,NURS 5130 Problem-Focused Pediatric Exam | Practice
Q&A | University of Texas at Arlington
1. Which developmental milestone should the nurse practitioner expect a 12-
month-old infant to have achieved?
A) Uses a spoon effectively
B) Walks while holding onto furniture
C) Builds a tower of six blocks
D) Ties shoelaces
Correct Answer: Walks while holding onto furniture
Rationale: Cruising or walking while holding onto furniture is a standard gross
motor milestone at 12 months. Using a spoon effectively or building a tower of six
blocks typically emerges later in the toddler years, and tying shoelaces is a much
later fine motor skill. This assessment helps determine whether neurologic and
muscular development is proceeding along the expected trajectory.
2. When performing an ear examination on a 2-year-old child, how should the
nurse practitioner position the pinna?
A) Pull the pinna up and back
B) Pull the pinna down and back
C) Pull the pinna straight back
D) Pull the pinna forward and down
,Correct Answer: Pull the pinna down and back
Rationale: In children under age 3, the external auditory canal is shorter and
directed upward. Pulling the pinna down and back straightens the canal for a
better view of the tympanic membrane. After age 3, the technique changes to
pulling the pinna up and back as the canal assumes a more adult-like orientation.
3. Which physical assessment finding is considered normal for a newborn during
the first 24 hours of life?
A) Generalized cyanosis
B) Expiratory grunting
C) Acrocyanosis
D) Sternal retractions
Correct Answer: Acrocyanosis
Rationale: Acrocyanosis is a bluish discoloration of the hands and feet that is
common and normal in the first 24 to 48 hours due to peripheral circulatory
sluggishness. Generalized cyanosis, grunting, and retractions are signs of
respiratory distress requiring immediate intervention. Recognizing the difference
between normal transitional physiology and pathology is critical.
4. Which maneuver is most effective for screening a 6-year-old child for scoliosis?
A) Trendelenburg test
B) Adams forward bend test
C) Ortolani maneuver
, D) McMurray test
Correct Answer: Adams forward bend test
Rationale: The Adams forward bend test is the standard screening tool for
detecting structural scoliosis in school-aged children and adolescents. The
examiner looks for a rib hump or spinal asymmetry while the child leans forward
with feet together and knees straight. Early detection allows timely referral to
orthopedics.
5. What is the purpose of the Ortolani maneuver during a newborn
musculoskeletal examination?
A) To check for knee stability
B) To assess for clubfoot
C) To evaluate for tibial torsion
D) To reduce a dislocated hip
Correct Answer: To reduce a dislocated hip
Rationale: The Ortolani maneuver confirms developmental dysplasia of the hip
by attempting to reduce a recently dislocated hip. The practitioner abducts the
infant’s hip while applying upward pressure, feeling for a clunk as the femoral
head slips back into the acetabulum. This test is most accurate in the first few
months before muscle contractures develop.
6. At what age does the anterior fontanelle typically close in a healthy infant?
Q&A | University of Texas at Arlington
1. Which developmental milestone should the nurse practitioner expect a 12-
month-old infant to have achieved?
A) Uses a spoon effectively
B) Walks while holding onto furniture
C) Builds a tower of six blocks
D) Ties shoelaces
Correct Answer: Walks while holding onto furniture
Rationale: Cruising or walking while holding onto furniture is a standard gross
motor milestone at 12 months. Using a spoon effectively or building a tower of six
blocks typically emerges later in the toddler years, and tying shoelaces is a much
later fine motor skill. This assessment helps determine whether neurologic and
muscular development is proceeding along the expected trajectory.
2. When performing an ear examination on a 2-year-old child, how should the
nurse practitioner position the pinna?
A) Pull the pinna up and back
B) Pull the pinna down and back
C) Pull the pinna straight back
D) Pull the pinna forward and down
,Correct Answer: Pull the pinna down and back
Rationale: In children under age 3, the external auditory canal is shorter and
directed upward. Pulling the pinna down and back straightens the canal for a
better view of the tympanic membrane. After age 3, the technique changes to
pulling the pinna up and back as the canal assumes a more adult-like orientation.
3. Which physical assessment finding is considered normal for a newborn during
the first 24 hours of life?
A) Generalized cyanosis
B) Expiratory grunting
C) Acrocyanosis
D) Sternal retractions
Correct Answer: Acrocyanosis
Rationale: Acrocyanosis is a bluish discoloration of the hands and feet that is
common and normal in the first 24 to 48 hours due to peripheral circulatory
sluggishness. Generalized cyanosis, grunting, and retractions are signs of
respiratory distress requiring immediate intervention. Recognizing the difference
between normal transitional physiology and pathology is critical.
4. Which maneuver is most effective for screening a 6-year-old child for scoliosis?
A) Trendelenburg test
B) Adams forward bend test
C) Ortolani maneuver
, D) McMurray test
Correct Answer: Adams forward bend test
Rationale: The Adams forward bend test is the standard screening tool for
detecting structural scoliosis in school-aged children and adolescents. The
examiner looks for a rib hump or spinal asymmetry while the child leans forward
with feet together and knees straight. Early detection allows timely referral to
orthopedics.
5. What is the purpose of the Ortolani maneuver during a newborn
musculoskeletal examination?
A) To check for knee stability
B) To assess for clubfoot
C) To evaluate for tibial torsion
D) To reduce a dislocated hip
Correct Answer: To reduce a dislocated hip
Rationale: The Ortolani maneuver confirms developmental dysplasia of the hip
by attempting to reduce a recently dislocated hip. The practitioner abducts the
infant’s hip while applying upward pressure, feeling for a clunk as the femoral
head slips back into the acetabulum. This test is most accurate in the first few
months before muscle contractures develop.
6. At what age does the anterior fontanelle typically close in a healthy infant?
