Michigan Nurse Practitioner Pediatric
Exam Practice Questions And Correct
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Rationale 2026 Q&A| Instant Download
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1. A 4-year-old child presents with a fever, sore throat, and drooling. On
examination, the child is leaning forward and has stridor. What is the
most likely diagnosis?
A. Viral pharyngitis
B. Epiglottitis
C. Croup
D. Retropharyngeal abscess
Epiglottitis is characterized by sudden onset of fever, drooling,
stridor, and a “tripod” position. Prompt recognition and airway
management are critical.
2. A 6-month-old infant presents with persistent vomiting, dehydration,
and a “sausage-shaped” mass in the abdomen. What is the most likely
diagnosis?
A. Gastroesophageal reflux
B. Intussusception
C. Pyloric stenosis
D. Malrotation
Pyloric stenosis typically presents in infants with projectile vomiting,
dehydration, and palpable pyloric mass (“olive”). Ultrasound
confirms hypertrophic pylorus.
,3. A pediatric patient presents with a painless limp. X-ray shows
avascular necrosis of the femoral head. Which condition should be
considered?
A. Legg-Calvé-Perthes disease
B. Slipped capital femoral epiphysis
C. Legg-Calvé-Perthes disease
D. Developmental dysplasia of the hip
Legg-Calvé-Perthes disease causes avascular necrosis of the femoral
head in children 4–10 years old, often presenting as a painless limp.
4. A 2-year-old child presents with fever, erythematous rash on the
cheeks, and mild upper respiratory symptoms. What is the most likely
viral etiology?
A. Measles
B. Rubella
C. Parvovirus B19 (Fifth disease)
D. Roseola
Fifth disease presents with a “slapped cheek” rash and mild
prodromal symptoms in children, caused by parvovirus B19.
5. A newborn presents with persistent jaundice beyond 2 weeks of age.
Labs show elevated direct bilirubin. Which condition should be
suspected?
A. Physiologic jaundice
B. Breast milk jaundice
C. Biliary atresia
D. Hemolytic disease of the newborn
Direct hyperbilirubinemia in a neonate beyond two weeks is
concerning for biliary atresia, which requires prompt surgical
intervention.
6. A 10-year-old presents with acute onset of right lower quadrant
abdominal pain, nausea, and low-grade fever. Which lab finding
supports appendicitis?
A. Low WBC count
B. Leukocytosis with neutrophilia
C. Thrombocytopenia
D. Elevated liver enzymes
, Acute appendicitis often presents with leukocytosis and neutrophilia;
imaging may assist in diagnosis.
7. A 5-year-old child has a barking cough, inspiratory stridor, and
hoarseness. Which treatment is indicated?
A. Oral antibiotics
B. Nebulized epinephrine and corticosteroids
C. Antihistamines
D. Antiviral therapy
Croup (laryngotracheitis) is viral; moderate to severe cases respond
to nebulized epinephrine and corticosteroids to reduce airway
edema.
8. A 3-month-old infant presents with repetitive, forceful vomiting,
weight loss, and visible peristaltic waves. Which diagnostic test is
preferred?
A. Abdominal X-ray
B. Abdominal ultrasound
C. Upper GI series
D. CT scan
Abdominal ultrasound is the first-line diagnostic test for pyloric
stenosis, showing hypertrophied pyloric muscle.
9. A 7-year-old child presents with polyuria, polydipsia, and weight loss.
Labs reveal hyperglycemia and ketones in urine. What is the most
likely diagnosis?
A. Type 2 diabetes mellitus
B. Type 1 diabetes mellitus
C. Diabetes insipidus
D. Cushing syndrome
Type 1 diabetes typically presents in children with polyuria,
polydipsia, weight loss, and may progress to ketoacidosis.
10. A newborn has a heart murmur, cyanosis, and differential
cyanosis between upper and lower extremities. Which congenital
heart defect is most likely?
A. Ventricular septal defect
B. Coarctation of the aorta
C. Atrial septal defect
Exam Practice Questions And Correct
Answers (Verified Answers) Plus
Rationale 2026 Q&A| Instant Download
1. A 4-year-old child presents with a fever, sore throat, and drooling. On
examination, the child is leaning forward and has stridor. What is the
most likely diagnosis?
A. Viral pharyngitis
B. Epiglottitis
C. Croup
D. Retropharyngeal abscess
Epiglottitis is characterized by sudden onset of fever, drooling,
stridor, and a “tripod” position. Prompt recognition and airway
management are critical.
2. A 6-month-old infant presents with persistent vomiting, dehydration,
and a “sausage-shaped” mass in the abdomen. What is the most likely
diagnosis?
A. Gastroesophageal reflux
B. Intussusception
C. Pyloric stenosis
D. Malrotation
Pyloric stenosis typically presents in infants with projectile vomiting,
dehydration, and palpable pyloric mass (“olive”). Ultrasound
confirms hypertrophic pylorus.
,3. A pediatric patient presents with a painless limp. X-ray shows
avascular necrosis of the femoral head. Which condition should be
considered?
A. Legg-Calvé-Perthes disease
B. Slipped capital femoral epiphysis
C. Legg-Calvé-Perthes disease
D. Developmental dysplasia of the hip
Legg-Calvé-Perthes disease causes avascular necrosis of the femoral
head in children 4–10 years old, often presenting as a painless limp.
4. A 2-year-old child presents with fever, erythematous rash on the
cheeks, and mild upper respiratory symptoms. What is the most likely
viral etiology?
A. Measles
B. Rubella
C. Parvovirus B19 (Fifth disease)
D. Roseola
Fifth disease presents with a “slapped cheek” rash and mild
prodromal symptoms in children, caused by parvovirus B19.
5. A newborn presents with persistent jaundice beyond 2 weeks of age.
Labs show elevated direct bilirubin. Which condition should be
suspected?
A. Physiologic jaundice
B. Breast milk jaundice
C. Biliary atresia
D. Hemolytic disease of the newborn
Direct hyperbilirubinemia in a neonate beyond two weeks is
concerning for biliary atresia, which requires prompt surgical
intervention.
6. A 10-year-old presents with acute onset of right lower quadrant
abdominal pain, nausea, and low-grade fever. Which lab finding
supports appendicitis?
A. Low WBC count
B. Leukocytosis with neutrophilia
C. Thrombocytopenia
D. Elevated liver enzymes
, Acute appendicitis often presents with leukocytosis and neutrophilia;
imaging may assist in diagnosis.
7. A 5-year-old child has a barking cough, inspiratory stridor, and
hoarseness. Which treatment is indicated?
A. Oral antibiotics
B. Nebulized epinephrine and corticosteroids
C. Antihistamines
D. Antiviral therapy
Croup (laryngotracheitis) is viral; moderate to severe cases respond
to nebulized epinephrine and corticosteroids to reduce airway
edema.
8. A 3-month-old infant presents with repetitive, forceful vomiting,
weight loss, and visible peristaltic waves. Which diagnostic test is
preferred?
A. Abdominal X-ray
B. Abdominal ultrasound
C. Upper GI series
D. CT scan
Abdominal ultrasound is the first-line diagnostic test for pyloric
stenosis, showing hypertrophied pyloric muscle.
9. A 7-year-old child presents with polyuria, polydipsia, and weight loss.
Labs reveal hyperglycemia and ketones in urine. What is the most
likely diagnosis?
A. Type 2 diabetes mellitus
B. Type 1 diabetes mellitus
C. Diabetes insipidus
D. Cushing syndrome
Type 1 diabetes typically presents in children with polyuria,
polydipsia, weight loss, and may progress to ketoacidosis.
10. A newborn has a heart murmur, cyanosis, and differential
cyanosis between upper and lower extremities. Which congenital
heart defect is most likely?
A. Ventricular septal defect
B. Coarctation of the aorta
C. Atrial septal defect
