NSG 548 Final Exam V2 | NSG 548 FNP
Role: Children & Families | Actual Q&A
with Rationale (NSG548 Final Exam) |
Wilkes University
1. A 12-month-old infant is brought to the clinic for a well-child visit. Which developmental
milestone should the Family Nurse Practitioner expect the infant to have achieved by this
age?
A. Walking independently without support
B. Using a spoon to feed themselves without spilling
C. Pulling to a standing position and cruising
D. Stacking at least six blocks
Answer: C
Rationale: By 12 months of age, most infants are able to pull themselves to a standing
position and cruise while holding onto furniture. While some infants may walk
independently, it is not a milestone that is universally expected until 15 months. Stacking
blocks and using a spoon effectively are milestones typically seen in older toddlers.
2. When screening a 2-year-old child for lead poisoning, which of the following blood lead
levels (BLL) is currently identified by the CDC as the threshold for clinical intervention?
A. 2 mcg/dL
,B. 5 mcg/dL
C. 10 mcg/dL
D. 15 mcg/dL
Answer: B
Rationale: The Centers for Disease Control and Prevention (CDC) currently uses a
reference value of 5 mcg/dL to identify children with elevated blood lead levels. This
threshold was lowered from 10 mcg/dL to ensure earlier intervention for environmental
lead exposure. Nurse practitioners must initiate education and environmental investigation
for any level at or above this reference.
3. An adolescent patient presents with a sore throat, fever, and significant lymphadenopathy.
Which physical exam finding would most strongly suggest Infectious Mononucleosis over
Group A Beta-Hemolytic Streptococcus?
A. Anterior cervical lymphadenopathy
B. Palatine petechiae
C. Tonsillar exudates
D. Posterior cervical lymphadenopathy
Answer: D
Rationale: Posterior cervical lymphadenopathy is a hallmark finding in Infectious
Mononucleosis and helps differentiate it from Streptococcal pharyngitis. While tonsillar
, exudates and fever occur in both conditions, the distribution of the nodes is a key clinical
clue. Splenomegaly is also often associated with Mononucleosis, necessitating the
avoidance of contact sports.
4. Which of the following is the most appropriate initial treatment for a 4-year-old child
diagnosed with acute otitis media (AOM) who has no known drug allergies and has not
received antibiotics in the last 30 days?
A. Ceftriaxone 50 mg/kg IM once
B. Azithromycin 10 mg/kg on day 1
C. Amoxicillin 80-90 mg/kg/day
D. Amoxicillin-Clavulanate 90 mg/kg/day
Answer: C
Rationale: High-dose amoxicillin remains the first-line therapy for pediatric AOM because
it provides excellent coverage against Streptococcus pneumoniae. The recommended
dosage is 80 to 90 mg/kg/day divided into two doses. Amoxicillin-Clavulanate is reserved
for patients who have failed initial therapy or have had recent antibiotic exposure.
5. During a newborn assessment, the FNP notes the presence of a ‘clunking’ sensation when
performing the Ortolani maneuver. What does this finding indicate?
A. The hip is being subluxated out of the acetabulum
B. The hip is stable and normal
C. The hip is dislocated and being reduced
Role: Children & Families | Actual Q&A
with Rationale (NSG548 Final Exam) |
Wilkes University
1. A 12-month-old infant is brought to the clinic for a well-child visit. Which developmental
milestone should the Family Nurse Practitioner expect the infant to have achieved by this
age?
A. Walking independently without support
B. Using a spoon to feed themselves without spilling
C. Pulling to a standing position and cruising
D. Stacking at least six blocks
Answer: C
Rationale: By 12 months of age, most infants are able to pull themselves to a standing
position and cruise while holding onto furniture. While some infants may walk
independently, it is not a milestone that is universally expected until 15 months. Stacking
blocks and using a spoon effectively are milestones typically seen in older toddlers.
2. When screening a 2-year-old child for lead poisoning, which of the following blood lead
levels (BLL) is currently identified by the CDC as the threshold for clinical intervention?
A. 2 mcg/dL
,B. 5 mcg/dL
C. 10 mcg/dL
D. 15 mcg/dL
Answer: B
Rationale: The Centers for Disease Control and Prevention (CDC) currently uses a
reference value of 5 mcg/dL to identify children with elevated blood lead levels. This
threshold was lowered from 10 mcg/dL to ensure earlier intervention for environmental
lead exposure. Nurse practitioners must initiate education and environmental investigation
for any level at or above this reference.
3. An adolescent patient presents with a sore throat, fever, and significant lymphadenopathy.
Which physical exam finding would most strongly suggest Infectious Mononucleosis over
Group A Beta-Hemolytic Streptococcus?
A. Anterior cervical lymphadenopathy
B. Palatine petechiae
C. Tonsillar exudates
D. Posterior cervical lymphadenopathy
Answer: D
Rationale: Posterior cervical lymphadenopathy is a hallmark finding in Infectious
Mononucleosis and helps differentiate it from Streptococcal pharyngitis. While tonsillar
, exudates and fever occur in both conditions, the distribution of the nodes is a key clinical
clue. Splenomegaly is also often associated with Mononucleosis, necessitating the
avoidance of contact sports.
4. Which of the following is the most appropriate initial treatment for a 4-year-old child
diagnosed with acute otitis media (AOM) who has no known drug allergies and has not
received antibiotics in the last 30 days?
A. Ceftriaxone 50 mg/kg IM once
B. Azithromycin 10 mg/kg on day 1
C. Amoxicillin 80-90 mg/kg/day
D. Amoxicillin-Clavulanate 90 mg/kg/day
Answer: C
Rationale: High-dose amoxicillin remains the first-line therapy for pediatric AOM because
it provides excellent coverage against Streptococcus pneumoniae. The recommended
dosage is 80 to 90 mg/kg/day divided into two doses. Amoxicillin-Clavulanate is reserved
for patients who have failed initial therapy or have had recent antibiotic exposure.
5. During a newborn assessment, the FNP notes the presence of a ‘clunking’ sensation when
performing the Ortolani maneuver. What does this finding indicate?
A. The hip is being subluxated out of the acetabulum
B. The hip is stable and normal
C. The hip is dislocated and being reduced
