CHAMBERLAIN NR 602 WEK 1-8 TEST BANK
NEWEST 2026 | NR 602 PEDIATRIC &
MATERNITY FINAL REVIEW | PASS
GUARANTEED 2026
Question: The parent of an infant experiencing colic asks about using a probiotic
medication. What will the primary care pediatric NP tell this parent?
A) Probiotic medications have demonstrated efficacy in treating colic.
B) Probiotics are not safe to use to treat infants who have colic.
C) There are no studies showing usefulness of probiotic to manage colic.
D) There is no conclusive evidence about using probiotics to treat colic.
Correct Answer: D There is no conclusive evidence about using probiotics to treat colic.
Expert Rationale: Current evidence on probiotics for infantile colic is inconclusive.
Understanding this is essential because while some studies suggest benefit, others show
no significant improvement over placebo. Parents should be informed about the mixed
evidence and potential risks before using probiotics in infants.
Question: A toddler who was born prematurely refuses most solid foods and has poor
weight gain. A barium swallow study reveals a normal esophagus. What will the
primary care pediatric NP consider the next to manage this child's nutritional needs?
A) Consultation with dietician
B) Fiberoptic endoscopy evaluation
C) MRI
D) Videofluoroscopy swallowing study (VFSS)
Correct Answer: D Videofluoroscopy swallowing study (VFSS)
Expert Rationale: A VFSS is the gold standard for evaluating swallowing function and
aspiration risk. Understanding this is essential because premature infants often have oral-
motor and swallowing difficulties that barium swallow cannot detect. VFSS provides real-
time assessment of the swallowing mechanism, including airway protection.
,Question: A toddler is seen in clinic after a 2-day history of intermittent vomiting and
diarrhea. An assessment reveals an irritable child with dry mucous membranes, 3-
second capillary refill, 2-second recoil of skin, mild tachycardia and tachypnea, and
cool hands and feet. The child has had 2 wet diapers in the past 24 hours. What will the
primary care pediatric NP recommend?
A) Anti-diarrheal medication & clear fluids for 24 hours
B) Bolus of IV NS in the clinic until improvement
C) Hospital admission for IV rehydration & oral fluids
D) Oral rehydration solution with follow-up in 24 hours
Correct Answer: D Oral rehydration solution with follow-up in 24 hours
Expert Rationale: This child shows signs of mild to moderate dehydration but can be
managed with oral rehydration. Understanding this is essential because oral rehydration
solution (ORS) is the first-line treatment for mild to moderate dehydration. The child has
some signs of dehydration but is not in shock or severely dehydrated. Anti-diarrheal
medications are contraindicated in children with acute gastroenteritis.
Question: A 9-year-old girl has a history of frequent vomiting and her mother has
frequent migraine headaches. The child has recently begun having more frequent and
prolonged episodes accompanied by headaches. An exam reveals abnormal eye
movement and mild ataxia. What is the correct action?
A) Begin using anti-migraine medications to prevent headaches
B) Prescribe ondansetron and lorazepam to help manage symptoms
C) Reassure the parent that this is expected with cyclic vomiting syndrome
D) Refer to a pediatric gastroenterologist for further workup
Correct Answer: D Refer to a pediatric gastroenterologist for further workup
Expert Rationale: The presence of abnormal eye movements and ataxia in a child with
vomiting raises concern for neurological involvement. Understanding this is essential
because these findings are not typical of cyclic vomiting syndrome and may indicate an
underlying neurological condition. Prompt referral to a pediatric gastroenterologist or
neurologist is warranted.
Question: The parent of a 3-month-old reports that the infant arches and gags while
feeding and spits up undigested formula frequently. The infant's weight gain has
,dropped to the 5th percentile from the 12th. What is the best course of treatment for
this infant?
A) Begin a trial of extensively hydrolyzed protein formula for 2-4 weeks
B) Institute an empiric trial of acid suppression with a PPI
C) Perform esophageal pH monitoring to determine the degree of reflux
D) Reassure the parent that these symptoms will likely resolve by 12-24 months
Correct Answer: A Begin a trial of extensively hydrolyzed protein formula for 2-4 weeks
Expert Rationale: This infant has symptoms of gastroesophageal reflux disease (GERD)
with poor weight gain, arching, and gagging. Understanding this is essential because cow's
milk protein allergy can cause reflux symptoms in infants. A trial of extensively hydrolyzed
formula is appropriate before invasive testing or acid suppression therapy, especially given
the growth concerns.
Question: A school-age child has a 3-month history of dull, aching epigastric pain that
worsens with eating and awakens from sleep. A CBC shows a Hgb of 8 mg/dL. What is
the next step in management?
A) Administration of H2RA or PPI medications
B) Empiric therapy for H. pylori
C) Ordering an upper GI series
D) Referral for EGD
Correct Answer: D Referral for EGD
Expert Rationale: This child has symptoms concerning for peptic ulcer disease with
significant anemia. Understanding this is essential because worsening epigastric pain,
awakening from sleep, and anemia are indications for endoscopic evaluation. EGD allows
direct visualization and biopsy for H. pylori testing.
Question: A 2-month-old infant cries up to 4 hours each day and, according to the
parents, is inconsolable during crying episodes with fits and legs noted to be tense
and stiff. The infant is breastfeeding frequently but is often fussy during feedings. The
physical exam is normal and the infant is gaining weight normally. What will the
primary care pediatric NP recommend?
A) A complete work-up, including lab and radiologic tests
B) Eliminating certain foods from the mother's diet
, C) Empiric treatment with PPI
D) Stopping breastfeeding & beginning a hydrolyzed formula
Correct Answer: B Eliminating certain foods from the mother's diet
Expert Rationale: This presentation is consistent with infantile colic, possibly related to
cow's milk protein allergy. Understanding this is essential because maternal elimination of
cow's milk, eggs, nuts, and soy may improve symptoms in breastfed infants with food
protein intolerance. The infant is gaining weight normally, so a complete workup is not
indicated.
Question: A child is in the clinic after swallowing a metal bead. A radiograph of the GI
tract shows a 6 mm cylindrical object in the child's stomach. The child is able to
swallow without difficulty and is not experiencing pain. What is the correct course of
treatment?
A) Administer ipecac to induce vomiting
B) Have the parents watch for the object in the child's stool
C) Insert a nasogastric tube to flush out the object
D) Refer the child for endoscopic removal of the object
Correct Answer: B Have the parents watch for the object in the child's stool
Expert Rationale: Small, smooth objects (less than 2 cm) in the stomach that are not
causing symptoms will typically pass through the GI tract spontaneously. Understanding
this is essential because most swallowed foreign bodies in children pass without
intervention. Ipecac and NG tube flushing are not recommended for foreign body ingestion.
Question: A 10-year-old child has had abdominal pain for 2 days, which began in the
periumbilical area and then localized to the RLQ. The child vomited once today and
then experienced relief from pain followed by an increased fever. What is the likely
diagnosis?
A) Appendicitis with perforation
B) Gastroenteritis
C) Pelvic inflammatory disease (PID)
D) UTI
Correct Answer: A Appendicitis with perforation
NEWEST 2026 | NR 602 PEDIATRIC &
MATERNITY FINAL REVIEW | PASS
GUARANTEED 2026
Question: The parent of an infant experiencing colic asks about using a probiotic
medication. What will the primary care pediatric NP tell this parent?
A) Probiotic medications have demonstrated efficacy in treating colic.
B) Probiotics are not safe to use to treat infants who have colic.
C) There are no studies showing usefulness of probiotic to manage colic.
D) There is no conclusive evidence about using probiotics to treat colic.
Correct Answer: D There is no conclusive evidence about using probiotics to treat colic.
Expert Rationale: Current evidence on probiotics for infantile colic is inconclusive.
Understanding this is essential because while some studies suggest benefit, others show
no significant improvement over placebo. Parents should be informed about the mixed
evidence and potential risks before using probiotics in infants.
Question: A toddler who was born prematurely refuses most solid foods and has poor
weight gain. A barium swallow study reveals a normal esophagus. What will the
primary care pediatric NP consider the next to manage this child's nutritional needs?
A) Consultation with dietician
B) Fiberoptic endoscopy evaluation
C) MRI
D) Videofluoroscopy swallowing study (VFSS)
Correct Answer: D Videofluoroscopy swallowing study (VFSS)
Expert Rationale: A VFSS is the gold standard for evaluating swallowing function and
aspiration risk. Understanding this is essential because premature infants often have oral-
motor and swallowing difficulties that barium swallow cannot detect. VFSS provides real-
time assessment of the swallowing mechanism, including airway protection.
,Question: A toddler is seen in clinic after a 2-day history of intermittent vomiting and
diarrhea. An assessment reveals an irritable child with dry mucous membranes, 3-
second capillary refill, 2-second recoil of skin, mild tachycardia and tachypnea, and
cool hands and feet. The child has had 2 wet diapers in the past 24 hours. What will the
primary care pediatric NP recommend?
A) Anti-diarrheal medication & clear fluids for 24 hours
B) Bolus of IV NS in the clinic until improvement
C) Hospital admission for IV rehydration & oral fluids
D) Oral rehydration solution with follow-up in 24 hours
Correct Answer: D Oral rehydration solution with follow-up in 24 hours
Expert Rationale: This child shows signs of mild to moderate dehydration but can be
managed with oral rehydration. Understanding this is essential because oral rehydration
solution (ORS) is the first-line treatment for mild to moderate dehydration. The child has
some signs of dehydration but is not in shock or severely dehydrated. Anti-diarrheal
medications are contraindicated in children with acute gastroenteritis.
Question: A 9-year-old girl has a history of frequent vomiting and her mother has
frequent migraine headaches. The child has recently begun having more frequent and
prolonged episodes accompanied by headaches. An exam reveals abnormal eye
movement and mild ataxia. What is the correct action?
A) Begin using anti-migraine medications to prevent headaches
B) Prescribe ondansetron and lorazepam to help manage symptoms
C) Reassure the parent that this is expected with cyclic vomiting syndrome
D) Refer to a pediatric gastroenterologist for further workup
Correct Answer: D Refer to a pediatric gastroenterologist for further workup
Expert Rationale: The presence of abnormal eye movements and ataxia in a child with
vomiting raises concern for neurological involvement. Understanding this is essential
because these findings are not typical of cyclic vomiting syndrome and may indicate an
underlying neurological condition. Prompt referral to a pediatric gastroenterologist or
neurologist is warranted.
Question: The parent of a 3-month-old reports that the infant arches and gags while
feeding and spits up undigested formula frequently. The infant's weight gain has
,dropped to the 5th percentile from the 12th. What is the best course of treatment for
this infant?
A) Begin a trial of extensively hydrolyzed protein formula for 2-4 weeks
B) Institute an empiric trial of acid suppression with a PPI
C) Perform esophageal pH monitoring to determine the degree of reflux
D) Reassure the parent that these symptoms will likely resolve by 12-24 months
Correct Answer: A Begin a trial of extensively hydrolyzed protein formula for 2-4 weeks
Expert Rationale: This infant has symptoms of gastroesophageal reflux disease (GERD)
with poor weight gain, arching, and gagging. Understanding this is essential because cow's
milk protein allergy can cause reflux symptoms in infants. A trial of extensively hydrolyzed
formula is appropriate before invasive testing or acid suppression therapy, especially given
the growth concerns.
Question: A school-age child has a 3-month history of dull, aching epigastric pain that
worsens with eating and awakens from sleep. A CBC shows a Hgb of 8 mg/dL. What is
the next step in management?
A) Administration of H2RA or PPI medications
B) Empiric therapy for H. pylori
C) Ordering an upper GI series
D) Referral for EGD
Correct Answer: D Referral for EGD
Expert Rationale: This child has symptoms concerning for peptic ulcer disease with
significant anemia. Understanding this is essential because worsening epigastric pain,
awakening from sleep, and anemia are indications for endoscopic evaluation. EGD allows
direct visualization and biopsy for H. pylori testing.
Question: A 2-month-old infant cries up to 4 hours each day and, according to the
parents, is inconsolable during crying episodes with fits and legs noted to be tense
and stiff. The infant is breastfeeding frequently but is often fussy during feedings. The
physical exam is normal and the infant is gaining weight normally. What will the
primary care pediatric NP recommend?
A) A complete work-up, including lab and radiologic tests
B) Eliminating certain foods from the mother's diet
, C) Empiric treatment with PPI
D) Stopping breastfeeding & beginning a hydrolyzed formula
Correct Answer: B Eliminating certain foods from the mother's diet
Expert Rationale: This presentation is consistent with infantile colic, possibly related to
cow's milk protein allergy. Understanding this is essential because maternal elimination of
cow's milk, eggs, nuts, and soy may improve symptoms in breastfed infants with food
protein intolerance. The infant is gaining weight normally, so a complete workup is not
indicated.
Question: A child is in the clinic after swallowing a metal bead. A radiograph of the GI
tract shows a 6 mm cylindrical object in the child's stomach. The child is able to
swallow without difficulty and is not experiencing pain. What is the correct course of
treatment?
A) Administer ipecac to induce vomiting
B) Have the parents watch for the object in the child's stool
C) Insert a nasogastric tube to flush out the object
D) Refer the child for endoscopic removal of the object
Correct Answer: B Have the parents watch for the object in the child's stool
Expert Rationale: Small, smooth objects (less than 2 cm) in the stomach that are not
causing symptoms will typically pass through the GI tract spontaneously. Understanding
this is essential because most swallowed foreign bodies in children pass without
intervention. Ipecac and NG tube flushing are not recommended for foreign body ingestion.
Question: A 10-year-old child has had abdominal pain for 2 days, which began in the
periumbilical area and then localized to the RLQ. The child vomited once today and
then experienced relief from pain followed by an increased fever. What is the likely
diagnosis?
A) Appendicitis with perforation
B) Gastroenteritis
C) Pelvic inflammatory disease (PID)
D) UTI
Correct Answer: A Appendicitis with perforation
