,FNP 593 Week 4 APEA QBank Quiz | Pediatrics (2026) Q&A |
USU
1. A 4-month-old infant is exclusively breastfed and the mother plans to introduce only small
amounts of fruits and vegetables. To ensure adequate iron intake, what should the nurse
practitioner recommend?
A) Elemental iron supplementation of 1 mg/kg/day until cereals are added
B) Elemental iron supplementation of 3 mg/kg/day for the duration of breastfeeding
C) Monitoring hemoglobin and hematocrit at every well-baby checkup
D) Offering iron-fortified formula to ensure adequate iron intake
Correct Answer: A) Elemental iron supplementation of 1 mg/kg/day until cereals are added
Rationale: Exclusively breastfed infants require iron supplementation starting at 4–6 months
of age. The recommended dose is 1 mg/kg/day of elemental iron until iron-rich
complementary foods are introduced.
2. A 6-month-old male has a palpable cystic mass in his scrotum, and his mother reports that
the size sometimes varies. What should the nurse practitioner do next?
A) Referral to urology as soon as possible
B) Referral to urology if this has not resolved in six or more months
C) Scrotal ultrasound should be ordered
D) Order a urine specimen to rule out infection
Correct Answer: B) Referral to urology if this has not resolved in six or more months
Rationale: This is a communicating hydrocele, which usually resolves by 12 months of age.
Referral to urology is indicated if it has not resolved by 12 months.
3. A 6-week-old infant is found to have positive Barlow and Ortolani maneuvers. What test
should the nurse practitioner order to assess and confirm developmental dysplasia of the hip?
,A) Frog leg x-rays
B) Plain hip x-rays
C) Ultrasound of the hip
D) CT of the hip
Correct Answer: C) Ultrasound of the hip
Rationale: The primary imaging technique for assessing developmental dysplasia of the hip
in the first 3–4 months of life is ultrasound. X-rays are of little benefit because the femoral
head is mostly cartilaginous and unossified.
4. A 13-month-old child received the varicella vaccine two weeks ago. How long must she
wait before receiving the MMR vaccine?
A) Two weeks
B) Four weeks
C) Six weeks
D) No wait is required
Correct Answer: B) Four weeks
Rationale: Live vaccines should be separated by at least 4 weeks to avoid interference. A 2-
week interval is insufficient.
5. A 4-year-old female is brought to the clinic because she is constantly scratching her
"private part." The child states that it itches. What is the most appropriate next step?
A) Obtain a urine specimen
B) Perform a pelvic exam
C) Prescribe topical hydrocortisone
D) Recommend sitz baths
Correct Answer: A) Obtain a urine specimen
, Rationale: The presentation suggests vulvovaginitis or a urinary tract infection. A urine
specimen should be obtained to rule out infection before other interventions are considered.
6. A 2-year-old child with sickle cell anemia presents with a cough and a fever of 101.5°F.
The child currently takes penicillin V prophylaxis. What should the nurse practitioner do?
A) Admit the child to the hospital to evaluate for sepsis
B) Give intravenous fluids and antibiotics in clinic
C) Increase the penicillin V dose to 250 mg
D) Order a chest radiograph
Correct Answer: A) Admit the child to the hospital to evaluate for sepsis
Rationale: A febrile child with sickle cell anemia is at high risk for sepsis, particularly from
encapsulated organisms. Immediate hospital admission for blood cultures and intravenous
antibiotics is required.
7. A 30-month-old child with sickle cell anemia has had one dose of the 23-valent
pneumococcal vaccine. Which is an appropriate action for health maintenance?
A) Administer an initial meningococcal vaccine
B) Begin folic acid dietary supplementation
C) Decrease the dose of penicillin V prophylaxis
D) Give a second dose of 23-valent pneumococcal vaccine
Correct Answer: A) Administer an initial meningococcal vaccine
Rationale: Children with sickle cell anemia are at increased risk for meningococcal infection
and should receive meningococcal vaccination. Folic acid supplementation is often
recommended but the vaccine is the priority at this visit.
USU
1. A 4-month-old infant is exclusively breastfed and the mother plans to introduce only small
amounts of fruits and vegetables. To ensure adequate iron intake, what should the nurse
practitioner recommend?
A) Elemental iron supplementation of 1 mg/kg/day until cereals are added
B) Elemental iron supplementation of 3 mg/kg/day for the duration of breastfeeding
C) Monitoring hemoglobin and hematocrit at every well-baby checkup
D) Offering iron-fortified formula to ensure adequate iron intake
Correct Answer: A) Elemental iron supplementation of 1 mg/kg/day until cereals are added
Rationale: Exclusively breastfed infants require iron supplementation starting at 4–6 months
of age. The recommended dose is 1 mg/kg/day of elemental iron until iron-rich
complementary foods are introduced.
2. A 6-month-old male has a palpable cystic mass in his scrotum, and his mother reports that
the size sometimes varies. What should the nurse practitioner do next?
A) Referral to urology as soon as possible
B) Referral to urology if this has not resolved in six or more months
C) Scrotal ultrasound should be ordered
D) Order a urine specimen to rule out infection
Correct Answer: B) Referral to urology if this has not resolved in six or more months
Rationale: This is a communicating hydrocele, which usually resolves by 12 months of age.
Referral to urology is indicated if it has not resolved by 12 months.
3. A 6-week-old infant is found to have positive Barlow and Ortolani maneuvers. What test
should the nurse practitioner order to assess and confirm developmental dysplasia of the hip?
,A) Frog leg x-rays
B) Plain hip x-rays
C) Ultrasound of the hip
D) CT of the hip
Correct Answer: C) Ultrasound of the hip
Rationale: The primary imaging technique for assessing developmental dysplasia of the hip
in the first 3–4 months of life is ultrasound. X-rays are of little benefit because the femoral
head is mostly cartilaginous and unossified.
4. A 13-month-old child received the varicella vaccine two weeks ago. How long must she
wait before receiving the MMR vaccine?
A) Two weeks
B) Four weeks
C) Six weeks
D) No wait is required
Correct Answer: B) Four weeks
Rationale: Live vaccines should be separated by at least 4 weeks to avoid interference. A 2-
week interval is insufficient.
5. A 4-year-old female is brought to the clinic because she is constantly scratching her
"private part." The child states that it itches. What is the most appropriate next step?
A) Obtain a urine specimen
B) Perform a pelvic exam
C) Prescribe topical hydrocortisone
D) Recommend sitz baths
Correct Answer: A) Obtain a urine specimen
, Rationale: The presentation suggests vulvovaginitis or a urinary tract infection. A urine
specimen should be obtained to rule out infection before other interventions are considered.
6. A 2-year-old child with sickle cell anemia presents with a cough and a fever of 101.5°F.
The child currently takes penicillin V prophylaxis. What should the nurse practitioner do?
A) Admit the child to the hospital to evaluate for sepsis
B) Give intravenous fluids and antibiotics in clinic
C) Increase the penicillin V dose to 250 mg
D) Order a chest radiograph
Correct Answer: A) Admit the child to the hospital to evaluate for sepsis
Rationale: A febrile child with sickle cell anemia is at high risk for sepsis, particularly from
encapsulated organisms. Immediate hospital admission for blood cultures and intravenous
antibiotics is required.
7. A 30-month-old child with sickle cell anemia has had one dose of the 23-valent
pneumococcal vaccine. Which is an appropriate action for health maintenance?
A) Administer an initial meningococcal vaccine
B) Begin folic acid dietary supplementation
C) Decrease the dose of penicillin V prophylaxis
D) Give a second dose of 23-valent pneumococcal vaccine
Correct Answer: A) Administer an initial meningococcal vaccine
Rationale: Children with sickle cell anemia are at increased risk for meningococcal infection
and should receive meningococcal vaccination. Folic acid supplementation is often
recommended but the vaccine is the priority at this visit.
