NR 602 MIDTERM EXAM CHAMBERLAIN
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ||
100% GUARANTEED PASS!!
<LATEST VERSION>
1. A 3-year-old child presents with sudden onset wheezing, urticaria, lip
swelling, and vomiting after eating peanuts. What is the most appropriate
immediate management?
A. Administer diphenhydramine orally
B. Administer intramuscular epinephrine
C. Administer intravenous corticosteroids
D. Provide nebulized albuterol only
Correct Answer: B
Rationale: Anaphylaxis is a life-threatening emergency requiring immediate
intramuscular epinephrine. Antihistamines and steroids do not reverse airway
obstruction or hypotension and should never replace epinephrine.
2. A newborn has a total serum bilirubin level in the high-intermediate risk
zone at 48 hours of life. The infant is breastfeeding well and has no risk
factors. What is the most appropriate management?
A. Exchange transfusion
B. Initiate phototherapy immediately
C. Close outpatient follow-up and repeat bilirubin
D. Discontinue breastfeeding
,Correct Answer: C
Rationale: Infants in the high-intermediate risk zone without additional risk
factors are managed with close monitoring and repeat bilirubin testing rather than
immediate intervention.
3. A 6-month-old infant is not yet sitting unsupported but is rolling both ways
and transferring objects between hands. How should this finding be
interpreted?
A. Developmental delay requiring immediate referral
B. Normal development for age
C. Concerning for gross motor delay
D. Indicative of cerebral palsy
Correct Answer: B
Rationale: Sitting unsupported typically develops between 6–8 months. Rolling
and transferring objects are appropriate milestones at this age.
4. A pregnant patient at 28 weeks gestation reports pruritus on the palms and
soles without rash. Liver enzymes are elevated. What is the most likely
diagnosis?
A. Preeclampsia
B. Intrahepatic cholestasis of pregnancy
C. HELLP syndrome
D. Acute fatty liver of pregnancy
Correct Answer: B
Rationale: Pruritus of palms and soles with elevated bile acids or liver enzymes in
the third trimester is classic for intrahepatic cholestasis of pregnancy.
,5. Which newborn screening result requires immediate follow-up due to the
risk of irreversible intellectual disability if untreated?
A. Sickle cell trait
B. Congenital hypothyroidism
C. Cystic fibrosis carrier status
D. Galactosemia carrier status
Correct Answer: B
Rationale: Untreated congenital hypothyroidism can cause permanent
neurodevelopmental impairment. Early diagnosis and treatment are critical.
6. A breastfeeding mother presents 10 days postpartum with unilateral breast
pain, erythema, fever, and malaise. What is the best initial management?
A. Discontinue breastfeeding
B. Warm compresses only
C. Oral antibiotics and continued breastfeeding
D. Surgical drainage
Correct Answer: C
Rationale: Mastitis is treated with antibiotics while continuing breastfeeding to
promote drainage and prevent abscess formation.
7. A toddler presents with barking cough, inspiratory stridor, and hoarseness
that worsens at night. Oxygen saturation is 97%. What is the most
appropriate treatment?
A. Oral antibiotics
B. Nebulized epinephrine
C. Intramuscular epinephrine
D. Observation only
Correct Answer: B
Rationale: Moderate croup is treated with nebulized epinephrine to reduce airway
edema and corticosteroids to shorten symptom duration.
, 8. Which finding is most concerning in a newborn during the first physical
examination?
A. Acrocyanosis
B. Caput succedaneum
C. Absent red reflex
D. Mongolian spots
Correct Answer: C
Rationale: An absent red reflex may indicate congenital cataracts or
retinoblastoma and requires urgent ophthalmologic evaluation.
9. A 14-year-old female presents requesting contraception and states she does
not want her parents informed. What is the most appropriate response?
A. Refuse care without parental consent
B. Provide education only
C. Provide confidential reproductive care
D. Contact child protective services
Correct Answer: C
Rationale: Adolescents have the right to confidential reproductive health services,
including contraception, in most jurisdictions.
10. A 2-week-old infant presents with poor feeding, vomiting, and jaundice.
Newborn screen was abnormal. Which diagnosis is most likely?
A. Physiologic jaundice
B. Biliary atresia
C. Galactosemia
D. Breast milk jaundice
Correct Answer: C
Rationale: Galactosemia presents early with feeding intolerance, jaundice, and
risk of sepsis. It is detected on newborn screening.
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES ||
100% GUARANTEED PASS!!
<LATEST VERSION>
1. A 3-year-old child presents with sudden onset wheezing, urticaria, lip
swelling, and vomiting after eating peanuts. What is the most appropriate
immediate management?
A. Administer diphenhydramine orally
B. Administer intramuscular epinephrine
C. Administer intravenous corticosteroids
D. Provide nebulized albuterol only
Correct Answer: B
Rationale: Anaphylaxis is a life-threatening emergency requiring immediate
intramuscular epinephrine. Antihistamines and steroids do not reverse airway
obstruction or hypotension and should never replace epinephrine.
2. A newborn has a total serum bilirubin level in the high-intermediate risk
zone at 48 hours of life. The infant is breastfeeding well and has no risk
factors. What is the most appropriate management?
A. Exchange transfusion
B. Initiate phototherapy immediately
C. Close outpatient follow-up and repeat bilirubin
D. Discontinue breastfeeding
,Correct Answer: C
Rationale: Infants in the high-intermediate risk zone without additional risk
factors are managed with close monitoring and repeat bilirubin testing rather than
immediate intervention.
3. A 6-month-old infant is not yet sitting unsupported but is rolling both ways
and transferring objects between hands. How should this finding be
interpreted?
A. Developmental delay requiring immediate referral
B. Normal development for age
C. Concerning for gross motor delay
D. Indicative of cerebral palsy
Correct Answer: B
Rationale: Sitting unsupported typically develops between 6–8 months. Rolling
and transferring objects are appropriate milestones at this age.
4. A pregnant patient at 28 weeks gestation reports pruritus on the palms and
soles without rash. Liver enzymes are elevated. What is the most likely
diagnosis?
A. Preeclampsia
B. Intrahepatic cholestasis of pregnancy
C. HELLP syndrome
D. Acute fatty liver of pregnancy
Correct Answer: B
Rationale: Pruritus of palms and soles with elevated bile acids or liver enzymes in
the third trimester is classic for intrahepatic cholestasis of pregnancy.
,5. Which newborn screening result requires immediate follow-up due to the
risk of irreversible intellectual disability if untreated?
A. Sickle cell trait
B. Congenital hypothyroidism
C. Cystic fibrosis carrier status
D. Galactosemia carrier status
Correct Answer: B
Rationale: Untreated congenital hypothyroidism can cause permanent
neurodevelopmental impairment. Early diagnosis and treatment are critical.
6. A breastfeeding mother presents 10 days postpartum with unilateral breast
pain, erythema, fever, and malaise. What is the best initial management?
A. Discontinue breastfeeding
B. Warm compresses only
C. Oral antibiotics and continued breastfeeding
D. Surgical drainage
Correct Answer: C
Rationale: Mastitis is treated with antibiotics while continuing breastfeeding to
promote drainage and prevent abscess formation.
7. A toddler presents with barking cough, inspiratory stridor, and hoarseness
that worsens at night. Oxygen saturation is 97%. What is the most
appropriate treatment?
A. Oral antibiotics
B. Nebulized epinephrine
C. Intramuscular epinephrine
D. Observation only
Correct Answer: B
Rationale: Moderate croup is treated with nebulized epinephrine to reduce airway
edema and corticosteroids to shorten symptom duration.
, 8. Which finding is most concerning in a newborn during the first physical
examination?
A. Acrocyanosis
B. Caput succedaneum
C. Absent red reflex
D. Mongolian spots
Correct Answer: C
Rationale: An absent red reflex may indicate congenital cataracts or
retinoblastoma and requires urgent ophthalmologic evaluation.
9. A 14-year-old female presents requesting contraception and states she does
not want her parents informed. What is the most appropriate response?
A. Refuse care without parental consent
B. Provide education only
C. Provide confidential reproductive care
D. Contact child protective services
Correct Answer: C
Rationale: Adolescents have the right to confidential reproductive health services,
including contraception, in most jurisdictions.
10. A 2-week-old infant presents with poor feeding, vomiting, and jaundice.
Newborn screen was abnormal. Which diagnosis is most likely?
A. Physiologic jaundice
B. Biliary atresia
C. Galactosemia
D. Breast milk jaundice
Correct Answer: C
Rationale: Galactosemia presents early with feeding intolerance, jaundice, and
risk of sepsis. It is detected on newborn screening.
