NR 602 Final exam
NR 602 Final Exam Questions and
Answers Top Rated 2025
Step 1 Asthma approach-Intermittent - Correct Ans-symptoms 2x or less per week
asymptomatic and normal PED
requires SABA 2 days/week
no interference with normal activities
brief exacerbations
nighttime symptoms 2x or less a month
lung fx- FEV>80% predicted
Step 2 Asthma Approach-Mild persistent - Correct Ans-Symptoms >2 x a week, less
than once per day
requires SABA more than 2days/week, no more than once a day
exacerbations may affect activity
nighttime symptoms 3-4x a month
FEV> 80% predicted
Step 3 Asthma Approach-Moderate Persistant - Correct Ans-daily symptoms
daily use of SABA
some limitations
2x or more per week exacerbations
nighttime symptoms more than 1x per week, not nightly
FEV >60% but <80%
Step 4 Asthma Approach-Severe Persistent - Correct Ans-continual symptoms
requires SABA multiple x a day
extremely limited activity
nighttime symptoms 7x a week
FEV <60%
Tx of asthma - Correct Ans-Stepwise approach
step 1: SABA PRN
step 2: low dose ICS
Step 3: low dose ICS+ LABA or medium dose ICS
step 4: Medium dose ICS+LABA
Step 5: high dose ICS+ LABA
Step 6: High dose ICS+LABA + corticosteroid
Step 6 Asthma Approach - Correct Ans-
Bulbar/palpebral conjunctival infection - Correct Ans-May be unilateral or bilateral
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,NR 602 Final exam
Leukocoria - Correct Ans-abnormal appearance of a white film in the pupil; immediate
referral to pediatric ophthalmologist warranted
Causes: retinal detachment, cataract, retinal dysplasia, newborn retinoblastoma
Visual screening in children - Correct Ans-At least once between ages 3-5 y/o according
to USPSTF
AOM - Correct Ans-RF: genetics, males, Native American, siblings, low economic
status, ages 6mo-3y, winter, supine bottle feeding, daycare, tobacco smoke
S/S of AOM - Correct Ans-erythema, otalgia, bulging TM, absent cone of light
Dx of AOM - Correct Ans-Audiometry, tympanometry, possible lateral neck xray to r/o
mass
TX of AOM - Correct Ans-uncomplicated: supportive with tylenol/ibuprofen; watchful
waiting 48-72 in 6m-2y/o; <5 benzocaine otic drops
1st line antx: amoxicillin 80-90mg/kg/day Q12 x 10days
if allergy to PCN- augmentin, cefuroxime
Bacterial rhinosinusitis - Correct Ans-Preceded by URI-typically worsens after 5-7 days-
not resolved in 2 weeks
Sx of bacterial rhinosinusitis - Correct Ans-Purulant nasal congestion, drainage, facial
pain, headache, fever
No imaging required- if no improvement refer to ENT
Bronchiolitis - Correct Ans-Usually caused by RSV
wheezing present
<2 y/o
other causes; influenza, adenovirus, rhinovirus
S/s of bronchiolitis - Correct Ans-Increased work of breathing, prolonged expiration,
grunting, retractions, nasal flaring
Croup sx - Correct Ans-Low grade fever, URI symptoms, barking cough, inspiratory
stridor can occur
Croup dx - Correct Ans-Made from symptoms
Croup tx - Correct Ans-Glucocorticoids possibly
0.6mg/kg-1mg/kg
humidified air
bronchodilators
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, NR 602 Final exam
Lead poisoning - Correct Ans-Inactivated heme synthesis by inhibiting insertion of iron-
leads to microcytic hypochromic anemia
Source of lead poisoning - Correct Ans-Lead based pain
Those at risk for lead poisoning - Correct Ans-Children 2-3 y/o
summer months
Lead poisoning testing - Correct Ans-Children with Medicaid need lead level @ 12
months and 24 months-capillary finger stick with venous sample as f/u
AAP recommends 6-9-12-18-24 mo as well as 3-4-5-6 y/o
Lead levels - Correct Ans-<5 is normal
>69 requires chelation
Genu varum - Correct Ans-Bow legged as a result of uterine position- normal finding up
to 3y/o
Legg-Calve-Perthes Disease - Correct Ans-Avascular necrosis of femoral head-
epiphyses associated with trauma, synovitis
Legg-Calve-Perthes Disease RF - Correct Ans-Associated with low birth weight,
socioeconomic status, or white race
Legg-Calve-Perthes Disease s/s - Correct Ans-Onset of painful limp of thigh, knee, or
hip worse with activity, not relieved by rest
restricted by abduction and rotation of affected hip
Legg-Calve-Perthes Disease Tx - Correct Ans-Abduction brace or long leg cast
Congenital Hip Dysplasia s/s - Correct Ans-Thick fold asymmetry, leg length inequality,
walking children- painless limp
Congenital Hip Dysplasia Dx & Tx - Correct Ans-Positive Barlow maneuver, ortolani or
Allis sign
US for <4 months, X-ray AP of pelvis >4 months
Tx: refer to orthopedist, pavlik harness, child should be seen weekly to prevent skin
breakdown, necrosis
Toxic trait synovitis - Correct Ans-Unilateral inflammation arthritis; acute onset;
decreased ROM extension and internal rotation; painful hip, crying at night; common in
boy 3-6 y/o
Toxic trait synovitis Dx and Tx - Correct Ans-Dx: WBC with leukocytosis, increased
ESR, hip xray normal
To: BR, NSAIDs, non WB
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NR 602 Final Exam Questions and
Answers Top Rated 2025
Step 1 Asthma approach-Intermittent - Correct Ans-symptoms 2x or less per week
asymptomatic and normal PED
requires SABA 2 days/week
no interference with normal activities
brief exacerbations
nighttime symptoms 2x or less a month
lung fx- FEV>80% predicted
Step 2 Asthma Approach-Mild persistent - Correct Ans-Symptoms >2 x a week, less
than once per day
requires SABA more than 2days/week, no more than once a day
exacerbations may affect activity
nighttime symptoms 3-4x a month
FEV> 80% predicted
Step 3 Asthma Approach-Moderate Persistant - Correct Ans-daily symptoms
daily use of SABA
some limitations
2x or more per week exacerbations
nighttime symptoms more than 1x per week, not nightly
FEV >60% but <80%
Step 4 Asthma Approach-Severe Persistent - Correct Ans-continual symptoms
requires SABA multiple x a day
extremely limited activity
nighttime symptoms 7x a week
FEV <60%
Tx of asthma - Correct Ans-Stepwise approach
step 1: SABA PRN
step 2: low dose ICS
Step 3: low dose ICS+ LABA or medium dose ICS
step 4: Medium dose ICS+LABA
Step 5: high dose ICS+ LABA
Step 6: High dose ICS+LABA + corticosteroid
Step 6 Asthma Approach - Correct Ans-
Bulbar/palpebral conjunctival infection - Correct Ans-May be unilateral or bilateral
1|Page
,NR 602 Final exam
Leukocoria - Correct Ans-abnormal appearance of a white film in the pupil; immediate
referral to pediatric ophthalmologist warranted
Causes: retinal detachment, cataract, retinal dysplasia, newborn retinoblastoma
Visual screening in children - Correct Ans-At least once between ages 3-5 y/o according
to USPSTF
AOM - Correct Ans-RF: genetics, males, Native American, siblings, low economic
status, ages 6mo-3y, winter, supine bottle feeding, daycare, tobacco smoke
S/S of AOM - Correct Ans-erythema, otalgia, bulging TM, absent cone of light
Dx of AOM - Correct Ans-Audiometry, tympanometry, possible lateral neck xray to r/o
mass
TX of AOM - Correct Ans-uncomplicated: supportive with tylenol/ibuprofen; watchful
waiting 48-72 in 6m-2y/o; <5 benzocaine otic drops
1st line antx: amoxicillin 80-90mg/kg/day Q12 x 10days
if allergy to PCN- augmentin, cefuroxime
Bacterial rhinosinusitis - Correct Ans-Preceded by URI-typically worsens after 5-7 days-
not resolved in 2 weeks
Sx of bacterial rhinosinusitis - Correct Ans-Purulant nasal congestion, drainage, facial
pain, headache, fever
No imaging required- if no improvement refer to ENT
Bronchiolitis - Correct Ans-Usually caused by RSV
wheezing present
<2 y/o
other causes; influenza, adenovirus, rhinovirus
S/s of bronchiolitis - Correct Ans-Increased work of breathing, prolonged expiration,
grunting, retractions, nasal flaring
Croup sx - Correct Ans-Low grade fever, URI symptoms, barking cough, inspiratory
stridor can occur
Croup dx - Correct Ans-Made from symptoms
Croup tx - Correct Ans-Glucocorticoids possibly
0.6mg/kg-1mg/kg
humidified air
bronchodilators
2|Page
, NR 602 Final exam
Lead poisoning - Correct Ans-Inactivated heme synthesis by inhibiting insertion of iron-
leads to microcytic hypochromic anemia
Source of lead poisoning - Correct Ans-Lead based pain
Those at risk for lead poisoning - Correct Ans-Children 2-3 y/o
summer months
Lead poisoning testing - Correct Ans-Children with Medicaid need lead level @ 12
months and 24 months-capillary finger stick with venous sample as f/u
AAP recommends 6-9-12-18-24 mo as well as 3-4-5-6 y/o
Lead levels - Correct Ans-<5 is normal
>69 requires chelation
Genu varum - Correct Ans-Bow legged as a result of uterine position- normal finding up
to 3y/o
Legg-Calve-Perthes Disease - Correct Ans-Avascular necrosis of femoral head-
epiphyses associated with trauma, synovitis
Legg-Calve-Perthes Disease RF - Correct Ans-Associated with low birth weight,
socioeconomic status, or white race
Legg-Calve-Perthes Disease s/s - Correct Ans-Onset of painful limp of thigh, knee, or
hip worse with activity, not relieved by rest
restricted by abduction and rotation of affected hip
Legg-Calve-Perthes Disease Tx - Correct Ans-Abduction brace or long leg cast
Congenital Hip Dysplasia s/s - Correct Ans-Thick fold asymmetry, leg length inequality,
walking children- painless limp
Congenital Hip Dysplasia Dx & Tx - Correct Ans-Positive Barlow maneuver, ortolani or
Allis sign
US for <4 months, X-ray AP of pelvis >4 months
Tx: refer to orthopedist, pavlik harness, child should be seen weekly to prevent skin
breakdown, necrosis
Toxic trait synovitis - Correct Ans-Unilateral inflammation arthritis; acute onset;
decreased ROM extension and internal rotation; painful hip, crying at night; common in
boy 3-6 y/o
Toxic trait synovitis Dx and Tx - Correct Ans-Dx: WBC with leukocytosis, increased
ESR, hip xray normal
To: BR, NSAIDs, non WB
3|Page
