NSG 548 Exam 3 V1 | NSG 548 FNP Role: Children &
Families | Actual Q&A with Rationale (NSG548
Exam 3) | Wilkes University
1. A 4-year-old child presents with a sudden onset of high fever, sore throat, and muffled
voice. The FNP notes drooling and the child is sitting in a ‘tripod’ position. What is the most
appropriate next step?
A. Perform a throat culture immediately
B. Initiate humidified oxygen and call for emergency transport
C. Examine the posterior pharynx with a tongue blade
D. Administer a dose of oral dexamethasone
Correct Answer: B
Explanation: The clinical presentation of drooling, tripod positioning, and high fever is
highly suggestive of epiglottitis, a medical emergency. Examining the throat with a tongue
blade must be avoided as it can trigger complete airway obstruction. The primary goal is to
maintain the airway and secure emergent transport to a facility equipped for pediatric
intubation.
2. When assessing an 18-month-old during a well-child visit, which screening tool is
specifically recommended by the American Academy of Pediatrics to evaluate for Autism
Spectrum Disorder (ASD)?
A. ASQ-3
,B. M-CHAT-R/F
C. PHQ-A
D. Vanderbilt Assessment Scale
Correct Answer: B
Explanation: The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-
CHAT-R/F) is the validated tool used for ASD screening at 18 and 24 months. While the
ASQ-3 is a general developmental screen, it is not specific to autism spectrum behaviors.
Early identification through these standardized tools allows for timely referral to
intervention services which improves long-term outcomes.
3. A mother brings her 6-month-old infant to the clinic concerned that the child is not
meeting milestones. The FNP observes the infant can sit with support but cannot roll from
back to front. Which assessment is most accurate?
A. This represents a significant developmental delay requiring neurology referral
B. Rolling from back to front is typically achieved by 4 to 5 months
C. The child is within the normal range for these specific milestones
D. Sitting with support should not occur until at least 9 months
Correct Answer: B
Explanation: Most infants are able to roll from their back to their front by approximately 4
to 5 months of age. Sitting with support is a milestone usually achieved by 6 months, so the
, inability to roll suggests a minor delay. The FNP should perform a full developmental
assessment to determine if other areas of growth are affected.
4. In the management of a pediatric patient with mild persistent asthma, which medication is
considered the preferred long-term control therapy?
A. Short-acting beta-agonists (SABA) as needed
B. Low-dose inhaled corticosteroids (ICS)
C. Long-acting beta-agonists (LABA) monotherapy
D. Oral leukotriene receptor antagonists (LTRA) only
Correct Answer: B
Explanation: According to the NAEPP guidelines, low-dose inhaled corticosteroids are the
gold standard for daily maintenance of mild persistent asthma. SABAs are used only for
rescue and do not address the underlying airway inflammation. Monotherapy with LABAs
is contraindicated in pediatric asthma management due to increased risk of severe
exacerbations.
5. A 2-year-old is brought to the clinic for a routine check-up. The FNP notes the child’s BMI is
in the 96th percentile for age and sex. How should this be classified?
A. Obese
B. Healthy weight
C. Overweight
Families | Actual Q&A with Rationale (NSG548
Exam 3) | Wilkes University
1. A 4-year-old child presents with a sudden onset of high fever, sore throat, and muffled
voice. The FNP notes drooling and the child is sitting in a ‘tripod’ position. What is the most
appropriate next step?
A. Perform a throat culture immediately
B. Initiate humidified oxygen and call for emergency transport
C. Examine the posterior pharynx with a tongue blade
D. Administer a dose of oral dexamethasone
Correct Answer: B
Explanation: The clinical presentation of drooling, tripod positioning, and high fever is
highly suggestive of epiglottitis, a medical emergency. Examining the throat with a tongue
blade must be avoided as it can trigger complete airway obstruction. The primary goal is to
maintain the airway and secure emergent transport to a facility equipped for pediatric
intubation.
2. When assessing an 18-month-old during a well-child visit, which screening tool is
specifically recommended by the American Academy of Pediatrics to evaluate for Autism
Spectrum Disorder (ASD)?
A. ASQ-3
,B. M-CHAT-R/F
C. PHQ-A
D. Vanderbilt Assessment Scale
Correct Answer: B
Explanation: The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-
CHAT-R/F) is the validated tool used for ASD screening at 18 and 24 months. While the
ASQ-3 is a general developmental screen, it is not specific to autism spectrum behaviors.
Early identification through these standardized tools allows for timely referral to
intervention services which improves long-term outcomes.
3. A mother brings her 6-month-old infant to the clinic concerned that the child is not
meeting milestones. The FNP observes the infant can sit with support but cannot roll from
back to front. Which assessment is most accurate?
A. This represents a significant developmental delay requiring neurology referral
B. Rolling from back to front is typically achieved by 4 to 5 months
C. The child is within the normal range for these specific milestones
D. Sitting with support should not occur until at least 9 months
Correct Answer: B
Explanation: Most infants are able to roll from their back to their front by approximately 4
to 5 months of age. Sitting with support is a milestone usually achieved by 6 months, so the
, inability to roll suggests a minor delay. The FNP should perform a full developmental
assessment to determine if other areas of growth are affected.
4. In the management of a pediatric patient with mild persistent asthma, which medication is
considered the preferred long-term control therapy?
A. Short-acting beta-agonists (SABA) as needed
B. Low-dose inhaled corticosteroids (ICS)
C. Long-acting beta-agonists (LABA) monotherapy
D. Oral leukotriene receptor antagonists (LTRA) only
Correct Answer: B
Explanation: According to the NAEPP guidelines, low-dose inhaled corticosteroids are the
gold standard for daily maintenance of mild persistent asthma. SABAs are used only for
rescue and do not address the underlying airway inflammation. Monotherapy with LABAs
is contraindicated in pediatric asthma management due to increased risk of severe
exacerbations.
5. A 2-year-old is brought to the clinic for a routine check-up. The FNP notes the child’s BMI is
in the 96th percentile for age and sex. How should this be classified?
A. Obese
B. Healthy weight
C. Overweight
