PEDIATRIC PRIMARY CARE PNCB 2 QUESTIONS AND ANSWERS 2026
NEWEST ASSURED SUCCESS
Advice for adolescents on the health risks of smoking cigarettes is
based on current research which has concluded that:
Early cigarette initiation age often results in adult nicotine dependency
and is associated with other risk behaviors.
Cigarette use frequently decreases as the grade in school increases.
Adolescent males are more likely to report cigarette use in the past
thirty days.
Pregnant adolescent females are less likely to smoke during pregnancy
than adult women. - --Answers----early cigarette initiation age often
results in adult nicotine dependency and is associated with other risk
behaviors.
Cigarette smoking has continued to be a health issue for adolescents.
The recent literature implies an increased daily smoking rate among
adolescents, especially females. Cigarette smoking has also been linked
to other health risk behaviors such as other types of substance use (e.g.
Marijuana use, sexual activity).
Despite the facts regarding long term cigarette smoking and cancer and
lung disease risks, adolescents continue to smoke, with initiating ages
as low as elementary school. As cigarette smoking is linked to sexual
activity, it is then a problem when adolescent females accidentally
become pregnant. They are more likely to continue smoking and thus
have added risks related to size of infant, prenatal loss, and premature
rupture of membranes.
,With which of the following factors should a child have
antihypertensive pharmacologic therapy initiated?
Pre-hypertension
Asymptomatic primary hypertension and a family member with
hypertension
Asymptomatic primary hypertension receiving stimulant therapy for
adhd
Secondary hypertension - --Answers----secondary hypertension
Any child with secondary hypertension should be started on
antihypertensive medication. Children with asymptomatic pre-
hypertension without evidence of end-organ damage or diabetes
should initially be managed with lifestyle modifications, including
exercise, weight reduction (if overweight), salt restriction, increased
intake of vegetables, fruits, and low-fat dairy products. Unless the child
has evidence of end-organ damage or diabetes, lifestyle modification
should be initiated and the hypertension re-evaluated in six months. If
lifestyle recommendations do not result in decrease in blood pressure,
consider antihypertensive pharmacologic therapy. Investigate
alternative stimulant pharmacologic therapies prior to starting
antihypertensive pharmacologic therapy. Family history of
hypertension is an important element of the medical history, but does
not by itself trigger medication therapy for the child.
Which is the preferred diagnostic test for a 2 day old who has spitting
and choking with feedings?
,Placement of an orogastric feeding tube with chest / abdominal
radiograph
Barium swallow with small bowel follow through
Ct of the esophagus and stomach with oral contrast
Placement of a nasogastric feeding tube and fluoroscopic evaluation - --
Answers----placement of an orogastric feeding tube with chest /
abdominal radiograph
Esophageal atresia (ea) with or without tracheoesophageal fistula (tef)
is commonly diagnosed in the newborn period when an infant has
recurrent spitting and choking with feeds. The diagnostic test for ea is
the passage of an orogastric tube followed by radiologic imaging to
confirm coiling of the tube in the thoracic region. Upper gi studies are
often used to diagnose obstruction, intestinal malrotation, and
intestinal duplication. Ct scan is not needed for diagnosis, nor is
nasogastric tube with fluoroscopy. Newborns are obligatory nose
breathers so it is best not to put the feeding tube in the nose.
An adolescent sustains a puncture wound in the sole of a foot after
stepping on a protruding nail. In addition to reviewing tetanus vaccine
status, the most appropriate initial management is
Debridement of epidermal edges.
Wound probing for retained material.
Initiation of prophylactic antibiotics.
Superficial irrigation of the wound. - --Answers----superficial irrigation
of the wound.
, Initial management of puncture wounds includes superficial irrigation
with sterile saline and cleansing the area of foreign matter to prevent
tattooing of debris into the dermal layers. High pressure wound
irrigation as well as surgical debridement and wound probing may
damage tissue and push foreign objects and bacteria deeper into the
wound. Prophylactic antibiotics are not indicated unless the risk of
infection is especially high such as with cat bites, puncture wounds of
the face, and human bite wounds.
Children with cochlear implants are at risk for which of the following
diseases?
Bacterial meningitis
Bell palsy
Cytomegalovirus
Serous otitis media - --Answers----bacterial meningitis
Children with cochlear implants are at risk for meningitis, usually due to
streptococcus pneumoniae, and should receive pneumococcal
vaccination. Cytomegalovirus (cmv) is a common cause of congenital
sensorineural hearing loss requiring a cochlear implant. Bell palsy and
otitis media do not occur more often in those with a cochlear implant.
A 10 year old has rhinorrhea, nasal congestion, and a sore throat, and is
sneezing. Physical examination is significant for dennie's lines, pale
boggy nasal mucosa, and clear mucus. These findings are most
characteristic of:
Upper respiratory infection
NEWEST ASSURED SUCCESS
Advice for adolescents on the health risks of smoking cigarettes is
based on current research which has concluded that:
Early cigarette initiation age often results in adult nicotine dependency
and is associated with other risk behaviors.
Cigarette use frequently decreases as the grade in school increases.
Adolescent males are more likely to report cigarette use in the past
thirty days.
Pregnant adolescent females are less likely to smoke during pregnancy
than adult women. - --Answers----early cigarette initiation age often
results in adult nicotine dependency and is associated with other risk
behaviors.
Cigarette smoking has continued to be a health issue for adolescents.
The recent literature implies an increased daily smoking rate among
adolescents, especially females. Cigarette smoking has also been linked
to other health risk behaviors such as other types of substance use (e.g.
Marijuana use, sexual activity).
Despite the facts regarding long term cigarette smoking and cancer and
lung disease risks, adolescents continue to smoke, with initiating ages
as low as elementary school. As cigarette smoking is linked to sexual
activity, it is then a problem when adolescent females accidentally
become pregnant. They are more likely to continue smoking and thus
have added risks related to size of infant, prenatal loss, and premature
rupture of membranes.
,With which of the following factors should a child have
antihypertensive pharmacologic therapy initiated?
Pre-hypertension
Asymptomatic primary hypertension and a family member with
hypertension
Asymptomatic primary hypertension receiving stimulant therapy for
adhd
Secondary hypertension - --Answers----secondary hypertension
Any child with secondary hypertension should be started on
antihypertensive medication. Children with asymptomatic pre-
hypertension without evidence of end-organ damage or diabetes
should initially be managed with lifestyle modifications, including
exercise, weight reduction (if overweight), salt restriction, increased
intake of vegetables, fruits, and low-fat dairy products. Unless the child
has evidence of end-organ damage or diabetes, lifestyle modification
should be initiated and the hypertension re-evaluated in six months. If
lifestyle recommendations do not result in decrease in blood pressure,
consider antihypertensive pharmacologic therapy. Investigate
alternative stimulant pharmacologic therapies prior to starting
antihypertensive pharmacologic therapy. Family history of
hypertension is an important element of the medical history, but does
not by itself trigger medication therapy for the child.
Which is the preferred diagnostic test for a 2 day old who has spitting
and choking with feedings?
,Placement of an orogastric feeding tube with chest / abdominal
radiograph
Barium swallow with small bowel follow through
Ct of the esophagus and stomach with oral contrast
Placement of a nasogastric feeding tube and fluoroscopic evaluation - --
Answers----placement of an orogastric feeding tube with chest /
abdominal radiograph
Esophageal atresia (ea) with or without tracheoesophageal fistula (tef)
is commonly diagnosed in the newborn period when an infant has
recurrent spitting and choking with feeds. The diagnostic test for ea is
the passage of an orogastric tube followed by radiologic imaging to
confirm coiling of the tube in the thoracic region. Upper gi studies are
often used to diagnose obstruction, intestinal malrotation, and
intestinal duplication. Ct scan is not needed for diagnosis, nor is
nasogastric tube with fluoroscopy. Newborns are obligatory nose
breathers so it is best not to put the feeding tube in the nose.
An adolescent sustains a puncture wound in the sole of a foot after
stepping on a protruding nail. In addition to reviewing tetanus vaccine
status, the most appropriate initial management is
Debridement of epidermal edges.
Wound probing for retained material.
Initiation of prophylactic antibiotics.
Superficial irrigation of the wound. - --Answers----superficial irrigation
of the wound.
, Initial management of puncture wounds includes superficial irrigation
with sterile saline and cleansing the area of foreign matter to prevent
tattooing of debris into the dermal layers. High pressure wound
irrigation as well as surgical debridement and wound probing may
damage tissue and push foreign objects and bacteria deeper into the
wound. Prophylactic antibiotics are not indicated unless the risk of
infection is especially high such as with cat bites, puncture wounds of
the face, and human bite wounds.
Children with cochlear implants are at risk for which of the following
diseases?
Bacterial meningitis
Bell palsy
Cytomegalovirus
Serous otitis media - --Answers----bacterial meningitis
Children with cochlear implants are at risk for meningitis, usually due to
streptococcus pneumoniae, and should receive pneumococcal
vaccination. Cytomegalovirus (cmv) is a common cause of congenital
sensorineural hearing loss requiring a cochlear implant. Bell palsy and
otitis media do not occur more often in those with a cochlear implant.
A 10 year old has rhinorrhea, nasal congestion, and a sore throat, and is
sneezing. Physical examination is significant for dennie's lines, pale
boggy nasal mucosa, and clear mucus. These findings are most
characteristic of:
Upper respiratory infection
