NSG 555 Exam 3 V3 | NSG 555 Nurse Practitioners
in Primary Care I | Wilkes University | 2026 Q&A
with Rationale (Wilkes NSG555 Exam 3 2026)
1. A 4-year-old male presents with a sudden onset of a ‘seal-like’ barky cough and inspiratory
stridor at night. What is the most likely diagnosis and recommended initial treatment?
A. Epiglottitis; immediate intubation
B. Foreign body aspiration; chest X-ray
C. Bronchiolitis; nebulized albuterol
D. Croup; single dose of oral Dexamethasone
Correct Answer: D
Explanation: Croup, or laryngotracheobronchitis, is characterized by a barky cough and
stridor due to subglottic edema. A single dose of Dexamethasone (0.6 mg/kg) is the
standard treatment to reduce airway inflammation. Clinical assessment for respiratory
distress is vital to determine if nebulized epinephrine is also required.
2. When managing a pediatric patient with Acute Otitis Media (AOM), which of the following
criteria warrants the immediate initiation of antibiotics rather than ‘watchful waiting’?
A. Age 6 months to 2 years with unilateral symptoms and mild pain
B. Age >2 years with bilateral symptoms and mild pain
C. Age >2 years with a temperature of 100.4°F
,D. Age <6 months regardless of symptom severity
Correct Answer: D
Explanation: According to AAP guidelines, any infant under 6 months of age with AOM
should receive immediate antibiotic therapy. For children aged 6 months to 2 years,
immediate antibiotics are recommended for severe symptoms or bilateral disease. This
approach balances the need for treatment with the goal of reducing antibiotic resistance.
3. A 15-year-old female presents with sore throat, fever, and cervical lymphadenopathy. A
rapid strep test is negative, but the patient has significant tonsillar exudates and palatal
petechiae. What is the next best step in management?
A. Prescribe Amoxicillin immediately
B. Perform a throat culture and consider a Monospot test
C. Diagnose viral pharyngitis and provide supportive care
D. Refer to ENT for urgent tonsillectomy
Correct Answer: B
Explanation: In adolescents, the presence of exudative pharyngitis and lymphadenopathy
should raise suspicion for Infectious Mononucleosis if the rapid strep is negative. A throat
culture is the gold standard for Group A Strep and should be performed to confirm a
negative rapid test. The Monospot test or EBV titers can help differentiate between
bacterial and viral etiologies.
, 4. A 6-month-old infant is brought in for a well-child check. Which developmental milestone
should the nurse practitioner expect the child to have achieved?
A. Sitting independently without support
B. Walking while holding onto furniture
C. Using a pincer grasp to pick up small objects
D. Speaking two-word sentences
Correct Answer: A
Explanation: At 6 months, infants are typically expected to sit without support and roll in
both directions. Walking while holding onto furniture (cruising) and the pincer grasp are
milestones usually achieved between 9 and 12 months. Early identification of
developmental delays allows for timely referral to early intervention programs.
5. In the treatment of pediatric asthma, which of the following is considered the preferred
‘Step 2’ long-term control medication for children aged 5-11?
A. Long-Acting Beta Agonists (LABA) monotherapy
B. Low-dose Inhaled Corticosteroids (ICS)
C. Oral Corticosteroids for 5 days
D. Theophylline
Correct Answer: B
in Primary Care I | Wilkes University | 2026 Q&A
with Rationale (Wilkes NSG555 Exam 3 2026)
1. A 4-year-old male presents with a sudden onset of a ‘seal-like’ barky cough and inspiratory
stridor at night. What is the most likely diagnosis and recommended initial treatment?
A. Epiglottitis; immediate intubation
B. Foreign body aspiration; chest X-ray
C. Bronchiolitis; nebulized albuterol
D. Croup; single dose of oral Dexamethasone
Correct Answer: D
Explanation: Croup, or laryngotracheobronchitis, is characterized by a barky cough and
stridor due to subglottic edema. A single dose of Dexamethasone (0.6 mg/kg) is the
standard treatment to reduce airway inflammation. Clinical assessment for respiratory
distress is vital to determine if nebulized epinephrine is also required.
2. When managing a pediatric patient with Acute Otitis Media (AOM), which of the following
criteria warrants the immediate initiation of antibiotics rather than ‘watchful waiting’?
A. Age 6 months to 2 years with unilateral symptoms and mild pain
B. Age >2 years with bilateral symptoms and mild pain
C. Age >2 years with a temperature of 100.4°F
,D. Age <6 months regardless of symptom severity
Correct Answer: D
Explanation: According to AAP guidelines, any infant under 6 months of age with AOM
should receive immediate antibiotic therapy. For children aged 6 months to 2 years,
immediate antibiotics are recommended for severe symptoms or bilateral disease. This
approach balances the need for treatment with the goal of reducing antibiotic resistance.
3. A 15-year-old female presents with sore throat, fever, and cervical lymphadenopathy. A
rapid strep test is negative, but the patient has significant tonsillar exudates and palatal
petechiae. What is the next best step in management?
A. Prescribe Amoxicillin immediately
B. Perform a throat culture and consider a Monospot test
C. Diagnose viral pharyngitis and provide supportive care
D. Refer to ENT for urgent tonsillectomy
Correct Answer: B
Explanation: In adolescents, the presence of exudative pharyngitis and lymphadenopathy
should raise suspicion for Infectious Mononucleosis if the rapid strep is negative. A throat
culture is the gold standard for Group A Strep and should be performed to confirm a
negative rapid test. The Monospot test or EBV titers can help differentiate between
bacterial and viral etiologies.
, 4. A 6-month-old infant is brought in for a well-child check. Which developmental milestone
should the nurse practitioner expect the child to have achieved?
A. Sitting independently without support
B. Walking while holding onto furniture
C. Using a pincer grasp to pick up small objects
D. Speaking two-word sentences
Correct Answer: A
Explanation: At 6 months, infants are typically expected to sit without support and roll in
both directions. Walking while holding onto furniture (cruising) and the pincer grasp are
milestones usually achieved between 9 and 12 months. Early identification of
developmental delays allows for timely referral to early intervention programs.
5. In the treatment of pediatric asthma, which of the following is considered the preferred
‘Step 2’ long-term control medication for children aged 5-11?
A. Long-Acting Beta Agonists (LABA) monotherapy
B. Low-dose Inhaled Corticosteroids (ICS)
C. Oral Corticosteroids for 5 days
D. Theophylline
Correct Answer: B
