NURSING LICENSURE
NSG 5442 FINAL EXAM | 2026/2027 UPDATE |
QUESTIONS AND ANSWERS | WITH COMPLETE
SOLUTIONS - SOUTH COLLEGE
A+
Complete Blueprint Coverage
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Developmental Assessment and Well-Child Care
Common Acute Conditions in Pediatrics
Chronic Conditions and Management
Immunizations, Infectious Disease, and Prevention
Adolescent Health and Care in Underserved Populations
STUVIAACTUALEXAM
,SECTION 1: DEVELOPMENTAL ASSESSMENT AND WELL-CHILD CARE
Q1
A 9-month-old infant is brought to the rural primary care clinic for a well-child visit. The infant sits without
support, transfers objects hand-to-hand, and babbles with consonant sounds, but does not yet pull to stand or
say any words with meaning. The mother reports exclusive breastfeeding and no prior developmental concerns.
Which action by the family nurse practitioner best aligns with evidence-based developmental surveillance at this
visit?
A. Reassure the mother that gross motor skills such as pulling to stand are expected only after 12 months and
schedule the next visit at 15 months.
B. Administer a formal developmental screening tool validated for 9 months of age and discuss anticipatory guidance
on emerging language and motor milestones.
C. Refer immediately to early intervention services because the absence of meaningful words indicates a speech
delay requiring therapy.
D. Order a comprehensive metabolic panel and head ultrasound to evaluate for possible metabolic or structural
causes of delayed motor skills.
Correct Answer: B
Rationale:
At 9 months, formal developmental screening with a validated tool is recommended by AAP guidelines in addition to ongoing
surveillance. The described skills are within expected ranges for sitting, object transfer, and babbling; pulling to stand and first
words typically emerge closer to 9–12 months. Immediate referral or laboratory evaluation is not indicated without
documented delay on screening.
Q2
During a 4-year-old well-child examination in an underserved community clinic, the nurse practitioner notes that
the child draws a person with only a head and legs, cannot hop on one foot, and has difficulty copying a circle.
The parent states the child has never attended preschool. Which interpretation and next step are most
appropriate?
A. These findings represent normal variation for children without preschool experience; continue routine surveillance
at the next annual visit.
B. The drawing and motor findings suggest possible fine-motor and visual-motor delay; perform a structured
developmental screen and consider early childhood education referral.
C. Inability to hop indicates a primary neurologic deficit; order MRI of the brain and refer to pediatric neurology.
D. The absence of preschool is the sole cause; prescribe home fine-motor exercises and recheck in six months
without formal screening.
Correct Answer: B
Rationale:
A 4-year-old should typically copy a circle, draw a person with at least three body parts, and hop on one foot. The
combination of findings warrants a validated developmental screen rather than reassurance alone. Imaging is not first-line in
the absence of red-flag neurologic signs, and home exercises without screening risk missing treatable delays.
NSG 5442 FINAL EXAM | 2026/2027 UPDATE | QUESTIONS AND ANSWERS | WITH COMPLETE SOLUTIONS - SOUTH COLLEGE
, NSG 5442 FINAL EXAM | 2026/2027 UPDATE Page 3
Q3
A term 2-week-old newborn is evaluated in the primary care office. Birth weight was 3.4 kg; current weight is 3.2
kg. The infant is exclusively breastfed, has 6–8 wet diapers daily, and produces yellow seedy stools. The mother
reports mild engorgement and asks whether supplementation is needed. Which management decision is most
appropriate?
A. Recommend immediate formula supplementation of 2 oz after each breastfeed to restore birth weight rapidly.
B. Reassure that a weight loss of less than 10% with adequate urine and stool output is acceptable and arrange
close weight follow-up in 3–5 days while supporting continued exclusive breastfeeding.
C. Order serum bilirubin and glucose because any weight loss in the first two weeks indicates pathologic failure to
thrive.
D. Advise pumping and bottle-feeding expressed milk exclusively for one week to quantify intake precisely.
Correct Answer: B
Rationale:
Weight loss up to approximately 7–10% of birth weight is common in exclusively breastfed newborns when feeding is
established and output is adequate. Close follow-up and lactation support are preferred over automatic supplementation,
which can interfere with milk supply. Laboratory evaluation is reserved for excessive loss, poor output, or clinical signs of
dehydration or jaundice.
Q4
A 15-month-old toddler presents for a well-child visit. The parent is concerned because the child does not yet
walk independently and prefers to cruise along furniture. The child uses a pincer grasp, says three words, and
points to request objects. Growth parameters are at the 40th percentile. Which response by the nurse
practitioner is most evidence-based?
A. Independent walking is expected by 12 months; refer immediately to physical therapy and developmental
pediatrics.
B. Cruising at 15 months with preserved fine-motor and language skills is within the broad normal range; provide
anticipatory guidance on walking and reassess at the 18-month visit.
C. Order hip radiographs to exclude developmental dysplasia of the hip as the cause of delayed independent
ambulation.
D. Prescribe orthotic shoes to encourage independent walking and schedule monthly weight-bearing exercises.
Correct Answer: B
Rationale:
The upper limit of the normal range for independent walking extends to 15–18 months. With intact fine-motor and language
skills and normal growth, observation with anticipatory guidance is appropriate. Immediate referral or imaging is reserved for
children who are not walking by 18 months or who show asymmetric findings or other red flags.
NSG 5442 FINAL EXAM | 2026/2027 UPDATE | QUESTIONS AND ANSWERS | WITH COMPLETE SOLUTIONS - SOUTH COLLEGE
NSG 5442 FINAL EXAM | 2026/2027 UPDATE |
QUESTIONS AND ANSWERS | WITH COMPLETE
SOLUTIONS - SOUTH COLLEGE
A+
Complete Blueprint Coverage
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Developmental Assessment and Well-Child Care
Common Acute Conditions in Pediatrics
Chronic Conditions and Management
Immunizations, Infectious Disease, and Prevention
Adolescent Health and Care in Underserved Populations
STUVIAACTUALEXAM
,SECTION 1: DEVELOPMENTAL ASSESSMENT AND WELL-CHILD CARE
Q1
A 9-month-old infant is brought to the rural primary care clinic for a well-child visit. The infant sits without
support, transfers objects hand-to-hand, and babbles with consonant sounds, but does not yet pull to stand or
say any words with meaning. The mother reports exclusive breastfeeding and no prior developmental concerns.
Which action by the family nurse practitioner best aligns with evidence-based developmental surveillance at this
visit?
A. Reassure the mother that gross motor skills such as pulling to stand are expected only after 12 months and
schedule the next visit at 15 months.
B. Administer a formal developmental screening tool validated for 9 months of age and discuss anticipatory guidance
on emerging language and motor milestones.
C. Refer immediately to early intervention services because the absence of meaningful words indicates a speech
delay requiring therapy.
D. Order a comprehensive metabolic panel and head ultrasound to evaluate for possible metabolic or structural
causes of delayed motor skills.
Correct Answer: B
Rationale:
At 9 months, formal developmental screening with a validated tool is recommended by AAP guidelines in addition to ongoing
surveillance. The described skills are within expected ranges for sitting, object transfer, and babbling; pulling to stand and first
words typically emerge closer to 9–12 months. Immediate referral or laboratory evaluation is not indicated without
documented delay on screening.
Q2
During a 4-year-old well-child examination in an underserved community clinic, the nurse practitioner notes that
the child draws a person with only a head and legs, cannot hop on one foot, and has difficulty copying a circle.
The parent states the child has never attended preschool. Which interpretation and next step are most
appropriate?
A. These findings represent normal variation for children without preschool experience; continue routine surveillance
at the next annual visit.
B. The drawing and motor findings suggest possible fine-motor and visual-motor delay; perform a structured
developmental screen and consider early childhood education referral.
C. Inability to hop indicates a primary neurologic deficit; order MRI of the brain and refer to pediatric neurology.
D. The absence of preschool is the sole cause; prescribe home fine-motor exercises and recheck in six months
without formal screening.
Correct Answer: B
Rationale:
A 4-year-old should typically copy a circle, draw a person with at least three body parts, and hop on one foot. The
combination of findings warrants a validated developmental screen rather than reassurance alone. Imaging is not first-line in
the absence of red-flag neurologic signs, and home exercises without screening risk missing treatable delays.
NSG 5442 FINAL EXAM | 2026/2027 UPDATE | QUESTIONS AND ANSWERS | WITH COMPLETE SOLUTIONS - SOUTH COLLEGE
, NSG 5442 FINAL EXAM | 2026/2027 UPDATE Page 3
Q3
A term 2-week-old newborn is evaluated in the primary care office. Birth weight was 3.4 kg; current weight is 3.2
kg. The infant is exclusively breastfed, has 6–8 wet diapers daily, and produces yellow seedy stools. The mother
reports mild engorgement and asks whether supplementation is needed. Which management decision is most
appropriate?
A. Recommend immediate formula supplementation of 2 oz after each breastfeed to restore birth weight rapidly.
B. Reassure that a weight loss of less than 10% with adequate urine and stool output is acceptable and arrange
close weight follow-up in 3–5 days while supporting continued exclusive breastfeeding.
C. Order serum bilirubin and glucose because any weight loss in the first two weeks indicates pathologic failure to
thrive.
D. Advise pumping and bottle-feeding expressed milk exclusively for one week to quantify intake precisely.
Correct Answer: B
Rationale:
Weight loss up to approximately 7–10% of birth weight is common in exclusively breastfed newborns when feeding is
established and output is adequate. Close follow-up and lactation support are preferred over automatic supplementation,
which can interfere with milk supply. Laboratory evaluation is reserved for excessive loss, poor output, or clinical signs of
dehydration or jaundice.
Q4
A 15-month-old toddler presents for a well-child visit. The parent is concerned because the child does not yet
walk independently and prefers to cruise along furniture. The child uses a pincer grasp, says three words, and
points to request objects. Growth parameters are at the 40th percentile. Which response by the nurse
practitioner is most evidence-based?
A. Independent walking is expected by 12 months; refer immediately to physical therapy and developmental
pediatrics.
B. Cruising at 15 months with preserved fine-motor and language skills is within the broad normal range; provide
anticipatory guidance on walking and reassess at the 18-month visit.
C. Order hip radiographs to exclude developmental dysplasia of the hip as the cause of delayed independent
ambulation.
D. Prescribe orthotic shoes to encourage independent walking and schedule monthly weight-bearing exercises.
Correct Answer: B
Rationale:
The upper limit of the normal range for independent walking extends to 15–18 months. With intact fine-motor and language
skills and normal growth, observation with anticipatory guidance is appropriate. Immediate referral or imaging is reserved for
children who are not walking by 18 months or who show asymmetric findings or other red flags.
NSG 5442 FINAL EXAM | 2026/2027 UPDATE | QUESTIONS AND ANSWERS | WITH COMPLETE SOLUTIONS - SOUTH COLLEGE
