NURS 535 PEDIATRICS TEST 2 CARSON–
NEWMAN UNIVERSITY Advanced Pediatric
Primary Care Assessment & Management
PEDIATRIC NURSE PRACTITIONER
CERTIFICATION EXAM QUESTIONS AND
100% VERIFIED ANSWERS WITH
RATIONALES GRADED A+ LATEST
1. A 4-month-old infant presents for a well-child visit. Which finding is
most concerning and requires further evaluation?
A. Head lag when pulled to sitting
B. Hands predominantly fisted
C. Inability to roll front to back
D. Absence of a social smile
Correct Answer: D
Rationale: By 2 months, infants should demonstrate a social smile. Absence
at 4 months may indicate developmental delay or neurologic concern. Head
lag may still be present until 4--6 months. Rolling and hand opening develop
later.
,2. A school-aged child presents with periorbital edema and dark urine
following a recent streptococcal infection. Which laboratory finding is
most consistent with the diagnosis?
A. Hypercalcemia
B. Elevated antistreptolysin O (ASO) titer
C. Decreased serum complement levels
D. Increased serum albumin
Correct Answer: C
Rationale: Post-streptococcal glomerulonephritis is associated with low
complement levels due to immune complex deposition. ASO titers may be
elevated but are not diagnostic alone.
3. A 6-year-old with asthma uses a short-acting beta-agonist inhaler
daily. What is the most appropriate next step in management?
A. Add a leukotriene modifier
B. Increase short-acting beta-agonist dose
C. Begin oral corticosteroids
D. Initiate daily inhaled corticosteroids
Correct Answer: D
Rationale: Daily reliance on rescue medication indicates poor control.
Inhaled corticosteroids are first-line controller therapy for persistent asthma.
###
,4. A toddler presents with a barking cough, inspiratory stridor, and
hoarseness. Symptoms worsen at night. What is the most likely
diagnosis?
A. Croup
B. Bronchiolitis
C. Bacterial tracheitis
D. Epiglottitis
Correct Answer: A
Rationale: Viral croup presents with a barking cough and stridor, often
worsening at night. Epiglottitis causes drooling and a toxic appearance.
5. A 10-year-old child presents with heel pain that worsens during
sports activities. Physical exam reveals tenderness at the posterior heel.
What is the most likely diagnosis?
A. Achilles tendon rupture
B. Plantar fasciitis
C. Osteomyelitis
D. Sever disease
Correct Answer: D
Rationale: Sever disease (calcaneal apophysitis) is a common cause of heel
pain in active children during growth spurts.
, 6. Which immunization is contraindicated in an immunocompromised
child?
A. Hepatitis B
B. Measles, mumps, rubella (MMR)
C. Pneumococcal conjugate
D. Inactivated influenza
Correct Answer: B
Rationale: Live vaccines such as MMR are contraindicated in
immunocompromised patients due to risk of infection. ###
7. A newborn has delayed passage of meconium, abdominal distention,
and bilious vomiting. What condition is most suspected?
A. Necrotizing enterocolitis
B. Pyloric stenosis
C. Hirschsprung disease
D. Intussusception
Correct Answer: C
Rationale: Hirschsprung disease results from absence of ganglion cells,
leading to functional obstruction and delayed meconium passage.
8. Which finding best differentiates type 1 diabetes from type 2 diabetes
in children?
NEWMAN UNIVERSITY Advanced Pediatric
Primary Care Assessment & Management
PEDIATRIC NURSE PRACTITIONER
CERTIFICATION EXAM QUESTIONS AND
100% VERIFIED ANSWERS WITH
RATIONALES GRADED A+ LATEST
1. A 4-month-old infant presents for a well-child visit. Which finding is
most concerning and requires further evaluation?
A. Head lag when pulled to sitting
B. Hands predominantly fisted
C. Inability to roll front to back
D. Absence of a social smile
Correct Answer: D
Rationale: By 2 months, infants should demonstrate a social smile. Absence
at 4 months may indicate developmental delay or neurologic concern. Head
lag may still be present until 4--6 months. Rolling and hand opening develop
later.
,2. A school-aged child presents with periorbital edema and dark urine
following a recent streptococcal infection. Which laboratory finding is
most consistent with the diagnosis?
A. Hypercalcemia
B. Elevated antistreptolysin O (ASO) titer
C. Decreased serum complement levels
D. Increased serum albumin
Correct Answer: C
Rationale: Post-streptococcal glomerulonephritis is associated with low
complement levels due to immune complex deposition. ASO titers may be
elevated but are not diagnostic alone.
3. A 6-year-old with asthma uses a short-acting beta-agonist inhaler
daily. What is the most appropriate next step in management?
A. Add a leukotriene modifier
B. Increase short-acting beta-agonist dose
C. Begin oral corticosteroids
D. Initiate daily inhaled corticosteroids
Correct Answer: D
Rationale: Daily reliance on rescue medication indicates poor control.
Inhaled corticosteroids are first-line controller therapy for persistent asthma.
###
,4. A toddler presents with a barking cough, inspiratory stridor, and
hoarseness. Symptoms worsen at night. What is the most likely
diagnosis?
A. Croup
B. Bronchiolitis
C. Bacterial tracheitis
D. Epiglottitis
Correct Answer: A
Rationale: Viral croup presents with a barking cough and stridor, often
worsening at night. Epiglottitis causes drooling and a toxic appearance.
5. A 10-year-old child presents with heel pain that worsens during
sports activities. Physical exam reveals tenderness at the posterior heel.
What is the most likely diagnosis?
A. Achilles tendon rupture
B. Plantar fasciitis
C. Osteomyelitis
D. Sever disease
Correct Answer: D
Rationale: Sever disease (calcaneal apophysitis) is a common cause of heel
pain in active children during growth spurts.
, 6. Which immunization is contraindicated in an immunocompromised
child?
A. Hepatitis B
B. Measles, mumps, rubella (MMR)
C. Pneumococcal conjugate
D. Inactivated influenza
Correct Answer: B
Rationale: Live vaccines such as MMR are contraindicated in
immunocompromised patients due to risk of infection. ###
7. A newborn has delayed passage of meconium, abdominal distention,
and bilious vomiting. What condition is most suspected?
A. Necrotizing enterocolitis
B. Pyloric stenosis
C. Hirschsprung disease
D. Intussusception
Correct Answer: C
Rationale: Hirschsprung disease results from absence of ganglion cells,
leading to functional obstruction and delayed meconium passage.
8. Which finding best differentiates type 1 diabetes from type 2 diabetes
in children?
