NURS 629 Final Exam V2 | NURS 629 Peds
| Actual Q&A with Rationale (NURS629
Final Exam) | Maryville University
1. A 6-month-old infant is brought to the clinic for a routine well-child visit. The mother
reports that the infant is not yet rolling over. Which of the following statements is most
accurate regarding this finding?
A. This is a significant developmental delay requiring immediate neurology referral.
B. The mother should be instructed to perform passive range of motion exercises daily.
C. The infant should be referred for early intervention services immediately.
D. This finding is within the normal range of development, as rolling usually occurs by 4 to
7 months.
Correct Answer: D
Most infants begin rolling from front to back around 4 months of age and back to front by
5 to 6 months. While many infants are rolling by 6 months, failure to do so is not
considered a definitive delay until after the 7-month mark. The provider should reassess at
the next visit while encouraging tummy time to strengthen core muscles.
2. Which of the following physical examination findings are considered diagnostic criteria for
Kawasaki Disease? (Select all that apply)
A. Bilateral bulbar conjunctival injection without exudate
,B. Polymorphous exanthema
C. Changes in oral lips and oral cavity, such as strawberry tongue
D. Cervical lymphadenopathy, usually unilateral
E. Splenomegaly
F. Changes in peripheral extremities, such as erythema of palms
Correct Answer: A, B, C, D, F
Kawasaki disease diagnosis requires a fever lasting at least five days plus at least four out
of five clinical criteria. These criteria include conjunctival injection, oral mucosal changes,
rash, extremity changes, and cervical lymphadenopathy. Splenomegaly is not a classic
diagnostic criterion for this specific vasculitis.
3. A 2-year-old child presents with a sudden onset of high fever, drooling, and a muffled
voice. The child is sitting in a ‘tripod’ position. What is the most appropriate next step?
A. Immediately arrange for transport to an emergency facility for airway management.
B. Obtain a lateral neck X-ray in the radiology department.
C. Perform a thorough throat culture to rule out Strep.
D. Administer a dose of oral dexamethasone.
Correct Answer: A
The clinical presentation is highly suggestive of epiglottitis, which is a medical emergency
due to potential for rapid airway obstruction. Agitating the child by examining the throat or
,transporting them without airway support can lead to laryngospasm. Definitive
management must occur in a controlled environment where intubation or tracheostomy
can be performed.
4. A 14-year-old male presents with sudden onset of unilateral scrotal pain and swelling. The
cremasteric reflex is absent on the affected side. What is the most likely diagnosis?
A. Epididymitis
B. Varicocele
C. Hydrocele
D. Testicular Torsion
Correct Answer: D
Testicular torsion is a surgical emergency characterized by the sudden onset of severe
pain and an absent cremasteric reflex. It is most common in adolescents and requires
immediate surgical intervention to salvage the testicle. Epididymitis usually presents with
a more gradual onset and a preserved cremasteric reflex.
5. When diagnosing ADHD in a school-aged child according to DSM-5 criteria, symptoms must
be present in at least how many settings?
A. One setting
B. Symptoms only need to be reported by the teacher.
C. Three settings
, D. Two or more settings
Correct Answer: D
According to DSM-5, ADHD symptoms must be present in two or more settings, such as
home and school, to ensure the behaviors are pervasive. This requirement helps
differentiate ADHD from situational behavioral issues or environmental stressors.
Documentation from both parents and teachers is essential for an accurate diagnosis.
6. A 12-month-old infant is being screened for developmental progress. Which of the
following findings would be considered a ‘red flag’ necessitating further evaluation? (Select
all that apply)
A. Failure to point to objects
B. Loss of previously acquired skills
C. Not searching for hidden objects (lack of object permanence)
D. Failure to say single words like ‘mama’ or ‘dada’
E. Walking with one hand held
F. Inability to stand even with support
Correct Answer: A, B, C, D, F
Red flags at 12 months include the inability to stand, lack of gesturing (pointing/waving),
and no single-word vocalizations. The loss of any milestone is a critical sign that warrants
| Actual Q&A with Rationale (NURS629
Final Exam) | Maryville University
1. A 6-month-old infant is brought to the clinic for a routine well-child visit. The mother
reports that the infant is not yet rolling over. Which of the following statements is most
accurate regarding this finding?
A. This is a significant developmental delay requiring immediate neurology referral.
B. The mother should be instructed to perform passive range of motion exercises daily.
C. The infant should be referred for early intervention services immediately.
D. This finding is within the normal range of development, as rolling usually occurs by 4 to
7 months.
Correct Answer: D
Most infants begin rolling from front to back around 4 months of age and back to front by
5 to 6 months. While many infants are rolling by 6 months, failure to do so is not
considered a definitive delay until after the 7-month mark. The provider should reassess at
the next visit while encouraging tummy time to strengthen core muscles.
2. Which of the following physical examination findings are considered diagnostic criteria for
Kawasaki Disease? (Select all that apply)
A. Bilateral bulbar conjunctival injection without exudate
,B. Polymorphous exanthema
C. Changes in oral lips and oral cavity, such as strawberry tongue
D. Cervical lymphadenopathy, usually unilateral
E. Splenomegaly
F. Changes in peripheral extremities, such as erythema of palms
Correct Answer: A, B, C, D, F
Kawasaki disease diagnosis requires a fever lasting at least five days plus at least four out
of five clinical criteria. These criteria include conjunctival injection, oral mucosal changes,
rash, extremity changes, and cervical lymphadenopathy. Splenomegaly is not a classic
diagnostic criterion for this specific vasculitis.
3. A 2-year-old child presents with a sudden onset of high fever, drooling, and a muffled
voice. The child is sitting in a ‘tripod’ position. What is the most appropriate next step?
A. Immediately arrange for transport to an emergency facility for airway management.
B. Obtain a lateral neck X-ray in the radiology department.
C. Perform a thorough throat culture to rule out Strep.
D. Administer a dose of oral dexamethasone.
Correct Answer: A
The clinical presentation is highly suggestive of epiglottitis, which is a medical emergency
due to potential for rapid airway obstruction. Agitating the child by examining the throat or
,transporting them without airway support can lead to laryngospasm. Definitive
management must occur in a controlled environment where intubation or tracheostomy
can be performed.
4. A 14-year-old male presents with sudden onset of unilateral scrotal pain and swelling. The
cremasteric reflex is absent on the affected side. What is the most likely diagnosis?
A. Epididymitis
B. Varicocele
C. Hydrocele
D. Testicular Torsion
Correct Answer: D
Testicular torsion is a surgical emergency characterized by the sudden onset of severe
pain and an absent cremasteric reflex. It is most common in adolescents and requires
immediate surgical intervention to salvage the testicle. Epididymitis usually presents with
a more gradual onset and a preserved cremasteric reflex.
5. When diagnosing ADHD in a school-aged child according to DSM-5 criteria, symptoms must
be present in at least how many settings?
A. One setting
B. Symptoms only need to be reported by the teacher.
C. Three settings
, D. Two or more settings
Correct Answer: D
According to DSM-5, ADHD symptoms must be present in two or more settings, such as
home and school, to ensure the behaviors are pervasive. This requirement helps
differentiate ADHD from situational behavioral issues or environmental stressors.
Documentation from both parents and teachers is essential for an accurate diagnosis.
6. A 12-month-old infant is being screened for developmental progress. Which of the
following findings would be considered a ‘red flag’ necessitating further evaluation? (Select
all that apply)
A. Failure to point to objects
B. Loss of previously acquired skills
C. Not searching for hidden objects (lack of object permanence)
D. Failure to say single words like ‘mama’ or ‘dada’
E. Walking with one hand held
F. Inability to stand even with support
Correct Answer: A, B, C, D, F
Red flags at 12 months include the inability to stand, lack of gesturing (pointing/waving),
and no single-word vocalizations. The loss of any milestone is a critical sign that warrants
