NURS6541 PEDIATRIC PRIMARY CARE
EXAM STUDY GUIDE
1. A 4-month-old infant is brought in for a well-child visit. Which developmental milestone
would the nurse practitioner expect the infant to have achieved?
A. Sitting without support
B. Transferring objects from hand to hand
C. Using a pincer grasp
D. Rolling from front to back
Answer: D
Conceptual Explanation: By 4 months, infants typically roll from front to back. Sitting
without support is a 6-month milestone, pincer grasp is 9-10 months, and transferring
objects is a 6-month milestone.
2. Which of the following physical findings is most characteristic of a child with Acute Otitis
Media (AOM)?
A. A pearly gray, translucent tympanic membrane
B. Bulging of the tympanic membrane with limited mobility
,C. Pain upon manipulation of the tragus
D. Retraction of the tympanic membrane with visible fluid levels
Answer: B
Conceptual Explanation: AOM is characterized by a bulging tympanic membrane and
decreased mobility on pneumatic otoscopy. Pain on tragus manipulation suggests Otitis
Externa.
3. A 2-year-old child presents with a ‘barking’ cough and inspiratory stridor that worsens at
night. What is the most likely diagnosis?
A. Bronchiolitis
B. Croup (Laryngotracheobronchitis)
C. Epiglottitis
D. Foreign body aspiration
Answer: B
Conceptual Explanation: Croup is characterized by a barking cough and inspiratory
stridor, often caused by parainfluenza virus. Epiglottitis is more severe with high fever and
drooling.
4. At what age should the first dose of the Measles, Mumps, and Rubella (MMR) vaccine be
administered according to the CDC schedule?
A. 6 months
, B. 9 months
C. 4-6 years
D. 12-15 months
Answer: D
Conceptual Explanation: The first dose of MMR is recommended at 12-15 months of age.
The second dose is usually given at 4-6 years.
5. A 10-year-old boy presents with a ‘slapped-cheek’ rash and a lacy maculopapular rash on
his trunk. Which virus is the cause?
A. Human Herpesvirus 6
B. Coxsackievirus
C. Parvovirus B19
D. Varicella-Zoster Virus
Answer: C
Conceptual Explanation: Parvovirus B19 causes Erythema Infectiosum, also known as
Fifth Disease, which is characterized by the ‘slapped-cheek’ appearance.
6. A newborn is found to have a harsh holosystolic murmur heard best at the left lower
sternal border. What is the most likely cardiac defect?
A. Ventricular Septal Defect (VSD)
B. Atrial Septal Defect (ASD)
EXAM STUDY GUIDE
1. A 4-month-old infant is brought in for a well-child visit. Which developmental milestone
would the nurse practitioner expect the infant to have achieved?
A. Sitting without support
B. Transferring objects from hand to hand
C. Using a pincer grasp
D. Rolling from front to back
Answer: D
Conceptual Explanation: By 4 months, infants typically roll from front to back. Sitting
without support is a 6-month milestone, pincer grasp is 9-10 months, and transferring
objects is a 6-month milestone.
2. Which of the following physical findings is most characteristic of a child with Acute Otitis
Media (AOM)?
A. A pearly gray, translucent tympanic membrane
B. Bulging of the tympanic membrane with limited mobility
,C. Pain upon manipulation of the tragus
D. Retraction of the tympanic membrane with visible fluid levels
Answer: B
Conceptual Explanation: AOM is characterized by a bulging tympanic membrane and
decreased mobility on pneumatic otoscopy. Pain on tragus manipulation suggests Otitis
Externa.
3. A 2-year-old child presents with a ‘barking’ cough and inspiratory stridor that worsens at
night. What is the most likely diagnosis?
A. Bronchiolitis
B. Croup (Laryngotracheobronchitis)
C. Epiglottitis
D. Foreign body aspiration
Answer: B
Conceptual Explanation: Croup is characterized by a barking cough and inspiratory
stridor, often caused by parainfluenza virus. Epiglottitis is more severe with high fever and
drooling.
4. At what age should the first dose of the Measles, Mumps, and Rubella (MMR) vaccine be
administered according to the CDC schedule?
A. 6 months
, B. 9 months
C. 4-6 years
D. 12-15 months
Answer: D
Conceptual Explanation: The first dose of MMR is recommended at 12-15 months of age.
The second dose is usually given at 4-6 years.
5. A 10-year-old boy presents with a ‘slapped-cheek’ rash and a lacy maculopapular rash on
his trunk. Which virus is the cause?
A. Human Herpesvirus 6
B. Coxsackievirus
C. Parvovirus B19
D. Varicella-Zoster Virus
Answer: C
Conceptual Explanation: Parvovirus B19 causes Erythema Infectiosum, also known as
Fifth Disease, which is characterized by the ‘slapped-cheek’ appearance.
6. A newborn is found to have a harsh holosystolic murmur heard best at the left lower
sternal border. What is the most likely cardiac defect?
A. Ventricular Septal Defect (VSD)
B. Atrial Septal Defect (ASD)
