NUR612/NUR 612 Exam 4 V1 | Advanced
Nursing II Q&A with Rationale | William
Paterson University
1. A 4-year-old child presents with a ‘barking’ cough and inspiratory stridor that worsens at
night. Which of the following is the most likely diagnosis?
A. Epiglottitis
B. Foreign Body Aspiration
C. Bacterial Tracheitis
D. Croup (Laryngotracheobronchitis)
Answer: D
Rationale: Croup is characterized by subglottic inflammation typically caused by
parainfluenza virus. The classic barking cough and stridor are hallmarks of this condition.
It is essential to distinguish this from epiglottitis which involves a high fever and drooling.
2. During a well-child exam, a nurse practitioner notes a 2-month-old infant has a positive
Ortolani sign. What does this finding indicate?
A. Scoliosis
B. Developmental Dysplasia of the Hip (DDH)
C. Genu Valgum
,D. Talipes Equinovarus
Answer: B
Rationale: The Ortolani maneuver is used to relocate a recently dislocated hip by
abducting the hips. A positive sign is a ‘clunk’ as the femoral head slips back into the
acetabulum. This is a critical screening tool for developmental dysplasia of the hip in
infants.
3. Which of the following is considered a hallmark clinical manifestation of Nephrotic
Syndrome in children?
A. Gross Hematuria
B. Hypotension
C. Severe Generalized Edema (Anasarca)
D. Glucosuria
Answer: C
Rationale: Nephrotic syndrome involves increased glomerular permeability to protein,
leading to massive proteinuria. This results in hypoalbuminemia, which lowers osmotic
pressure and causes fluid to shift into the interstitial spaces. Consequently, severe edema is
a primary finding in affected children.
4. A 5-year-old is suspected of having pinworms (Enterobius vermicularis). Which diagnostic
test should the nurse practitioner instruct the parents to perform?
A. Stool culture for ova and parasites
, B. Tape test in the morning
C. Serum IgE levels
D. Abdominal X-ray
Answer: B
Rationale: The tape test is the gold standard for diagnosing pinworms because the female
worms migrate to the perianal area at night to lay eggs. Parents should apply transparent
tape to the perianal skin early in the morning before the child bathes or has a bowel
movement. The tape is then examined under a microscope for eggs.
5. A child presents with high fever for 5 days, strawberry tongue, and edema of the hands and
feet. Which condition is the clinician most concerned about?
A. Scarlet Fever
B. Measles
C. Kawasaki Disease
D. Rheumatic Fever
Answer: C
Rationale: Kawasaki Disease is an acute systemic vasculitis of unknown etiology. Diagnosis
requires a fever for at least 5 days along with other clinical criteria like strawberry tongue
and extremity changes. Early detection is vital to prevent coronary artery aneurysms.
Nursing II Q&A with Rationale | William
Paterson University
1. A 4-year-old child presents with a ‘barking’ cough and inspiratory stridor that worsens at
night. Which of the following is the most likely diagnosis?
A. Epiglottitis
B. Foreign Body Aspiration
C. Bacterial Tracheitis
D. Croup (Laryngotracheobronchitis)
Answer: D
Rationale: Croup is characterized by subglottic inflammation typically caused by
parainfluenza virus. The classic barking cough and stridor are hallmarks of this condition.
It is essential to distinguish this from epiglottitis which involves a high fever and drooling.
2. During a well-child exam, a nurse practitioner notes a 2-month-old infant has a positive
Ortolani sign. What does this finding indicate?
A. Scoliosis
B. Developmental Dysplasia of the Hip (DDH)
C. Genu Valgum
,D. Talipes Equinovarus
Answer: B
Rationale: The Ortolani maneuver is used to relocate a recently dislocated hip by
abducting the hips. A positive sign is a ‘clunk’ as the femoral head slips back into the
acetabulum. This is a critical screening tool for developmental dysplasia of the hip in
infants.
3. Which of the following is considered a hallmark clinical manifestation of Nephrotic
Syndrome in children?
A. Gross Hematuria
B. Hypotension
C. Severe Generalized Edema (Anasarca)
D. Glucosuria
Answer: C
Rationale: Nephrotic syndrome involves increased glomerular permeability to protein,
leading to massive proteinuria. This results in hypoalbuminemia, which lowers osmotic
pressure and causes fluid to shift into the interstitial spaces. Consequently, severe edema is
a primary finding in affected children.
4. A 5-year-old is suspected of having pinworms (Enterobius vermicularis). Which diagnostic
test should the nurse practitioner instruct the parents to perform?
A. Stool culture for ova and parasites
, B. Tape test in the morning
C. Serum IgE levels
D. Abdominal X-ray
Answer: B
Rationale: The tape test is the gold standard for diagnosing pinworms because the female
worms migrate to the perianal area at night to lay eggs. Parents should apply transparent
tape to the perianal skin early in the morning before the child bathes or has a bowel
movement. The tape is then examined under a microscope for eggs.
5. A child presents with high fever for 5 days, strawberry tongue, and edema of the hands and
feet. Which condition is the clinician most concerned about?
A. Scarlet Fever
B. Measles
C. Kawasaki Disease
D. Rheumatic Fever
Answer: C
Rationale: Kawasaki Disease is an acute systemic vasculitis of unknown etiology. Diagnosis
requires a fever for at least 5 days along with other clinical criteria like strawberry tongue
and extremity changes. Early detection is vital to prevent coronary artery aneurysms.
