NR602 PEDIATRIC MIDTERM EXAM REVIEW –
ORIGINAL PRACTICE QUESTIONS AND DETAILED
RATIONALES | CHAMBERLAIN UNIVERSITY | PRIMARY
CARE OF THE CHILD-BEARING FAMILY | ORIGINAL
STUDY QUESTIONS
1. A 4-month-old infant should be able to perform which of the following gross
motor milestones?
A. Sit without support
B. Roll from prone to supine
C. Crawl on hands and knees
D. Walk with assistance
B. Roll from prone to supine
RATIONALE: Rolling from prone to supine typically develops at 4–5 months.
Sitting without support occurs at 6–8 months, crawling at 8–10 months, and walking
with assistance at 10–12 months.
2. A 2-year-old child should have a vocabulary of approximately how many
words?
A. 10–20 words
B. 50–100 words
C. 200–300 words
D. 500–600 words
, C. 200–300 words
RATIONALE: By 2 years of age, a child typically has a vocabulary of 200–300
words and can combine two words into simple phrases.
3. A newborn presents with a yellow discoloration of the skin and sclera at 48
hours of life. Which is the most appropriate initial step?
A. Obtain a serum bilirubin level
B. Begin phototherapy immediately
C. Reassure the parents that this is normal
D. Order a complete blood count
A. Obtain a serum bilirubin level
RATIONALE: Jaundice appearing within the first 24–48 hours may be pathologic
and requires serum bilirubin measurement to determine the need for phototherapy.
4. A 6-month-old infant presents with a hoarse cough, inspiratory stridor, and
low-grade fever. Which diagnosis is most likely?
A. Bronchiolitis
B. Croup
C. Epiglottitis
D. Asthma
B. Croup
RATIONALE: Croup (laryngotracheobronchitis) presents with a barking cough,
inspiratory stridor, and low-grade fever, typically in children 6 months to 3 years.
,5. Which vaccine is contraindicated in a child with a severe egg allergy?
A. MMR
B. DTaP
C. Influenza
D. Hepatitis B
C. Influenza
RATIONALE: Influenza vaccine is grown in eggs and may contain egg protein.
However, current guidelines allow administration even with egg allergy with
appropriate precautions. MMR and DTaP are not egg-based.
6. A 3-year-old presents with fever, sore throat, and a sandpaper-like rash.
Which diagnosis is most likely?
A. Scarlet fever
B. Measles
C. Rubella
D. Roseola
A. Scarlet fever
RATIONALE: Scarlet fever presents with fever, sore throat, and a sandpaper-like
rash, caused by group A Streptococcus.
7. A 4-week-old infant presents with projectile vomiting after feeding. Which
diagnosis should be suspected?
A. GERD
B. Pyloric stenosis
, C. Intussusception
D. Gastroenteritis
B. Pyloric stenosis
RATIONALE: Projectile vomiting in a 4-week-old infant suggests hypertrophic
pyloric stenosis. Ultrasound confirms the diagnosis.
8. A 5-year-old presents with a honey-colored crusted lesion around the nose.
Which diagnosis is most likely?
A. Impetigo
B. Eczema
C. Tinea
D. Cellulitis
A. Impetigo
RATIONALE: Honey-colored crusts are classic for impetigo, commonly caused
by Staphylococcus aureus or Streptococcus pyogenes.
9. A 10-year-old presents with polyuria, polydipsia, and weight loss. Which
diagnosis should be suspected?
A. Type 1 diabetes
B. Type 2 diabetes
C. Diabetes insipidus
D. SIADH
A. Type 1 diabetes
ORIGINAL PRACTICE QUESTIONS AND DETAILED
RATIONALES | CHAMBERLAIN UNIVERSITY | PRIMARY
CARE OF THE CHILD-BEARING FAMILY | ORIGINAL
STUDY QUESTIONS
1. A 4-month-old infant should be able to perform which of the following gross
motor milestones?
A. Sit without support
B. Roll from prone to supine
C. Crawl on hands and knees
D. Walk with assistance
B. Roll from prone to supine
RATIONALE: Rolling from prone to supine typically develops at 4–5 months.
Sitting without support occurs at 6–8 months, crawling at 8–10 months, and walking
with assistance at 10–12 months.
2. A 2-year-old child should have a vocabulary of approximately how many
words?
A. 10–20 words
B. 50–100 words
C. 200–300 words
D. 500–600 words
, C. 200–300 words
RATIONALE: By 2 years of age, a child typically has a vocabulary of 200–300
words and can combine two words into simple phrases.
3. A newborn presents with a yellow discoloration of the skin and sclera at 48
hours of life. Which is the most appropriate initial step?
A. Obtain a serum bilirubin level
B. Begin phototherapy immediately
C. Reassure the parents that this is normal
D. Order a complete blood count
A. Obtain a serum bilirubin level
RATIONALE: Jaundice appearing within the first 24–48 hours may be pathologic
and requires serum bilirubin measurement to determine the need for phototherapy.
4. A 6-month-old infant presents with a hoarse cough, inspiratory stridor, and
low-grade fever. Which diagnosis is most likely?
A. Bronchiolitis
B. Croup
C. Epiglottitis
D. Asthma
B. Croup
RATIONALE: Croup (laryngotracheobronchitis) presents with a barking cough,
inspiratory stridor, and low-grade fever, typically in children 6 months to 3 years.
,5. Which vaccine is contraindicated in a child with a severe egg allergy?
A. MMR
B. DTaP
C. Influenza
D. Hepatitis B
C. Influenza
RATIONALE: Influenza vaccine is grown in eggs and may contain egg protein.
However, current guidelines allow administration even with egg allergy with
appropriate precautions. MMR and DTaP are not egg-based.
6. A 3-year-old presents with fever, sore throat, and a sandpaper-like rash.
Which diagnosis is most likely?
A. Scarlet fever
B. Measles
C. Rubella
D. Roseola
A. Scarlet fever
RATIONALE: Scarlet fever presents with fever, sore throat, and a sandpaper-like
rash, caused by group A Streptococcus.
7. A 4-week-old infant presents with projectile vomiting after feeding. Which
diagnosis should be suspected?
A. GERD
B. Pyloric stenosis
, C. Intussusception
D. Gastroenteritis
B. Pyloric stenosis
RATIONALE: Projectile vomiting in a 4-week-old infant suggests hypertrophic
pyloric stenosis. Ultrasound confirms the diagnosis.
8. A 5-year-old presents with a honey-colored crusted lesion around the nose.
Which diagnosis is most likely?
A. Impetigo
B. Eczema
C. Tinea
D. Cellulitis
A. Impetigo
RATIONALE: Honey-colored crusts are classic for impetigo, commonly caused
by Staphylococcus aureus or Streptococcus pyogenes.
9. A 10-year-old presents with polyuria, polydipsia, and weight loss. Which
diagnosis should be suspected?
A. Type 1 diabetes
B. Type 2 diabetes
C. Diabetes insipidus
D. SIADH
A. Type 1 diabetes
