NSG 548 Exam 2 V3 | NSG 548 FNP Role: Children &
Families | Actual Q&A with Rationale (NSG548
Exam 2) | Wilkes University
1. A 6-month-old infant is brought to the clinic for a well-child visit. Which developmental
milestone is most appropriate for the FNP to assess at this age?
A. Sitting with little or no support
B. Walking while holding onto furniture
C. Using a neat pincer grasp
D. Saying two or three specific words
Correct Answer: A
Explanation: By 6 months of age, most infants should be able to sit with little to no support
as their trunk control improves. Walking while holding onto furniture (cruising) and the
pincer grasp are typically seen between 9 and 12 months. Language skills such as specific
words usually emerge closer to the one-year mark.
2. When evaluating a newborn for Developmental Dysplasia of the Hip (DDH), the FNP
performs the Ortolani maneuver. A positive Ortolani sign is characterized by:
A. Resistance to abduction of the affected hip
B. Asymmetry of the gluteal skin folds
C. A palpable ‘clunk’ as the femoral head moves into the acetabulum
,D. A clicking sound heard during hip rotation
Correct Answer: C
Explanation: The Ortolani maneuver involves abducting the hip to reduce a dislocated
femoral head back into the acetabulum, which produces a palpable ‘clunk.’ This test is
distinct from the Barlow maneuver, which attempts to dislocate a lax hip. Asymmetry of
gluteal folds is a physical finding suggestive of DDH but is not the Ortolani sign itself.
3. A 2-year-old child presents with a sudden onset of a ‘barking’ cough and inspiratory stridor
that worsens at night. The FNP suspects Croup (Laryngotracheobronchitis). What is the
primary cause of this condition?
A. Haemophilus influenzae type b
B. Respiratory Syncytial Virus (RSV)
C. Group A Streptococcus
D. Parainfluenza virus
Correct Answer: D
Explanation: Parainfluenza virus is the most common cause of viral croup in young
children. The characteristic barking cough results from inflammation and narrowing of the
subglottic airway. While RSV causes bronchiolitis and H. influenzae can cause epiglottitis,
croup is predominantly associated with parainfluenza.
,4. According to the Bright Futures guidelines, at what age should universal screening for Lead
Toxicity begin in children considered at risk or in high-prevalence areas?
A. 6 months and 12 months
B. 12 months and 24 months
C. 18 months and 3 years
D. Only at the 5-year school entry exam
Correct Answer: B
Explanation: Universal lead screening is recommended at 12 and 24 months of age for
children in high-risk categories or those covered by Medicaid. This timing coincides with
increased mobility and hand-to-mouth behavior in toddlers. Early detection is critical
because lead exposure can cause irreversible neurodevelopmental damage.
5. A 4-year-old child is diagnosed with Acute Otitis Media (AOM). The FNP decides to
prescribe Amoxicillin. What is the standard recommended pediatric dosage for first-line
treatment of AOM?
A. 20-30 mg/kg/day
B. 40-45 mg/kg/day
C. 100-120 mg/kg/day
D. 80-90 mg/kg/day
Correct Answer: D
, Explanation: High-dose Amoxicillin at 80-90 mg/kg/day is the first-line treatment for
AOM in children. This high dosage is necessary to overcome potential resistance from
Streptococcus pneumoniae. The total daily dose is typically divided into two doses for
better compliance and therapeutic levels.
6. An adolescent female is evaluated for scoliosis. The FNP performs the Adam’s Forward
Bend test. Which finding indicates a positive result?
A. A rib hump or spinal asymmetry when the patient leans forward
B. A lateral curvature of the spine visible only when upright
C. Equal shoulder height while standing
D. Pain upon palpation of the lumbar vertebrae
Correct Answer: A
Explanation: The Adam’s Forward Bend test is used to detect structural scoliosis by
looking for a rib hump caused by vertebral rotation. As the patient bends forward, the
rotation of the spine becomes more apparent, creating an asymmetrical prominence on one
side of the back. This is a primary screening tool used in pediatric and school settings.
7. A 15-month-old child has not yet received the Measles, Mumps, and Rubella (MMR)
vaccine. The mother expresses concern about the timing. What is the correct CDC
recommendation for the first dose of MMR?
A. 12-15 months of age
B. 6 months of age
Families | Actual Q&A with Rationale (NSG548
Exam 2) | Wilkes University
1. A 6-month-old infant is brought to the clinic for a well-child visit. Which developmental
milestone is most appropriate for the FNP to assess at this age?
A. Sitting with little or no support
B. Walking while holding onto furniture
C. Using a neat pincer grasp
D. Saying two or three specific words
Correct Answer: A
Explanation: By 6 months of age, most infants should be able to sit with little to no support
as their trunk control improves. Walking while holding onto furniture (cruising) and the
pincer grasp are typically seen between 9 and 12 months. Language skills such as specific
words usually emerge closer to the one-year mark.
2. When evaluating a newborn for Developmental Dysplasia of the Hip (DDH), the FNP
performs the Ortolani maneuver. A positive Ortolani sign is characterized by:
A. Resistance to abduction of the affected hip
B. Asymmetry of the gluteal skin folds
C. A palpable ‘clunk’ as the femoral head moves into the acetabulum
,D. A clicking sound heard during hip rotation
Correct Answer: C
Explanation: The Ortolani maneuver involves abducting the hip to reduce a dislocated
femoral head back into the acetabulum, which produces a palpable ‘clunk.’ This test is
distinct from the Barlow maneuver, which attempts to dislocate a lax hip. Asymmetry of
gluteal folds is a physical finding suggestive of DDH but is not the Ortolani sign itself.
3. A 2-year-old child presents with a sudden onset of a ‘barking’ cough and inspiratory stridor
that worsens at night. The FNP suspects Croup (Laryngotracheobronchitis). What is the
primary cause of this condition?
A. Haemophilus influenzae type b
B. Respiratory Syncytial Virus (RSV)
C. Group A Streptococcus
D. Parainfluenza virus
Correct Answer: D
Explanation: Parainfluenza virus is the most common cause of viral croup in young
children. The characteristic barking cough results from inflammation and narrowing of the
subglottic airway. While RSV causes bronchiolitis and H. influenzae can cause epiglottitis,
croup is predominantly associated with parainfluenza.
,4. According to the Bright Futures guidelines, at what age should universal screening for Lead
Toxicity begin in children considered at risk or in high-prevalence areas?
A. 6 months and 12 months
B. 12 months and 24 months
C. 18 months and 3 years
D. Only at the 5-year school entry exam
Correct Answer: B
Explanation: Universal lead screening is recommended at 12 and 24 months of age for
children in high-risk categories or those covered by Medicaid. This timing coincides with
increased mobility and hand-to-mouth behavior in toddlers. Early detection is critical
because lead exposure can cause irreversible neurodevelopmental damage.
5. A 4-year-old child is diagnosed with Acute Otitis Media (AOM). The FNP decides to
prescribe Amoxicillin. What is the standard recommended pediatric dosage for first-line
treatment of AOM?
A. 20-30 mg/kg/day
B. 40-45 mg/kg/day
C. 100-120 mg/kg/day
D. 80-90 mg/kg/day
Correct Answer: D
, Explanation: High-dose Amoxicillin at 80-90 mg/kg/day is the first-line treatment for
AOM in children. This high dosage is necessary to overcome potential resistance from
Streptococcus pneumoniae. The total daily dose is typically divided into two doses for
better compliance and therapeutic levels.
6. An adolescent female is evaluated for scoliosis. The FNP performs the Adam’s Forward
Bend test. Which finding indicates a positive result?
A. A rib hump or spinal asymmetry when the patient leans forward
B. A lateral curvature of the spine visible only when upright
C. Equal shoulder height while standing
D. Pain upon palpation of the lumbar vertebrae
Correct Answer: A
Explanation: The Adam’s Forward Bend test is used to detect structural scoliosis by
looking for a rib hump caused by vertebral rotation. As the patient bends forward, the
rotation of the spine becomes more apparent, creating an asymmetrical prominence on one
side of the back. This is a primary screening tool used in pediatric and school settings.
7. A 15-month-old child has not yet received the Measles, Mumps, and Rubella (MMR)
vaccine. The mother expresses concern about the timing. What is the correct CDC
recommendation for the first dose of MMR?
A. 12-15 months of age
B. 6 months of age
