NRNP 6541 – PRIMARY CARE OF ADOLESCENTS AND
CHILDREN (QUARTER 6 /11-WEEK) COMPREHENSIVE
EXAM BANK
It includes 180 multiple-choice questions with answers and rationales in italics.
Week 1-2: Adolescent Growth & Development + Communication
1. A 14-year-old boy is concerned because one testicle appears lower than the other.
What is the best response?
a) "This is abnormal and requires surgical evaluation."
b) "This is normal anatomical variation."
c) "This indicates a hernia."
d) "This is caused by a varicocele."
Answer: b
Rationale: In males, the left testicle normally hangs lower than the right to prevent torsion
and allow comfortable movement. This is a normal finding.
2. According to Piaget, which cognitive stage describes a 16-year-old who thinks about
justice, morality, and hypothetical situations?
a) Concrete operational
b) Formal operational
c) Preoperational
d) Sensorimotor
Answer: b
*Rationale: Formal operational stage (age 11+), characterized by abstract thinking,
deductive reasoning, and consideration of hypothetical scenarios.*
,3. What is the most common cause of mortality in adolescents?
a) Cancer
b) Congenital anomalies
c) Unintentional injury (motor vehicle crashes)
d) Suicide
Answer: c
*Rationale: Unintentional injuries, especially MVCs, are the leading cause of death in
adolescents 15-19 years. Suicide is the second leading cause.*
4. A 13-year-old girl refuses to wear her glasses because "my friends will laugh at me."
This reflects which psychosocial stage per Erikson?
a) Industry vs. Inferiority
b) Autonomy vs. Shame
c) Identity vs. Role Confusion
d) Intimacy vs. Isolation
Answer: c
*Rationale: Identity vs. Role Confusion (ages 12-18) focuses on peer acceptance and
forming self-identity. Peer opinion is paramount.*
5. What is the recommended well-visit frequency for a healthy 15-year-old?
a) Every 6 months
b) Annually
c) Every 2 years
d) Only when sick
Answer: b
Rationale: AAP recommends annual health supervision visits for all adolescents through
age 21 to address physical, developmental, and psychosocial health.
Week 3-4: Mental Health & Behavioral Disorders
,6. A 16-year-old reports depressed mood and anhedonia for 8 months. Which screening
tool is most appropriate?
a) CRAFFT
b) HEADSSS
c) PHQ-9 modified for adolescents
d) M-CHAT
Answer: c
*Rationale: PHQ-9 modified (or PHQ-A) is validated for adolescent depression screening.
HEADSSS is psychosocial, CRAFFT is substance use.*
7. Which medication is FDA-approved for depression in adolescents?
a) Paroxetine
b) Fluoxetine
c) Amitriptyline
d) Bupropion
Answer: b
*Rationale: Fluoxetine is FDA-approved for MDD in children 8+. Escitalopram is also
approved. Paroxetine carries higher suicide risk and is not first-line.*
8. A 15-year-old girl has weight loss, amenorrhea, intense fear of weight gain, and
distorted body image. Most likely diagnosis?
a) Bulimia nervosa
b) Binge eating disorder
c) Anorexia nervosa
d) ARFID
Answer: c
*Rationale: Anorexia nervosa features low weight, fear of gain, and body image
distortion. Amenorrhea is common but no longer required for DSM-5 criteria.*
9. What is the first-line treatment for pediatric generalized anxiety disorder?
a) Benzodiazepines
b) Buspirone
, c) CBT plus an SSRI (escitalopram or fluoxetine)
d) Propranolol
Answer: c
Rationale: CBT combined with SSRI (escitalopram, fluoxetine, or sertraline) is first-line.
Benzodiazepines are avoided in youth due to risk.
10. A 14-year-old has recurrent episodes of binge eating followed by self-induced
vomiting. Labs: hypokalemia, metabolic alkalosis. Diagnosis?
a) Anorexia nervosa, binge-purge type
b) Bulimia nervosa
c) Purging disorder
d) Binge eating disorder
Answer: b
Rationale: Bulimia nervosa = recurrent binge eating + compensatory behaviors (vomiting,
laxatives) with normal or overweight status. Hypokalemia and metabolic alkalosis from
vomiting.
Week 5-6: Reproductive & Sexual Health
11. A sexually active 17-year-old requests contraception. Which method is most
effective (>99%) to prevent pregnancy?
a) Condoms alone
b) Oral contraceptive pills
c) Etonogestrel implant (Nexplanon)
d) Withdrawal
Answer: c
Rationale: LARC methods (implant, IUD) have >99% efficacy. Implant failure rate <0.05%
vs. OCP typical use ~91%.
CHILDREN (QUARTER 6 /11-WEEK) COMPREHENSIVE
EXAM BANK
It includes 180 multiple-choice questions with answers and rationales in italics.
Week 1-2: Adolescent Growth & Development + Communication
1. A 14-year-old boy is concerned because one testicle appears lower than the other.
What is the best response?
a) "This is abnormal and requires surgical evaluation."
b) "This is normal anatomical variation."
c) "This indicates a hernia."
d) "This is caused by a varicocele."
Answer: b
Rationale: In males, the left testicle normally hangs lower than the right to prevent torsion
and allow comfortable movement. This is a normal finding.
2. According to Piaget, which cognitive stage describes a 16-year-old who thinks about
justice, morality, and hypothetical situations?
a) Concrete operational
b) Formal operational
c) Preoperational
d) Sensorimotor
Answer: b
*Rationale: Formal operational stage (age 11+), characterized by abstract thinking,
deductive reasoning, and consideration of hypothetical scenarios.*
,3. What is the most common cause of mortality in adolescents?
a) Cancer
b) Congenital anomalies
c) Unintentional injury (motor vehicle crashes)
d) Suicide
Answer: c
*Rationale: Unintentional injuries, especially MVCs, are the leading cause of death in
adolescents 15-19 years. Suicide is the second leading cause.*
4. A 13-year-old girl refuses to wear her glasses because "my friends will laugh at me."
This reflects which psychosocial stage per Erikson?
a) Industry vs. Inferiority
b) Autonomy vs. Shame
c) Identity vs. Role Confusion
d) Intimacy vs. Isolation
Answer: c
*Rationale: Identity vs. Role Confusion (ages 12-18) focuses on peer acceptance and
forming self-identity. Peer opinion is paramount.*
5. What is the recommended well-visit frequency for a healthy 15-year-old?
a) Every 6 months
b) Annually
c) Every 2 years
d) Only when sick
Answer: b
Rationale: AAP recommends annual health supervision visits for all adolescents through
age 21 to address physical, developmental, and psychosocial health.
Week 3-4: Mental Health & Behavioral Disorders
,6. A 16-year-old reports depressed mood and anhedonia for 8 months. Which screening
tool is most appropriate?
a) CRAFFT
b) HEADSSS
c) PHQ-9 modified for adolescents
d) M-CHAT
Answer: c
*Rationale: PHQ-9 modified (or PHQ-A) is validated for adolescent depression screening.
HEADSSS is psychosocial, CRAFFT is substance use.*
7. Which medication is FDA-approved for depression in adolescents?
a) Paroxetine
b) Fluoxetine
c) Amitriptyline
d) Bupropion
Answer: b
*Rationale: Fluoxetine is FDA-approved for MDD in children 8+. Escitalopram is also
approved. Paroxetine carries higher suicide risk and is not first-line.*
8. A 15-year-old girl has weight loss, amenorrhea, intense fear of weight gain, and
distorted body image. Most likely diagnosis?
a) Bulimia nervosa
b) Binge eating disorder
c) Anorexia nervosa
d) ARFID
Answer: c
*Rationale: Anorexia nervosa features low weight, fear of gain, and body image
distortion. Amenorrhea is common but no longer required for DSM-5 criteria.*
9. What is the first-line treatment for pediatric generalized anxiety disorder?
a) Benzodiazepines
b) Buspirone
, c) CBT plus an SSRI (escitalopram or fluoxetine)
d) Propranolol
Answer: c
Rationale: CBT combined with SSRI (escitalopram, fluoxetine, or sertraline) is first-line.
Benzodiazepines are avoided in youth due to risk.
10. A 14-year-old has recurrent episodes of binge eating followed by self-induced
vomiting. Labs: hypokalemia, metabolic alkalosis. Diagnosis?
a) Anorexia nervosa, binge-purge type
b) Bulimia nervosa
c) Purging disorder
d) Binge eating disorder
Answer: b
Rationale: Bulimia nervosa = recurrent binge eating + compensatory behaviors (vomiting,
laxatives) with normal or overweight status. Hypokalemia and metabolic alkalosis from
vomiting.
Week 5-6: Reproductive & Sexual Health
11. A sexually active 17-year-old requests contraception. Which method is most
effective (>99%) to prevent pregnancy?
a) Condoms alone
b) Oral contraceptive pills
c) Etonogestrel implant (Nexplanon)
d) Withdrawal
Answer: c
Rationale: LARC methods (implant, IUD) have >99% efficacy. Implant failure rate <0.05%
vs. OCP typical use ~91%.
