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Core Domains
Advanced Pediatric Assessment and Management
Adolescent Behavioral and Mental Health
Reproductive and Sexual Health
Common Acute Pediatric Illnesses
Chronic Childhood Disease Management
Growth, Development, and Immunizations
Family Systems Theory and Dynamics
Pharmacological Interventions in Pediatrics
Introduction
This comprehensive midterm assessment is designed to evaluate the advanced practice
nursing student's proficiency in managing the healthcare needs of families, with a specific
focus on pediatric and adolescent populations. The exam assesses clinical reasoning,
diagnostic accuracy, and the application of evidence-based interventions across diverse
healthcare settings. Utilizing a rigorous multiple-choice and scenario-based structure, the
,assessment mirrors real-world clinical encounters to test the student’s ability to navigate
complex family dynamics, legal mandates, and ethical dilemmas. Successful completion
requires deep knowledge of developmental milestones, acute and chronic illness
management, and preventative care strategies essential for the family nurse practitioner.
SECTION ONE: QUESTIONS 1–100
1. A 4-year-old child presents with a "barking" cough, inspiratory stridor, and low-grade
fever. The clinician suspects viral croup. Which of the following is the primary
treatment for moderate symptoms?
A. Oral Amoxicillin
B. Albuterol nebulizer
🟢 C. Dexamethasone
D. Cool mist humidifier alone
🔴 Explanation: Dexamethasone is the standard of care for croup as it reduces airway
inflammation and edema, significantly decreasing the rate of hospitalization and
intubation.
2. During a well-child visit, a mother expresses concern that her 18-month-old is not yet
using two-word phrases. What is the appropriate developmental guidance?
,A. Refer immediately for a hearing evaluation
B. Diagnose expressive language delay
🟢 C. Monitor and reassess at the 24-month visit
D. Advise the mother to use more "baby talk" to encourage imitation
🔴 Explanation: While children start using single words around 12 months, two-word
phrases are typically a milestone achieved by 24 months.
3. Which of the following is a classic clinical finding in a child diagnosed with pyloric
stenosis?
🟢 A. Projectile non-bilious vomiting
B. Currant jelly stools
C. High-grade fever and rebound tenderness
D. Chronic constipation and ribbon-like stools
🔴 Explanation: Pyloric stenosis typically presents in infants between 3-6 weeks of age
with forceful, non-bilious projectile vomiting due to hypertrophy of the pyloric sphincter.
4. An adolescent female presents requesting contraception. According to the principle
of "minor consent" in most jurisdictions, the nurse practitioner should:
, A. Require a parent's signature before prescribing
🟢 B. Provide confidential services for contraception
C. Notify the parents within 24 hours of the visit
D. Refer the patient to an adult gynecologist only
🔴 Explanation: In the United States, minors generally have the legal right to consent to
confidential services regarding reproductive health, including contraception and STI
testing.
5. A 6-year-old presents with perianal itching that is worse at night. The most likely
diagnosis is:
A. Tinea corporis
B. Scabies
🟢 C. Enterobiasis (Pinworms)
D. Contact dermatitis
🔴 Explanation: Enterobiasis is characterized by nocturnal perianal pruritus, as the
female worms migrate to the anal area at night to lay eggs.
6. What is the first-line antibiotic treatment for an uncomplicated urinary tract infection
in a 7-year-old female with no known allergies?