,NSG 548 Exam 3 Family Nurse Practitioner Questions And Answers
2026/2027 Wilkes University
Q1. A healthy 2-year-old walks with both feet pointing inward.
Examination shows internal rotation of the tibiae without pain,
weakness, or functional limitation. Which diagnosis is most likely?
A) Slipped capital femoral epiphysis
B) Internal tibial torsion
C) Septic arthritis
D) Legg-Calvé-Perthes disease
Correct Answer: B) Internal tibial torsion
Rationale: Internal tibial torsion is a common developmental cause of
intoeing in toddlers. The tibia is rotated inward relative to the knee, causing
the feet to point medially during walking.
Q2. Which management is most appropriate for uncomplicated
internal tibial torsion in a young child with normal function?
A) Observation and reassurance because spontaneous improvement is
common
B) Immediate corrective surgery
C) Full-time rigid bracing
D) Long-term activity restriction
Correct Answer: A) Observation and reassurance because spontaneous
improvement is common
Rationale: Most internal tibial torsion improves naturally with growth.
Special shoes, braces, and routine stretching have not demonstrated
meaningful benefit in typical uncomplicated cases.
Q3. Which finding in a child with intoeing warrants additional
orthopedic evaluation rather than routine reassurance?
A) Symmetric mild intoeing in a toddler
B) Normal strength and gait function
C) Gradual improvement with age
, D) Marked asymmetry, pain, progressive deformity, or functional impairment
Correct Answer: D) Marked asymmetry, pain, progressive deformity, or
functional impairment
Rationale: Symmetric developmental rotational variants are often benign.
Pain, severe asymmetry, progression, neurologic abnormalities, or impaired
function suggests a pathologic process requiring further evaluation.
Q4. Which rotational variation most commonly causes intoeing in an
older preschool or school-age child because the femur rotates
excessively inward?
A) Tibial bowing
B) Genu valgum
C) Femoral anteversion
D) Pes planus
Correct Answer: C) Femoral anteversion
Rationale: Femoral anteversion commonly becomes apparent after
toddlerhood and can cause inward-facing knees and feet. Many cases
improve spontaneously as the femur remodels during childhood.
Q5. A flexible forefoot curves inward while the hindfoot remains
relatively normal in a young infant. Which condition is most likely?
A) Metatarsus adductus
B) Clubfoot with rigid equinus
C) Slipped capital femoral epiphysis
D) Osgood-Schlatter disease
Correct Answer: A) Metatarsus adductus
Rationale: Metatarsus adductus causes medial deviation of the forefoot.
Flexible cases frequently resolve spontaneously, whereas rigid or severe
deformities may require closer orthopedic management.
Q6. Which statement about common pediatric rotational variations
is most accurate?
A) Most require surgical correction before school age
2026/2027 Wilkes University
Q1. A healthy 2-year-old walks with both feet pointing inward.
Examination shows internal rotation of the tibiae without pain,
weakness, or functional limitation. Which diagnosis is most likely?
A) Slipped capital femoral epiphysis
B) Internal tibial torsion
C) Septic arthritis
D) Legg-Calvé-Perthes disease
Correct Answer: B) Internal tibial torsion
Rationale: Internal tibial torsion is a common developmental cause of
intoeing in toddlers. The tibia is rotated inward relative to the knee, causing
the feet to point medially during walking.
Q2. Which management is most appropriate for uncomplicated
internal tibial torsion in a young child with normal function?
A) Observation and reassurance because spontaneous improvement is
common
B) Immediate corrective surgery
C) Full-time rigid bracing
D) Long-term activity restriction
Correct Answer: A) Observation and reassurance because spontaneous
improvement is common
Rationale: Most internal tibial torsion improves naturally with growth.
Special shoes, braces, and routine stretching have not demonstrated
meaningful benefit in typical uncomplicated cases.
Q3. Which finding in a child with intoeing warrants additional
orthopedic evaluation rather than routine reassurance?
A) Symmetric mild intoeing in a toddler
B) Normal strength and gait function
C) Gradual improvement with age
, D) Marked asymmetry, pain, progressive deformity, or functional impairment
Correct Answer: D) Marked asymmetry, pain, progressive deformity, or
functional impairment
Rationale: Symmetric developmental rotational variants are often benign.
Pain, severe asymmetry, progression, neurologic abnormalities, or impaired
function suggests a pathologic process requiring further evaluation.
Q4. Which rotational variation most commonly causes intoeing in an
older preschool or school-age child because the femur rotates
excessively inward?
A) Tibial bowing
B) Genu valgum
C) Femoral anteversion
D) Pes planus
Correct Answer: C) Femoral anteversion
Rationale: Femoral anteversion commonly becomes apparent after
toddlerhood and can cause inward-facing knees and feet. Many cases
improve spontaneously as the femur remodels during childhood.
Q5. A flexible forefoot curves inward while the hindfoot remains
relatively normal in a young infant. Which condition is most likely?
A) Metatarsus adductus
B) Clubfoot with rigid equinus
C) Slipped capital femoral epiphysis
D) Osgood-Schlatter disease
Correct Answer: A) Metatarsus adductus
Rationale: Metatarsus adductus causes medial deviation of the forefoot.
Flexible cases frequently resolve spontaneously, whereas rigid or severe
deformities may require closer orthopedic management.
Q6. Which statement about common pediatric rotational variations
is most accurate?
A) Most require surgical correction before school age
