NR 602 Midterm Exam (2026) |
Chamberlain Primary Care Questions and
Ansẉers with
Expert-Verified Explanation 2026\2027
update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
, Expert-Verified Explanation
Verified ẉith trusted textbooks
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─
1. A 2-year-old child is brought to the clinic for a well-child visit. The parent is
concerned because the child says "no" to everything and has temper tantrums.
What should the primary care provider advise?
A. This is abnormal behavior and requires a developmental evaluation.
B. This is typical behavior for a 2-year-old in the autonomy versus shame stage.
C. The child should be referred to a behavioral specialist immediately.
D. The parent should use physical discipline to correct the behavior.
Correct answer: B
Explanation: According to Erikson’s psychosocial stages, a 2-year-old is in the
autonomy versus shame and doubt stage. Saying "no" and having temper
tantrums are normal expressions of developing independence. The provider
should reassure the parent, offer guidance on consistent limit-setting, and
suggest redirection techniques. Referral is not needed unless behaviors are
extreme or accompanied by developmental regression.
2. A 4-month-old infant is here for a well-child check. Which developmental
milestone should the infant have achieved?
A. Sitting without support
B. Rolling from back to front
C. Pincer grasp
D. Walking with assistance
Correct answer: B
Explanation: By 4 months, most infants can roll from back to front or front to
back, hold head steady without support, and bring hands to midline. Sitting
without support occurs around 6-8 months. Pincer grasp develops around 9-10
months. Walking with assistance occurs around 12 months. The provider
,should assess for these milestones and educate parents on age-appropriate
developmental surveillance.
3. A 12-month-old infant is not yet saying any words and does not babble. The
parent reports the infant does not turn to sounds. What is the most appropriate
next step?
A. Reassure the parent that this is normal.
B. Schedule a follow-up visit in 3 months.
C. Perform an immediate hearing screening and refer to audiology.
D. Refer to a speech therapist without further testing.
Correct answer: C
Explanation: Failure to babble or say words by 12 months, combined with not
turning to sounds, raises concern for hearing impairment. Immediate hearing
screening and referral to audiology are essential. Early detection of hearing loss
is critical for language development. Speech therapy may be needed after
hearing is assessed. Reassurance or delayed follow-up would be inappropriate.
4. A 15-month-old child is due for immunizations. Which vaccines are
recommended at this age according to the CDC schedule?
A. DTaP, IPV, Hib, PCV13, MMR, Varicella, Hep A, Hep B
B. Tdap, HPV, MenACWY
C. DTaP, IPV, MMR, Varicella, Hep A, Hep B, PCV13, Hib
D. DTaP, IPV, MMR, Varicella, Hep B, PCV13, Hib, RV
Correct answer: A
Explanation: At 12-15 months, the CDC recommends DTaP (4th dose), IPV (3rd
dose), Hib (booster), PCV13 (booster), MMR (1st dose), Varicella (1st dose), Hep
A (1st dose), and Hep B (3rd dose if not given at birth). RV is not given after 8
months. HPV and MenACWY are adolescent vaccines. Tdap is given at 11-12
years. The provider should verify immunization history and address parental
concerns.
5. A 16-year-old female requests contraception. She has a history of migraines
with aura. Which contraceptive method is contraindicated?
A. Copper IUD
B. Etonogestrel implant (Nexplanon)
C. Combined oral contraceptive pills (COCs)
D. Depot medroxyprogesterone acetate (DMPA)
, Correct answer: C
Explanation: Combined oral contraceptives (estrogen-containing) are
contraindicated in women with migraines with aura due to increased risk of
ischemic stroke. Progestin-only methods (implant, DMPA, LNG-IUD) and copper
IUD are safe alternatives. The provider should counsel the patient on
appropriate options and document the contraindication.
6. A 28-year-old woman at 10 weeks gestation presents with nausea and
vomiting. She has lost 2 kg. Which medication is first-line for hyperemesis
gravidarum?
A. Ondansetron (Zofran)
B. Metoclopramide (Reglan)
C. Doxylamine/pyridoxine (Diclegis)
D. Promethazine (Phenergan)
Correct answer: C
Explanation: Doxylamine/pyridoxine (Diclegis) is FDA-approved and first-line for
nausea and vomiting in pregnancy. It is safe and effective. Ondansetron is used
for severe cases but has a possible small risk of cleft palate. Metoclopramide
and promethazine are second-line. The provider should also recommend dietary
changes (small, frequent meals), hydration, and thiamine supplementation to
prevent Wernicke encephalopathy.
7. A 3-year-old child presents with fever, cough, and inspiratory stridor that is
worse at night. The parent reports the child awoke with a "barking" cough. What
is the most likely diagnosis?
A. Bacterial tracheitis
B. Epiglottitis
C. Croup (laryngotracheobronchitis)
D. Foreign body aspiration
Correct answer: C
Explanation: Croup presents with inspiratory stridor, barking cough, and
hoarseness, typically worse at night. It is usually viral (parainfluenza) and self-
limited. Epiglottitis (now rare due to Hib vaccine) presents with drooling,
dysphagia, and tripod positioning. Bacterial tracheitis causes high fever and
toxic appearance. Foreign body aspiration causes sudden onset of coughing
without fever. Mild croup is managed with supportive care and possibly
dexamethasone.
Chamberlain Primary Care Questions and
Ansẉers with
Expert-Verified Explanation 2026\2027
update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
, Expert-Verified Explanation
Verified ẉith trusted textbooks
───────────────────────────────────────────────────────
─
1. A 2-year-old child is brought to the clinic for a well-child visit. The parent is
concerned because the child says "no" to everything and has temper tantrums.
What should the primary care provider advise?
A. This is abnormal behavior and requires a developmental evaluation.
B. This is typical behavior for a 2-year-old in the autonomy versus shame stage.
C. The child should be referred to a behavioral specialist immediately.
D. The parent should use physical discipline to correct the behavior.
Correct answer: B
Explanation: According to Erikson’s psychosocial stages, a 2-year-old is in the
autonomy versus shame and doubt stage. Saying "no" and having temper
tantrums are normal expressions of developing independence. The provider
should reassure the parent, offer guidance on consistent limit-setting, and
suggest redirection techniques. Referral is not needed unless behaviors are
extreme or accompanied by developmental regression.
2. A 4-month-old infant is here for a well-child check. Which developmental
milestone should the infant have achieved?
A. Sitting without support
B. Rolling from back to front
C. Pincer grasp
D. Walking with assistance
Correct answer: B
Explanation: By 4 months, most infants can roll from back to front or front to
back, hold head steady without support, and bring hands to midline. Sitting
without support occurs around 6-8 months. Pincer grasp develops around 9-10
months. Walking with assistance occurs around 12 months. The provider
,should assess for these milestones and educate parents on age-appropriate
developmental surveillance.
3. A 12-month-old infant is not yet saying any words and does not babble. The
parent reports the infant does not turn to sounds. What is the most appropriate
next step?
A. Reassure the parent that this is normal.
B. Schedule a follow-up visit in 3 months.
C. Perform an immediate hearing screening and refer to audiology.
D. Refer to a speech therapist without further testing.
Correct answer: C
Explanation: Failure to babble or say words by 12 months, combined with not
turning to sounds, raises concern for hearing impairment. Immediate hearing
screening and referral to audiology are essential. Early detection of hearing loss
is critical for language development. Speech therapy may be needed after
hearing is assessed. Reassurance or delayed follow-up would be inappropriate.
4. A 15-month-old child is due for immunizations. Which vaccines are
recommended at this age according to the CDC schedule?
A. DTaP, IPV, Hib, PCV13, MMR, Varicella, Hep A, Hep B
B. Tdap, HPV, MenACWY
C. DTaP, IPV, MMR, Varicella, Hep A, Hep B, PCV13, Hib
D. DTaP, IPV, MMR, Varicella, Hep B, PCV13, Hib, RV
Correct answer: A
Explanation: At 12-15 months, the CDC recommends DTaP (4th dose), IPV (3rd
dose), Hib (booster), PCV13 (booster), MMR (1st dose), Varicella (1st dose), Hep
A (1st dose), and Hep B (3rd dose if not given at birth). RV is not given after 8
months. HPV and MenACWY are adolescent vaccines. Tdap is given at 11-12
years. The provider should verify immunization history and address parental
concerns.
5. A 16-year-old female requests contraception. She has a history of migraines
with aura. Which contraceptive method is contraindicated?
A. Copper IUD
B. Etonogestrel implant (Nexplanon)
C. Combined oral contraceptive pills (COCs)
D. Depot medroxyprogesterone acetate (DMPA)
, Correct answer: C
Explanation: Combined oral contraceptives (estrogen-containing) are
contraindicated in women with migraines with aura due to increased risk of
ischemic stroke. Progestin-only methods (implant, DMPA, LNG-IUD) and copper
IUD are safe alternatives. The provider should counsel the patient on
appropriate options and document the contraindication.
6. A 28-year-old woman at 10 weeks gestation presents with nausea and
vomiting. She has lost 2 kg. Which medication is first-line for hyperemesis
gravidarum?
A. Ondansetron (Zofran)
B. Metoclopramide (Reglan)
C. Doxylamine/pyridoxine (Diclegis)
D. Promethazine (Phenergan)
Correct answer: C
Explanation: Doxylamine/pyridoxine (Diclegis) is FDA-approved and first-line for
nausea and vomiting in pregnancy. It is safe and effective. Ondansetron is used
for severe cases but has a possible small risk of cleft palate. Metoclopramide
and promethazine are second-line. The provider should also recommend dietary
changes (small, frequent meals), hydration, and thiamine supplementation to
prevent Wernicke encephalopathy.
7. A 3-year-old child presents with fever, cough, and inspiratory stridor that is
worse at night. The parent reports the child awoke with a "barking" cough. What
is the most likely diagnosis?
A. Bacterial tracheitis
B. Epiglottitis
C. Croup (laryngotracheobronchitis)
D. Foreign body aspiration
Correct answer: C
Explanation: Croup presents with inspiratory stridor, barking cough, and
hoarseness, typically worse at night. It is usually viral (parainfluenza) and self-
limited. Epiglottitis (now rare due to Hib vaccine) presents with drooling,
dysphagia, and tripod positioning. Bacterial tracheitis causes high fever and
toxic appearance. Foreign body aspiration causes sudden onset of coughing
without fever. Mild croup is managed with supportive care and possibly
dexamethasone.
