NR 602 Midterm Exam: 200 Additional
Practice Questions with Detailed Rationales
NR 602 midterm with 200 pediatric primary care practice questions covering SIDS, growth
and development, immunizations, and common pediatric disorders—each with detailed
answers and rationales.
Section 1: Pediatric Foundations & Roles (Questions 1–50)
1. A nurse practitioner is explaining the concept of the "medical home" to a group of new parents.
Which statement best describes this model?
A. A single clinic where all pediatric specialists practice together
B. A continuous, comprehensive, family-centered source of primary care that is accessible and
coordinated
C. A hospital-based urgent care center for children
D. A government-funded insurance program for low-income children
Correct: B
Rationale: The medical home model emphasizes continuous, comprehensive, family-centered,
coordinated, compassionate, and culturally effective care. It is not defined by a physical location or
insurance program.
2. Which of the following is NOT within the scope of practice for a primary care pediatric nurse
practitioner?
A. Diagnosing and treating acute otitis media
B. Prescribing inhaled corticosteroids for asthma
C. Performing surgical repair of a congenital heart defect
D. Providing anticipatory guidance on injury prevention
Correct: C
Rationale: Surgical repair of congenital heart defects is outside the scope of a primary care PNP. PNPs
diagnose and manage common pediatric conditions, prescribe medications, and provide preventive
care.
Page 1 of 48
,3. A 7-year-old child is brought to the clinic for a well-child visit. The parent asks about the "new" CDC
immunization schedule changes. What is the NP's best response?
A. "All vaccines have been removed from the schedule."
B. "The CDC now categorizes vaccines into three tiers: recommended for all, recommended for high-risk
groups, and shared clinical decision-making."
C. "The schedule is exactly the same as last year."
D. "Vaccines are no longer recommended for children."
Correct: B
Rationale: On January 5, 2026, HHS announced revisions to the CDC childhood immunization schedule,
organizing vaccines into three categories: recommended for all children, recommended for high-risk
groups, and based on shared clinical decision-making .
4. Which of the following is an example of primary prevention in pediatric practice?
A. Administering the MMR vaccine at 12 months
B. Screening for elevated lead levels at 12 months
C. Prescribing an asthma controller medication
D. Referring a child with developmental delay for therapy
Correct: A
Rationale: Immunizations prevent disease before it occurs. Lead screening is secondary prevention,
controller medications and therapy referrals are tertiary prevention.
5. A nurse practitioner is counseling a parent about safe sleep. Which statement by the parent
indicates correct understanding?
A. "I will put my baby on her side to sleep so she doesn't spit up."
B. "I will use a soft bumper pad to prevent her from hitting the crib sides."
C. "I will place her on her back for every sleep and keep the crib free of soft objects."
D. "I will let her sleep in my bed so I can check on her breathing."
Correct: C
Rationale: Supine positioning for every sleep is the most effective SIDS risk reduction strategy. Soft
bedding and bed-sharing increase risk .
6. Which of the following describes the correct approach when a parent declines a recommended
vaccine?
A. Document the refusal and dismiss the family from the practice
B. Explore the parent's concerns, provide evidence-based information, and document the discussion
C. Administer the vaccine anyway
D. Refer the family to child protective services
Correct: B
Rationale: The NP should use a non-judgmental, empathetic approach to address vaccine hesitancy,
providing evidence-based information while respecting parental autonomy.
7. A 2-month-old infant is brought to the clinic. Which preventive service is indicated at this visit?
Page 2 of 48
,A. MMR vaccine
B. DTaP, Hib, IPV, pneumococcal conjugate, and rotavirus vaccines
C. Vision screening
D. Lead level screening
Correct: B
Rationale: At 2 months, infants receive DTaP, Hib, IPV, pneumococcal conjugate, and rotavirus vaccines.
MMR is given at 12–15 months. Vision and lead screening are not routine at 2 months.
8. Which of the following is a key component of a well-child visit for a 12-month-old?
A. Assessing developmental milestones and administering MMR and varicella vaccines
B. Performing a chest X-ray
C. Ordering a complete blood count
D. Referring for speech therapy
Correct: A
Rationale: Well-child visits at 12 months focus on developmental assessment and administration of
MMR and varicella vaccines, along with anticipatory guidance.
9. The nurse practitioner is assessing a 5-year-old child. Which finding would be most concerning?
A. The child cannot yet write their name
B. The child cannot yet draw a person with 6 parts
C. The child cannot yet hop on one foot
D. The child cannot yet tie shoelaces
Correct: C
Rationale: Hopping on one foot is a 4-year milestone. Failure to achieve this at 5 years warrants further
evaluation. Writing their name and drawing a person with 6 parts are 5-year milestones. Tying shoelaces
is a 6-year milestone.
10. A parent asks the NP about the "Vaccines for Children" (VFC) program. What is the correct
explanation?
A. A program that provides free vaccines to all children regardless of insurance
B. A program that provides vaccines at no cost to children who are Medicaid-eligible, uninsured, or
American Indian/Alaska Native
C. A program that only covers influenza vaccines
D. A program that requires families to pay a copay for each vaccine
Correct: B
Rationale: The VFC program provides vaccines at no cost to children who are Medicaid-eligible,
uninsured, or American Indian/Alaska Native .
11. Which of the following is an example of secondary prevention?
A. Administering the HPV vaccine
B. Performing a developmental screening at 18 months
Page 3 of 48
, C. Teaching a child with asthma how to use an inhaler
D. Providing car seat education
Correct: B
Rationale: Developmental screening detects delays early, before symptoms become severe. Vaccination
and car seat education are primary prevention. Inhaler teaching is tertiary prevention.
12. A 3-year-old child is brought to the clinic. The parent reports the child has been having frequent
tantrums. What is the NP's best response?
A. "This is abnormal and requires psychiatric evaluation."
B. "Tantrums are a normal part of development at this age as the child seeks autonomy."
C. "You should discipline the child more strictly."
D. "This indicates the child has oppositional defiant disorder."
Correct: B
Rationale: Tantrums are developmentally normal in toddlers and preschoolers as they assert
independence (Erikson's autonomy vs. shame and doubt, initiative vs. guilt).
13. Which statement about SIDS is correct?
A. SIDS is most common in infants older than 12 months.
B. SIDS rates have increased significantly in recent years.
C. SIDS is the leading cause of death in infants aged 1 month to 1 year.
D. SIDS is entirely preventable.
Correct: C
Rationale: SIDS is the leading cause of death in infants aged 1 month to 1 year. It peaks at 2–4 months.
Rates have declined since the Back to Sleep campaign, but racial disparities persist.
14. A parent asks whether a fan in the infant's room can prevent SIDS. What is the NP's best
response?
A. "Fans have been proven to eliminate SIDS risk."
B. "Some studies suggest fan use may be associated with reduced SIDS risk, but it should not replace
other safe sleep practices."
C. "Fans increase the risk of SIDS."
D. "Fans should only be used if the infant has a respiratory infection."
Correct: B
Rationale: Fan use may improve air circulation and reduce CO₂ pooling, but it is not a substitute for
supine sleeping, a firm surface, and removing soft bedding.
15. Which of the following is a non-modifiable risk factor for SIDS?
A. Prone sleeping
B. Maternal smoking
C. Male sex
D. Soft bedding
Page 4 of 48
Practice Questions with Detailed Rationales
NR 602 midterm with 200 pediatric primary care practice questions covering SIDS, growth
and development, immunizations, and common pediatric disorders—each with detailed
answers and rationales.
Section 1: Pediatric Foundations & Roles (Questions 1–50)
1. A nurse practitioner is explaining the concept of the "medical home" to a group of new parents.
Which statement best describes this model?
A. A single clinic where all pediatric specialists practice together
B. A continuous, comprehensive, family-centered source of primary care that is accessible and
coordinated
C. A hospital-based urgent care center for children
D. A government-funded insurance program for low-income children
Correct: B
Rationale: The medical home model emphasizes continuous, comprehensive, family-centered,
coordinated, compassionate, and culturally effective care. It is not defined by a physical location or
insurance program.
2. Which of the following is NOT within the scope of practice for a primary care pediatric nurse
practitioner?
A. Diagnosing and treating acute otitis media
B. Prescribing inhaled corticosteroids for asthma
C. Performing surgical repair of a congenital heart defect
D. Providing anticipatory guidance on injury prevention
Correct: C
Rationale: Surgical repair of congenital heart defects is outside the scope of a primary care PNP. PNPs
diagnose and manage common pediatric conditions, prescribe medications, and provide preventive
care.
Page 1 of 48
,3. A 7-year-old child is brought to the clinic for a well-child visit. The parent asks about the "new" CDC
immunization schedule changes. What is the NP's best response?
A. "All vaccines have been removed from the schedule."
B. "The CDC now categorizes vaccines into three tiers: recommended for all, recommended for high-risk
groups, and shared clinical decision-making."
C. "The schedule is exactly the same as last year."
D. "Vaccines are no longer recommended for children."
Correct: B
Rationale: On January 5, 2026, HHS announced revisions to the CDC childhood immunization schedule,
organizing vaccines into three categories: recommended for all children, recommended for high-risk
groups, and based on shared clinical decision-making .
4. Which of the following is an example of primary prevention in pediatric practice?
A. Administering the MMR vaccine at 12 months
B. Screening for elevated lead levels at 12 months
C. Prescribing an asthma controller medication
D. Referring a child with developmental delay for therapy
Correct: A
Rationale: Immunizations prevent disease before it occurs. Lead screening is secondary prevention,
controller medications and therapy referrals are tertiary prevention.
5. A nurse practitioner is counseling a parent about safe sleep. Which statement by the parent
indicates correct understanding?
A. "I will put my baby on her side to sleep so she doesn't spit up."
B. "I will use a soft bumper pad to prevent her from hitting the crib sides."
C. "I will place her on her back for every sleep and keep the crib free of soft objects."
D. "I will let her sleep in my bed so I can check on her breathing."
Correct: C
Rationale: Supine positioning for every sleep is the most effective SIDS risk reduction strategy. Soft
bedding and bed-sharing increase risk .
6. Which of the following describes the correct approach when a parent declines a recommended
vaccine?
A. Document the refusal and dismiss the family from the practice
B. Explore the parent's concerns, provide evidence-based information, and document the discussion
C. Administer the vaccine anyway
D. Refer the family to child protective services
Correct: B
Rationale: The NP should use a non-judgmental, empathetic approach to address vaccine hesitancy,
providing evidence-based information while respecting parental autonomy.
7. A 2-month-old infant is brought to the clinic. Which preventive service is indicated at this visit?
Page 2 of 48
,A. MMR vaccine
B. DTaP, Hib, IPV, pneumococcal conjugate, and rotavirus vaccines
C. Vision screening
D. Lead level screening
Correct: B
Rationale: At 2 months, infants receive DTaP, Hib, IPV, pneumococcal conjugate, and rotavirus vaccines.
MMR is given at 12–15 months. Vision and lead screening are not routine at 2 months.
8. Which of the following is a key component of a well-child visit for a 12-month-old?
A. Assessing developmental milestones and administering MMR and varicella vaccines
B. Performing a chest X-ray
C. Ordering a complete blood count
D. Referring for speech therapy
Correct: A
Rationale: Well-child visits at 12 months focus on developmental assessment and administration of
MMR and varicella vaccines, along with anticipatory guidance.
9. The nurse practitioner is assessing a 5-year-old child. Which finding would be most concerning?
A. The child cannot yet write their name
B. The child cannot yet draw a person with 6 parts
C. The child cannot yet hop on one foot
D. The child cannot yet tie shoelaces
Correct: C
Rationale: Hopping on one foot is a 4-year milestone. Failure to achieve this at 5 years warrants further
evaluation. Writing their name and drawing a person with 6 parts are 5-year milestones. Tying shoelaces
is a 6-year milestone.
10. A parent asks the NP about the "Vaccines for Children" (VFC) program. What is the correct
explanation?
A. A program that provides free vaccines to all children regardless of insurance
B. A program that provides vaccines at no cost to children who are Medicaid-eligible, uninsured, or
American Indian/Alaska Native
C. A program that only covers influenza vaccines
D. A program that requires families to pay a copay for each vaccine
Correct: B
Rationale: The VFC program provides vaccines at no cost to children who are Medicaid-eligible,
uninsured, or American Indian/Alaska Native .
11. Which of the following is an example of secondary prevention?
A. Administering the HPV vaccine
B. Performing a developmental screening at 18 months
Page 3 of 48
, C. Teaching a child with asthma how to use an inhaler
D. Providing car seat education
Correct: B
Rationale: Developmental screening detects delays early, before symptoms become severe. Vaccination
and car seat education are primary prevention. Inhaler teaching is tertiary prevention.
12. A 3-year-old child is brought to the clinic. The parent reports the child has been having frequent
tantrums. What is the NP's best response?
A. "This is abnormal and requires psychiatric evaluation."
B. "Tantrums are a normal part of development at this age as the child seeks autonomy."
C. "You should discipline the child more strictly."
D. "This indicates the child has oppositional defiant disorder."
Correct: B
Rationale: Tantrums are developmentally normal in toddlers and preschoolers as they assert
independence (Erikson's autonomy vs. shame and doubt, initiative vs. guilt).
13. Which statement about SIDS is correct?
A. SIDS is most common in infants older than 12 months.
B. SIDS rates have increased significantly in recent years.
C. SIDS is the leading cause of death in infants aged 1 month to 1 year.
D. SIDS is entirely preventable.
Correct: C
Rationale: SIDS is the leading cause of death in infants aged 1 month to 1 year. It peaks at 2–4 months.
Rates have declined since the Back to Sleep campaign, but racial disparities persist.
14. A parent asks whether a fan in the infant's room can prevent SIDS. What is the NP's best
response?
A. "Fans have been proven to eliminate SIDS risk."
B. "Some studies suggest fan use may be associated with reduced SIDS risk, but it should not replace
other safe sleep practices."
C. "Fans increase the risk of SIDS."
D. "Fans should only be used if the infant has a respiratory infection."
Correct: B
Rationale: Fan use may improve air circulation and reduce CO₂ pooling, but it is not a substitute for
supine sleeping, a firm surface, and removing soft bedding.
15. Which of the following is a non-modifiable risk factor for SIDS?
A. Prone sleeping
B. Maternal smoking
C. Male sex
D. Soft bedding
Page 4 of 48
