NR 602 Midterm Exam 2026/2027: Actual Q&As with
Rationales (Chamberlain) - Verified Grade A Guide
This premium study resource delivers 400 highly targeted, multiple-choice practice questions
specifically engineered for the Chamberlain University NR602 Midterm Exam. Each question
features the correct answer highlighted in bold italics alongside an in-depth clinical rationale
mapping out pediatric milestones, immunization schedules, and maternal health indicators.
Formatted with clean spacing and clear structural divisions, this guide is optimized for rapid self-
testing, conceptual mastery, and earning an A on your exam.
1. A 4-year-old child presents with a 6-day history of high fever, bilateral non-
purulent conjunctivitis, erythema of the oral mucosa ("strawberry tongue"), and
polymorphous rash. Which of the following is the most appropriate initial
management step?
A) Amoxicillin 90 mg/kg/day divided into two doses
B) Intravenous immunoglobulin (IVIG) and high-dose aspirin
C) Topical corticosteroids and antihistamines
D) Immediate isolation and administration of acyclovir
Correct Answer: B
Rationale: The clinical presentation describes Kawasaki disease, which requires
immediate treatment with intravenous immunoglobulin (IVIG) and high-dose aspirin to
minimize the risk of developing coronary artery aneurysms. Antibiotics, isolation, and
topical steroids do not treat this systemic vasculitis.
2. A 24-year-old female patient presents to the clinic reporting amenorrhea for 6
weeks, breast tenderness, and frequent morning nausea. During the pelvic
exam, the nurse practitioner notes a softening of the lower uterine segment. How
should this pelvic exam finding be documented?
A) Positive sign of pregnancy
B) Presumptive sign of pregnancy
C) Probable sign of pregnancy (Hegar's sign)
D) Probable sign of pregnancy (Goodell's sign)
Correct Answer: C
Rationale: Softening of the lower uterine segment is Hegar's sign, which is categorized
as a probable sign of pregnancy. Presumptive signs are subjective sensations
experienced by the patient (nausea, breast tenderness). Goodell's sign refers to the
softening of the cervix. Positive signs are definitive objective proofs of a fetus, such as
an ultrasound or fetal heart tones.
3. During a well-child check, the mother of an 8-month-old infant asks if her child's
motor development is on track. Which of the following gross motor milestones
should an infant typically achieve by 8 months of age?
A) Walking while holding onto furniture (cruising)
B) Sitting independently without support
C) Rolling from back to stomach only
D) Standing alone for at least 10 seconds
,Correct Answer: B
Rationale: Sitting independently without support is a major developmental milestone
typically mastered between 6 and 8 months of age. Cruising and standing alone occur
later, closer to 10 to 12 months, while rolling from back to stomach is achieved earlier
around 4 to 5 months.
4. A 5-year-old child presents to the clinic with a sandpaper-like rash that began on
the neck and spread to the trunk, a high fever, and circumoral pallor. The
patient's rapid strep test is positive. What is the first-line pharmacological
treatment?
A) Penicillin V potassium or Amoxicillin
B) Azithromycin
C) Doxycycline
D) Ceftriaxone intramuscularly
Correct Answer: A
Rationale: The patient exhibits classic signs of scarlet fever (Group A Streptococcus
infection). Penicillin or amoxicillin remains the first-line treatment choice due to its
proven efficacy and narrow spectrum. Macrolides like azithromycin are reserved for
patients with true penicillin allergies.
5. A 28-year-old pregnant woman at 36 weeks gestation tests positive for active
Herpes Simplex Virus 2 (HSV-2) genital lesions. Which management path is
most appropriate to protect the newborn from vertical transmission?
A) Schedule a routine elective induction at 39 weeks
B) Begin antiviral suppressive therapy and plan a Cesarean delivery if active
lesions are present at labor onset
C) Reassure the patient that maternal antibodies fully protect the fetus during a
vaginal birth
D) Administer high-dose intravenous acyclovir to the mother during active labor
for a vaginal delivery
Correct Answer: B
Rationale: Guidelines recommend initiating suppressive antiviral therapy (such as
acyclovir) late in pregnancy for women with recurrent HSV. If active genital lesions or
prodromal symptoms are present at the onset of labor, a Cesarean delivery is indicated
to prevent severe neonatal HSV infection.
6. A 15-month-old toddler is brought to the clinic for a routine wellness exam. Which
vaccine is a standard requirement for delivery at this age according to the CDC
pediatric immunization schedule?
A) Tdap (Tetanus, Diphtheria, Pertussis)
B) Meningococcal ACWY
C) MMR (Measles, Mumps, Rubella) first dose
D) Human Papillomavirus (HPV)
Correct Answer: C
Rationale: The first dose of the MMR vaccine is recommended between 12 and 15
months of age. Tdap is given to older children (11-12 years), Meningococcal is given at
11-12 years, and HPV series begins at age 9-11.
7. A postpartum mother presents to the clinic 3 weeks after an uncomplicated
vaginal delivery. She reports intense sadness, crying spells, and feeling
, inadequate to care for her infant. She denies any suicidal or homicidal thoughts.
What is the most likely diagnosis?
A) Postpartum blues
B) Postpartum psychosis
C) Postpartum depression
D) Generalized anxiety disorder
Correct Answer: C
Rationale: Postpartum depression (PPD) onset typically occurs within the first few
weeks up to a year postpartum and lasts beyond the first 2 weeks. Postpartum blues
resolves spontaneously within 10 to 14 days. Postpartum psychosis involves
hallucinations or delusions, which are absent here.
8. During a physical assessment of a newborn, the nurse practitioner notes a
bluish-black, flat, irregular pigmentation over the lumbosacral region. The skin is
intact and there is no tenderness. What is the correct clinical interpretation?
A) Child abuse secondary to blunt force trauma
B) Congenital dermal melanocytosis (Mongolian spot)
C) Erythema toxicum neonatorum
D) Café-au-lait spot indicating neurofibromatosis
Correct Answer: B
Rationale: Congenital dermal melanocytosis (formerly called Mongolian spots) are
benign, flat, blue-grey skin markings commonly found on newborns of darker-skinned
ethnicities. They naturally fade over early childhood and must not be confused with
bruises or trauma.
9. A 3-year-old child presents with a sudden onset of barking cough, inspiratory
stridor, and hoarseness that worsens at night. The child has mild intercostal
retractions. What is the primary therapeutic agent used to treat this condition?
A) Albuterol nebulizer therapy
B) Oral Dexamethasone
C) Amoxicillin/Clavulanate
D) Intravenous Azithromycin
Correct Answer: B
Rationale: The clinical scenario describes croup (laryngotracheobronchitis). A single
dose of oral dexamethasone is the gold standard for reducing laryngeal mucosal edema
in mild-to-moderate croup. Albuterol does not address upper airway inflammation, and
antibiotics are useless against this viral infection.
10. A pregnant female at 28 weeks gestation presents for a routine prenatal
encounter. Her blood type screening indicates she is Rh-negative, and her
indirect Coombs test is negative. What intervention is required?
A) No treatment is needed because the Coombs test is negative
B) Administer Rho(D) immune globulin (RhoGAM) injection now
C) Immediate induction of labor to prevent hemolytic disease
D) Administer RhoGAM only after delivery if the baby is found to be Rh-negative
Correct Answer: B
Rationale: Rh-negative pregnant women who are unsensitized (negative indirect
Coombs test) must receive prophylactic Rho(D) immune globulin (RhoGAM) at 28
, weeks gestation to prevent alloimmunization. A second dose is given within 72 hours of
birth if the newborn is Rh-positive.
11. A 6-year-old boy presents with perianal itching that is significantly worse at night.
The parent notes the child is restless during sleep. What diagnostic test should
the nurse practitioner instruct the parent to perform?
A) Stool culture and sensitivity for ova and parasites
B) Perianal cellophane tape test in the morning before bathing
C) Serum IgE level assessment
D) Digital rectal exam and biopsy
Correct Answer: B
Rationale: Enterobius vermicularis (pinworms) lay eggs overnight around the perianal
region. The cellophane tape test performed first thing in the morning captures these
eggs for microscopic identification. Stool cultures are generally ineffective for pinworm
diagnosis.
12. A 16-year-old female presents requesting a screening test for Chlamydia
trachomatis. She has no active symptoms and denies abdominal pain. Which
diagnostic method is considered the gold standard for screening this patient?
A) High-vaginal swab for wet mount microscopy
B) Nucleic Acid Amplification Test (NAAT) on a first-catch urine sample
C) Cervical culture on Thayer-Martin agar
D) Serum IgG and IgM antibody titers
Correct Answer: B
Rationale: Nucleic Acid Amplification Tests (NAATs) provide the highest sensitivity and
specificity for detecting Chlamydia trachomatis and Neisseria gonorrhoeae. For
females, either a self-collected vaginal swab or a first-catch urine sample is highly
effective and non-invasive.
13. A 2-week-old neonate is brought to the clinic for a wellness check. The clinician
performs a hip assessment using the Barlow and Ortolani maneuvers. A palpable
"clunk" is felt during the Ortolani maneuver. What does this indicate?
A) Normal developmental skeletal variant
B) Developmental Dysplasia of the Hip (DDH)
C) Transient synovitis of the hip joint
D) Fractured clavicle sustained during delivery
Correct Answer: B
Rationale: A positive Ortolani or Barlow test indicates hip instability or dislocation,
confirming Developmental Dysplasia of the Hip (DDH). The Ortolani maneuver reduces
a dislocated hip back into the acetabulum, producing a palpable or audible clunk.
Immediate referral to pediatric orthopedics is required.
14. A 12-month-old infant is brought to the clinic. The mother asks when the child's
posterior fontanel should have closed. What is the typical physiological timeline
for posterior fontanel closure?
A) 12 to 18 months of age
B) 6 to 8 weeks of age
C) 24 to 30 months of age
D) Immediately at birth
Correct Answer: B
Rationales (Chamberlain) - Verified Grade A Guide
This premium study resource delivers 400 highly targeted, multiple-choice practice questions
specifically engineered for the Chamberlain University NR602 Midterm Exam. Each question
features the correct answer highlighted in bold italics alongside an in-depth clinical rationale
mapping out pediatric milestones, immunization schedules, and maternal health indicators.
Formatted with clean spacing and clear structural divisions, this guide is optimized for rapid self-
testing, conceptual mastery, and earning an A on your exam.
1. A 4-year-old child presents with a 6-day history of high fever, bilateral non-
purulent conjunctivitis, erythema of the oral mucosa ("strawberry tongue"), and
polymorphous rash. Which of the following is the most appropriate initial
management step?
A) Amoxicillin 90 mg/kg/day divided into two doses
B) Intravenous immunoglobulin (IVIG) and high-dose aspirin
C) Topical corticosteroids and antihistamines
D) Immediate isolation and administration of acyclovir
Correct Answer: B
Rationale: The clinical presentation describes Kawasaki disease, which requires
immediate treatment with intravenous immunoglobulin (IVIG) and high-dose aspirin to
minimize the risk of developing coronary artery aneurysms. Antibiotics, isolation, and
topical steroids do not treat this systemic vasculitis.
2. A 24-year-old female patient presents to the clinic reporting amenorrhea for 6
weeks, breast tenderness, and frequent morning nausea. During the pelvic
exam, the nurse practitioner notes a softening of the lower uterine segment. How
should this pelvic exam finding be documented?
A) Positive sign of pregnancy
B) Presumptive sign of pregnancy
C) Probable sign of pregnancy (Hegar's sign)
D) Probable sign of pregnancy (Goodell's sign)
Correct Answer: C
Rationale: Softening of the lower uterine segment is Hegar's sign, which is categorized
as a probable sign of pregnancy. Presumptive signs are subjective sensations
experienced by the patient (nausea, breast tenderness). Goodell's sign refers to the
softening of the cervix. Positive signs are definitive objective proofs of a fetus, such as
an ultrasound or fetal heart tones.
3. During a well-child check, the mother of an 8-month-old infant asks if her child's
motor development is on track. Which of the following gross motor milestones
should an infant typically achieve by 8 months of age?
A) Walking while holding onto furniture (cruising)
B) Sitting independently without support
C) Rolling from back to stomach only
D) Standing alone for at least 10 seconds
,Correct Answer: B
Rationale: Sitting independently without support is a major developmental milestone
typically mastered between 6 and 8 months of age. Cruising and standing alone occur
later, closer to 10 to 12 months, while rolling from back to stomach is achieved earlier
around 4 to 5 months.
4. A 5-year-old child presents to the clinic with a sandpaper-like rash that began on
the neck and spread to the trunk, a high fever, and circumoral pallor. The
patient's rapid strep test is positive. What is the first-line pharmacological
treatment?
A) Penicillin V potassium or Amoxicillin
B) Azithromycin
C) Doxycycline
D) Ceftriaxone intramuscularly
Correct Answer: A
Rationale: The patient exhibits classic signs of scarlet fever (Group A Streptococcus
infection). Penicillin or amoxicillin remains the first-line treatment choice due to its
proven efficacy and narrow spectrum. Macrolides like azithromycin are reserved for
patients with true penicillin allergies.
5. A 28-year-old pregnant woman at 36 weeks gestation tests positive for active
Herpes Simplex Virus 2 (HSV-2) genital lesions. Which management path is
most appropriate to protect the newborn from vertical transmission?
A) Schedule a routine elective induction at 39 weeks
B) Begin antiviral suppressive therapy and plan a Cesarean delivery if active
lesions are present at labor onset
C) Reassure the patient that maternal antibodies fully protect the fetus during a
vaginal birth
D) Administer high-dose intravenous acyclovir to the mother during active labor
for a vaginal delivery
Correct Answer: B
Rationale: Guidelines recommend initiating suppressive antiviral therapy (such as
acyclovir) late in pregnancy for women with recurrent HSV. If active genital lesions or
prodromal symptoms are present at the onset of labor, a Cesarean delivery is indicated
to prevent severe neonatal HSV infection.
6. A 15-month-old toddler is brought to the clinic for a routine wellness exam. Which
vaccine is a standard requirement for delivery at this age according to the CDC
pediatric immunization schedule?
A) Tdap (Tetanus, Diphtheria, Pertussis)
B) Meningococcal ACWY
C) MMR (Measles, Mumps, Rubella) first dose
D) Human Papillomavirus (HPV)
Correct Answer: C
Rationale: The first dose of the MMR vaccine is recommended between 12 and 15
months of age. Tdap is given to older children (11-12 years), Meningococcal is given at
11-12 years, and HPV series begins at age 9-11.
7. A postpartum mother presents to the clinic 3 weeks after an uncomplicated
vaginal delivery. She reports intense sadness, crying spells, and feeling
, inadequate to care for her infant. She denies any suicidal or homicidal thoughts.
What is the most likely diagnosis?
A) Postpartum blues
B) Postpartum psychosis
C) Postpartum depression
D) Generalized anxiety disorder
Correct Answer: C
Rationale: Postpartum depression (PPD) onset typically occurs within the first few
weeks up to a year postpartum and lasts beyond the first 2 weeks. Postpartum blues
resolves spontaneously within 10 to 14 days. Postpartum psychosis involves
hallucinations or delusions, which are absent here.
8. During a physical assessment of a newborn, the nurse practitioner notes a
bluish-black, flat, irregular pigmentation over the lumbosacral region. The skin is
intact and there is no tenderness. What is the correct clinical interpretation?
A) Child abuse secondary to blunt force trauma
B) Congenital dermal melanocytosis (Mongolian spot)
C) Erythema toxicum neonatorum
D) Café-au-lait spot indicating neurofibromatosis
Correct Answer: B
Rationale: Congenital dermal melanocytosis (formerly called Mongolian spots) are
benign, flat, blue-grey skin markings commonly found on newborns of darker-skinned
ethnicities. They naturally fade over early childhood and must not be confused with
bruises or trauma.
9. A 3-year-old child presents with a sudden onset of barking cough, inspiratory
stridor, and hoarseness that worsens at night. The child has mild intercostal
retractions. What is the primary therapeutic agent used to treat this condition?
A) Albuterol nebulizer therapy
B) Oral Dexamethasone
C) Amoxicillin/Clavulanate
D) Intravenous Azithromycin
Correct Answer: B
Rationale: The clinical scenario describes croup (laryngotracheobronchitis). A single
dose of oral dexamethasone is the gold standard for reducing laryngeal mucosal edema
in mild-to-moderate croup. Albuterol does not address upper airway inflammation, and
antibiotics are useless against this viral infection.
10. A pregnant female at 28 weeks gestation presents for a routine prenatal
encounter. Her blood type screening indicates she is Rh-negative, and her
indirect Coombs test is negative. What intervention is required?
A) No treatment is needed because the Coombs test is negative
B) Administer Rho(D) immune globulin (RhoGAM) injection now
C) Immediate induction of labor to prevent hemolytic disease
D) Administer RhoGAM only after delivery if the baby is found to be Rh-negative
Correct Answer: B
Rationale: Rh-negative pregnant women who are unsensitized (negative indirect
Coombs test) must receive prophylactic Rho(D) immune globulin (RhoGAM) at 28
, weeks gestation to prevent alloimmunization. A second dose is given within 72 hours of
birth if the newborn is Rh-positive.
11. A 6-year-old boy presents with perianal itching that is significantly worse at night.
The parent notes the child is restless during sleep. What diagnostic test should
the nurse practitioner instruct the parent to perform?
A) Stool culture and sensitivity for ova and parasites
B) Perianal cellophane tape test in the morning before bathing
C) Serum IgE level assessment
D) Digital rectal exam and biopsy
Correct Answer: B
Rationale: Enterobius vermicularis (pinworms) lay eggs overnight around the perianal
region. The cellophane tape test performed first thing in the morning captures these
eggs for microscopic identification. Stool cultures are generally ineffective for pinworm
diagnosis.
12. A 16-year-old female presents requesting a screening test for Chlamydia
trachomatis. She has no active symptoms and denies abdominal pain. Which
diagnostic method is considered the gold standard for screening this patient?
A) High-vaginal swab for wet mount microscopy
B) Nucleic Acid Amplification Test (NAAT) on a first-catch urine sample
C) Cervical culture on Thayer-Martin agar
D) Serum IgG and IgM antibody titers
Correct Answer: B
Rationale: Nucleic Acid Amplification Tests (NAATs) provide the highest sensitivity and
specificity for detecting Chlamydia trachomatis and Neisseria gonorrhoeae. For
females, either a self-collected vaginal swab or a first-catch urine sample is highly
effective and non-invasive.
13. A 2-week-old neonate is brought to the clinic for a wellness check. The clinician
performs a hip assessment using the Barlow and Ortolani maneuvers. A palpable
"clunk" is felt during the Ortolani maneuver. What does this indicate?
A) Normal developmental skeletal variant
B) Developmental Dysplasia of the Hip (DDH)
C) Transient synovitis of the hip joint
D) Fractured clavicle sustained during delivery
Correct Answer: B
Rationale: A positive Ortolani or Barlow test indicates hip instability or dislocation,
confirming Developmental Dysplasia of the Hip (DDH). The Ortolani maneuver reduces
a dislocated hip back into the acetabulum, producing a palpable or audible clunk.
Immediate referral to pediatric orthopedics is required.
14. A 12-month-old infant is brought to the clinic. The mother asks when the child's
posterior fontanel should have closed. What is the typical physiological timeline
for posterior fontanel closure?
A) 12 to 18 months of age
B) 6 to 8 weeks of age
C) 24 to 30 months of age
D) Immediately at birth
Correct Answer: B
