NSG 548 Final Exam V1 | NSG 548 FNP Role:
Children & Families | Actual Q&A with Rationale
(NSG548 Final Exam) | Wilkes University
1. A 12-month-old infant is brought to the clinic for a well-child visit. According to the CDC
immunization schedule, which vaccines should the FNP prepare to administer?
A. MMR, Varicella, HepA, and DTaP
B. IPV, Rotavirus, and HPV
C. Hib, PCV13, and Meningococcal B
D. Tdap, MCV4, and Influenza
Correct Answer: A
Explanation: At the 12-month visit, the standard CDC schedule recommends the first doses
of MMR (Measles, Mumps, Rubella) and Varicella. Additionally, the first dose of Hepatitis A
and the fourth dose of DTaP are typically administered between 12 and 15 months. The
FNP must ensure that the infant is up to date on these series to maintain community
immunity and individual protection.
2. A 4-year-old child presents with a ‘barking’ cough and inspiratory stridor that worsens at
night. Which diagnosis is most likely?
A. Epiglottitis
B. Bacterial Tracheitis
,C. Laryngotracheobronchitis (Croup)
D. Foreign Body Aspiration
Correct Answer: C
Explanation: Croup, or laryngotracheobronchitis, is characterized by the classic barking
cough and inspiratory stridor due to subglottic swelling. It is most commonly caused by the
parainfluenza virus and typically affects children between 6 months and 3 years of age.
Symptoms frequently intensify during the night hours and may be relieved by exposure to
cool mist or cold air.
3. A 9-month-old infant is evaluated for failure to thrive. Which developmental milestone
should the FNP expect a healthy 9-month-old to have achieved?
A. Pincer grasp
B. Walking independently
C. Speaking in 2-word sentences
D. Stacking three blocks
Correct Answer: A
Explanation: The development of the pincer grasp, where the infant uses the thumb and
index finger to pick up small objects, typically occurs around 9 months of age. Walking
independently and stacking blocks are milestones associated with the 12 to 15-month
range. Two-word sentences are a milestone for a child approximately 24 months old.
,4. When assessing a 2-week-old neonate, the FNP notes a positive Ortolani maneuver. What
does this finding indicate?
A. Spina Bifida Occulta
B. Developmental Dysplasia of the Hip (DDH)
C. Clubfoot (Talipes Equinovarus)
D. Tibial Torsion
Correct Answer: B
Explanation: A positive Ortolani maneuver occurs when a ‘clunk’ is felt as the femoral
head is reduced back into the acetabulum during abduction. This finding is highly
suggestive of developmental dysplasia of the hip (DDH), which requires prompt orthopedic
referral. Early detection is critical for successful non-surgical management using devices
like the Pavlik harness.
5. A 10-year-old male presents with sudden onset of scrotal pain, nausea, and an absent
cremasteric reflex. What is the priority management?
A. Prescribe a 10-day course of Ciprofloxacin
B. Order an immediate scrotal ultrasound and surgical consult
C. Apply ice packs and recommend scrotal support
D. Perform a urinalysis to check for nitrites
Correct Answer: B
, Explanation: The absence of the cremasteric reflex combined with acute scrotal pain is a
classic sign of testicular torsion, which is a surgical emergency. The ‘golden window’ for
salvage of the testicle is generally within 6 hours of the onset of symptoms. Immediate
imaging and surgical intervention are necessary to restore blood flow and prevent necrosis.
6. According to the Bright Futures guidelines, at what age should universal screening for
depression begin?
A. 12 years old
B. 10 years old
C. 8 years old
D. 15 years old
Correct Answer: A
Explanation: Universal screening for depression using tools such as the PHQ-9 is
recommended annually starting at age 12. This guideline reflects the increased incidence of
mood disorders during early adolescence and the importance of early identification. The
FNP should conduct these screenings in a private environment to encourage honest
responses from the patient.
7. A 6-year-old child presents with a ‘honey-colored’ crusted lesion around the mouth. What
is the most likely causative organism?
A. Staphylococcus aureus
B. Streptococcus pneumoniae
Children & Families | Actual Q&A with Rationale
(NSG548 Final Exam) | Wilkes University
1. A 12-month-old infant is brought to the clinic for a well-child visit. According to the CDC
immunization schedule, which vaccines should the FNP prepare to administer?
A. MMR, Varicella, HepA, and DTaP
B. IPV, Rotavirus, and HPV
C. Hib, PCV13, and Meningococcal B
D. Tdap, MCV4, and Influenza
Correct Answer: A
Explanation: At the 12-month visit, the standard CDC schedule recommends the first doses
of MMR (Measles, Mumps, Rubella) and Varicella. Additionally, the first dose of Hepatitis A
and the fourth dose of DTaP are typically administered between 12 and 15 months. The
FNP must ensure that the infant is up to date on these series to maintain community
immunity and individual protection.
2. A 4-year-old child presents with a ‘barking’ cough and inspiratory stridor that worsens at
night. Which diagnosis is most likely?
A. Epiglottitis
B. Bacterial Tracheitis
,C. Laryngotracheobronchitis (Croup)
D. Foreign Body Aspiration
Correct Answer: C
Explanation: Croup, or laryngotracheobronchitis, is characterized by the classic barking
cough and inspiratory stridor due to subglottic swelling. It is most commonly caused by the
parainfluenza virus and typically affects children between 6 months and 3 years of age.
Symptoms frequently intensify during the night hours and may be relieved by exposure to
cool mist or cold air.
3. A 9-month-old infant is evaluated for failure to thrive. Which developmental milestone
should the FNP expect a healthy 9-month-old to have achieved?
A. Pincer grasp
B. Walking independently
C. Speaking in 2-word sentences
D. Stacking three blocks
Correct Answer: A
Explanation: The development of the pincer grasp, where the infant uses the thumb and
index finger to pick up small objects, typically occurs around 9 months of age. Walking
independently and stacking blocks are milestones associated with the 12 to 15-month
range. Two-word sentences are a milestone for a child approximately 24 months old.
,4. When assessing a 2-week-old neonate, the FNP notes a positive Ortolani maneuver. What
does this finding indicate?
A. Spina Bifida Occulta
B. Developmental Dysplasia of the Hip (DDH)
C. Clubfoot (Talipes Equinovarus)
D. Tibial Torsion
Correct Answer: B
Explanation: A positive Ortolani maneuver occurs when a ‘clunk’ is felt as the femoral
head is reduced back into the acetabulum during abduction. This finding is highly
suggestive of developmental dysplasia of the hip (DDH), which requires prompt orthopedic
referral. Early detection is critical for successful non-surgical management using devices
like the Pavlik harness.
5. A 10-year-old male presents with sudden onset of scrotal pain, nausea, and an absent
cremasteric reflex. What is the priority management?
A. Prescribe a 10-day course of Ciprofloxacin
B. Order an immediate scrotal ultrasound and surgical consult
C. Apply ice packs and recommend scrotal support
D. Perform a urinalysis to check for nitrites
Correct Answer: B
, Explanation: The absence of the cremasteric reflex combined with acute scrotal pain is a
classic sign of testicular torsion, which is a surgical emergency. The ‘golden window’ for
salvage of the testicle is generally within 6 hours of the onset of symptoms. Immediate
imaging and surgical intervention are necessary to restore blood flow and prevent necrosis.
6. According to the Bright Futures guidelines, at what age should universal screening for
depression begin?
A. 12 years old
B. 10 years old
C. 8 years old
D. 15 years old
Correct Answer: A
Explanation: Universal screening for depression using tools such as the PHQ-9 is
recommended annually starting at age 12. This guideline reflects the increased incidence of
mood disorders during early adolescence and the importance of early identification. The
FNP should conduct these screenings in a private environment to encourage honest
responses from the patient.
7. A 6-year-old child presents with a ‘honey-colored’ crusted lesion around the mouth. What
is the most likely causative organism?
A. Staphylococcus aureus
B. Streptococcus pneumoniae
