NSG 548 Exam 1 V3 | NSG 548 FNP Role: Children &
Families | Actual Q&A with Rationale (NSG548
Exam 1) | Wilkes University
1. According to Erikson’s theory of psychosocial development, which stage is a 4-year-old
child currently navigating?
A. Trust vs. Mistrust
B. Initiative vs. Guilt
C. Autonomy vs. Shame and Doubt
D. Industry vs. Inferiority
Correct Answer: B
Explanation: Children in the preschool years, typically ages 3 to 5, are in the stage of
Initiative vs. Guilt. During this period, they begin to assert power and control over their
world through directing play and other social interactions. Success in this stage leads to a
sense of purpose, while children who fail to acquire these skills may be left with a sense of
guilt and self-doubt.
2. At what age should the Family Nurse Practitioner first screen a child for Autism Spectrum
Disorder using the M-CHAT-R/F tool?
A. 12 months
B. 24 months
,C. 18 months
D. 36 months
Correct Answer: C
Explanation: The American Academy of Pediatrics recommends formal screening for
Autism Spectrum Disorder (ASD) at the 18-month and 24-month well-child visits. The
Modified Checklist for Autism in Toddlers (M-CHAT) is the standard validated tool used for
this purpose in primary care. Early identification is crucial because it allows for timely
intervention and improved developmental outcomes for the child.
3. Which of the following is considered a contraindication for the administration of the MMR
vaccine in a pediatric patient?
A. Severe immunodeficiency or pregnancy
B. Current treatment with inhaled corticosteroids
C. History of a mild upper respiratory infection
D. Family history of seizures
Correct Answer: A
Explanation: The MMR vaccine is a live attenuated virus vaccine and is contraindicated in
patients with severe immunodeficiency, such as those with symptomatic HIV or those
receiving high-dose systemic steroids. It is also contraindicated during pregnancy due to
the theoretical risk to the fetus from the live virus. Clinicians must always screen for these
conditions before administering any live vaccines to ensure patient safety.
,4. A 6-month-old infant is brought to the clinic for a well-child visit. Which developmental
milestone should the NP expect the infant to have achieved?
A. Walking while holding onto furniture
B. Speaking two-word sentences
C. Sitting independently without support
D. Using a neat pincer grasp
Correct Answer: C
Explanation: By 6 months of age, most infants are able to sit with little to no support,
which is a key gross motor milestone. They are also typically rolling in both directions and
beginning to babble with consonant sounds. The pincer grasp and cruising (walking while
holding onto furniture) are milestones that generally occur later, closer to 9 to 12 months.
5. What is the first-line antibiotic treatment for a 3-year-old child diagnosed with acute otitis
media who has no known drug allergies?
A. Azithromycin
B. Amoxicillin
C. Cephalexin
D. Trimethoprim-sulfamethoxazole
Correct Answer: B
, Explanation: High-dose Amoxicillin (80-90 mg/kg/day) is the recommended first-line
treatment for acute otitis media in pediatric patients without a penicillin allergy. This
antibiotic is preferred because of its effectiveness against the most common bacterial
pathogens, including Streptococcus pneumoniae. If the patient has received amoxicillin in
the previous 30 days or has concurrent conjunctivitis, Amoxicillin-Clavulanate is often
preferred instead.
6. During a newborn assessment, the NP notes a collection of blood under the scalp that does
not cross the suture lines. What is this condition called?
A. Caput succedaneum
B. Subgaleal hemorrhage
C. Cephalohematoma
D. Molding
Correct Answer: C
Explanation: A cephalohematoma is a collection of blood between the periosteum and the
skull bone, which is why it does not cross suture lines. This is in contrast to caput
succedaneum, which is edema of the scalp that does cross suture lines. Cephalohematomas
typically resolve spontaneously over several weeks but may increase the risk of
hyperbilirubinemia as the blood is reabsorbed.
Families | Actual Q&A with Rationale (NSG548
Exam 1) | Wilkes University
1. According to Erikson’s theory of psychosocial development, which stage is a 4-year-old
child currently navigating?
A. Trust vs. Mistrust
B. Initiative vs. Guilt
C. Autonomy vs. Shame and Doubt
D. Industry vs. Inferiority
Correct Answer: B
Explanation: Children in the preschool years, typically ages 3 to 5, are in the stage of
Initiative vs. Guilt. During this period, they begin to assert power and control over their
world through directing play and other social interactions. Success in this stage leads to a
sense of purpose, while children who fail to acquire these skills may be left with a sense of
guilt and self-doubt.
2. At what age should the Family Nurse Practitioner first screen a child for Autism Spectrum
Disorder using the M-CHAT-R/F tool?
A. 12 months
B. 24 months
,C. 18 months
D. 36 months
Correct Answer: C
Explanation: The American Academy of Pediatrics recommends formal screening for
Autism Spectrum Disorder (ASD) at the 18-month and 24-month well-child visits. The
Modified Checklist for Autism in Toddlers (M-CHAT) is the standard validated tool used for
this purpose in primary care. Early identification is crucial because it allows for timely
intervention and improved developmental outcomes for the child.
3. Which of the following is considered a contraindication for the administration of the MMR
vaccine in a pediatric patient?
A. Severe immunodeficiency or pregnancy
B. Current treatment with inhaled corticosteroids
C. History of a mild upper respiratory infection
D. Family history of seizures
Correct Answer: A
Explanation: The MMR vaccine is a live attenuated virus vaccine and is contraindicated in
patients with severe immunodeficiency, such as those with symptomatic HIV or those
receiving high-dose systemic steroids. It is also contraindicated during pregnancy due to
the theoretical risk to the fetus from the live virus. Clinicians must always screen for these
conditions before administering any live vaccines to ensure patient safety.
,4. A 6-month-old infant is brought to the clinic for a well-child visit. Which developmental
milestone should the NP expect the infant to have achieved?
A. Walking while holding onto furniture
B. Speaking two-word sentences
C. Sitting independently without support
D. Using a neat pincer grasp
Correct Answer: C
Explanation: By 6 months of age, most infants are able to sit with little to no support,
which is a key gross motor milestone. They are also typically rolling in both directions and
beginning to babble with consonant sounds. The pincer grasp and cruising (walking while
holding onto furniture) are milestones that generally occur later, closer to 9 to 12 months.
5. What is the first-line antibiotic treatment for a 3-year-old child diagnosed with acute otitis
media who has no known drug allergies?
A. Azithromycin
B. Amoxicillin
C. Cephalexin
D. Trimethoprim-sulfamethoxazole
Correct Answer: B
, Explanation: High-dose Amoxicillin (80-90 mg/kg/day) is the recommended first-line
treatment for acute otitis media in pediatric patients without a penicillin allergy. This
antibiotic is preferred because of its effectiveness against the most common bacterial
pathogens, including Streptococcus pneumoniae. If the patient has received amoxicillin in
the previous 30 days or has concurrent conjunctivitis, Amoxicillin-Clavulanate is often
preferred instead.
6. During a newborn assessment, the NP notes a collection of blood under the scalp that does
not cross the suture lines. What is this condition called?
A. Caput succedaneum
B. Subgaleal hemorrhage
C. Cephalohematoma
D. Molding
Correct Answer: C
Explanation: A cephalohematoma is a collection of blood between the periosteum and the
skull bone, which is why it does not cross suture lines. This is in contrast to caput
succedaneum, which is edema of the scalp that does cross suture lines. Cephalohematomas
typically resolve spontaneously over several weeks but may increase the risk of
hyperbilirubinemia as the blood is reabsorbed.
