NR 602 / NR602 Midterm Exam
Expanded 2024/2025 Primary Care of the Childbearing & Childrearing Family Practicum Study Guide
Scope: Independently authored study material based on the public preview and topic signals from the supplied Stuvia listing. It does not
reproduce the paid document and does not claim to contain leaked or actual examination questions.
Current-care note: Vaccine recommendations can change. Use the current CDC age-based and catch-up schedules for exact dose timing
and special situations. ■cite■turn0search0■turn0search1■
NR602 Expanded Midterm Practicum Study Guide Page 1
, Exam Blueprint
Section Focus
Pediatric Assessment & Fever Age-specific assessment, fever, red flags, hydration and clinical reasoning
Growth, Development & Screening Milestones, developmental surveillance, screening tools and anticipatory guidance
Well-Child Care & Prevention Routine visits, preventive counseling, safety and family-centered care
Immunization & Catch-Up Routine pediatric vaccination principles, HPV, MMR, catch-up and special situations
Pediatric ENT & Respiratory Croup, otitis media, pharyngitis, epiglottitis, bronchiolitis and asthma
Pediatric Infectious Disease Strep/scarlet fever, viral illness, gastroenteritis and infection-control reasoning
Pediatric Cardiology & Kawasaki Kawasaki disease, murmurs, congenital heart concepts and urgent findings
GI, GU & Dermatology Dehydration, abdominal complaints, common rashes, dermatitis and GU concerns
Pregnancy Assessment & Prenatal Care Routine prenatal care, fetal movement, warning signs and testing
Labor, Postpartum & Newborn Postpartum bleeding, newborn transition, feeding and urgent maternal/newborn findings
Adolescent & Reproductive Health Confidential care, STI prevention, contraception and preventive screening
Clinical Reasoning & NGN-Style Cases Prioritization, cue recognition, differential thinking and next-best-action questions
Rapid Review & Exam Traps High-yield distinctions, memory cues and final practice checkpoints
Integrated Scenario Practice Cross-topic clinical reasoning and prioritization
NR602 Expanded Midterm Practicum Study Guide Page 2
, Pediatric Assessment & Fever
Age-specific assessment, fever, red flags, hydration and clinical reasoning
Q1. A 6-month-old has fever and irritability. What is the safest first approach?
Answer: Begin with a focused history and complete physical assessment, including appearance, hydration, respiratory status and
potential source.
Rationale / exam cue: Do not jump to antibiotics or invasive testing before assessing the child's clinical condition.
Q2. Which finding in a febrile infant should increase concern for serious illness?
Answer: Toxic appearance, poor perfusion, altered responsiveness, respiratory distress, significant dehydration, seizure, or other
abnormal vital/physical findings.
Rationale / exam cue: In pediatrics, appearance and physiologic stability can be more important than the temperature number alone.
Q3. What is the purpose of developmental surveillance at well-child visits?
Answer: To continually assess developmental progress and identify concerns that warrant standardized screening or further evaluation.
Rationale / exam cue: Surveillance is ongoing; screening uses a structured validated tool.
Q4. Which tool is commonly used as a parent-completed developmental screening instrument?
Answer: The Ages and Stages Questionnaire (ASQ) is a commonly used parent-completed developmental screening tool.
Rationale / exam cue: Know the distinction between screening tools and diagnostic developmental testing.
Q5. What is the general purpose of a well-child visit?
Answer: Preventive care, growth and developmental assessment, immunization review, screening, anticipatory guidance, and
identification of emerging health concerns.
Rationale / exam cue: Think prevention plus early detection—not simply treatment of illness.
Q6. What is an important principle of pediatric medication dosing?
Answer: Dosing frequently depends on weight and the specific medication formulation; verify the current weight, concentration,
maximum dose, and calculation before administration.
Rationale / exam cue: Never rely on an old weight or assume adult dosing.
Q7. At what age can routine HPV vaccination begin?
Answer: HPV vaccination can begin at age 9; routine vaccination is recommended in early adolescence.
Rationale / exam cue: Use the current CDC schedule and distinguish routine vaccination from catch-up.
Q8. What is a key timing principle for HPV vaccination when the series begins before age 15?
Answer: A two-dose series is generally used, with doses separated by the recommended minimum interval.
Rationale / exam cue: For unusual histories, use the current CDC catch-up schedule.
Q9. Which vaccine is routinely associated with the 12–15 month period?
Answer: MMR is routinely initiated at 12–15 months, alongside other vaccines scheduled around this age.
Rationale / exam cue: Always verify the current schedule.
Q10. What is the basic principle of catch-up vaccination?
Answer: Do not restart a valid series simply because a child is late; use the current catch-up schedule to determine remaining doses
and minimum intervals.
Rationale / exam cue: Late vaccination usually means continue, not restart.
Q11. A 4-year-old has a barking cough and stridor. What diagnosis should be considered?
Answer: Croup is a classic consideration, especially with a barking cough and upper-airway symptoms.
Rationale / exam cue: Stridor at rest signals greater severity.
Q12. What is a classic feature of croup?
Answer: A barking cough with inspiratory stridor caused by upper-airway inflammation.
Rationale / exam cue: Differentiate stridor from lower-airway wheezing.
Q13. Why is epiglottitis an airway emergency?
Answer: Rapid upper-airway obstruction can occur; drooling, dysphagia, toxic appearance and respiratory distress are major warning
signs.
Rationale / exam cue: Avoid unnecessary agitation or throat manipulation when epiglottitis is suspected.
NR602 Expanded Midterm Practicum Study Guide Page 3
, Q14. What is commonly first-line therapy for uncomplicated acute otitis media when antibiotics are indicated?
Answer: Amoxicillin is commonly first-line, with the exact choice depending on clinical circumstances and current guidance.
Rationale / exam cue: Consider age, severity, laterality, recent antibiotics and allergy history.
Q15. A child has sore throat and fever without cough. What infection should be considered?
Answer: Group A streptococcal pharyngitis should be considered and evaluated with appropriate testing.
Rationale / exam cue: Do not confirm GAS from symptoms alone.
Q16. What is scarlet fever?
Answer: A toxin-mediated syndrome associated with group A streptococcal infection, classically producing a fine, sandpaper-like rash
with pharyngitis.
Rationale / exam cue: Treat the underlying GAS infection according to current guidance.
Q17. What important complication can appropriate treatment of GAS pharyngitis help prevent?
Answer: Acute rheumatic fever is an important preventable nonsuppurative complication.
Rationale / exam cue: Diagnosis and treatment matter beyond symptom relief.
Q18. What is a major concern in pediatric gastroenteritis?
Answer: Dehydration, assessed through intake/output, urine frequency, mucous membranes, tears, capillary refill, mental status and
overall appearance.
Rationale / exam cue: Hydration status drives urgency.
Q19. What is the preferred general approach to mild-to-moderate dehydration when oral intake is possible?
Answer: Oral rehydration with an appropriate oral rehydration solution is generally preferred when clinically appropriate.
Rationale / exam cue: Small, frequent amounts may be easier to tolerate.
Q20. What are classic features of Kawasaki disease?
Answer: Persistent fever with findings such as conjunctival injection, oral/mucosal changes, extremity changes, rash and cervical
lymphadenopathy.
Rationale / exam cue: Kawasaki matters because of coronary complications.
Q21. Why is Kawasaki disease urgent?
Answer: It can cause coronary artery abnormalities and other cardiovascular complications; timely recognition and treatment are
important.
Rationale / exam cue: Persistent fever plus mucocutaneous findings is a high-yield pattern.
Q22. A pregnant patient at 28 weeks reports decreased fetal movement. What is the next step?
Answer: Prompt evaluation of fetal well-being is indicated; fetal surveillance such as a nonstress test may be used when clinically
appropriate.
Rationale / exam cue: Do not simply reassure a patient with a significant change.
Q23. What is the purpose of a nonstress test?
Answer: It evaluates fetal heart-rate response associated with fetal movement and helps assess fetal well-being.
Rationale / exam cue: Interpret in context of gestational age and clinical circumstances.
Q24. What is the significance of heavy postpartum bleeding?
Answer: It may represent postpartum hemorrhage or another urgent complication and requires prompt assessment of hemodynamic
status and cause.
Rationale / exam cue: Do not label significant bleeding as normal lochia without assessment.
Q25. What are major categories of postpartum hemorrhage causes?
Answer: Uterine atony, retained placental tissue, genital tract trauma, and coagulopathy.
Rationale / exam cue: Use the 4 Ts: tone, tissue, trauma, thrombin.
Q26. What is an important newborn priority immediately after birth?
Answer: Assess breathing, heart rate, temperature, tone and overall transition while following newborn stabilization protocols.
Rationale / exam cue: Newborn deterioration can be rapid.
Q27. What is family-centered care?
Answer: Care that incorporates the child's needs and the family's knowledge, preferences, resources and participation in decisions.
Rationale / exam cue: The family is a partner.
NR602 Expanded Midterm Practicum Study Guide Page 4
Expanded 2024/2025 Primary Care of the Childbearing & Childrearing Family Practicum Study Guide
Scope: Independently authored study material based on the public preview and topic signals from the supplied Stuvia listing. It does not
reproduce the paid document and does not claim to contain leaked or actual examination questions.
Current-care note: Vaccine recommendations can change. Use the current CDC age-based and catch-up schedules for exact dose timing
and special situations. ■cite■turn0search0■turn0search1■
NR602 Expanded Midterm Practicum Study Guide Page 1
, Exam Blueprint
Section Focus
Pediatric Assessment & Fever Age-specific assessment, fever, red flags, hydration and clinical reasoning
Growth, Development & Screening Milestones, developmental surveillance, screening tools and anticipatory guidance
Well-Child Care & Prevention Routine visits, preventive counseling, safety and family-centered care
Immunization & Catch-Up Routine pediatric vaccination principles, HPV, MMR, catch-up and special situations
Pediatric ENT & Respiratory Croup, otitis media, pharyngitis, epiglottitis, bronchiolitis and asthma
Pediatric Infectious Disease Strep/scarlet fever, viral illness, gastroenteritis and infection-control reasoning
Pediatric Cardiology & Kawasaki Kawasaki disease, murmurs, congenital heart concepts and urgent findings
GI, GU & Dermatology Dehydration, abdominal complaints, common rashes, dermatitis and GU concerns
Pregnancy Assessment & Prenatal Care Routine prenatal care, fetal movement, warning signs and testing
Labor, Postpartum & Newborn Postpartum bleeding, newborn transition, feeding and urgent maternal/newborn findings
Adolescent & Reproductive Health Confidential care, STI prevention, contraception and preventive screening
Clinical Reasoning & NGN-Style Cases Prioritization, cue recognition, differential thinking and next-best-action questions
Rapid Review & Exam Traps High-yield distinctions, memory cues and final practice checkpoints
Integrated Scenario Practice Cross-topic clinical reasoning and prioritization
NR602 Expanded Midterm Practicum Study Guide Page 2
, Pediatric Assessment & Fever
Age-specific assessment, fever, red flags, hydration and clinical reasoning
Q1. A 6-month-old has fever and irritability. What is the safest first approach?
Answer: Begin with a focused history and complete physical assessment, including appearance, hydration, respiratory status and
potential source.
Rationale / exam cue: Do not jump to antibiotics or invasive testing before assessing the child's clinical condition.
Q2. Which finding in a febrile infant should increase concern for serious illness?
Answer: Toxic appearance, poor perfusion, altered responsiveness, respiratory distress, significant dehydration, seizure, or other
abnormal vital/physical findings.
Rationale / exam cue: In pediatrics, appearance and physiologic stability can be more important than the temperature number alone.
Q3. What is the purpose of developmental surveillance at well-child visits?
Answer: To continually assess developmental progress and identify concerns that warrant standardized screening or further evaluation.
Rationale / exam cue: Surveillance is ongoing; screening uses a structured validated tool.
Q4. Which tool is commonly used as a parent-completed developmental screening instrument?
Answer: The Ages and Stages Questionnaire (ASQ) is a commonly used parent-completed developmental screening tool.
Rationale / exam cue: Know the distinction between screening tools and diagnostic developmental testing.
Q5. What is the general purpose of a well-child visit?
Answer: Preventive care, growth and developmental assessment, immunization review, screening, anticipatory guidance, and
identification of emerging health concerns.
Rationale / exam cue: Think prevention plus early detection—not simply treatment of illness.
Q6. What is an important principle of pediatric medication dosing?
Answer: Dosing frequently depends on weight and the specific medication formulation; verify the current weight, concentration,
maximum dose, and calculation before administration.
Rationale / exam cue: Never rely on an old weight or assume adult dosing.
Q7. At what age can routine HPV vaccination begin?
Answer: HPV vaccination can begin at age 9; routine vaccination is recommended in early adolescence.
Rationale / exam cue: Use the current CDC schedule and distinguish routine vaccination from catch-up.
Q8. What is a key timing principle for HPV vaccination when the series begins before age 15?
Answer: A two-dose series is generally used, with doses separated by the recommended minimum interval.
Rationale / exam cue: For unusual histories, use the current CDC catch-up schedule.
Q9. Which vaccine is routinely associated with the 12–15 month period?
Answer: MMR is routinely initiated at 12–15 months, alongside other vaccines scheduled around this age.
Rationale / exam cue: Always verify the current schedule.
Q10. What is the basic principle of catch-up vaccination?
Answer: Do not restart a valid series simply because a child is late; use the current catch-up schedule to determine remaining doses
and minimum intervals.
Rationale / exam cue: Late vaccination usually means continue, not restart.
Q11. A 4-year-old has a barking cough and stridor. What diagnosis should be considered?
Answer: Croup is a classic consideration, especially with a barking cough and upper-airway symptoms.
Rationale / exam cue: Stridor at rest signals greater severity.
Q12. What is a classic feature of croup?
Answer: A barking cough with inspiratory stridor caused by upper-airway inflammation.
Rationale / exam cue: Differentiate stridor from lower-airway wheezing.
Q13. Why is epiglottitis an airway emergency?
Answer: Rapid upper-airway obstruction can occur; drooling, dysphagia, toxic appearance and respiratory distress are major warning
signs.
Rationale / exam cue: Avoid unnecessary agitation or throat manipulation when epiglottitis is suspected.
NR602 Expanded Midterm Practicum Study Guide Page 3
, Q14. What is commonly first-line therapy for uncomplicated acute otitis media when antibiotics are indicated?
Answer: Amoxicillin is commonly first-line, with the exact choice depending on clinical circumstances and current guidance.
Rationale / exam cue: Consider age, severity, laterality, recent antibiotics and allergy history.
Q15. A child has sore throat and fever without cough. What infection should be considered?
Answer: Group A streptococcal pharyngitis should be considered and evaluated with appropriate testing.
Rationale / exam cue: Do not confirm GAS from symptoms alone.
Q16. What is scarlet fever?
Answer: A toxin-mediated syndrome associated with group A streptococcal infection, classically producing a fine, sandpaper-like rash
with pharyngitis.
Rationale / exam cue: Treat the underlying GAS infection according to current guidance.
Q17. What important complication can appropriate treatment of GAS pharyngitis help prevent?
Answer: Acute rheumatic fever is an important preventable nonsuppurative complication.
Rationale / exam cue: Diagnosis and treatment matter beyond symptom relief.
Q18. What is a major concern in pediatric gastroenteritis?
Answer: Dehydration, assessed through intake/output, urine frequency, mucous membranes, tears, capillary refill, mental status and
overall appearance.
Rationale / exam cue: Hydration status drives urgency.
Q19. What is the preferred general approach to mild-to-moderate dehydration when oral intake is possible?
Answer: Oral rehydration with an appropriate oral rehydration solution is generally preferred when clinically appropriate.
Rationale / exam cue: Small, frequent amounts may be easier to tolerate.
Q20. What are classic features of Kawasaki disease?
Answer: Persistent fever with findings such as conjunctival injection, oral/mucosal changes, extremity changes, rash and cervical
lymphadenopathy.
Rationale / exam cue: Kawasaki matters because of coronary complications.
Q21. Why is Kawasaki disease urgent?
Answer: It can cause coronary artery abnormalities and other cardiovascular complications; timely recognition and treatment are
important.
Rationale / exam cue: Persistent fever plus mucocutaneous findings is a high-yield pattern.
Q22. A pregnant patient at 28 weeks reports decreased fetal movement. What is the next step?
Answer: Prompt evaluation of fetal well-being is indicated; fetal surveillance such as a nonstress test may be used when clinically
appropriate.
Rationale / exam cue: Do not simply reassure a patient with a significant change.
Q23. What is the purpose of a nonstress test?
Answer: It evaluates fetal heart-rate response associated with fetal movement and helps assess fetal well-being.
Rationale / exam cue: Interpret in context of gestational age and clinical circumstances.
Q24. What is the significance of heavy postpartum bleeding?
Answer: It may represent postpartum hemorrhage or another urgent complication and requires prompt assessment of hemodynamic
status and cause.
Rationale / exam cue: Do not label significant bleeding as normal lochia without assessment.
Q25. What are major categories of postpartum hemorrhage causes?
Answer: Uterine atony, retained placental tissue, genital tract trauma, and coagulopathy.
Rationale / exam cue: Use the 4 Ts: tone, tissue, trauma, thrombin.
Q26. What is an important newborn priority immediately after birth?
Answer: Assess breathing, heart rate, temperature, tone and overall transition while following newborn stabilization protocols.
Rationale / exam cue: Newborn deterioration can be rapid.
Q27. What is family-centered care?
Answer: Care that incorporates the child's needs and the family's knowledge, preferences, resources and participation in decisions.
Rationale / exam cue: The family is a partner.
NR602 Expanded Midterm Practicum Study Guide Page 4
