NUR 6130 Exam 2 V3 | NUR 6130
Advanced Practice Nursing III | Q&A with
Rationale (NUR6130 Exam 2) | William
Paterson University
1. A 4-year-old male is brought to the clinic for a routine check-up. The mother mentions that
he often has a high-pitched ‘seal-like’ cough at night. On examination, the child appears
comfortable but has mild inspiratory stridor when agitated. What is the most likely
diagnosis?
A. Epiglottitis
B. Foreign Body Aspiration
C. Laryngotracheobronchitis (Croup)
D. Bacterial Tracheitis
Answer: C
Rationale: Laryngotracheobronchitis, or croup, is characterized by subglottic
inflammation and a classic barking cough. It most commonly affects children aged 6
months to 3 years and is typically caused by parainfluenza virus. Management depends on
severity but often includes a single dose of dexamethasone and monitoring.
,2. During a well-child visit for an 18-month-old, which developmental milestone should the
Advanced Practice Nurse expect the child to have achieved?
A. Using a spoon with little spilling
B. Walking up and down stairs alone
C. Running well and jumping in place
D. Building a tower of 3 to 4 cubes
Answer: D
Rationale: An 18-month-old should be able to build a tower of 3 to 4 blocks and walk well.
This stage is marked by the development of fine motor skills and the beginning of more
complex play. Assessment of these milestones is critical to identifying developmental
delays early in primary care.
3. A 15-year-old female presents with a 2-day history of sore throat, fever, and cervical
lymphadenopathy. Physical exam reveals palatal petechiae and splenomegaly. What is the
most appropriate next step in management?
A. Prescribe Amoxicillin for suspected Strep throat
B. Order a Monospot test and CBC
C. Perform an immediate chest X-ray
D. Administer a corticosteroid injection
Answer: B
,Rationale: The clinical presentation of fever, lymphadenopathy, and splenomegaly is
highly suggestive of Infectious Mononucleosis. A Monospot (heterophile antibody) test and
CBC showing lymphocytosis are standard diagnostic tools. Patients must be counseled to
avoid contact sports for at least 3-4 weeks to prevent splenic rupture.
4. A 24-year-old female presents for her first Pap smear. According to current ASCCP and
ACOG guidelines, how frequently should she be screened if her results are normal?
A. Every year with cytology alone
B. Screening is not recommended until age 30
C. Every 5 years with HPV co-testing
D. Every 3 years with cytology alone
Answer: D
Rationale: For women aged 21 to 29, cervical cancer screening is recommended every 3
years with cytology alone. HPV co-testing is not recommended in this age group because
transient HPV infections are very common and often resolve spontaneously. Starting at age
30, the preferred method is co-testing every 5 years or cytology alone every 3 years.
5. An 8-year-old child presents with itchy, honey-colored crusted lesions around the mouth
and nose. What is the first-line topical treatment for this condition?
A. Hydrocortisone 1% cream
B. Ketoconazole cream
C. Mupirocin (Bactroban) ointment
, D. Permethrin 5% cream
Answer: C
Rationale: The description of honey-colored crusts is classic for non-bullous impetigo,
usually caused by S. aureus or S. pyogenes. Mupirocin is the preferred topical antibiotic for
localized lesions. If the infection is widespread or systemic symptoms are present, oral
antibiotics like cephalexin may be indicated.
6. A mother brings her 3-week-old infant to the clinic concerned about ‘projectile vomiting’
after every feeding. The infant appears hungry and dehydrated. On palpation, an olive-
shaped mass is felt in the epigastrium. What is the definitive management?
A. Switching to a hydrolyzed protein formula
B. Thickening feeds with rice cereal
C. Prescribing Ranitidine for GERD
D. Surgical pyloromyotomy
Answer: D
Rationale: Hypertrophic Pyloric Stenosis is characterized by non-bilious projectile
vomiting and an olive-shaped mass. This is a surgical emergency that requires fluid
resuscitation followed by a pyloromyotomy. Ultrasound is the diagnostic gold standard to
confirm the thickening of the pyloric muscle.
Advanced Practice Nursing III | Q&A with
Rationale (NUR6130 Exam 2) | William
Paterson University
1. A 4-year-old male is brought to the clinic for a routine check-up. The mother mentions that
he often has a high-pitched ‘seal-like’ cough at night. On examination, the child appears
comfortable but has mild inspiratory stridor when agitated. What is the most likely
diagnosis?
A. Epiglottitis
B. Foreign Body Aspiration
C. Laryngotracheobronchitis (Croup)
D. Bacterial Tracheitis
Answer: C
Rationale: Laryngotracheobronchitis, or croup, is characterized by subglottic
inflammation and a classic barking cough. It most commonly affects children aged 6
months to 3 years and is typically caused by parainfluenza virus. Management depends on
severity but often includes a single dose of dexamethasone and monitoring.
,2. During a well-child visit for an 18-month-old, which developmental milestone should the
Advanced Practice Nurse expect the child to have achieved?
A. Using a spoon with little spilling
B. Walking up and down stairs alone
C. Running well and jumping in place
D. Building a tower of 3 to 4 cubes
Answer: D
Rationale: An 18-month-old should be able to build a tower of 3 to 4 blocks and walk well.
This stage is marked by the development of fine motor skills and the beginning of more
complex play. Assessment of these milestones is critical to identifying developmental
delays early in primary care.
3. A 15-year-old female presents with a 2-day history of sore throat, fever, and cervical
lymphadenopathy. Physical exam reveals palatal petechiae and splenomegaly. What is the
most appropriate next step in management?
A. Prescribe Amoxicillin for suspected Strep throat
B. Order a Monospot test and CBC
C. Perform an immediate chest X-ray
D. Administer a corticosteroid injection
Answer: B
,Rationale: The clinical presentation of fever, lymphadenopathy, and splenomegaly is
highly suggestive of Infectious Mononucleosis. A Monospot (heterophile antibody) test and
CBC showing lymphocytosis are standard diagnostic tools. Patients must be counseled to
avoid contact sports for at least 3-4 weeks to prevent splenic rupture.
4. A 24-year-old female presents for her first Pap smear. According to current ASCCP and
ACOG guidelines, how frequently should she be screened if her results are normal?
A. Every year with cytology alone
B. Screening is not recommended until age 30
C. Every 5 years with HPV co-testing
D. Every 3 years with cytology alone
Answer: D
Rationale: For women aged 21 to 29, cervical cancer screening is recommended every 3
years with cytology alone. HPV co-testing is not recommended in this age group because
transient HPV infections are very common and often resolve spontaneously. Starting at age
30, the preferred method is co-testing every 5 years or cytology alone every 3 years.
5. An 8-year-old child presents with itchy, honey-colored crusted lesions around the mouth
and nose. What is the first-line topical treatment for this condition?
A. Hydrocortisone 1% cream
B. Ketoconazole cream
C. Mupirocin (Bactroban) ointment
, D. Permethrin 5% cream
Answer: C
Rationale: The description of honey-colored crusts is classic for non-bullous impetigo,
usually caused by S. aureus or S. pyogenes. Mupirocin is the preferred topical antibiotic for
localized lesions. If the infection is widespread or systemic symptoms are present, oral
antibiotics like cephalexin may be indicated.
6. A mother brings her 3-week-old infant to the clinic concerned about ‘projectile vomiting’
after every feeding. The infant appears hungry and dehydrated. On palpation, an olive-
shaped mass is felt in the epigastrium. What is the definitive management?
A. Switching to a hydrolyzed protein formula
B. Thickening feeds with rice cereal
C. Prescribing Ranitidine for GERD
D. Surgical pyloromyotomy
Answer: D
Rationale: Hypertrophic Pyloric Stenosis is characterized by non-bilious projectile
vomiting and an olive-shaped mass. This is a surgical emergency that requires fluid
resuscitation followed by a pyloromyotomy. Ultrasound is the diagnostic gold standard to
confirm the thickening of the pyloric muscle.
