NR602 PEDIATRIC PRIMARY CARE
ADVANCED PRACTICE EXAM
COMPREHENSIVE STUDY GUIDE
(2025/2026 EDITION) | 400 HIGH-YIELD
NCLEX/NP PRACTICE QUESTIONS &
RATIONALES (PDF)
Master your advanced practice pediatric
nursing curriculum with the ultimate Stuvia-
ready exam preparation package! This high-
density study guide features 400 meticulously
compiled, high-yield multiple-choice questions
structurally mapped directly to the latest NR602
Pediatric Primary Care course objectives and
national nurse practitioner certification
blueprints. Every clinical prompt is paired with
fully highlatable, bold-italic answers and in-
depth evidence-based rationales inside
brackets—covering essential competencies
from developmental milestones and
immunization schedules to complex pediatric
pathologies like Kawasaki disease, croup, and
, congenital cardiac anomalies. Designed for
automated testing engines, rapid self-
assessment, or high-efficiency review sessions,
this turn-key resource is the definitive academic
asset for students aiming to secure top-tier
marks on their board certifications.
1.The parent of an infant experiencing colic asks about using a probiotic medication.
What will the primary care pediatric NP tell this parent?
A) Probiotic medications have demonstrated efficacy in treating colic.
B) Probiotics are not safe to use to treat infants who have colic.
C) There are no studies showing usefulness of probiotic to manage colic.
D) There is no conclusive evidence about using probiotics to treat colic.
Answer: D) There is no conclusive evidence about using probiotics to treat colic.
Rationale: Current clinical guidelines indicate that data regarding the routine use
of probiotics to prevent or treat infantile colic remains inconsistent and
inconclusive. Parents should be counseled on supportive care techniques, and
any trial of supplements should be approached with caution.
2. A toddler who was born prematurely refuses most solid foods and has poor weight gain.
A barium swallow study reveals a normal esophagus. What will the primary care
pediatric NP consider next to manage this child's nutritional needs?
, A) Consultation with dietician
B) Fiberoptic endoscopy evaluation
C) MRI
D) Videofluoroscopy swallowing study (VOSS)
Answer: D) Videofluoroscopy swallowing study (VOSS)
Rationale: In a premature toddler presenting with feeding refusal, poor weight
gain, and structural rule-outs via a normal barium swallow, a videofluoroscopy
swallowing study (VOSS)—also known as a speech/feeding swallowing study—is
indicated to evaluate for underlying functional pharyngeal dysphagia or micro-
aspiration.
3. A toddler is seen in clinic after a 2-day hx of intermittent V/D. An assessment reveals an
irritable child with dry mucous membranes, 3-second cap refill, 2-second recoil of skin,
mild tachycardia and tachypnea, and cool hands and feet. The child has had 2 wet
diapers in the past 24 hours. What will the primary care pediatric NP recommend?
A) Anti-diarrheal medication & clear fluids for 24H
B) Bolus of IV NS in the clinic until improvement
C) Oral rehydration solution with f/u in 24H
D) Admission for inpatient intravenous hydration therapy
Answer: C) Oral rehydration solution with f/u in 24H
Rationale: The clinical signs described point to moderate dehydration (prolonged
capillary refill, altered skin turgor, tachycardia, dry membranes, decreased urine
output). For mild-to-moderate dehydration, current pediatric guidelines heavily
prioritize oral rehydration therapy (ORT) over invasive IV fluids, paired with close
follow-up monitoring within 24 hours.
4. A 4-month-old infant is brought to the clinic for a routine well-child visit. The parent is
concerned because the infant cannot sit unsupported. What is the correct
developmental assessment by the NP?
A) This represents a significant motor delay requiring an immediate neurology referral.
B) Sitting unsupported is a milestone typically achieved between 6 and 8 months of age.
C) The infant should be placed in a physical therapy evaluation program immediately.
D) The parent should avoid tummy time to prevent strain on the infant's lower back
muscles.
Answer: B) Sitting unsupported is a milestone typically achieved between 6 and 8
months of age.
Rationale: According to standard pediatric developmental milestones, an infant
typically learns to sit unsupported between 6 and 8 months of age. Expecting this
milestone at 4 months is premature, and the NP should reassure the parent while
encouraging supervised prone playtime (tummy time).
5. A 2-year-old child presents with a sudden onset of a barking cough, inspiratory stridor,
and mild intercostal retractions. What is the most likely diagnosis and primary treatment
for mild symptoms?
A) Asthma; treat with an inhaled short-acting beta agonist.
B) Croup (Laryngotracheobronchitis); treat with a single dose of oral dexamethasone.
, C) Epiglottitis; treat with immediate endotracheal intubation.
D) Pertussis; treat with a 5-day course of azithromycin.
Answer: B) Croup (Laryngotracheobronchitis); treat with a single dose of oral
dexamethasone.
Rationale: A barking cough and inspiratory stridor are classic clinical indicators of
croup, typically caused by parainfluenza virus. Current guidelines recommend a
single dose of oral dexamethasone (0.6 mg/kg) to reduce airway inflammation,
even in mild cases without significant respiratory distress.
6. Which of the following physical findings is considered a pathognomonic sign of a
measles (rubeola) infection?
A) Erythema infectiosum "slapped cheek" rash
B) Koplik spots on the buccal mucosa
C) Honey-colored crusted lesions around the nares
D) Target-like erythema migrans lesions
Answer: B) Koplik spots on the buccal mucosa
Rationale: Koplik spots are small, bluish-white spots on an erythematous
background found on the buccal mucosa opposite the molars. They are
pathognomonic for measles and appear during the prodromal phase before the
generalized maculopapular rash develops.
7. A 12-month-old child is brought to the clinic for a well-child assessment. The NP notes
that the child's hemoglobin level is 9.2 g/dL. Which nutritional question is most critical to
ask the parent?
A) How many servings of fresh green vegetables does the child consume daily?
B) Is the child consuming more than 16 to 24 ounces of cow's milk per day?
C) Does the child feed themselves finger foods independently?
D) Was the child exclusively formula-fed during the first two months of life?
Answer: B) Is the child consuming more than 16 to 24 ounces of cow's milk per
day?
Rationale: Iron-deficiency anemia in toddlers is frequently driven by excessive
intake of cow's milk (more than 16–24 oz/day). High milk volume can displace
iron-rich solid foods from the diet and cause low-grade occult gastrointestinal
blood loss, decreasing overall iron absorption.
8. A 5-year-old child presents with a thick, honey-colored crusted lesion on an
erythematous base around the upper lip. What is the most appropriate primary
intervention?
A) Prescription for oral acyclovir
B) Application of topical mupirocin 2% ointment
C) Administration of an intramuscular penicillin G injection
D) Daily application of over-the-counter hydrocortisone cream
Answer: B) Application of topical mupirocin 2% ointment
Rationale: Honey-colored crusted lesions are characteristic of superficial
impetigo, a localized bacterial skin infection typically caused by Staphylococcus
ADVANCED PRACTICE EXAM
COMPREHENSIVE STUDY GUIDE
(2025/2026 EDITION) | 400 HIGH-YIELD
NCLEX/NP PRACTICE QUESTIONS &
RATIONALES (PDF)
Master your advanced practice pediatric
nursing curriculum with the ultimate Stuvia-
ready exam preparation package! This high-
density study guide features 400 meticulously
compiled, high-yield multiple-choice questions
structurally mapped directly to the latest NR602
Pediatric Primary Care course objectives and
national nurse practitioner certification
blueprints. Every clinical prompt is paired with
fully highlatable, bold-italic answers and in-
depth evidence-based rationales inside
brackets—covering essential competencies
from developmental milestones and
immunization schedules to complex pediatric
pathologies like Kawasaki disease, croup, and
, congenital cardiac anomalies. Designed for
automated testing engines, rapid self-
assessment, or high-efficiency review sessions,
this turn-key resource is the definitive academic
asset for students aiming to secure top-tier
marks on their board certifications.
1.The parent of an infant experiencing colic asks about using a probiotic medication.
What will the primary care pediatric NP tell this parent?
A) Probiotic medications have demonstrated efficacy in treating colic.
B) Probiotics are not safe to use to treat infants who have colic.
C) There are no studies showing usefulness of probiotic to manage colic.
D) There is no conclusive evidence about using probiotics to treat colic.
Answer: D) There is no conclusive evidence about using probiotics to treat colic.
Rationale: Current clinical guidelines indicate that data regarding the routine use
of probiotics to prevent or treat infantile colic remains inconsistent and
inconclusive. Parents should be counseled on supportive care techniques, and
any trial of supplements should be approached with caution.
2. A toddler who was born prematurely refuses most solid foods and has poor weight gain.
A barium swallow study reveals a normal esophagus. What will the primary care
pediatric NP consider next to manage this child's nutritional needs?
, A) Consultation with dietician
B) Fiberoptic endoscopy evaluation
C) MRI
D) Videofluoroscopy swallowing study (VOSS)
Answer: D) Videofluoroscopy swallowing study (VOSS)
Rationale: In a premature toddler presenting with feeding refusal, poor weight
gain, and structural rule-outs via a normal barium swallow, a videofluoroscopy
swallowing study (VOSS)—also known as a speech/feeding swallowing study—is
indicated to evaluate for underlying functional pharyngeal dysphagia or micro-
aspiration.
3. A toddler is seen in clinic after a 2-day hx of intermittent V/D. An assessment reveals an
irritable child with dry mucous membranes, 3-second cap refill, 2-second recoil of skin,
mild tachycardia and tachypnea, and cool hands and feet. The child has had 2 wet
diapers in the past 24 hours. What will the primary care pediatric NP recommend?
A) Anti-diarrheal medication & clear fluids for 24H
B) Bolus of IV NS in the clinic until improvement
C) Oral rehydration solution with f/u in 24H
D) Admission for inpatient intravenous hydration therapy
Answer: C) Oral rehydration solution with f/u in 24H
Rationale: The clinical signs described point to moderate dehydration (prolonged
capillary refill, altered skin turgor, tachycardia, dry membranes, decreased urine
output). For mild-to-moderate dehydration, current pediatric guidelines heavily
prioritize oral rehydration therapy (ORT) over invasive IV fluids, paired with close
follow-up monitoring within 24 hours.
4. A 4-month-old infant is brought to the clinic for a routine well-child visit. The parent is
concerned because the infant cannot sit unsupported. What is the correct
developmental assessment by the NP?
A) This represents a significant motor delay requiring an immediate neurology referral.
B) Sitting unsupported is a milestone typically achieved between 6 and 8 months of age.
C) The infant should be placed in a physical therapy evaluation program immediately.
D) The parent should avoid tummy time to prevent strain on the infant's lower back
muscles.
Answer: B) Sitting unsupported is a milestone typically achieved between 6 and 8
months of age.
Rationale: According to standard pediatric developmental milestones, an infant
typically learns to sit unsupported between 6 and 8 months of age. Expecting this
milestone at 4 months is premature, and the NP should reassure the parent while
encouraging supervised prone playtime (tummy time).
5. A 2-year-old child presents with a sudden onset of a barking cough, inspiratory stridor,
and mild intercostal retractions. What is the most likely diagnosis and primary treatment
for mild symptoms?
A) Asthma; treat with an inhaled short-acting beta agonist.
B) Croup (Laryngotracheobronchitis); treat with a single dose of oral dexamethasone.
, C) Epiglottitis; treat with immediate endotracheal intubation.
D) Pertussis; treat with a 5-day course of azithromycin.
Answer: B) Croup (Laryngotracheobronchitis); treat with a single dose of oral
dexamethasone.
Rationale: A barking cough and inspiratory stridor are classic clinical indicators of
croup, typically caused by parainfluenza virus. Current guidelines recommend a
single dose of oral dexamethasone (0.6 mg/kg) to reduce airway inflammation,
even in mild cases without significant respiratory distress.
6. Which of the following physical findings is considered a pathognomonic sign of a
measles (rubeola) infection?
A) Erythema infectiosum "slapped cheek" rash
B) Koplik spots on the buccal mucosa
C) Honey-colored crusted lesions around the nares
D) Target-like erythema migrans lesions
Answer: B) Koplik spots on the buccal mucosa
Rationale: Koplik spots are small, bluish-white spots on an erythematous
background found on the buccal mucosa opposite the molars. They are
pathognomonic for measles and appear during the prodromal phase before the
generalized maculopapular rash develops.
7. A 12-month-old child is brought to the clinic for a well-child assessment. The NP notes
that the child's hemoglobin level is 9.2 g/dL. Which nutritional question is most critical to
ask the parent?
A) How many servings of fresh green vegetables does the child consume daily?
B) Is the child consuming more than 16 to 24 ounces of cow's milk per day?
C) Does the child feed themselves finger foods independently?
D) Was the child exclusively formula-fed during the first two months of life?
Answer: B) Is the child consuming more than 16 to 24 ounces of cow's milk per
day?
Rationale: Iron-deficiency anemia in toddlers is frequently driven by excessive
intake of cow's milk (more than 16–24 oz/day). High milk volume can displace
iron-rich solid foods from the diet and cause low-grade occult gastrointestinal
blood loss, decreasing overall iron absorption.
8. A 5-year-old child presents with a thick, honey-colored crusted lesion on an
erythematous base around the upper lip. What is the most appropriate primary
intervention?
A) Prescription for oral acyclovir
B) Application of topical mupirocin 2% ointment
C) Administration of an intramuscular penicillin G injection
D) Daily application of over-the-counter hydrocortisone cream
Answer: B) Application of topical mupirocin 2% ointment
Rationale: Honey-colored crusted lesions are characteristic of superficial
impetigo, a localized bacterial skin infection typically caused by Staphylococcus
