NR 602 MID-TERM EXAM: 100% EXPERT VERIFIED
STUDY GUIDE REAL TESTING 2026|2027 QUESTIONS
DETAILED ANSWERS AND INSTRUCTOR NOTE FOR A+
GUARANTEED PASS
Asthma - Answers -- Step 1 (intermittent): sx <2x/week, normal PFts, nighttime sx <2/month,
exacerbations brief, no interference with normal activity
- Step 2 (mild persistent): >2x/week but not more than 1 per day, 3-4 nighttime sx/month, FEV
>80%
- Step 3 (mod persistent): daily sx, daily SABA, some limitations, exacerbations affect activity and
may last days. FEV >60 but <80
- Step 4 (severe persistent): Continual sx, requires SABA several x's/day, extremely limited
physical activity, frequent exacerbations, nightly sx, FEV <60%
Asthma treatment steps - Answers -- Step 1: SABA PRn
- Step 2: Low-dose ICS, OR LTRA, Cromolyn
- Step 3: Low-dose ICS + LABA OR Med- dose ICS
- Step 4: Med- dose ICS + LABA OR med-dose ICS + LTRA
- Step 5: High-dose ICS + LABA AND omalizumab for pts who have allergies
- Step 6: High-dose ICS + Laba + Oral steroid AND omalizumab for allergies
- consult asthma specialist after step 3-4( for sure at 4)
rotavirus - Answers -- 1-3 day incubation period
- more prevalent in cooler months
1|Page
,- Acute onset fever, vomiting, watery diarrhea occur 2-4 days later in child <5, esp those
between 3-24 months.
-3-8 days till recovery
- fecal-oral transmission, lives on inanimate objects, rarely contaminated water or food
- Testing: enzyme immunoassay & latex agglutination assay for group a rotavirus
- Tx: supportive care, correct dehydration, Prevent: diaper precautions in daycare
Salmonella - Answers -- 1-3 day incubation, 4-7 day duration of illness
- s/s: diarrhea, fever, abd cramps, rebound tenderness, n/v
- typhy & paratyphi produce typhoid with insidious onset with fever, HA, constipation, malaise,
chills, myalgia, diarrhea is uncommon and vomiting not severe
-transmitted through eggs poultry, unpasteurized milk/juice, cheese, raw fruit & veggies. Typhi:
epidemics from fecal contamination of water supply
-test: stool cultures: leukocytosis, gross blood. WBC high
-tx: supportive care. ATB ONLY for infants <3m, those with chronic GI disease, cancer, HIV,
immunosuppressed (Ampicillin or Amox, Azith, or TMP-SMX ORR ceftriax)
C. diff - Answers -- unknown incubation, duration: after several weeks of ATB
- Sx: explosive diarrhea, bloody stools, abd pain, fever, n/v
- acquired from the environment or oral-fecal route
-Test: stool culture, enzyme immunoassay for toxin a or a and B
- Tx: d/c ATB (esp. clinda, ampa, or cephalosporins), fluid & lyte replacement. ** If ATB still
needed, treat with oral Metronidadole or Vanco for 7-10 days, probiotic
2|Page
, Cryptosporidium parvum - Answers -- 3-14 day incubation, Self-limiting duration (6-14 days)
-Sx: watery diarrhea, ABD cramps, bloating, slight fever, anorexia, wt loss, n/v, flatulence, fatigue
- Fecal/oral route from uncooked food or contaminated from an ill person , drinking water (
collects on water filters that cannot be disinfected)
- test: Cryptosporidium test using antigen detection test.
- Tx: supportive, if person immunocompromised, Paromomycin x 7 days. For children 1-11 years,
Nitazoxanide x3 days
Intussusception - Answers -- A section of intestine being pulled antegrade into the adjacent
intestine and being trapped.
- Most common cause of bowel obstruction in children
- Usually between 5-10 months. 80% of cases before 2 years old
- Sx: Triad- crampy abd pain, vomiting, and bloody mucous stools (<25% of cases), screaming
with drawing up legs, periods of calm/sleeping, stool maybe with blood and diarrhea, infant
may appear glassy-eyed and sedated between episodes, sausage like mass in RUQ & emptiness
in RLQ
-Normal x-ray, *Ultrasound*, air contrast enema is both diagnostic and a treatment
- Tx: surgery is necessary is perforation, peritonitis, hypovolemic shock. IV ATB, radiologic
reduction
Celiac Disease - Answers -- Gluten-sensitivity. Immune mediated systemic disorder
- Frequently occurs with other autoimmune diseases (DM 1, liver disease, IgA nephropathy,
juvenile chronic arthritis)
-Risk: immigration from another country, born by c-section, 6m-2years, female,
- Sx: Chronic or intermittent diarrhea, persistent or unexplained Gi symptoms, wt loss,
prolonged fatigue, growth failure, steatorrhea, low trauma fractures, dental enamel defects
3|Page
STUDY GUIDE REAL TESTING 2026|2027 QUESTIONS
DETAILED ANSWERS AND INSTRUCTOR NOTE FOR A+
GUARANTEED PASS
Asthma - Answers -- Step 1 (intermittent): sx <2x/week, normal PFts, nighttime sx <2/month,
exacerbations brief, no interference with normal activity
- Step 2 (mild persistent): >2x/week but not more than 1 per day, 3-4 nighttime sx/month, FEV
>80%
- Step 3 (mod persistent): daily sx, daily SABA, some limitations, exacerbations affect activity and
may last days. FEV >60 but <80
- Step 4 (severe persistent): Continual sx, requires SABA several x's/day, extremely limited
physical activity, frequent exacerbations, nightly sx, FEV <60%
Asthma treatment steps - Answers -- Step 1: SABA PRn
- Step 2: Low-dose ICS, OR LTRA, Cromolyn
- Step 3: Low-dose ICS + LABA OR Med- dose ICS
- Step 4: Med- dose ICS + LABA OR med-dose ICS + LTRA
- Step 5: High-dose ICS + LABA AND omalizumab for pts who have allergies
- Step 6: High-dose ICS + Laba + Oral steroid AND omalizumab for allergies
- consult asthma specialist after step 3-4( for sure at 4)
rotavirus - Answers -- 1-3 day incubation period
- more prevalent in cooler months
1|Page
,- Acute onset fever, vomiting, watery diarrhea occur 2-4 days later in child <5, esp those
between 3-24 months.
-3-8 days till recovery
- fecal-oral transmission, lives on inanimate objects, rarely contaminated water or food
- Testing: enzyme immunoassay & latex agglutination assay for group a rotavirus
- Tx: supportive care, correct dehydration, Prevent: diaper precautions in daycare
Salmonella - Answers -- 1-3 day incubation, 4-7 day duration of illness
- s/s: diarrhea, fever, abd cramps, rebound tenderness, n/v
- typhy & paratyphi produce typhoid with insidious onset with fever, HA, constipation, malaise,
chills, myalgia, diarrhea is uncommon and vomiting not severe
-transmitted through eggs poultry, unpasteurized milk/juice, cheese, raw fruit & veggies. Typhi:
epidemics from fecal contamination of water supply
-test: stool cultures: leukocytosis, gross blood. WBC high
-tx: supportive care. ATB ONLY for infants <3m, those with chronic GI disease, cancer, HIV,
immunosuppressed (Ampicillin or Amox, Azith, or TMP-SMX ORR ceftriax)
C. diff - Answers -- unknown incubation, duration: after several weeks of ATB
- Sx: explosive diarrhea, bloody stools, abd pain, fever, n/v
- acquired from the environment or oral-fecal route
-Test: stool culture, enzyme immunoassay for toxin a or a and B
- Tx: d/c ATB (esp. clinda, ampa, or cephalosporins), fluid & lyte replacement. ** If ATB still
needed, treat with oral Metronidadole or Vanco for 7-10 days, probiotic
2|Page
, Cryptosporidium parvum - Answers -- 3-14 day incubation, Self-limiting duration (6-14 days)
-Sx: watery diarrhea, ABD cramps, bloating, slight fever, anorexia, wt loss, n/v, flatulence, fatigue
- Fecal/oral route from uncooked food or contaminated from an ill person , drinking water (
collects on water filters that cannot be disinfected)
- test: Cryptosporidium test using antigen detection test.
- Tx: supportive, if person immunocompromised, Paromomycin x 7 days. For children 1-11 years,
Nitazoxanide x3 days
Intussusception - Answers -- A section of intestine being pulled antegrade into the adjacent
intestine and being trapped.
- Most common cause of bowel obstruction in children
- Usually between 5-10 months. 80% of cases before 2 years old
- Sx: Triad- crampy abd pain, vomiting, and bloody mucous stools (<25% of cases), screaming
with drawing up legs, periods of calm/sleeping, stool maybe with blood and diarrhea, infant
may appear glassy-eyed and sedated between episodes, sausage like mass in RUQ & emptiness
in RLQ
-Normal x-ray, *Ultrasound*, air contrast enema is both diagnostic and a treatment
- Tx: surgery is necessary is perforation, peritonitis, hypovolemic shock. IV ATB, radiologic
reduction
Celiac Disease - Answers -- Gluten-sensitivity. Immune mediated systemic disorder
- Frequently occurs with other autoimmune diseases (DM 1, liver disease, IgA nephropathy,
juvenile chronic arthritis)
-Risk: immigration from another country, born by c-section, 6m-2years, female,
- Sx: Chronic or intermittent diarrhea, persistent or unexplained Gi symptoms, wt loss,
prolonged fatigue, growth failure, steatorrhea, low trauma fractures, dental enamel defects
3|Page
