NSG 548 Exam 3 V3 | NSG 548 FNP Role: Children &
Families | Actual Q&A with Rationale (NSG548
Exam 3) | Wilkes University
1. A 9-month-old infant is brought to the clinic for a well-child visit. Which fine motor
milestone is most appropriate for this age?
A. Transferring objects from hand to hand
B. Building a tower of two cubes
C. Development of the pincer grasp
D. Scribbling spontaneously on paper
Correct Answer: C
Explanation: At 9 months of age, the development of the pincer grasp is a key milestone
where the infant uses the thumb and forefinger to pick up small objects. Transferring
objects usually occurs by 6 months, while building towers and scribbling are later
milestones around 15-18 months. Assessing these milestones allows the FNP to monitor
for developmental delays in the fine motor domain.
2. When screening for lead poisoning, at what age should a child residing in a high-risk area
typically receive their first blood lead level (BLL) test?
A. 6 months
B. 36 months
,C. 24 months
D. 12 months
Correct Answer: D
Explanation: Standard practice for children in high-risk environments involves screening
for lead at 12 and 24 months of age. Lead toxicity is particularly dangerous for developing
brains and can cause irreversible cognitive impairment. The FNP must identify
environmental sources of exposure and initiate appropriate follow-up if levels exceed 5
mcg/dL.
3. A 4-year-old child presents with a ‘barky’ cough and inspiratory stridor that worsens at
night. What is the most likely diagnosis?
A. Epiglottitis
B. Bacterial Tracheitis
C. Croup (Laryngotracheobronchitis)
D. Foreign Body Aspiration
Correct Answer: C
Explanation: Croup is characterized by subglottic inflammation typically caused by the
parainfluenza virus, leading to a distinctive seal-like barky cough. It is most common in
children aged 6 months to 3 years but can occur in older preschoolers. Management often
involves a single dose of dexamethasone and monitoring for respiratory distress.
, 4. In the management of pediatric asthma, which medication is considered the preferred
daily controller for Step 2 of the stepwise approach?
A. Long-Acting Beta Agonist (LABA)
B. Short-Acting Beta Agonist (SABA)
C. Low-dose Inhaled Corticosteroid (ICS)
D. Oral Prednisolone
Correct Answer: C
Explanation: Step 2 asthma management focuses on daily anti-inflammatory therapy to
reduce airway hyper-responsiveness. Low-dose inhaled corticosteroids are the gold
standard for achieving long-term control in pediatric patients. The FNP should regularly
review the child’s technique and adherence to ensure optimal outcomes.
5. A 2-week-old neonate presents with a rectal temperature of 100.8°F (38.2°C). What is the
priority intervention for this patient?
A. Administer pediatric acetaminophen and follow up in 24 hours
B. Recheck the temperature in 4 hours and monitor for a rash
C. Obtain a chest X-ray and treat for viral bronchiolitis
D. Perform a complete septic workup and admit for IV antibiotics
Correct Answer: D
Families | Actual Q&A with Rationale (NSG548
Exam 3) | Wilkes University
1. A 9-month-old infant is brought to the clinic for a well-child visit. Which fine motor
milestone is most appropriate for this age?
A. Transferring objects from hand to hand
B. Building a tower of two cubes
C. Development of the pincer grasp
D. Scribbling spontaneously on paper
Correct Answer: C
Explanation: At 9 months of age, the development of the pincer grasp is a key milestone
where the infant uses the thumb and forefinger to pick up small objects. Transferring
objects usually occurs by 6 months, while building towers and scribbling are later
milestones around 15-18 months. Assessing these milestones allows the FNP to monitor
for developmental delays in the fine motor domain.
2. When screening for lead poisoning, at what age should a child residing in a high-risk area
typically receive their first blood lead level (BLL) test?
A. 6 months
B. 36 months
,C. 24 months
D. 12 months
Correct Answer: D
Explanation: Standard practice for children in high-risk environments involves screening
for lead at 12 and 24 months of age. Lead toxicity is particularly dangerous for developing
brains and can cause irreversible cognitive impairment. The FNP must identify
environmental sources of exposure and initiate appropriate follow-up if levels exceed 5
mcg/dL.
3. A 4-year-old child presents with a ‘barky’ cough and inspiratory stridor that worsens at
night. What is the most likely diagnosis?
A. Epiglottitis
B. Bacterial Tracheitis
C. Croup (Laryngotracheobronchitis)
D. Foreign Body Aspiration
Correct Answer: C
Explanation: Croup is characterized by subglottic inflammation typically caused by the
parainfluenza virus, leading to a distinctive seal-like barky cough. It is most common in
children aged 6 months to 3 years but can occur in older preschoolers. Management often
involves a single dose of dexamethasone and monitoring for respiratory distress.
, 4. In the management of pediatric asthma, which medication is considered the preferred
daily controller for Step 2 of the stepwise approach?
A. Long-Acting Beta Agonist (LABA)
B. Short-Acting Beta Agonist (SABA)
C. Low-dose Inhaled Corticosteroid (ICS)
D. Oral Prednisolone
Correct Answer: C
Explanation: Step 2 asthma management focuses on daily anti-inflammatory therapy to
reduce airway hyper-responsiveness. Low-dose inhaled corticosteroids are the gold
standard for achieving long-term control in pediatric patients. The FNP should regularly
review the child’s technique and adherence to ensure optimal outcomes.
5. A 2-week-old neonate presents with a rectal temperature of 100.8°F (38.2°C). What is the
priority intervention for this patient?
A. Administer pediatric acetaminophen and follow up in 24 hours
B. Recheck the temperature in 4 hours and monitor for a rash
C. Obtain a chest X-ray and treat for viral bronchiolitis
D. Perform a complete septic workup and admit for IV antibiotics
Correct Answer: D
