NURS 629 Exam 1 V3 | NURS 629 Peds |
Actual Q&A with Rationale (NURS629
Exam 1) | Maryville University
1. A primary care provider is conducting a developmental surveillance at a 9-month-old well-
child visit. Which of the following observations would warrant a referral for further
developmental evaluation?
A. The infant does not demonstrate a pincer grasp.
B. The infant is able to sit without support.
C. The infant is rolling from prone to supine.
D. The infant babbles with consonant sounds.
Correct Answer: A
By the age of 9 months, the development of a fine pincer grasp is a significant milestone
that should be observed or reported by parents. Failure to achieve this fine motor skill may
indicate a developmental delay in motor coordination or neurological processing. The
provider should utilize a standardized screening tool like the Ages and Stages
Questionnaire (ASQ) to further assess the child’s progress.
,2. Select All That Apply (SATA): A nurse practitioner is reviewing contraindications for the
administration of live-attenuated vaccines, such as MMR and Varicella. Which of the
following conditions are considered contraindications?
A. Pregnancy
B. Mild acute illness with low-grade fever
C. Severe immunocompromise due to chemotherapy
D. Anaphylactic reaction to a previous dose or vaccine component
E. Recent household exposure to an infectious disease
F. Receipt of high-dose systemic corticosteroids for more than two weeks
Correct Answer: A, C, D, F
Live vaccines are generally avoided in patients who are pregnant or severely
immunocompromised due to the theoretical risk of uncontrolled viral replication.
Anaphylaxis is an absolute contraindication for any vaccine regardless of its type. It is also
essential to wait for a specific period after high-dose steroid therapy before administering
these immunizations to ensure an adequate immune response.
3. A mother brings her 4-week-old infant to the clinic concerned about yellowing of the skin.
The infant is breastfeeding well and gaining weight appropriately. Laboratory results show a
total bilirubin of 8 mg/dL with a direct bilirubin of 0.3 mg/dL. What is the most likely
diagnosis?
A. Biliary atresia
,B. Pathologic jaundice
C. Breast milk jaundice
D. Hemolytic disease of the newborn
Correct Answer: C
Breast milk jaundice typically appears after the first week of life and can persist for
several weeks in healthy breastfed infants. This condition is characterized by unconjugated
hyperbilirubinemia while the infant otherwise appears well and has normal weight gain.
Management usually involves continued breastfeeding and monitoring since the bilirubin
levels are typically below the threshold for phototherapy.
4. During a 4-year-old well-child exam, the provider notes a BMI at the 96th percentile for age
and sex. How should this finding be categorized?
A. Underweight
B. Obese
C. Overweight
D. Healthy weight
Correct Answer: B
In the pediatric population, a BMI at or above the 95th percentile for age and sex is
classified as obese. Children falling between the 85th and 94th percentiles are categorized
, as overweight. This finding necessitates a detailed assessment of dietary habits, physical
activity, and family history to develop a metabolic health plan.
5. The provider is educating a new parent on dental health for their infant. At what age
should the first dental visit occur according to the American Academy of Pediatrics (AAP)?
A. When all primary teeth have erupted
B. By 12 months of age
C. At 3 years of age
D. Only if dental decay is suspected
Correct Answer: B
The AAP and the American Academy of Pediatric Dentistry recommend that a child’s first
dental visit occur by their first birthday. This early visit allows for the establishment of a
dental home and provides parents with anticipatory guidance on oral hygiene. Early
intervention is key to preventing early childhood caries and promoting lifelong dental
health.
6. A 5-year-old presents with a high fever for six days, bilateral conjunctival injection without
exudate, a strawberry tongue, and edema of the hands and feet. What is the priority
management for this patient?
A. Amoxicillin for suspected strep throat
B. Supportive care with fluids and rest for a viral exanthem
C. Intravenous immunoglobulin (IVIG) and high-dose aspirin
Actual Q&A with Rationale (NURS629
Exam 1) | Maryville University
1. A primary care provider is conducting a developmental surveillance at a 9-month-old well-
child visit. Which of the following observations would warrant a referral for further
developmental evaluation?
A. The infant does not demonstrate a pincer grasp.
B. The infant is able to sit without support.
C. The infant is rolling from prone to supine.
D. The infant babbles with consonant sounds.
Correct Answer: A
By the age of 9 months, the development of a fine pincer grasp is a significant milestone
that should be observed or reported by parents. Failure to achieve this fine motor skill may
indicate a developmental delay in motor coordination or neurological processing. The
provider should utilize a standardized screening tool like the Ages and Stages
Questionnaire (ASQ) to further assess the child’s progress.
,2. Select All That Apply (SATA): A nurse practitioner is reviewing contraindications for the
administration of live-attenuated vaccines, such as MMR and Varicella. Which of the
following conditions are considered contraindications?
A. Pregnancy
B. Mild acute illness with low-grade fever
C. Severe immunocompromise due to chemotherapy
D. Anaphylactic reaction to a previous dose or vaccine component
E. Recent household exposure to an infectious disease
F. Receipt of high-dose systemic corticosteroids for more than two weeks
Correct Answer: A, C, D, F
Live vaccines are generally avoided in patients who are pregnant or severely
immunocompromised due to the theoretical risk of uncontrolled viral replication.
Anaphylaxis is an absolute contraindication for any vaccine regardless of its type. It is also
essential to wait for a specific period after high-dose steroid therapy before administering
these immunizations to ensure an adequate immune response.
3. A mother brings her 4-week-old infant to the clinic concerned about yellowing of the skin.
The infant is breastfeeding well and gaining weight appropriately. Laboratory results show a
total bilirubin of 8 mg/dL with a direct bilirubin of 0.3 mg/dL. What is the most likely
diagnosis?
A. Biliary atresia
,B. Pathologic jaundice
C. Breast milk jaundice
D. Hemolytic disease of the newborn
Correct Answer: C
Breast milk jaundice typically appears after the first week of life and can persist for
several weeks in healthy breastfed infants. This condition is characterized by unconjugated
hyperbilirubinemia while the infant otherwise appears well and has normal weight gain.
Management usually involves continued breastfeeding and monitoring since the bilirubin
levels are typically below the threshold for phototherapy.
4. During a 4-year-old well-child exam, the provider notes a BMI at the 96th percentile for age
and sex. How should this finding be categorized?
A. Underweight
B. Obese
C. Overweight
D. Healthy weight
Correct Answer: B
In the pediatric population, a BMI at or above the 95th percentile for age and sex is
classified as obese. Children falling between the 85th and 94th percentiles are categorized
, as overweight. This finding necessitates a detailed assessment of dietary habits, physical
activity, and family history to develop a metabolic health plan.
5. The provider is educating a new parent on dental health for their infant. At what age
should the first dental visit occur according to the American Academy of Pediatrics (AAP)?
A. When all primary teeth have erupted
B. By 12 months of age
C. At 3 years of age
D. Only if dental decay is suspected
Correct Answer: B
The AAP and the American Academy of Pediatric Dentistry recommend that a child’s first
dental visit occur by their first birthday. This early visit allows for the establishment of a
dental home and provides parents with anticipatory guidance on oral hygiene. Early
intervention is key to preventing early childhood caries and promoting lifelong dental
health.
6. A 5-year-old presents with a high fever for six days, bilateral conjunctival injection without
exudate, a strawberry tongue, and edema of the hands and feet. What is the priority
management for this patient?
A. Amoxicillin for suspected strep throat
B. Supportive care with fluids and rest for a viral exanthem
C. Intravenous immunoglobulin (IVIG) and high-dose aspirin
