MENTAL HEALTH EXAM QUESTIONS AND ANSWERS
A 13-year-old child presents to your office c/o mild pain and swelling below the left patellar that
worsens when he runs during soccer practice but eases with rest. You notice that the child has
grown 3 inches since visiting 10 months earlier. His vital signs are normal, but the physical
exam is remarkable for a tender, bony bump on the left shinbone below the patellar. Muscle
tone and reflexes are normal. What is the most likely diagnosis?
Osgood-Schlatter Disease
Patellofemoral pain
syndrome Ankylosing-
spondylitis Patellar tendon
rupture
• A 14-year-old client recently diagnosed with Osgood Schlatter Disease presents to the
clinic in severe pain. How should the provider treat this condition?
Recommend ibuprofen for pain relief, cold compress to the left anterior knee and
activity modification
Recommend ibuprofen for pain relief, hot compress to the left anterior knee and
activity modification
Recommend ibuprofen for pain relief, hot compress to the left anterior knee, and physical
therapy 3 times a week.
Recommend ibuprofen for pain relief, cold compresses to the left anterior knee, and
physical therapy 3 times a week
• An ill-appearing 5-year-old child presents to the clinic. The parent reports the sudden
onset of low-grade fever about 4 days ago, a loss of appetite, sore throat, oral ulcers, and fluid-
filled bumps on the hands and feet. The patient has a low-grade fever of 99 F. The physical
exam is remarkable for an inflamed oropharynx with yellowish ulcers on an erythematous base
on the tongue and buccal mucosa and vesicopustules to the hands and feet. The NP suspects
the child is infected with the coxsackievirus A16. What is the most likely diagnosis?
Hand foot mouth
disease Aphthous
stomatitis
Herpangina
Herpes simplex
,• A 4 year-old-client with hands-foot-mouth disease presents to the clinic for treatment.
What does the provider do?
Recommend acetaminophen for pain and fever relief, topical anesthetic for oral ulcers,
adequate hydration to prevent dehydration and inform the parent that the condition is self-
limiting.
Recommend acetylsalicylic acid for pain and fever relief, a topical anesthetic for oral
ulcers, adequate hydration to prevent dehydration and inform the parents that the
condition is self-limiting
Recommend acetylsalicylic acid for pain and fever relief, antivirals for the vesicles,
adequate hydration to prevent dehydration and inform the parents that the condition is self-
limiting
Recommend acetaminophen for pain and fever relief, antivirals for the vesicles, adequate
hydration to prevent dehydration, and inform the parent that the condition is self-limiting
• A new patient presents to the clinic to establish care. During the health history, the
provider learns that the patient has Klinefelter syndrome. What is this patient’s gender and
genetic makeup?
Females with XO sex-chromosomes
Male with XXY sex-chromosomes
Female with XXX sex –
chromosomes Male and XYY sex-
chromosomes
• What are the physical characteristics of Klinefelter’s syndrome?
Short stature, webbed neck, small jaw, high-arched palates, and lack of secondary sexual
characteristics
Unusually long legs, slender torso, slight learning difficulties, infertility, and
hirsutism High pitched voice, gynecomastia, hypogonadism, sterility, and feminine
body contours Unusually tall, slender, severe facial acne, clumsy, aggressive, and
antisocial
• A well-appearing 5-year-old child comes to the clinic for a well-child visit.
, What immunizations should the child receive today?
IPV, MMR varicella DTaP,
influenza IPV, MMR, Varicella,
DTaP, Hep A IPV, MMR,
Varicella, DTaP, Hep B
IPV, MMR, Varicella DTaP, Pneumococcal conjugate
• When performing a sports physical exam on a 17-year-old child, what family medical
history would the provider be most concerned about?
Sudden death from hypertrophic cardiomyopathy before age 55
Myocardial infarction from hypertrophic cardiomyopathy before age
55 Sudden death from restrictive cardiomyopathy before age 55
Myocardial infarction from restrictive cardiomyopathy before age 55
• What is a contraindication to immunization administration in the pediatric population?
Select all that apply
Allergies to egg protein in the immunocompromised child only
Administering live vaccines to the immunocompromised child only
Allergies to egg protein in the healthy and immunocompromised child
only
Administering live vaccines to the healthy and immunocompromised child only
• Lead poisoning poses the greatest risk to the developing brain of a child and it is linked
to behavioral problems, developmental delays, anemia, and more. Therefore, the provider
should screen for lead:
At 12-months of age then again at 24 months and then annually until 6 years of
age At 12 months of age then again at 36 months and then annually until 5 years
At 12 months of age then again at 24 months and then annually until 5 years
At 12 months of age then again at 36 months and then annually until 6 years of age
A 13-year-old child presents to your office c/o mild pain and swelling below the left patellar that
worsens when he runs during soccer practice but eases with rest. You notice that the child has
grown 3 inches since visiting 10 months earlier. His vital signs are normal, but the physical
exam is remarkable for a tender, bony bump on the left shinbone below the patellar. Muscle
tone and reflexes are normal. What is the most likely diagnosis?
Osgood-Schlatter Disease
Patellofemoral pain
syndrome Ankylosing-
spondylitis Patellar tendon
rupture
• A 14-year-old client recently diagnosed with Osgood Schlatter Disease presents to the
clinic in severe pain. How should the provider treat this condition?
Recommend ibuprofen for pain relief, cold compress to the left anterior knee and
activity modification
Recommend ibuprofen for pain relief, hot compress to the left anterior knee and
activity modification
Recommend ibuprofen for pain relief, hot compress to the left anterior knee, and physical
therapy 3 times a week.
Recommend ibuprofen for pain relief, cold compresses to the left anterior knee, and
physical therapy 3 times a week
• An ill-appearing 5-year-old child presents to the clinic. The parent reports the sudden
onset of low-grade fever about 4 days ago, a loss of appetite, sore throat, oral ulcers, and fluid-
filled bumps on the hands and feet. The patient has a low-grade fever of 99 F. The physical
exam is remarkable for an inflamed oropharynx with yellowish ulcers on an erythematous base
on the tongue and buccal mucosa and vesicopustules to the hands and feet. The NP suspects
the child is infected with the coxsackievirus A16. What is the most likely diagnosis?
Hand foot mouth
disease Aphthous
stomatitis
Herpangina
Herpes simplex
,• A 4 year-old-client with hands-foot-mouth disease presents to the clinic for treatment.
What does the provider do?
Recommend acetaminophen for pain and fever relief, topical anesthetic for oral ulcers,
adequate hydration to prevent dehydration and inform the parent that the condition is self-
limiting.
Recommend acetylsalicylic acid for pain and fever relief, a topical anesthetic for oral
ulcers, adequate hydration to prevent dehydration and inform the parents that the
condition is self-limiting
Recommend acetylsalicylic acid for pain and fever relief, antivirals for the vesicles,
adequate hydration to prevent dehydration and inform the parents that the condition is self-
limiting
Recommend acetaminophen for pain and fever relief, antivirals for the vesicles, adequate
hydration to prevent dehydration, and inform the parent that the condition is self-limiting
• A new patient presents to the clinic to establish care. During the health history, the
provider learns that the patient has Klinefelter syndrome. What is this patient’s gender and
genetic makeup?
Females with XO sex-chromosomes
Male with XXY sex-chromosomes
Female with XXX sex –
chromosomes Male and XYY sex-
chromosomes
• What are the physical characteristics of Klinefelter’s syndrome?
Short stature, webbed neck, small jaw, high-arched palates, and lack of secondary sexual
characteristics
Unusually long legs, slender torso, slight learning difficulties, infertility, and
hirsutism High pitched voice, gynecomastia, hypogonadism, sterility, and feminine
body contours Unusually tall, slender, severe facial acne, clumsy, aggressive, and
antisocial
• A well-appearing 5-year-old child comes to the clinic for a well-child visit.
, What immunizations should the child receive today?
IPV, MMR varicella DTaP,
influenza IPV, MMR, Varicella,
DTaP, Hep A IPV, MMR,
Varicella, DTaP, Hep B
IPV, MMR, Varicella DTaP, Pneumococcal conjugate
• When performing a sports physical exam on a 17-year-old child, what family medical
history would the provider be most concerned about?
Sudden death from hypertrophic cardiomyopathy before age 55
Myocardial infarction from hypertrophic cardiomyopathy before age
55 Sudden death from restrictive cardiomyopathy before age 55
Myocardial infarction from restrictive cardiomyopathy before age 55
• What is a contraindication to immunization administration in the pediatric population?
Select all that apply
Allergies to egg protein in the immunocompromised child only
Administering live vaccines to the immunocompromised child only
Allergies to egg protein in the healthy and immunocompromised child
only
Administering live vaccines to the healthy and immunocompromised child only
• Lead poisoning poses the greatest risk to the developing brain of a child and it is linked
to behavioral problems, developmental delays, anemia, and more. Therefore, the provider
should screen for lead:
At 12-months of age then again at 24 months and then annually until 6 years of
age At 12 months of age then again at 36 months and then annually until 5 years
At 12 months of age then again at 24 months and then annually until 5 years
At 12 months of age then again at 36 months and then annually until 6 years of age
