NSG 548 Final Exam V2 | NSG 548 FNP Role:
Children & Families | Actual Q&A with Rationale
(NSG548 Final Exam) | Wilkes University
1. A 15-month-old child is brought to the clinic for a well-child visit. Which developmental
milestone should the Family Nurse Practitioner expect the child to have achieved?
A. Ability to jump with both feet
B. Speaking in four-word sentences
C. Using a spoon without spilling
D. Walking independently
Correct Answer: D
Explanation: By 15 months, most children are expected to walk independently, which is a
key gross motor milestone. The ability to jump usually develops around 2 years of age,
while complex sentence structure occurs later in the preschool years. The Family Nurse
Practitioner must assess these milestones using standardized tools like the Denver II to
ensure appropriate development.
2. According to the CDC immunization schedule, at what age should a child receive their first
dose of the Measles, Mumps, and Rubella (MMR) vaccine?
A. 6 months
B. 12-15 months
,C. 9 months
D. 4-6 years
Correct Answer: B
Explanation: The first dose of the MMR vaccine is recommended between 12 and 15
months of age to allow for the waning of maternal antibodies. Administering it earlier may
result in a sub-optimal immune response unless there is a high risk during an outbreak.
The second dose is typically administered between 4 and 6 years of age to ensure long-
term immunity.
3. A 4-year-old presents with a high fever, muffled voice, and drooling. The child is sitting in a
tripod position. What is the most appropriate immediate action for the FNP?
A. Examine the throat with a tongue blade
B. Keep the child calm and arrange emergency transport
C. Obtain a throat culture for Strep
D. Administer oral ibuprofen for the fever
Correct Answer: B
Explanation: These symptoms are classic signs of epiglottitis, which is a medical
emergency due to the risk of total airway obstruction. Attempting to visualize the throat or
performing invasive procedures can trigger laryngospasm and immediate respiratory
arrest. The provider must maintain a calm environment and ensure the airway is secured
by specialized emergency staff in a controlled setting.
,4. Which physical examination finding is most diagnostic of Acute Otitis Media (AOM) in a
pediatric patient?
A. Erythema of the tympanic membrane alone
B. Presence of fluid behind the drum without symptoms
C. Bulging of the tympanic membrane with impaired mobility
D. Pain when pulling on the pinna
Correct Answer: C
Explanation: Acute Otitis Media requires the presence of middle ear effusion, indicated by
bulging and decreased mobility, along with signs of acute inflammation. Erythema alone is
often caused by crying or fever and is not specific to AOM. Differentiating AOM from Otitis
Media with Effusion (OME) is critical to prevent the unnecessary use of antibiotics.
5. A 2-year-old child is being evaluated for iron deficiency anemia. What is the most common
cause of this condition in this age group?
A. Excessive consumption of cow’s milk
B. Gastrointestinal bleeding
C. Genetic predisposition
D. Vitamin C deficiency
Correct Answer: A
, Explanation: Excessive intake of cow’s milk (more than 24 ounces per day) in toddlers is
the leading cause of iron deficiency anemia because it displaces iron-rich foods. Cow’s milk
is low in iron and can cause microscopic intestinal bleeding in some young children. The
FNP should educate parents on limiting milk intake and focusing on a diverse, nutrient-
dense diet.
6. During a sports physical for a 14-year-old male, the FNP notes a Cobb angle of 15 degrees
on the spinal report. What is the recommended management?
A. Immediate surgical consultation
B. Application of a rigid back brace
C. Reassurance that this is a normal variant
D. Observation and re-evaluation in 6 months
Correct Answer: D
Explanation: A Cobb angle between 10 and 20 degrees is considered mild scoliosis and
generally requires monitoring for progression rather than immediate intervention. Bracing
is usually reserved for angles between 25 and 45 degrees in a growing child, while surgery
is considered for angles greater than 45-50 degrees. Regular follow-ups are necessary to
detect rapid progression during the adolescent growth spurt.
7. What is the primary goal of the M-CHAT-R/F screening tool used during the 18- and 24-
month well-child visits?
A. To screen for Autism Spectrum Disorder
Children & Families | Actual Q&A with Rationale
(NSG548 Final Exam) | Wilkes University
1. A 15-month-old child is brought to the clinic for a well-child visit. Which developmental
milestone should the Family Nurse Practitioner expect the child to have achieved?
A. Ability to jump with both feet
B. Speaking in four-word sentences
C. Using a spoon without spilling
D. Walking independently
Correct Answer: D
Explanation: By 15 months, most children are expected to walk independently, which is a
key gross motor milestone. The ability to jump usually develops around 2 years of age,
while complex sentence structure occurs later in the preschool years. The Family Nurse
Practitioner must assess these milestones using standardized tools like the Denver II to
ensure appropriate development.
2. According to the CDC immunization schedule, at what age should a child receive their first
dose of the Measles, Mumps, and Rubella (MMR) vaccine?
A. 6 months
B. 12-15 months
,C. 9 months
D. 4-6 years
Correct Answer: B
Explanation: The first dose of the MMR vaccine is recommended between 12 and 15
months of age to allow for the waning of maternal antibodies. Administering it earlier may
result in a sub-optimal immune response unless there is a high risk during an outbreak.
The second dose is typically administered between 4 and 6 years of age to ensure long-
term immunity.
3. A 4-year-old presents with a high fever, muffled voice, and drooling. The child is sitting in a
tripod position. What is the most appropriate immediate action for the FNP?
A. Examine the throat with a tongue blade
B. Keep the child calm and arrange emergency transport
C. Obtain a throat culture for Strep
D. Administer oral ibuprofen for the fever
Correct Answer: B
Explanation: These symptoms are classic signs of epiglottitis, which is a medical
emergency due to the risk of total airway obstruction. Attempting to visualize the throat or
performing invasive procedures can trigger laryngospasm and immediate respiratory
arrest. The provider must maintain a calm environment and ensure the airway is secured
by specialized emergency staff in a controlled setting.
,4. Which physical examination finding is most diagnostic of Acute Otitis Media (AOM) in a
pediatric patient?
A. Erythema of the tympanic membrane alone
B. Presence of fluid behind the drum without symptoms
C. Bulging of the tympanic membrane with impaired mobility
D. Pain when pulling on the pinna
Correct Answer: C
Explanation: Acute Otitis Media requires the presence of middle ear effusion, indicated by
bulging and decreased mobility, along with signs of acute inflammation. Erythema alone is
often caused by crying or fever and is not specific to AOM. Differentiating AOM from Otitis
Media with Effusion (OME) is critical to prevent the unnecessary use of antibiotics.
5. A 2-year-old child is being evaluated for iron deficiency anemia. What is the most common
cause of this condition in this age group?
A. Excessive consumption of cow’s milk
B. Gastrointestinal bleeding
C. Genetic predisposition
D. Vitamin C deficiency
Correct Answer: A
, Explanation: Excessive intake of cow’s milk (more than 24 ounces per day) in toddlers is
the leading cause of iron deficiency anemia because it displaces iron-rich foods. Cow’s milk
is low in iron and can cause microscopic intestinal bleeding in some young children. The
FNP should educate parents on limiting milk intake and focusing on a diverse, nutrient-
dense diet.
6. During a sports physical for a 14-year-old male, the FNP notes a Cobb angle of 15 degrees
on the spinal report. What is the recommended management?
A. Immediate surgical consultation
B. Application of a rigid back brace
C. Reassurance that this is a normal variant
D. Observation and re-evaluation in 6 months
Correct Answer: D
Explanation: A Cobb angle between 10 and 20 degrees is considered mild scoliosis and
generally requires monitoring for progression rather than immediate intervention. Bracing
is usually reserved for angles between 25 and 45 degrees in a growing child, while surgery
is considered for angles greater than 45-50 degrees. Regular follow-ups are necessary to
detect rapid progression during the adolescent growth spurt.
7. What is the primary goal of the M-CHAT-R/F screening tool used during the 18- and 24-
month well-child visits?
A. To screen for Autism Spectrum Disorder
