NURS 6541 / NRNP 6541 PRIMARY CARE
OF ADOLESCENTS & CHILDREN FINAL
EXAM QUESTIONS AND ANSWERS
1. A 9-month-old infant is brought to the clinic for a well-child visit. Which developmental
milestone should the nurse practitioner expect the child to have achieved?
A. Walking without assistance
B. Speaking in 2-word sentences
C. Using a neat pincer grasp to pick up small objects
D. Building a tower of four blocks
Answer: C
Conceptual Explanation: A neat pincer grasp typically develops around 9 months of age.
Walking independently and building blocks occur later (12-15 months), and 2-word
sentences appear around 24 months.
2. Which of the following physical findings is most characteristic of a patient with Kawasaki
Disease in the acute phase?
A. Low-grade fever for 48 hours
,B. Vesicular rash on the trunk
C. Bilateral purulent conjunctivitis
D. Strawberry tongue and erythema of the oral mucosa
Answer: D
Conceptual Explanation: Kawasaki Disease clinical criteria include high fever for 5+ days
plus 4/5 features, one of which is oral changes like strawberry tongue. The conjunctivitis in
Kawasaki is non-purulent.
3. A 4-year-old presents with a ‘barking’ cough and inspiratory stridor that worsens at night.
What is the most likely diagnosis?
A. Epiglottitis
B. Croup (Laryngotracheobronchitis)
C. Foreign body aspiration
D. Bacterial tracheitis
Answer: B
Conceptual Explanation: Croup is characterized by a barking cough and stridor, usually
caused by parainfluenza virus. Epiglottitis presents with drooling, high fever, and no cough.
4. A 15-year-old athlete presents with sudden onset of unilateral scrotal pain and a negative
Prehn sign. What is the priority management?
A. Perform an immediate Doppler ultrasound and surgical referral
, B. Prescribe 10 days of Doxycycline
C. Apply ice packs and recommend bed rest
D. Check a urinalysis for evidence of infection
Answer: A
Conceptual Explanation: These symptoms suggest testicular torsion, a surgical
emergency. A negative Prehn sign (no relief of pain with elevation) helps differentiate it
from epididymitis.
5. According to the GINA guidelines, a child with asthma who experiences symptoms 3 times
a week and nocturnal awakenings 3 times a month falls into which category?
A. Intermittent
B. Mild Persistent
C. Moderate Persistent
D. Severe Persistent
Answer: B
Conceptual Explanation: Mild persistent asthma is defined by symptoms occurring >2
days/week but not daily, and nighttime awakenings 3-4 times/month.
6. Which physical exam maneuver is used to assess for Developmental Dysplasia of the Hip
(DDH) by attempting to relocate a recently dislocated hip?
A. Barlow maneuver
OF ADOLESCENTS & CHILDREN FINAL
EXAM QUESTIONS AND ANSWERS
1. A 9-month-old infant is brought to the clinic for a well-child visit. Which developmental
milestone should the nurse practitioner expect the child to have achieved?
A. Walking without assistance
B. Speaking in 2-word sentences
C. Using a neat pincer grasp to pick up small objects
D. Building a tower of four blocks
Answer: C
Conceptual Explanation: A neat pincer grasp typically develops around 9 months of age.
Walking independently and building blocks occur later (12-15 months), and 2-word
sentences appear around 24 months.
2. Which of the following physical findings is most characteristic of a patient with Kawasaki
Disease in the acute phase?
A. Low-grade fever for 48 hours
,B. Vesicular rash on the trunk
C. Bilateral purulent conjunctivitis
D. Strawberry tongue and erythema of the oral mucosa
Answer: D
Conceptual Explanation: Kawasaki Disease clinical criteria include high fever for 5+ days
plus 4/5 features, one of which is oral changes like strawberry tongue. The conjunctivitis in
Kawasaki is non-purulent.
3. A 4-year-old presents with a ‘barking’ cough and inspiratory stridor that worsens at night.
What is the most likely diagnosis?
A. Epiglottitis
B. Croup (Laryngotracheobronchitis)
C. Foreign body aspiration
D. Bacterial tracheitis
Answer: B
Conceptual Explanation: Croup is characterized by a barking cough and stridor, usually
caused by parainfluenza virus. Epiglottitis presents with drooling, high fever, and no cough.
4. A 15-year-old athlete presents with sudden onset of unilateral scrotal pain and a negative
Prehn sign. What is the priority management?
A. Perform an immediate Doppler ultrasound and surgical referral
, B. Prescribe 10 days of Doxycycline
C. Apply ice packs and recommend bed rest
D. Check a urinalysis for evidence of infection
Answer: A
Conceptual Explanation: These symptoms suggest testicular torsion, a surgical
emergency. A negative Prehn sign (no relief of pain with elevation) helps differentiate it
from epididymitis.
5. According to the GINA guidelines, a child with asthma who experiences symptoms 3 times
a week and nocturnal awakenings 3 times a month falls into which category?
A. Intermittent
B. Mild Persistent
C. Moderate Persistent
D. Severe Persistent
Answer: B
Conceptual Explanation: Mild persistent asthma is defined by symptoms occurring >2
days/week but not daily, and nighttime awakenings 3-4 times/month.
6. Which physical exam maneuver is used to assess for Developmental Dysplasia of the Hip
(DDH) by attempting to relocate a recently dislocated hip?
A. Barlow maneuver
