Nsg 5442 Final Exam Questions
and Answers | 2026 Update |
100% Correct.
Course Nsg 5442
Section 1: Pediatric Primary Care and Development
1. Developmental assessment
A nurse practitioner evaluates a 6-year-old child who has difficulty transitioning from one
activity to another. Which executive-function skill is most likely impaired?
A. Working memory B. Cognitive flexibility C. Processing speed D. Visual recognition
Correct answer: B. Cognitive flexibility
Rationale: Cognitive flexibility enables a child to adapt to changes, switch tasks, and adjust
behavior when circumstances change.
2. Infant immunity
Which immunoglobulin provides important mucosal protection to a breastfed infant?
A. IgE B. IgM C. Secretory IgA D. IgD
Correct answer: C. Secretory IgA
,Rationale: Secretory IgA in breast milk helps protect the infant's gastrointestinal and respiratory
mucosal surfaces against pathogens.
3. Maternal antibodies
Which immunoglobulin normally crosses the placenta and provides passive immunity to the
fetus?
A. IgA B. IgE C. IgM D. IgG
Correct answer: D. IgG
Rationale: Maternal IgG crosses the placenta and provides temporary passive protection during
early infancy.
4. Introduction of cow's milk
At what age can whole cow's milk generally be introduced as a beverage for a healthy infant?
A. 4 months B. 6 months C. 9 months D. 12 months
Correct answer: D. 12 months
Rationale: Whole cow's milk is generally introduced at 12 months. Earlier use as the primary
milk beverage can increase the risk of iron deficiency and does not provide the appropriate
nutritional balance for young infants.
5. Newborn vitamin K
Why is vitamin K administered to newborns shortly after birth?
A. To prevent neonatal hypoglycemia B. To prevent vitamin K deficiency bleeding C. To
improve pulmonary function D. To prevent neonatal jaundice
,Correct answer: B. To prevent vitamin K deficiency bleeding
Rationale: Newborns have low vitamin K stores, limited placental transfer, and an immature
intestinal microbiome. Vitamin K prophylaxis helps prevent potentially serious bleeding.
6. Developmental screening
A parent reports that a 24-month-old child has stopped using previously acquired words and no
longer responds consistently to their name. What is the most appropriate next step?
A. Reassure the parent that regression is normal B. Wait until the next annual examination C.
Arrange prompt developmental evaluation and hearing assessment D. Recommend preschool
enrollment without further evaluation
Correct answer: C. Arrange prompt developmental evaluation and hearing assessment
Rationale: Developmental regression is a significant warning sign. Prompt assessment can
identify developmental, neurologic, or hearing-related conditions that require intervention.
7. Growth assessment
Why are BMI percentiles used when assessing children and adolescents?
A. Adult BMI thresholds apply equally to all ages B. BMI interpretation must account for age
and sex C. BMI measures bone density directly D. BMI eliminates the need to assess growth
patterns
Correct answer: B. BMI interpretation must account for age and sex
Rationale: BMI changes during childhood and adolescence. For children aged 2 years and older,
BMI-for-age percentiles help interpret weight status in the context of age and sex.
, 8. Adolescent confidentiality
A 16-year-old requests confidential counseling about sexual health. What is the best initial
response?
A. Refuse to speak with the adolescent without a parent present B. Promise absolute
confidentiality under all circumstances C. Explain confidentiality and its limits, then assess the
adolescent privately D. Disclose all information immediately to the parent
Correct answer: C. Explain confidentiality and its limits, then assess the adolescent privately
Rationale: Developmentally appropriate private time encourages honest communication. The
clinician must explain relevant limits, including applicable reporting requirements and
immediate safety concerns.
9. Adolescent preventive care
Which approach best supports effective preventive counseling during an adolescent health visit?
A. Deliver all counseling exclusively to the parent B. Use a confidential, developmentally
appropriate, nonjudgmental interview C. Avoid discussing mental health unless the parent
requests it D. Restrict the visit to physical measurements
Correct answer: B. Use a confidential, developmentally appropriate, nonjudgmental interview
Rationale: Adolescents benefit from confidential, respectful assessment covering physical health,
mental health, substance use, relationships, safety, and other age-relevant concerns.
10. Down syndrome and neurologic symptoms
and Answers | 2026 Update |
100% Correct.
Course Nsg 5442
Section 1: Pediatric Primary Care and Development
1. Developmental assessment
A nurse practitioner evaluates a 6-year-old child who has difficulty transitioning from one
activity to another. Which executive-function skill is most likely impaired?
A. Working memory B. Cognitive flexibility C. Processing speed D. Visual recognition
Correct answer: B. Cognitive flexibility
Rationale: Cognitive flexibility enables a child to adapt to changes, switch tasks, and adjust
behavior when circumstances change.
2. Infant immunity
Which immunoglobulin provides important mucosal protection to a breastfed infant?
A. IgE B. IgM C. Secretory IgA D. IgD
Correct answer: C. Secretory IgA
,Rationale: Secretory IgA in breast milk helps protect the infant's gastrointestinal and respiratory
mucosal surfaces against pathogens.
3. Maternal antibodies
Which immunoglobulin normally crosses the placenta and provides passive immunity to the
fetus?
A. IgA B. IgE C. IgM D. IgG
Correct answer: D. IgG
Rationale: Maternal IgG crosses the placenta and provides temporary passive protection during
early infancy.
4. Introduction of cow's milk
At what age can whole cow's milk generally be introduced as a beverage for a healthy infant?
A. 4 months B. 6 months C. 9 months D. 12 months
Correct answer: D. 12 months
Rationale: Whole cow's milk is generally introduced at 12 months. Earlier use as the primary
milk beverage can increase the risk of iron deficiency and does not provide the appropriate
nutritional balance for young infants.
5. Newborn vitamin K
Why is vitamin K administered to newborns shortly after birth?
A. To prevent neonatal hypoglycemia B. To prevent vitamin K deficiency bleeding C. To
improve pulmonary function D. To prevent neonatal jaundice
,Correct answer: B. To prevent vitamin K deficiency bleeding
Rationale: Newborns have low vitamin K stores, limited placental transfer, and an immature
intestinal microbiome. Vitamin K prophylaxis helps prevent potentially serious bleeding.
6. Developmental screening
A parent reports that a 24-month-old child has stopped using previously acquired words and no
longer responds consistently to their name. What is the most appropriate next step?
A. Reassure the parent that regression is normal B. Wait until the next annual examination C.
Arrange prompt developmental evaluation and hearing assessment D. Recommend preschool
enrollment without further evaluation
Correct answer: C. Arrange prompt developmental evaluation and hearing assessment
Rationale: Developmental regression is a significant warning sign. Prompt assessment can
identify developmental, neurologic, or hearing-related conditions that require intervention.
7. Growth assessment
Why are BMI percentiles used when assessing children and adolescents?
A. Adult BMI thresholds apply equally to all ages B. BMI interpretation must account for age
and sex C. BMI measures bone density directly D. BMI eliminates the need to assess growth
patterns
Correct answer: B. BMI interpretation must account for age and sex
Rationale: BMI changes during childhood and adolescence. For children aged 2 years and older,
BMI-for-age percentiles help interpret weight status in the context of age and sex.
, 8. Adolescent confidentiality
A 16-year-old requests confidential counseling about sexual health. What is the best initial
response?
A. Refuse to speak with the adolescent without a parent present B. Promise absolute
confidentiality under all circumstances C. Explain confidentiality and its limits, then assess the
adolescent privately D. Disclose all information immediately to the parent
Correct answer: C. Explain confidentiality and its limits, then assess the adolescent privately
Rationale: Developmentally appropriate private time encourages honest communication. The
clinician must explain relevant limits, including applicable reporting requirements and
immediate safety concerns.
9. Adolescent preventive care
Which approach best supports effective preventive counseling during an adolescent health visit?
A. Deliver all counseling exclusively to the parent B. Use a confidential, developmentally
appropriate, nonjudgmental interview C. Avoid discussing mental health unless the parent
requests it D. Restrict the visit to physical measurements
Correct answer: B. Use a confidential, developmentally appropriate, nonjudgmental interview
Rationale: Adolescents benefit from confidential, respectful assessment covering physical health,
mental health, substance use, relationships, safety, and other age-relevant concerns.
10. Down syndrome and neurologic symptoms
