NSG 548 Exam 3 V2 | NSG 548 FNP Role:
Children & Families | Actual Q&A with
Rationale (NSG548 Exam 3) | Wilkes
University
1. A 4-year-old child presents with a sudden onset of high fever, drooling, and an inspiratory
stridor. The child is sitting in a ‘tripod’ position. What is the most appropriate next step for
the FNP?
A. Attempt to visualize the throat using a tongue blade
B. Obtain a throat culture for Group A Strep
C. Maintain a calm environment and arrange for immediate emergency transport
D. Administer nebulized racemic epinephrine
Answer: C
Rationale: This presentation is highly suspicious for epiglottitis, which is a medical
emergency that can lead to total airway obstruction. Attempting to visualize the throat or
perform a swab can trigger a laryngospasm and should never be done outside a controlled
surgical environment. The FNP’s priority is to keep the child calm to prevent further airway
compromise and ensure rapid transport to a facility capable of emergency intubation.
,2. According to the AAP guidelines, which of the following is the first-line antibiotic treatment
for a 2-year-old child diagnosed with non-severe Acute Otitis Media who has not received
antibiotics in the past month?
A. Amoxicillin 80-90 mg/kg/day
B. Ceftriaxone 50mg/kg IM
C. Azithromycin 10 mg/kg on day 1
D. Cefdinir 14 mg/kg/day
Answer: A
Rationale: High-dose Amoxicillin remains the first-line treatment for AOM in children
without a penicillin allergy or recent antibiotic use. This dose is specifically targeted to
overcome penicillin-resistant Streptococcus pneumoniae. If the patient had taken
amoxicillin in the last 30 days, Amoxicillin-Clavulanate would then be the preferred choice.
3. A 9-month-old infant is being evaluated for developmental milestones. Which of the
following findings would be considered a developmental ‘red flag’ at this age?
A. Failure to sit without support
B. Inability to walk independently
C. Absence of pincer grasp
D. Lack of ‘mama/dada’ specific words
Answer: A
,Rationale: Most infants should be able to sit unsupported by 6 to 7 months of age, and
failure to do so by 9 months is a significant red flag requiring further evaluation. While a
pincer grasp usually develops around this time, its absence is less critical than gross motor
delays like sitting. Walking independently and specific word usage are milestones typically
achieved closer to 12 months.
4. Which physical exam maneuver is specifically used to assess for Developmental Dysplasia
of the Hip (DDH) by attempting to relocate a dislocated hip?
A. Barlow maneuver
B. Galeazzi sign
C. Ortolani maneuver
D. Trendelenburg test
Answer: C
Rationale: The Ortolani maneuver is used to reduce a dislocated hip by abducting the hip
while applying upward pressure on the greater trochanter. In contrast, the Barlow
maneuver is a provocative test used to see if a hip can be subluxated or dislocated. The
Galeazzi sign looks for limb length discrepancy, while the Trendelenburg test assesses for
hip abductor weakness in older children.
, 5. A 15-year-old male athlete presents with pain and a bony prominence at the tibial
tuberosity. He reports the pain worsens during basketball practice. What is the most likely
diagnosis?
A. Legg-Calve-Perthes Disease
B. Slipped Capital Femoral Epiphysis (SCFE)
C. Osgood-Schlatter Disease
D. Sever Disease
Answer: C
Rationale: Osgood-Schlatter Disease is a common overuse injury in adolescents
characterized by inflammation of the patellar ligament at the tibial tuberosity. It typically
presents during growth spurts in children who participate in sports involving running and
jumping. Management is generally conservative, focusing on rest, ice, and activity
modification.
6. During a routine well-child visit, a 2-year-old’s mother expresses concern that her child is a
‘picky eater’ and only wants to drink milk. What is the primary nutritional risk for this child?
A. Vitamin D toxicity
B. Hypercalcemia
C. Iron deficiency anemia
D. Protein-energy malnutrition
Children & Families | Actual Q&A with
Rationale (NSG548 Exam 3) | Wilkes
University
1. A 4-year-old child presents with a sudden onset of high fever, drooling, and an inspiratory
stridor. The child is sitting in a ‘tripod’ position. What is the most appropriate next step for
the FNP?
A. Attempt to visualize the throat using a tongue blade
B. Obtain a throat culture for Group A Strep
C. Maintain a calm environment and arrange for immediate emergency transport
D. Administer nebulized racemic epinephrine
Answer: C
Rationale: This presentation is highly suspicious for epiglottitis, which is a medical
emergency that can lead to total airway obstruction. Attempting to visualize the throat or
perform a swab can trigger a laryngospasm and should never be done outside a controlled
surgical environment. The FNP’s priority is to keep the child calm to prevent further airway
compromise and ensure rapid transport to a facility capable of emergency intubation.
,2. According to the AAP guidelines, which of the following is the first-line antibiotic treatment
for a 2-year-old child diagnosed with non-severe Acute Otitis Media who has not received
antibiotics in the past month?
A. Amoxicillin 80-90 mg/kg/day
B. Ceftriaxone 50mg/kg IM
C. Azithromycin 10 mg/kg on day 1
D. Cefdinir 14 mg/kg/day
Answer: A
Rationale: High-dose Amoxicillin remains the first-line treatment for AOM in children
without a penicillin allergy or recent antibiotic use. This dose is specifically targeted to
overcome penicillin-resistant Streptococcus pneumoniae. If the patient had taken
amoxicillin in the last 30 days, Amoxicillin-Clavulanate would then be the preferred choice.
3. A 9-month-old infant is being evaluated for developmental milestones. Which of the
following findings would be considered a developmental ‘red flag’ at this age?
A. Failure to sit without support
B. Inability to walk independently
C. Absence of pincer grasp
D. Lack of ‘mama/dada’ specific words
Answer: A
,Rationale: Most infants should be able to sit unsupported by 6 to 7 months of age, and
failure to do so by 9 months is a significant red flag requiring further evaluation. While a
pincer grasp usually develops around this time, its absence is less critical than gross motor
delays like sitting. Walking independently and specific word usage are milestones typically
achieved closer to 12 months.
4. Which physical exam maneuver is specifically used to assess for Developmental Dysplasia
of the Hip (DDH) by attempting to relocate a dislocated hip?
A. Barlow maneuver
B. Galeazzi sign
C. Ortolani maneuver
D. Trendelenburg test
Answer: C
Rationale: The Ortolani maneuver is used to reduce a dislocated hip by abducting the hip
while applying upward pressure on the greater trochanter. In contrast, the Barlow
maneuver is a provocative test used to see if a hip can be subluxated or dislocated. The
Galeazzi sign looks for limb length discrepancy, while the Trendelenburg test assesses for
hip abductor weakness in older children.
, 5. A 15-year-old male athlete presents with pain and a bony prominence at the tibial
tuberosity. He reports the pain worsens during basketball practice. What is the most likely
diagnosis?
A. Legg-Calve-Perthes Disease
B. Slipped Capital Femoral Epiphysis (SCFE)
C. Osgood-Schlatter Disease
D. Sever Disease
Answer: C
Rationale: Osgood-Schlatter Disease is a common overuse injury in adolescents
characterized by inflammation of the patellar ligament at the tibial tuberosity. It typically
presents during growth spurts in children who participate in sports involving running and
jumping. Management is generally conservative, focusing on rest, ice, and activity
modification.
6. During a routine well-child visit, a 2-year-old’s mother expresses concern that her child is a
‘picky eater’ and only wants to drink milk. What is the primary nutritional risk for this child?
A. Vitamin D toxicity
B. Hypercalcemia
C. Iron deficiency anemia
D. Protein-energy malnutrition
