NURS 5433 Family II (FNP 2) ACTUAL
EXAM [2025/2026] | 120 Questions |
Updated Blueprint | Pass Guaranteed - A+
Graded
SECTION 1: Acute Pediatric Conditions (18 Questions)
Clinical Scenario 1 (Q1–Q5):
A 4-year-old presents with 2 days of rhinorrhea, low-grade fever, and a barky cough.
Parents report inspiratory stridor when the child is upset. The child appears playful and
well-hydrated.
Q1: Which diagnosis is MOST likely?
A. Epiglottitis
B. Bacterial tracheitis
C. Viral croup (laryngotracheobronchitis)
D. Foreign body aspiration
Correct Answer: C
Rationale: Viral croup presents with a prodrome of upper respiratory infection
symptoms followed by a barky "seal-like" cough and inspiratory stridor that worsens at
night. A well-appearing child with intermittent stridor is characteristic of croup.
,Q2: The parents ask about treatment. The MOST appropriate initial management is:
A. Nebulized epinephrine and dexamethasone
B. Immediate intubation
C. Broad-spectrum antibiotics
D. Heliox and bronchodilators
Correct Answer: A
Rationale: Nebulized racemic epinephrine provides rapid relief of upper airway edema,
and dexamethasone (0.15–0.6 mg/kg) reduces subglottic inflammation. Most children
with mild to moderate croup respond to corticosteroids and do not require
hospitalization.
Q3: Which finding would MOST suggest a diagnosis other than croup, such as
epiglottitis, requiring emergent intervention?
A. Barking cough
B. Drooling with tripod positioning
C. Low-grade fever
D. Symptom improvement with cool mist
Correct Answer: B
Rationale: Epiglottitis presents with the "4 Ds": dysphagia, dysphonia, drooling, and
distress. The tripod position (sitting upright leaning forward) with drooling indicates
severe upper airway obstruction and requires emergent airway management.
,Q4: The child is discharged home. Which instruction is MOST important for the parents?
A. Administer over-the-counter cough suppressants every 4 hours
B. Keep the child calm and avoid agitation; return if stridor occurs at rest
C. Give aspirin if fever develops
D. Schedule a chest X-ray in the morning
Correct Answer: B
Rationale: Agitation and crying worsen subglottic edema and stridor in croup. Parents
should keep the child calm, use cool mist humidification, and seek immediate care if
stridor occurs at rest, retractions worsen, or the child becomes lethargic.
Q5: Two days later, the child develops a fever of 39.5°C, appears toxic, and has a
productive cough. Chest X-ray shows a right lower lobe infiltrate. The MOST likely
etiology is:
A. Respiratory syncytial virus
B. Streptococcus pneumoniae
C. Mycoplasma pneumoniae
D. Bordetella pertussis
Correct Answer: B
Rationale: Following a viral upper respiratory infection, bacterial superinfection with
Streptococcus pneumoniae is a common cause of community-acquired pneumonia in
, preschool-aged children. The focal infiltrate and high fever in a toxic-appearing child
support bacterial pneumonia requiring antibiotic therapy.
Q6: A 6-year-old presents with 3 days of ear pain, fever 38.8°C, and a bulging,
erythematous tympanic membrane with limited mobility. First-line antibiotic therapy is:
A. Azithromycin
B. Amoxicillin 80–90 mg/kg/day divided twice daily
C. Amoxicillin-clavulanate immediately
D. Cefdinir
Correct Answer: B
Rationale: First-line treatment for acute otitis media in children without recent antibiotic
use is high-dose amoxicillin (80–90 mg/kg/day divided BID) to cover Streptococcus
pneumoniae, the most common bacterial pathogen.
Q7: A 5-year-old has sore throat, fever, tonsillar exudates, tender anterior cervical
adenopathy, and no cough. The Centor score is 4. The MOST appropriate next step is:
A. Empiric amoxicillin
B. Rapid antigen detection test
C. Throat culture only
D. Acetaminophen and observation
Correct Answer: B
EXAM [2025/2026] | 120 Questions |
Updated Blueprint | Pass Guaranteed - A+
Graded
SECTION 1: Acute Pediatric Conditions (18 Questions)
Clinical Scenario 1 (Q1–Q5):
A 4-year-old presents with 2 days of rhinorrhea, low-grade fever, and a barky cough.
Parents report inspiratory stridor when the child is upset. The child appears playful and
well-hydrated.
Q1: Which diagnosis is MOST likely?
A. Epiglottitis
B. Bacterial tracheitis
C. Viral croup (laryngotracheobronchitis)
D. Foreign body aspiration
Correct Answer: C
Rationale: Viral croup presents with a prodrome of upper respiratory infection
symptoms followed by a barky "seal-like" cough and inspiratory stridor that worsens at
night. A well-appearing child with intermittent stridor is characteristic of croup.
,Q2: The parents ask about treatment. The MOST appropriate initial management is:
A. Nebulized epinephrine and dexamethasone
B. Immediate intubation
C. Broad-spectrum antibiotics
D. Heliox and bronchodilators
Correct Answer: A
Rationale: Nebulized racemic epinephrine provides rapid relief of upper airway edema,
and dexamethasone (0.15–0.6 mg/kg) reduces subglottic inflammation. Most children
with mild to moderate croup respond to corticosteroids and do not require
hospitalization.
Q3: Which finding would MOST suggest a diagnosis other than croup, such as
epiglottitis, requiring emergent intervention?
A. Barking cough
B. Drooling with tripod positioning
C. Low-grade fever
D. Symptom improvement with cool mist
Correct Answer: B
Rationale: Epiglottitis presents with the "4 Ds": dysphagia, dysphonia, drooling, and
distress. The tripod position (sitting upright leaning forward) with drooling indicates
severe upper airway obstruction and requires emergent airway management.
,Q4: The child is discharged home. Which instruction is MOST important for the parents?
A. Administer over-the-counter cough suppressants every 4 hours
B. Keep the child calm and avoid agitation; return if stridor occurs at rest
C. Give aspirin if fever develops
D. Schedule a chest X-ray in the morning
Correct Answer: B
Rationale: Agitation and crying worsen subglottic edema and stridor in croup. Parents
should keep the child calm, use cool mist humidification, and seek immediate care if
stridor occurs at rest, retractions worsen, or the child becomes lethargic.
Q5: Two days later, the child develops a fever of 39.5°C, appears toxic, and has a
productive cough. Chest X-ray shows a right lower lobe infiltrate. The MOST likely
etiology is:
A. Respiratory syncytial virus
B. Streptococcus pneumoniae
C. Mycoplasma pneumoniae
D. Bordetella pertussis
Correct Answer: B
Rationale: Following a viral upper respiratory infection, bacterial superinfection with
Streptococcus pneumoniae is a common cause of community-acquired pneumonia in
, preschool-aged children. The focal infiltrate and high fever in a toxic-appearing child
support bacterial pneumonia requiring antibiotic therapy.
Q6: A 6-year-old presents with 3 days of ear pain, fever 38.8°C, and a bulging,
erythematous tympanic membrane with limited mobility. First-line antibiotic therapy is:
A. Azithromycin
B. Amoxicillin 80–90 mg/kg/day divided twice daily
C. Amoxicillin-clavulanate immediately
D. Cefdinir
Correct Answer: B
Rationale: First-line treatment for acute otitis media in children without recent antibiotic
use is high-dose amoxicillin (80–90 mg/kg/day divided BID) to cover Streptococcus
pneumoniae, the most common bacterial pathogen.
Q7: A 5-year-old has sore throat, fever, tonsillar exudates, tender anterior cervical
adenopathy, and no cough. The Centor score is 4. The MOST appropriate next step is:
A. Empiric amoxicillin
B. Rapid antigen detection test
C. Throat culture only
D. Acetaminophen and observation
Correct Answer: B
