NSG 548 Exam 4 V3 | NSG 548 FNP Role: Children &
Families | Actual Q&A with Rationale (NSG548
Exam 4) | Wilkes University
1. A 4-year-old child presents with a sudden onset of high fever, drooling, and a ‘tripod’
sitting position. Which is the most appropriate next step for the Family Nurse Practitioner?
A. Perform a thorough throat culture to identify the causative organism.
B. Administer a dose of oral dexamethasone to reduce airway inflammation.
C. Initiate immediate transport to the emergency department without examining the
throat.
D. Obtain a lateral neck X-ray to confirm the presence of the ‘steeple sign’.
Correct Answer: C
Explanation: The clinical presentation is highly suggestive of epiglottitis, a life-threatening
medical emergency. Attempting to examine the throat or perform a culture can trigger
complete airway obstruction. Immediate transport to a facility with advanced airway
management capabilities is the priority intervention to ensure patient safety.
2. According to the Bright Futures guidelines, at what age should universal screening for lipid
disorders begin in children without specific risk factors?
A. Between ages 2 and 4 years.
B. Between ages 9 and 11 years.
,C. Between ages 6 and 8 years.
D. Between ages 12 and 14 years.
Correct Answer: B
Explanation: Universal lipid screening is recommended for all children between the ages
of 9 and 11 years to identify early markers of cardiovascular disease. This screening is
repeated once more between the ages of 17 and 21 years. For children with known risk
factors, such as a family history of early heart disease, screening may begin as early as age
2.
3. A 15-year-old female athlete complains of gradual onset of knee pain localized to the tibial
tuberosity. What is the most likely diagnosis?
A. Osgood-Schlatter Disease
B. Slipped Capital Femoral Epiphysis (SCFE)
C. Legg-Calve-Perthes Disease
D. Patellofemoral Pain Syndrome
Correct Answer: A
Explanation: Osgood-Schlatter Disease is an overuse injury causing inflammation of the
patellar tendon at the tibial tubercle, common in active adolescents. Pain is typically
exacerbated by jumping, running, or direct pressure on the knee. Management focuses on
activity modification, ice, and physical therapy rather than surgical intervention.
,4. Which developmental milestone is expected for a typically developing 18-month-old child?
A. Walking up steps and following one-step commands.
B. Using a spoon and fork proficiently.
C. Drawing a circle and a cross.
D. Naming at least four colors and counting to ten.
Correct Answer: A
Explanation: At 18 months, children are expected to walk up steps and follow simple, one-
step commands without gestures. They should also possess a vocabulary of approximately
10 to 25 words and demonstrate the ability to point to body parts. Naming colors and
drawing specific shapes are milestones associated with older preschool-aged children.
5. In the management of a 6-year-old with Mild Persistent Asthma, which medication is
considered the first-line long-term controller therapy?
A. Short-acting beta-agonist (SABA) PRN.
B. Leukotriene receptor antagonist (LTRA) monotherapy.
C. Long-acting beta-agonist (LABA) monotherapy.
D. Low-dose Inhaled Corticosteroid (ICS).
Correct Answer: D
Explanation: For mild persistent asthma, daily low-dose inhaled corticosteroids are the
preferred first-line controller therapy to reduce airway inflammation. SABAs are used for
, quick relief but do not address the underlying inflammatory process. LABAs should never
be used as monotherapy in asthma management due to safety concerns.
6. A mother brings in her 2-week-old infant and notes projectile vomiting after every feeding.
Physical exam reveals a palpable ‘olive-shaped’ mass in the epigastrium. What is the
definitive treatment?
A. Pyloromyotomy.
B. Thickening feeds with rice cereal.
C. Oral administration of H2 blockers.
D. Daily administration of polyethylene glycol.
Correct Answer: A
Explanation: The clinical findings of projectile vomiting and an olive-shaped mass are
pathognomonic for hypertrophic pyloric stenosis. This condition requires surgical
correction via a pyloromyotomy to alleviate the gastric outlet obstruction. Before surgery,
the infant’s electrolyte imbalances and dehydration must be stabilized.
7. A 12-year-old male presents for a sports physical. During the exam, you note the presence
of sparse, long, pigmented pubic hair at the base of the penis and slight enlargement of the
scrotum. Which Tanner Stage is he in?
A. Tanner Stage 2
B. Tanner Stage 1
C. Tanner Stage 3
Families | Actual Q&A with Rationale (NSG548
Exam 4) | Wilkes University
1. A 4-year-old child presents with a sudden onset of high fever, drooling, and a ‘tripod’
sitting position. Which is the most appropriate next step for the Family Nurse Practitioner?
A. Perform a thorough throat culture to identify the causative organism.
B. Administer a dose of oral dexamethasone to reduce airway inflammation.
C. Initiate immediate transport to the emergency department without examining the
throat.
D. Obtain a lateral neck X-ray to confirm the presence of the ‘steeple sign’.
Correct Answer: C
Explanation: The clinical presentation is highly suggestive of epiglottitis, a life-threatening
medical emergency. Attempting to examine the throat or perform a culture can trigger
complete airway obstruction. Immediate transport to a facility with advanced airway
management capabilities is the priority intervention to ensure patient safety.
2. According to the Bright Futures guidelines, at what age should universal screening for lipid
disorders begin in children without specific risk factors?
A. Between ages 2 and 4 years.
B. Between ages 9 and 11 years.
,C. Between ages 6 and 8 years.
D. Between ages 12 and 14 years.
Correct Answer: B
Explanation: Universal lipid screening is recommended for all children between the ages
of 9 and 11 years to identify early markers of cardiovascular disease. This screening is
repeated once more between the ages of 17 and 21 years. For children with known risk
factors, such as a family history of early heart disease, screening may begin as early as age
2.
3. A 15-year-old female athlete complains of gradual onset of knee pain localized to the tibial
tuberosity. What is the most likely diagnosis?
A. Osgood-Schlatter Disease
B. Slipped Capital Femoral Epiphysis (SCFE)
C. Legg-Calve-Perthes Disease
D. Patellofemoral Pain Syndrome
Correct Answer: A
Explanation: Osgood-Schlatter Disease is an overuse injury causing inflammation of the
patellar tendon at the tibial tubercle, common in active adolescents. Pain is typically
exacerbated by jumping, running, or direct pressure on the knee. Management focuses on
activity modification, ice, and physical therapy rather than surgical intervention.
,4. Which developmental milestone is expected for a typically developing 18-month-old child?
A. Walking up steps and following one-step commands.
B. Using a spoon and fork proficiently.
C. Drawing a circle and a cross.
D. Naming at least four colors and counting to ten.
Correct Answer: A
Explanation: At 18 months, children are expected to walk up steps and follow simple, one-
step commands without gestures. They should also possess a vocabulary of approximately
10 to 25 words and demonstrate the ability to point to body parts. Naming colors and
drawing specific shapes are milestones associated with older preschool-aged children.
5. In the management of a 6-year-old with Mild Persistent Asthma, which medication is
considered the first-line long-term controller therapy?
A. Short-acting beta-agonist (SABA) PRN.
B. Leukotriene receptor antagonist (LTRA) monotherapy.
C. Long-acting beta-agonist (LABA) monotherapy.
D. Low-dose Inhaled Corticosteroid (ICS).
Correct Answer: D
Explanation: For mild persistent asthma, daily low-dose inhaled corticosteroids are the
preferred first-line controller therapy to reduce airway inflammation. SABAs are used for
, quick relief but do not address the underlying inflammatory process. LABAs should never
be used as monotherapy in asthma management due to safety concerns.
6. A mother brings in her 2-week-old infant and notes projectile vomiting after every feeding.
Physical exam reveals a palpable ‘olive-shaped’ mass in the epigastrium. What is the
definitive treatment?
A. Pyloromyotomy.
B. Thickening feeds with rice cereal.
C. Oral administration of H2 blockers.
D. Daily administration of polyethylene glycol.
Correct Answer: A
Explanation: The clinical findings of projectile vomiting and an olive-shaped mass are
pathognomonic for hypertrophic pyloric stenosis. This condition requires surgical
correction via a pyloromyotomy to alleviate the gastric outlet obstruction. Before surgery,
the infant’s electrolyte imbalances and dehydration must be stabilized.
7. A 12-year-old male presents for a sports physical. During the exam, you note the presence
of sparse, long, pigmented pubic hair at the base of the penis and slight enlargement of the
scrotum. Which Tanner Stage is he in?
A. Tanner Stage 2
B. Tanner Stage 1
C. Tanner Stage 3
