NR602 Pediatric FINAL 2026/2027
TestBANK EXAM With 350 Questions And Correct
Answers (100% Correct Verified Answers) WITH
RATIONALES / NR602 Pediatric 2026
A child who has psoriasis, who has been using a moderate-potency topical steroid on thick plaques
on the extremities and a high-potency topical steroid on more severe plaques on the elbows and
knees, continues to have worsening of plaques. In consultation with a dermatologist, which
treatment will be added?
Anthralin ointment in high strength applied for 10 to 30 minutes daily
Calcipotriol cream applied liberally each day to the entire body
Oral steroids and methotrexate therapy until plaques resolve
Wideband ultraviolet therapy for 15 minutes twice daily ANS: A
Anthralin ointment is useful for plaques that are resistant to steroids. Calcipotriol cream is effective
for mild to moderate plaques, but when applied in excessive quantities over large areas can cause
hypercalcemia. Oral steroids are not indicated and may worsen symptoms by causing pustular flare.
Methotrexate is used for severe disease, and these symptoms indicate that this is moderate disease.
If UV light is used, narrowband UVB light therapy is preferred in children for safety and efficacy.
The primary care pediatric nurse practitioner notes velvety, brown thickening of skin in the axillae,
groin, and neck folds of an adolescent Hispanic female who is overweight. What is the initial step
in managing this condition?
Consultation with a pediatric dermatologist
Performing metabolic laboratory tests
Prescribing topical retinoic acid cream
Referral to a pediatric endocrinologist ANS: B
The initial step is to determine whether metabolic syndrome is the underlying cause for these lesions,
which, according to the other physical findings, is most likely. If hyperinsulinemia is present, referral
to a pediatric endocrinologist is the next step. A dermatology referral is not indicated. Unless the
lesions are thick or cause discomfort, prescribing retinoic acid is not necessary.
A pre-school age child has honey-crusted lesions on erythematous, eroded skin around the nose
and mouth, with satellite lesions on the arms and legs. The child's parent has several similar
lesions and reports that other children in the day care have a similar rash. How will this be
treated?
Amoxicillin 40 to 5 mg/kg/day for 7 to 10 days
,Amoxicillin-clavulanate 90 mg/kg/day for 10 days
Bacitracin cream applied to lesions for 10 to 14 days
Mupirocin ointment applied to lesions until clear ANS: B
When children have multiple impetigo lesions or non-bullous impetigo with infection in multiple
family members or child care groups, oral antibiotics are indicated. Amoxicillin-clavulanate is a first-
line drug for this indication. Amoxicillin is not used for skin infections. Bacitracin is bacteriostatic and
may be used when only a few lesions are present and if bacterial resistance is not an issue. Mupirocin
is used for mild impetigo when the case is isolated.
The primary care pediatric nurse practitioner is teaching a parent of a child with dry skin about
hydrating the skin with bathing. What will the nurse practitioner include in teaching?
Apply lubricating agents at least 1 hour after the bath.
Have the child soak in a lukewarm water bath.
Keep the child in the bath until the skin begins to "prune."
Soaping should be done at the beginning of the bath. ANS: B
When using bathing to hydrate dry skin, lukewarm water should be used. Lubricating agents should
be applied immediately after patting the skin dry. The bath should last long enough to allow the skin
to become moisturized without becoming supersaturated or "pruned." Soaping and shampooing
should be performed at the end of the bath followed by thorough rinsing.
A 9-month-old infant has vesiculopustular lesions on the palms and soles, on the face and neck,
and in skin folds of the extremities. The primary care pediatric nurse practitioner notes linear and
S-shaped burrow lesions on the parent's hands and wrists. What is the treatment for this rash for
this infant?
Ivermectin 200 mcg/kg for 7 to 14 days, along with symptomatic treatment for itching
Permethrin 5% cream applied to face, neck, and body and rinsed off in 8 to 14 hours
Treatment of all family members except the infant with permethrin 5% cream and ivermectin
Treatment with permethrin 5% cream for 7 days in conjunction with ivermectin 200 mcg/kg
ANS: B
Permethrin 5% cream is the drug of choice for treating scabies and is intended for use in infants as
young as 2 months of age. Infants will get lesions on the face and neck, and permethrin may be
applied to the face, avoiding the eyes. Ivermectin is not recommended for children under 5 years old.
Treatment must include the infant as well as all family members whether symptomatic or not.
An adolescent female has grouped vesicles on her oral mucosa. To determine whether these are
caused by HSV-1 or HSV-2, the primary care pediatric nurse practitioner will order which test?
,Direct fluorescent antibody test
Enzyme-linked immunosorbent assay
Tzanck smear
Viral culture ANS: D
Oral lesions are possible with both forms of herpesvirus. Viral culture is the gold standard for
distinguishing HSV-1 from HSV-2. DFA and ELISA are usually used only with severe forms of infection.
Tzanck smear dose not distinguish HSV-1 from HSV-2.
A school-age child has a rash without fever or preceding symptoms. Physical examination reveals a
3-cm ovoid, erythematous lesion on the trunk with a finely scaled elevated border, along with
generalized macular, ovoid lesions appearing in a "Christmas tree" pattern on the child's back.
What is the initial action?
Obtain a KOH preparation of a skin scraping to verify the diagnosis.
Prescribe topical steroid creams to shorten the course of the disease.
Reassure the child's parents that the rash is benign and self-limited.
Recommend topical antihistamines and emollients to control the spread. ANS: C
This rash is typical of pityriasis rosea, a benign, self-limited papulosquamous disease that is not
contagious. Patients may be reassured that this is the case. Because the herald lesion is
characteristic, it is not necessary to obtain a KOH scraping to look for tinea corporis. Topical steroids
do not alter the course of the disease. Topical antihistamines and emollients may be used if itching
occurs, but this is not the initial management action.
An adolescent who recently spent time in a hot tub while on vacation has discrete, erythematous
1- to 2-mm papules that are centered around hair follicles on the thighs, upper arms, and
buttocks. How will the primary care pediatric nurse practitioner manage this condition?
Culture the lesions and treat with appropriate IM antibiotics.
Hospitalize for incision and drainage and intravenous antibiotics.
Order an antistaphylococcal beta-lactamase-resistant antibiotic.
Prescribe topical keratolytics and topical antibiotics. ANS: D
This adolescent has hot-tub folliculitis that is superficial at this point and may be treated with topical
keratolytics and topical antibiotics. Culture is indicated if the lesions are resistant to treatment. IV
and oral antibiotics and I&D are indicated for more severe episodes.
When prescribing topical glucocorticoids to treat inflammatory skin conditions, the primary care
pediatric nurse practitioner will
initiate therapy with a high-potency glucocorticoid.
, order lotions when higher potency is necessary.
prescribe brand-name preparations for consistent effects.
use fluorinated steroids to minimize adverse effects. ANS: C
Brand-name preparations often have a more consistent base and potency. PNPs should be familiar
with a few high-, medium-, and low-potency products and use those consistently. Therapy should be
initiated with the lowest possible potency. Lotions have a lower potency than ointments and creams.
Fluorinated steroids have the highest potency and a higher risk of side effects
A child has several circular, scaly lesions on the arms and abdomen, some of which have central
clearing. The primary care pediatric nurse practitioner notes a smaller, scaly lesion on the child's
scalp. How will the nurse practitioner treat this child?
Obtain scrapings of the lesions for fungal cultures.
Order prescription-strength antifungal creams.
Prescribe oral griseofulvin for 2 to 4 weeks.
Recommend OTC antifungal creams and shampoos. ANS: C
Whenever tinea lesions occur on the scalp or nails, oral griseofulvin must be given for 2 to 4 weeks.
Unless the infection is resistant to treatment, fungal cultures are not necessary. Topical medications
alone are not effective for tinea capitus.
A child will need an occlusive dressing to treat lichen simplex chronicus. What will the primary
care pediatric nurse practitioner tell the parents about applying this treatment?
Apply ointment before the dressing.
Plastic wrap should not be used.
The dressing should be applied to dry skin.
Change the dressing twice daily. ANS: A
Occlusive dressings are placed over creams and ointments to enhance hydration and absorption of
topical medications. Plastic wrap is often used. The medications and dressings should be applied to
damp skin. The dressing should not be left on more than 8 hours.
A previously healthy school-age child develops herpes zoster on the lower back. What will the
primary care pediatric nurse practitioner do to manage this condition?
Order Burow solution and warm soothing baths as comfort measures.
Prescribe oral acyclovir 30 mg/kg/day in 4 doses/day for 5 days.
Recommend topical antihistamines to control itching.
Stress the need to remain home from school until the lesions are gone. ANS: A
TestBANK EXAM With 350 Questions And Correct
Answers (100% Correct Verified Answers) WITH
RATIONALES / NR602 Pediatric 2026
A child who has psoriasis, who has been using a moderate-potency topical steroid on thick plaques
on the extremities and a high-potency topical steroid on more severe plaques on the elbows and
knees, continues to have worsening of plaques. In consultation with a dermatologist, which
treatment will be added?
Anthralin ointment in high strength applied for 10 to 30 minutes daily
Calcipotriol cream applied liberally each day to the entire body
Oral steroids and methotrexate therapy until plaques resolve
Wideband ultraviolet therapy for 15 minutes twice daily ANS: A
Anthralin ointment is useful for plaques that are resistant to steroids. Calcipotriol cream is effective
for mild to moderate plaques, but when applied in excessive quantities over large areas can cause
hypercalcemia. Oral steroids are not indicated and may worsen symptoms by causing pustular flare.
Methotrexate is used for severe disease, and these symptoms indicate that this is moderate disease.
If UV light is used, narrowband UVB light therapy is preferred in children for safety and efficacy.
The primary care pediatric nurse practitioner notes velvety, brown thickening of skin in the axillae,
groin, and neck folds of an adolescent Hispanic female who is overweight. What is the initial step
in managing this condition?
Consultation with a pediatric dermatologist
Performing metabolic laboratory tests
Prescribing topical retinoic acid cream
Referral to a pediatric endocrinologist ANS: B
The initial step is to determine whether metabolic syndrome is the underlying cause for these lesions,
which, according to the other physical findings, is most likely. If hyperinsulinemia is present, referral
to a pediatric endocrinologist is the next step. A dermatology referral is not indicated. Unless the
lesions are thick or cause discomfort, prescribing retinoic acid is not necessary.
A pre-school age child has honey-crusted lesions on erythematous, eroded skin around the nose
and mouth, with satellite lesions on the arms and legs. The child's parent has several similar
lesions and reports that other children in the day care have a similar rash. How will this be
treated?
Amoxicillin 40 to 5 mg/kg/day for 7 to 10 days
,Amoxicillin-clavulanate 90 mg/kg/day for 10 days
Bacitracin cream applied to lesions for 10 to 14 days
Mupirocin ointment applied to lesions until clear ANS: B
When children have multiple impetigo lesions or non-bullous impetigo with infection in multiple
family members or child care groups, oral antibiotics are indicated. Amoxicillin-clavulanate is a first-
line drug for this indication. Amoxicillin is not used for skin infections. Bacitracin is bacteriostatic and
may be used when only a few lesions are present and if bacterial resistance is not an issue. Mupirocin
is used for mild impetigo when the case is isolated.
The primary care pediatric nurse practitioner is teaching a parent of a child with dry skin about
hydrating the skin with bathing. What will the nurse practitioner include in teaching?
Apply lubricating agents at least 1 hour after the bath.
Have the child soak in a lukewarm water bath.
Keep the child in the bath until the skin begins to "prune."
Soaping should be done at the beginning of the bath. ANS: B
When using bathing to hydrate dry skin, lukewarm water should be used. Lubricating agents should
be applied immediately after patting the skin dry. The bath should last long enough to allow the skin
to become moisturized without becoming supersaturated or "pruned." Soaping and shampooing
should be performed at the end of the bath followed by thorough rinsing.
A 9-month-old infant has vesiculopustular lesions on the palms and soles, on the face and neck,
and in skin folds of the extremities. The primary care pediatric nurse practitioner notes linear and
S-shaped burrow lesions on the parent's hands and wrists. What is the treatment for this rash for
this infant?
Ivermectin 200 mcg/kg for 7 to 14 days, along with symptomatic treatment for itching
Permethrin 5% cream applied to face, neck, and body and rinsed off in 8 to 14 hours
Treatment of all family members except the infant with permethrin 5% cream and ivermectin
Treatment with permethrin 5% cream for 7 days in conjunction with ivermectin 200 mcg/kg
ANS: B
Permethrin 5% cream is the drug of choice for treating scabies and is intended for use in infants as
young as 2 months of age. Infants will get lesions on the face and neck, and permethrin may be
applied to the face, avoiding the eyes. Ivermectin is not recommended for children under 5 years old.
Treatment must include the infant as well as all family members whether symptomatic or not.
An adolescent female has grouped vesicles on her oral mucosa. To determine whether these are
caused by HSV-1 or HSV-2, the primary care pediatric nurse practitioner will order which test?
,Direct fluorescent antibody test
Enzyme-linked immunosorbent assay
Tzanck smear
Viral culture ANS: D
Oral lesions are possible with both forms of herpesvirus. Viral culture is the gold standard for
distinguishing HSV-1 from HSV-2. DFA and ELISA are usually used only with severe forms of infection.
Tzanck smear dose not distinguish HSV-1 from HSV-2.
A school-age child has a rash without fever or preceding symptoms. Physical examination reveals a
3-cm ovoid, erythematous lesion on the trunk with a finely scaled elevated border, along with
generalized macular, ovoid lesions appearing in a "Christmas tree" pattern on the child's back.
What is the initial action?
Obtain a KOH preparation of a skin scraping to verify the diagnosis.
Prescribe topical steroid creams to shorten the course of the disease.
Reassure the child's parents that the rash is benign and self-limited.
Recommend topical antihistamines and emollients to control the spread. ANS: C
This rash is typical of pityriasis rosea, a benign, self-limited papulosquamous disease that is not
contagious. Patients may be reassured that this is the case. Because the herald lesion is
characteristic, it is not necessary to obtain a KOH scraping to look for tinea corporis. Topical steroids
do not alter the course of the disease. Topical antihistamines and emollients may be used if itching
occurs, but this is not the initial management action.
An adolescent who recently spent time in a hot tub while on vacation has discrete, erythematous
1- to 2-mm papules that are centered around hair follicles on the thighs, upper arms, and
buttocks. How will the primary care pediatric nurse practitioner manage this condition?
Culture the lesions and treat with appropriate IM antibiotics.
Hospitalize for incision and drainage and intravenous antibiotics.
Order an antistaphylococcal beta-lactamase-resistant antibiotic.
Prescribe topical keratolytics and topical antibiotics. ANS: D
This adolescent has hot-tub folliculitis that is superficial at this point and may be treated with topical
keratolytics and topical antibiotics. Culture is indicated if the lesions are resistant to treatment. IV
and oral antibiotics and I&D are indicated for more severe episodes.
When prescribing topical glucocorticoids to treat inflammatory skin conditions, the primary care
pediatric nurse practitioner will
initiate therapy with a high-potency glucocorticoid.
, order lotions when higher potency is necessary.
prescribe brand-name preparations for consistent effects.
use fluorinated steroids to minimize adverse effects. ANS: C
Brand-name preparations often have a more consistent base and potency. PNPs should be familiar
with a few high-, medium-, and low-potency products and use those consistently. Therapy should be
initiated with the lowest possible potency. Lotions have a lower potency than ointments and creams.
Fluorinated steroids have the highest potency and a higher risk of side effects
A child has several circular, scaly lesions on the arms and abdomen, some of which have central
clearing. The primary care pediatric nurse practitioner notes a smaller, scaly lesion on the child's
scalp. How will the nurse practitioner treat this child?
Obtain scrapings of the lesions for fungal cultures.
Order prescription-strength antifungal creams.
Prescribe oral griseofulvin for 2 to 4 weeks.
Recommend OTC antifungal creams and shampoos. ANS: C
Whenever tinea lesions occur on the scalp or nails, oral griseofulvin must be given for 2 to 4 weeks.
Unless the infection is resistant to treatment, fungal cultures are not necessary. Topical medications
alone are not effective for tinea capitus.
A child will need an occlusive dressing to treat lichen simplex chronicus. What will the primary
care pediatric nurse practitioner tell the parents about applying this treatment?
Apply ointment before the dressing.
Plastic wrap should not be used.
The dressing should be applied to dry skin.
Change the dressing twice daily. ANS: A
Occlusive dressings are placed over creams and ointments to enhance hydration and absorption of
topical medications. Plastic wrap is often used. The medications and dressings should be applied to
damp skin. The dressing should not be left on more than 8 hours.
A previously healthy school-age child develops herpes zoster on the lower back. What will the
primary care pediatric nurse practitioner do to manage this condition?
Order Burow solution and warm soothing baths as comfort measures.
Prescribe oral acyclovir 30 mg/kg/day in 4 doses/day for 5 days.
Recommend topical antihistamines to control itching.
Stress the need to remain home from school until the lesions are gone. ANS: A
