CMN 568 ACTUAL EXAM SCRIPT 2026
QUESTIONS WITH SOLUTIONS GRADED A+
◉ Definition of fever.
Answer: Rectal temperature ≥ 100.4°F
◉ Tympanic temperature.
Answer: Not accurate in infants under 3 months
◉ Fever Causes.
Answer: Most common Benign viral illness, can also caused by
bacterial or fungal infections, drug reactions including
immunizations, malignancies, autoimmune or metabolic disorders,
CNS disorders, excessive environmental temperatures.
◉ Factors that increase likelihood of serious bacterial illness.
Answer: Age under 3 months, history of prematurity, chronic
medical conditions such as immunosupression or aspenia, previous
hospitalizations, daycare. Toxic appearance
◉ Non-Toxic appearance.
Answer: Strong cry
,Consolable
Alert and easy to arouse
Pink skin tones
Good hydration; good turgor, tears, moist mucous membranes
Smiles, responsive to environment
◉ Toxic appearance.
Answer: Weak or high pitched cry
Inconsolable
Difficult to arouse
Pale, ashen, cyanotic, or mottled skin tones
Poor hydration; poor turgor, dry mucous membranes, no tears
No smile, listless, dull, infant won't alert to environment
◉ Signs of serious illness.
Answer: Fever greater than 40 (105)
Nuchal rigidity
Petechial skin rash
Seizure activity
Stridor or increased WOB
◉ Physical exam signs of serious infection: Skin.
,Answer: Petechiae, rashes
◉ Physical exam signs of serious infection: head/neck.
Answer: Sunken or bulging fontanelles, nuchal rigidity
◉ Physical exam signs of serious infection: ears.
Answer: Bulging TM, AOM, mastoiditis
◉ Physical exam signs of serious infection: Chest.
Answer: Tachypnea, wheezing, rales, rhonchi
◉ Physical exam signs of serious infection: Heart.
Answer: Murmurs
◉ Physical exam signs of serious infection: Abdomen.
Answer: Tenderness, distension
◉ Physical exam signs of serious infection: Musculoskeletal.
Answer: Refusal to bear weight or use an extremity,
erythema/warmth over joint
◉ Diagnostic tests for fever in infant and young child.
, Answer: CBC w/ Diff (WBC > 15,000 may indicate SBI. Child with
overwhelming sepsis my have WBC <5,000)
UA/ C&S: R/O UTI
CXR: R/O Pneumonia
Lumbar Puncture: R/O meningitis
Blood cultures: R/O Bacteremia
Stools for C&S: R/O Infectious diarrhea
◉ Management of fever in infant < 4 weeks.
Answer: Refer to pediatrician
Hospitalization
Full septic workup
IV antibiotics pending culture results
◉ Management of fever in infant 4 weeks - 3Mo.
Answer: Toxic appearance:
Refer to pediatrician
Hospitalization
Full septic workup
IV antibiotics pending culture results
Non-Toxic appearance/No risk factors for SBI:
Full septic workup
QUESTIONS WITH SOLUTIONS GRADED A+
◉ Definition of fever.
Answer: Rectal temperature ≥ 100.4°F
◉ Tympanic temperature.
Answer: Not accurate in infants under 3 months
◉ Fever Causes.
Answer: Most common Benign viral illness, can also caused by
bacterial or fungal infections, drug reactions including
immunizations, malignancies, autoimmune or metabolic disorders,
CNS disorders, excessive environmental temperatures.
◉ Factors that increase likelihood of serious bacterial illness.
Answer: Age under 3 months, history of prematurity, chronic
medical conditions such as immunosupression or aspenia, previous
hospitalizations, daycare. Toxic appearance
◉ Non-Toxic appearance.
Answer: Strong cry
,Consolable
Alert and easy to arouse
Pink skin tones
Good hydration; good turgor, tears, moist mucous membranes
Smiles, responsive to environment
◉ Toxic appearance.
Answer: Weak or high pitched cry
Inconsolable
Difficult to arouse
Pale, ashen, cyanotic, or mottled skin tones
Poor hydration; poor turgor, dry mucous membranes, no tears
No smile, listless, dull, infant won't alert to environment
◉ Signs of serious illness.
Answer: Fever greater than 40 (105)
Nuchal rigidity
Petechial skin rash
Seizure activity
Stridor or increased WOB
◉ Physical exam signs of serious infection: Skin.
,Answer: Petechiae, rashes
◉ Physical exam signs of serious infection: head/neck.
Answer: Sunken or bulging fontanelles, nuchal rigidity
◉ Physical exam signs of serious infection: ears.
Answer: Bulging TM, AOM, mastoiditis
◉ Physical exam signs of serious infection: Chest.
Answer: Tachypnea, wheezing, rales, rhonchi
◉ Physical exam signs of serious infection: Heart.
Answer: Murmurs
◉ Physical exam signs of serious infection: Abdomen.
Answer: Tenderness, distension
◉ Physical exam signs of serious infection: Musculoskeletal.
Answer: Refusal to bear weight or use an extremity,
erythema/warmth over joint
◉ Diagnostic tests for fever in infant and young child.
, Answer: CBC w/ Diff (WBC > 15,000 may indicate SBI. Child with
overwhelming sepsis my have WBC <5,000)
UA/ C&S: R/O UTI
CXR: R/O Pneumonia
Lumbar Puncture: R/O meningitis
Blood cultures: R/O Bacteremia
Stools for C&S: R/O Infectious diarrhea
◉ Management of fever in infant < 4 weeks.
Answer: Refer to pediatrician
Hospitalization
Full septic workup
IV antibiotics pending culture results
◉ Management of fever in infant 4 weeks - 3Mo.
Answer: Toxic appearance:
Refer to pediatrician
Hospitalization
Full septic workup
IV antibiotics pending culture results
Non-Toxic appearance/No risk factors for SBI:
Full septic workup
