FNP 654 Exam 3 Questions and Answers
250 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 FNP 654 Exam 3 Questions and Answers
Page 1
,Q1
A family nurse practitioner is assessing a 9-month-old infant during a well-baby visit. The infant
clings to the mother and begins to cry when the mother hands the baby to the NP. How should
the NP document this behavior?
A) Abnormal attachment requiring referral to child psychology
B) Normal separation protest consistent with expected developmental milestone CORRECT
C) Evidence of an anxiety disorder requiring further evaluation
D) Sign of autism spectrum disorder
Rationale
Separation protest and stranger wariness typically emerge between 7 and 12 months of age as part of
normal socioemotional development. The infant recognizes the primary caregiver as a secure base and
shows distress when separated. This is a healthy sign of attachment, not pathology. The FNP should
reassure the parents and provide anticipatory guidance about this normal phase.
Q2
A 30-month-old child with sickle cell disease is seen for a well-child visit. Which immunization
should the FNP prioritize for this patient?
A) Hepatitis B booster
B) Meningococcal vaccine CORRECT
C) Varicella vaccine
D) Rotavirus vaccine
Rationale
Children with sickle cell disease are at significantly increased risk for invasive pneumococcal and
meningococcal infections due to functional asplenia. The meningococcal vaccine is specifically
recommended for children with sickle cell disease starting at age 2 months, with a two-dose primary
series and boosters. This is a critical health maintenance intervention for this vulnerable population.
Page 2
,Q3
A 7-year-old boy is brought to the clinic by his mother due to concerns about difficulty paying
attention in school, fidgeting, and interrupting others. The teacher reports similar concerns.
Symptoms have been present for over 6 months and occur in multiple settings. Which
assessment tool is most appropriate for the FNP to use?
A) Beck Depression Inventory
B) Vanderbilt ADHD Diagnostic Rating Scale CORRECT
C) Geriatric Depression Scale
D) Mini-Mental State Examination
Rationale
The Vanderbilt ADHD Diagnostic Rating Scale is a validated, widely used tool for assessing ADHD in
children ages 6-12. It collects information from both parents and teachers, which is required for diagnosis
per DSM-5 criteria. Symptoms must be present in two or more settings and cause functional impairment.
Q4
The FNP provides primary care for a 30-month-old child who has sickle cell anemia and has had
one dose of 23-valent pneumococcal vaccine. Which is an appropriate action for health
maintenance in this child?
A) Administer an initial meningococcal vaccine CORRECT
B) Administer a second dose of 23-valent pneumococcal vaccine
C) Administer the influenza vaccine
D) No further vaccines are needed
Rationale
Children with sickle cell anemia are at increased risk for encapsulated bacterial infections, including
meningococcal disease. They should receive the meningococcal conjugate vaccine as part of routine
care. The 23-valent pneumococcal vaccine is typically given after age 2, but meningococcal vaccination
is a priority.
Page 3
, Q5
The primary care nurse practitioner attempts to learn more about the emotional health of an 18-
month-old child through which assessment strategy?
A) Observation of the child with caretakers in structured and unstructured
CORRECT
situations
B) Direct questioning of the child
C) Reviewing the child's medical records
D) Interviewing the parents separately
Rationale
Observing a toddler's interactions within their natural environment, both structured and unstructured,
provides the most authentic insight into their emotional health and attachment patterns. This approach
allows the nurse practitioner to assess social-emotional development through behavioral cues and
relational dynamics.
Q6
During a well-baby exam on a 9-month-old infant, the parent reports that the baby always uses
the left hand to pick up objects and asks if the baby will be left-handed. What will the primary
care nurse practitioner do?
A) Perform a careful assessment of fine and gross motor skills CORRECT
B) Reassure the parent that handedness is established by 9 months
C) Refer to a neurologist
D) Order a brain MRI
Rationale
Assessing fine and gross motor skills is paramount to determine if handedness preference is established
or if there's a potential underlying neurological issue affecting motor development. This evaluation guides
appropriate anticipatory guidance for the parent regarding developmental milestones.
Page 4
250 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 FNP 654 Exam 3 Questions and Answers
Page 1
,Q1
A family nurse practitioner is assessing a 9-month-old infant during a well-baby visit. The infant
clings to the mother and begins to cry when the mother hands the baby to the NP. How should
the NP document this behavior?
A) Abnormal attachment requiring referral to child psychology
B) Normal separation protest consistent with expected developmental milestone CORRECT
C) Evidence of an anxiety disorder requiring further evaluation
D) Sign of autism spectrum disorder
Rationale
Separation protest and stranger wariness typically emerge between 7 and 12 months of age as part of
normal socioemotional development. The infant recognizes the primary caregiver as a secure base and
shows distress when separated. This is a healthy sign of attachment, not pathology. The FNP should
reassure the parents and provide anticipatory guidance about this normal phase.
Q2
A 30-month-old child with sickle cell disease is seen for a well-child visit. Which immunization
should the FNP prioritize for this patient?
A) Hepatitis B booster
B) Meningococcal vaccine CORRECT
C) Varicella vaccine
D) Rotavirus vaccine
Rationale
Children with sickle cell disease are at significantly increased risk for invasive pneumococcal and
meningococcal infections due to functional asplenia. The meningococcal vaccine is specifically
recommended for children with sickle cell disease starting at age 2 months, with a two-dose primary
series and boosters. This is a critical health maintenance intervention for this vulnerable population.
Page 2
,Q3
A 7-year-old boy is brought to the clinic by his mother due to concerns about difficulty paying
attention in school, fidgeting, and interrupting others. The teacher reports similar concerns.
Symptoms have been present for over 6 months and occur in multiple settings. Which
assessment tool is most appropriate for the FNP to use?
A) Beck Depression Inventory
B) Vanderbilt ADHD Diagnostic Rating Scale CORRECT
C) Geriatric Depression Scale
D) Mini-Mental State Examination
Rationale
The Vanderbilt ADHD Diagnostic Rating Scale is a validated, widely used tool for assessing ADHD in
children ages 6-12. It collects information from both parents and teachers, which is required for diagnosis
per DSM-5 criteria. Symptoms must be present in two or more settings and cause functional impairment.
Q4
The FNP provides primary care for a 30-month-old child who has sickle cell anemia and has had
one dose of 23-valent pneumococcal vaccine. Which is an appropriate action for health
maintenance in this child?
A) Administer an initial meningococcal vaccine CORRECT
B) Administer a second dose of 23-valent pneumococcal vaccine
C) Administer the influenza vaccine
D) No further vaccines are needed
Rationale
Children with sickle cell anemia are at increased risk for encapsulated bacterial infections, including
meningococcal disease. They should receive the meningococcal conjugate vaccine as part of routine
care. The 23-valent pneumococcal vaccine is typically given after age 2, but meningococcal vaccination
is a priority.
Page 3
, Q5
The primary care nurse practitioner attempts to learn more about the emotional health of an 18-
month-old child through which assessment strategy?
A) Observation of the child with caretakers in structured and unstructured
CORRECT
situations
B) Direct questioning of the child
C) Reviewing the child's medical records
D) Interviewing the parents separately
Rationale
Observing a toddler's interactions within their natural environment, both structured and unstructured,
provides the most authentic insight into their emotional health and attachment patterns. This approach
allows the nurse practitioner to assess social-emotional development through behavioral cues and
relational dynamics.
Q6
During a well-baby exam on a 9-month-old infant, the parent reports that the baby always uses
the left hand to pick up objects and asks if the baby will be left-handed. What will the primary
care nurse practitioner do?
A) Perform a careful assessment of fine and gross motor skills CORRECT
B) Reassure the parent that handedness is established by 9 months
C) Refer to a neurologist
D) Order a brain MRI
Rationale
Assessing fine and gross motor skills is paramount to determine if handedness preference is established
or if there's a potential underlying neurological issue affecting motor development. This evaluation guides
appropriate anticipatory guidance for the parent regarding developmental milestones.
Page 4
