NR 602 Final Exam Review Guide Recently
Updated 250 Test Questions and Correct
Answers/ NR602/ NR 602 Final exam 2025-2026/
NR 602 Primary Care of the Childbearing
A child is in the clinic after swallowing a metal bead. A radiograph of the GI tract
shows a 6 mm cylindrical object in the child's stomach. The child is able to
swallow without difficulty and is not experiencing pain. What is the correct course
of treatment?
Have the parents watch for the object in the child's stool.
A 10 year old child has had abdominal pain for 2 days, which began in the
periumbilical area and then localized to the right lower quadrant. The child
vomited once today and then experienced relief from pain followed by an
increased fever. What is the likely diagnosis
Appendicitis with perforation
During a well child examination of a 2 year old child, the primary care pediatric
nurse practitioner palpates a unilateral, smooth, firm abdominal mass which does
not cross the midline. What is the next course of action that?
Refer the child to an oncologist immediately.
A 6 month old infant has a retractile testis that was noted at the 2month well baby
exam. What will the primary care pediatric nurse practitioner do to manage this
condition?
Refer the infant to a pediatric urologist or surgeon for possible orchiopexy.
A 9 month old infant is brought to the clinic with scrotal swelling and fussiness.
The primary care pediatric nurse practitioner notes a tender mass in the affected
scrotum that is difficult to reduce. What is the correct action
Refer immediately to a pediatric surgeon.
The mother of a 12 month old uncircumcised male infant reports that the child
seems to have pain associated with voiding. A physical examination reveals a tight,
pg. 1
,pinpoint opening of the foreskin, which thickened and inflamed. What will the
primary care pediatric nurse practitioner do?
Refer the child to a pediatric urologist.
An adolescent male comes to the clinic reporting unilateral scrotal pain, nausea,
and vomiting that began that morning. The primary care pediatric nurse
practitioner palpates a painful, swollen testis and elicits increased pain with slight
elevation of the testis (a negative Phren's sign). What will the nurse practitioner
do?
Refer the adolescent immediately to a pediatric urologist or surgeon. Correct
The primary care pediatric nurse practitioner evaluates children's growth to screen
for endocrine and metabolic disorders. Which is a critical component of this
screening?
Obtaining serial measurements to assess patterns over time
The primary care pediatric nurse practitioner is performing a well child
examination on a 5yearold girl. The parents ask if the childs adult height can be
predicted. The nurse practitioner learns that the mother is 5'8" tall and the father is
5'11" tall. The nurse practitioner will estimate which expected adult height for this
child?
5'7" tall
The primary care pediatric nurse practitioner is performing a well child
examination on a 2yearoldchild with a history of intrauterine growth retardation
(IUGR) whose height remains less than the 3rd percentile on a WHO growth chart.
What will the nurse practitioner do?
Refer the child to a pediatric endocrinologist.
The primary care pediatric nurse practitioner is evaluating a child who has short
stature. Although bone age studies reveal a delay in bone age, the child's growth is
consistent with bone age. Which diagnosis is most likely?
Constitutional growth delay
The mother of a female infant is concerned that her daughter is developing breasts.
The primary care pediatric nurse practitioner notes mild breast development but no
pubic or axillary hair. What is the likely diagnosis?
pg. 2
,Premature thelarche which will resolve over time
A 7 year old female has recently developed pubic and axillary hair without breast
development. Her bone age is consistent with her chronological age, and a
pediatric endocrinologist has diagnosed idiopathic premature adrenarche. The
primary care pediatric nurse practitioner will monitor this child for which
condition?
Polycystic ovary syndrome
A 6 year old female has had a recent growth spurt and an exam reveals breast and
pubic hair development. Her bone age is determined to be 8 years. What will the
primary care pediatric nurse practitioner do next?
Refer the child to a pediatric endocrinologist for management.
An infant has congenital adrenal hyperplasia. At a routine well baby checkup, the
primary care pediatric nurse practitioner notes vomiting, poor feeding, lethargy,
and dehydration. Which action is correct?
Refer the infant to the emergency department for fluids, dextrose, and steroids.
The primary care pediatric nurse practitioner performs a physical examination on a
9 month old infant with congenital hypothyroidism who takes daily levothyroxine
sodium and notes a recent slowing of the infant's growth rate. What will the nurse
practitioner order?
Free serum T4 and TSH levels
A 12 year old child has a recent history of increased thirst and frequent urination.
The child's weight has been in the 95th percentile for several years. A dipstick UA
is positive for glucose, and random plasma glucose is 350 mg/dL. Which test will
the primary care pediatric nurse practitioner order to determine the type of diabetes
in this child
Pancreatic antibodies
The primary care pediatric nurse practitioner diagnoses an 8 year old child with
type 1 diabetes after a routine urine screen is positive for glucose and negative for
ketones and plasma glucose is 350 mg/dL. The child's weight is normal and the
parents report a mild increase in thirst and urine output in the past few days. Which
course of action is correct?
pg. 3
, Begin insulin and refer the child to a children's diabetes center.
The primary care pediatric nurse practitioner is reviewing lab work and diabetes
management with a school-age child whose HbA1C is 7.6% who reports usual
blood sugars before meals as being 80 to 90 mg/dL. The nurse practitioner will
consult with the child's endocrinologist to consider which therapy?
Continuous glucose monitoring
The primary care pediatric nurse practitioner is performing a well child
examination on a 12 year old child who was diagnosed with type 1 diabetes at age
9. The child had a lipid screen at age 10 with an LDL cholesterol <100 mg/dL.
What will the nurse practitioner recommend as part of ongoing management for
this child?
Comprehensive ophthalmologic exam
The parent of an infant asks about using a probiotic medication. What will the
primary care pediatric nurse practitioner tell this parent?
There is no conclusive evidence about using probiotics to treat colic.
A toddler who was born prematurely refuses most solid foods and has poor weight
gain. A barium swallow study reveals a normal esophagus. What will the primary
care pediatric nurse practitioner consider next to manage this child's nutritional
needs?
Video fluoroscopy swallowing
A toddler is seen in the clinic after a 2 day history of intermittent vomiting and
diarrhea. An assessment reveals an irritable child with dry mucous membranes, 3
second capillary refill, 2 second recoil of skin, mild tachycardia and tachypnea, and
cool hands and feet. The child has had two wet diapers in the past 24 hours. What
will the primary care pediatric nurse practitioner recommend?
Oral rehydration solution with follow-up in 24
A 9 year old girl has a history of frequent vomiting and her mother has frequent
migraine headaches. The child has recently begun having more frequent and
prolonged episodes accompanied by headaches. An exam reveals abnormal eye
movements and mild ataxia. What is the correct action?
Refer to a pediatric gastroenterologist for further workup
pg. 4
Updated 250 Test Questions and Correct
Answers/ NR602/ NR 602 Final exam 2025-2026/
NR 602 Primary Care of the Childbearing
A child is in the clinic after swallowing a metal bead. A radiograph of the GI tract
shows a 6 mm cylindrical object in the child's stomach. The child is able to
swallow without difficulty and is not experiencing pain. What is the correct course
of treatment?
Have the parents watch for the object in the child's stool.
A 10 year old child has had abdominal pain for 2 days, which began in the
periumbilical area and then localized to the right lower quadrant. The child
vomited once today and then experienced relief from pain followed by an
increased fever. What is the likely diagnosis
Appendicitis with perforation
During a well child examination of a 2 year old child, the primary care pediatric
nurse practitioner palpates a unilateral, smooth, firm abdominal mass which does
not cross the midline. What is the next course of action that?
Refer the child to an oncologist immediately.
A 6 month old infant has a retractile testis that was noted at the 2month well baby
exam. What will the primary care pediatric nurse practitioner do to manage this
condition?
Refer the infant to a pediatric urologist or surgeon for possible orchiopexy.
A 9 month old infant is brought to the clinic with scrotal swelling and fussiness.
The primary care pediatric nurse practitioner notes a tender mass in the affected
scrotum that is difficult to reduce. What is the correct action
Refer immediately to a pediatric surgeon.
The mother of a 12 month old uncircumcised male infant reports that the child
seems to have pain associated with voiding. A physical examination reveals a tight,
pg. 1
,pinpoint opening of the foreskin, which thickened and inflamed. What will the
primary care pediatric nurse practitioner do?
Refer the child to a pediatric urologist.
An adolescent male comes to the clinic reporting unilateral scrotal pain, nausea,
and vomiting that began that morning. The primary care pediatric nurse
practitioner palpates a painful, swollen testis and elicits increased pain with slight
elevation of the testis (a negative Phren's sign). What will the nurse practitioner
do?
Refer the adolescent immediately to a pediatric urologist or surgeon. Correct
The primary care pediatric nurse practitioner evaluates children's growth to screen
for endocrine and metabolic disorders. Which is a critical component of this
screening?
Obtaining serial measurements to assess patterns over time
The primary care pediatric nurse practitioner is performing a well child
examination on a 5yearold girl. The parents ask if the childs adult height can be
predicted. The nurse practitioner learns that the mother is 5'8" tall and the father is
5'11" tall. The nurse practitioner will estimate which expected adult height for this
child?
5'7" tall
The primary care pediatric nurse practitioner is performing a well child
examination on a 2yearoldchild with a history of intrauterine growth retardation
(IUGR) whose height remains less than the 3rd percentile on a WHO growth chart.
What will the nurse practitioner do?
Refer the child to a pediatric endocrinologist.
The primary care pediatric nurse practitioner is evaluating a child who has short
stature. Although bone age studies reveal a delay in bone age, the child's growth is
consistent with bone age. Which diagnosis is most likely?
Constitutional growth delay
The mother of a female infant is concerned that her daughter is developing breasts.
The primary care pediatric nurse practitioner notes mild breast development but no
pubic or axillary hair. What is the likely diagnosis?
pg. 2
,Premature thelarche which will resolve over time
A 7 year old female has recently developed pubic and axillary hair without breast
development. Her bone age is consistent with her chronological age, and a
pediatric endocrinologist has diagnosed idiopathic premature adrenarche. The
primary care pediatric nurse practitioner will monitor this child for which
condition?
Polycystic ovary syndrome
A 6 year old female has had a recent growth spurt and an exam reveals breast and
pubic hair development. Her bone age is determined to be 8 years. What will the
primary care pediatric nurse practitioner do next?
Refer the child to a pediatric endocrinologist for management.
An infant has congenital adrenal hyperplasia. At a routine well baby checkup, the
primary care pediatric nurse practitioner notes vomiting, poor feeding, lethargy,
and dehydration. Which action is correct?
Refer the infant to the emergency department for fluids, dextrose, and steroids.
The primary care pediatric nurse practitioner performs a physical examination on a
9 month old infant with congenital hypothyroidism who takes daily levothyroxine
sodium and notes a recent slowing of the infant's growth rate. What will the nurse
practitioner order?
Free serum T4 and TSH levels
A 12 year old child has a recent history of increased thirst and frequent urination.
The child's weight has been in the 95th percentile for several years. A dipstick UA
is positive for glucose, and random plasma glucose is 350 mg/dL. Which test will
the primary care pediatric nurse practitioner order to determine the type of diabetes
in this child
Pancreatic antibodies
The primary care pediatric nurse practitioner diagnoses an 8 year old child with
type 1 diabetes after a routine urine screen is positive for glucose and negative for
ketones and plasma glucose is 350 mg/dL. The child's weight is normal and the
parents report a mild increase in thirst and urine output in the past few days. Which
course of action is correct?
pg. 3
, Begin insulin and refer the child to a children's diabetes center.
The primary care pediatric nurse practitioner is reviewing lab work and diabetes
management with a school-age child whose HbA1C is 7.6% who reports usual
blood sugars before meals as being 80 to 90 mg/dL. The nurse practitioner will
consult with the child's endocrinologist to consider which therapy?
Continuous glucose monitoring
The primary care pediatric nurse practitioner is performing a well child
examination on a 12 year old child who was diagnosed with type 1 diabetes at age
9. The child had a lipid screen at age 10 with an LDL cholesterol <100 mg/dL.
What will the nurse practitioner recommend as part of ongoing management for
this child?
Comprehensive ophthalmologic exam
The parent of an infant asks about using a probiotic medication. What will the
primary care pediatric nurse practitioner tell this parent?
There is no conclusive evidence about using probiotics to treat colic.
A toddler who was born prematurely refuses most solid foods and has poor weight
gain. A barium swallow study reveals a normal esophagus. What will the primary
care pediatric nurse practitioner consider next to manage this child's nutritional
needs?
Video fluoroscopy swallowing
A toddler is seen in the clinic after a 2 day history of intermittent vomiting and
diarrhea. An assessment reveals an irritable child with dry mucous membranes, 3
second capillary refill, 2 second recoil of skin, mild tachycardia and tachypnea, and
cool hands and feet. The child has had two wet diapers in the past 24 hours. What
will the primary care pediatric nurse practitioner recommend?
Oral rehydration solution with follow-up in 24
A 9 year old girl has a history of frequent vomiting and her mother has frequent
migraine headaches. The child has recently begun having more frequent and
prolonged episodes accompanied by headaches. An exam reveals abnormal eye
movements and mild ataxia. What is the correct action?
Refer to a pediatric gastroenterologist for further workup
pg. 4
