NR602 PRIMARY CARE OF THE
CHILDBEARING AND CHILDREARING
FAMILY FINAL EXAM STUDY GUIDE
1. A 4-month-old infant is brought in for a well-child check. During the physical exam, the
clinician notes a clunking sensation when abducting the infant’s hip. Which maneuver is the
clinician performing, and what is the suspected diagnosis?
A. Galeazzi test; Femoral shortening
B. Trendelenburg test; Legg-Calve-Perthes disease
C. Barlow maneuver; Septic arthritis
D. Ortolani maneuver; Developmental Dysplasia of the Hip (DDH)
Answer: D
Conceptual Explanation: The Ortolani maneuver is performed by abducting the hip to
reduce a dislocated femoral head back into the acetabulum, often producing a ‘clunk’. This
is a key diagnostic physical exam for DDH.
,2. A 3-week-old male presents with non-bilious, projectile vomiting after feeding and a
palpable ‘olive-shaped’ mass in the epigastrium. What is the most likely diagnosis?
A. Gastroesophageal reflux
B. Intussusception
C. Hypertrophic Pyloric Stenosis
D. Hirschsprung disease
Answer: C
Conceptual Explanation: Hypertrophic pyloric stenosis typically presents between 3-6
weeks of age with projectile vomiting and a palpable olive-shaped mass in the right upper
quadrant or epigastrium.
3. When assessing a 15-year-old female for scoliosis, the clinician asks the patient to bend
forward at the waist with arms hanging down. What is the name of this test?
A. McMurray test
B. Adams Forward Bend test
C. Lachman test
D. Phalen test
Answer: B
Conceptual Explanation: The Adams Forward Bend test is the standard screening tool for
scoliosis in adolescents to observe for rib hump or spinal curvature.
, 4. A 24-month-old child is expected to have achieved which of the following developmental
milestones?
A. Tying shoelaces and hopping on one foot
B. Walking up stairs alternating feet and using a spoon well
C. Drawing a square and naming four colors
D. Speaking in 2-3 word sentences and kicking a ball
Answer: D
Conceptual Explanation: At 2 years (24 months), children typically use two-word
phrases, follow simple commands, and exhibit gross motor skills like kicking a ball.
5. A pregnant patient at 28 weeks gestation presents for a routine visit. Her glucose challenge
test (1-hour GTT) result is 155 mg/dL. What is the next appropriate step?
A. Perform a 3-hour oral glucose tolerance test (OGTT)
B. Repeat the 1-hour GTT in two weeks
C. Diagnose Gestational Diabetes Mellitus (GDM) immediately
D. Start the patient on insulin therapy
Answer: A
Conceptual Explanation: A 1-hour GTT result above the threshold (usually 130-140
mg/dL) is a screening positive, necessitating the diagnostic 3-hour OGTT.
CHILDBEARING AND CHILDREARING
FAMILY FINAL EXAM STUDY GUIDE
1. A 4-month-old infant is brought in for a well-child check. During the physical exam, the
clinician notes a clunking sensation when abducting the infant’s hip. Which maneuver is the
clinician performing, and what is the suspected diagnosis?
A. Galeazzi test; Femoral shortening
B. Trendelenburg test; Legg-Calve-Perthes disease
C. Barlow maneuver; Septic arthritis
D. Ortolani maneuver; Developmental Dysplasia of the Hip (DDH)
Answer: D
Conceptual Explanation: The Ortolani maneuver is performed by abducting the hip to
reduce a dislocated femoral head back into the acetabulum, often producing a ‘clunk’. This
is a key diagnostic physical exam for DDH.
,2. A 3-week-old male presents with non-bilious, projectile vomiting after feeding and a
palpable ‘olive-shaped’ mass in the epigastrium. What is the most likely diagnosis?
A. Gastroesophageal reflux
B. Intussusception
C. Hypertrophic Pyloric Stenosis
D. Hirschsprung disease
Answer: C
Conceptual Explanation: Hypertrophic pyloric stenosis typically presents between 3-6
weeks of age with projectile vomiting and a palpable olive-shaped mass in the right upper
quadrant or epigastrium.
3. When assessing a 15-year-old female for scoliosis, the clinician asks the patient to bend
forward at the waist with arms hanging down. What is the name of this test?
A. McMurray test
B. Adams Forward Bend test
C. Lachman test
D. Phalen test
Answer: B
Conceptual Explanation: The Adams Forward Bend test is the standard screening tool for
scoliosis in adolescents to observe for rib hump or spinal curvature.
, 4. A 24-month-old child is expected to have achieved which of the following developmental
milestones?
A. Tying shoelaces and hopping on one foot
B. Walking up stairs alternating feet and using a spoon well
C. Drawing a square and naming four colors
D. Speaking in 2-3 word sentences and kicking a ball
Answer: D
Conceptual Explanation: At 2 years (24 months), children typically use two-word
phrases, follow simple commands, and exhibit gross motor skills like kicking a ball.
5. A pregnant patient at 28 weeks gestation presents for a routine visit. Her glucose challenge
test (1-hour GTT) result is 155 mg/dL. What is the next appropriate step?
A. Perform a 3-hour oral glucose tolerance test (OGTT)
B. Repeat the 1-hour GTT in two weeks
C. Diagnose Gestational Diabetes Mellitus (GDM) immediately
D. Start the patient on insulin therapy
Answer: A
Conceptual Explanation: A 1-hour GTT result above the threshold (usually 130-140
mg/dL) is a screening positive, necessitating the diagnostic 3-hour OGTT.
