,South College NSG 5442 Exam 1 | Pediatric Primary Care
(2026) Q&A
1. The primary care pediatric nurse practitioner is performing a well-child examination on a
4-month-old infant. The infant's head circumference has not increased since the 2-month
visit. Which action should the nurse practitioner take first?
A) Document the finding as normal and schedule the next visit
B) Ask the mother about the infant's nutritional intake
C) Re-measure the head circumference, assess developmental milestones, and discuss
findings with the provider
D) Order a stat head ultrasound to rule out hydrocephalus
Correct Answer: Re-measure the head circumference, assess developmental milestones, and
discuss findings with the provider
Rationale: A lack of head growth in a 4-month-old is concerning and requires a systematic
approach. The nurse practitioner should first re-measure to confirm accuracy, assess
developmental milestones for other red flags, and discuss the findings with the provider.
Rushing to order imaging without further assessment is premature, while documenting as
normal or focusing solely on nutrition is insufficient.
2. During a clinic visit, a child's rapid capillary screening test for lead reveals a level of 11
mcg/dL. What is the most appropriate next step for the primary care pediatric nurse
practitioner?
A) Institute lead abatement measures in the child's home
B) Monitor lead levels monthly until decreased
C) Order a venous sample to test for lead levels
D) Test the child's siblings and parents for lead
Correct Answer: Order a venous sample to test for lead levels
,Rationale: Capillary screening tests can be falsely elevated due to external contamination. A
venous sample is required to confirm elevated lead levels before initiating any intervention.
Initiating abatement, monthly monitoring, or family testing without confirmation is
premature.
3. A child who has not exhibited enuresis in four years has begun wetting the bed again for
the past week. The primary care pediatric nurse practitioner recognizes that this regression
is most likely due to:
A) Hallucinations
B) Behavioral challenges
C) Delusions
D) Stress
Correct Answer: Stress
Rationale: Regression in previously mastered skills such as toileting is a common response to
stress in children. A significant life change, such as a new sibling, parental divorce, or starting
school, can trigger this temporary regression.
4. Which region globally has the highest infant mortality rate?
A) Indonesia
B) Southern Asia
C) Sub-Saharan Africa
D) Syria
Correct Answer: Sub-Saharan Africa
Rationale: Sub-Saharan Africa has the highest infant mortality rate globally due to limited
healthcare access, high rates of infectious disease, and socioeconomic factors. This region
faces significant challenges in reducing preventable infant deaths.
, 5. The primary care pediatric nurse practitioner understands that, to achieve the greatest
worldwide reduction in child mortality from pneumonia and diarrhea, which intervention is
most effective?
A) Antibiotics
B) Optimal nutrition
C) Vaccinations
D) Water purification
Correct Answer: Vaccinations
Rationale: Vaccinations provide the most significant reduction in child mortality from
preventable infectious diseases like pneumonia and diarrhea. While antibiotics, nutrition,
and water purification are important, vaccines prevent the diseases from occurring in the
first place.
6. Which statement is true about the health status of children in the United States?
A) Globalism has relatively little impact on child health measures in the U.S.
B) Obesity rates among 2 to 5 year olds have shown a recent significant decrease
C) The rate of household poverty is lower than in other economically developed nations
D) Young children who attend preschool or day care have higher food insecurity
Correct Answer: Obesity rates among 2 to 5 year olds have shown a recent significant
decrease
Rationale: Recent data indicate a significant decrease in obesity rates among children aged 2
to 5 years in the United States. This positive trend is attributed to improved nutrition and
public health initiatives.
7. An infant displays depression by which behavior?
A) Smiling at strangers
(2026) Q&A
1. The primary care pediatric nurse practitioner is performing a well-child examination on a
4-month-old infant. The infant's head circumference has not increased since the 2-month
visit. Which action should the nurse practitioner take first?
A) Document the finding as normal and schedule the next visit
B) Ask the mother about the infant's nutritional intake
C) Re-measure the head circumference, assess developmental milestones, and discuss
findings with the provider
D) Order a stat head ultrasound to rule out hydrocephalus
Correct Answer: Re-measure the head circumference, assess developmental milestones, and
discuss findings with the provider
Rationale: A lack of head growth in a 4-month-old is concerning and requires a systematic
approach. The nurse practitioner should first re-measure to confirm accuracy, assess
developmental milestones for other red flags, and discuss the findings with the provider.
Rushing to order imaging without further assessment is premature, while documenting as
normal or focusing solely on nutrition is insufficient.
2. During a clinic visit, a child's rapid capillary screening test for lead reveals a level of 11
mcg/dL. What is the most appropriate next step for the primary care pediatric nurse
practitioner?
A) Institute lead abatement measures in the child's home
B) Monitor lead levels monthly until decreased
C) Order a venous sample to test for lead levels
D) Test the child's siblings and parents for lead
Correct Answer: Order a venous sample to test for lead levels
,Rationale: Capillary screening tests can be falsely elevated due to external contamination. A
venous sample is required to confirm elevated lead levels before initiating any intervention.
Initiating abatement, monthly monitoring, or family testing without confirmation is
premature.
3. A child who has not exhibited enuresis in four years has begun wetting the bed again for
the past week. The primary care pediatric nurse practitioner recognizes that this regression
is most likely due to:
A) Hallucinations
B) Behavioral challenges
C) Delusions
D) Stress
Correct Answer: Stress
Rationale: Regression in previously mastered skills such as toileting is a common response to
stress in children. A significant life change, such as a new sibling, parental divorce, or starting
school, can trigger this temporary regression.
4. Which region globally has the highest infant mortality rate?
A) Indonesia
B) Southern Asia
C) Sub-Saharan Africa
D) Syria
Correct Answer: Sub-Saharan Africa
Rationale: Sub-Saharan Africa has the highest infant mortality rate globally due to limited
healthcare access, high rates of infectious disease, and socioeconomic factors. This region
faces significant challenges in reducing preventable infant deaths.
, 5. The primary care pediatric nurse practitioner understands that, to achieve the greatest
worldwide reduction in child mortality from pneumonia and diarrhea, which intervention is
most effective?
A) Antibiotics
B) Optimal nutrition
C) Vaccinations
D) Water purification
Correct Answer: Vaccinations
Rationale: Vaccinations provide the most significant reduction in child mortality from
preventable infectious diseases like pneumonia and diarrhea. While antibiotics, nutrition,
and water purification are important, vaccines prevent the diseases from occurring in the
first place.
6. Which statement is true about the health status of children in the United States?
A) Globalism has relatively little impact on child health measures in the U.S.
B) Obesity rates among 2 to 5 year olds have shown a recent significant decrease
C) The rate of household poverty is lower than in other economically developed nations
D) Young children who attend preschool or day care have higher food insecurity
Correct Answer: Obesity rates among 2 to 5 year olds have shown a recent significant
decrease
Rationale: Recent data indicate a significant decrease in obesity rates among children aged 2
to 5 years in the United States. This positive trend is attributed to improved nutrition and
public health initiatives.
7. An infant displays depression by which behavior?
A) Smiling at strangers
