PEDIATRIC PRIMARY CARE PNCB 2,
Exam Questions & Answers Latest
Versions 2025 A+
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?" - "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. - 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 - 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
keep medications out of reach, continue to use car seat in rear-facing position, cover electrical
outlets
avoid finger foods that can be easily aspirated, teach stranger safety, place Mr. Yuk stickers on
toxic materials
keep matches out of reach, place Mr. Yuk stickers on toxic materials, teach stranger safety - keep
medications out of reach, continue to use car seat in rear-facing position, cover electrical outlets
An 8 month old is beginning to cruise, crawl and develop a fine pincer grasp. Keeping
medications and small objects out of reach in this age group assists in avoiding choking or toxic
ingestions. Covering electrical outlets helps to prevent accidental electrocution while the infant is
exploring his surroundings. An infant should maintain the rear-facing position of the car seat
until the age of one year. An 8 month old is not at a developmental level to understand stranger
caution nor Mr. Yuk stickers. Keeping matches out of reach is important, although it is not as
likely that an 8 month old would have the dexterity to strike a match.
The INITIAL treatment for a school-age female with well-demarcated erythema and mucoid
discharge in the vulva area includes:
discontinuation of bubble baths.
instruction on front to back cleansing.
oral penicillin.
, topical Premarin. - instruction on front to back cleansing.
Vulvovaginitis is the most common genital complaint among prepubertal girls due to the thin
hypo estrogenized mucosal tissue with an alkaline pH, small labia minora, and location proximal
to the anus. Vulvovaginitis, caused by streptococcal bacterial infections, is identified by well-
demarcated areas of erythema with a mucoid discharge. A 10-day regimen of oral penicillin or
amoxicillin is the treatment for a streptococcal infection which is the most common organism.
Vulvovaginitis can be caused by poor hygiene in girls who may be wiping inadequately or
inappropriately (e.g. from back to front), leading to local irritation. Prepubertal females should
be instructed in proper hygiene and wiping of perianal area. Soaps, shampoos, and bubble baths
are the most common cause of dysuria due to chemical urethritis. Topical Premarin is used in the
initial treatment of labial adhesions.
Emphasis on promoting healthy behavioral changes for the overweight child should include
which of the following?
establishing family goals
maintaining family holiday meal rituals
weighing child daily
using weight loss as a sign of success - establishing family goals
Effective weight loss planning and implementation need to involve the entire family. Emphasis
should be placed on family change and family goals as children will copy their parents'
behaviors. In addition, parents have control over some aspects of the change process that can
occur in relation to goals and meals in the home. Daily weights are not recommended, and
weight loss should not be used as the measure of success. Changing behaviors is a success by
itself and should be celebrated. New family and holiday rituals should be established for a focus
on non-food related events.
A 7 year old fell, injuring the right wrist. Radiographs of the wrist were negative, and the child
was treated for a moderate sprain and sent home with a sling. Ten days later the child is still
complaining of wrist pain with point tenderness. Which should be the NEXT step in
Exam Questions & Answers Latest
Versions 2025 A+
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?" - "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. - 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 - 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
keep medications out of reach, continue to use car seat in rear-facing position, cover electrical
outlets
avoid finger foods that can be easily aspirated, teach stranger safety, place Mr. Yuk stickers on
toxic materials
keep matches out of reach, place Mr. Yuk stickers on toxic materials, teach stranger safety - keep
medications out of reach, continue to use car seat in rear-facing position, cover electrical outlets
An 8 month old is beginning to cruise, crawl and develop a fine pincer grasp. Keeping
medications and small objects out of reach in this age group assists in avoiding choking or toxic
ingestions. Covering electrical outlets helps to prevent accidental electrocution while the infant is
exploring his surroundings. An infant should maintain the rear-facing position of the car seat
until the age of one year. An 8 month old is not at a developmental level to understand stranger
caution nor Mr. Yuk stickers. Keeping matches out of reach is important, although it is not as
likely that an 8 month old would have the dexterity to strike a match.
The INITIAL treatment for a school-age female with well-demarcated erythema and mucoid
discharge in the vulva area includes:
discontinuation of bubble baths.
instruction on front to back cleansing.
oral penicillin.
, topical Premarin. - instruction on front to back cleansing.
Vulvovaginitis is the most common genital complaint among prepubertal girls due to the thin
hypo estrogenized mucosal tissue with an alkaline pH, small labia minora, and location proximal
to the anus. Vulvovaginitis, caused by streptococcal bacterial infections, is identified by well-
demarcated areas of erythema with a mucoid discharge. A 10-day regimen of oral penicillin or
amoxicillin is the treatment for a streptococcal infection which is the most common organism.
Vulvovaginitis can be caused by poor hygiene in girls who may be wiping inadequately or
inappropriately (e.g. from back to front), leading to local irritation. Prepubertal females should
be instructed in proper hygiene and wiping of perianal area. Soaps, shampoos, and bubble baths
are the most common cause of dysuria due to chemical urethritis. Topical Premarin is used in the
initial treatment of labial adhesions.
Emphasis on promoting healthy behavioral changes for the overweight child should include
which of the following?
establishing family goals
maintaining family holiday meal rituals
weighing child daily
using weight loss as a sign of success - establishing family goals
Effective weight loss planning and implementation need to involve the entire family. Emphasis
should be placed on family change and family goals as children will copy their parents'
behaviors. In addition, parents have control over some aspects of the change process that can
occur in relation to goals and meals in the home. Daily weights are not recommended, and
weight loss should not be used as the measure of success. Changing behaviors is a success by
itself and should be celebrated. New family and holiday rituals should be established for a focus
on non-food related events.
A 7 year old fell, injuring the right wrist. Radiographs of the wrist were negative, and the child
was treated for a moderate sprain and sent home with a sling. Ten days later the child is still
complaining of wrist pain with point tenderness. Which should be the NEXT step in
