Advanced Primary Care Across the Lifespan
NU 665D - PRIMARY CARE ADULT WOMAN II | EXAM QUESTIONS AND
CORRECT ANSWERS | VERIFIED WOMEN’S HEALTH AND
GYNECOLOGIC CARE LATEST 2026/2027
Nu 665D Exam
ADVANCED PRIMARY CARE ACROSS THE LIFESPAN
1. A 3-year-old is brought in refusing to use his right arm after his
father swung him up by the hands. The arm is held slightly flexed and
pronated with no swelling. What is the most likely diagnosis?
A. Clavicle fracture
B. Elbow dislocation
C. Radial head subluxation
D. Supracondylar humerus fracture
C. Radial head subluxation
Sudden axial traction on an extended, pronated arm in a toddler is the
classic mechanism for nursemaid's elbow; absence of swelling makes
fracture unlikely.
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, Advanced Primary Care Across the Lifespan
2. Which reduction technique is most commonly used for radial head
subluxation in the office?
A. Shoulder abduction with external rotation
B. Hyperpronation of the forearm, or supination followed by elbow
flexion
C. Wrist dorsiflexion while extending the elbow
D. Gentle traction with the elbow fully extended
B. Hyperpronation of the forearm, or supination followed by elbow
flexion
Hyperpronation and supination-flexion are both accepted; hyperpronation
has a slightly higher first-attempt success rate.
3. During a newborn exam, the NP adducts the hip and applies gentle
posterior pressure, feeling the femoral head slip out of the acetabulum.
This maneuver is called:
A. Trendelenburg test
B. Galeazzi test
C. Barlow maneuver
D. Ortolani maneuver
C. Barlow maneuver
Barlow dislocates an unstable hip posteriorly; Ortolani relocates a
dislocated hip with abduction and anterior lift.
4. The preferred imaging study to evaluate suspected developmental
dysplasia of the hip in an infant younger than 4 months is:
A. MRI of the hips
B. CT of the pelvis
C. Hip ultrasound
D. Plain radiograph of the pelvis
C. Hip ultrasound
The femoral head is still cartilaginous before about 4 to 6 months, so
ultrasound is preferred over radiographs.
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, Advanced Primary Care Across the Lifespan
5. An obese 12-year-old boy reports several weeks of knee pain and
now walks with an externally rotated limp. Internal rotation of the hip
is limited. What is the priority action?
A. Prescribe ibuprofen and quadriceps strengthening
B. Order a knee MRI and follow up in two weeks
C. Advise rest from sports for one month
D. Make him non-weight bearing and refer urgently to orthopedics
D. Make him non-weight bearing and refer urgently to orthopedics
These findings suggest slipped capital femoral epiphysis; weight bearing
risks further slippage and avascular necrosis, so protect the hip and refer
urgently.
6. A 13-year-old soccer player has pain and a tender bony prominence
just below the patella that worsens with running and kneeling. The
most likely diagnosis is:
A. Osteosarcoma of the proximal tibia
B. Osgood-Schlatter disease
C. Sinding-Larsen-Johansson syndrome
D. Patellofemoral pain syndrome
B. Osgood-Schlatter disease
Traction apophysitis at the tibial tubercle in an active adolescent is typical
of Osgood-Schlatter; it is self-limited and managed with activity
modification.
7. A 6-year-old boy has an intermittent painless limp and mildly limited
hip abduction. X-ray shows flattening and fragmentation of the femoral
head. This presentation is most consistent with:
A. Slipped capital femoral epiphysis
B. Septic arthritis
C. Transient synovitis
D. Legg-Calve-Perthes disease
D. Legg-Calve-Perthes disease
Perthes is idiopathic avascular necrosis of the femoral head, usually in
boys aged 4 to 8, presenting with an insidious limp.
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, Advanced Primary Care Across the Lifespan
8. A fracture that passes through the physis and exits through the
metaphysis is classified as Salter-Harris type:
A. III
B. II
C. I
D. IV
B. II
Type II, the most common, runs through the growth plate and out the
metaphysis, leaving a metaphyseal fragment.
9. A febrile 4-year-old refuses to bear weight on the left leg. WBC is
14,500, ESR 48 mm/hr, and temperature 39.1°C. Which condition is
most important to rule out?
A. Growing pains
B. Toddler's fracture
C. Septic arthritis of the hip
D. Transient synovitis
C. Septic arthritis of the hip
Fever above 38.5°C, inability to bear weight, ESR above 40 and WBC
above 12,000 are the Kocher criteria; meeting several strongly suggests
septic arthritis.
10. Screening for idiopathic scoliosis in the office is best performed
with the:
A. Thomas test
B. FABER test
C. Adams forward bend test
D. Ober test
C. Adams forward bend test
Bending forward at the waist exposes a rib hump from vertebral rotation;
a scoliometer reading of 7 degrees or more warrants radiographs.
Page 4 of 63
NU 665D - PRIMARY CARE ADULT WOMAN II | EXAM QUESTIONS AND
CORRECT ANSWERS | VERIFIED WOMEN’S HEALTH AND
GYNECOLOGIC CARE LATEST 2026/2027
Nu 665D Exam
ADVANCED PRIMARY CARE ACROSS THE LIFESPAN
1. A 3-year-old is brought in refusing to use his right arm after his
father swung him up by the hands. The arm is held slightly flexed and
pronated with no swelling. What is the most likely diagnosis?
A. Clavicle fracture
B. Elbow dislocation
C. Radial head subluxation
D. Supracondylar humerus fracture
C. Radial head subluxation
Sudden axial traction on an extended, pronated arm in a toddler is the
classic mechanism for nursemaid's elbow; absence of swelling makes
fracture unlikely.
Page 1 of 63
, Advanced Primary Care Across the Lifespan
2. Which reduction technique is most commonly used for radial head
subluxation in the office?
A. Shoulder abduction with external rotation
B. Hyperpronation of the forearm, or supination followed by elbow
flexion
C. Wrist dorsiflexion while extending the elbow
D. Gentle traction with the elbow fully extended
B. Hyperpronation of the forearm, or supination followed by elbow
flexion
Hyperpronation and supination-flexion are both accepted; hyperpronation
has a slightly higher first-attempt success rate.
3. During a newborn exam, the NP adducts the hip and applies gentle
posterior pressure, feeling the femoral head slip out of the acetabulum.
This maneuver is called:
A. Trendelenburg test
B. Galeazzi test
C. Barlow maneuver
D. Ortolani maneuver
C. Barlow maneuver
Barlow dislocates an unstable hip posteriorly; Ortolani relocates a
dislocated hip with abduction and anterior lift.
4. The preferred imaging study to evaluate suspected developmental
dysplasia of the hip in an infant younger than 4 months is:
A. MRI of the hips
B. CT of the pelvis
C. Hip ultrasound
D. Plain radiograph of the pelvis
C. Hip ultrasound
The femoral head is still cartilaginous before about 4 to 6 months, so
ultrasound is preferred over radiographs.
Page 2 of 63
, Advanced Primary Care Across the Lifespan
5. An obese 12-year-old boy reports several weeks of knee pain and
now walks with an externally rotated limp. Internal rotation of the hip
is limited. What is the priority action?
A. Prescribe ibuprofen and quadriceps strengthening
B. Order a knee MRI and follow up in two weeks
C. Advise rest from sports for one month
D. Make him non-weight bearing and refer urgently to orthopedics
D. Make him non-weight bearing and refer urgently to orthopedics
These findings suggest slipped capital femoral epiphysis; weight bearing
risks further slippage and avascular necrosis, so protect the hip and refer
urgently.
6. A 13-year-old soccer player has pain and a tender bony prominence
just below the patella that worsens with running and kneeling. The
most likely diagnosis is:
A. Osteosarcoma of the proximal tibia
B. Osgood-Schlatter disease
C. Sinding-Larsen-Johansson syndrome
D. Patellofemoral pain syndrome
B. Osgood-Schlatter disease
Traction apophysitis at the tibial tubercle in an active adolescent is typical
of Osgood-Schlatter; it is self-limited and managed with activity
modification.
7. A 6-year-old boy has an intermittent painless limp and mildly limited
hip abduction. X-ray shows flattening and fragmentation of the femoral
head. This presentation is most consistent with:
A. Slipped capital femoral epiphysis
B. Septic arthritis
C. Transient synovitis
D. Legg-Calve-Perthes disease
D. Legg-Calve-Perthes disease
Perthes is idiopathic avascular necrosis of the femoral head, usually in
boys aged 4 to 8, presenting with an insidious limp.
Page 3 of 63
, Advanced Primary Care Across the Lifespan
8. A fracture that passes through the physis and exits through the
metaphysis is classified as Salter-Harris type:
A. III
B. II
C. I
D. IV
B. II
Type II, the most common, runs through the growth plate and out the
metaphysis, leaving a metaphyseal fragment.
9. A febrile 4-year-old refuses to bear weight on the left leg. WBC is
14,500, ESR 48 mm/hr, and temperature 39.1°C. Which condition is
most important to rule out?
A. Growing pains
B. Toddler's fracture
C. Septic arthritis of the hip
D. Transient synovitis
C. Septic arthritis of the hip
Fever above 38.5°C, inability to bear weight, ESR above 40 and WBC
above 12,000 are the Kocher criteria; meeting several strongly suggests
septic arthritis.
10. Screening for idiopathic scoliosis in the office is best performed
with the:
A. Thomas test
B. FABER test
C. Adams forward bend test
D. Ober test
C. Adams forward bend test
Bending forward at the waist exposes a rib hump from vertebral rotation;
a scoliometer reading of 7 degrees or more warrants radiographs.
Page 4 of 63
