NURS6541 PRIMARY CARE OF THE
CHILD FINAL EXAM PREP QUESTIONS
AND ANSWERS
1. A 4-month-old infant is brought in for a well-child check. The nurse practitioner notes the
infant cannot hold their head steady when upright and does not push up on arms when lying
on the tummy. What is the most appropriate next step?
A. Reassure the parents that infants develop at different rates.
B. Schedule a follow-up in 2 months to re-evaluate.
C. Perform a developmental screening using a validated tool like the ASQ.
D. Refer immediately to a pediatric neurologist.
Answer: C
Conceptual Explanation: Red flags at 4 months include poor head control and inability to
push up. A validated screening tool is required to objectively assess delays before further
referral.
,2. Which of the following physical exam findings is most suggestive of Turner Syndrome in a
newborn female?
A. Macroglossia and umbilical hernia
B. Clenched fists with overlapping fingers
C. Hypotonia and a single palmar crease
D. Lymphedema of the hands and feet and a webbed neck
Answer: D
Conceptual Explanation: Turner Syndrome (45,X) often presents in neonates with
peripheral lymphedema and redundant skin folds at the neck (webbing).
3. A 2-year-old child presents with a ‘barky’ cough and stridor at rest. The clinician notes a
‘steeple sign’ on the anteroposterior neck X-ray. What is the most likely diagnosis?
A. Epiglottitis
B. Foreign body aspiration
C. Bacterial tracheitis
D. Laryngotracheobronchitis (Croup)
Answer: D
Conceptual Explanation: Croup is characterized by a barking cough and subglottic
narrowing known as the steeple sign on X-ray.
, 4. An 18-month-old child has a lead level of 12 mcg/dL. According to current guidelines, what
is the priority intervention?
A. Immediate chelation therapy
B. Admit the child to the hospital for observation
C. Recheck the level in one year
D. Repeat the test with a venous sample and investigate environmental sources
Answer: D
Conceptual Explanation: A level above 5 mcg/dL requires a confirmatory venous sample
and investigation of the home environment for lead sources.
5. A 6-year-old presents with high fever, sore throat, and a ‘strawberry tongue.’ A fine,
sandpaper-like rash is noted on the trunk. What is the recommended first-line treatment?
A. Amoxicillin
B. Azithromycin
C. Acyclovir
D. Ceftriaxone
Answer: A
Conceptual Explanation: These are classic signs of Scarlet Fever, caused by Group A
Streptococcus, which is treated first-line with Amoxicillin or Penicillin V.
CHILD FINAL EXAM PREP QUESTIONS
AND ANSWERS
1. A 4-month-old infant is brought in for a well-child check. The nurse practitioner notes the
infant cannot hold their head steady when upright and does not push up on arms when lying
on the tummy. What is the most appropriate next step?
A. Reassure the parents that infants develop at different rates.
B. Schedule a follow-up in 2 months to re-evaluate.
C. Perform a developmental screening using a validated tool like the ASQ.
D. Refer immediately to a pediatric neurologist.
Answer: C
Conceptual Explanation: Red flags at 4 months include poor head control and inability to
push up. A validated screening tool is required to objectively assess delays before further
referral.
,2. Which of the following physical exam findings is most suggestive of Turner Syndrome in a
newborn female?
A. Macroglossia and umbilical hernia
B. Clenched fists with overlapping fingers
C. Hypotonia and a single palmar crease
D. Lymphedema of the hands and feet and a webbed neck
Answer: D
Conceptual Explanation: Turner Syndrome (45,X) often presents in neonates with
peripheral lymphedema and redundant skin folds at the neck (webbing).
3. A 2-year-old child presents with a ‘barky’ cough and stridor at rest. The clinician notes a
‘steeple sign’ on the anteroposterior neck X-ray. What is the most likely diagnosis?
A. Epiglottitis
B. Foreign body aspiration
C. Bacterial tracheitis
D. Laryngotracheobronchitis (Croup)
Answer: D
Conceptual Explanation: Croup is characterized by a barking cough and subglottic
narrowing known as the steeple sign on X-ray.
, 4. An 18-month-old child has a lead level of 12 mcg/dL. According to current guidelines, what
is the priority intervention?
A. Immediate chelation therapy
B. Admit the child to the hospital for observation
C. Recheck the level in one year
D. Repeat the test with a venous sample and investigate environmental sources
Answer: D
Conceptual Explanation: A level above 5 mcg/dL requires a confirmatory venous sample
and investigation of the home environment for lead sources.
5. A 6-year-old presents with high fever, sore throat, and a ‘strawberry tongue.’ A fine,
sandpaper-like rash is noted on the trunk. What is the recommended first-line treatment?
A. Amoxicillin
B. Azithromycin
C. Acyclovir
D. Ceftriaxone
Answer: A
Conceptual Explanation: These are classic signs of Scarlet Fever, caused by Group A
Streptococcus, which is treated first-line with Amoxicillin or Penicillin V.
