratory finding is most consistent
Q113 - school-age child with a history Q138 - 9-year-old with type 1 diabetes
Q114 - pediatric patient with severe asthma Q139 - of the following is the
Q115 - 6-year-old is diagnosed with a Q140 - 12-year-old with asthma uses a
Q116 - of the following is the Q141 - a child with suspected intussusception,
Q117 - 7-year-old with a history of Q142 - child presents with acute hemiparesis
Q118 - of the following is a Q143 - of the following best explains
Q119 - 5-year-old with a history of Q144 - previously healthy child presents with
Q120 - of the following findings is Q145 - of the following best explains
Q121 - a neonate with suspected sepsis, Q146 - child with suspected appendicitis has
Q122 - pathophysiologic mechanism best explains the Q147 - of the following is the
Q123 - 3-month-old infant presents with poor Q148 - child presents with vomiting, diarrhea,
Q124 - a school-aged child with persistent Q149 - of the following findings in
Q125 - For a pediatric patient with Q150 - child with a ventricular septal
Page 3
, Advanced Pediatric Nurse Practitioner (PNP) Pediatric Nurse Practitioner (PNP) -
- Advanced Clinical Reasoning Advanced Clinical Reasoning Review
Q151 - provider is evaluating a child Q176 - 7-year-old with asthma is prescribed
Q152 - managing a child with moderate Q177 - 5-year-old is brought in with
Q153 - school-age child presents with a Q178 - 13-year-old is diagnosed with mild
Q154 - developmental milestone is typically achi... Q179 - 4-year-old with a history of
Q155 - pediatric provider is assessing a Q180 - 15-year-old with sickle cell disease
Q156 - of the following findings in Q181 - 4-year-old presents with a 2-day
Q157 - child with a history of Q182 - An infant with suspected pyloric
Q158 - of the following immunizations is Q183 - school-age child with asthma is
Q159 - pediatric patient presents with a Q184 - 10-year-old with a history of
Q160 - of the following is the Q185 - 7-year-old with acute lymphoblastic leukemia
Q161 - a child with suspected growth Q186 - a child with suspected acute
Q162 - pathophysiological mechanism best explain... Q187 - 6-month-old infant presents with failure
Q163 - child with persistent asthma is Q188 - 12-year-old with type 1 diabetes
Q164 - finding is most consistent with Q189 - 5-year-old with a history of
Q165 - 6-month-old infant presents with failure Q190 - 14-year-old with cystic fibrosis has
Q166 - clinical scenario most likely indicates Q191 - 14-year-old with cystic fibrosis presents
Q167 - an infant with suspected congenital Q192 - a child with severe asthma
Q168 - statement best reflects the current Q193 - of the following best explains
Q169 - finding is most consistent with Q194 - 6-year-old with acute lymphoblastic leukemia
Q170 - a child with suspected acute Q195 - of the following findings is
Q171 - 10-year-old with severe persistent asthma Q196 - 3-year-old with a history of
Q172 - 14-year-old with no prior seizures Q197 - a child with suspected urinary
Q173 - 6-year-old with ADHD is being Q198 - of the following is the
Q174 - 12-year-old with type 1 diabetes Q199 - 2-month-old infant presents with poor
Q175 - 9-year-old presents with fever, sore Q200 - of the following is the
Q1 DIFFERENTIATE COMPLEX PEDIATRIC PRESENTATIONS USING ADVANCED CLINICAL
REASONING AND CURRENT EVIDENCE
A previously healthy school-age child presents with fever, pharyngitis, and a
sandpaper-like rash on the trunk. Rapid strep test is negative. Given the clinical
suspicion, which additional finding would most strongly support a diagnosis of
scarlet fever over a viral exanthem?
A. Palatal petechiae and strawberry tongue CORRECT
B. Bilateral conjunctival injection without discharge
C. Cervical lymphadenopathy and hepatosplenomegaly
D. Presence of cough and coryza
RATIONALE: Scarlet fever is caused by group A Streptococcus and presents with pharyngitis,
fever, and a fine erythematous rash. Palatal petechiae and strawberry tongue are specific clinical
findings supporting streptococcal infection. Viral exanthems often present with cough, coryza,
and conjunctivitis (B, D). Hepatosplenomegaly (C) is more consistent with viral syndromes like
EBV.
Page 4
STUDY GUIDE QUESTIONS AND ANSWERS
2026 UPDATE 100% CORRECT - SC.
200 QUESTIONS
TABLE OF CONTENTS
Differentiate complex pediatric Select and justify evidence-based
presentations using advanced clinical management plans for pediatric conditions
Q1 - previously healthy school-age child presents Q26 - assessment finding would most effectively
Q2 - managing a child with moderate Q27 - a child with newly diagnosed
Q3 - 4-year-old presents with a 3-day Q28 - of the following is the
Q4 - of the following best explains Q29 - toddler presents with a 2-day
Q5 - 2-month-old infant presents with poor Q30 - of the following is the
Q6 - of the following best describes Q31 - a child with suspected acute
Q7 - 6-year-old with a history of Q32 - 4-year-old presents with acute-onset stri...
Q8 - of the following is the Q33 - of the following best differentiates
Q9 - 3-year-old presents with a 2-day Q34 - of the following findings is
Q10 - a child with suspected intussusception, Q35 - child with sickle cell disease
Q11 - a school-based asthma program, a Q36 - of the following findings on
Q12 - 14-year-old with type 1 diabetes Q37 - 6-month-old infant presents with poor
Q13 - combination of findings is most Q38 - of the following findings is
Q14 - 16-year-old female presents with a Q39 - of the following is the
Q15 - 3-year-old presents with a 2-day Q40 - child with asthma is on
Q16 - NP is evaluating a 2-year-old Q41 - a child with suspected acute
Q17 - 7-year-old with asthma is well-controlled Q42 - child with a history of
Q18 - 12-year-old with a history of Q43 - the management of a child
Q19 - 4-year-old with a history of Q44 - of the following best explains
Q20 - 15-year-old presents with a 5-day Q45 - child with cystic fibrosis has
Q21 - a child with suspected acute Q46 - a child with suspected intussusception,
Q22 - school-age child presents with acute-onset Q47 - of the following findings in
Q23 - finding on a newborn's screening Q48 - child with a ventriculoperitoneal shunt
Q24 - managing an infant with bronchiolitis, Q49 - of the following best explains
Q25 - 6-year-old presents with fever, cough, Q50 - a child with suspected appendicitis,
Page 1
,Interpret diagnostic data to guide safe and NSG 5442 Pediatric NP Exam 2 Rationale
effective pharmacologic and Study Guide Questions and Answers 2026
Q51 - clinician is evaluating a child Q76 - 4-year-old with type 1 diabetes
Q52 - managing a child with severe Q77 - child with sickle cell disease
Q53 - school-age child presents with a Q78 - 2-year-old has a 3-day history
Q54 - of the following best explains Q79 - 5-year-old with a history of
Q55 - a child with type 1 Q80 - of the following best reflects
Q56 - prescribing an antibiotic for a Q81 - a school-based asthma program, a
Q57 - child with asthma is being Q82 - 14-year-old with type 1 diabetes
Q58 - of the following findings is Q83 - 6-year-old is brought in with
Q59 - assessing a child for suspected Q84 - 3-year-old with a history of
Q60 - of the following immunization recommendat... Q85 - 16-year-old with moderate persistent asthma
Q61 - child with severe asthma is Q86 - 4-year-old with type 1 diabetes
Q62 - a term infant with suspected Q87 - 9-year-old with asthma is being
Q63 - 4-year-old presents with a 2-day Q88 - 12-year-old with type 1 diabetes
Q64 - school-age child with a history Q89 - 7-year-old with mild intermittent asthma
Q65 - 6-month-old infant with bronchiolitis is Q90 - 5-year-old with type 1 diabetes
Q66 - a child with acute rheumatic Q91 - a child with suspected appendicitis,
Q67 - 10-year-old with a history of Q92 - school-age child presents with acute-onset
Q68 - 14-year-old female presents with acute Q93 - previously healthy child presents with
Q69 - 2-month-old infant with poor weight Q94 - of the following represents the
Q70 - 5-year-old with a history of Q95 - child with a history of
Q71 - school-age child with asthma has Q96 - child with suspected bacterial meningitis
Q72 - a child with suspected growth Q97 - child with a history of
Q73 - 3-year-old presents with acute-onset stri... Q98 - 10-year-old child is diagnosed with
Q74 - 6-month-old infant with bronchiolitis has Q99 - child with a ventriculoperitoneal shunt
Q75 - clinical scenario most strongly suggests Q100 - child with a history of
Page 2
,Foundations of Pediatric Nurse Practitioner Applied Pediatric Nurse Practitioner (PNP) -
(PNP) - Advanced Clinical Reasoning Advanced Clinical Reasoning
Q101 - previously healthy adolescent presents with Q126 - finding on a newborn metabolic
Q102 - child with a history of Q127 - 6-year-old presents with recurrent abdominal
Q103 - According to the 2026 AAP Q128 - combination of clinical findings most
Q104 - 2-year-old with a history of Q129 - an infant with bronchiolitis, which
Q105 - school-age child presents with a Q130 - of the following is the
Q106 - pediatric patient with cystic fibrosis Q131 - a pediatric clinic, a 4-year-old
Q107 - 4-year-old presents with a 2-day Q132 - child with moderate persistent asthma
Q108 - 6-year-old with a history of Q133 - 6-year-old is diagnosed with uncomplicated
Q109 - neonate is noted to have Q134 - of the following best explains
Q110 - 14-year-old female presents with weight Q135 - 7-year-old with ADHD is being
Q111 - 4-year-old presents with a 3-day Q136 - managing a pediatric migraine, which
Q112 - of the following best describes Q137 - laboratory finding is most consistent
Q113 - school-age child with a history Q138 - 9-year-old with type 1 diabetes
Q114 - pediatric patient with severe asthma Q139 - of the following is the
Q115 - 6-year-old is diagnosed with a Q140 - 12-year-old with asthma uses a
Q116 - of the following is the Q141 - a child with suspected intussusception,
Q117 - 7-year-old with a history of Q142 - child presents with acute hemiparesis
Q118 - of the following is a Q143 - of the following best explains
Q119 - 5-year-old with a history of Q144 - previously healthy child presents with
Q120 - of the following findings is Q145 - of the following best explains
Q121 - a neonate with suspected sepsis, Q146 - child with suspected appendicitis has
Q122 - pathophysiologic mechanism best explains the Q147 - of the following is the
Q123 - 3-month-old infant presents with poor Q148 - child presents with vomiting, diarrhea,
Q124 - a school-aged child with persistent Q149 - of the following findings in
Q125 - For a pediatric patient with Q150 - child with a ventricular septal
Page 3
, Advanced Pediatric Nurse Practitioner (PNP) Pediatric Nurse Practitioner (PNP) -
- Advanced Clinical Reasoning Advanced Clinical Reasoning Review
Q151 - provider is evaluating a child Q176 - 7-year-old with asthma is prescribed
Q152 - managing a child with moderate Q177 - 5-year-old is brought in with
Q153 - school-age child presents with a Q178 - 13-year-old is diagnosed with mild
Q154 - developmental milestone is typically achi... Q179 - 4-year-old with a history of
Q155 - pediatric provider is assessing a Q180 - 15-year-old with sickle cell disease
Q156 - of the following findings in Q181 - 4-year-old presents with a 2-day
Q157 - child with a history of Q182 - An infant with suspected pyloric
Q158 - of the following immunizations is Q183 - school-age child with asthma is
Q159 - pediatric patient presents with a Q184 - 10-year-old with a history of
Q160 - of the following is the Q185 - 7-year-old with acute lymphoblastic leukemia
Q161 - a child with suspected growth Q186 - a child with suspected acute
Q162 - pathophysiological mechanism best explain... Q187 - 6-month-old infant presents with failure
Q163 - child with persistent asthma is Q188 - 12-year-old with type 1 diabetes
Q164 - finding is most consistent with Q189 - 5-year-old with a history of
Q165 - 6-month-old infant presents with failure Q190 - 14-year-old with cystic fibrosis has
Q166 - clinical scenario most likely indicates Q191 - 14-year-old with cystic fibrosis presents
Q167 - an infant with suspected congenital Q192 - a child with severe asthma
Q168 - statement best reflects the current Q193 - of the following best explains
Q169 - finding is most consistent with Q194 - 6-year-old with acute lymphoblastic leukemia
Q170 - a child with suspected acute Q195 - of the following findings is
Q171 - 10-year-old with severe persistent asthma Q196 - 3-year-old with a history of
Q172 - 14-year-old with no prior seizures Q197 - a child with suspected urinary
Q173 - 6-year-old with ADHD is being Q198 - of the following is the
Q174 - 12-year-old with type 1 diabetes Q199 - 2-month-old infant presents with poor
Q175 - 9-year-old presents with fever, sore Q200 - of the following is the
Q1 DIFFERENTIATE COMPLEX PEDIATRIC PRESENTATIONS USING ADVANCED CLINICAL
REASONING AND CURRENT EVIDENCE
A previously healthy school-age child presents with fever, pharyngitis, and a
sandpaper-like rash on the trunk. Rapid strep test is negative. Given the clinical
suspicion, which additional finding would most strongly support a diagnosis of
scarlet fever over a viral exanthem?
A. Palatal petechiae and strawberry tongue CORRECT
B. Bilateral conjunctival injection without discharge
C. Cervical lymphadenopathy and hepatosplenomegaly
D. Presence of cough and coryza
RATIONALE: Scarlet fever is caused by group A Streptococcus and presents with pharyngitis,
fever, and a fine erythematous rash. Palatal petechiae and strawberry tongue are specific clinical
findings supporting streptococcal infection. Viral exanthems often present with cough, coryza,
and conjunctivitis (B, D). Hepatosplenomegaly (C) is more consistent with viral syndromes like
EBV.
Page 4
