ANSWERS|LATEST 2025/2026|GUARANTEED
1. During a well child exam, the primary care pediatric nurse practitioner learns that the paren
B B B B B B B B B B B B B B B
ts of a young child fight frequently about finances. The parents state that they do not fight in fr
B B B B B B B B B B B B B B B B B B
ont of the child and feel that the situation is temporary and related to the father's job layoff. W
B B B B B B B B B B B B B B B B B B
hat will the nurse practitioner do?
B B B B B B
a. Reassure them that the child is too young to understand.
B B B B B B B B B B
b. Recommend that they continue to not argue in front of the child.
B B B B B B B B B B B B
c. Suggest counseling to learn ways to handle stress.
B B B B B B B B
d. Tell them that the conflict will resolve when the situation changes. - ANSWER-
B B B B B B B B B B B B B ANS: C B
Marital problems can result in child behavior difficulties and anxieties, and conflict can be pick
B B B B B B B B B B B B B B
ed up by the child. The parents should try to learn to modify unhealthy behaviors, such as incr
B B B B B B B B B B B B B B B B B
eased conflict during stressful situations. Even when children do not understand, they pick up
B B B B B B B B B B B B B B
on cues from the parents about anxiety and stress and can internalize these feelings. Avoiding
B B B B B B B B B B B B B B B
arguments in front of the child does not alleviate the underlying conflict and stress. The behav
B B B B B B B B B B B B B B B
ior of fighting during this stressful situation may indicate a pattern of response to stress and wi
B B B B B B B B B B B B B B B B
ll only recur with each subsequent stressful period.
B B B B B B B
2. The primary care pediatric nurse practitioner conducts a well baby exam on an infant and n
B B B B B B B B B B B B B B B B
otes mild gross motor delays but no delays in other areas. Which initial course of action will th
B B B B B B B B B B B B B B B B B
e nurse practitioner recommend?
B B B B
a. Consult a developmental specialist for a more complete evaluation.
B B B B B B B B B
b. Prepare the parents for a potentially serious developmental disorder.
B B B B B B B B B
c. Refer the infant to an early intervention program for physical therapy.
B B B B B B B B B B B
d. Teach the parents to provide exercises to encourage motor development. - ANSWER-
B B B B B B B B B B B B
ANS: D B
The child who has mild delays in only one area may be managed initially by having the parent
B B B B B B B B B B B B B B B B B B
provide appropriate exercises. If this is not effective, or if delays become more severe, referral
B B B B B B B B B B B B B B
s for evaluation or early intervention services are warranted. A mild delay does not necessarily
B B B B B B B B B B B B B B
signal a serious disorder, so this action is not indicated.
B B B B B B B B B B
1
Wicky
,3. The primary care pediatric nurse practitioner sees a developmentally delayed toddler for an
B B B B B B B B B B B B B
initial visit. The family has just moved to the area and asks the nurse practitioner about comm
B B B B B B B B B B B B B B B B B
unity services and resources for their child. What should the nurse practitioner do initially?
B B B B B B B B B B B B B B
a. Ask the parents if they have an individualized family service plan (IFSP).
B B B B B B B B B B B B
b. Consult with a physician to ensure the child gets appropriate care.
B B B B B B B B B B B
c. Inform the family that services are provided when the child begins school.
B B B B B B B B B B B B
d. Refer the family to a social worker for assistance with referrals and services. - ANSWER-
B B B B B B B B B B B B B B B
ANS: A B
Families with children who have developmental delays are eligible for early intervention servi
B B B B B B B B B B B B
ces and should have IFSPs in place. This family may have one from their previous community, a
B B B B B B B B B B B B B B B B
nd it can be used as a starting point to determine needs. It is not necessary to consult with a p
B B B B B B B B B B B B B B B B B B B B
hysician to coordinate community resources. Early intervention is provided from birth, accordi
B B B B B B B B B B B
ng to federal law. Until the specific referrals are known, the social worker is not consulted.
B B B B B B B B B B B B B B B
4. The primary care pediatric nurse practitioner is examining a newborn infant recently discha
B B B B B B B B B B B B B
rged from the neonatal intensive care unit after a premature birth. The parent is upset and ex
B B B B B B B B B B B B B B B B
presses worry about whether the infant will be normal. What will the nurse practitioner do in
B B B B B B B B B B B B B B B B
this situation? B B
a. Explain to the parent that developmental delays often do not manifest at first.
B B B B B B B B B B B B B
b. Perform a developmental assessment and tell the parent which delays are evident.
B B B B B B B B B B B B
c. Point out the tasks that the infant can perform while conducting the assessment.
B B B B B B B B B B B B B
d. Refer the infant to a developmental specialist for a complete evaluation. - ANSWER-
B B B B B B B B B B B B B
ANS: C B
When discussing developmental delays with parents, it is important to be positive and to initia
B B B B B B B B B B B B B B
lly focus on strengths. Explaining that developmental delays develop over time is true but doe
B B B B B B B B B B B B B B
s not reassure the parent or help the parent cope with feelings. Referrals are not indicated unl
B B B B B B B B B B B B B B B B
ess delays are present and may take time.
B B B B B B B
5. Which recommendation will a primary care pediatric nurse practitioner make when parents
B B B B B B B B B B B B
ask about ways to discipline their 3-year-old child who draws on the walls with crayons?
B B B B B B B B B B B B B B B
a. Give the child washable markers so the drawings can be removed easily.
B B B B B B B B B B B B
b. Provide a roll of paper for drawing and teach the child to use this.
B B B B B B B B B B B B B B
2
Wicky
,c. Put the child in "timeout" each time the child draws on the walls.
B B B B B B B B B B B B B
d. Take the crayons away from the child to prevent the behavior. - ANSWER-
B B B B B B B B B B B B B ANS: B B
Discipline involves training or education that molds appropriate behavior and is used to teach
B B B B B B B B B B B B B B
the child what is permitted and encouraged. Providing an appropriate outlet for drawing helps
B B B B B B B B B B B B B
Bto teach the child where to use the crayons. Using washable markers allows the parents to cle
B B B B B B B B B B B B B B B B
an the walls but does not teach the child appropriate behaviors. Timeout and taking away the
B B B B B B B B B B B B B B B B
crayons are forms of punishment, or a loss of privileges, that are administered as a form of retr
B B B B B B B B B B B B B B B B B
ibution.
6. The primary care pediatric nurse practitioner enters an exam room and finds a 2-month-
B B B B B B B B B B B B B B
old infant in a car seat on the exam table. The infant's mother is playing a game on her smart p
B B B B B B B B B B B B B B B B B B B B
hone. The nurse practitioner interprets this behavior as :
B B B B B B B B B
a. a sign that the mother has postpartum depression.
B B B B B B B B
b. extremely concerning for potential parental neglect.
B B B B B B
c. of moderate concern for parenting problems.
B B B B B B
d. within the normal range of behavior in early parenthood. - ANSWER-
B B B B B B B B B B B ANS: C B
A parent who seems disinterested in a child raises moderate concerns for parenting problems.
B B B B B B B B B B B B B
It does not necessarily signal postpartum depression. It is not a mark for extreme concern. It i
B B B B B B B B B B B B B B B B B
s not within the expected range of behaviors.
B B B B B B B
7. During a well child assessment of an 18-month-
B B B B B B B B
old child, the primary care pediatric nurse practitioner observes the child becoming irritable a
B B B B B B B B B B B B B
nd uncooperative. The parent tells the child to stop fussing. What will the nurse practitioner d
B B B B B B B B B B B B B B B
o? B
a. Allow the parent to put the child in a "timeout."
B B B B B B B B B B
b. Ask the parent about usual discipline practices.
B B B B B B B
c. Offer the child a book or a toy to look at.
B B B B B B B B B B B
d. Stop the exam since the child has reached a "meltdown." - ANSWER-
B B B B B B B B B B B B ANS: C B
The child has exhibited early signs of misbehavior. At this stage, distraction and active engage
B B B B B B B B B B B B B B
ment may be used to stop more problems from occurring. It is not necessary to use a timeout
B B B B B B B B B B B B B B B B B B
because the child hasn't reached the point where cooperation is impossible. The PNP should
B B B B B B B B B B B B B B
model appropriate interventions by offering the child a distraction and may ask the parent ab
B B B B B B B B B B B B B B
out discipline practices later in the visit. The child is not at a "meltdown" state.
B B B B B B B B B B B B B B
3
Wicky
, 8. The primary care pediatric nurse practitioner performs a physical examination on a 9-
B B B B B B B B B B B B B
month-
old infant and notes two central incisors on the lower gums. The parent states that the infant n
B B B B B B B B B B B B B B B B B
urses, takes solid foods three times daily, and occasionally takes water from a cup. What will t
B B B B B B B B B B B B B B B B
he pediatric nurse practitioner counsel the parent to promote optimum dental health?
B B B B B B B B B B B B
a. To begin brushing the infant's teeth with toothpaste
B B B B B B B B
b. To consider weaning the infant from breastfeeding
B B B B B B B
c. To discontinue giving fluoride supplements
B B B B B
d. To make an appointment for an initial dental examination - ANSWER-
B B B B B B B B B B B ANS: D B
The American Academy of Pediatric Dentistry recommends a first dental examination at the ti
B B B B B B B B B B B B B
me of eruption of the first tooth and no later than 12 months old. Parents should be counsele
B B B B B B B B B B B B B B B B B
d to clean the infant's teeth but with water only. Weaning from breastfeeding is not indicated,
B B B B B B B B B B B B B B B B
although mothers should not let the infant nurse while sleeping to prevent milk from bathing t
B B B B B B B B B B B B B B B
he teeth. Fluoride supplements should not be discontinued.
B B B B B B B
9. The primary care pediatric nurse practitioner has a cohort of patients who have special heal
B B B B B B B B B B B B B B B
th care needs. Which is an important role of the nurse practitioner when caring for these child
B B B B B B B B B B B B B B B B
ren? B
a. Care coordination and collaboration
B B B B
b. Developing protocols for parents to follow
B B B B B B
c. Monitoring individual education plans (IEPs)
B B B B B
d. Providing lists of resources for families - ANSWER-
B B B B B B B B ANS: A B
Care coordination is one of the key elements for children with special health care needs. PNPs
B B B B B B B B B B B B B B B B
are especially suited for this role and have the unique skills to function as care coordinators. C
B B B B B B B B B B B B B B B B
are for these children should involve shared decision making and individualized care and not "
B B B B B B B B B B B B B B
cookbook" approaches. The PNP may advocate for children's health care needs for the IEP but
B B B B B B B B B B B B B B B
does not monitor these. The PNP should not just give parents lists of phone numbers but shou
B B B B B B B B B B B B B B B B
ld assist them to make appointments.
B B B B B
10. A single mother of an infant worries that living in a household with only one parent will ca
B B B B B B B B B B B B B B B B B B
use her child to be maladjusted. To help address the mother's concerns, the primary care pedi
B B B B B B B B B B B B B B B
atric nurse practitioner will suggest :
B B B B B
4
Wicky
1. During a well child exam, the primary care pediatric nurse practitioner learns that the paren
B B B B B B B B B B B B B B B
ts of a young child fight frequently about finances. The parents state that they do not fight in fr
B B B B B B B B B B B B B B B B B B
ont of the child and feel that the situation is temporary and related to the father's job layoff. W
B B B B B B B B B B B B B B B B B B
hat will the nurse practitioner do?
B B B B B B
a. Reassure them that the child is too young to understand.
B B B B B B B B B B
b. Recommend that they continue to not argue in front of the child.
B B B B B B B B B B B B
c. Suggest counseling to learn ways to handle stress.
B B B B B B B B
d. Tell them that the conflict will resolve when the situation changes. - ANSWER-
B B B B B B B B B B B B B ANS: C B
Marital problems can result in child behavior difficulties and anxieties, and conflict can be pick
B B B B B B B B B B B B B B
ed up by the child. The parents should try to learn to modify unhealthy behaviors, such as incr
B B B B B B B B B B B B B B B B B
eased conflict during stressful situations. Even when children do not understand, they pick up
B B B B B B B B B B B B B B
on cues from the parents about anxiety and stress and can internalize these feelings. Avoiding
B B B B B B B B B B B B B B B
arguments in front of the child does not alleviate the underlying conflict and stress. The behav
B B B B B B B B B B B B B B B
ior of fighting during this stressful situation may indicate a pattern of response to stress and wi
B B B B B B B B B B B B B B B B
ll only recur with each subsequent stressful period.
B B B B B B B
2. The primary care pediatric nurse practitioner conducts a well baby exam on an infant and n
B B B B B B B B B B B B B B B B
otes mild gross motor delays but no delays in other areas. Which initial course of action will th
B B B B B B B B B B B B B B B B B
e nurse practitioner recommend?
B B B B
a. Consult a developmental specialist for a more complete evaluation.
B B B B B B B B B
b. Prepare the parents for a potentially serious developmental disorder.
B B B B B B B B B
c. Refer the infant to an early intervention program for physical therapy.
B B B B B B B B B B B
d. Teach the parents to provide exercises to encourage motor development. - ANSWER-
B B B B B B B B B B B B
ANS: D B
The child who has mild delays in only one area may be managed initially by having the parent
B B B B B B B B B B B B B B B B B B
provide appropriate exercises. If this is not effective, or if delays become more severe, referral
B B B B B B B B B B B B B B
s for evaluation or early intervention services are warranted. A mild delay does not necessarily
B B B B B B B B B B B B B B
signal a serious disorder, so this action is not indicated.
B B B B B B B B B B
1
Wicky
,3. The primary care pediatric nurse practitioner sees a developmentally delayed toddler for an
B B B B B B B B B B B B B
initial visit. The family has just moved to the area and asks the nurse practitioner about comm
B B B B B B B B B B B B B B B B B
unity services and resources for their child. What should the nurse practitioner do initially?
B B B B B B B B B B B B B B
a. Ask the parents if they have an individualized family service plan (IFSP).
B B B B B B B B B B B B
b. Consult with a physician to ensure the child gets appropriate care.
B B B B B B B B B B B
c. Inform the family that services are provided when the child begins school.
B B B B B B B B B B B B
d. Refer the family to a social worker for assistance with referrals and services. - ANSWER-
B B B B B B B B B B B B B B B
ANS: A B
Families with children who have developmental delays are eligible for early intervention servi
B B B B B B B B B B B B
ces and should have IFSPs in place. This family may have one from their previous community, a
B B B B B B B B B B B B B B B B
nd it can be used as a starting point to determine needs. It is not necessary to consult with a p
B B B B B B B B B B B B B B B B B B B B
hysician to coordinate community resources. Early intervention is provided from birth, accordi
B B B B B B B B B B B
ng to federal law. Until the specific referrals are known, the social worker is not consulted.
B B B B B B B B B B B B B B B
4. The primary care pediatric nurse practitioner is examining a newborn infant recently discha
B B B B B B B B B B B B B
rged from the neonatal intensive care unit after a premature birth. The parent is upset and ex
B B B B B B B B B B B B B B B B
presses worry about whether the infant will be normal. What will the nurse practitioner do in
B B B B B B B B B B B B B B B B
this situation? B B
a. Explain to the parent that developmental delays often do not manifest at first.
B B B B B B B B B B B B B
b. Perform a developmental assessment and tell the parent which delays are evident.
B B B B B B B B B B B B
c. Point out the tasks that the infant can perform while conducting the assessment.
B B B B B B B B B B B B B
d. Refer the infant to a developmental specialist for a complete evaluation. - ANSWER-
B B B B B B B B B B B B B
ANS: C B
When discussing developmental delays with parents, it is important to be positive and to initia
B B B B B B B B B B B B B B
lly focus on strengths. Explaining that developmental delays develop over time is true but doe
B B B B B B B B B B B B B B
s not reassure the parent or help the parent cope with feelings. Referrals are not indicated unl
B B B B B B B B B B B B B B B B
ess delays are present and may take time.
B B B B B B B
5. Which recommendation will a primary care pediatric nurse practitioner make when parents
B B B B B B B B B B B B
ask about ways to discipline their 3-year-old child who draws on the walls with crayons?
B B B B B B B B B B B B B B B
a. Give the child washable markers so the drawings can be removed easily.
B B B B B B B B B B B B
b. Provide a roll of paper for drawing and teach the child to use this.
B B B B B B B B B B B B B B
2
Wicky
,c. Put the child in "timeout" each time the child draws on the walls.
B B B B B B B B B B B B B
d. Take the crayons away from the child to prevent the behavior. - ANSWER-
B B B B B B B B B B B B B ANS: B B
Discipline involves training or education that molds appropriate behavior and is used to teach
B B B B B B B B B B B B B B
the child what is permitted and encouraged. Providing an appropriate outlet for drawing helps
B B B B B B B B B B B B B
Bto teach the child where to use the crayons. Using washable markers allows the parents to cle
B B B B B B B B B B B B B B B B
an the walls but does not teach the child appropriate behaviors. Timeout and taking away the
B B B B B B B B B B B B B B B B
crayons are forms of punishment, or a loss of privileges, that are administered as a form of retr
B B B B B B B B B B B B B B B B B
ibution.
6. The primary care pediatric nurse practitioner enters an exam room and finds a 2-month-
B B B B B B B B B B B B B B
old infant in a car seat on the exam table. The infant's mother is playing a game on her smart p
B B B B B B B B B B B B B B B B B B B B
hone. The nurse practitioner interprets this behavior as :
B B B B B B B B B
a. a sign that the mother has postpartum depression.
B B B B B B B B
b. extremely concerning for potential parental neglect.
B B B B B B
c. of moderate concern for parenting problems.
B B B B B B
d. within the normal range of behavior in early parenthood. - ANSWER-
B B B B B B B B B B B ANS: C B
A parent who seems disinterested in a child raises moderate concerns for parenting problems.
B B B B B B B B B B B B B
It does not necessarily signal postpartum depression. It is not a mark for extreme concern. It i
B B B B B B B B B B B B B B B B B
s not within the expected range of behaviors.
B B B B B B B
7. During a well child assessment of an 18-month-
B B B B B B B B
old child, the primary care pediatric nurse practitioner observes the child becoming irritable a
B B B B B B B B B B B B B
nd uncooperative. The parent tells the child to stop fussing. What will the nurse practitioner d
B B B B B B B B B B B B B B B
o? B
a. Allow the parent to put the child in a "timeout."
B B B B B B B B B B
b. Ask the parent about usual discipline practices.
B B B B B B B
c. Offer the child a book or a toy to look at.
B B B B B B B B B B B
d. Stop the exam since the child has reached a "meltdown." - ANSWER-
B B B B B B B B B B B B ANS: C B
The child has exhibited early signs of misbehavior. At this stage, distraction and active engage
B B B B B B B B B B B B B B
ment may be used to stop more problems from occurring. It is not necessary to use a timeout
B B B B B B B B B B B B B B B B B B
because the child hasn't reached the point where cooperation is impossible. The PNP should
B B B B B B B B B B B B B B
model appropriate interventions by offering the child a distraction and may ask the parent ab
B B B B B B B B B B B B B B
out discipline practices later in the visit. The child is not at a "meltdown" state.
B B B B B B B B B B B B B B
3
Wicky
, 8. The primary care pediatric nurse practitioner performs a physical examination on a 9-
B B B B B B B B B B B B B
month-
old infant and notes two central incisors on the lower gums. The parent states that the infant n
B B B B B B B B B B B B B B B B B
urses, takes solid foods three times daily, and occasionally takes water from a cup. What will t
B B B B B B B B B B B B B B B B
he pediatric nurse practitioner counsel the parent to promote optimum dental health?
B B B B B B B B B B B B
a. To begin brushing the infant's teeth with toothpaste
B B B B B B B B
b. To consider weaning the infant from breastfeeding
B B B B B B B
c. To discontinue giving fluoride supplements
B B B B B
d. To make an appointment for an initial dental examination - ANSWER-
B B B B B B B B B B B ANS: D B
The American Academy of Pediatric Dentistry recommends a first dental examination at the ti
B B B B B B B B B B B B B
me of eruption of the first tooth and no later than 12 months old. Parents should be counsele
B B B B B B B B B B B B B B B B B
d to clean the infant's teeth but with water only. Weaning from breastfeeding is not indicated,
B B B B B B B B B B B B B B B B
although mothers should not let the infant nurse while sleeping to prevent milk from bathing t
B B B B B B B B B B B B B B B
he teeth. Fluoride supplements should not be discontinued.
B B B B B B B
9. The primary care pediatric nurse practitioner has a cohort of patients who have special heal
B B B B B B B B B B B B B B B
th care needs. Which is an important role of the nurse practitioner when caring for these child
B B B B B B B B B B B B B B B B
ren? B
a. Care coordination and collaboration
B B B B
b. Developing protocols for parents to follow
B B B B B B
c. Monitoring individual education plans (IEPs)
B B B B B
d. Providing lists of resources for families - ANSWER-
B B B B B B B B ANS: A B
Care coordination is one of the key elements for children with special health care needs. PNPs
B B B B B B B B B B B B B B B B
are especially suited for this role and have the unique skills to function as care coordinators. C
B B B B B B B B B B B B B B B B
are for these children should involve shared decision making and individualized care and not "
B B B B B B B B B B B B B B
cookbook" approaches. The PNP may advocate for children's health care needs for the IEP but
B B B B B B B B B B B B B B B
does not monitor these. The PNP should not just give parents lists of phone numbers but shou
B B B B B B B B B B B B B B B B
ld assist them to make appointments.
B B B B B
10. A single mother of an infant worries that living in a household with only one parent will ca
B B B B B B B B B B B B B B B B B B
use her child to be maladjusted. To help address the mother's concerns, the primary care pedi
B B B B B B B B B B B B B B B
atric nurse practitioner will suggest :
B B B B B
4
Wicky
