NR 602 MIDTERM -PRIMARY CARE OF CHILD
BEARING&CHILD BEARING FAMILY PRACTICUM |ACTUAL
QUESTIONS AND VERIFIED ANSWERS|BRAND NEW 2026-
2027 UPDATE|GRADED A+
Question 1
The parent of a toddler is concerned that the child may have autism. The primary care
pediatric nurse practitioner completes a Modified Checklist for Autism in Toddlers (M-
CHAT) tool, which indicates several areas of concern. What will the nurse practitioner do?
Administer a Childhood Autism Rating Scale (CARS) in the clinic.
Consult a specialist to determine appropriate early intervention strategies.
Refer the child to a behavioral specialist for further evaluation.
Tell the parent that this result indicates that the child has autism.
CORRECT ANSWER
ANS: C
The M-CHAT is a screening tool and is useful for detecting behaviors that may indicate
autism. This instrument has been found to have acceptable sensitivity, specificity, and
significant positive predictive value. If these behaviors are detected, the PNP should refer
the child to a specialist for further assessment, using more diagnostic tools. The CARS
may be used but requires specialty training and proper credentials. Until the diagnosis is
determined, strategies for intervention are not discussed. The M-CHAT is a screening tool
and is not diagnostic.
Question 2
The mother of a newborn tells the primary care pediatric nurse practitioner that she is
worried that her child will develop allergies and asthma. Which tool will the nurse
practitioner use to evaluate this risk?
Three-generation pedigree
Review of systems
Genogram
1
@THE STUDY VAULT
,Ecomap
CORRECT ANSWER
ANS: A
The three-generation pedigree is used to map out risks for genetic diseases in families, as
well as conditions with modifiable risk factors. The review of systems is used to evaluate
the history of the child's body systems. The genogram is an approach to developing a
family database to provide a graphic representation of family structure, roles, and
problems of recurring significance in a family. The ecomap is used to identify
relationships in the family and community that are supportive or harmful.
Question 3
The primary care pediatric nurse practitioner is performing a well child check-up on a 20-
month-old child. The child was 4 weeks premature and, according to a parent-completed
developmental questionnaire, has achieved milestones for a 15-month-old infant. Which
action is correct?
Perform an in-depth developmental assessment screen at this visit to evaluate this child.
Reassure the parent that the child will catch up to normal development by age 2 years.
Re-evaluate this child's development and milestone achievements at the 2-year visit.
Refer the child to a specialty clinic for evaluation and treatment of developmental delay.
CORRECT ANSWER
ANS: A
This child should be at a 19-month adjusted age for prematurity so, according to the
parent screen, is 4 months behind. The PNP should perform a more in-depth screen to
evaluate this delay. Waiting to see if the child will "catch up" or assuring the parent that
this will happen will cause the delays to become more severe. A referral to a specialty
clinic should not be made solely on the basis of the parent-completed questionnaire but
only after further evaluation of possible delays.
Question 4
2
@THE STUDY VAULT
,When formulating developmental diagnoses for pediatric patients, the primary care
pediatric nurse practitioner may use which resource?
DC: 0-3R
ICD-10-CM
ICSD-3
NANDA International
CORRECT ANSWER
ANS: A
The DC: 0-3R refers to the Diagnostic Classification of Mental Health and Developmental
Disorders of Infancy and Early Childhood and is useful for developmental problem
diagnosis. The ICD-10-CM is the International Classification of Diseases-Tenth Revision,
Clinical Modification and is useful for identifying physiologic diseases. The ICSD-3 is the
International Classification of Sleep Disorders - 3rd edition. NANDA International is used
to label problems in the functional health domain.
Question 5
The primary care pediatric nurse practitioner is evaluating health literacy in the mother of
a new preschool-age child. How will the nurse practitioner assess this?
Ask the child how many books he has at home.
Ask the mother about her highest grade in school.
Ask the mother to determine the correct dose of a drug from a label.
Ask the mother to read a health information handout aloud.
CORRECT ANSWER
ANS: A
The "newest vital sign," or health literacy, can be determined quickly by asking the
parent how many children's books are in the home. Greater than 10 books in the home is
an independent positive predictor of adequate parent health literacy. The other
questions may determine a specific level of literacy in general but are not as efficient.
3
@THE STUDY VAULT
, Question 6
The primary care pediatric nurse practitioner learns that the mother of a 3-year-old child
has been treated for depression for over 5 years. Which aspect of this child's development
will be of the most concern to the nurse practitioner?
Fine motor
Gross motor
Social/emotional
Speech and language
CORRECT ANSWER
ANS: D
Maternal depression in the first year of life has been associated with poorer language
development at 3 years of age.
Question 7
The primary care pediatric nurse practitioner sees a 3-year-old child who chronically
withholds stools, in spite of the parents' attempts to stop the behavior, requiring frequent
treatments with laxative medications. Which diagnosis will the nurse practitioner use to
facilitate third-party reimbursement?
Altered elimination pattern
Elimination disorder
Encopresis
Parenting alteration
CORRECT ANSWER
ANS: C
Encopresis is a medical diagnosis, classified in the ICD-10-CM, and is recognized for
reimbursement purposes. "Altered elimination pattern" and "Parenting alteration" are
NANDA International diagnoses and are not recognized for reimbursement. "Elimination
disorder" is a developmental diagnosis.
4
@THE STUDY VAULT
BEARING&CHILD BEARING FAMILY PRACTICUM |ACTUAL
QUESTIONS AND VERIFIED ANSWERS|BRAND NEW 2026-
2027 UPDATE|GRADED A+
Question 1
The parent of a toddler is concerned that the child may have autism. The primary care
pediatric nurse practitioner completes a Modified Checklist for Autism in Toddlers (M-
CHAT) tool, which indicates several areas of concern. What will the nurse practitioner do?
Administer a Childhood Autism Rating Scale (CARS) in the clinic.
Consult a specialist to determine appropriate early intervention strategies.
Refer the child to a behavioral specialist for further evaluation.
Tell the parent that this result indicates that the child has autism.
CORRECT ANSWER
ANS: C
The M-CHAT is a screening tool and is useful for detecting behaviors that may indicate
autism. This instrument has been found to have acceptable sensitivity, specificity, and
significant positive predictive value. If these behaviors are detected, the PNP should refer
the child to a specialist for further assessment, using more diagnostic tools. The CARS
may be used but requires specialty training and proper credentials. Until the diagnosis is
determined, strategies for intervention are not discussed. The M-CHAT is a screening tool
and is not diagnostic.
Question 2
The mother of a newborn tells the primary care pediatric nurse practitioner that she is
worried that her child will develop allergies and asthma. Which tool will the nurse
practitioner use to evaluate this risk?
Three-generation pedigree
Review of systems
Genogram
1
@THE STUDY VAULT
,Ecomap
CORRECT ANSWER
ANS: A
The three-generation pedigree is used to map out risks for genetic diseases in families, as
well as conditions with modifiable risk factors. The review of systems is used to evaluate
the history of the child's body systems. The genogram is an approach to developing a
family database to provide a graphic representation of family structure, roles, and
problems of recurring significance in a family. The ecomap is used to identify
relationships in the family and community that are supportive or harmful.
Question 3
The primary care pediatric nurse practitioner is performing a well child check-up on a 20-
month-old child. The child was 4 weeks premature and, according to a parent-completed
developmental questionnaire, has achieved milestones for a 15-month-old infant. Which
action is correct?
Perform an in-depth developmental assessment screen at this visit to evaluate this child.
Reassure the parent that the child will catch up to normal development by age 2 years.
Re-evaluate this child's development and milestone achievements at the 2-year visit.
Refer the child to a specialty clinic for evaluation and treatment of developmental delay.
CORRECT ANSWER
ANS: A
This child should be at a 19-month adjusted age for prematurity so, according to the
parent screen, is 4 months behind. The PNP should perform a more in-depth screen to
evaluate this delay. Waiting to see if the child will "catch up" or assuring the parent that
this will happen will cause the delays to become more severe. A referral to a specialty
clinic should not be made solely on the basis of the parent-completed questionnaire but
only after further evaluation of possible delays.
Question 4
2
@THE STUDY VAULT
,When formulating developmental diagnoses for pediatric patients, the primary care
pediatric nurse practitioner may use which resource?
DC: 0-3R
ICD-10-CM
ICSD-3
NANDA International
CORRECT ANSWER
ANS: A
The DC: 0-3R refers to the Diagnostic Classification of Mental Health and Developmental
Disorders of Infancy and Early Childhood and is useful for developmental problem
diagnosis. The ICD-10-CM is the International Classification of Diseases-Tenth Revision,
Clinical Modification and is useful for identifying physiologic diseases. The ICSD-3 is the
International Classification of Sleep Disorders - 3rd edition. NANDA International is used
to label problems in the functional health domain.
Question 5
The primary care pediatric nurse practitioner is evaluating health literacy in the mother of
a new preschool-age child. How will the nurse practitioner assess this?
Ask the child how many books he has at home.
Ask the mother about her highest grade in school.
Ask the mother to determine the correct dose of a drug from a label.
Ask the mother to read a health information handout aloud.
CORRECT ANSWER
ANS: A
The "newest vital sign," or health literacy, can be determined quickly by asking the
parent how many children's books are in the home. Greater than 10 books in the home is
an independent positive predictor of adequate parent health literacy. The other
questions may determine a specific level of literacy in general but are not as efficient.
3
@THE STUDY VAULT
, Question 6
The primary care pediatric nurse practitioner learns that the mother of a 3-year-old child
has been treated for depression for over 5 years. Which aspect of this child's development
will be of the most concern to the nurse practitioner?
Fine motor
Gross motor
Social/emotional
Speech and language
CORRECT ANSWER
ANS: D
Maternal depression in the first year of life has been associated with poorer language
development at 3 years of age.
Question 7
The primary care pediatric nurse practitioner sees a 3-year-old child who chronically
withholds stools, in spite of the parents' attempts to stop the behavior, requiring frequent
treatments with laxative medications. Which diagnosis will the nurse practitioner use to
facilitate third-party reimbursement?
Altered elimination pattern
Elimination disorder
Encopresis
Parenting alteration
CORRECT ANSWER
ANS: C
Encopresis is a medical diagnosis, classified in the ICD-10-CM, and is recognized for
reimbursement purposes. "Altered elimination pattern" and "Parenting alteration" are
NANDA International diagnoses and are not recognized for reimbursement. "Elimination
disorder" is a developmental diagnosis.
4
@THE STUDY VAULT
