NR602 Actual Pediatric Midterm Exam
Study Set Questions with accurate
answers Graded A+ 2026/2027 update
The primary care pediatric nurse practitioner conducts a well baby exam on an infant and notes mild gross motor
delays but no delays in other areas. Which initial course of action will the nurse practitioner recommend??-
Consult a developmental specialist for a more complete evaluation.
Prepare the parents for a potentially serious developmental disorder.
Refer the infant to an early intervention program for physical therapy.
Teach the parents to provide exercises to encourage motor development.
CORRECT ANS: D
The child who has mild delays in only one area may be managed initially by having the parent provide appropriate
exercises. If this is not effective, or if delays become more severe, referrals for evaluation or early intervention
services are warranted. A mild delay does not necessarily signal a serious disorder, so this action is not indicated.
The primary care pediatric nurse practitioner sees a developmentally delayed toddler for an initial visit. The family
has just moved to the area and asks the nurse practitioner about community services and resources for their child.
What should the nurse practitioner do initially??-
Ask the parents if they have an individualized family service plan (IFSP).
Consult with a physician to ensure the child gets appropriate care.
Inform the family that services are provided when the child begins school.
Refer the family to a social worker for assistance with referrals and services.
CORRECT ANS: A
Families with children who have developmental delays are eligible for early intervention services and should have
IFSPs in place. This family may have one from their previous community, and it can be used as a starting point to
determine needs. It is not necessary to consult with a physician to coordinate community resources. Early
intervention is provided from birth, according to federal law. Until the specific referrals are known, the social worker
is not consulted.
The primary care pediatric nurse practitioner is examining a newborn infant recently discharged from the neonatal
intensive care unit after a premature birth. The parent is upset and expresses worry about whether the infant will
be normal. What will the nurse practitioner do in this situation??-
Explain to the parent that developmental delays often do not manifest at first.
Perform a developmental assessment and tell the parent which delays are evident.
Point out the tasks that the infant can perform while conducting the assessment.
Refer the infant to a developmental specialist for a complete evaluation.
,CORRECT ANS: C
When discussing developmental delays with parents, it is important to be positive and to initially focus on
strengths. Explaining that developmental delays develop over time is true but does not reassure the parent or help
the parent cope with feelings. Referrals are not indicated unless delays are present and may take time.
Which recommendation will a primary care pediatric nurse practitioner make when parents ask about ways to
discipline their 3-year-old child who draws on the walls with crayons??-
Give the child washable markers so the drawings can be removed easily.
Provide a roll of paper for drawing and teach the child to use this.
Put the child in "timeout" each time the child draws on the walls.
Take the crayons away from the child to prevent the behavior.
CORRECT ANS: B
Discipline involves training or education that molds appropriate behavior and is used to teach the child what is
permitted and encouraged. Providing an appropriate outlet for drawing helps to teach the child where to use the
crayons. Using washable markers allows the parents to clean the walls but does not teach the child appropriate
behaviors. Timeout and taking away the crayons are forms of punishment, or a loss of privileges, that are
administered as a form of retribution.
The primary care pediatric nurse practitioner enters an exam room and finds a 2-month-old infant in a car seat on
the exam table. The infant's mother is playing a game on her smart phone. The nurse practitioner interprets this
behavior as :
a sign that the mother has postpartum depression.
extremely concerning for potential parental neglect.
of moderate concern for parenting problems.
within the normal range of behavior in early parenthood.
CORRECT ANS: C
A parent who seems disinterested in a child raises moderate concerns for parenting problems. It does not
necessarily signal postpartum depression. It is not a mark for extreme concern. It is not within the expected range
of behaviors.
During a well child assessment of an 18-month-old child, the primary care pediatric nurse practitioner observes the
child becoming irritable and uncooperative. The parent tells the child to stop fussing. What will the nurse
practitioner do??-
Allow the parent to put the child in a "timeout."
CORRECT ANS: C
The child has exhibited early signs of misbehavior. At this stage, distraction and active engagement may be used to
stop more problems from occurring. It is not necessary to use a timeout because the child hasn't reached the point
where cooperation is impossible. The PNP should model appropriate interventions by offering the child a distraction
and may ask the parent about discipline practices later in the visit. The child is not at a "meltdown" state.
,The primary care pediatric nurse practitioner performs a physical examination on a 9-month-old infant and notes
two central incisors on the lower gums. The parent states that the infant nurses, takes solid foods three times daily,
and occasionally takes water from a cup. What will the pediatric nurse practitioner counsel the parent to promote
optimum dental health??-
To begin brushing the infant's teeth with toothpaste
To consider weaning the infant from breastfeeding
To discontinue giving fluoride supplements
To make an appointment for an initial dental examination
CORRECT ANS: D
The American Academy of Pediatric Dentistry recommends a first dental examination at the time of eruption of the
first tooth and no later than 12 months old. Parents should be counseled to clean the infant's teeth but with water
only. Weaning from breastfeeding is not indicated, although mothers should not let the infant nurse while sleeping
to prevent milk from bathing the teeth. Fluoride supplements should not be discontinued.
The primary care pediatric nurse practitioner has a cohort of patients who have special health care needs. Which is
an important role of the nurse practitioner when caring for these children??-
Care coordination and collaboration
Developing protocols for parents to follow
Monitoring individual education plans (IEPs)
Providing lists of resources for families
CORRECT ANS: A
Care coordination is one of the key elements for children with special health care needs. PNPs are especially suited
for this role and have the unique skills to function as care coordinators. Care for these children should involve
shared decision making and individualized care and not "cookbook" approaches. The PNP may advocate for
children's health care needs for the IEP but does not monitor these. The PNP should not just give parents lists of
phone numbers but should assist them to make appointments.
A single mother of an infant worries that living in a household with only one parent will cause her child to be
maladjusted. To help address the mother's concerns, the primary care pediatric nurse practitioner will suggest :
developing consistent daily routines for the child.
exposing her child to extended family members when possible.
not working outside the home during the first few years.
taking her child to regular play date activities with other children.
CORRECT ANS: A
, Providers can teach parents that providing predictable, consistent, and loving care helps an infant to learn trust and
help influence positive brain development. Involving extended family members and going to play dates are good
ways to socialize children but are not essential to learning trust. It may not be possible for her to be a stay-at-home
mother.
The primary care pediatric nurse practitioner performs a well baby examination on a 7-day-old infant who is nursing
well, according to the mother. The nurse practitioner notes that the infant weighed 3250 grams at birth and 2990
grams when discharged on the second day of life. The infant weighs 3080 grams at this visit. Which action is
correct??-
Follow up at the 2-month checkup.
Refer to a lactation consultant.
Schedule a weight check in 1 week.
Suggest supplementing with formula.
CORRECT ANS: C
This infant lost about 8% of its birth weight, which is normal and, since discharge home, has gained at least 15
grams per day, which is also normal. The PNP should schedule a weight check in a week to make sure the infant
regains its birth weight, since most should regain this in 10 to 14 days and since this loss of birth weight is at the
high end of normal. It is not necessary to refer to a lactation consultant or supplement with formula, since the
infant is gaining weight adequately.
The parent of a newborn infant asks the primary care pediatric nurse practitioner when to intervene to help the
infant's future intellectual growth. What will the nurse practitioner tell the parent??-
Cognitive learning begins during the toddler years.
Intellectual growth begin when speech develops.
Language and literacy skills begin at birth.
Preschool is an optimal time to begin general learning.
CORRECT ANS: C
General learning and acquisition of skills for later reading and writing begin at birth, not in kindergarten or first
grade, and these skills grow with everyday loving interactions between infants and caregivers. Cognitive learning
changes during toddler years but begins at birth. Intellectual growth is not tied to speech alone.
During an assessment of a 4-week-old infant, the primary care pediatric nurse practitioner learns that a breastfed
infant nurses every 2 hours during the day but is able to sleep for a 4-hour period during the night. The infant has
gained 20 grams per day in the interval since last seen in the clinic. What will the nurse practitioner recommend??-
Continuing to nurse the infant using the current pattern
Nursing the infant for longer periods every 4 hours
Supplementing with formula at the last nighttime feeding
Waking the infant every 2 hours to nurse during the night
Study Set Questions with accurate
answers Graded A+ 2026/2027 update
The primary care pediatric nurse practitioner conducts a well baby exam on an infant and notes mild gross motor
delays but no delays in other areas. Which initial course of action will the nurse practitioner recommend??-
Consult a developmental specialist for a more complete evaluation.
Prepare the parents for a potentially serious developmental disorder.
Refer the infant to an early intervention program for physical therapy.
Teach the parents to provide exercises to encourage motor development.
CORRECT ANS: D
The child who has mild delays in only one area may be managed initially by having the parent provide appropriate
exercises. If this is not effective, or if delays become more severe, referrals for evaluation or early intervention
services are warranted. A mild delay does not necessarily signal a serious disorder, so this action is not indicated.
The primary care pediatric nurse practitioner sees a developmentally delayed toddler for an initial visit. The family
has just moved to the area and asks the nurse practitioner about community services and resources for their child.
What should the nurse practitioner do initially??-
Ask the parents if they have an individualized family service plan (IFSP).
Consult with a physician to ensure the child gets appropriate care.
Inform the family that services are provided when the child begins school.
Refer the family to a social worker for assistance with referrals and services.
CORRECT ANS: A
Families with children who have developmental delays are eligible for early intervention services and should have
IFSPs in place. This family may have one from their previous community, and it can be used as a starting point to
determine needs. It is not necessary to consult with a physician to coordinate community resources. Early
intervention is provided from birth, according to federal law. Until the specific referrals are known, the social worker
is not consulted.
The primary care pediatric nurse practitioner is examining a newborn infant recently discharged from the neonatal
intensive care unit after a premature birth. The parent is upset and expresses worry about whether the infant will
be normal. What will the nurse practitioner do in this situation??-
Explain to the parent that developmental delays often do not manifest at first.
Perform a developmental assessment and tell the parent which delays are evident.
Point out the tasks that the infant can perform while conducting the assessment.
Refer the infant to a developmental specialist for a complete evaluation.
,CORRECT ANS: C
When discussing developmental delays with parents, it is important to be positive and to initially focus on
strengths. Explaining that developmental delays develop over time is true but does not reassure the parent or help
the parent cope with feelings. Referrals are not indicated unless delays are present and may take time.
Which recommendation will a primary care pediatric nurse practitioner make when parents ask about ways to
discipline their 3-year-old child who draws on the walls with crayons??-
Give the child washable markers so the drawings can be removed easily.
Provide a roll of paper for drawing and teach the child to use this.
Put the child in "timeout" each time the child draws on the walls.
Take the crayons away from the child to prevent the behavior.
CORRECT ANS: B
Discipline involves training or education that molds appropriate behavior and is used to teach the child what is
permitted and encouraged. Providing an appropriate outlet for drawing helps to teach the child where to use the
crayons. Using washable markers allows the parents to clean the walls but does not teach the child appropriate
behaviors. Timeout and taking away the crayons are forms of punishment, or a loss of privileges, that are
administered as a form of retribution.
The primary care pediatric nurse practitioner enters an exam room and finds a 2-month-old infant in a car seat on
the exam table. The infant's mother is playing a game on her smart phone. The nurse practitioner interprets this
behavior as :
a sign that the mother has postpartum depression.
extremely concerning for potential parental neglect.
of moderate concern for parenting problems.
within the normal range of behavior in early parenthood.
CORRECT ANS: C
A parent who seems disinterested in a child raises moderate concerns for parenting problems. It does not
necessarily signal postpartum depression. It is not a mark for extreme concern. It is not within the expected range
of behaviors.
During a well child assessment of an 18-month-old child, the primary care pediatric nurse practitioner observes the
child becoming irritable and uncooperative. The parent tells the child to stop fussing. What will the nurse
practitioner do??-
Allow the parent to put the child in a "timeout."
CORRECT ANS: C
The child has exhibited early signs of misbehavior. At this stage, distraction and active engagement may be used to
stop more problems from occurring. It is not necessary to use a timeout because the child hasn't reached the point
where cooperation is impossible. The PNP should model appropriate interventions by offering the child a distraction
and may ask the parent about discipline practices later in the visit. The child is not at a "meltdown" state.
,The primary care pediatric nurse practitioner performs a physical examination on a 9-month-old infant and notes
two central incisors on the lower gums. The parent states that the infant nurses, takes solid foods three times daily,
and occasionally takes water from a cup. What will the pediatric nurse practitioner counsel the parent to promote
optimum dental health??-
To begin brushing the infant's teeth with toothpaste
To consider weaning the infant from breastfeeding
To discontinue giving fluoride supplements
To make an appointment for an initial dental examination
CORRECT ANS: D
The American Academy of Pediatric Dentistry recommends a first dental examination at the time of eruption of the
first tooth and no later than 12 months old. Parents should be counseled to clean the infant's teeth but with water
only. Weaning from breastfeeding is not indicated, although mothers should not let the infant nurse while sleeping
to prevent milk from bathing the teeth. Fluoride supplements should not be discontinued.
The primary care pediatric nurse practitioner has a cohort of patients who have special health care needs. Which is
an important role of the nurse practitioner when caring for these children??-
Care coordination and collaboration
Developing protocols for parents to follow
Monitoring individual education plans (IEPs)
Providing lists of resources for families
CORRECT ANS: A
Care coordination is one of the key elements for children with special health care needs. PNPs are especially suited
for this role and have the unique skills to function as care coordinators. Care for these children should involve
shared decision making and individualized care and not "cookbook" approaches. The PNP may advocate for
children's health care needs for the IEP but does not monitor these. The PNP should not just give parents lists of
phone numbers but should assist them to make appointments.
A single mother of an infant worries that living in a household with only one parent will cause her child to be
maladjusted. To help address the mother's concerns, the primary care pediatric nurse practitioner will suggest :
developing consistent daily routines for the child.
exposing her child to extended family members when possible.
not working outside the home during the first few years.
taking her child to regular play date activities with other children.
CORRECT ANS: A
, Providers can teach parents that providing predictable, consistent, and loving care helps an infant to learn trust and
help influence positive brain development. Involving extended family members and going to play dates are good
ways to socialize children but are not essential to learning trust. It may not be possible for her to be a stay-at-home
mother.
The primary care pediatric nurse practitioner performs a well baby examination on a 7-day-old infant who is nursing
well, according to the mother. The nurse practitioner notes that the infant weighed 3250 grams at birth and 2990
grams when discharged on the second day of life. The infant weighs 3080 grams at this visit. Which action is
correct??-
Follow up at the 2-month checkup.
Refer to a lactation consultant.
Schedule a weight check in 1 week.
Suggest supplementing with formula.
CORRECT ANS: C
This infant lost about 8% of its birth weight, which is normal and, since discharge home, has gained at least 15
grams per day, which is also normal. The PNP should schedule a weight check in a week to make sure the infant
regains its birth weight, since most should regain this in 10 to 14 days and since this loss of birth weight is at the
high end of normal. It is not necessary to refer to a lactation consultant or supplement with formula, since the
infant is gaining weight adequately.
The parent of a newborn infant asks the primary care pediatric nurse practitioner when to intervene to help the
infant's future intellectual growth. What will the nurse practitioner tell the parent??-
Cognitive learning begins during the toddler years.
Intellectual growth begin when speech develops.
Language and literacy skills begin at birth.
Preschool is an optimal time to begin general learning.
CORRECT ANS: C
General learning and acquisition of skills for later reading and writing begin at birth, not in kindergarten or first
grade, and these skills grow with everyday loving interactions between infants and caregivers. Cognitive learning
changes during toddler years but begins at birth. Intellectual growth is not tied to speech alone.
During an assessment of a 4-week-old infant, the primary care pediatric nurse practitioner learns that a breastfed
infant nurses every 2 hours during the day but is able to sleep for a 4-hour period during the night. The infant has
gained 20 grams per day in the interval since last seen in the clinic. What will the nurse practitioner recommend??-
Continuing to nurse the infant using the current pattern
Nursing the infant for longer periods every 4 hours
Supplementing with formula at the last nighttime feeding
Waking the infant every 2 hours to nurse during the night
