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NSG 5442 Final Exam Study Guide
2026/2027 | Pediatric Primary Care
Questions & Answers
NSG 5442 Final Exam practice questions with detailed
rationales covering pediatric primary care. Topics include
ADHD, autism screening, asthma management, cardiac
murmurs, Kawasaki disease, otitis media, and adolescent
gynecology. Aligned with South College course
objectives for 2026/2027. Practice questions reinforce
clinical reasoning and evidence-based pediatric
management.
1. A 4-year-old child is brought in for a well-child visit. The parent reports the child
has difficulty transitioning from one activity to another and becomes very upset
when routines change. Which area of executive function is primarily affected?
A) Activation
B) Focus
C) Flexibility
D) Memory
C) Flexibility
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Flexibility is the executive function that allows a child to shift between tasks, activities,
or mental sets. Difficulty transitioning and distress with routine changes are classic
signs of inflexibility, often seen in ADHD and autism spectrum disorder.
2. A 7-year-old with ADHD is struggling to start homework each evening. He sits
down but cannot figure out where to begin and becomes overwhelmed. Which
executive function deficit does this represent?
A) Activation
B) Effort
C) Emotion
D) Action
A) Activation
Activation is the executive function responsible for organizing, prioritizing, and
initiating tasks. Difficulty getting started and not knowing where to begin reflects an
activation deficit.
3. A parent asks when the M-CHAT should be administered. What is the correct age
range?
A) 6 and 12 months
B) 12 and 18 months
C) 18 and 24 months
D) 24 and 36 months
C) 18 and 24 months
The Modified Checklist for Autism in Toddlers (M-CHAT) is validated for use at 18 and
24 months during well-child visits to screen for autism spectrum disorder.
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4. A 9-year-old with asthma uses his albuterol rescue inhaler 4 times per week and
wakes at night twice per month. How should this be classified?
A) Well-controlled asthma
B) Not well-controlled asthma
C) Very poorly controlled asthma
D) Intermittent asthma requiring no controller
B) Not well-controlled asthma
Using a rescue inhaler more than twice per week or nighttime awakenings more than
twice per month indicates asthma is not well-controlled. The next step is to step up
controller therapy.
5. A 5-year-old is diagnosed with sensory processing disorder. He becomes
extremely upset when a hall light is left on and insists both shoes be tied equally
tight. How is this child best described?
A) Under responder
B) Over responder
C) Sensory seeker
D) Sensory discriminator
B) Over responder
An over responder (sensory avoidant) is overly sensitive to sensory input and reacts
strongly to stimuli others find tolerable, such as light or clothing texture.
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6. A 15-year-old presents with chest pain and palpitations during exercise. What is
the most appropriate next step?
A) Clear for sports without restriction
B) Refer to cardiology
C) Order CBC and BMP
D) Advise avoidance of all activity
B) Refer to cardiology
Exertional chest pain and palpitations in an adolescent require cardiology referral to
rule out hypertrophic cardiomyopathy, arrhythmias, or structural heart disease.
7. A 6-year-old is found to have a grade 3/6 systolic murmur with a normal S2 and
no thrill. What is the most likely diagnosis?
A) Ventricular septal defect
B) Innocent murmur
C) Aortic stenosis
D) Tetralogy of Fallot
B) Innocent murmur
A grade 3/6 or softer systolic murmur with a normal S2, no thrill, and no other
symptoms is most consistent with an innocent (functional) murmur.
8. Which murmur finding is always considered pathologic?
A) Grade 2/6 systolic murmur
B) Diastolic murmur
NSG 5442 Final Exam Study Guide
2026/2027 | Pediatric Primary Care
Questions & Answers
NSG 5442 Final Exam practice questions with detailed
rationales covering pediatric primary care. Topics include
ADHD, autism screening, asthma management, cardiac
murmurs, Kawasaki disease, otitis media, and adolescent
gynecology. Aligned with South College course
objectives for 2026/2027. Practice questions reinforce
clinical reasoning and evidence-based pediatric
management.
1. A 4-year-old child is brought in for a well-child visit. The parent reports the child
has difficulty transitioning from one activity to another and becomes very upset
when routines change. Which area of executive function is primarily affected?
A) Activation
B) Focus
C) Flexibility
D) Memory
C) Flexibility
,2|Page
Flexibility is the executive function that allows a child to shift between tasks, activities,
or mental sets. Difficulty transitioning and distress with routine changes are classic
signs of inflexibility, often seen in ADHD and autism spectrum disorder.
2. A 7-year-old with ADHD is struggling to start homework each evening. He sits
down but cannot figure out where to begin and becomes overwhelmed. Which
executive function deficit does this represent?
A) Activation
B) Effort
C) Emotion
D) Action
A) Activation
Activation is the executive function responsible for organizing, prioritizing, and
initiating tasks. Difficulty getting started and not knowing where to begin reflects an
activation deficit.
3. A parent asks when the M-CHAT should be administered. What is the correct age
range?
A) 6 and 12 months
B) 12 and 18 months
C) 18 and 24 months
D) 24 and 36 months
C) 18 and 24 months
The Modified Checklist for Autism in Toddlers (M-CHAT) is validated for use at 18 and
24 months during well-child visits to screen for autism spectrum disorder.
,3|Page
4. A 9-year-old with asthma uses his albuterol rescue inhaler 4 times per week and
wakes at night twice per month. How should this be classified?
A) Well-controlled asthma
B) Not well-controlled asthma
C) Very poorly controlled asthma
D) Intermittent asthma requiring no controller
B) Not well-controlled asthma
Using a rescue inhaler more than twice per week or nighttime awakenings more than
twice per month indicates asthma is not well-controlled. The next step is to step up
controller therapy.
5. A 5-year-old is diagnosed with sensory processing disorder. He becomes
extremely upset when a hall light is left on and insists both shoes be tied equally
tight. How is this child best described?
A) Under responder
B) Over responder
C) Sensory seeker
D) Sensory discriminator
B) Over responder
An over responder (sensory avoidant) is overly sensitive to sensory input and reacts
strongly to stimuli others find tolerable, such as light or clothing texture.
, 4|Page
6. A 15-year-old presents with chest pain and palpitations during exercise. What is
the most appropriate next step?
A) Clear for sports without restriction
B) Refer to cardiology
C) Order CBC and BMP
D) Advise avoidance of all activity
B) Refer to cardiology
Exertional chest pain and palpitations in an adolescent require cardiology referral to
rule out hypertrophic cardiomyopathy, arrhythmias, or structural heart disease.
7. A 6-year-old is found to have a grade 3/6 systolic murmur with a normal S2 and
no thrill. What is the most likely diagnosis?
A) Ventricular septal defect
B) Innocent murmur
C) Aortic stenosis
D) Tetralogy of Fallot
B) Innocent murmur
A grade 3/6 or softer systolic murmur with a normal S2, no thrill, and no other
symptoms is most consistent with an innocent (functional) murmur.
8. Which murmur finding is always considered pathologic?
A) Grade 2/6 systolic murmur
B) Diastolic murmur
