2026 GRADED A+ EXAM
2026 NURS 5432 Family I Midterm Exam ACTUAL QUESTIONS AND
WELL REVISED ANSWERS - LATEST AND COMPLETE UPDATE WITH
VERIFIED SOLUTIONS
Q1: A 4-year-old child presents with a "barking" cough and inspiratory stridor
that worsens at night. What is the most likely diagnosis?
• Answer: Croup (Laryngotracheobronchitis).
• Rationale: Croup is characterized by subglottic edema caused by viral infection,
leading to the classic seal-like barking cough and stridor, typically in children
aged 6 months to 3 years.
Q2: Which developmental milestone is expected for a 6-month-old infant?
• Answer: Sitting with support and rolling from back to stomach.
• Rationale: By 6 months, infants gain trunk control to sit with support and typically
master the roll from a supine to prone position.
Q3: A 15-year-old female presents with primary amenorrhea and a short stature
with a "webbed neck." What is the suspected genetic condition?
• Answer: Turner Syndrome (45, X).
• Rationale: Turner Syndrome occurs in females missing an X chromosome;
common physical findings include lymphedema, webbed neck, and ovarian
dysgenesis leading to amenorrhea.
Q4: What is the first-line antibiotic for an otherwise healthy child diagnosed with
Acute Otitis Media (AOM)?
• Answer: Amoxicillin (80-90 mg/kg/day).
• Rationale: High-dose amoxicillin is the gold standard for AOM to
cover Streptococcus pneumoniae, the most common bacterial pathogen.
Q5: A mother brings in her 2-week-old infant for a check-up and mentions
"projectile vomiting" after every feeding. What should the NP assess for?
• Answer: Hypertrophic Pyloric Stenosis.
,2026 GRADED A+ EXAM
• Rationale: Projectile, non-bilious vomiting in early infancy is a classic sign of
pyloric stenosis, often associated with an "olive-shaped" mass in the epigastrium.
Q6: What is the primary screening tool used for Autism Spectrum Disorder (ASD)
at the 18-month and 24-month well-child visits?
• Answer: M-CHAT-R (Modified Checklist for Autism in Toddlers).
• Rationale: The M-CHAT-R is the validated standard for identifying red flags for
ASD in early childhood.
Q7: A 7-year-old presents with periorbital edema, gross hematuria ("cola-colored"
urine), and hypertension following a sore throat two weeks ago. Diagnosis?
• Answer: Post-Streptococcal Glomerulonephritis (PSGN).
• Rationale: PSGN is an immune-complex mediated disease that follows a
GABHS infection, characterized by the sudden onset of edema and hematuria.
Q8: At what age should the first dose of the Measles, Mumps, and Rubella (MMR)
vaccine be administered?
• Answer: 12 to 15 months.
• Rationale: Per the CDC schedule, the first MMR dose is given at 12–15 months,
followed by a second dose at 4–6 years.
Q9: Which primitive reflex should disappear by 4 to 6 months of age in a healthy
infant?
• Answer: Moro Reflex (Startle reflex).
• Rationale: The Moro reflex typically disappears around 4 months; persistence
beyond 6 months may indicate neurological delay.
Q10: A 3-year-old is brought to the clinic for "walking on toes." What should be
included in the differential diagnosis?
• Answer: Cerebral Palsy or Autism Spectrum Disorder.
• Rationale: While sometimes idiopathic, persistent toe walking can be a marker
for upper motor neuron disorders (CP) or sensory processing issues (ASD).
Q11: What is the recommended treatment for a pediatric patient with a positive
"strawberry tongue" and a "sandpaper" rash?
• Answer: Penicillin or Amoxicillin (to treat Scarlet Fever).
,2026 GRADED A+ EXAM
• Rationale: These findings are classic for Scarlet Fever, a systemic manifestation
of Group A Strep infection.
Q12: A 10-year-old child presents with a "bullseye" (erythema migrans) rash.
What is the treatment of choice?
• Answer: Doxycycline.
• Rationale: Doxycycline is the first-line treatment for Lyme disease in children,
regardless of age, for short-term courses (less than 21 days).
Q13: Which heart murmur is commonly benign in children and is described as
musical or vibratory, heard best at the left lower sternal border?
• Answer: Still’s Murmur.
• Rationale: Still’s murmur is the most common innocent murmur in children,
typically resolving by adolescence.
Q14: A 14-year-old male presents with sudden onset of severe scrotal pain and a
lost cremasteric reflex. What is the immediate priority?
• Answer: Emergency surgical referral for suspected Testicular Torsion.
• Rationale: Testicular torsion is a surgical emergency; the window for salvage is
usually less than 6 hours.
Q15: What is the first-line treatment for pediatric nocturnal enuresis (bedwetting)
after behavioral modifications fail?
• Answer: Enuresis Alarm.
• Rationale: Bedwetting alarms have the highest long-term success rate and lower
relapse rate compared to pharmacological options like Desmopressin.
Q16: A child presents with high fever for 5 days, bilateral conjunctivitis,
"strawberry tongue," and edema of the hands. What is the diagnosis?
• Answer: Kawasaki Disease.
• Rationale: Kawasaki is a medium-vessel vasculitis; the primary concern is the
development of coronary artery aneurysms.
Q17: What is the most common cause of painless rectal bleeding in a 2-year-old
child?
• Answer: Meckel’s Diverticulum.
, 2026 GRADED A+ EXAM
• Rationale: Meckel's is a vestigial remnant that can contain ectopic gastric tissue,
leading to painless hematochezia.
Q18: An adolescent presents with "Phalen’s" and "Tinel’s" signs. What is the
diagnosis?
• Answer: Carpal Tunnel Syndrome.
• Rationale: These tests provoke the median nerve to assess for compression at
the wrist.
Q19: Which Tanner Stage is characterized by the elevation of the papilla only (the
"breast bud")?
• Answer: Tanner Stage 2.
• Rationale: Stage 2 is the onset of puberty, where breast buds form and areolae
begin to enlarge.
Q20: A mother reports her 4-year-old has "pinworms." What is the recommended
pharmacological treatment?
• Answer: Pyrantel Pamoate or Albendazole.
• Rationale: These antiparasitic agents are first-line for Enterobius vermicularis,
usually given in two doses, two weeks apart.
Q21: What is the most appropriate diagnostic test for a suspected hip dysplasia
in a 2-month-old infant?
• Answer: Ultrasound of the hips.
• Rationale: X-rays are not useful until 4–6 months because the femoral head has
not yet ossified; ultrasound is the gold standard for infants.
Q22: A toddler presents with "currant jelly" stools and intermittent abdominal
pain. What is the diagnosis?
• Answer: Intussusception.
• Rationale: Currant jelly stools (blood and mucus) occur when a segment of the
bowel telescopes into another, causing ischemia.
Q23: At what age should blood pressure screening begin for healthy children?
• Answer: 3 years old.
2026 NURS 5432 Family I Midterm Exam ACTUAL QUESTIONS AND
WELL REVISED ANSWERS - LATEST AND COMPLETE UPDATE WITH
VERIFIED SOLUTIONS
Q1: A 4-year-old child presents with a "barking" cough and inspiratory stridor
that worsens at night. What is the most likely diagnosis?
• Answer: Croup (Laryngotracheobronchitis).
• Rationale: Croup is characterized by subglottic edema caused by viral infection,
leading to the classic seal-like barking cough and stridor, typically in children
aged 6 months to 3 years.
Q2: Which developmental milestone is expected for a 6-month-old infant?
• Answer: Sitting with support and rolling from back to stomach.
• Rationale: By 6 months, infants gain trunk control to sit with support and typically
master the roll from a supine to prone position.
Q3: A 15-year-old female presents with primary amenorrhea and a short stature
with a "webbed neck." What is the suspected genetic condition?
• Answer: Turner Syndrome (45, X).
• Rationale: Turner Syndrome occurs in females missing an X chromosome;
common physical findings include lymphedema, webbed neck, and ovarian
dysgenesis leading to amenorrhea.
Q4: What is the first-line antibiotic for an otherwise healthy child diagnosed with
Acute Otitis Media (AOM)?
• Answer: Amoxicillin (80-90 mg/kg/day).
• Rationale: High-dose amoxicillin is the gold standard for AOM to
cover Streptococcus pneumoniae, the most common bacterial pathogen.
Q5: A mother brings in her 2-week-old infant for a check-up and mentions
"projectile vomiting" after every feeding. What should the NP assess for?
• Answer: Hypertrophic Pyloric Stenosis.
,2026 GRADED A+ EXAM
• Rationale: Projectile, non-bilious vomiting in early infancy is a classic sign of
pyloric stenosis, often associated with an "olive-shaped" mass in the epigastrium.
Q6: What is the primary screening tool used for Autism Spectrum Disorder (ASD)
at the 18-month and 24-month well-child visits?
• Answer: M-CHAT-R (Modified Checklist for Autism in Toddlers).
• Rationale: The M-CHAT-R is the validated standard for identifying red flags for
ASD in early childhood.
Q7: A 7-year-old presents with periorbital edema, gross hematuria ("cola-colored"
urine), and hypertension following a sore throat two weeks ago. Diagnosis?
• Answer: Post-Streptococcal Glomerulonephritis (PSGN).
• Rationale: PSGN is an immune-complex mediated disease that follows a
GABHS infection, characterized by the sudden onset of edema and hematuria.
Q8: At what age should the first dose of the Measles, Mumps, and Rubella (MMR)
vaccine be administered?
• Answer: 12 to 15 months.
• Rationale: Per the CDC schedule, the first MMR dose is given at 12–15 months,
followed by a second dose at 4–6 years.
Q9: Which primitive reflex should disappear by 4 to 6 months of age in a healthy
infant?
• Answer: Moro Reflex (Startle reflex).
• Rationale: The Moro reflex typically disappears around 4 months; persistence
beyond 6 months may indicate neurological delay.
Q10: A 3-year-old is brought to the clinic for "walking on toes." What should be
included in the differential diagnosis?
• Answer: Cerebral Palsy or Autism Spectrum Disorder.
• Rationale: While sometimes idiopathic, persistent toe walking can be a marker
for upper motor neuron disorders (CP) or sensory processing issues (ASD).
Q11: What is the recommended treatment for a pediatric patient with a positive
"strawberry tongue" and a "sandpaper" rash?
• Answer: Penicillin or Amoxicillin (to treat Scarlet Fever).
,2026 GRADED A+ EXAM
• Rationale: These findings are classic for Scarlet Fever, a systemic manifestation
of Group A Strep infection.
Q12: A 10-year-old child presents with a "bullseye" (erythema migrans) rash.
What is the treatment of choice?
• Answer: Doxycycline.
• Rationale: Doxycycline is the first-line treatment for Lyme disease in children,
regardless of age, for short-term courses (less than 21 days).
Q13: Which heart murmur is commonly benign in children and is described as
musical or vibratory, heard best at the left lower sternal border?
• Answer: Still’s Murmur.
• Rationale: Still’s murmur is the most common innocent murmur in children,
typically resolving by adolescence.
Q14: A 14-year-old male presents with sudden onset of severe scrotal pain and a
lost cremasteric reflex. What is the immediate priority?
• Answer: Emergency surgical referral for suspected Testicular Torsion.
• Rationale: Testicular torsion is a surgical emergency; the window for salvage is
usually less than 6 hours.
Q15: What is the first-line treatment for pediatric nocturnal enuresis (bedwetting)
after behavioral modifications fail?
• Answer: Enuresis Alarm.
• Rationale: Bedwetting alarms have the highest long-term success rate and lower
relapse rate compared to pharmacological options like Desmopressin.
Q16: A child presents with high fever for 5 days, bilateral conjunctivitis,
"strawberry tongue," and edema of the hands. What is the diagnosis?
• Answer: Kawasaki Disease.
• Rationale: Kawasaki is a medium-vessel vasculitis; the primary concern is the
development of coronary artery aneurysms.
Q17: What is the most common cause of painless rectal bleeding in a 2-year-old
child?
• Answer: Meckel’s Diverticulum.
, 2026 GRADED A+ EXAM
• Rationale: Meckel's is a vestigial remnant that can contain ectopic gastric tissue,
leading to painless hematochezia.
Q18: An adolescent presents with "Phalen’s" and "Tinel’s" signs. What is the
diagnosis?
• Answer: Carpal Tunnel Syndrome.
• Rationale: These tests provoke the median nerve to assess for compression at
the wrist.
Q19: Which Tanner Stage is characterized by the elevation of the papilla only (the
"breast bud")?
• Answer: Tanner Stage 2.
• Rationale: Stage 2 is the onset of puberty, where breast buds form and areolae
begin to enlarge.
Q20: A mother reports her 4-year-old has "pinworms." What is the recommended
pharmacological treatment?
• Answer: Pyrantel Pamoate or Albendazole.
• Rationale: These antiparasitic agents are first-line for Enterobius vermicularis,
usually given in two doses, two weeks apart.
Q21: What is the most appropriate diagnostic test for a suspected hip dysplasia
in a 2-month-old infant?
• Answer: Ultrasound of the hips.
• Rationale: X-rays are not useful until 4–6 months because the femoral head has
not yet ossified; ultrasound is the gold standard for infants.
Q22: A toddler presents with "currant jelly" stools and intermittent abdominal
pain. What is the diagnosis?
• Answer: Intussusception.
• Rationale: Currant jelly stools (blood and mucus) occur when a segment of the
bowel telescopes into another, causing ischemia.
Q23: At what age should blood pressure screening begin for healthy children?
• Answer: 3 years old.
