NSG 548 Exam 2 V3 | NSG 548 FNP Role:
Children & Families | Actual Q&A with
Rationale (NSG548 Exam 2) | Wilkes
University
1. A 4-month-old infant is brought into the clinic for a well-child visit. According to
developmental milestones, which motor skill should the FNP expect to observe?
A. Rolling from front to back
B. Sitting without support
C. Pincer grasp
D. Pulling to a stand
Answer: A
Rationale: At 4 months of age, infants typically begin to roll from their abdomen to their
back. Sitting without support usually occurs around 6 months, while the pincer grasp and
pulling to a stand are milestones for older infants around 9 months. It is essential for the
FNP to monitor these sequential developments to identify potential delays early.
2. When evaluating a 2-week-old neonate, the FNP notes a yellow tint to the skin and sclera.
The total bilirubin is 8 mg/dL. This is most likely indicative of which condition?
A. Biliary atresia
B. Pathologic jaundice
,C. Physiologic jaundice
D. Breast milk jaundice
Answer: C
Rationale: Physiologic jaundice typically appears after the first 24 hours of life and peaks
around day 3 to 5. A bilirubin level of 8 mg/dL at 2 weeks might represent a lingering
physiologic process or breast milk jaundice, but pathologic jaundice usually presents
within the first 24 hours with much higher levels. The FNP must differentiate these to
ensure the infant does not develop kernicterus.
3. A 15-month-old child presents with a high fever for 4 days, followed by the sudden
appearance of a maculopapular rash on the trunk as the fever breaks. What is the most likely
diagnosis?
A. Rubeola
B. Varicella
C. Roseola infantum
D. Scarlet fever
Answer: C
Rationale: Roseola infantum, caused by Human Herpesvirus 6, is characterized by a high
fever that ends abruptly, followed by a rose-colored rash. The rash typically starts on the
trunk and spreads to the extremities. Clinical management focuses on supportive care as
the condition is self-limiting and usually benign in healthy children.
, 4. Which physical exam finding is pathognomonic for developmental dysplasia of the hip
(DDH) in a 2-month-old infant?
A. Positive Ortolani maneuver
B. Positive Gower sign
C. Positive Trendelenburg sign
D. Asymmetric leg length only
Answer: A
Rationale: The Ortolani maneuver involves abducting the hip to reduce a dislocated
femoral head back into the acetabulum, producing a palpable ‘clunk’. It is the gold standard
clinical test for DDH in early infancy. The Barlow maneuver is also used to check for hip
instability by attempting to displace the femoral head.
5. An 18-month-old is seen for a sick visit with a barky cough, inspiratory stridor, and low-
grade fever. What is the most likely causative agent?
A. Parainfluenza virus
B. Respiratory syncytial virus (RSV)
C. Haemophilus influenzae type b
D. Streptococcus pneumoniae
Answer: A
Children & Families | Actual Q&A with
Rationale (NSG548 Exam 2) | Wilkes
University
1. A 4-month-old infant is brought into the clinic for a well-child visit. According to
developmental milestones, which motor skill should the FNP expect to observe?
A. Rolling from front to back
B. Sitting without support
C. Pincer grasp
D. Pulling to a stand
Answer: A
Rationale: At 4 months of age, infants typically begin to roll from their abdomen to their
back. Sitting without support usually occurs around 6 months, while the pincer grasp and
pulling to a stand are milestones for older infants around 9 months. It is essential for the
FNP to monitor these sequential developments to identify potential delays early.
2. When evaluating a 2-week-old neonate, the FNP notes a yellow tint to the skin and sclera.
The total bilirubin is 8 mg/dL. This is most likely indicative of which condition?
A. Biliary atresia
B. Pathologic jaundice
,C. Physiologic jaundice
D. Breast milk jaundice
Answer: C
Rationale: Physiologic jaundice typically appears after the first 24 hours of life and peaks
around day 3 to 5. A bilirubin level of 8 mg/dL at 2 weeks might represent a lingering
physiologic process or breast milk jaundice, but pathologic jaundice usually presents
within the first 24 hours with much higher levels. The FNP must differentiate these to
ensure the infant does not develop kernicterus.
3. A 15-month-old child presents with a high fever for 4 days, followed by the sudden
appearance of a maculopapular rash on the trunk as the fever breaks. What is the most likely
diagnosis?
A. Rubeola
B. Varicella
C. Roseola infantum
D. Scarlet fever
Answer: C
Rationale: Roseola infantum, caused by Human Herpesvirus 6, is characterized by a high
fever that ends abruptly, followed by a rose-colored rash. The rash typically starts on the
trunk and spreads to the extremities. Clinical management focuses on supportive care as
the condition is self-limiting and usually benign in healthy children.
, 4. Which physical exam finding is pathognomonic for developmental dysplasia of the hip
(DDH) in a 2-month-old infant?
A. Positive Ortolani maneuver
B. Positive Gower sign
C. Positive Trendelenburg sign
D. Asymmetric leg length only
Answer: A
Rationale: The Ortolani maneuver involves abducting the hip to reduce a dislocated
femoral head back into the acetabulum, producing a palpable ‘clunk’. It is the gold standard
clinical test for DDH in early infancy. The Barlow maneuver is also used to check for hip
instability by attempting to displace the femoral head.
5. An 18-month-old is seen for a sick visit with a barky cough, inspiratory stridor, and low-
grade fever. What is the most likely causative agent?
A. Parainfluenza virus
B. Respiratory syncytial virus (RSV)
C. Haemophilus influenzae type b
D. Streptococcus pneumoniae
Answer: A
