NR602 PRIMARY CARE OF THE
CHILDBEARING AND CHILDREARING
FAMILY COMPREHENSIVE
PRACTICUM EXAM
1. A 28-year-old female at 26 weeks gestation presents for a routine prenatal visit. Her 1-hour
glucose challenge test (GCT) result is 155 mg/dL. What is the most appropriate next step in
management?
A. Perform a 3-hour 100g oral glucose tolerance test (OGTT)
B. Diagnose Gestational Diabetes Mellitus (GDM) and start insulin
C. Repeat the 1-hour GCT in two weeks
D. Advise strict carbohydrate restriction and recheck A1C
Answer: A
Conceptual Explanation: A 1-hour GCT result above 130-140 mg/dL is considered
positive/elevated and requires a diagnostic 3-hour OGTT to confirm Gestational Diabetes.
2. A 4-year-old child is brought to the clinic with a sudden onset of high fever, drooling, and
an inspiratory stridor. The child is sitting in a ‘tripod’ position. What is the priority
intervention?
A. Maintain a calm environment and prepare for emergency airway management
,B. Administer nebulized racemic epinephrine immediately
C. Perform a throat culture and visual inspection of the pharynx
D. Obtain a lateral neck X-ray to look for the steeple sign
Answer: A
Conceptual Explanation: These symptoms are classic for epiglottitis. The priority is
maintaining the airway and avoiding agitation (like throat exams), as this can cause
complete airway obstruction.
3. During a well-child visit, a 12-month-old is noted to have a hemoglobin level of 9.5 g/dL.
Which of the following is the most likely cause and appropriate management?
A. Lead poisoning; initiate chelation therapy
B. Thalassemia trait; refer to hematology immediately
C. Physiologic anemia of infancy; reassure the parents
D. Iron deficiency anemia; start iron supplementation at 3-6 mg/kg/day
Answer: D
Conceptual Explanation: Iron deficiency is common at 12 months due to high cow’s milk
intake or low iron diet. 9.5 g/dL is low, warranting iron supplementation and dietary
counseling.
, 4. A 16-year-old female presents with primary amenorrhea. Physical exam reveals Tanner
Stage 1 breast development and a short stature with a webbed neck. Which diagnostic test is
most definitive?
A. Serum Prolactin level
B. Pelvic Ultrasound
C. Karyotype analysis
D. Thyroid Stimulating Hormone (TSH)
Answer: C
Conceptual Explanation: The clinical presentation suggests Turner Syndrome (45, X),
which is confirmed via karyotype analysis.
5. Which of the following findings is considered a ‘positive’ sign of pregnancy?
A. Auscultation of fetal heart tones by a provider
B. Positive serum Beta-hCG
C. Chadwick’s sign (bluish discoloration of the cervix)
D. Amenorrhea and breast tenderness
Answer: A
Conceptual Explanation: Positive signs of pregnancy are those that prove a fetus is
present (Fetal heart tones, ultrasound visualization, fetal movement felt by provider). hCG
and Chadwick’s are probable signs.
CHILDBEARING AND CHILDREARING
FAMILY COMPREHENSIVE
PRACTICUM EXAM
1. A 28-year-old female at 26 weeks gestation presents for a routine prenatal visit. Her 1-hour
glucose challenge test (GCT) result is 155 mg/dL. What is the most appropriate next step in
management?
A. Perform a 3-hour 100g oral glucose tolerance test (OGTT)
B. Diagnose Gestational Diabetes Mellitus (GDM) and start insulin
C. Repeat the 1-hour GCT in two weeks
D. Advise strict carbohydrate restriction and recheck A1C
Answer: A
Conceptual Explanation: A 1-hour GCT result above 130-140 mg/dL is considered
positive/elevated and requires a diagnostic 3-hour OGTT to confirm Gestational Diabetes.
2. A 4-year-old child is brought to the clinic with a sudden onset of high fever, drooling, and
an inspiratory stridor. The child is sitting in a ‘tripod’ position. What is the priority
intervention?
A. Maintain a calm environment and prepare for emergency airway management
,B. Administer nebulized racemic epinephrine immediately
C. Perform a throat culture and visual inspection of the pharynx
D. Obtain a lateral neck X-ray to look for the steeple sign
Answer: A
Conceptual Explanation: These symptoms are classic for epiglottitis. The priority is
maintaining the airway and avoiding agitation (like throat exams), as this can cause
complete airway obstruction.
3. During a well-child visit, a 12-month-old is noted to have a hemoglobin level of 9.5 g/dL.
Which of the following is the most likely cause and appropriate management?
A. Lead poisoning; initiate chelation therapy
B. Thalassemia trait; refer to hematology immediately
C. Physiologic anemia of infancy; reassure the parents
D. Iron deficiency anemia; start iron supplementation at 3-6 mg/kg/day
Answer: D
Conceptual Explanation: Iron deficiency is common at 12 months due to high cow’s milk
intake or low iron diet. 9.5 g/dL is low, warranting iron supplementation and dietary
counseling.
, 4. A 16-year-old female presents with primary amenorrhea. Physical exam reveals Tanner
Stage 1 breast development and a short stature with a webbed neck. Which diagnostic test is
most definitive?
A. Serum Prolactin level
B. Pelvic Ultrasound
C. Karyotype analysis
D. Thyroid Stimulating Hormone (TSH)
Answer: C
Conceptual Explanation: The clinical presentation suggests Turner Syndrome (45, X),
which is confirmed via karyotype analysis.
5. Which of the following findings is considered a ‘positive’ sign of pregnancy?
A. Auscultation of fetal heart tones by a provider
B. Positive serum Beta-hCG
C. Chadwick’s sign (bluish discoloration of the cervix)
D. Amenorrhea and breast tenderness
Answer: A
Conceptual Explanation: Positive signs of pregnancy are those that prove a fetus is
present (Fetal heart tones, ultrasound visualization, fetal movement felt by provider). hCG
and Chadwick’s are probable signs.
