2022-2023 NRNP6541 Final Exam (3 Versions) with Answers (200 Solved Questions)

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NRNP 6541 Final Exam (3 Versions, 300 Q
& A, Latest-2022/2023) / NRNP 6541N
Final Exam / NRNP6541 Final Exam /
NRNP-6541N Final Exam: Walden
University | 100% Verified Q & A |

 Question 1
0 out of 1 points
Medicaid provides health insurance coverage to
Selected
Answer:
b.
Newborn, pregnant women, and those older than 65 whose personal income
falls below the federal poverty level.
 Question 2
1 out of 1 points
A differential diagnosis for child abuse would include all of the following except.
Selected Answer: c.
Prader-Wlli syndrome
 Question 3
1 out of 1 points
Which of the following injuries is most likely to be caused by abuse of a toddler?
Selected Answer: d.
A displaced posterior rib fracture.
 Question 4
1 out of 1 points

You are doing a kindergarten physical on a 5-year-old girl. Which of the following scenarios
would suggest the child is not ready to start kindergarten in the fall?
Selected Answer: a.
Counts to 4 and draws a person with three parts.
 Question 5
1 out of 1 points
The first sign of the onset of female puberty is usually:
Selected Answer: b.
Breast buds
 Question 6
1 out of 1 points
You see a 7-year-old with complaints of "having accidents at night." Physical exam and
history are unremarkable. Urinalysis, urine culture, and specific gravity are normal. His
parents ask about the best treatment for this problem. The best response is
Selected Answer: b.
Fluid restriction and voiding prior to the night may be effective.
 Question 7
1 out of 1 points
Which of the following statements about bullying is true?

Selected Answer: d.
It occurs most commonly during unstructured times (lunch, recess, etc.).
 Question 8
0 out of 1 points
The mother of a 5-year-old informs you that her daughter cheats when playing board games.
What is the best response?
Selected
Answer:
d.
Tell the mother to spend time clarifying board game rules before starting
games.
 Question 9
0 out of 1 points
Which of the following conditions requires urgent inpatient admission?
Selected Answer: d.
Epiglottis
 Question 10
1 out of 1 points
All of the following are consistent with peritonsillar abscess except:
Selected Answer: d.
Trismus

 Question 11
1 out of 1 points
The parents of a 7-year-old are concerned their son does not want to attend school. Which of
the historical findings are not usually associated with the diagnosis of school phobia?
Selected Answer: d.
Chronic medical illness
 Question 12
0 out of 1 points
You are performing an examination of a 3-year-old who is new to your office. Which finding
requires immediate further evaluation?
Selected Answer: c.
Heart rate increases during inspiration and decreases during expiration.
 Question 13
1 out of 1 points
A child's head circumference is routinely measured on each well visit until what age?
Selected Answer: a.
2 years
 Question 14
1 out of 1 points

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Which of the following children has abnormal language development?
Selected Answer: c.
Speech is 50% understandable at 36 months of age
 Question 15
1 out of 1 points
Please interpret the following labs for an adolescent. The adolescent has a history of obesity
and acanthosis nigricans.
Test Results
Fasting blood glucose 112 mg/dL
2 hour postprandial glucose 138 mg/dL
Selected Answer: d.
Impaired fasting glucose, postprandial glucose within normal limits
 Question 16
1 out of 1 points
Which of the following issues or concepts is relevant to the school-age child?
Selected Answer: c.
Erikson's initiative versus guilt
 Question 17
1 out of 1 points

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The diagnostic criteria for autism spectrum disorder include all of the following except
Selected Answer: d.
Tolerance of flexibility with routines
 Question 18
1 out of 1 points
Conductive hearing loss can be caused by
Selected Answer: d.
Serous otitis
 Question 19
1 out of 1 points
The most common substance used in middle school is
Selected Answer: a.
Alcohol
 Question 20
0 out of 1 points
The results of the hemoglobin A1c test are LESS reliable in children with which of the
following conditions? (Hint: select two)
Selected Answers: a.

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Crohn's Disease
b.
Celiac Disease
 Question 21
1 out of 1 points
A teenage female who is overweight has moderate acne on the face and chest, and irregular
menses. Elevation of which laboratory test provides the test evidence of polycystic ovarian
syndrome?
Selected Answer: d.
free testosterone
 Question 22
1 out of 1 points
Mark is in the exam room. You are concerned he may have epiglottitis. In what position do
these patients prefer to sit?
Selected Answer: a.
Sitting up and leaning forward
 Question 23
1 out of 1 points
You see a 30-month-old who speaks in mixed Spanish and English. The child’s
vocabulary is normal but at the low end of the normal language spectrum. The parent
is worried the child’s development will not be normal because she mixes up the two

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languages. You respond:
Selected
Answer:
b.
"Your child's speech is normal and bilingual children commonly intermix the
words from both languages until about 3 years of age."
 Question 24
1 out of 1 points
Which of the following characterizes middle adolescence (14 to 16 years old)?
Selected
Answer:
b.
Intense peer group involvement, feelings of immortality, sexual
experimentation
 Question 25
1 out of 1 points
You see a 4-year-old for a well-child visit. He has received four diphtheria, tetanus,
and acellular pertussis vaccines (DTaP); three injected polio vaccines (IPV); one
measles, mumps, and rubella vaccine (MMR); one varicella vaccine; and two
hepatitis B (Hep B) vaccines. What do you order today?
Selected Answer: c.
DTaP, IPV, MMR, and Varivax
 Question 26
1 out of 1 points
A 14-year old has ataxia. He is brought to the local emergency department, where he

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appears euphoric, emotionally labile, and a bit disoriented. He has nystagmus and
hypersalivation. Many notice his abusive language. Which of the following agents is
most likely responsible for his condition?
Selected Answer: d.
Alcohol
 Question 27
1 out of 1 points
Parents bring their 6-month-old son to see you. He is symmetrically less than the 5th
percentile for height, weight and head circumference. He was born at 30 weeks’
gestation and weighed 1000g. He was a planned pregnancy, and his mother’s
prenatal course was uneventful until an automobile accident initiated the labor. He
was ventilated for 3 days in the intensive care unit but otherwise did well without
ongoing problems. He was discharged at 8 weeks of life. Which of the following is
the most likely explanation for his small size?
Selected Answer: b.
Normal ex-preemie infant growth
 Question 28
1 out of 1 points
A fifteen-year-old female makes a statement to you during a well visit. Which of the
following statements should not be kept confidential?
Selected Answer: c.
"Sometimes I feel like ending my life."
 Question 29

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1 out of 1 points
Most children can independently get dressed by themselves by age:
Selected Answer: b.
5 years
 Question 30
0 out of 1 points
A 13-month-old child is noted to be at the 25th percentile for weight, the 10th
percentile for height, and less than the 5th percentile for head circumference. She
was born at term. She was noted to have a small head at birth, to be
developmentally delayed throughout her life, and to have required cataract surgery
shortly after birth. She currently takes phenobarbital for seizures. Which of the
following would most likely explain this child’s small size?
Selected Answer: b.
Down syndrome
 Question 31
1 out of 1 points
A 4-month-old child has poor weight gain. Her current weight is less than the 5th percentile,
height about the 10th percentile, and head circumference at the 50th percentile. The planned
pregnancy resulted in a normal, spontaneous, vaginal delivery; mother and child were
discharged after a 48-hour hospitalization. Feeding is via breast and bottle; the quantity
seems sufficient. The child has had no illness. The examination is unremarkable except for
the child’s small size. Screening laboratory shows the hemoglobin and hematocrit are 11
mg/dL and 33% respectively, with a platelet count of 198,000/mm3. Serum electrolyte levels
are sodium 140, chloride 105, potassium 3.5, bicarbonate 17, blood urea nitrogen 15, and
creatinine 0.3. Liver function tests are normal. Urinalysis reveals a pH of 8 with occasional
epithelial cells but no white blood cells, bacteria, protein, ketones, or reducing substances.
Which of the following is the most appropriate therapy for this child?

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Selected Answer: d.
Oral supplementation with bicarbonate
 Question 32
1 out of 1 points
Chelsea, age 8, complains that she feels as if something is stuck in her ear. What action is
contraindicated?
Selected Answer: b.
Flushing the ear with water.
 Question 33
1 out of 1 points
Which of the following substances is associated with pupillary constriction?
Selected Answer: c.
Heroin
 Question 34
0 out of 1 points
Which of the following children should be referred for a comprehensive developmental
evaluation?
Selected Answer: a.
A 12-month-old who does not speak.

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 Question 35
0 out of 1 points
John is diagnosed with allergic conjunctivitis. What type of discharge do you expect to see
upon exam?
Selected Answer: a.
Purulent
 Question 36
1 out of 1 points
You diagnose a 16-year-old with acute otitis media and need to prescribe an antibiotic with
beta-lactamase coverage. What do you choose?
Selected Answer: d.
amoxicillin and potassium clavulanate (Augmentin)
 Question 37
1 out of 1 points
A new mom calls the NP on postpartum day 5. She reports her newborn wants to nurse for 30
minutes every 1-1/2 to 2 hours. Which of these is the best response?
Selected
Answer:
d.
"This is a very healthy breastfeeding pattern. Be sure to rest when you can.
You are doing a great job."
 Question 38
1 out of 1 points

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Which of the following represents normal sequencing of development in a toddler?
Selected Answer: b.
Feeds self, can undress self with help, washes hands, imitates
housework.
 Question 39
1 out of 1 points
By what age should most children be able to sit well without support?
Selected Answer: a.
9 months
 Question 40
0 out of 1 points
A common feature of 2-year-old behavior is:
Selected Answer: d.
a and b
 Question 41
1 out of 1 points
You assess a 15-year-old's visual acuity and note her vision to be 20/50 in the right eye. She
asks you what that means and you respond
Selected d.

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Answer:
"You can see at 20 feet with your right eye what most people can see at
50 feet."
 Question 42
1 out of 1 points
Flourescein staining of the eye is used to detect a
Selected Answer: b.
Corneal abrasion
 Question 43
1 out of 1 points
Blood pressure should be measured at well-child visits starting at age:
Selected Answer: a.
3 years
 Question 44
1 out of 1 points
Sarah, 7 years old, is in the office today. All of the following are acceptable management
options for allergic rhinitis, except
Selected Answer: a.
Nasal neosynephrine

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