NR602 Primary Care of Women & Child Health FINAL EXAM:
Latest 2025 Real Exam (Complete Exam) 150 Questions &
Correct Answers | Grade A Verified
Subject: Primary Care of Women & Child Health – Pediatric Gastrointestinal Disorders (colic, GERD,
cyclic vomiting syndrome, appendicitis, intussusception, FAP, celiac disease, Crohn disease, failure to
thrive); Pediatric GU Disorders (UTI, vesicoureteral reflux, hematuria, nephrotic syndrome,
nephrolithiasis, Wilms tumor); Pediatric Reproductive/Genital Disorders (retractile testis, inguinal
hernia, phimosis, testicular torsion); Pediatric Endocrinology (congenital hypothyroidism, type 1
diabetes, type 2 diabetes, metabolic syndrome); Pediatric Behavioral/Mental Health (ADHD, executive
function disorders, autism, GAD, OCD, depression, bipolar disorder, oppositional defiant disorder,
eating disorders); Women's Health – Breast Disorders (mastalgia, mammary duct ectasia,
fibroadenoma, breast cancer screening); Menstrual Disorders (amenorrhea, dysmenorrhea, PMS,
PMDD, AUB); Reproductive Anatomy (levator ani, Bartholin gland, fallopian tubes, menstrual cycle
physiology).
Source: NR602 Final Exam 2025, AAP, ACOG, USPSTF, CDC.
Format: Q&A Guide with Clinical Rationale | Verified Answers | Grade A Guaranteed
The parent of an infant experiencing colic asks about using a probiotic medication. What will
the primary care pediatric NP tell this parent?
Correct Answer: D. There is no conclusive evidence about using probiotics to treat colic.
1. Probiotics (Lactobacillus reuteri) have shown mixed results in trials; not standard of care. Most colic
resolves by 3-4 months with parental support.
2. Management: swaddling, white noise, rocking, elimination of cow's milk protein from diet (if formula-
fed).
A toddler with poor weight gain and normal barium swallow – next step?
Correct Answer: D. Videofluoroscopic swallowing study (VFSS).
1. VFSS evaluates oral/pharyngeal phase of swallowing (aspiration risk) and esophageal motility. Barium
swallow rules out structural anomalies.
2. If VFSS normal, consider feeding therapy, calorie-dense supplements, and treat GERD if present.
Toddler with V/D, dry mucous membranes, mild tachycardia, 2 wet diapers/24h.
Recommendation?
Correct Answer: D. Oral rehydration solution with f/u in 24H.
1. Mild-moderate dehydration (3-6%): oral rehydration therapy (ORT) with Pedialyte, 50-100 mL/kg over
4 hours.
2. Indications for IV/hospitalization: severe dehydration (>10% loss), inability to tolerate PO,
hemodynamic instability, intractable vomiting.
, 9-year-old girl with cyclic vomiting, abnormal eye movement, ataxia – correct action?
Correct Answer: D. Refer to a pediatric gastroenterologist for further workup.
1. Neurologic symptoms (ataxia, abnormal eye movements) + cyclic vomiting suggest metabolic disorder
(mitochondrial disease) or CNS lesion. Urgent referral.
3-month-old with arching, gagging, spitting, poor weight gain (5th percentile) – best treatment?
Correct Answer: A. Begin a trial of extensively hydrolyzed protein formula for 2-4 weeks.
1. Suspect cow's milk protein allergy (CMPA) – presents with GERD-like symptoms, poor weight gain.
Eliminate cow's milk from mother's diet (breastfed) or use hydrolyzed formula.
2. PPI therapy not first-line in infants without erosive esophagitis.
School-age child, dull epigastric pain, awakens from sleep, Hgb 8. Next step?
Correct Answer: D. Referral for EGD (esophagogastroduodenoscopy).
1. Alarm symptoms: weight loss, bleeding, anemia, nocturnal pain, family history of gastric cancer/IBD.
EGD with biopsy to diagnose peptic ulcer disease, H. pylori, celiac disease.
2-month-old with inconsolable crying, normal exam, normal weight gain – recommendation?
Correct Answer: B. Eliminating certain foods from the mother's diet.
1. Suspect CMPA in breastfed infant with colic >3 hours/day, >3 days/week, >3 weeks (Wessel criteria).
Eliminate dairy from maternal diet x2-4 weeks.
Child swallowed metal bead (6mm) in stomach, asymptomatic – correct treatment?
Correct Answer: B. Have the parents watch for the object in the child's stool.
1. Most ingested foreign bodies <2cm pass spontaneously. Instruct parents to monitor for passage in
stool (72h – 2 weeks). Seek care if abdominal pain, vomiting, bleeding, fever.
10-year-old child with RLQ pain, vomiting, fever after pain relief – likely diagnosis?
Correct Answer: A. Appendicitis with perforation (relief of pain after vomiting suggests perforation).
1. Classic appendicitis: periumbilical to RLQ migration, anorexia, vomiting, fever. Perforation causes
temporary pain relief then worsening peritonitis.
18-month-old child with intermittent colicky pain, screaming, lethargy, bloody mucus stool –
likely diagnosis?
Correct Answer: C. Intussusception.
1. Intussusception: telescoping of bowel (ileocecal most common). Triad: colicky pain, vomiting, currant
jelly stool. Air enema for diagnosis/reduction; surgery if fails.
Functional abdominal pain (FAP) – important part of treatment?
Correct Answer: C. Teaching about the brain-gut interaction causing symptoms.
1. FAP is real pain (not malingering) mediated by visceral hyperalgesia and altered gut motility.
Explanation of biopsychosocial model reduces anxiety, validates child's experience.
Latest 2025 Real Exam (Complete Exam) 150 Questions &
Correct Answers | Grade A Verified
Subject: Primary Care of Women & Child Health – Pediatric Gastrointestinal Disorders (colic, GERD,
cyclic vomiting syndrome, appendicitis, intussusception, FAP, celiac disease, Crohn disease, failure to
thrive); Pediatric GU Disorders (UTI, vesicoureteral reflux, hematuria, nephrotic syndrome,
nephrolithiasis, Wilms tumor); Pediatric Reproductive/Genital Disorders (retractile testis, inguinal
hernia, phimosis, testicular torsion); Pediatric Endocrinology (congenital hypothyroidism, type 1
diabetes, type 2 diabetes, metabolic syndrome); Pediatric Behavioral/Mental Health (ADHD, executive
function disorders, autism, GAD, OCD, depression, bipolar disorder, oppositional defiant disorder,
eating disorders); Women's Health – Breast Disorders (mastalgia, mammary duct ectasia,
fibroadenoma, breast cancer screening); Menstrual Disorders (amenorrhea, dysmenorrhea, PMS,
PMDD, AUB); Reproductive Anatomy (levator ani, Bartholin gland, fallopian tubes, menstrual cycle
physiology).
Source: NR602 Final Exam 2025, AAP, ACOG, USPSTF, CDC.
Format: Q&A Guide with Clinical Rationale | Verified Answers | Grade A Guaranteed
The parent of an infant experiencing colic asks about using a probiotic medication. What will
the primary care pediatric NP tell this parent?
Correct Answer: D. There is no conclusive evidence about using probiotics to treat colic.
1. Probiotics (Lactobacillus reuteri) have shown mixed results in trials; not standard of care. Most colic
resolves by 3-4 months with parental support.
2. Management: swaddling, white noise, rocking, elimination of cow's milk protein from diet (if formula-
fed).
A toddler with poor weight gain and normal barium swallow – next step?
Correct Answer: D. Videofluoroscopic swallowing study (VFSS).
1. VFSS evaluates oral/pharyngeal phase of swallowing (aspiration risk) and esophageal motility. Barium
swallow rules out structural anomalies.
2. If VFSS normal, consider feeding therapy, calorie-dense supplements, and treat GERD if present.
Toddler with V/D, dry mucous membranes, mild tachycardia, 2 wet diapers/24h.
Recommendation?
Correct Answer: D. Oral rehydration solution with f/u in 24H.
1. Mild-moderate dehydration (3-6%): oral rehydration therapy (ORT) with Pedialyte, 50-100 mL/kg over
4 hours.
2. Indications for IV/hospitalization: severe dehydration (>10% loss), inability to tolerate PO,
hemodynamic instability, intractable vomiting.
, 9-year-old girl with cyclic vomiting, abnormal eye movement, ataxia – correct action?
Correct Answer: D. Refer to a pediatric gastroenterologist for further workup.
1. Neurologic symptoms (ataxia, abnormal eye movements) + cyclic vomiting suggest metabolic disorder
(mitochondrial disease) or CNS lesion. Urgent referral.
3-month-old with arching, gagging, spitting, poor weight gain (5th percentile) – best treatment?
Correct Answer: A. Begin a trial of extensively hydrolyzed protein formula for 2-4 weeks.
1. Suspect cow's milk protein allergy (CMPA) – presents with GERD-like symptoms, poor weight gain.
Eliminate cow's milk from mother's diet (breastfed) or use hydrolyzed formula.
2. PPI therapy not first-line in infants without erosive esophagitis.
School-age child, dull epigastric pain, awakens from sleep, Hgb 8. Next step?
Correct Answer: D. Referral for EGD (esophagogastroduodenoscopy).
1. Alarm symptoms: weight loss, bleeding, anemia, nocturnal pain, family history of gastric cancer/IBD.
EGD with biopsy to diagnose peptic ulcer disease, H. pylori, celiac disease.
2-month-old with inconsolable crying, normal exam, normal weight gain – recommendation?
Correct Answer: B. Eliminating certain foods from the mother's diet.
1. Suspect CMPA in breastfed infant with colic >3 hours/day, >3 days/week, >3 weeks (Wessel criteria).
Eliminate dairy from maternal diet x2-4 weeks.
Child swallowed metal bead (6mm) in stomach, asymptomatic – correct treatment?
Correct Answer: B. Have the parents watch for the object in the child's stool.
1. Most ingested foreign bodies <2cm pass spontaneously. Instruct parents to monitor for passage in
stool (72h – 2 weeks). Seek care if abdominal pain, vomiting, bleeding, fever.
10-year-old child with RLQ pain, vomiting, fever after pain relief – likely diagnosis?
Correct Answer: A. Appendicitis with perforation (relief of pain after vomiting suggests perforation).
1. Classic appendicitis: periumbilical to RLQ migration, anorexia, vomiting, fever. Perforation causes
temporary pain relief then worsening peritonitis.
18-month-old child with intermittent colicky pain, screaming, lethargy, bloody mucus stool –
likely diagnosis?
Correct Answer: C. Intussusception.
1. Intussusception: telescoping of bowel (ileocecal most common). Triad: colicky pain, vomiting, currant
jelly stool. Air enema for diagnosis/reduction; surgery if fails.
Functional abdominal pain (FAP) – important part of treatment?
Correct Answer: C. Teaching about the brain-gut interaction causing symptoms.
1. FAP is real pain (not malingering) mediated by visceral hyperalgesia and altered gut motility.
Explanation of biopsychosocial model reduces anxiety, validates child's experience.
