NR602 Pediatric Midterm Study Set with
Questions and Approved Answers | 2026 Prep
1.The parent of a toddler is concerned that the child may have autism. The
primary care pediatric nurse practitioner completes a Modified Checklist for
Autism in Toddlers (M-CHAT) tool, which indicates several areas of concern.
What will the nurse practitioner do?
a. Administer a Childhood Autism Rating Scale (CARS) in the clinic.
b.Consult a specialist to determine appropriate early intervention strategies.
c.Refer the child to a behavioral specialist for further evaluation.
d.Tell the parent that this result indicates that the child has autism. - Correct
Answer✔✔-ANS: C
2.The M-CHAT is a screening tool and is useful for detecting behaviors that
may indicate autism. This instrument has been found to have acceptable
sensitivity, specificity, and significant positive predictive value. If these
behaviors are detected, the PNP should refer the child to a specialist for further
assessment, using more diagnostic tools. The CARS may be used but requires
specialty training and proper credentials. Until the diagnosis is determined,
strategies for intervention are not discussed. The M-CHAT is a screening tool
and is not diagnostic.
The mother of a newborn tells the primary care pediatric nurse practitioner that
she is worried that her child will develop allergies and asthma. Which tool will
the nurse practitioner use to evaluate this risk?
a.Three-generation pedigree
b.Review of systems
c.Genogram
d.Ecomap - Correct Answer✔✔-ANS: A
3.The three-generation pedigree is used to map out risks for genetic diseases in
families, as well as conditions with modifiable risk factors. The review of
systems is used to evaluate the history of the child's body systems. The
genogram is an approach to developing a family database to provide a graphic
representation of family structure, roles, and problems of recurring significance
in a family. The ecomap is used to identify relationships in the family and
community that are supportive or harmful.
The primary care pediatric nurse practitioner is performing a well child check-
up on a 20-month-old child. The child was 4 weeks premature and, according to
,a parent-completed developmental questionnaire, has achieved milestones for a
15-month-old infant. Which action is correct?
a.Perform an in-depth developmental assessment screen at this visit to evaluate
this child.
b.Reassure the parent that the child will catch up to normal development by age
2 years.
c.Re-evaluate this child's development and milestone achievements at the 2-year
visit.
,dRefer the child to a specialty clinic for evaluation and treatment of
developmental delay. - Correct Answer✔✔-ANS: A
4.This child should be at a 19-month adjusted age for prematurity so, according
to the parent screen, is 4 months behind. The PNP should perform a more in-
depth screen to evaluate this delay. Waiting to see if the child will "catch up" or
assuring the parent that this will happen will cause the delays to become more
severe. A referral to a specialty clinic should not be made solely on the basis of
the parent-completed questionnaire but only after further evaluation of possible
delays.
When formulating developmental diagnoses for pediatric patients, the primary
care pediatric nurse practitioner may use which resource?
a.ADC: 0-3R
b.ICD-10-CM
c.ICSD-3
d.NANDA International - Correct Answer✔✔-ANS: A
5.The DC: 0-3R refers to the Diagnostic Classification of Mental Health and
Developmental Disorders of Infancy and Early Childhood and is useful for
developmental problem diagnosis. The ICD-10-CM is the International
Classification of Diseases-Tenth Revision, Clinical Modification and is useful
for identifying physiologic diseases. The ICSD-3 is the International
Classification of Sleep Disorders - 3rd edition. NANDA International is used to
label problems in the functional health domain.
The primary care pediatric nurse practitioner is evaluating health literacy in the
mother of a new preschool-age child. How will the nurse practitioner assess
this?
a.Ask the child how many books he has at home.
b.Ask the mother about her highest grade in school.
c.Ask the mother to determine the correct dose of a drug from a label.
d.Ask the mother to read a health information handout aloud. - Correct
Answer✔✔-ANS: A
,6.The "newest vital sign," or health literacy, can be determined quickly by
asking the parent how many children's books are in the home. Greater than 10
books in the home is an independent positive predictor of adequate parent health
literacy. The other questions may determine a specific level of literacy in
general but are not as efficient.
The primary care pediatric nurse practitioner learns that the mother of a 3-year-
old child has been treated for depression for over 5 years. Which aspect of this
child's development will be of the most concern to the nurse practitioner?
a.Fine motor
b.Gross motor
c.Social/emotional
d.Speech and language - Correct Answer✔✔-ANS: D
7.Maternal depression in the first year of life has been associated with poorer
language development at 3 years of age.
The primary care pediatric nurse practitioner sees a 3-year-old child who
chronically withholds stools, in spite of the parents' attempts to stop the
behavior, requiring frequent treatments with laxative medications. Which
diagnosis will the nurse practitioner use to facilitate third-party reimbursement?
a.Altered elimination pattern
b.Elimination disorder
c.Encopresis
d.Parenting alteration - Correct Answer✔✔-ANS: C
8.Encopresis is a medical diagnosis, classified in the ICD-10-CM, and is
recognized for reimbursement purposes. "Altered elimination pattern" and
"Parenting alteration" are NANDA International diagnoses and are not
recognized for reimbursement. "Elimination disorder" is a developmental
diagnosis.
A child is in the clinic for evaluation of an asthma action plan. The primary care
pediatric nurse practitioner notes that the child's last visit was for a pre-
kindergarten physical and observes that the child is extremely anxious. What
will the nurse practitioner do initially?
a.Ask the child's parent why the child is so anxious.
b.Perform a physical assessment to rule out shortness of breath.
c.Reassure the child that there is nothing to be afraid of.
d.Review the purpose of this visit and any anticipated procedures. - Correct
Answer✔✔-ANS: D
, 9.The PNP should remember that young children are learning "scripts" for
health care visits and may be stressed when recalling previous visits, especially
if those involved immunizations. The PNP should explain the purpose and any
anticipated procedures for this visit to help put the child at ease.
When meeting with a new family, the primary care pediatric nurse practitioner
develops a database that identifies family members and others living in the
household, relationships with others outside the household, and significant
behavioral and emotional problems. Which tool will the nurse practitioner use
to record this information?
a.CRAFFT
b.Ecomap
c.Genogram
d.Pedigree - Correct Answer✔✔-ANS: C
10.The genogram is an approach to developing a family database to provide a
graphic representation of family structure, roles, and problems of recurring
significance in a family. The CRAFFT tool is used to assess substance abuse in
adolescents. The ecomap is used to identify relationships in the family and
community that are supportive or harmful. The pedigree is used to identify
potential genetic disorders.
The primary care pediatric nurse practitioner evaluates a school-age child whose
body mass index (BMI) is greater than the 97th percentile. The nurse
practitioner is concerned about possible metabolic syndrome and orders
laboratory tests to evaluate this. Which diagnosis will the nurse practitioner
document for this visit?
a.Metabolic syndrome
b.Nutritional alteration: more than required
c.Obesity
d.Rule out type 2 diabetes mellitus - Correct Answer✔✔-ANS: C
11.A problem should never be included on the problem list that is not supported
by subjective and objective data found and recorded in the database. This child
has a BMI that suggests obesity, so this may be used as a diagnosis. Metabolic
syndrome is a diagnosis that is determined by laboratory data, which has not
been evaluated yet. Nutritional alteration is a NANDA diagnosis and not
acceptable for reimbursement. "Rule out" should not be used as a diagnosis, but
may be considered part of a plan.
The primary care pediatric nurse practitioner performs a developmental
assessment on a 3-year-old child and notes normal cognitive, fine-motor, and
Questions and Approved Answers | 2026 Prep
1.The parent of a toddler is concerned that the child may have autism. The
primary care pediatric nurse practitioner completes a Modified Checklist for
Autism in Toddlers (M-CHAT) tool, which indicates several areas of concern.
What will the nurse practitioner do?
a. Administer a Childhood Autism Rating Scale (CARS) in the clinic.
b.Consult a specialist to determine appropriate early intervention strategies.
c.Refer the child to a behavioral specialist for further evaluation.
d.Tell the parent that this result indicates that the child has autism. - Correct
Answer✔✔-ANS: C
2.The M-CHAT is a screening tool and is useful for detecting behaviors that
may indicate autism. This instrument has been found to have acceptable
sensitivity, specificity, and significant positive predictive value. If these
behaviors are detected, the PNP should refer the child to a specialist for further
assessment, using more diagnostic tools. The CARS may be used but requires
specialty training and proper credentials. Until the diagnosis is determined,
strategies for intervention are not discussed. The M-CHAT is a screening tool
and is not diagnostic.
The mother of a newborn tells the primary care pediatric nurse practitioner that
she is worried that her child will develop allergies and asthma. Which tool will
the nurse practitioner use to evaluate this risk?
a.Three-generation pedigree
b.Review of systems
c.Genogram
d.Ecomap - Correct Answer✔✔-ANS: A
3.The three-generation pedigree is used to map out risks for genetic diseases in
families, as well as conditions with modifiable risk factors. The review of
systems is used to evaluate the history of the child's body systems. The
genogram is an approach to developing a family database to provide a graphic
representation of family structure, roles, and problems of recurring significance
in a family. The ecomap is used to identify relationships in the family and
community that are supportive or harmful.
The primary care pediatric nurse practitioner is performing a well child check-
up on a 20-month-old child. The child was 4 weeks premature and, according to
,a parent-completed developmental questionnaire, has achieved milestones for a
15-month-old infant. Which action is correct?
a.Perform an in-depth developmental assessment screen at this visit to evaluate
this child.
b.Reassure the parent that the child will catch up to normal development by age
2 years.
c.Re-evaluate this child's development and milestone achievements at the 2-year
visit.
,dRefer the child to a specialty clinic for evaluation and treatment of
developmental delay. - Correct Answer✔✔-ANS: A
4.This child should be at a 19-month adjusted age for prematurity so, according
to the parent screen, is 4 months behind. The PNP should perform a more in-
depth screen to evaluate this delay. Waiting to see if the child will "catch up" or
assuring the parent that this will happen will cause the delays to become more
severe. A referral to a specialty clinic should not be made solely on the basis of
the parent-completed questionnaire but only after further evaluation of possible
delays.
When formulating developmental diagnoses for pediatric patients, the primary
care pediatric nurse practitioner may use which resource?
a.ADC: 0-3R
b.ICD-10-CM
c.ICSD-3
d.NANDA International - Correct Answer✔✔-ANS: A
5.The DC: 0-3R refers to the Diagnostic Classification of Mental Health and
Developmental Disorders of Infancy and Early Childhood and is useful for
developmental problem diagnosis. The ICD-10-CM is the International
Classification of Diseases-Tenth Revision, Clinical Modification and is useful
for identifying physiologic diseases. The ICSD-3 is the International
Classification of Sleep Disorders - 3rd edition. NANDA International is used to
label problems in the functional health domain.
The primary care pediatric nurse practitioner is evaluating health literacy in the
mother of a new preschool-age child. How will the nurse practitioner assess
this?
a.Ask the child how many books he has at home.
b.Ask the mother about her highest grade in school.
c.Ask the mother to determine the correct dose of a drug from a label.
d.Ask the mother to read a health information handout aloud. - Correct
Answer✔✔-ANS: A
,6.The "newest vital sign," or health literacy, can be determined quickly by
asking the parent how many children's books are in the home. Greater than 10
books in the home is an independent positive predictor of adequate parent health
literacy. The other questions may determine a specific level of literacy in
general but are not as efficient.
The primary care pediatric nurse practitioner learns that the mother of a 3-year-
old child has been treated for depression for over 5 years. Which aspect of this
child's development will be of the most concern to the nurse practitioner?
a.Fine motor
b.Gross motor
c.Social/emotional
d.Speech and language - Correct Answer✔✔-ANS: D
7.Maternal depression in the first year of life has been associated with poorer
language development at 3 years of age.
The primary care pediatric nurse practitioner sees a 3-year-old child who
chronically withholds stools, in spite of the parents' attempts to stop the
behavior, requiring frequent treatments with laxative medications. Which
diagnosis will the nurse practitioner use to facilitate third-party reimbursement?
a.Altered elimination pattern
b.Elimination disorder
c.Encopresis
d.Parenting alteration - Correct Answer✔✔-ANS: C
8.Encopresis is a medical diagnosis, classified in the ICD-10-CM, and is
recognized for reimbursement purposes. "Altered elimination pattern" and
"Parenting alteration" are NANDA International diagnoses and are not
recognized for reimbursement. "Elimination disorder" is a developmental
diagnosis.
A child is in the clinic for evaluation of an asthma action plan. The primary care
pediatric nurse practitioner notes that the child's last visit was for a pre-
kindergarten physical and observes that the child is extremely anxious. What
will the nurse practitioner do initially?
a.Ask the child's parent why the child is so anxious.
b.Perform a physical assessment to rule out shortness of breath.
c.Reassure the child that there is nothing to be afraid of.
d.Review the purpose of this visit and any anticipated procedures. - Correct
Answer✔✔-ANS: D
, 9.The PNP should remember that young children are learning "scripts" for
health care visits and may be stressed when recalling previous visits, especially
if those involved immunizations. The PNP should explain the purpose and any
anticipated procedures for this visit to help put the child at ease.
When meeting with a new family, the primary care pediatric nurse practitioner
develops a database that identifies family members and others living in the
household, relationships with others outside the household, and significant
behavioral and emotional problems. Which tool will the nurse practitioner use
to record this information?
a.CRAFFT
b.Ecomap
c.Genogram
d.Pedigree - Correct Answer✔✔-ANS: C
10.The genogram is an approach to developing a family database to provide a
graphic representation of family structure, roles, and problems of recurring
significance in a family. The CRAFFT tool is used to assess substance abuse in
adolescents. The ecomap is used to identify relationships in the family and
community that are supportive or harmful. The pedigree is used to identify
potential genetic disorders.
The primary care pediatric nurse practitioner evaluates a school-age child whose
body mass index (BMI) is greater than the 97th percentile. The nurse
practitioner is concerned about possible metabolic syndrome and orders
laboratory tests to evaluate this. Which diagnosis will the nurse practitioner
document for this visit?
a.Metabolic syndrome
b.Nutritional alteration: more than required
c.Obesity
d.Rule out type 2 diabetes mellitus - Correct Answer✔✔-ANS: C
11.A problem should never be included on the problem list that is not supported
by subjective and objective data found and recorded in the database. This child
has a BMI that suggests obesity, so this may be used as a diagnosis. Metabolic
syndrome is a diagnosis that is determined by laboratory data, which has not
been evaluated yet. Nutritional alteration is a NANDA diagnosis and not
acceptable for reimbursement. "Rule out" should not be used as a diagnosis, but
may be considered part of a plan.
The primary care pediatric nurse practitioner performs a developmental
assessment on a 3-year-old child and notes normal cognitive, fine-motor, and
