2025-2026 NEWEST NR 602 ACTUAL FINAL EXAM WITH
COMPLETE QUESTIONS AND ANSWERS
Step 1 Asthma approach-Intermi ent - correct answers symptoms 2x or less per week
asymptoma c and normal PED
requires SABA 2 days/week
no interference with normal ac vi es
brief exacerba ons
nigh me symptoms 2x or less a month
lung fx- FEV>80% predicted
Step 2 Asthma Approach-Mild persistent - correct answers Symptoms >2 x a week, less than
once per day
requires SABA more than 2days/week, no more than once a day
exacerba ons may affect ac vity
nigh me symptoms 3-4x a month
FEV> 80% predicted
Step 3 Asthma Approach-Moderate Persistant - correct answers daily symptoms
daily use of SABA
some limita ons
2x or more per week exacerba ons
,nigh me symptoms more than 1x per week, not nightly
FEV >60% but <80%
Step 4 Asthma Approach-Severe Persistent - correct answers con nual symptoms
requires SABA mul ple x a day
extremely limited ac vity
nigh me symptoms 7x a week
FEV <60%
Tx of asthma - correct answers 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 + cor costeroid
Step 6 Asthma Approach - correct answers
Bulbar/palpebral conjunc val infec on - correct answers May be unilateral or bilateral
Leukocoria - correct answers abnormal appearance of a white film in the pupil; immediate
referral to pediatric ophthalmologist warranted
Causes: re nal detachment, cataract, re nal dysplasia, newborn re noblastoma
Visual screening in children - correct answers At least once between ages 3-5 y/o according to
USPSTF
, AOM - correct answers RF: gene cs, males, Na ve American, siblings, low economic status,
ages 6mo-3y, winter, supine bo le feeding, daycare, tobacco smoke
S/S of AOM - correct answers erythema, otalgia, bulging TM, absent cone of light
Dx of AOM - correct answers Audiometry, tympanometry, possible lateral neck xray to r/o mass
TX of AOM - correct answers uncomplicated: suppor ve with tylenol/ibuprofen; watchful
wai ng 48-72 in 6m-2y/o; <5 benzocaine o c drops
1st line antx: amoxicillin 80-90mg/kg/day Q12 x 10days
if allergy to PCN- augmen n, cefuroxime
Bacterial rhinosinusi s - correct answers Preceded by URI-typically worsens a er 5-7 days- not
resolved in 2 weeks
Sx of bacterial rhinosinusi s - correct answers Purulant nasal conges on, drainage, facial pain,
headache, fever
No imaging required- if no improvement refer to ENT
Bronchioli s - correct answers Usually caused by RSV
wheezing present
<2 y/o
other causes; influenza, adenovirus, rhinovirus
S/s of bronchioli s - correct answers Increased work of breathing, prolonged expira on,
grun ng, retrac ons, nasal flaring
COMPLETE QUESTIONS AND ANSWERS
Step 1 Asthma approach-Intermi ent - correct answers symptoms 2x or less per week
asymptoma c and normal PED
requires SABA 2 days/week
no interference with normal ac vi es
brief exacerba ons
nigh me symptoms 2x or less a month
lung fx- FEV>80% predicted
Step 2 Asthma Approach-Mild persistent - correct answers Symptoms >2 x a week, less than
once per day
requires SABA more than 2days/week, no more than once a day
exacerba ons may affect ac vity
nigh me symptoms 3-4x a month
FEV> 80% predicted
Step 3 Asthma Approach-Moderate Persistant - correct answers daily symptoms
daily use of SABA
some limita ons
2x or more per week exacerba ons
,nigh me symptoms more than 1x per week, not nightly
FEV >60% but <80%
Step 4 Asthma Approach-Severe Persistent - correct answers con nual symptoms
requires SABA mul ple x a day
extremely limited ac vity
nigh me symptoms 7x a week
FEV <60%
Tx of asthma - correct answers 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 + cor costeroid
Step 6 Asthma Approach - correct answers
Bulbar/palpebral conjunc val infec on - correct answers May be unilateral or bilateral
Leukocoria - correct answers abnormal appearance of a white film in the pupil; immediate
referral to pediatric ophthalmologist warranted
Causes: re nal detachment, cataract, re nal dysplasia, newborn re noblastoma
Visual screening in children - correct answers At least once between ages 3-5 y/o according to
USPSTF
, AOM - correct answers RF: gene cs, males, Na ve American, siblings, low economic status,
ages 6mo-3y, winter, supine bo le feeding, daycare, tobacco smoke
S/S of AOM - correct answers erythema, otalgia, bulging TM, absent cone of light
Dx of AOM - correct answers Audiometry, tympanometry, possible lateral neck xray to r/o mass
TX of AOM - correct answers uncomplicated: suppor ve with tylenol/ibuprofen; watchful
wai ng 48-72 in 6m-2y/o; <5 benzocaine o c drops
1st line antx: amoxicillin 80-90mg/kg/day Q12 x 10days
if allergy to PCN- augmen n, cefuroxime
Bacterial rhinosinusi s - correct answers Preceded by URI-typically worsens a er 5-7 days- not
resolved in 2 weeks
Sx of bacterial rhinosinusi s - correct answers Purulant nasal conges on, drainage, facial pain,
headache, fever
No imaging required- if no improvement refer to ENT
Bronchioli s - correct answers Usually caused by RSV
wheezing present
<2 y/o
other causes; influenza, adenovirus, rhinovirus
S/s of bronchioli s - correct answers Increased work of breathing, prolonged expira on,
grun ng, retrac ons, nasal flaring
