PNP Final Exam Questions and Answers 2022
H.O. is a 5 yo Vietnamese child who has fallen off of his growth curve. The best intervention would be
to:
a. Suggest high-calorie breakfast drinks as supplements
b. incorporate traditional foods into a management plan that will provide increased calories and nutrients
c. educate the family on the need for increased calories and nutrients
d. refer the family to growth clinic for evaluation
B
While taking the history of 6-month old E.M. you learn that she is not sleeping through the night and will
not fall back to sleep without the parents rocking or feeding her. This is an example of:
a. somnambulism
b. pavor nocturnus
c. learned behavior
d. delayed sleep phase
C
Which of the following scenarios is suggestive of a child who may not be ready to enter first grade? An
inability to:
a. recognize six colors and remember one's phone number
b. accurately use pronouns
c. empathize with others
d. count to five and draw a person with three parts
d
T.T. is a 9 week old preterm infant whose birth wt was 2.3 kg. Mom was HBs Ag Neg. He is seen today
for the first time since discharge from the nursery. He has received no prior immunizations. The
appropriate immunizations to give at this time would be:
a. Dtap, Hib, IPV, rotavirus, HepB 1, pneumo
b. Dtap, Hib, OPV, rotavirus, HepB 1
c. Dtap, Hib, rotavirus, IPV, pneumo
d. Dtap, Hib, IPV, pneumo
a
While examining 10 yo RMs teeth you note that the upper incisors slightly overlap the lower incisors.
The second and lower first molars are absent. Your assessment is:
a. malocclusion
b. delayed mandibular dentition
c. normal dentition
d. hyperdontia
b
,The mother of 5yo DW is concerned that her son often cheats when playing board games with his older
sister. What is the most appropriate response to DWs behavior?
a. encourage the parent to use 5 minute time-outs when cheating occurs
b. explain that DW is developmentally unable to comprehend rigid rules
c. make sure that DW understands the rules before starting to play the game
d. explain to DW that cheating is like lying and is not acceptable
behavior b
Which of the following is not a sign of readiness to toilet train?
a. can sit for extended periods
b. can follow directions
c. occasional waking from naps with dry diapers
d. regularity of bowel
movements d
Which of the following physical findings in a 2 month old child warrants an immediate referral to a
neurologist/neurosurgeon?
a. head circumference growing faster than height and weight
b. unresolved cephalhematoma
c. rigid and immobile sagittal suture
d. snapping sensation when pressure is applied to parietal bone
c
While listening to 2.5 yo KL talk, you note that she frequently omits final consonants and her sentences
are two and three words in length. The appropriate plan of care would be.
a. routine follow up at next well child visit
b. referring for hearing screening
c. assessing for developmental delays
d. referring to a speech
pathologist a
The mother of 3 yo GW reports that he has begun to stutter. Further probing reveals that the stuttering
occurs frequently and lasts 1 to 2 seconds. GW does not seem bothered by the stuttering. The appropirate
management would be:
a. referral to a speech pathologist
b. referral for an evaluation for an anxiety disorder
c. reassuring the mother that this is a mild problem
d. demonstrating to GW slow, deep breathing before
talking c
You would expect a school age child to:
a. grow 1.5 inches per year
b. grow 0.5 inch per year
c. gain about 6 lbs per year
d. gain about 3 lbs per year
c
,During 8 mon old LBs physical exam, the father boasts that LB is going to be a left-handed batter since
he prefers doing everything with his left hand. The appropriate response would be to:
a. ask if others in the family are left handed
b. suggest play activities that require using both hands
c. present toys more often to the right hand
d. perform a careful neurological exam
d
At 12 yo, Peter has been dx with constitutional growth delay. Appropriate management would include:
a. starting low-dose testosterone therapy now
b. counseling regarding delayed onset of puberty
c. thyroxine replacement
d. nutritional counseling
b
Which of the following best describes behavior associated with Piaget's concrete operations?
a. learning primarily by trial and error
b. interpreting events in relationship to themselves
c. categorizing information into lower to higher classes
d. drawing logical conclusions from observations
c
Jeffrey, at 8 years of age, has been diagnosed with ADHD and is receiving stimulant medication. Which
of the following interventions would be least helpful?
a. monthly ht and wt checks
b. small frequent meals and snack
c. high-calorie supplemental drinks
d. elimination of refined sugar from diet
d
The principle that growth and development becomes increasingly integrated is best demonstrated by:
a. gaining head control before raising the chest
b. bringing the cup to mouth, tipping and swallowing
c. rolling over before sitting
d. grasping with fist before using
fingers b
In males, Tanner stage III can be distinguished from tanner stage II by:
a. fine downy pubic hair at the base of penis
b. adultlike pubic hair not extending to thighs
c. penile growth in width
d. penile growth in length
d
TJ, 13 yo, reluctantly shares with you that his "chest hurts." On physical exam, you note unilateral breast
enlargement, which is tender to palpation. You suspect physiolgic gynecomastia. Which tanner stage
, would support that diagnosis?
a. tanner stage I
b. tanner stage III
c. tanner stage IV
d. tanner stage V
b
During a physical exam of 10.5 yo Melissa, you note the appearance of breast buds. You tell her that she
can expect which of the following in approximately 2 years?
a. growth of pubic hair
b. peak height velocity
c. onset of menses
d. axillary hair
c
Adolescents who engage in risky behavior, such as driving without a seat belt, are displaying:
a. a type of egocentrism
b. a need for independence
c. role experimentation
d. low self-esteem
a
An increase in which of the following behaviors is seen more frequently in late, rather than in early,
adolescence?
a. value conflict with parents
b. focus on physical apperance
c. peer group involvement
d. understanding inner motivations of
others d
You detect a hear murmur while examining a 3 yo child. In determining whether of not a referral is
necessary, you determine it is an "innocent" heart murmur for which of the following reasons?
a. It is best heard during diastole
b. it radiates to the axilla
c. the intensity is no greater than I or II/VI
d. there is no variation with change in child's
position c
When providing anticipatory guidance about infant development, you might teach parents that a normal
infant could first transfer an object from hand to hand at which age?
a. 2 mos
b. 4 mos
c. 7 mos
d. 9 mos
c
H.O. is a 5 yo Vietnamese child who has fallen off of his growth curve. The best intervention would be
to:
a. Suggest high-calorie breakfast drinks as supplements
b. incorporate traditional foods into a management plan that will provide increased calories and nutrients
c. educate the family on the need for increased calories and nutrients
d. refer the family to growth clinic for evaluation
B
While taking the history of 6-month old E.M. you learn that she is not sleeping through the night and will
not fall back to sleep without the parents rocking or feeding her. This is an example of:
a. somnambulism
b. pavor nocturnus
c. learned behavior
d. delayed sleep phase
C
Which of the following scenarios is suggestive of a child who may not be ready to enter first grade? An
inability to:
a. recognize six colors and remember one's phone number
b. accurately use pronouns
c. empathize with others
d. count to five and draw a person with three parts
d
T.T. is a 9 week old preterm infant whose birth wt was 2.3 kg. Mom was HBs Ag Neg. He is seen today
for the first time since discharge from the nursery. He has received no prior immunizations. The
appropriate immunizations to give at this time would be:
a. Dtap, Hib, IPV, rotavirus, HepB 1, pneumo
b. Dtap, Hib, OPV, rotavirus, HepB 1
c. Dtap, Hib, rotavirus, IPV, pneumo
d. Dtap, Hib, IPV, pneumo
a
While examining 10 yo RMs teeth you note that the upper incisors slightly overlap the lower incisors.
The second and lower first molars are absent. Your assessment is:
a. malocclusion
b. delayed mandibular dentition
c. normal dentition
d. hyperdontia
b
,The mother of 5yo DW is concerned that her son often cheats when playing board games with his older
sister. What is the most appropriate response to DWs behavior?
a. encourage the parent to use 5 minute time-outs when cheating occurs
b. explain that DW is developmentally unable to comprehend rigid rules
c. make sure that DW understands the rules before starting to play the game
d. explain to DW that cheating is like lying and is not acceptable
behavior b
Which of the following is not a sign of readiness to toilet train?
a. can sit for extended periods
b. can follow directions
c. occasional waking from naps with dry diapers
d. regularity of bowel
movements d
Which of the following physical findings in a 2 month old child warrants an immediate referral to a
neurologist/neurosurgeon?
a. head circumference growing faster than height and weight
b. unresolved cephalhematoma
c. rigid and immobile sagittal suture
d. snapping sensation when pressure is applied to parietal bone
c
While listening to 2.5 yo KL talk, you note that she frequently omits final consonants and her sentences
are two and three words in length. The appropriate plan of care would be.
a. routine follow up at next well child visit
b. referring for hearing screening
c. assessing for developmental delays
d. referring to a speech
pathologist a
The mother of 3 yo GW reports that he has begun to stutter. Further probing reveals that the stuttering
occurs frequently and lasts 1 to 2 seconds. GW does not seem bothered by the stuttering. The appropirate
management would be:
a. referral to a speech pathologist
b. referral for an evaluation for an anxiety disorder
c. reassuring the mother that this is a mild problem
d. demonstrating to GW slow, deep breathing before
talking c
You would expect a school age child to:
a. grow 1.5 inches per year
b. grow 0.5 inch per year
c. gain about 6 lbs per year
d. gain about 3 lbs per year
c
,During 8 mon old LBs physical exam, the father boasts that LB is going to be a left-handed batter since
he prefers doing everything with his left hand. The appropriate response would be to:
a. ask if others in the family are left handed
b. suggest play activities that require using both hands
c. present toys more often to the right hand
d. perform a careful neurological exam
d
At 12 yo, Peter has been dx with constitutional growth delay. Appropriate management would include:
a. starting low-dose testosterone therapy now
b. counseling regarding delayed onset of puberty
c. thyroxine replacement
d. nutritional counseling
b
Which of the following best describes behavior associated with Piaget's concrete operations?
a. learning primarily by trial and error
b. interpreting events in relationship to themselves
c. categorizing information into lower to higher classes
d. drawing logical conclusions from observations
c
Jeffrey, at 8 years of age, has been diagnosed with ADHD and is receiving stimulant medication. Which
of the following interventions would be least helpful?
a. monthly ht and wt checks
b. small frequent meals and snack
c. high-calorie supplemental drinks
d. elimination of refined sugar from diet
d
The principle that growth and development becomes increasingly integrated is best demonstrated by:
a. gaining head control before raising the chest
b. bringing the cup to mouth, tipping and swallowing
c. rolling over before sitting
d. grasping with fist before using
fingers b
In males, Tanner stage III can be distinguished from tanner stage II by:
a. fine downy pubic hair at the base of penis
b. adultlike pubic hair not extending to thighs
c. penile growth in width
d. penile growth in length
d
TJ, 13 yo, reluctantly shares with you that his "chest hurts." On physical exam, you note unilateral breast
enlargement, which is tender to palpation. You suspect physiolgic gynecomastia. Which tanner stage
, would support that diagnosis?
a. tanner stage I
b. tanner stage III
c. tanner stage IV
d. tanner stage V
b
During a physical exam of 10.5 yo Melissa, you note the appearance of breast buds. You tell her that she
can expect which of the following in approximately 2 years?
a. growth of pubic hair
b. peak height velocity
c. onset of menses
d. axillary hair
c
Adolescents who engage in risky behavior, such as driving without a seat belt, are displaying:
a. a type of egocentrism
b. a need for independence
c. role experimentation
d. low self-esteem
a
An increase in which of the following behaviors is seen more frequently in late, rather than in early,
adolescence?
a. value conflict with parents
b. focus on physical apperance
c. peer group involvement
d. understanding inner motivations of
others d
You detect a hear murmur while examining a 3 yo child. In determining whether of not a referral is
necessary, you determine it is an "innocent" heart murmur for which of the following reasons?
a. It is best heard during diastole
b. it radiates to the axilla
c. the intensity is no greater than I or II/VI
d. there is no variation with change in child's
position c
When providing anticipatory guidance about infant development, you might teach parents that a normal
infant could first transfer an object from hand to hand at which age?
a. 2 mos
b. 4 mos
c. 7 mos
d. 9 mos
c
