NR 602 EXAM with Questions and Answers/Plus
a Rationale Updated 2026 A+/Instant Download
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Table of Contents
1. EXAM COVERAGE
2. Questions 1-100
EXAM COVERAGE
1. Pediatric Growth and Developmental Milestones
2. Pediatric Physical Assessment and Physical Findings
3. Pediatric Infectious Disease and Immunizations
4. Dermatological Conditions in Infants and Children
5. HEENT (Head, Eyes, Ears, Nose, Throat) Disorders
6. Respiratory Pathologies
7. Gastrointestinal and Genitourinary Concerns
8. Musculoskeletal and Orthopedic Conditions
9. Behavioral and Mental Health Screening
10. Pediatric Pharmacotherapeutics and Dosage Calculation
,1. A 4-month-old infant is brought for a well-child check. The parent is concerned about a "flat
spot" on the back of the child's head. On assessment, the infant has a palpable posterior
plagiocephaly with normal development. Which intervention is most appropriate at this time?
A. Refer to a neurosurgeon for immediate imaging.
B. Counsel on "tummy time" and frequent repositioning.
C. Apply a corrective cranial orthosis helmet immediately.
D. Recommend a specialized mattress to prevent SIDS.
CORRECT ANSWER : B
Rationale: Positional plagiocephaly is commonly managed by increasing "tummy time" and
alternating head position to relieve pressure on the occiput. A is incorrect because neurosurgical
referral is reserved for suspected craniosynostosis (premature suture fusion), which shows
abnormal suture ridging. C is incorrect as helmets are secondary therapy if conservative
management fails after several months. D is incorrect as mattress type is not the primary
treatment for positional molding.
2. An 18-month-old presents with a high fever (103°F) for 3 days, followed by the appearance of a
maculopapular rash on the trunk as the fever breaks. The child appears well otherwise. What is
the most likely diagnosis?
A. Rubella
B. Measles
C. Roseola infantum
D. Erythema infectiosum
CORRECT ANSWER : C
Rationale: Roseola (Exanthem subitum) typically presents with high fever lasting 3-4 days,
followed by a sudden defervescence and the emergence of a blanching, maculopapular rash on
the trunk. A and B are incorrect because Rubella and Measles usually present with prodromal
symptoms (cough, coryza, conjunctivitis in measles) and the rash appears with or before fever. D
(Fifth disease) presents with a "slapped-cheek" rash and reticular pattern on extremities.
3. A 6-year-old child presents with a sore throat, fever, and tender anterior cervical
lymphadenopathy. A Rapid Antigen Detection Test (RADT) for Group A Streptococcus is
negative. What is the next best step?
A. Start empiric antibiotics due to high clinical suspicion.
, B. Perform a throat culture to confirm the negative result.
C. Order a monospot test to rule out Epstein-Barr virus.
D. Reassure the parent and advise supportive care only.
CORRECT ANSWER : B
Rationale: In school-aged children, the sensitivity of rapid testing is high, but a negative result
should be confirmed with a throat culture in patients with clinical symptoms suggestive of strep
throat to prevent complications like rheumatic fever. A is incorrect because empiric treatment
without confirmation is not recommended. C is incorrect as the primary diagnostic priority for
pharyngitis with these symptoms is ruling out Strep. D is incorrect because the child's age makes
Strep a high clinical probability.
4. A 9-month-old infant is observed pulling to a stand, grasping with a pincer grasp, and saying
"mama" and "dada" specifically. Which other skill is expected at this developmental stage?
A. Walking independently
B. Playing peek-a-boo
C. Building a tower of 3 blocks
D. Scribbling spontaneously
CORRECT ANSWER : B
Rationale: At 9 months, infants typically engage in social games like peek-a-boo and waving
bye-bye. A is incorrect because independent walking is typically achieved between 12-15 months.
C and D are incorrect as these are skills typically seen in the 18-24 month age range.
5. A 12-year-old male presents with hip pain radiating to the knee and a limp. He is obese. Range
of motion shows limited internal rotation of the hip. What is the most likely diagnosis?
A. Legg-Calvé-Perthes disease
B. Osgood-Schlatter disease
C. Slipped Capital Femoral Epiphysis (SCFE)
D. Septic arthritis
CORRECT ANSWER : C
, Rationale: SCFE is common in obese adolescents and presents with hip/knee pain and limited
internal rotation of the hip. A is incorrect as LCP occurs typically in younger children (4-8
years). B is incorrect because Osgood-Schlatter involves knee pain at the tibial tubercle. D is
incorrect as septic arthritis usually presents with acute systemic illness, fever, and refusal to
bear weight.
6. A parent reports their 3-year-old child has frequent "staring spells" that last 10-15 seconds,
during which they do not respond to their name. An EEG shows generalized 3-Hz spike-and-
wave activity. What is the treatment of choice?
A. Carbamazepine
B. Phenobarbital
C. Ethosuximide
D. Gabapentin
CORRECT ANSWER : C
Rationale: The clinical presentation and EEG findings are pathognomonic for absence seizures,
for which ethosuximide is the first-line treatment. A is incorrect as carbamazepine can
exacerbate absence seizures. B is incorrect as it is not first-line and has significant cognitive side
effects. D is not a standard treatment for absence epilepsy.
7. A 2-month-old infant is brought in for a well-child visit. Which of the following immunizations
is routinely scheduled at this visit?
A. MMR
B. DTaP
C. Varicella
D. Hepatitis A
CORRECT ANSWER : B
Rationale: The DTaP, Hib, IPV, PCV13/15, and Rotavirus vaccines are part of the 2-month
immunization schedule. A and C are incorrect because MMR and Varicella are administered at
12-15 months. D is incorrect as the Hepatitis A series begins at 12 months.
8. An adolescent female presents with lower abdominal pain and vaginal discharge. Pelvic exam
reveals cervical motion tenderness. What is the most important diagnostic test to order?
A. Pelvic ultrasound
a Rationale Updated 2026 A+/Instant Download
Table of Contents
1. EXAM COVERAGE
2. Questions 1-100
EXAM COVERAGE
1. Pediatric Growth and Developmental Milestones
2. Pediatric Physical Assessment and Physical Findings
3. Pediatric Infectious Disease and Immunizations
4. Dermatological Conditions in Infants and Children
5. HEENT (Head, Eyes, Ears, Nose, Throat) Disorders
6. Respiratory Pathologies
7. Gastrointestinal and Genitourinary Concerns
8. Musculoskeletal and Orthopedic Conditions
9. Behavioral and Mental Health Screening
10. Pediatric Pharmacotherapeutics and Dosage Calculation
,1. A 4-month-old infant is brought for a well-child check. The parent is concerned about a "flat
spot" on the back of the child's head. On assessment, the infant has a palpable posterior
plagiocephaly with normal development. Which intervention is most appropriate at this time?
A. Refer to a neurosurgeon for immediate imaging.
B. Counsel on "tummy time" and frequent repositioning.
C. Apply a corrective cranial orthosis helmet immediately.
D. Recommend a specialized mattress to prevent SIDS.
CORRECT ANSWER : B
Rationale: Positional plagiocephaly is commonly managed by increasing "tummy time" and
alternating head position to relieve pressure on the occiput. A is incorrect because neurosurgical
referral is reserved for suspected craniosynostosis (premature suture fusion), which shows
abnormal suture ridging. C is incorrect as helmets are secondary therapy if conservative
management fails after several months. D is incorrect as mattress type is not the primary
treatment for positional molding.
2. An 18-month-old presents with a high fever (103°F) for 3 days, followed by the appearance of a
maculopapular rash on the trunk as the fever breaks. The child appears well otherwise. What is
the most likely diagnosis?
A. Rubella
B. Measles
C. Roseola infantum
D. Erythema infectiosum
CORRECT ANSWER : C
Rationale: Roseola (Exanthem subitum) typically presents with high fever lasting 3-4 days,
followed by a sudden defervescence and the emergence of a blanching, maculopapular rash on
the trunk. A and B are incorrect because Rubella and Measles usually present with prodromal
symptoms (cough, coryza, conjunctivitis in measles) and the rash appears with or before fever. D
(Fifth disease) presents with a "slapped-cheek" rash and reticular pattern on extremities.
3. A 6-year-old child presents with a sore throat, fever, and tender anterior cervical
lymphadenopathy. A Rapid Antigen Detection Test (RADT) for Group A Streptococcus is
negative. What is the next best step?
A. Start empiric antibiotics due to high clinical suspicion.
, B. Perform a throat culture to confirm the negative result.
C. Order a monospot test to rule out Epstein-Barr virus.
D. Reassure the parent and advise supportive care only.
CORRECT ANSWER : B
Rationale: In school-aged children, the sensitivity of rapid testing is high, but a negative result
should be confirmed with a throat culture in patients with clinical symptoms suggestive of strep
throat to prevent complications like rheumatic fever. A is incorrect because empiric treatment
without confirmation is not recommended. C is incorrect as the primary diagnostic priority for
pharyngitis with these symptoms is ruling out Strep. D is incorrect because the child's age makes
Strep a high clinical probability.
4. A 9-month-old infant is observed pulling to a stand, grasping with a pincer grasp, and saying
"mama" and "dada" specifically. Which other skill is expected at this developmental stage?
A. Walking independently
B. Playing peek-a-boo
C. Building a tower of 3 blocks
D. Scribbling spontaneously
CORRECT ANSWER : B
Rationale: At 9 months, infants typically engage in social games like peek-a-boo and waving
bye-bye. A is incorrect because independent walking is typically achieved between 12-15 months.
C and D are incorrect as these are skills typically seen in the 18-24 month age range.
5. A 12-year-old male presents with hip pain radiating to the knee and a limp. He is obese. Range
of motion shows limited internal rotation of the hip. What is the most likely diagnosis?
A. Legg-Calvé-Perthes disease
B. Osgood-Schlatter disease
C. Slipped Capital Femoral Epiphysis (SCFE)
D. Septic arthritis
CORRECT ANSWER : C
, Rationale: SCFE is common in obese adolescents and presents with hip/knee pain and limited
internal rotation of the hip. A is incorrect as LCP occurs typically in younger children (4-8
years). B is incorrect because Osgood-Schlatter involves knee pain at the tibial tubercle. D is
incorrect as septic arthritis usually presents with acute systemic illness, fever, and refusal to
bear weight.
6. A parent reports their 3-year-old child has frequent "staring spells" that last 10-15 seconds,
during which they do not respond to their name. An EEG shows generalized 3-Hz spike-and-
wave activity. What is the treatment of choice?
A. Carbamazepine
B. Phenobarbital
C. Ethosuximide
D. Gabapentin
CORRECT ANSWER : C
Rationale: The clinical presentation and EEG findings are pathognomonic for absence seizures,
for which ethosuximide is the first-line treatment. A is incorrect as carbamazepine can
exacerbate absence seizures. B is incorrect as it is not first-line and has significant cognitive side
effects. D is not a standard treatment for absence epilepsy.
7. A 2-month-old infant is brought in for a well-child visit. Which of the following immunizations
is routinely scheduled at this visit?
A. MMR
B. DTaP
C. Varicella
D. Hepatitis A
CORRECT ANSWER : B
Rationale: The DTaP, Hib, IPV, PCV13/15, and Rotavirus vaccines are part of the 2-month
immunization schedule. A and C are incorrect because MMR and Varicella are administered at
12-15 months. D is incorrect as the Hepatitis A series begins at 12 months.
8. An adolescent female presents with lower abdominal pain and vaginal discharge. Pelvic exam
reveals cervical motion tenderness. What is the most important diagnostic test to order?
A. Pelvic ultrasound
