NU 664 ACTUAL 2026 STUDY GUIDE QUESTIONS AND
SOLUTIONS RATED A+
✔✔A 12 y.o. female presents to the clinic after being bit by a dog on the face. Abrasion
with 2 puncture wounds on the upper right cheek, approximately 1 inch below the eye.
The area is slightly erythematous, with a small amount of bruising and raised area along
the cheekbone. - ✔✔Using normal saline, irrigate the wounds using high pressure
(greater than 4 pounds per square inch) and high volume (greater than 1 L). Isolated
puncture wounds should not be irrigated, instead soak the wound in a diluted solution of
tap water and povidone-iodine for 15 .minutes • Prescribe a 3- to 5-day course of
prophylactic antibiotics
✔✔A 4 yo child has clusters of small, clear, tense vesicles with an erythematous base
on one side of the mouth along the vermillion border, which are causing discomfort and
difficulty eating. What will the PNP recommend as treatment? - ✔✔Topical
diphenhydramine and magnesium hydroxide.
✔✔A 4 year old child with PE tubes in both ears has otalgia in one ear. The PNP is able
to visualize the tube and does not see exudate in the ear canal and obtains a type A
tympanogram. What will the NP do? - ✔✔Order ototopical corticosteroid/antibiotic
drops.
✔✔The parent of a 1-week old is concerned about the unusual shape of their child's
head. In the physical exam, which of the following signs would not support the diagnosis
of craniosynostosis? - ✔✔A palpable lesion at the occipital region.
✔✔A toddler exhibits exotropia of the right eye during a cover-uncover screen. The PNP
will refer to pediatric ophthalmologist to initiate which treatment? - ✔✔Patching the
unaffected eye for 2 hrs./day
✔✔The most typical radiograph finding with a diagnosis of asthma - ✔✔Hyperinflation
✔✔Nasal mucosa pale, boggy and edematous with allergic shiners - ✔✔Allergic rhinitis
✔✔The category on your asthma action plan when you have had exposure to a known
trigger, are coughing with wheezing, have a tight chest and are coughing at night. -
✔✔Yellow or cautious phase
✔✔Classification of asthma severity for a child who is 6 years old who has symptoms 3
days a week, uses his inhaler daily for exercise, but not otherwise, has minor limitation
to activity and wakes 3 times a month with cough - ✔✔mild persistent asthma
✔✔Should not be used to treat asthma in children under the age of 4? - ✔✔dry powder
inhalers
, ✔✔In addition to the routine PCV 13 vaccine series, sickle cell anemia patients older
than 2 years of age should receive this once and then a booster in 5 years. -
✔✔PPSV23
✔✔cradle cap or seborrheic dermatitis - ✔✔Often treated with Selsun blue shampoo.
✔✔Bilateral conjunctival injection, 5 days of fever, cervical lymphadenopathy,
polymorphous exanthema, changes in peripheral extremities - ✔✔Kawasaki Disease
✔✔First line treatment for allergic rhinitis - ✔✔Oral H1 antihistamines and/or intranasal
steroids
✔✔Treatment for 3 year old with intermittent asthma - ✔✔SABA prn (Albuterol and
levalbuterol)
✔✔Treatment for Kawasaki - ✔✔IVIG and High dose aspirin
✔✔A 9-year-old boy presents with a fever of 102 and leg pains. Mother reports he had
an upper respiratory infection with a sore throat approximately 2 weeks ago which
subsided without therapy. On physical exam, he has tender, swollen knees bilaterally.
His heart rate is 120 beats per minute and a blowing systolic murmur is heard at the
apex. No murmur previously noted. The most likely diagnosis is. - ✔✔Rheumatic Fever
✔✔labs for rheumatic fever - ✔✔ASO Titer
✔✔A 2 week old infant with complaint of rash near left upper eyelid several vesicular
lesions on his left upper eyelid. What would you discuss with the mother as the PNP? -
✔✔It is important that you go to the children's hospital emergency department now
because your child needs an immediate referral to a pediatric ophthalmologist.
✔✔A 3 year old w/ hx of blepharitis and his mother asks whether there is anything she
can do to prevent this from occurring again. What would you suggest as the PNP? -
✔✔Good handwashing and daily eye lid and lash scrub with diluted baby shampoo
should prevent this from reoccurring.
✔✔A 5 year old feeling like something might be in his eye. No visual changes had
occurred, normal EOM, no known injury. You decide to complete fluorescein staining to
the affected eye because you suspect - ✔✔Corneal abrasion
✔✔A 4-month-old w/1-week hx of nasal congestion and occasional cough. Prior
evening Temp 102F refused to breastfeed and had coughing and noisy labored
breathing. On exam ill-appearing infant who is lethargic w/ tachypnea, wheezing, and
intercostal retractions. Does not attend daycare but has a 3-year-old sibling who is in
SOLUTIONS RATED A+
✔✔A 12 y.o. female presents to the clinic after being bit by a dog on the face. Abrasion
with 2 puncture wounds on the upper right cheek, approximately 1 inch below the eye.
The area is slightly erythematous, with a small amount of bruising and raised area along
the cheekbone. - ✔✔Using normal saline, irrigate the wounds using high pressure
(greater than 4 pounds per square inch) and high volume (greater than 1 L). Isolated
puncture wounds should not be irrigated, instead soak the wound in a diluted solution of
tap water and povidone-iodine for 15 .minutes • Prescribe a 3- to 5-day course of
prophylactic antibiotics
✔✔A 4 yo child has clusters of small, clear, tense vesicles with an erythematous base
on one side of the mouth along the vermillion border, which are causing discomfort and
difficulty eating. What will the PNP recommend as treatment? - ✔✔Topical
diphenhydramine and magnesium hydroxide.
✔✔A 4 year old child with PE tubes in both ears has otalgia in one ear. The PNP is able
to visualize the tube and does not see exudate in the ear canal and obtains a type A
tympanogram. What will the NP do? - ✔✔Order ototopical corticosteroid/antibiotic
drops.
✔✔The parent of a 1-week old is concerned about the unusual shape of their child's
head. In the physical exam, which of the following signs would not support the diagnosis
of craniosynostosis? - ✔✔A palpable lesion at the occipital region.
✔✔A toddler exhibits exotropia of the right eye during a cover-uncover screen. The PNP
will refer to pediatric ophthalmologist to initiate which treatment? - ✔✔Patching the
unaffected eye for 2 hrs./day
✔✔The most typical radiograph finding with a diagnosis of asthma - ✔✔Hyperinflation
✔✔Nasal mucosa pale, boggy and edematous with allergic shiners - ✔✔Allergic rhinitis
✔✔The category on your asthma action plan when you have had exposure to a known
trigger, are coughing with wheezing, have a tight chest and are coughing at night. -
✔✔Yellow or cautious phase
✔✔Classification of asthma severity for a child who is 6 years old who has symptoms 3
days a week, uses his inhaler daily for exercise, but not otherwise, has minor limitation
to activity and wakes 3 times a month with cough - ✔✔mild persistent asthma
✔✔Should not be used to treat asthma in children under the age of 4? - ✔✔dry powder
inhalers
, ✔✔In addition to the routine PCV 13 vaccine series, sickle cell anemia patients older
than 2 years of age should receive this once and then a booster in 5 years. -
✔✔PPSV23
✔✔cradle cap or seborrheic dermatitis - ✔✔Often treated with Selsun blue shampoo.
✔✔Bilateral conjunctival injection, 5 days of fever, cervical lymphadenopathy,
polymorphous exanthema, changes in peripheral extremities - ✔✔Kawasaki Disease
✔✔First line treatment for allergic rhinitis - ✔✔Oral H1 antihistamines and/or intranasal
steroids
✔✔Treatment for 3 year old with intermittent asthma - ✔✔SABA prn (Albuterol and
levalbuterol)
✔✔Treatment for Kawasaki - ✔✔IVIG and High dose aspirin
✔✔A 9-year-old boy presents with a fever of 102 and leg pains. Mother reports he had
an upper respiratory infection with a sore throat approximately 2 weeks ago which
subsided without therapy. On physical exam, he has tender, swollen knees bilaterally.
His heart rate is 120 beats per minute and a blowing systolic murmur is heard at the
apex. No murmur previously noted. The most likely diagnosis is. - ✔✔Rheumatic Fever
✔✔labs for rheumatic fever - ✔✔ASO Titer
✔✔A 2 week old infant with complaint of rash near left upper eyelid several vesicular
lesions on his left upper eyelid. What would you discuss with the mother as the PNP? -
✔✔It is important that you go to the children's hospital emergency department now
because your child needs an immediate referral to a pediatric ophthalmologist.
✔✔A 3 year old w/ hx of blepharitis and his mother asks whether there is anything she
can do to prevent this from occurring again. What would you suggest as the PNP? -
✔✔Good handwashing and daily eye lid and lash scrub with diluted baby shampoo
should prevent this from reoccurring.
✔✔A 5 year old feeling like something might be in his eye. No visual changes had
occurred, normal EOM, no known injury. You decide to complete fluorescein staining to
the affected eye because you suspect - ✔✔Corneal abrasion
✔✔A 4-month-old w/1-week hx of nasal congestion and occasional cough. Prior
evening Temp 102F refused to breastfeed and had coughing and noisy labored
breathing. On exam ill-appearing infant who is lethargic w/ tachypnea, wheezing, and
intercostal retractions. Does not attend daycare but has a 3-year-old sibling who is in
