21 NNP Practice Exam with Complete
Solution
A 10 day old SGA infant presents with abdominal distention and nonbilious emesis. A
palpable mass is noted on physical exam. The most likely diagnosis is:
a. gastric perforation
b. lactobezoar
c. pyloric stenosis - ANS-b. lactobezoar
pathological conglomeration of milk and mucus in the stomach of infants causing an
gastric outlet obstruction
A 5 day old neonate becomes irritable, cyanotic and tachypneic. The NP notices that
when the infant cries, the cyanosis becomes more pronounced. The most likely origin of
these symptoms is:
a. cardiac
b. metabolic
c. pulmonary - ANS-a. cardiac
A characteristic that differentiates gastroschisis from omphalocele is:
a. edematous and herniated bowel
b. enlarged umbilical ring
c. herniated liver - ANS-a. edematous and herniated bowel
A common cause of neonatal renal vein thrombosis is:
a. birth asphyxia
b. mesenchymal development arrest
c. obstruction of the urinary tract - ANS-a. birth asphyxia
A complication of rapid infusion of volume expansion in the preterm infant is:
a. bradycardia
b. hypertension
c. IVH - ANS-c. IVH
A cranial suture line of a neonate reveals an immovable bony prominence which is even
and smooth bilaterally. This neonate should be evaluated for :
,a. a linear skull fracture
b. increased intracranial pressure
c. seizure activity - ANS-b. increased intracranial pressure
A disadvantage of continuous rental replacement therapy with hemofiltration in the
treatment of acute renal failure is that:
a. constant heparinization during therapy is required
b. it causes rapid solute and fluid shifts
c. the patient must be hemodynamically stable prior to therapy - ANS-a. constant
heparinization during therapy is required
A female neonate was delivered at 28 weeks gestation. The amniotic fluid was
meconium stained. Physical exam shows an erythematous rash with small, pale
papules. Tone is poor and the infant has several episodes of apnea. Infection is
suspected. The organism most likely responsible for this neonates symptoms is:
a. Escherichia coli
b. GBS
c. listeria monocytogenes - ANS-c. listeria monocytogenes
A gallop rhythm is associated with:
a. congestive heart failure
b. tetralogy of fallot
c. ventricular septal defect - ANS-a. congestive heart failure
A giant nevus is the most concerning of the congenital pigment nevi because:
a. it is often associated with hearing loss
b. of increased risk of malignant transformation
c. ulceration and bleeding are common - ANS-b. of increased risk of malignant
transformation
A major characteristic of autosomal recessive disorders is:
a. 50% risk for each offspring
b. multiple generations are affected
c. possible consanguinity - ANS-possible consanguinity
A neonate born at 36 weeks weighing 3000g is at increased risk for:
a. jaundice
b. PDA
c. polycythemia - ANS-a. jaundice
, A neonate born at 41 weeks gestation remains cyanotic despite oxygen administration.
A soft murmur can be heard at the upper left sternal border. A chest x-ray reveals an
increased heart size with decreased pulmonary vascularity. These findings are
consistent with:
a. Arterial septal defect
b. coarctation of the aorta
c. pulmonary atresia - ANS-c. pulmonary atresia
A neonate can be assured to be at an advanced gestational age if neuromuscular
development demonstrated increased:
a. hip flexion and adduction
b. popliteal angle
c. square window angle measurement - ANS-c. square window angle measurement
a neonate has a firm fluctuant swelling crossing suture lines that persists after birth and
dissects along tissue planes into the neck. These findings are consistent with:
a. caput succedaneum
b. cephalohematoma
c. subgaleal hemorrhage - ANS-c. subgaleal hemorrhage
A neonate has a firm, fluctuant mass over the cranial bone which does not cross the
suture line. This neonate should also be evaluated for:
a. a linear skull fracture
b. increased intracranial pressure
c. subdural hemorrhage - ANS-a. a linear skull fracture
A neonate has a flat pink lesion on the nose. The lesion has diffuse borders, blanches
with pressure and becomes pinker with crying. The NP should suspect:
a. hemangioma
b. nevus simplex
c. port wine stain - ANS-b. nevus simplex
(stork bite)
A neonate is 48 hours old post-surgery secondary to NEC and is on a ventilator. The
neonate is grimacing and eyes are tightly shut. The heart rate is increased and the
neonate is breathing over the ventilator. The most appropriate intervention would be to
obtain an order for:
a. arterial blood gas
b. pain medication
Solution
A 10 day old SGA infant presents with abdominal distention and nonbilious emesis. A
palpable mass is noted on physical exam. The most likely diagnosis is:
a. gastric perforation
b. lactobezoar
c. pyloric stenosis - ANS-b. lactobezoar
pathological conglomeration of milk and mucus in the stomach of infants causing an
gastric outlet obstruction
A 5 day old neonate becomes irritable, cyanotic and tachypneic. The NP notices that
when the infant cries, the cyanosis becomes more pronounced. The most likely origin of
these symptoms is:
a. cardiac
b. metabolic
c. pulmonary - ANS-a. cardiac
A characteristic that differentiates gastroschisis from omphalocele is:
a. edematous and herniated bowel
b. enlarged umbilical ring
c. herniated liver - ANS-a. edematous and herniated bowel
A common cause of neonatal renal vein thrombosis is:
a. birth asphyxia
b. mesenchymal development arrest
c. obstruction of the urinary tract - ANS-a. birth asphyxia
A complication of rapid infusion of volume expansion in the preterm infant is:
a. bradycardia
b. hypertension
c. IVH - ANS-c. IVH
A cranial suture line of a neonate reveals an immovable bony prominence which is even
and smooth bilaterally. This neonate should be evaluated for :
,a. a linear skull fracture
b. increased intracranial pressure
c. seizure activity - ANS-b. increased intracranial pressure
A disadvantage of continuous rental replacement therapy with hemofiltration in the
treatment of acute renal failure is that:
a. constant heparinization during therapy is required
b. it causes rapid solute and fluid shifts
c. the patient must be hemodynamically stable prior to therapy - ANS-a. constant
heparinization during therapy is required
A female neonate was delivered at 28 weeks gestation. The amniotic fluid was
meconium stained. Physical exam shows an erythematous rash with small, pale
papules. Tone is poor and the infant has several episodes of apnea. Infection is
suspected. The organism most likely responsible for this neonates symptoms is:
a. Escherichia coli
b. GBS
c. listeria monocytogenes - ANS-c. listeria monocytogenes
A gallop rhythm is associated with:
a. congestive heart failure
b. tetralogy of fallot
c. ventricular septal defect - ANS-a. congestive heart failure
A giant nevus is the most concerning of the congenital pigment nevi because:
a. it is often associated with hearing loss
b. of increased risk of malignant transformation
c. ulceration and bleeding are common - ANS-b. of increased risk of malignant
transformation
A major characteristic of autosomal recessive disorders is:
a. 50% risk for each offspring
b. multiple generations are affected
c. possible consanguinity - ANS-possible consanguinity
A neonate born at 36 weeks weighing 3000g is at increased risk for:
a. jaundice
b. PDA
c. polycythemia - ANS-a. jaundice
, A neonate born at 41 weeks gestation remains cyanotic despite oxygen administration.
A soft murmur can be heard at the upper left sternal border. A chest x-ray reveals an
increased heart size with decreased pulmonary vascularity. These findings are
consistent with:
a. Arterial septal defect
b. coarctation of the aorta
c. pulmonary atresia - ANS-c. pulmonary atresia
A neonate can be assured to be at an advanced gestational age if neuromuscular
development demonstrated increased:
a. hip flexion and adduction
b. popliteal angle
c. square window angle measurement - ANS-c. square window angle measurement
a neonate has a firm fluctuant swelling crossing suture lines that persists after birth and
dissects along tissue planes into the neck. These findings are consistent with:
a. caput succedaneum
b. cephalohematoma
c. subgaleal hemorrhage - ANS-c. subgaleal hemorrhage
A neonate has a firm, fluctuant mass over the cranial bone which does not cross the
suture line. This neonate should also be evaluated for:
a. a linear skull fracture
b. increased intracranial pressure
c. subdural hemorrhage - ANS-a. a linear skull fracture
A neonate has a flat pink lesion on the nose. The lesion has diffuse borders, blanches
with pressure and becomes pinker with crying. The NP should suspect:
a. hemangioma
b. nevus simplex
c. port wine stain - ANS-b. nevus simplex
(stork bite)
A neonate is 48 hours old post-surgery secondary to NEC and is on a ventilator. The
neonate is grimacing and eyes are tightly shut. The heart rate is increased and the
neonate is breathing over the ventilator. The most appropriate intervention would be to
obtain an order for:
a. arterial blood gas
b. pain medication
