PNCB PEDIATRIC PRIMARY CARE EXAM 2
2026 FINAL PAPER TEST BANK WITH FULL
SOLVED QUESTIONS
⫸ A healthy 24 month old can be expected to have achieved which of
the following language milestones?
counts three objects correctly
speaks using 30 - 50 words
states full name
tells a story Answer: speaks using 30 - 50 words
Utilizing the Early Language Milestone Scale, beginning at the age of 11
months and continuing to 24 months of age, the child should have a
vocabulary of 50 words. This child should be able to put words together
in short, 2 - 3 word sentences and name at least one object in a picture.
The child at age 3 - 4 years will be able to tell a short story and begin to
count. A 2 year old may know his first name, but usually cannot state
full name until he/she is older.
⫸ Which is the MOST important safety question to ask a 17 year old?
"Are you aware of ways to avoid accidents?"
,"Do you play violent video games more than 2 hours a day?"
"Do you always wear a seat belt when driving or riding in a car?"
"Is there a gun anywhere in your house?" Answer: "Do you always wear
a seat belt when driving or riding in a car?"
Motor vehicle accidents are the leading cause of death among children in
the United States, with 78% of all unintentional injury deaths related to
MVA among adolescents. When correctly used, restraint systems can
prevent fatalities and reduce the number and severity of injuries to
children and adolescents. As adolescents begin to drive and carry peer
passengers, it is especially important to remind them of basic safety
issues, including the use of seat belts, emphasizing the danger of driving,
drinking and drug use as well as appropriate behavior while in the car.
Reinforcing pedestrian safety is another important issue with
adolescents. Firearm injuries have decreased over recent years,
especially among older children, and there is no link between violent
video games and increased accidents.
⫸ The parent of an 8 month old, reports switching the baby's formula to
cow's milk due to the continued expense of formula. Which is the BEST
response?
Cow's milk does not contain adequate nutrition, and poses a higher risk
for allergy.
,Cow's milk has a lower protein and fat content, which will impede
growth of the baby.
Switching to cow's milk sooner than 1 year will not cause any harm.
There is no need to continue formula as long as the child is receiving
other baby foods. Answer: Cow's milk does not contain adequate
nutrition, and poses a higher risk for allergy.
During the first year of life, infants should receive only formula or breast
milk. The use of cow's milk is contraindicated because of its high
protein content, inappropriate nutrition composition, especially lack of
iron sources, and the risk of gastrointestinal bleeding and allergic
reactions. If an infant is switched sooner than one year, the practitioner
should encourage the family to resume use of formula or breast milk
until the one year birthday. Despite the addition of table foods or baby
solid foods, formula and breast milk are still the dietary mainstay.
⫸ A 10 month old has had apparent abdominal pain for the past 4 hours.
During episodes of pain, the infant screams inconsolably and draws his
legs towards the abdomen, has vomited twice, but has had no diarrhea.
Between episodes the infant is calm and quiet. The MOST likely
diagnosis is:
Meckel's diverticulum
, intussusception
acute appendicitis
acute gastroenteritis Answer: intussusception
Acute onset of abdominal pain requires immediate investigation. The
nurse practitioner must be able to distinguish between conditions that
can safely be managed at home and those requiring immediate referral.
Meckel's diverticulum usually involves painless rectal bleeding. Acute
appendicitis can occur in infants and must be considered in the
differential diagnosis. The pain history of acute appendicitis is usually
more continuous, and there is no palpable mass. Acute gastroenteritis
may involve intermittent pain and cramping, but more typically the child
appears ill, and vomiting and diarrhea play a more prominent role. The
pain of intussusception is very severe, with periods of well-being in
between. There is frequently vomiting, however stools initially are
normal. Later stools can be like red jelly in appearance. A sausage
shaped mass is frequently palpable in the right upper quadrant and aids
in diagnosis.
⫸ For the parents of an 8 month old, the MOST appropriate age-related
anticipatory guidance regarding safety includes which of the following?
cover electrical outlets, keep small objects out of reach, turn car seat to
forward-facing position
2026 FINAL PAPER TEST BANK WITH FULL
SOLVED QUESTIONS
⫸ A healthy 24 month old can be expected to have achieved which of
the following language milestones?
counts three objects correctly
speaks using 30 - 50 words
states full name
tells a story Answer: speaks using 30 - 50 words
Utilizing the Early Language Milestone Scale, beginning at the age of 11
months and continuing to 24 months of age, the child should have a
vocabulary of 50 words. This child should be able to put words together
in short, 2 - 3 word sentences and name at least one object in a picture.
The child at age 3 - 4 years will be able to tell a short story and begin to
count. A 2 year old may know his first name, but usually cannot state
full name until he/she is older.
⫸ Which is the MOST important safety question to ask a 17 year old?
"Are you aware of ways to avoid accidents?"
,"Do you play violent video games more than 2 hours a day?"
"Do you always wear a seat belt when driving or riding in a car?"
"Is there a gun anywhere in your house?" Answer: "Do you always wear
a seat belt when driving or riding in a car?"
Motor vehicle accidents are the leading cause of death among children in
the United States, with 78% of all unintentional injury deaths related to
MVA among adolescents. When correctly used, restraint systems can
prevent fatalities and reduce the number and severity of injuries to
children and adolescents. As adolescents begin to drive and carry peer
passengers, it is especially important to remind them of basic safety
issues, including the use of seat belts, emphasizing the danger of driving,
drinking and drug use as well as appropriate behavior while in the car.
Reinforcing pedestrian safety is another important issue with
adolescents. Firearm injuries have decreased over recent years,
especially among older children, and there is no link between violent
video games and increased accidents.
⫸ The parent of an 8 month old, reports switching the baby's formula to
cow's milk due to the continued expense of formula. Which is the BEST
response?
Cow's milk does not contain adequate nutrition, and poses a higher risk
for allergy.
,Cow's milk has a lower protein and fat content, which will impede
growth of the baby.
Switching to cow's milk sooner than 1 year will not cause any harm.
There is no need to continue formula as long as the child is receiving
other baby foods. Answer: Cow's milk does not contain adequate
nutrition, and poses a higher risk for allergy.
During the first year of life, infants should receive only formula or breast
milk. The use of cow's milk is contraindicated because of its high
protein content, inappropriate nutrition composition, especially lack of
iron sources, and the risk of gastrointestinal bleeding and allergic
reactions. If an infant is switched sooner than one year, the practitioner
should encourage the family to resume use of formula or breast milk
until the one year birthday. Despite the addition of table foods or baby
solid foods, formula and breast milk are still the dietary mainstay.
⫸ A 10 month old has had apparent abdominal pain for the past 4 hours.
During episodes of pain, the infant screams inconsolably and draws his
legs towards the abdomen, has vomited twice, but has had no diarrhea.
Between episodes the infant is calm and quiet. The MOST likely
diagnosis is:
Meckel's diverticulum
, intussusception
acute appendicitis
acute gastroenteritis Answer: intussusception
Acute onset of abdominal pain requires immediate investigation. The
nurse practitioner must be able to distinguish between conditions that
can safely be managed at home and those requiring immediate referral.
Meckel's diverticulum usually involves painless rectal bleeding. Acute
appendicitis can occur in infants and must be considered in the
differential diagnosis. The pain history of acute appendicitis is usually
more continuous, and there is no palpable mass. Acute gastroenteritis
may involve intermittent pain and cramping, but more typically the child
appears ill, and vomiting and diarrhea play a more prominent role. The
pain of intussusception is very severe, with periods of well-being in
between. There is frequently vomiting, however stools initially are
normal. Later stools can be like red jelly in appearance. A sausage
shaped mass is frequently palpable in the right upper quadrant and aids
in diagnosis.
⫸ For the parents of an 8 month old, the MOST appropriate age-related
anticipatory guidance regarding safety includes which of the following?
cover electrical outlets, keep small objects out of reach, turn car seat to
forward-facing position
