NURS 629 Final Exam V3 | NURS 629 Peds
| Actual Q&A with Rationale (NURS629
Final Exam) | Maryville University
1. A 6-year-old child presents with asthma symptoms occurring 3 days per week and
nighttime awakenings 3 times per month. How should this child’s asthma be classified?
A. Intermittent
B. Mild Persistent
C. Moderate Persistent
D. Severe Persistent
Correct Answer: B
The patient’s symptoms occur more than 2 days per week but not daily, and nighttime
awakenings are 3-4 times per month, which aligns with mild persistent asthma.
Intermittent asthma involves symptoms less than or equal to 2 days per week and
nighttime awakenings less than or equal to 2 times per month. Identifying the correct
classification is essential for determining the appropriate stepwise pharmacological
intervention.
2. Which characteristic clinical presentation is most indicative of Roseola Infantum
(Exanthema Subitum) in a toddler?
A. High fever followed by a pruritic vesicular rash
,B. High fever that resolves abruptly followed by a maculopapular rash
C. Cough, coryza, and conjunctivitis with Koplik spots
D. Low-grade fever and a slapped-cheek facial rash
Correct Answer: B
Roseola is typically caused by human herpesvirus 6 and is characterized by a high fever
lasting 3-5 days. Once the fever subsides abruptly, a rose-pink maculopapular rash appears
on the trunk and spreads to the extremities. This sequence of clinical events is
pathognomonic for the condition in pediatric primary care.
3. A 4-week-old infant is brought to the clinic with a history of forceful, non-bilious projectile
vomiting after feedings. Upon palpation of the abdomen, the nurse practitioner notes a
small, firm mass in the right upper quadrant. What is the most likely diagnosis?
A. Gastroesophageal Reflux Disease
B. Intussusception
C. Hypertrophic Pyloric Stenosis
D. Hirschsprung Disease
Correct Answer: C
The clinical triad of projectile vomiting, an olive-shaped mass in the epigastrium, and
visible peristalsis is classic for pyloric stenosis. This condition typically presents between 3
,to 6 weeks of age and requires surgical intervention. Ultrasound is the preferred imaging
modality to confirm the thickening of the pyloric muscle.
4. During a newborn assessment, the nurse practitioner performs the Ortolani maneuver.
What is the purpose of this specific assessment?
A. To evaluate for spinal cord defects
B. To assess for tibial torsion
C. To check for metatarsus adductus
D. To reduce a recently dislocated hip and detect developmental dysplasia
Correct Answer: D
The Ortolani maneuver involves abducting the infant’s hip while applying upward
pressure on the greater trochanter to see if the femoral head slips back into the
acetabulum. A positive result is felt as a ‘clunk’ as the hip reduces. This is a critical
screening tool used in conjunction with the Barlow maneuver to identify developmental
dysplasia of the hip (DDH).
5. A primary care pediatric nurse practitioner is evaluating a 15-month-old infant for iron
deficiency anemia. Which of the following factors increase the risk for this condition? Select
all that apply.
A. Consumption of more than 24 oz of cow’s milk per day
B. History of low birth weight or prematurity
C. Low socioeconomic status
, D. Introduction of iron-fortified cereals at 6 months
E. Exposure to environmental lead
F. Frequent consumption of leafy green vegetables
Correct Answer: A, B, C, E
Excessive cow’s milk intake is a leading cause of nutritional iron deficiency as it lacks
sufficient iron and can cause occult intestinal bleeding. Premature infants are at higher risk
because they miss the iron deposition that occurs during the third trimester of pregnancy.
Lead exposure competes with iron for absorption and socioeconomic factors often limit
access to iron-rich food sources.
6. At an 18-month well-child visit, which developmental milestone is expected for a child
developing normally?
A. Using a 3-word sentence
B. Riding a tricycle
C. Pointing to at least one body part
D. Drawing a circle
Correct Answer: C
By 18 months, a child should be able to follow simple commands and point to body parts
when asked. They typically have a vocabulary of 10-25 words and are beginning to use a
| Actual Q&A with Rationale (NURS629
Final Exam) | Maryville University
1. A 6-year-old child presents with asthma symptoms occurring 3 days per week and
nighttime awakenings 3 times per month. How should this child’s asthma be classified?
A. Intermittent
B. Mild Persistent
C. Moderate Persistent
D. Severe Persistent
Correct Answer: B
The patient’s symptoms occur more than 2 days per week but not daily, and nighttime
awakenings are 3-4 times per month, which aligns with mild persistent asthma.
Intermittent asthma involves symptoms less than or equal to 2 days per week and
nighttime awakenings less than or equal to 2 times per month. Identifying the correct
classification is essential for determining the appropriate stepwise pharmacological
intervention.
2. Which characteristic clinical presentation is most indicative of Roseola Infantum
(Exanthema Subitum) in a toddler?
A. High fever followed by a pruritic vesicular rash
,B. High fever that resolves abruptly followed by a maculopapular rash
C. Cough, coryza, and conjunctivitis with Koplik spots
D. Low-grade fever and a slapped-cheek facial rash
Correct Answer: B
Roseola is typically caused by human herpesvirus 6 and is characterized by a high fever
lasting 3-5 days. Once the fever subsides abruptly, a rose-pink maculopapular rash appears
on the trunk and spreads to the extremities. This sequence of clinical events is
pathognomonic for the condition in pediatric primary care.
3. A 4-week-old infant is brought to the clinic with a history of forceful, non-bilious projectile
vomiting after feedings. Upon palpation of the abdomen, the nurse practitioner notes a
small, firm mass in the right upper quadrant. What is the most likely diagnosis?
A. Gastroesophageal Reflux Disease
B. Intussusception
C. Hypertrophic Pyloric Stenosis
D. Hirschsprung Disease
Correct Answer: C
The clinical triad of projectile vomiting, an olive-shaped mass in the epigastrium, and
visible peristalsis is classic for pyloric stenosis. This condition typically presents between 3
,to 6 weeks of age and requires surgical intervention. Ultrasound is the preferred imaging
modality to confirm the thickening of the pyloric muscle.
4. During a newborn assessment, the nurse practitioner performs the Ortolani maneuver.
What is the purpose of this specific assessment?
A. To evaluate for spinal cord defects
B. To assess for tibial torsion
C. To check for metatarsus adductus
D. To reduce a recently dislocated hip and detect developmental dysplasia
Correct Answer: D
The Ortolani maneuver involves abducting the infant’s hip while applying upward
pressure on the greater trochanter to see if the femoral head slips back into the
acetabulum. A positive result is felt as a ‘clunk’ as the hip reduces. This is a critical
screening tool used in conjunction with the Barlow maneuver to identify developmental
dysplasia of the hip (DDH).
5. A primary care pediatric nurse practitioner is evaluating a 15-month-old infant for iron
deficiency anemia. Which of the following factors increase the risk for this condition? Select
all that apply.
A. Consumption of more than 24 oz of cow’s milk per day
B. History of low birth weight or prematurity
C. Low socioeconomic status
, D. Introduction of iron-fortified cereals at 6 months
E. Exposure to environmental lead
F. Frequent consumption of leafy green vegetables
Correct Answer: A, B, C, E
Excessive cow’s milk intake is a leading cause of nutritional iron deficiency as it lacks
sufficient iron and can cause occult intestinal bleeding. Premature infants are at higher risk
because they miss the iron deposition that occurs during the third trimester of pregnancy.
Lead exposure competes with iron for absorption and socioeconomic factors often limit
access to iron-rich food sources.
6. At an 18-month well-child visit, which developmental milestone is expected for a child
developing normally?
A. Using a 3-word sentence
B. Riding a tricycle
C. Pointing to at least one body part
D. Drawing a circle
Correct Answer: C
By 18 months, a child should be able to follow simple commands and point to body parts
when asked. They typically have a vocabulary of 10-25 words and are beginning to use a
