NR 602 Midterm Exam Primary Care of the Childbearing Family
(Chamberlain College of Nursing) Questions with Correct Verified Answers -
2026/2027
1. What is the recommended first-line antibiotic for an initial episode of acute otitis media in a
non-penicillin-allergic child? High-dose amoxicillin (80-90 mg/kg/day divided twice daily) for 10 days in
children under 2, or 5-7 days in older children.
2. A child with recurrent otitis media has failed two courses of amoxicillin. What is the appropriate next step in
antibiotic therapy? Switch to amoxicillin-clavulanate (Augmentin) to cover beta-lactamase producing
organisms.
3. What is the most common causative organism of acute otitis media? Streptococcus pneumoniae.
4. What physical exam finding differentiates otitis media with effusion from acute otitis media? Otitis media
with effusion shows a dull, retracted or neutral tympanic membrane without bulging or acute
inflammation, while acute otitis media shows a bulging, erythematous TM.
5. What is the classic radiographic finding in croup? Subglottic narrowing, described as the 'steeple sign' on
anteroposterior neck x-ray.
6. What is the first-line treatment for mild to moderate croup in the outpatient setting? A single dose of oral
dexamethasone.
7. What is the most common trigger for an acute asthma exacerbation in young children? Viral upper
respiratory infections.
8. What spirometry finding is diagnostic of an obstructive pattern consistent with asthma? A reduced FEV1/FVC
ratio with reversibility (improvement of at least 12%) after bronchodilator administration.
9. What is the step-up treatment recommended for a child with persistent asthma symptoms not controlled on a
low-dose inhaled corticosteroid alone? Addition of a long-acting beta-agonist (LABA) or increasing the
inhaled corticosteroid dose per stepwise asthma management guidelines.
10. What historical feature is classic for intussusception in an infant? Intermittent, severe abdominal pain with
drawing up of the legs, followed by lethargy, and later 'currant jelly' stools.
11. What is the diagnostic and often therapeutic procedure of choice for intussusception? Air or contrast enema,
which can both diagnose and reduce the intussusception.
12. What condition should be suspected in a toddler with a palpable 'olive-shaped' mass in the epigastrium and
projectile non-bilious vomiting? Pyloric stenosis.
13. A 4-week-old presents with non-bilious projectile vomiting after feeds. What electrolyte abnormality is
classically associated with this presentation? Hypochloremic, hypokalemic metabolic alkalosis.
14. What is the recommended dietary advice for an 8-month-old with mild diarrhea and no signs of dehydration?
Continue age-appropriate regular diet, including breast milk/formula and solids as tolerated, rather than
restricting to a bland or clear-liquid diet.
15. What is the appropriate management approach for Osgood-Schlatter disease in an active adolescent? Activity
modification/relative rest, ice application, and NSAIDs for pain, with gradual return to activity as
symptoms improve.
16. What is the most common form of childhood chronic arthritis? Juvenile idiopathic arthritis (JIA).
17. A child with juvenile idiopathic arthritis and a positive ANA is at increased risk for which often-asymptomatic
ocular complication requiring regular screening? Uveitis, which requires routine slit-lamp ophthalmologic
screening (frequency guided by ANA status and JIA subtype).
, 18. What chromosomal abnormality is associated with short stature, webbed neck, and ovarian dysgenesis in
girls? Turner syndrome (45,X).
19. What is the classic phenotypic triad description most associated with Down syndrome (Trisomy 21) on
newborn exam? Hypotonia, flat facial profile with upslanting palpebral fissures, and a single palmar
(simian) crease.
20. What developmental milestone would you expect a healthy 4- to 5-year-old to have typically achieved
regarding toileting? Independent toileting, though may still need assistance with wiping.
21. At what age does a typically developing child usually begin to walk independently? Around 12 to 15 months
of age.
22. At what age should a child be able to speak in two- to three-word phrases? Around 24 months (2 years) of
age.
23. What is a normal expected finding regarding object permanence development in a 9-month-old infant? The
infant should demonstrate object permanence, searching for a hidden object rather than acting as though it
no longer exists.
24. What is an absolute contraindication to the use of combined hormonal contraceptives in an adolescent? A
personal history of venous thromboembolism (VTE).
25. Which contraceptive method is considered safe for use in an adolescent with a history of migraine with aura?
Progestin-only methods (e.g., progestin-only pill, implant, or injection), since estrogen-containing methods
are contraindicated with migraine with aura due to stroke risk.
26. What is the mechanism of action of the copper intrauterine device (IUD)? It causes a local
inflammatory/spermicidal reaction in the uterus that impairs sperm motility and function, preventing
fertilization; it does not contain hormones.
27. Which long-acting reversible contraceptive method is considered first-line for adolescents according to ACOG
guidance? The subdermal contraceptive implant or the intrauterine device (IUD), given their high efficacy
and low user-dependency.
28. What is the recommended timing for initiating combined oral contraceptives in a patient with a regular
menstrual cycle? Within 5 days of the start of menses (quick-start initiation is also acceptable with a
negative pregnancy test and backup contraception for 7 days).
29. A sexually active adolescent presents with dysuria and vaginal discharge. What are the two most common
causative organisms to test for? Chlamydia trachomatis and Neisseria gonorrhoeae.
30. What is the CDC-recommended first-line treatment regimen for uncomplicated chlamydia infection?
Doxycycline 100 mg orally twice daily for 7 days.
31. What is the recommended treatment for uncomplicated gonorrhea infection per current CDC guidelines?
Ceftriaxone as a single intramuscular dose (dosing per current CDC weight-based guidance).
32. At what age does the CDC recommend routine initiation of the HPV vaccine series? Age 11 to 12 years (can
be started as early as age 9).
33. How many doses of HPV vaccine are recommended if the series is initiated before age 15? Two doses, given
6 to 12 months apart.
34. What screening test is recommended for cervical cancer screening in a 25-year-old with no prior abnormal
results? Primary HPV testing (or co-testing with Pap and HPV, or Pap alone depending on current
guideline and resource setting) starting at age 21-25 per current guidelines.
35. A 14-year-old presents to the clinic showing hesitancy in discussing an issue related to her self-identity. What
is the most appropriate clinician action? Offer to speak with the adolescent privately/confidentially, without
the parent present, to create a safe space for disclosure while explaining the limits of confidentiality.
(Chamberlain College of Nursing) Questions with Correct Verified Answers -
2026/2027
1. What is the recommended first-line antibiotic for an initial episode of acute otitis media in a
non-penicillin-allergic child? High-dose amoxicillin (80-90 mg/kg/day divided twice daily) for 10 days in
children under 2, or 5-7 days in older children.
2. A child with recurrent otitis media has failed two courses of amoxicillin. What is the appropriate next step in
antibiotic therapy? Switch to amoxicillin-clavulanate (Augmentin) to cover beta-lactamase producing
organisms.
3. What is the most common causative organism of acute otitis media? Streptococcus pneumoniae.
4. What physical exam finding differentiates otitis media with effusion from acute otitis media? Otitis media
with effusion shows a dull, retracted or neutral tympanic membrane without bulging or acute
inflammation, while acute otitis media shows a bulging, erythematous TM.
5. What is the classic radiographic finding in croup? Subglottic narrowing, described as the 'steeple sign' on
anteroposterior neck x-ray.
6. What is the first-line treatment for mild to moderate croup in the outpatient setting? A single dose of oral
dexamethasone.
7. What is the most common trigger for an acute asthma exacerbation in young children? Viral upper
respiratory infections.
8. What spirometry finding is diagnostic of an obstructive pattern consistent with asthma? A reduced FEV1/FVC
ratio with reversibility (improvement of at least 12%) after bronchodilator administration.
9. What is the step-up treatment recommended for a child with persistent asthma symptoms not controlled on a
low-dose inhaled corticosteroid alone? Addition of a long-acting beta-agonist (LABA) or increasing the
inhaled corticosteroid dose per stepwise asthma management guidelines.
10. What historical feature is classic for intussusception in an infant? Intermittent, severe abdominal pain with
drawing up of the legs, followed by lethargy, and later 'currant jelly' stools.
11. What is the diagnostic and often therapeutic procedure of choice for intussusception? Air or contrast enema,
which can both diagnose and reduce the intussusception.
12. What condition should be suspected in a toddler with a palpable 'olive-shaped' mass in the epigastrium and
projectile non-bilious vomiting? Pyloric stenosis.
13. A 4-week-old presents with non-bilious projectile vomiting after feeds. What electrolyte abnormality is
classically associated with this presentation? Hypochloremic, hypokalemic metabolic alkalosis.
14. What is the recommended dietary advice for an 8-month-old with mild diarrhea and no signs of dehydration?
Continue age-appropriate regular diet, including breast milk/formula and solids as tolerated, rather than
restricting to a bland or clear-liquid diet.
15. What is the appropriate management approach for Osgood-Schlatter disease in an active adolescent? Activity
modification/relative rest, ice application, and NSAIDs for pain, with gradual return to activity as
symptoms improve.
16. What is the most common form of childhood chronic arthritis? Juvenile idiopathic arthritis (JIA).
17. A child with juvenile idiopathic arthritis and a positive ANA is at increased risk for which often-asymptomatic
ocular complication requiring regular screening? Uveitis, which requires routine slit-lamp ophthalmologic
screening (frequency guided by ANA status and JIA subtype).
, 18. What chromosomal abnormality is associated with short stature, webbed neck, and ovarian dysgenesis in
girls? Turner syndrome (45,X).
19. What is the classic phenotypic triad description most associated with Down syndrome (Trisomy 21) on
newborn exam? Hypotonia, flat facial profile with upslanting palpebral fissures, and a single palmar
(simian) crease.
20. What developmental milestone would you expect a healthy 4- to 5-year-old to have typically achieved
regarding toileting? Independent toileting, though may still need assistance with wiping.
21. At what age does a typically developing child usually begin to walk independently? Around 12 to 15 months
of age.
22. At what age should a child be able to speak in two- to three-word phrases? Around 24 months (2 years) of
age.
23. What is a normal expected finding regarding object permanence development in a 9-month-old infant? The
infant should demonstrate object permanence, searching for a hidden object rather than acting as though it
no longer exists.
24. What is an absolute contraindication to the use of combined hormonal contraceptives in an adolescent? A
personal history of venous thromboembolism (VTE).
25. Which contraceptive method is considered safe for use in an adolescent with a history of migraine with aura?
Progestin-only methods (e.g., progestin-only pill, implant, or injection), since estrogen-containing methods
are contraindicated with migraine with aura due to stroke risk.
26. What is the mechanism of action of the copper intrauterine device (IUD)? It causes a local
inflammatory/spermicidal reaction in the uterus that impairs sperm motility and function, preventing
fertilization; it does not contain hormones.
27. Which long-acting reversible contraceptive method is considered first-line for adolescents according to ACOG
guidance? The subdermal contraceptive implant or the intrauterine device (IUD), given their high efficacy
and low user-dependency.
28. What is the recommended timing for initiating combined oral contraceptives in a patient with a regular
menstrual cycle? Within 5 days of the start of menses (quick-start initiation is also acceptable with a
negative pregnancy test and backup contraception for 7 days).
29. A sexually active adolescent presents with dysuria and vaginal discharge. What are the two most common
causative organisms to test for? Chlamydia trachomatis and Neisseria gonorrhoeae.
30. What is the CDC-recommended first-line treatment regimen for uncomplicated chlamydia infection?
Doxycycline 100 mg orally twice daily for 7 days.
31. What is the recommended treatment for uncomplicated gonorrhea infection per current CDC guidelines?
Ceftriaxone as a single intramuscular dose (dosing per current CDC weight-based guidance).
32. At what age does the CDC recommend routine initiation of the HPV vaccine series? Age 11 to 12 years (can
be started as early as age 9).
33. How many doses of HPV vaccine are recommended if the series is initiated before age 15? Two doses, given
6 to 12 months apart.
34. What screening test is recommended for cervical cancer screening in a 25-year-old with no prior abnormal
results? Primary HPV testing (or co-testing with Pap and HPV, or Pap alone depending on current
guideline and resource setting) starting at age 21-25 per current guidelines.
35. A 14-year-old presents to the clinic showing hesitancy in discussing an issue related to her self-identity. What
is the most appropriate clinician action? Offer to speak with the adolescent privately/confidentially, without
the parent present, to create a safe space for disclosure while explaining the limits of confidentiality.
