Burns Pediatric Practice Test

These questions are part of the practice quiz. Start practicing

• An adolescent with a family history of hyperinsulinemia and type 2 diabetes should avoid which foods to help reduce risk?
• When a school-age child expresses anger about a grandparent's death years after the event, what is the best explanation?
• During an initial well-child exam for a recently adopted 3-year-old from Africa with fully vaccinated records, what should the nurse practitioner do?
• Which hormone pair is implicated in obesity-associated sleep apnea and satiety regulation?
• A parent asks about baby led weaning for a 6 month old. Which statement best describes this practice?
• In a 3-year-old with hepatitis A exposure, what is the recommended management?
• A 3-year-old child exposed to measles at a birthday party within the last 2 days. What is the best course of action?
• An adolescent with major depression is being treated with fluoxetine. Which additional treatment best protects against suicide risk?
• A 6-year-old child has chronic constipation with encopresis and neurogenic etiology has been ruled out. What is key to management?
• Rimantadine for influenza should be used only if susceptibility is reliable.
• For pneumococcal vaccination, PCV13 is universally recommended for which age group?
• An adolescent has right-sided flank pain without fever. A dipstick urinalysis reveals gross hematuria without signs of infection or bacteriuria, and the PCP suspects nephrolithiasis. What is the initial treatment?
• In a breastfeeding infant with colic symptoms, what is the first step to pursue?
• Which statement about avulsed primary teeth is true?
• Which statement about the nutrient content of breast milk is true?
• During anticipatory guidance, how should you address a 12-month-old who repeatedly grabs items from the mother’s purse?
• What will the primary care pediatric nurse practitioner teach the parent of an infant about cleaning the child's teeth?
• When considering reuse of a bicycle helmet, which statement is appropriate?
• A 7-year-old child with fever, headache, stiff neck, and photophobia should be treated how?
• Which label on a CAM therapy product verifies that a product meets standards for contamination, adulteration, manufacturing processes, and pharmacologic properties?
• Which test is the specific serologic test for EBV infection?
• In a previously healthy school-age child with herpes zoster on the lower back, the most appropriate initial management is?
• In croup with more severe symptoms, which statement is true about the use of racemic epinephrine?
• An adolescent who has asthma and severe perennial allergies has poor asthma control in spite of appropriate use of a SABA and a daily high-dose inhaled corticosteroid. What will the primary care pediatric nurse practitioner do next to manage this child's asthma?
• What is the recommended time window for initiating IVIG therapy in Kawasaki disease?
• During the first week of life, how often should a newborn who is exclusively breastfeeding be nursed to establish milk supply?
• If a school-age child refuses cooked vegetables, what is recommended?
• According to an Institute of Medicine report, which statement about vaccine adverse reactions is accurate?
• When prescribing contraception for an adolescent who has not used birth control before, which preparation is used initially?
• Tear duct obstruction in an infant is best managed with which technique?
• Which test is most helpful for confirming EBV infection after the first week of illness?
• An adolescent presents with suspected infectious mononucleosis after recent exposure. Which test confirms EBV infection?
• A 14-year-old with headaches, unilateral weakness, and prior episodes; neurology would order which test to diagnose multiple sclerosis?
• For an adolescent with major depression treated with SSRIs, which adjunct therapy provides protective effect against suicide risk?
• Which finding in a child with cyclic vomiting syndrome warrants referral for neurologic evaluation?
• A toddler with anemia and reticulocytopenia after a recent viral infection should be managed how?
• Which statement about adolescence and the concept of 'storm and stress' is most accurate?
• A school-age child with purulent discharge and a pearly-white tympanic membrane lesion is suspected to have cholesteatoma. What is the most appropriate next step?
• When formulating developmental diagnoses for pediatric patients, the primary care pediatric nurse practitioner may use which resource?
• Which regimen may not require follow-up cultures for gonorrhea due to its use?
• A 4-year-old with an upper respiratory infection has cloudy nasal discharge and congestion. Which symptom-relief measure is recommended?
• Gluten free diets may be deficient in essential nutrients. Which statement best reflects this concern?
• To promote access to healthy foods for impoverished children, which strategy is most likely to ensure success?
• Prophylaxis for Lyme disease is indicated only if the tick is reliably identified as Ixodes scapularis and exposure duration is known; otherwise what should parents do?
• A child presents with gross hematuria, abdominal pain, arthralgia, and a purpuric rash. Which diagnosis is most likely?
• Which supplement has potential adverse effects including diabetes, cardiomyopathy, hepatitis, and renal failure?
• For a school-age child with recurrent stomach pain and a normal exam, what is an appropriate step?
• A child has a small, round object in the external auditory canal near the tympanic membrane; the parent suspects a dried pea. What should the nurse practitioner do to remove this object?
• Which assessment component is most useful in evaluating suspected pediatric fibromyalgia?
• A 6-month-old infant has a retractile testis that has not descended into the scrotum by 6 months. What is the recommended management?
• In a well-child asthma visit, a child on a daily medium-dose inhaled corticosteroid (ICS) shows poor control with a SABA that provides temporary relief. What is the best next step?
• In grandparent-headed households, what is a common challenge that can affect health care access for the grandchild?
• During history taking for a child whose family recently escaped a war-torn country, which topic should be prioritized?
• Which label sets standards for cleanliness, maintenance, and documented quality checks?
• A 15-year-old female basketball player with secondary amenorrhea has BMI in the 3rd percentile. What is the recommended course of action?
• Which term best describes viewing an ethnic group as having a fixed set of traits and applying them to all members?
• What percentage of children recover completely from Bell's palsy?
• A 3-year-old draws on walls with crayons. Which initial disciplinary strategy is recommended by a primary care pediatric nurse practitioner?
• The parent of a 5-year-old beginning kindergarten asks how to support the child during the birth of a sibling. Which strategy is recommended?
• In Lyme disease, which finding would be diagnostic for a child with erythema migrans and a compatible exposure history?
• Maternal antibodies can neutralize some vaccines, leading to delaying some vaccines until 12 months. Which statement best reflects this?
• Which common error erodes self-esteem when a parent says 'Red hair gives him such a temper'?
• What is a normal developmental task for children after divorce?
• When is oral fluoride supplementation indicated?
• Indication for endoscopic removal of a swallowed foreign body includes which condition?
• During a developmental assessment, a 3-year-old refuses to speak in the clinic but talks at home. The nurse practitioner should.
• An 18-month-old child received an MMR immunization 2 days prior to the first birthday. What is the correct next step in immunization planning?
• A school-age child with allergic rhinitis has persistent symptoms despite non-sedating antihistamines. What is the best step to manage this season’s symptoms?
• When prescribing topical glucocorticoids for inflammatory skin conditions in children, which practice is recommended?
• A wide splitting of S2 during expiration in a 2-week-old infant may indicate which condition?
• A 9-year-old with abnormal neurologic signs during episodes of vomiting would warrant which course of action?
• Which statement about non-venomous snakebites is true?
• During an 18-month-old assessment, a clinician chooses to engage the child with a toy rather than scold. What principle does this illustrate?
• A primary care pediatric nurse practitioner assesses a hymenal tear in a prepubertal female who is anxious about the exam. Which positioning is preferred for noninvasive internal visualization?
• A toddler who resists sleep and is irritable during the day: what is the appropriate interpretation?
• A 3-year-old recently began masturbating. What is the most appropriate counseling point for the parent?
• In evaluating suspected organic failure to thrive, which history finding most strongly supports an organic cause?
• Infants fed goat milk or on a strict vegetarian diet are at risk for deficiency of which nutrients requiring evaluation?
• In a 5-year-old school readiness assessment, which finding may limit readiness?
• Which labeling should be used to express confidence in ingredient quality and purity of natural products?
• What is the best initial approach when a preschooler's behavior concerns are reported?
• Which term describes the stage when a child uses a single word to express a complete thought?
• Why is asking a patient to read back information a useful strategy for assessing health literacy?
• For newborns exposed to HIV in utero, the recommended duration of combination antiretroviral prophylaxis is how long?
• What is the purpose of an Individual Education Plan (IEP)?
• What does GRAS stand for?
• Which description is pathognomonic for patent ductus arteriosus?
• A dipstick urinalysis is positive for leukocyte esterase and nitrites in a school-age child with dysuria and foul-smelling urine but no fever who has not had previous urinary tract infections. A culture is pending. What is the recommended treatment?
• An 18-month-old child with high fever, chills, myalgias, and a dry, hacking cough has a negative rapid influenza test and a viral culture pending. What should be done?
• When a 9-month-old presents with fever and rash consistent with roseola, what is the most appropriate initial step regarding management?
• A parent of a 5-month-old reports the infant is fussy but not always hungry. What is the most likely explanation?
• A tympanogram shows a sharp peak at -180 mm H2O. What does this value indicate?
• At about 3 months of age, which social milestone is typically observed?
• An infant develops bright erythema in neck folds after recent antibiotic use. Which is the first-line treatment for a candida skin infection in intertriginous areas?
• Parents worried about older classmates influencing their 12-year-old; what is the best advice?
• When evaluating an adopted child with uncertain vaccination history, what is the best approach to determine immunity?
• What is the appropriate response when an adolescent asks about sexual identity during a confidential visit?
• Which statement aligns with the Institute of Medicine findings about thimerosal-containing vaccines and developmental disorders?
• At about 6 months of age, what approach supports continued breastfeeding while introducing complementary foods?
• A 2-month-old infant has a staccato cough and fever. Which aspect of the history is most important in determining the diagnosis?
• An 18-month-old child has a brief febrile seizure and currently has a fever with a left otitis media. Which action is appropriate for the nurse practitioner?
• Which tympanogram indicates negative middle ear pressure?
• A school-age child has BMI above the 97th percentile. Which diagnosis is most appropriate to document at this visit?
• A 4-week-old breastfed infant nurses every 2 hours during the day and sleeps about 4 hours at night. Weight gain has been appropriate. What is the recommended plan?
• Which functional health pattern identifies beliefs that influence daily living and the meaning of life?
• Which serologic test peaks 6 to 8 weeks after the initial GAS infection and helps confirm a recent streptococcal infection?
• Which factor most supports language development in toddlers?
• If a Mantoux test is positive, what is the next appropriate step to evaluate for active TB?
• A 12-year-old girl shows early puberty and spends more time with an older group of peers. What should the nurse explain about risk?
• In pediatric SLE, which lifestyle modification helps minimize disease flares?
• A left shift on the CBC differential is characterized by elevation of which white blood cells?
• Migraine management in children: which option is appropriate for frequent or disabling headaches?
• What percentage of expected weight constitutes a diagnostic criterion for anorexia nervosa?
• A child with a recent GABHS infection presents with periorbital edema, dyspnea, and elevated blood pressure; urinalysis shows tea-colored urine with hematuria and mild proteinuria. What is the appropriate management?
• Which document is typically used to determine eligibility for early intervention services for a child with developmental delays?
• An adolescent female has periods every 30 days that are consistently heavy and last from 5 to 8 days. What is the diagnosis?
• What is the appropriate action after mandated reporting for child exposure to intimate partner violence?
• A primary care pediatric nurse practitioner has a cohort of patients with special health care needs. Which is an important role of the nurse practitioner when caring for these children?
• A 3-year-old child with pressure-equalizing tubes in both ears has otalgia in one ear. The nurse practitioner can visualize the tube, there is no exudate in the ear canal, and the tympanogram is type A. What is the appropriate management?
• Which statement best exemplifies cultural humility in clinical practice?
• To integrate nursing and medical aspects of primary care, which item should be included in the medical history?
• A 9-month-old infant presents with scrotal swelling and fussiness; a tender mass in the scrotum is difficult to reduce. What is the correct action?
• In a neonate treated with parenteral acyclovir for neonatal herpes, what is recommended if neutropenia occurs?
• Which antibiotic is generally avoided for treatment of UTIs in young children due to safety concerns?
• For non-pathologic phimosis in a young child, which management approach is appropriate?
• For a 4-month-old exclusively breastfed infant, what is the recommended elemental iron supplementation until iron-containing foods are introduced?
• A school-age child sustained a contusion on the front of one thigh while playing football and reports some difficulty flexing his foot on the affected side. What will the primary care pediatric nurse practitioner do to treat this injury?
• If a mother has active tuberculosis that is untreated, what is recommended regarding nursing?
• A child with bright red lesions on the buttocks has sharp margins and an 'orange peel' appearance and is afebrile. What is the course of treatment?
• A 2-month-old infant who is feeding frequently has a parent worried about drying milk. Which action is correct?
• In pediatric Crohn disease, which complication is most likely?
• Iron-deficiency anemia in infants is best characterized by which red blood cell morphology?
• When there is disagreement about cosmetic body modification, which approach best supports healthy adolescent development?
• Which cognitive characteristic describes the adolescent's reaction when blaming a parent’s mood on premenstrual symptoms while not recognizing their own role?
• An infant aged 6 months with a newly noted hip dislocation on exam: which treatment is most appropriate?
• A school-age child has had herpes stomatitis for a week and continues to complain of pain. What will the primary care pediatric nurse practitioner recommend?
• A 12-month-old with bilaterally asymmetric tibial bowing and a tibial angle greater than 15 degrees. What is the correct action?
• A child with cerebral palsy receives all nutrition via gastrostomy tube. What will the primary care pediatric nurse practitioner recommend to promote dental health?
• In Down syndrome, up to what percentage have occipito-atlantal hypermobility?
• For a mild, localized reaction to an insect sting, which treatment is appropriate?
• What is the correct statement about toothpaste use in infants?
• Concerning rubella infection during pregnancy, how common is congenital rubella syndrome in newborns?
• A child who has been camping in a region with endemic Lyme disease has had several tick bites and is asymptomatic. What is the best course of action?
• What is the recommended approach when using herbal remedies for children with allergies?
• The mother of a newborn is worried the child will develop allergies and asthma. Which tool will the nurse practitioner use to evaluate this risk?
• During a well-child examination, an infant shows asymmetric red reflex with the left eye appearing dark red-brown and the right eye red-orange. What is the most appropriate action?
• A child presents with generalized, annular rash with raised wheals and pale centers after strawberry ingestion. Initial treatment?
• A school-age child with fever, sore throat, exudative tonsils, and a rapid strep test positive presents to the clinic. How should this illness be managed?
• For suspected meningitis in a child with fever and neck stiffness, what is the recommended course of action?
• A toddler is below the 3rd percentile for weight despite claims of constant eating. What should the clinician do first?
• If a toddler refuses foods, which parental action is recommended to avoid food battles?
• Using reframing with a parent who quit smoking and feels fidgety, which response best reframes the situation?
• A 2-year-old child treated for acute otitis media has dull-gray tympanic membranes with an air-fluid level; the child is afebrile and not in pain. What is the next course of action?
• How will the nurse practitioner quickly assess health literacy in the mother of a preschool-age child?
• A 10-year-old spends time with same-gender peers; what is true?
• The parent of a 2-month-old infant is reluctant to have the baby vaccinated. What is an initial step in responding to these concerns?
• A previously healthy school-age child develops a cough and a low-grade fever. The pediatric nurse practitioner auscultates wheezes in all lung fields. Which diagnosis is most likely?
• During a well-child exam, the adolescent on the wrestling team with weight fluctuations and a plan for a scholarship; father blames teachers; the nurse may identify problems with ______.
• For recurrent abdominal pain with normal exam, what action is correct?
• An infant born to an HIV-positive mother was delivered by cesarean section, started on prophylaxis, and was not breastfed. Which is the correct management approach?
• An adolescent presents with localized gum bleeding when brushing; exam shows plaque and calculus on the teeth. What is the primary care NP's most appropriate recommendation?
• Fluorescein stain shows entire cornea cloudy under cobalt blue light; interpretation?
• In an infant with trisomy 21 and a complete AV canal defect, which finding is expected?
• In an adolescent with suspected orthostatic proteinuria, a first-morning urine sample is negative for protein. What is the recommended next step?
• In a child with a small spherical object in the external auditory canal near the tympanic membrane, which action is recommended?
• An adolescent adopted from an abusive home should be evaluated for which long-term effect?
• A 12-year-old with poor diabetes control has a parent who forgets to remind her to check blood sugars. Which action is correct?
• A mother reports that her 6-year-old child only wants French fries and hamburgers and refuses most vegetables. Which recommendation should the nurse make?
• A child with ADHD symptoms and depression who suddenly has boundless energy should be evaluated for what disorder?
• An area of inflammation on the neck began after wearing a hand-knot woolen sweater. The skin is chafed with mild erythematous patches; not itchy. What is an appropriate initial treatment?
• Which statement about orthostatic proteinuria is most accurate?
• What is the most appropriate way to respond when a grandparent attributes a toddler's low weight to the grandmother's daughter's past without concern?
• Vaccine doses may be given within a flexible window around minimum intervals; the next MMR dose is scheduled for which age range?
• Which dietary supplement would you question in a high school football player with hypercalciuria?
• For Kawasaki disease, what imaging study is recommended at diagnosis to assess for coronary involvement?
• Among pneumococcal vaccines, which is used primarily for older children over age 2 years who are at higher risk of pneumococcal disease?
• A school-age child sustains an eye injury with a glass fragment. What should the nurse practitioner do first?
• A child with fever, headache, malaise, and a red annular lesion with surrounding clearing is seen. What is the diagnostic step?
• Occlusive dressings for lichen simplex chronicus should be left on for no more than how many hours?
• Which areas are the site of the hallmark palpable purpura in Henoch-Schonlein purpura?
• Which substance is similar to an amphetamine and is associated with tachycardia and arrhythmias?
• A 24-month-old who is being toilet trained shows inconsistent toilet use. What is the best initial approach?
• Which description best fits coarctation of the aorta in a child?
• How many exposures to a new food may be required before a toddler accepts it?
• A 12-year-old with BMI above the 95th percentile and persistent hypertension after lifestyle changes. What is the next step?
• A 6-month-old asks why they can say 'dada' but not 'mama' despite the caregiver's time spent with the child. How should this be explained?
• When communicating with a patient who has limited English proficiency, why is it preferred to use a professional interpreter rather than a family member?
• What is an appropriate initial step when a parent expresses reluctance to vaccinate their infant?
• Which statement about the management of uncomplicated herpes zoster in children is NOT recommended?
• After complete repair of a congenital heart defect, amoxicillin is recommended for 6 months to prevent which condition?
• A 5-year-old with a harsh murmur at the left lower sternal border; which condition is most likely?
• Neonatal chlamydial conjunctivitis is treated with which therapy?
• In a Down syndrome infant with a complete AV canal defect, which auscultatory finding is most consistent with pulmonary hypertension?
• A 3-month-old male infant has a penile erection shortly after nursing. Which statement is most accurate?
• Which therapy is most closely linked to the risk of cardiomyopathy and arrhythmias in pediatric cancer survivors?
• An adolescent female reports facial pain and frequent popping of her jaw. An exam reveals unilateral tender facial muscles and a deviation of the mandible to the affected side with opening of the mouth. What will the primary care pediatric nurse practitioner do?
• During a rubella outbreak, which assessment should be performed for an unimmunized child to determine protection status?
• A child with a history of a pustular rash at the site of a cat scratch on one arm now has warm, tender, swollen axillary lymph nodes on the affected side. The primary care pediatric nurse practitioner notes induration and erythema of these nodes. What will the nurse practitioner do?
• During the maintenance stage of change, what is the primary goal?
• In Salter-Harris Type II fractures, which statement is correct?
• Which substance is a prohormone that is converted to testosterone or estrone and can cause gynecomastia and acne?
• In a 2-month-old infant with a staccato cough and fever, which aspect of the history is most important for determining the likely diagnosis?
• During an initial visit for a developmentally delayed toddler, the family asks about community services. What should the nurse practitioner do first?
• During a well-child examination, a 2-year-old child has a unilateral, smooth, firm abdominal mass that does not cross the midline. What is the next course of action?
• If vesicoureteral reflux is suspected due to dysfunctional voiding and recurrent urinary tract infections, what is the appropriate intervention?
• A 3-year-old child is brought in after being swung by both arms. The arm is held slightly flexed with no swelling. What is the initial management?
• During a well-child exam of a 13-year-old male, small testicles with pubic and axillary hair are noted. To further evaluate, which question is most pertinent?
• Which statement is true regarding post-acute rheumatic fever management?
• In the context of reducing risk for hypernatremia and delayed gastric emptying, which supplement should be questioned?
• In pediatric obsessive-compulsive disorder, what is considered first-line treatment for mild symptoms?
• For a highly active toddler, what is the recommended discipline approach?
• Which lab value is most concerning in an infant with fever and a suspected bacterial infection?
• For molluscum contagiosum that persists or is symptomatic, which treatment option may be used with caution?
• A 5-day-old infant presents with mild conjunctivitis, corneal opacity, and serosanguinous discharge in the right eye. What course of action is correct?
• A 1-cm forehead laceration proximal to the hairline after a sports mishap: to minimize infection risk, the nurse practitioner should irrigate and do what next?
• Which principle should guide confidentiality with minors in a primary care setting?
• In exclusively breastfed infants, does routine hemoglobin/hematocrit monitoring while on iron supplementation have to be performed at every well visit?
• For a school-age child with oligoarticular juvenile idiopathic arthritis, which exercise is recommended to reduce symptoms?
• A 5-month-old child who received VariZIG after varicella exposure during chemotherapy is 5 months post-therapy. Which vaccines should be ordered?
• An older child who has had a pituitary tumor removed now has altered hypothalamic control over hunger and satiety and is morbidly obese. Which intervention is most appropriate for weight management?
• Transient erythroblastopenia of childhood is typically self-limited. Which finding best supports this diagnosis?
• What is the mainstay nonpharmacologic approach to pediatric dyssomnias?
• An 18-month-old child who had Varicella exposure and received VariZIG is evaluated for kindergarten vaccines 5 months after stopping chemotherapy. Which vaccine plan is appropriate?
• A 7-year-old child with repaired congenital heart disease presents with dental caries, gingival erythema, and fever 102.5°F. What is the next step in management?
• Which teething comfort measure is NOT recommended for infants?
• A 5-year-old with enlarged tonsils, recurrent throat infections, snoring, and concerns about sleep. What is the next step to evaluate for sleep-disordered breathing?
• A toddler on a plant based diet is consuming rice milk and almond milk instead of cow's milk. Which nutrient is most at risk?
• Review of a white blood cell count suggests a viral infection when which component is elevated?
• In a febrile 2-month-old with a normal chest radiograph and good feeding, which of the following steps is most appropriate next?
• By 9 to 10 months, which fine motor skill is expected?
• The Natural Products Association (NPA) labeling is intended to ensure which attribute of ingredients?
• The primary care NP is considering use of a relatively new drug for a 15-month-old; the drug is metabolized by the liver; what dosing approach is likely?
• An infant is underweight and the grandmother suggests her daughter's weight history is similar; what is the best approach to engage the family?
• Adolescents are more likely to smoke cigarettes and drink alcohol if they live in which household arrangement?
• A pre-pubertal female wants to begin a strength-training program to improve swimming. Which program design is recommended?
• In a study of geographic clusters in northern California, which factor was associated with higher rates of under-immunization?
• When using motivational interviewing with an adolescent who does not want to give up favorite foods, which response best supports collaboration?
• After camping in a Lyme-endemic region, a child has multiple tick bites; the family cannot verify tick type or attachment duration. What is the best course?
• Calcipotriol safety considerations in pediatric psoriasis include which statement?
• In allergic conjunctivitis, which treatment is contraindicated due to risk of rebound hyperemia?
• Which autoantibody is most specific for systemic lupus erythematosus and often used to confirm the diagnosis?
• In evaluating an adolescent with gynecologic complaints, which finding would indicate ordering a pelvic ultrasound?
• For lichen simplex chronicus with pruritus, which statement about occlusive dressings is correct?
• A 4-year-old is having trouble adjusting to a new day care and is often playing solitary when the parent arrives. Which assessment step is most appropriate?
• In guiding an adolescent smoker with relapse risk, which strategy aligns with the maintenance stage of change?
• During a well-child visit, a child presents with yellow serpentine-border lesions on the tongue. What is the best course of action?
• If a product’s ingredient list includes casein or whey, what does this indicate?
• Because of their inability to ambulate, children with cerebral palsy should be evaluated for which nutrients?
• A 7-year-old is evaluated for ADHD; which rating scale is typically used for screening?
• Permethrin 5% cream is approved for treating scabies in infants as young as what age?
• An overweight adolescent presents with velvety brown thickening of skin in the axillae, groin, and neck folds. What is the initial step in management?
• Which of the following is not recommended for URI symptom relief due to questionable efficacy or potential side effects?
• An adolescent with hot-tub folliculitis should be managed as follows. Which choice is most appropriate?
• A 15-year-old female reports menarche at 13 with five periods in the last year. Which action is correct?
• During a well-baby examination, a newborn has adduction of the right forefoot, with normal position of the mid- and hind-foot and a convex-shaped lateral border of the foot. How should the nurse practitioner evaluate this deformity?
• During a well-child visit, an infant 1 month old treated with parenteral acyclovir for neonatal herpes currently takes oral acyclovir. What should the nurse practitioner do?
• After 14 days of amoxicillin 45 mg/kg/day for acute rhinosinusitis, a child has mucopurulent nasal discharge with eyelid induration and erythema. What is the next course of action?
• What is the appropriate counseling for promoting dental health in a 9‑month‑old?
• A female infant stops meeting developmental milestones at age 12 months and then loses previously acquired skills. What prognosis should the clinician tell the parents?
• A 16-year-old female reports dull, cramping lower abdominal pain lasting 2–3 hours that occurs between menses. She is not sexually active. What is the treatment?
• Which statement accurately describes the relationship between maternal cholesterol intake and infant serum cholesterol values?
• For a child with Down syndrome, what precaution is advised before participating in sports?
• An immunocompromised child presents with fever and a vesicular rash consistent with varicella. What is the appropriate management?
• A 6-week-old breastfed infant has bowel movements every third day. What is the most appropriate interpretation?
• To determine whether oral herpes lesions are caused by HSV-1 or HSV-2, which test is the gold standard?
• A 12-month-old uncircumcised boy has pain with voiding and a tight, pinhole foreskin that is thickened and inflamed. What is the appropriate management?
• What should parents do when outside influences challenge a child's values?
• During a health visit for a homeless child with an acute illness, what assessment should be prioritized?
• A toddler with a suspected viral pneumonia and mild illness should be managed how?
• Which antibiotic is commonly used for rheumatic fever prophylaxis?
• A school-age child with a pityriasis rosea rash asks about prognosis and management. Which action is appropriate first?
• A 3-year-old awakened from deep sleep showed confusion and disorientation. Which statement best describes this pattern?
• A school-age child has several annular lesions on the abdomen with central clearing and scaly borders. What is the first step in management?
• A 4-year-old with snoring and daytime crankiness; which statement about sleep disorders at this age is most accurate?
• A 4-year-old child with decreased leg reflexes and a dimple above the gluteal cleft; which diagnosis may be considered?
• Which statement regarding vitamin D for breastfed infants is consistent with guidelines?
• Which statement best distinguishes conditional self-worth from unconditional worthiness?
• In managing sleep-disordered breathing with maxillofacial deformities, which option is typically considered a last resort?
• When hydrating dry skin with bathing, when should moisturizers be applied?
• During a focused assessment of a child with asthma, one parent continues to smoke around the child despite advice. This is a possible alteration in which functional health pattern?
• Lumbar puncture may be performed in febrile seizures primarily in which age group?
• A 9-month-old infant has a grade III/VI, harsh, rumbling, continuous murmur in the left infraclavicular fossa and pulmonic area with cardiomegaly on chest radiograph. What repair method is most appropriate?
• An initial well-child exam for a 3-year-old adopted from Africa with a fully vaccinated record should be managed by?
• In Henoch-Schonlein purpura, which extra-cutaneous symptom is commonly observed?
• Which statement is NOT true about herbal supplements?
• Based on an Institute of Medicine report, which statement about vaccines will the primary care pediatric nurse practitioner tell the parent?
• A clean catch urine sample from a child with dysuria and fever shows 50,000 to 100,000 CFU of E. coli. What is the appropriate management?
• A child who has had a single non-febrile seizure with a normal neurologic exam. Which diagnostic test is indicated?
• A 16-year-old adolescent on the wrestling team experiences weight fluctuations before matches and talks about trophies and a wrestling scholarship, while his father says his grades will never be good enough. This pattern most likely reflects a problem with ______.
• In a pediculosis capitis infestation, what is likely to be found on physical examination along with live lice?
• According to the 2007 NHIS analysis of CAM therapy, use was higher among :
• A toddler shows exotropia of the right eye on a cover-uncover test. What is the initial treatment?
• An adolescent female who is sexually active and who has not had the HPV vaccine asks if she may have it. What will the primary care pediatric nurse practitioner tell her?
• During a private discussion about sexuality education with an adolescent and a parent who says the topic is off limits, what is the appropriate action for the nurse practitioner?
• Historically, which vaccine contains whole-cell pertussis and is used in many countries outside the United States?
• Which statement is true regarding the use of acyclovir for preventing varicella in healthy children after exposure?
• Which statement about the health status of children in the United States is true?
• A 12-month-old with microcytic, hypochromic anemia and pallor but no hepatosplenomegaly most likely has which condition?
• A newly divorced parent reports that a toddler has nightmares, difficulty sleeping, angry outbursts, and social withdrawal. What should the primary care pediatric nurse practitioner do initially?
• Which management is not recommended as first-line for gastroesophageal reflux disease in infants?
• Which statement best describes Still's murmur?
• A child with suspected toxic epidermal necrolysis presents with fever and widespread blistering. What is the appropriate management?
• A school-age child fears hidden aliens in closets. Which statement would be appropriate to convey to the parent?
• An unimmunized school-age child whose mother is in her first trimester of pregnancy is diagnosed with rubella after a local outbreak. What should the primary care pediatric nurse practitioner recommend?
• A 10-year-old described as a 'class clown' denies problems at school; which strategy should the nurse practitioner recommend?
• In evaluating suspected school refusal in a school-age child with recurrent stomach pain and headaches, what should the clinician initially ask the parent?
• Adolescent female with unilateral headache around menses; naproxen ineffective; abortive therapy?
• In adolescent depression, when is suicide risk greatest?
• Which approach is recommended to address a toddler who resists vegetables?
• Which late effect is a known consequence of cranial irradiation in childhood cancer survivors?
• A mother of a 15-year-old female expresses concerns that her daughter may be sexually active because she's had a steady boyfriend for over a year. The family is Catholic and the mother had an abortion at 16. What should the nurse practitioner do initially?
• A 3-year-old child with up-to-date immunizations has been exposed to measles within the last 2 days. What is the best course of action?
• For a 10-month-old infant with the chronic hepatitis B infection, what is the recommended management?
• In evaluating a child with cerebral palsy, which element of the family history raises concerns about maltreatment?
• Which supplement is believed to enhance endurance but increases weight and lacks androgenic effects such as gynecomastia or acne?
• Which mechanism explains how early abuse can influence mental health later in life?
• In juvenile idiopathic arthritis with a positive ANA, which specialty referral is most critical?
• Which description best characterizes a pulmonary flow murmur?
• Which description describes both heavy menstrual bleeding and irregular cycles?
• For an infant with exclusive breastfeeding and reduced stool frequency, what is the appropriate initial response?
• At 3 months, the infant coos and smiles. What is important for the caregiver to learn?
• Tethered cord symptoms can include which of the following?
• Which strategy may improve adherence for an adolescent who forgets twice-daily inhaled corticosteroids?
• During a well-child visit, a 6-month-old has a harsh, blowing grade IV/VI murmur. What should be done next?
• A parent asks about the health implications of adolescent e-cigarette use. Which statement is most accurate?
• When bullying is suspected, which reason supports interviewing the adolescent separately from the parent?
• When cyber-bullying is suspected, what should be the initial response?
• A preschool-age child presents with fever 102.2°F, swelling and erythema of the upper eyelid, and pain when looking to the side. What is the correct course of treatment?
• Infants with galactosemia cannot consume galactose. What should the mother do?
• In a newborn, regain of birth weight is expected by approximately how many weeks?
• Which statement best describes the development of sexual orientation in children?
• An 18-month-old child with upper respiratory symptoms, high fever, and a dry, hacking cough has a negative rapid influenza test and a viral culture pending. What should the clinician do?
• Prompt caregiver responses to an infant's needs are associated with which outcome?
• Indomethacin administration is primarily used to close PDA in which patients?
• For a 9-month-old, which is the recommended approach to dental care?
• During a pre-participation examination, which heart murmur finding would be a concern requiring referral to a cardiologist?
• A child swallowed a metal bead; stomach radiograph shows a 6 mm cylindrical object. What is the correct course of treatment?
• In the integrated assessment model, which option represents the developmental domain exemplified by a child’s speech and language development?
• Which tool is best to estimate reading level in a parent of a toddler for health literacy assessment?
• A child presents with unilateral foul-smelling nasal discharge and a visible shiny object in the nasal cavity. What is the most appropriate next step?
• An 18-month-old with intermittent cramping abdominal pain and a small amount of bloody, mucous stool is observed. What is the most likely diagnosis?
• A 4-year-old presents with clusters of small, tense vesicles on the vermilion border and is causing discomfort. What is the recommended treatment?
• A 3-month-old infant with a late-presenting murmur; which diagnosis is most likely?
• If a mother suspects her toddler is not engaging with peers during a playgroup, what is the most accurate interpretation?
• A 3-year-old with chronic stool withholding requiring laxatives is being prepared for third-party reimbursement. Which diagnosis should the nurse practitioner use to facilitate reimbursement?
• A preschool-age child presents with intense red cheeks and circumoral pallor; what is the correct parental counseling?
• A 6-year-old with repeated BP measurements in the 95-99th percentile for SBP and 90-95th percentile for DBP. How is this BP classified?
• Which test best confirms cat-scratch fever by detecting serum antibodies?
• An adolescent begins by limiting one sugary drink as part of weight management. Which stage of change best fits this behavior?
• A 15-year-old female reports that some friends have begun having sex and she has a boyfriend but denies having sex. What should the nurse practitioner do initially?
• A 30-month-old child with sickle cell anemia has had one dose of the 23-valent pneumococcal vaccine. Which is an appropriate action for health maintenance?
• When discussing probiotic use for infant colic, which statement best reflects current evidence?
• What is the most appropriate initial management for gingivitis in an adolescent with poor dental hygiene?
• A 14-year-old girl presents with chest pain associated with coughing; tenderness is noted over several ribs with no cardiopulmonary abnormal findings. What is the appropriate initial management?
• Infants typically have growth spurts every 3 to 4 weeks. What should a caregiver do to support increased milk supply during these periods?
• Without treatment, what is the major cardiovascular complication of Kawasaki disease?
• Who is typically authorized to order medications for pediatric mental health after a diagnosis has been established?
• A 9-year-old child shows school refusal and reluctance to attend sleepovers; the child has recently started sleeping in the parents' bed. What initial action by the clinician is appropriate?
• A school-age child with chronic otitis media presents with vertigo, profuse purulent otorrhea from both tympanostomy tubes, and a pearly-white lesion on one tympanic membrane. Which condition is most likely?
• Polymenorrhea is defined as cycles of what length between menses?
• During a well-baby examination of a 6-week-old infant, the infant shows poor weight gain, acrocyanosis of the hands and feet, a respiratory rate of 60, and oxygen saturation of 93% on room air. The remainder of the exam is unremarkable. What is the correct action?
• The American Academy of Pediatrics PediaLink program is a source for what?
• When epiglottitis is suspected, which practice is contraindicated?
• Which ingredient may signal the presence of wheat on labels?
• A 16-year-old sexually active female with fever, bilateral lower abdominal pain, and malaise. A speculum and bimanual exam reveals adnexal tenderness. The urinalysis is normal and cervical cultures are pending. What medications will the primary care pediatric nurse practitioner prescribe for this patient?
• During a well-child visit, parents report frequent financial conflicts. What is the most appropriate step for the clinician?
• Which feature best differentiates craniosynostosis from positional plagiocephaly?
• A 16-year-old whose parents recently divorced shows behavior issues; which statement best describes how to approach the situation?
• For a child with epilepsy, what should be recommended regarding sports participation?
• To achieve the greatest worldwide reduction in child mortality from pneumonia and diarrhea, which intervention is most effective?
• Which ability indicates school readiness for a 5-year-old?
• In adolescent health care, how should confidentiality be handled regarding sexual health discussions?
• Meningococcal vaccination for children with sickle cell disease: which statement is true?
• Which sign is elicited by passively flexing the neck to cause hip and knee flexion?
• Under PREA, if the FDA declares a drug possibly useful to ill children, what may the pharmaceutical company be required to do?
• An adolescent has acne with lesions on the cheeks and under the chin. Which distribution is this?
• A 12-year-old on twice-daily inhaled corticosteroids reports inconsistent use. In client-centered care, what is the first step the clinician should take?
• During parental divorce, which arrangement best supports children's adjustment?
• A parent asks what cutting marks on the teen’s arms mean. What is the correct interpretation?
• Which ferritin threshold is associated with periodic limb movements and warrants iron therapy in children?
• In acute otitis media without tympanic membrane perforation, which treatment is not indicated?
• A child is diagnosed with tinea versicolor. Which is the correct management?
• Which tool is used to illustrate family structure, roles, and recurring problems within a family?
• A 7-year-old child with fever, headache, stiff neck, and photophobia should be managed with what course of action?
• Why is primary closure not always performed in dog bite injuries?
• The parent of a 4-month-old infant is concerned that the infant cannot hear. Which test should be ordered to evaluate potential hearing loss in this infant?
• Which symptom progression is most characteristic of appendicitis with perforation?
• An 8-year-old asks why a schoolmate has '2 daddies' and wants guidance on how to talk about it. What is the recommended approach?
• Which statement is true about venomous snake bites management in children?
• Which major child health outcome worldwide is most associated with climate change?
• The Best Pharmaceuticals for Children Act (BPCA) primarily provides incentives to study drugs in children by offering what?
• Which term describes the process of internalizing negative perceptions of self from others?
• In a 2-year-old with a barking cough and mild respiratory symptoms, what is the next step in treatment?
• A 16-year-old female has not had a menstrual period yet and is concerned. She denies sexual activity. An exam reveals an adult sexual maturity rating. Which laboratory test will the primary care pediatric nurse practitioner order initially?
• A 4-year-old child has a new grade II vibratory, mid-systolic murmur at the mid-sternal border that is louder when the child is supine. What is the most likely diagnosis?
• A parent asks about ways to promote dental health in school-age children while on a family vacation that are convenient while camping and picnicking. What will the primary care pediatric nurse practitioner recommend?
• Which statement about erythema migrans and Lyme disease is true?
• A 3-year-old with acute otitis media treated with amoxicillin, now has a type B tympanogram, fever (102.5°F), and a bulging tympanic membrane. What will the primary care pediatric nurse practitioner order?
• In encopresis without an underlying pathology, parents should be taught that stool retention is:
• A 9-month-old with normal hearing vocalizes only in single syllables. What is the recommended step to support speech and language development?
• Which approach is recommended when a toddler refuses vegetables and shows food neophobia?
• A school-age child who had complete repair of a tetralogy of Fallot defect in infancy requires what in ongoing health maintenance?
• During an 18-month-old well-child assessment, the child becomes irritable despite parental instructions. What should the nurse practitioner do first?
• A 9-month-old infant with a history of three urinary tract infections is diagnosed with grade II vesicoureteral reflux. Which medication will be prescribed?
• An 8-year-old with primary nocturnal enuresis is considering medication versus an enuresis alarm. What is the recommended approach?
• Which vaccine is used to prevent pneumococcal disease in an 18-month-old child with bronchopulmonary dysplasia?
• Which practice aligns with the most recent American Academy of Pediatrics Recommendations for Preventive Pediatric Health Care when caring for an infant in the first year of life?
• In iron-deficiency anemia with initial Hb 8.8 g/dL after iron therapy, an Hb 10.5 g/dL and Hct 36% is observed. What is the next step?
• To address a 3‑year‑old who refuses usual foods and wants only certain items, what is the best guidance?
• A 5-year-old child who has a history of pertussis infection as an infant is in the clinic for immunizations prior to kindergarten. Which vaccine will be given?
• A 5-year-old with frequent stool soiling and intermittent stomach aches for 2 months presents for evaluation. Which initial assessment should the nurse practitioner make?
• Which feature is characteristic of pityriasis rosea?
• A mother of two school-age children is divorcing; which counseling strategy helps children cope?
• During anticipatory guidance for a 13-year-old female with Down syndrome, what should the nurse practitioner tell the parents?
• What is the recommended exercise approach for a child with hypertension?
• Which nasal relief method is commonly recommended for children with congested nasal passages?
• When discussing developmental concerns with a worried parent, which approach is most appropriate?
• Which assessment tool is used to screen for adolescent substance abuse?
• A 3-year-old labeled as a picky eater. What is the best initial assessment step to determine nutrient adequacy?
• A 3-year-old daycare attendee with dark urine and RUQ tenderness presents after exposure to hepatitis A; what is the appropriate treatment?
• Oral fluconazole is used in candida skin infections under which circumstance?
• A single mother of an infant asks how to support positive development. Which suggestion is evidence-based for addressing concerns about maladjustment?
• What is the commonly cited incubation period for varicella after exposure?
• Roseola infantum is most commonly caused by which virus?
• For preventing basketball-related injuries during tryouts, which recommendation provides the most benefit?
• Immunoglobulin to prevent measles exposure may be given to which group?
• In a well-child exam of a 6-year-old girl, the child resists taking off her underwear and becomes embarrassed. What should the clinician infer?
• An adolescent has a Mantoux skin test with 10 mm induration after 48 hours and no risk factors for TB. What should the clinician do next?
• A child is brought in after falling from a swing and scraping both knees and hands. An examination reveals abraded skin with oozing serous fluid and blood, along with dirt and grime from the playground surface. What will the primary care pediatric nurse practitioner do to minimize the risk of infection?
• A 3-year-old who has recently refused bowel movements and is becoming constipated; what should the clinician do first?
• During a well-baby exam on a 9-month-old, the parent asks if the baby will be left-handed. What should the clinician do?
• A school-age child with repetitive checking behaviors interfering with daily life; which therapy is used for mild to moderate symptoms?
• A 14-year-old female presents with three months of amenorrhea. Her weight is 82% of the expected for age and height, and she frequently vomits and refuses most foods. Which condition is most suspected?
• In athletic adolescents, what lean body mass percentage is associated with maintaining regular ovulatory cycles?
• Which statement about MMR dosing timing is true?
• An adolescent with unprotected intercourse 4 days ago is worried about pregnancy. What will the nurse practitioner do?
• A school-age child hopes that his parents will remarry after their divorce. What should the nurse practitioner tell the parents?
• An 18-month-old has horizontal bright white lines along the upper gum line. What is the most important question to ask the parents?
• A 10-month-old infant develops a fluctuant, non-draining abscess after antibiotic therapy for impetigo; what is the next step?
• Which activity is contraindicated in children with hypertension?
• Some vaccines, such as MMR, are not given at 2, 4, and 6 months. What explains this scheduling?
• What is the recommended first step when families use complementary medicines?
• Which tool is designed to assess risk behaviors that contribute to most morbidity, mortality, and social problems in teens?
• A child is diagnosed with community-acquired pneumonia and will be treated as an outpatient. Which antibiotic should be prescribed?
• For an infant on suppressive acyclovir therapy after neonatal herpes, which monitoring is essential?
• How often should bicycle helmets be replaced?
• Which test is used primarily to detect middle ear effusion rather than to assess hearing thresholds?
• Which home literacy factor is associated with adequate parent health literacy?
• A 13-year-old with several weeks of mild depression now exhibits a sudden burst of energy and inability to sit still. What action should be taken?
• Which statement about gluten-related labeling is accurate?
• When a family with limited English proficiency relies on a sponsor to translate, which communication approach is most appropriate?
• Which statement about cognitive learning is true?
• A newborn recently discharged from NICU has parent worry about the infant's development. What will the clinician do initially?
• A child presents with an erythema migrans rash and a history suggestive of tick exposure. What is the most important first question to determine the diagnosis?
• For pre-pubertal youth, how often should weight training workouts be performed?
• Ventricular septal defect murmurs may not be present at birth but become audible later as what develops?
• Which finding is most characteristic of enthesitis-related juvenile idiopathic arthritis?
• An adolescent with thick yellow greasy scales on the forehead and behind the ears; what will you recommend?
• Which statement best describes the effect of 6 months of suppressive oral acyclovir following neonatal herpes treatment?
• A child with beta-thalassemia minor and an Hgb of 8 g/dL should have which test before considering iron therapy?
• The parent of a school-age child reports that the child’s father was killed while deployed, and the child is skipping school and getting poor grades. The pediatrician should:
• An 11-month-old infant who has had three viral respiratory illnesses causing bronchiolitis has parents who ask whether the infant may have asthma. What will the nurse practitioner tell the parents?
• For a viral diarrheal illness in a child, which intervention can shorten the duration of diarrhea by about 25 hours and is considered safe for children?
• When prescribing a drug off-label for a child, what must the primary care pediatric nurse practitioner do?
• What does PREA stand for?
• If amoxicillin-clavulanate fails to resolve acute otitis media, which antibiotic is commonly used next?
• When do language and literacy skills begin?
• A newborn has been exposed in utero to HIV. Management involves:
• A child with asthma comes home with severe wheezing after gym class and needs to use his metered-dose inhaler right away. What action should the NP take?
• What is the typical incubation period for varicella after exposure?
• Which type of thinking is demonstrated by a preschooler who says, 'That's your sister' and insists 'It's my baby'?
• For an infant with warning signs of immunodeficiency, what is the initial laboratory evaluation?
• Procalcitonin testing is used to differentiate viral from bacterial infections.
• Neonatal gonococcal conjunctivitis is best treated with which intervention?
• During fluorescein staining, which statement is true about staining of the cornea?
• An adolescent with exercise-induced asthma reports reduced effectiveness of albuterol with regular practice. What is the best next step in management?
• An adolescent with mild depressive symptoms who does not want medication; which approach is recommended?
• During palpation for suspected Wilms tumor in a child, what is the key precaution to prevent tumor rupture?
• A 4-year-old has a vision screen of 20/50 with difficulty cooperating. What is the recommended course of action?
• A school-age child with frequent nosebleeds and normal coagulation studies continues to bleed despite symptomatic measures. What is the next course of action?
• A toddler's parent is concerned that the child may have autism. The M-CHAT indicates several areas of concern. What should the nurse practitioner do?
• Which medication regimen is used to facilitate airway clearance in a child with cystic fibrosis?
• A school-age child steps on a nail while wearing sneakers and develops cellulitis of the foot; immunizations are up-to-date. What empiric antibiotic is preferred?
• Regarding rubella vaccination during pregnancy, which statement is true?
• How will the nurse practitioner begin the well child exam for an 8-year-old?
• A 3-year-old has just completed a 7-day course of amoxicillin for a second febrile urinary tract infection and now has a negative urine culture. What is the next course of action?
• What is the most common initial management for a pediatric clavicle fracture after a fall?
• A 4-year-old child who has had extensive dental surgery to treat dental caries has white spot lesions on the primary teeth. How often should this child receive fluoride varnish applications?
• During a well-child visit for a 12-month-old with predictable bowel and bladder habits, what should the parent be told about toilet training?
• During times of change in a family, which strategy best supports a child’s adjustment?
• Child with eye trauma and hyphema; cannot tolerate examination; action?
• Atypical Kawasaki disease is more common in which age groups?
• Which statement about bilingual language development is most accurate?
• With a 2‑year‑old who has a speech delay but normal motor and cognitive skills and a normal hearing test, what is the next step?
• Lacrimal duct obstruction with conjunctivitis not improving after 2 weeks of topical antibiotics; next step?
• Pressure-equalizing tubes typically remain in place for about how long before spontaneous extrusion?
• A 4-month-old infant has a history of reddened, dry, itchy skin. The primary care pediatric nurse practitioner notes fine papules on the extensor aspect of the infant's arms, anterior thighs, and lateral aspects of the cheeks. What is the initial treatment?
• A child with mild scoliosis signs in the standing position, which disappears on forward bending: which statement is correct?
• When a clinician suspects intimate partner violence affecting a child, what is the priority response?
• A 3-year-old child whose mother has been treated for depression for over 5 years is at greatest risk for delays in which aspect of development?
• After a positive screen on the M-CHAT, which step is recommended?
• During a well-child visit, a 12-month-old who was born 6 weeks premature is noted to use a raking grasp. What is the correct initial step when screening suggests potential delay?
• A family uses gluten free grains for a child who has not been diagnosed with celiac disease. Which statement about gluten free diets is most accurate?
• A term 4-month-old infant with positional plagiocephaly; after repositioning efforts, head shape worsens; recommended next step?
• During a well child exam, a school-age child shows angry episodes and withdrawal. What is appropriate first step?
• Newborn conjunctivitis that presents with nonpurulent discharge is most consistent with which type?
• In the northern California immunization study, which factor was not examined for its association with under-immunization?
• A 7-day-old infant is nursing well. The infant weighed 3250 g at birth, 2990 g at discharge on day 2, and now weighs 3080 g at the current visit. What is the correct next action for the primary care provider?
• Why can’t 'natural' be assumed safe for herbal products?
• In Henoch-Schonlein purpura, which ongoing evaluation is essential to monitor for renal involvement?
• A 4-year-old girl has frequent evening urination with incontinence after voiding and soft stools. What is the initial assessment?
• A 12-month-old infant with poor weight gain and no vomiting or diarrhea should have which history taken to evaluate for failure to thrive?
• In general, when do guidelines recommend transitioning from milk to 2 percent or fat free milk?
• A 5-year-old child who had a repair for transposition of the great arteries shortly after birth is growing normally but now has mild shortness of breath with exertion and dizziness. What is the appropriate action?
• When ultraviolet light therapy is used for pediatric psoriasis, which modality is preferred for safety and efficacy?
• Which stool description is classically associated with intussusception?
• An adolescent has a TB skin test prior to working as a volunteer in a hospital. The adolescent is healthy and has not travelled to or from a TB-endemic area or had close contact with anyone who has TB. The Mantoux skin test shows 10 mm of induration after 48 hours. What will the primary care pediatric nurse practitioner do?
• Who orders a voiding cystourethrogram when vesicoureteral reflux is suspected?
• What is the current evidence regarding pre- or post-vaccination use of acetaminophen and ibuprofen for fever management around vaccines?
• Which statement about baby led weaning is correct?
• Which lab value is most concerning in an infant with fever and a suspected bacterial infection?
• According to recent research, which population is more likely to have under-immunization rates?
• A child with circular, scaly lesions with central clearing on the arms and trunk, plus a scalp lesion. How should this be treated?
• A child with a urinary tract infection has 50,000 to 100,000 CFU of a single pathogen and persistent symptoms. Which action is indicated?
• A 4-year-old female with persistent dysuria and genital redness has a thin membrane from the posterior fourchette nearly to the clitoris. Which treatment is indicated?
• Which symptom is associated with pediatric PANDAS?
• A 7-month-old infant has had two prior acute otitis media episodes and is on day 10 of therapy with amoxicillin-clavulanate after a failed course of amoxicillin. The child has marked middle ear effusion and erythema of the tympanic membrane. What is the next step in management?
• Once frozen breast milk is thawed, how soon should it be used?
• For a 6-year-old who dislikes school and fakes illness, what should be asked first?
• Which statement best reflects management goals during a health crisis for a child and family?
• A school-age child with excessive bruising and a history of a URI 2 weeks prior has a platelet count of 60,000/mm3 with normal PT and aPTT. How will the NP manage?
• In assessing risk of maltreatment for an infant with colic, which resource-related question is most urgent?
• A school-age child with fever, sore throat, exudative tonsils, a diffuse erythematous sandpaper-like rash on the neck and trunk, and a positive rapid strep test is treated with which of the following?
• 9-month-old infant with a history of prematurity treated for ROP; when is ophthalmologic exam needed?
• If griseofulvin-resistant tinea capitis occurs, which oral antifungals may be used?
• Which domain of cultural competence involves understanding one’s own cultural background?
• For separation anxiety disorder in a child, what is the recommended approach?
• Gluten free grains are sometimes used in the management of which metabolic condition due to protein restrictions?
• A 5-month-old with three days of cough and rhinorrhea develops respiratory distress with audible wheezes but remains well hydrated and with normal oxygen saturation. What is the recommended treatment?
• If a Mantoux test is positive in a healthy child with no risk factors, what is the next step?
• When are titers for mumps, measles, and rubella indicated?
• A smartphone-using parent in a well visit with a 2-month-old asks how to interpret the parent's behavior. Which interpretation is most appropriate?
• An overweight school-age child with daytime irritability and sleepiness despite 9-10 hours of sleep overnight is referred for a sleep study after evaluation for possible sleep-disordered breathing. Which action is most appropriate?
• In a patient with hypercalciuria, which statement about sports drinks and urinary calcium is true?
• Which distribution describes hormonal acne?
• Esotropia that appears or persists at around 3 to 4 months of age should be managed by which action?
• For activities lasting up to one hour, what is the recommended hydration strategy?
• A child with a history of rheumatic fever recently had arthritis but no cardiac involvement. Which statement describes ongoing care?
• For a mother pregnant with multiples, which feeding strategy is advised?
• A 12-month-old infant fed goat's milk and vegetarian diet is pale with a beefy-red tongue. Which tests should be ordered to evaluate this condition?
• When counseling about SIDS risk reduction, which statement is appropriate to include?
• A child with psoriasis on thick plaques uses a moderate-potency topical steroid on thick plaques and a high-potency topical steroid on the elbows and knees, but symptoms worsen. Which treatment should be added?
• Which approach provides the best initial information when a preschooler’s behavior concerns are reported?
• A child has a fever and arthralgia. The primary care pediatric nurse practitioner learns that the child had a sore throat 3 weeks prior and auscultates a murmur in the clinic. Which test will the nurse practitioner order?
• Under the Pediatric Research Equity Act (PREA), what can the FDA require of a drug company?
• During a well-child exam, 10 café au lait spots on the trunk raise concern for which condition?
• A school-age child with a recent URI develops unilateral facial sagging; cannot close eye or mouth on affected side but no limb weakness; management?
• A 5-year-old child is hit in the face with a baseball bat and presents with avulsed primary maxillary incisors. What is the recommended initial management?
• A 9-month-old infant has developed two teeth since the 6-month checkup. The local water supply contains fluoride. What will the primary care pediatric nurse practitioner do to promote healthy dentition at this visit?
• Which statement about supplemental oxygen in pediatric sleep-disordered breathing is true?
• A healthy 14-year-old female has a dipstick urinalysis positive for 5-6 RBCs per high-power field but otherwise normal. What is the first question the PCPNP should ask?
• Ulipristal acetate can be used up to how many days after unprotected intercourse?
• A child sustains head injury with vomiting and slurred speech after a fall. What course of action is warranted?
• A toddler is receiving long-term antibiotics to treat osteomyelitis. Which laboratory test will the primary care pediatric nurse practitioner order to monitor response to therapy?
• For a healthy 2-week-old infant, what is the optimal total daily sleep?
• What is a commonly noted benefit of starting a strength-training program before menarche?
• During a pre-participation sports physical for a 14-year-old wrestler, which topic should be included?
• What is the initial physical sign of puberty in males?
• After asthma treatment, if a patient has an FEV1 less than 40% of personal best, what is the recommended action?
• A toddler has begun hitting and biting after a new sibling joins the family. What is the most appropriate initial approach by the clinician?
• In a 5-year-old child with a history of pertussis infection as an infant who is about to start kindergarten, which vaccine should be given?
• Global health knowledge: which statement best describes global awareness?
• When meeting a new family, which tool is used to record family members and their relationships, plus significant behavioral and emotional problems?
• DC:0-3R is a diagnostic framework used for what purpose?
• The Hirschberg test is used to evaluate which aspect of vision?
• A 5-year-old with pallor; Hb 8.5 g/dL and hematocrit 31% is evaluated by the NP. How will the child be managed?
• In a child with difficulty initiating and maintaining sleep, which medication is most commonly prescribed when pharmacologic therapy is considered?
• In a child with asthma, allergy testing is not diagnostic but may be considered. Which statement best reflects this?
• A toddler with weight and BMI below the 3rd percentile, irregular meals, and constant juice intake. The nurse practitioner plans to work with the family to develop improved meal patterns. Which diagnosis best fits this problem?
• A 15-year-old female with two fainting spells and normal orthostatic blood pressures. Which test should be ordered first?
• A 12-year-old with vocal cord dysfunction wants to know about sports participation.
• How long can refrigerated breast milk be stored?
• A 4-year-old with asthma has smooth, cupped-out erosion on the chewing surfaces of the teeth. Which is the most likely explanation?
• If a parent refuses vaccines and the child has been exposed to varicella, what is the recommended policy for day care attendance?
• A sexually active adolescent with positive tests for N. gonorrhoeae and C. trachomatis wants treatment today. Which regimen should be ordered?
• Which developmental stage allows understanding of how stress can relate to the symptoms of irritable bowel syndrome?
• For a school-age child with suspected functional abdominal pain, what is included in the initial diagnostic work-up?
• A school-age child recently immigrated with frequent school conflicts; what should the nurse practitioner evaluate?
• An 18-month-old child has bronchopulmonary dysplasia. To help prevent pneumococcal disease, which vaccine will be ordered?
• In product safety labeling, what does contamination refer to?
• An immunocompromised child presents with fever and a rash of macules, papules, and pustules. What is the appropriate management?
• An integrated primary care assessment model includes three domains: developmental problems (such as speech and language development), functional health problems (such as beliefs about health), and diseases (chief complaint). Which option best reflects these domains?
• What should the nurse practitioner do when a 17-year-old requests an eyebrow piercing and the mother objects?
• During a well-child examination of a 4-month-old, which parental statement suggests a potential problem with the parent-infant relationship?
• A preschool child has honey-crusted lesions around the nose and mouth with satellite lesions and other children in day care have similar lesions. How will this be treated?
• A 5-year-old on a baseball team experiences sleepwalking; what safety measure is recommended?
• In children with sleep-disordered breathing, what educational outcome is associated with untreated symptoms before school age?
• A child is brought to the clinic immediately after being stung by a wasp while playing in the yard. The physical examination reveals localized redness and edema at the site, along with abdominal tenderness, watery eyes, and generalized hives. What is the initial treatment?
• A 15-year-old female patient who is pregnant asks the nurse practitioner not to tell her parents. What should the nurse practitioner do first?
• Which test result would most strongly support a urinary tract infection as the source of fever in a febrile 2-month-old?
• A 12-year-old with sickle cell trait asks about playing football. What is the recommended approach?
• A 12-year-old child with weight in the 75th percentile has a diastolic blood pressure between the 95th and 99th percentile on three separate occasions. Initial tests should include?
• A mother pregnant with triplets asks for feeding guidance; which plan is recommended?
• In breast milk jaundice, bilirubin may remain elevated for up to how long?
• Which cognitive development stage includes not distinguishing between the body and the mind?
• A preschool-age child who is anxious and has tachycardia and tremors; what is the best referral?
• What is a potential risk when using multiple herbal remedies?
• Which statement about exercise in children with asthma is true?
• A toddler on long-term antibiotics for osteomyelitis is being monitored. Which laboratory test best monitors response to therapy?
• To avoid nipple confusion when establishing breastfeeding, what is recommended regarding bottle feeding and formula supplementation?
• Which pneumococcal vaccine replaced PCV7 in routine immunization in 2010?
• Nominal realism refers to preschoolers' belief that a word can only refer to the named thing, with no variation. Which term best captures this concept?
• A young adolescent female has mild unequal scapula prominences that disappear in the Adams forward bending position. What should the clinician do?
• In a child with cerebral palsy and athetosis with poor weight gain, which specialty consultation is prioritized to address GERD and nutrition?
• In nursemaid's elbow, radiographs are rarely necessary to diagnose. Which option is correct about radiographic use?
• A 12-year-old with poor hygiene and late-night texting; what action will promote healthy practices?
• In a toddler born prematurely with feeding difficulties and poor weight gain, a normal esophagus on imaging means which next step should be used to evaluate swallowing?
• When hydrating dry skin with bathing, which instruction is correct?
• What is the recommended supervision approach to support safe exploration in a curious toddler?
• During the initial visit of a school-age child with special needs, what is a priority concern for the clinician?
• A child with a history of otitis externa asks about prevention. What is the best recommendation?
• An 8-year-old immigrant child has a weight at the 25th percentile relative to a reference group. If the clinician explains this is within a healthy range, which domain of cultural competence is illustrated?
• An adolescent female reports heavy, irregular menses. The complete blood count shows hemoglobin 8.9 g/dL. What test should be ordered next?
• A 4-year-old female with enuresis and new daytime incontinence at preschool. What is the next best step in evaluation?
• During a routine visit, a 2-month-old infant has a recent growth spurt and the mother notes increased fussiness and nursing. What is the best explanation?
• A child is bitten on one arm by a neighbor's dog. The dog is immunized against rabies and the child's last tetanus immunization was 4 years prior. The wound edges are gaping and avulsed. What is an important initial intervention when treating this injury?
• For parents of a child with a disability, which approach is most appropriate when addressing sexuality education?
• A 17-year-old sexually active female with moderate to severe dull lower abdominal pain associated with periods but also occurring at other times; pregnancy test negative. Which course of action is most important?
• A 2-month-old infant is receiving initial immunizations, and the parent asks about giving medications to comfort the infant and minimize fever. Which is recommended?
• The primary care pediatric nurse practitioner is examining a school-age child who has had several hospitalizations for bronchitis and wheezing. The parent reports that the child has several coughing episodes associated with chest tightness each week and gets relief with an albuterol metered-dose inhaler. What will the nurse practitioner order?
• A child complains of itching in both ears with hearing difficulties. There is periauricular edema and marked swelling of the external auditory canal with severe pain when manipulating the external ear structures. Which intervention is appropriate?
• A 15-year-old girl on a vegan diet is undergoing a well-child exam. Which nutrients may this adolescent need to supplement?
• During an asthma action plan visit, the child is extremely anxious. What should the clinician do first?
• Persistent epistaxis with normal coagulation studies and ineffective symptomatic measures: what is the recommended next step?
• A school-age child has abrupt onset sore throat, fever, and exudative tonsils with a negative RADT. What is the next step in management?
• A 10-year-old with abdominal pain that starts around the umbilicus and then localizes to the right lower quadrant, with vomiting and fever, most likely has which problem?
• When reviewing a white blood cell (WBC) count, which element is typically elevated in a viral infection?
• Which statement reflects a growth mindset?
• A 1-week-old infant with mild jaundice who is breastfeeding well and gaining weight. Which action is correct?
• What should you tell the parent of a child with asthma about engaging in strenuous exercise?
• What is the recommended approach when outside influences conflict with family values in school-age children?
• An overweight school-age child is being counseled on fitness. Which statement best aligns with AAP recommendations?
• During a sports physical, a adolescent with mild aortic stenosis should have which clearance?
• How is community-based participatory research (CBPR) best described?
• If a teen engages in self-injury, which statement most accurately describes its purpose?
• A school-age child becomes frustrated when unable to perform tasks, has frequent temper tantrums, irritability, and poor sleep. Which disorder is most likely?
• A 4-year-old with otitis media whose mother has difficulty giving twice-daily amoxicillin; what is best approach?
• Why are some vaccines delayed until 12 months, such as MMR?
• A machinery-like murmur is most characteristic of which condition?
• A 9-month-old infant has vesiculopustular lesions on the palms and soles, plus the face and neck, with linear burrow lesions on the hands and wrists. What is the treatment?
• Which antibiotic is not considered first-line for uncomplicated pyelonephritis in a well-hydrated preschool-age child?
• In a respiratory disorder causing a check-valve obstruction, which symptoms will be present?
• Positive Ortolani and Barlow signs in a 6-month-old infant not previously noted in the medical record; what is the correct treatment?
• A child has small, firm, flesh-colored papules in both axillae which are mildly pruritic. What is an acceptable initial approach to managing this condition?
• A toddler with 2 days of vomiting and diarrhea shows signs of dehydration. Which management is most appropriate in the primary care setting?
• A preschool-age child in day care has 2 days of matted eyelids in the morning with burning and itching, yellow-green purulent discharge, conjunctival erythema, and mild URI symptoms. Action is correct?
• If abuse is suspected after a burn in a child, what is the priority action?
• Why is 2 percent cow's milk recommended at 12 months instead of continuing whole milk?
• In a school-age child with recurrent diarrhea and poor nutrient absorption, which test is the next appropriate step after a two-week lactose-free trial suggests no lactose intolerance?
• An school-age child who uses a SABA and an inhaled corticosteroid medication is seen in the clinic for an acute asthma exacerbation. After 4 puffs of an inhaled short-acting B2-agonist (SABA) every 20 minutes for three treatments, spirometry testing shows an FEV1 of 60% of the child's personal best. What will the primary care pediatric nurse practitioner do next?
• The primary care pediatric nurse practitioner is performing a medication history on a child and learns that the child's parents use various complementary treatments and remedies for the child. According to the American Academy of Pediatrics standard for providers, what will the nurse practitioner do?
• Galeazzi maneuver yields which finding indicating a positive test?
• Which imaging is used to diagnose multiple sclerosis with gadolinium enhancement?
• A high school athlete becomes short of breath only when exercising. What is the most appropriate next step?
• Which assessment tool is used to screen for psychosocial issues in adolescents?
• The primary care pediatric nurse practitioner is prescribing ibuprofen for a 25 kg child with JIA who has oligoarthitis. If the child will take 4 doses per day, what is the maximum amount the child will receive per dose?
• Which statement about VariZIG (varicella immune globulin) is correct?
• Which statement about Rett syndrome is true?
• A sexually active adolescent who has not had the HPV vaccine asks if she may receive it. What should you tell her?
• A school-age child has a Salter-Harris Type II fracture. Which statement is true?
• BPCA incentives include which primary outcome?
• Why is 2 percent milk often recommended during the second year of life?
• An adolescent with several weeks of fatigue, poor concentration, and appetite loss without an identifiable life event seeks help. What is the most important next step?
• A child with a difficult temperament is being seen in primary care. Which statement best guides management?
• A child diagnosed with nephrotic syndrome responds well to steroids. What is the appropriate message to give the parents about relapses?
• An adolescent male presents with sudden unilateral scrotal pain, nausea, and vomiting; elevation of the testis worsens pain (negative Phren's sign). What is the correct action?
• Are antipyretics useful in preventing febrile seizures?
• To evaluate brain tissue disorders in infants, which test is useful?
• During initial immunizations at 2 months, the parent asks about fever-reducing medications to minimize fever. What is recommended?
• For a 10-month-old with chronic hepatitis B infection, what is the recommended management?
• After constipation resolves in encopresis, how long should maintenance laxatives continue?
• Which contraception method is typically used by older adolescents committed to long-term contraception?
• Iron supplementation for a breastfed infant is typically started at what age when solid foods are introduced?
• In a child with erythema migrans rash due to Lyme disease, is serologic testing required when the rash is present with a history of tick exposure?
• A 1-month-old infant recently discharged from the NICU after neonatal herpetic infection is on oral acyclovir. What action is appropriate for management?
• A 16-year-old with breast tenderness and a small fluid-filled mass; pregnancy test negative. Which action is correct?
• To ensure health literacy for a parent of a special needs infant, which approach is best?
• Which sleep strategy is described by leaving the room as the child becomes drowsy and checking on the child at intervals?
• An acute infection causing lower airway obstruction: which initial symptom is expected?
• An infant with otitis media is homeless; what is a priority during this visit?
• A child with Down syndrome who has sleep-disordered breathing that persists after tonsillectomy, adenoidectomy, leukotriene receptor antagonist, and nasal steroid therapy: which therapy would be discussed at a sleep disorder clinic?
• Which medication is associated with potential dependence and is discouraged for pediatric sleep problems?
• A school-age female has had vulvovaginitis for 2 months. All cultures and tests are negative, but the symptoms persist after treatment with both topical antibiotics and oral amoxicillin. What is the next course of action to treat this condition?
• An overweight adolescent expresses a desire to lose weight but does not want to give up sweets and soft drinks because he enjoys them. Which stage of change does this represent?
• In toddlers with nighttime fears, which sleep arrangement is not recommended?
• A school-age child with 3 months of dull, epigastric pain worsened by meals and anemia requires which diagnostic step for suspected peptic ulcer disease in children?
• Which diagnostic test for suspected peptic ulcer disease in children may yield false negative results?
• Which supplement may increase bleeding risk when taken with NSAIDs?
• A 2-month-old with fever and cough has a WBC of 14,000/mm3 and a normal chest radiograph. What is an appropriate next step?
• Which activity most effectively promotes language development in infants?
• A child with otitis externa has severe swelling of the external auditory canal after 2 days of ototopical antibiotic/corticosteroid drops. What is the next step in treatment?
• Desmopressin nasal spray used for nocturnal enuresis carries which safety warning?
• A newborn with ankyloglossia is being evaluated. What is the next best step in management?
• An 18-month-old child with no previous history presents at night with ear pain, temperature 100.5°F, a red bulging tympanic membrane, and tympanogram peak of +150 mm H2O. What is the recommended treatment?
• A school-age child has had nasal discharge and daytime cough for 12 days without fever. What is the appropriate initial treatment for presumed acute rhinosinusitis?
• Brand-name herbal products have been tested for efficacy.
• An adolescent will begin taking the combination oral contraceptive pill (OCP). Which supplement will the primary care pediatric nurse practitioner caution the adolescent to avoid while taking OCPs?
• On exam of a 9-month-old, two lower incisors are erupted. The parent reports the infant nurses and takes solids, plus water from a cup. What is counsel for optimal dental health?
• A 9-month-old with fever of 103 F for 2 days develops a diffuse maculopapular rash that blanches. Immunizations are up to date. What is the appropriate management?
• Which activity is developmentally appropriate for a preschool to early school-age child?
• In a healthy child 4 years and older with no risk factors for TB, a Mantoux induration of 10 mm is interpreted as:
• A 4-month-old infant with a ventricular septal defect who has poor weight gain; what dietary change is recommended?
• A 5-year-old child has elevated blood pressure in the upper extremities with mottling of feet and a systolic ejection murmur at the left infraclavicular region radiating to the back. Which condition is most likely?
• The parents of a formula-fed newborn report that they get their drinking water from a well. What will the primary care pediatric nurse practitioner recommend to provide adequate fluoride for this infant?
• At a well-child visit for a 2-year-old in emergency foster care with a teen mother, what is a priority for the nurse practitioner?
• A family planning a 3-month trip to Africa with a child who has special needs asks about medications and equipment. This illustrates which concept?
• When assessing a picky eater, is it necessary to meet dietary reference intakes (DRIs) every day?
• By what age should a dental home be established for a child?
• A 14-year-old female has menometrorrhagia with a moderate increase in menstrual flow and irregular periods. Her hemoglobin is 13.1 g/dL. How will this be managed?
• The primary care pediatric nurse practitioner is closing a laceration on a child's forehead using topical skin adhesive. What is the correct way to apply this product?
• A child presents with a tender, swollen red furuncle on the upper lid margin. What treatment is recommended?
• A preschool-age child with no previous history has mild flank pain and fever; a urinalysis shows leukocyte esterase and nitrites; culture is pending. Which is the correct course of treatment?
• A 4-year-old pulls out hair and is anxious when tired or stressed. What is an appropriate initial treatment approach?
• A positive Barlow maneuver during newborn hip screening indicates what finding?
• Which statement about exercise recommendations for mild aortic stenosis is true?
• A parent of a school-age child worries that the child will be short and will not participate in sports; what counsel should the nurse practitioner provide?
• Under mandatory reporting laws, health care professionals are required to do what when abuse is suspected?
• Which health behavior prediction model is most appropriate when discussing lifestyle changes with an obese adolescent whose parents have type 2 diabetes?
• Which initial therapy is appropriate for a 4-month-old with atopic dermatitis presenting with itchy, dry skin and extensor papules?
• A 12-month-old who underwent cardiopulmonary bypass with RBC and plasma infusions; which vaccine may be administered at this visit?
• For an infant on suppressive oral acyclovir after neonatal herpes treatment, what is the recommended action if neutropenia occurs?
• An 18-month-old has received an MMR immunization 2 days before the first birthday. Which action is appropriate?
• A child presents with symptoms suggesting epiglottitis. What is the next step in management?
• A toddler with a deep partial-thickness burn on the palm after grabbing a curling iron: which statement is true regarding healing?
• Which screening tool is used to evaluate ADHD symptoms in children 6-18?
• A ferritin level of 30 ng/mL with suspected periodic limb movements prompts which therapy?
• At a well-baby examination of a newborn with an adolescent mother, which topic should the nurse practitioner discuss?
• In a daycare setting with multiple impetigo lesions, which antibiotic therapy is first-line?
• A 30-month-old girl with daytime enuresis and dysuria and a low-grade fever; dipstick urinalysis is negative for leukocyte esterase and nitrites. What is the next step?
• Which action demonstrates the health belief and self-efficacy model when teaching a school-age child with asthma management?
• A left shift on the WBC differential indicates an increase in which cells?
• A 14-year-old consistently skips classes despite disciplinary measures. What is the nurse practitioner’s recommended initial evaluation?
• A 12-month-old child who had repair of a congenital heart defect at 8 months of age has a normal exam. The parent reports no medications. The nurse practitioner will discuss with the cardiologist whether the child needs which medication?
• A 14-year-old with a 2-week history of severe itching and tearing, redness and swelling of the eyelids, and stringy mucoid discharge. Which medication is appropriate?
• Newborn conjunctivitis at 1 week old with moderate eyelid swelling and thick purulent discharge; most likely diagnosis?
• In an infant, how is the Kernig sign elicited during a neurologic examination?
• The primary care pediatric nurse practitioner examines a child who has had stiffness and warmth in the right knee and left ankle for 7 or 8 months but no back pain. The nurse practitioner will refer the child to a rheumatology specialist to evaluate for which juvenile idiopathic arthritis subtype?
• If a pre-participation murmur is graded 3 or 4, what action is typically recommended?
• A 3-year-old with persistent middle ear effusion for about 2 months after an acute otitis media episode has no fever or pain. What is the appropriate management?
• Which statement reflects a recommended nutrition pattern for toddlers?
• After varicella exposure, what is the recommended policy for day care attendance?
• What assessment strategy is most appropriate to learn about the emotional health of an 18-month-old?
• A child is bitten by a snake near a swimming pool in an area where copperhead snakes are known to inhabit, although the parents cannot describe the snake. An examination of the bite reveals a severe local reaction at the site with edema and intense pain. What will the primary care pediatric nurse practitioner do first?
• A 5-year-old who has been urinating in the toilet since age 3 but defecating in pull-ups; physical exam is normal. What is the recommended strategy?
• A child is 20 months old and was born 4 weeks premature. What is the corrected (adjusted) age for developmental screening?
• In a 4-month-old exclusively breastfed infant with fewer stools per day, what counseling is appropriate?
• Which scenario best illustrates shyness in a preschooler?
• Which supplement is recommended for a breastfeeding infant?
• PCV7 was replaced by which pneumococcal vaccine in 2010?
• In pediatric wound management, what is the approximate infection rate for sutured lacerations?
• An African-American family in a high-crime neighborhood is advised to move for safety. This illustrates which concept?
• When planning to pump during work, how long can frozen breast milk be stored in a 0°F freezer?
• A 20-month-old child was born 4 weeks premature and has milestone achievements consistent with a 15-month-old infant. What action is correct at this visit?
• Which feature is least likely to occur in acute Kawasaki disease?
• What should the primary care pediatric nurse practitioner teach the parents of a child who has new pressure-equalizing tubes (PET) in both ears?
• Which region globally has the highest infant mortality rate?
• During a well-child follow-up after a motor vehicle accident, which approach best supports the child in processing trauma?
• A child who recently stopped chemotherapy is eligible for routine vaccines. Which combination should be given?
• Which tool provides a rapid screen for depression in adolescents?
• Which statement accurately describes sexual reflexes in newborns with respect to erections?
• A 4-month-old infant shows convergence and accommodation with mild esotropia of the left eye during a vision screen. What is the appropriate next step?
• A 2-year-old child with SCA on penicillin V prophylaxis presents with cough and fever of 101.5°C. What should the NP do?
• Which of the following is not considered first-line treatment for pediatric anxiety disorders?
• To report a previously unknown adverse drug reaction, the nurse practitioner should ...
• An adolescent asks to follow a vegetarian diet; how should the provider respond?
• Which nutrient is particularly at risk for deficiency in menstruating adolescent girls?
• Progestin-only mini-pill is typically used in which situation?
• If antibiotics fail to treat prepubertal, nonspecific vulvovaginitis, what is the next recommended treatment?
• Among systemic lupus erythematosus–specific autoantibodies, which is highly specific but found in only about 30% of patients?
• In pediatric psoriasis, which ultraviolet therapy option is preferred due to safety and efficacy?
• A 14-year-old boy who is overweight develops a unilateral limp with hip and knee pain; examination shows external rotation of the hip and pain with internal rotation. What is the most important initial step?
• Two weeks after a concussion, a 10-year-old still has some sleepiness. What is the recommended return-to-play approach?
• A parent who encourages competitiveness in a child who excels in a single sport may foster which feeling?
• A 3-year-old child has head lice. What will the initial treatment recommendation be to treat this child?
• Which vesicoureteral reflux grade is least likely to resolve spontaneously?
• In a 3-month-old with arching during feeds and poor weight gain, what is the best initial course of treatment?
• The parent of a toddler asks about treatment for grade V vesicoureteral reflux. What is the typical treatment plan?
• A 12-year-old girl reports sexual contact with her mother's boyfriend; the clinician reports to the local child abuse hotline. What is the next action?
• In orthostatic proteinuria, when is a 24-hour urine collection indicated?
• An 8-year-old child is diagnosed with systemic lupus erythematosus (SLE), and the child's parent asks if there is a cure. What will the primary care pediatric nurse practitioner tell the parent?
• For a 15-month-old child who is continuing to breastfeed, what practice is recommended to protect the child's dental health?
• A child who plays soccer reports knee pain and swelling with focal tenderness at the tibial tuberosities. What is the treatment?
• A 6-month-old infant who is breastfed takes 400 IU of vitamin D daily and has started cereals, fruits, and vegetables in addition to nursing. What is the appropriate anticipatory guidance?
• An African-American child with recurrent tinea capitis has just developed a new area of alopecia after successful treatment several months prior. When prescribing treatment with griseofulvin and selenium shampoo, what else should the clinician do?
• A child with a pustular rash at a cat scratch site and tender axillary lymphadenopathy: which test best confirms cat-scratch fever?
• In a child who has undergone repair of tetralogy of Fallot, when are hypercyanotic episodes most likely to occur?
• A 9-month-old with fever 103°F for 2 days and a diffuse maculopapular rash that blanches on pressure. The infant's immunizations are up-to-date. What is the appropriate action for the primary care pediatric nurse practitioner?
• A toddler and a 4-week-old infant have just been diagnosed with pertussis. What should be done to prevent transmission to the infant?
• Which act allows labeling stating that safety and effectiveness in pediatric patients have not been established on drugs with insufficient evidence to support pediatric indications?
• Which test is definitive to diagnose suspected leukemia?
• In functional abdominal pain in a child, what concept is important to address in treatment?
• Which auscultatory finding is most suggestive of an atrial septal defect?
• A child who has been diagnosed with asthma for several years has been using a short-acting B2-agonist (SABA) to control symptoms. The child recently began using the SABA two or three times each week to treat wheezing and shortness of breath. The child currently has clear breath sounds and an FEV1 of 75% of personal best. What will the nurse practitioner do next?
• When should the second dose of the 23-valent pneumococcal vaccine be given after the first dose?
• In adolescent major depression, when is hospitalization indicated?
• A child has several shallow mucosal lesions on the buccal mucosa and tongue that are surrounded with an erythematous halo and covered by yellow plaques. What will the primary care pediatric nurse practitioner recommend?
• A school-age child suffers a closed fracture of the right clavicle after a fall from a swing. How is this managed?
• The parent of a newborn reports using echinacea for family members to help treat viral illnesses and feels that it is usually effective. What will the primary care pediatric nurse practitioner tell this parent?
• Which of the following is the mainstay therapy for otitis externa?
• What is the best initial approach when a Native American family uses herbal remedies to promote health in children?
• A high school athlete with infectious mononucleosis asks when she may resume play. What is the usual guideline?
• Why is it important to discuss healthy sexuality with adolescents who have disabilities?
• A 32‑month‑old child has about 70% intelligible speech and difficulty pronouncing t, d, k, and g sounds. Which action is correct?
• Xylitol gum usage frequency for caries prevention?
• Which labeling is associated with ensuring ingredient quality and purity in natural products?
• In suspected functional abdominal pain, which dietary trial is commonly recommended alongside an initial lab work-up?
• An 18‑month‑old says 'Want puppy!' when pointing at a dog. This is an example of which speech stage?
• An adolescent has acne characterized by papules and pustules mostly on the forehead and chin. Which prescription is most appropriate?
• For a healthy 4-week-old infant, which nighttime feeding pattern is acceptable?
• Which statement about PCV23 vaccination in children under 2 years is accurate?
• A newborn weighs 3250 g at birth and 2990 g at discharge on day 2. At the current visit the weight is 3080 g. What is the recommended action?
• Post-streptococcal glomerulonephritis after a GABHS infection typically requires hospitalization due to which of the following features?
• What will the primary care pediatric nurse practitioner recommend to the parent of an infant who is teething who asks about comfort measures?
• When initiating anticipatory guidance for an 8-year-old girl showing breast buds, which topic is appropriate to include?
• Which finding most suggests body lice infestation rather than head lice infestation?
• Mild delays in only one developmental area are most appropriately managed by which approach initially?
• A preschool-age child has intense red cheeks with circumoral pallor; which rash pattern is most consistent with this description?
• Which response demonstrates a growth mindset?
• A 10-month-old with a non-draining fluctuant abscess after 10 days of amoxicillin for impetigo; what is the next step?
• How should you respond to a 24‑month‑old when asked about toilet training readiness?
• If cognitive-behavioral therapy is not effective for mild to moderate tic disorders, what is the next recommended step?
• A 5-year-old has recurrent fevers, bone pain, weight loss, scattered petechiae, lymphadenopathy, bruising, and CBC showing thrombocytopenia, anemia, and leukocytosis. The NP will refer this child to a specialist for a?
• An adolescent female with a history of repaired tetralogy of Fallot is at risk for which long-term complication?
• At what age are solids typically introduced into an infant's diet?
• Which vaccine contains whole-cell pertussis and is used in some countries but not in the United States?
• A child with nephrotic syndrome on steroids and salt restriction has a dipstick showing 1+ protein, down from 3+ at the start of the episode. In consultation with the nephrologist, what is the correct course of treatment?
• To estimate the onset of menarche, which developmental milestone is most informative?
• Which statement about exclusive breastfeeding is supported by evidence?
• Why is it important to explore the family's prior experiences in caring for a child with special needs during the initial visit?
• An unimmunized school-age child diagnosed during a rubella outbreak; what is the recommended action?