Pediatric Comat Exam
Pediatric Comat Exam Test Bank 2025-2026
With Complete Verified Questions And Correct
Answers with Detailed Rationales |Already
Graded A+||Brand New Guaranteed Pass
1. The primary care pediatric nurse practitioner sees a 12-month-old infant who is being fed
goat's milk
and a vegetarian diet. The child is pale and has a beefy-red, sore tongue and oral mucous
membranes.
Which tests will the nurse practitioner order to evaluate this child's condition?
a. Hemoglobin electrophoresis
b. RBC folate, iron, and B12 levels
c. Reticulocyte levels
d. Serum lead levels
- Correct Answer :ANS: B
Infants and children who are fed goat's milk or who are on a strict vegetarian diet are at risk for
folic acid
and vitamin B12 deficiency. These should be evaluated, along with iron, to rule out IDA.
Hemoglobin
electrophoresis is used to evaluate diseases associated with altered hemoglobin, such as beta-
thalassemia
and sickle cell anemia, neither of which is indicated by this child's history. Reticulocyte levels are
evaluated to evaluate transient erythroblastopenia of childhood, a condition that frequently
follows a viral
infection. Serum lead levels are not indicated based on this history.
2. A 2-year-old child who has SCA comes to the clinic with a cough and a fever of 101.5°C. The
child
currently takes penicillin V prophylaxis 125 mg orally twice daily. What will the primary care
pediatric nurse practitioner do?
a. Admit the child to the hospital to evaluate for sepsis.
b. Give intravenous fluids and antibiotics in clinic.
c. Increase the penicillin V dose to 250 mg.
d. Order a chest radiograph to rule out pneumonia.
- Correct Answer :ANS: A
A+ TEST BANK 1
, Pediatric Comat Exam
Fever and pulmonary symptoms are two conditions warranting referral or emergency admission
to the
hospital to rule out sepsis and acute chest syndrome. Increasing the dose of penicillin V or giving
IV
antibiotics is not indicated.
3. The primary care pediatric nurse practitioner evaluates a 5-year-old child who presents with
pallor and
obtains labs revealing a hemoglobin of 8.5 g/dL and a hematocrit of 31%. How will the nurse
practitioner manage this patient?
a. Prescribe elemental iron and recheck labs in 1 month.
b. Reassure the parent that this represents mild anemia.
c. Recommend a diet high in iron-rich foods.
d. Refer to a hematologist for further evaluation.
- Correct Answer :ANS: A
The child has mild to moderate iron-deficiency anemia and will need iron supplementation. The
hemoglobin, hematocrit, and reticulocytes should be reevaluated in 4 weeks after initiation of
treatment.
The child needs iron supplementation, so reassurance alone is not indicated. It is difficult to get
iron from
foods, so supplementation will be needed. Children with hemoglobin levels less than 4 g/dL and
some
children with hemoglobin levels less than 7 g/dL must be referred.
4. The primary care pediatric nurse practitioner is examining a 5-year-old child who has had
recurrent
fevers, bone pain, and a recent loss of weight. The physical exam reveals scattered petechiae,
lymphadenopathy, and bruising. A complete blood count shows thrombocytopenia, anemia, and
an
elevated white cell blood count. The nurse practitioner will refer this child to a specialist for
a. bone marrow biopsy.
b. corticosteroids and IVIG.
c. hemoglobin electrophoresis.
d. immunoglobulin testing.
- Correct Answer :ANS: A
This child has symptoms and initial lab tests consistent with leukemia and should be referred to a
pediatric hematologist-oncologist for a bone marrow biopsy for a definitive diagnosis.
Corticosteroids and
IVIG are given for severe ITP. Hgb electrophoresis is used to diagnose SCA. Immunoglobulins are
evaluated when immune deficiency syndromes are suspected.
A+ TEST BANK 2
, Pediatric Comat Exam
5. The pediatric nurse practitioner provides primary care for a 30-month-old child who has sickle
cell
anemia who has had one dose of 23-valent pneumococcal vaccine. Which is an appropriate
action for
health maintenance in this child?
a. Administer an initial meningococcal vaccine.
b. Begin folic acid dietary supplementation.
c. Decrease the dose of penicillin V prophylaxis.
d. Give a second dose of 23-valent pneumococcal vaccine.
- Correct Answer :ANS: A
Invasive bacterial infection is the leading cause of death in young children with SCA.
Meningococcal
vaccine should be given initially for all children over the age of 2 years and a booster dose given
every 5
years after that. Folic acid supplementation is often used for adults but not for children unless
there is a
documented deficiency. Penicillin V prophylaxis is started at 2 months of age, with the dose
increased at
age 3 years. The 23-valent pneumococcal polysaccharide second dose is given 5 years after the
first.
6. The primary care pediatric nurse practitioner reviews hematology reports on a child with beta-
thalassemia minor and notes an Hgb level of 8 g/dL. What will the nurse practitioner do?
a. Evaluate serum ferritin.
b. Order Hgb electrophoresis.
c. Prescribe supplemental iron.
d. Refer for RBC transfusions.
- Correct Answer :ANS: A
Children with beta-thalassemia minor may have low hemoglobin without iron deficiency so,
before
prescribing iron, the PNP should measure serum iron levels or serum ferritin. Hgb
electrophoresis is
indicated in a child whose diagnosis is unknown to diagnose this disorder. Supplemental iron
should only
be ordered when there is documented iron deficiency. RBC transfusions are controversial and
used only
for more severe iron deficiency.
A+ TEST BANK 3
, Pediatric Comat Exam
7. A school-age child comes to the clinic for evaluation of excessive bruising. The primary care
pediatric
nurse practitioner notes a history of an upper respiratory infection 2 weeks prior. The physical
exam is
negative for hepatosplenomegaly and lymphadenopathy. Blood work reveals a platelet count of
60,000/mm3 with normal PT and aPTT. How will the nurse practitioner manage this child's
condition?
a. Admit to the hospital for IVIG therapy.
b. Begin a short course of corticosteroid therapy.
c. Refer to a pediatric hematologist.
d. Teach to avoid NSAIDs and contact sports
. - Correct Answer :ANS: D
This child has symptoms, a history, and lab work that indicate idiopathic thrombocytopenic
purpura.
Since platelets are greater than 20,000/mm3, management without specific therapy may be
done on an
outpatient basis by teaching the family to avoid things that contribute to bleeding. IVIG therapy
is used
for children with active, severe bleeding. Corticosteroids are given for platelet counts less than
20,000/mm3. Referral to a hematologist is necessary for more severe cases.
8. A toddler who presents with anemia and reticulocytopenia has a history of a gradual decrease
in
energy and increase in pallor beginning after a recent viral infection. How will the primary care
pediatric nurse practitioner treat this child?
a. Closely observe the child's symptoms and lab values.
b. Consult with a pediatric hematologist.
c. Prescribe supplemental iron for 4 to 6 months.
d. Refer for transfusions to correct the anemia.
- Correct Answer :ANS: A
This child has symptoms and a history consistent with transient erythroblastopenia of childhood
(TEC),
which is usually self-limited. The PNP should monitor the child closely without treatment unless
the
anemia gets worse. Any of the other options may be necessary if the child's condition worsens.
9. The primary care pediatric nurse practitioner is managing care for a child diagnosed with iron-
deficiency anemia who had an initial hemoglobin of 8.8 g/dL and hematocrit of 32% who has
been
A+ TEST BANK 4
Pediatric Comat Exam Test Bank 2025-2026
With Complete Verified Questions And Correct
Answers with Detailed Rationales |Already
Graded A+||Brand New Guaranteed Pass
1. The primary care pediatric nurse practitioner sees a 12-month-old infant who is being fed
goat's milk
and a vegetarian diet. The child is pale and has a beefy-red, sore tongue and oral mucous
membranes.
Which tests will the nurse practitioner order to evaluate this child's condition?
a. Hemoglobin electrophoresis
b. RBC folate, iron, and B12 levels
c. Reticulocyte levels
d. Serum lead levels
- Correct Answer :ANS: B
Infants and children who are fed goat's milk or who are on a strict vegetarian diet are at risk for
folic acid
and vitamin B12 deficiency. These should be evaluated, along with iron, to rule out IDA.
Hemoglobin
electrophoresis is used to evaluate diseases associated with altered hemoglobin, such as beta-
thalassemia
and sickle cell anemia, neither of which is indicated by this child's history. Reticulocyte levels are
evaluated to evaluate transient erythroblastopenia of childhood, a condition that frequently
follows a viral
infection. Serum lead levels are not indicated based on this history.
2. A 2-year-old child who has SCA comes to the clinic with a cough and a fever of 101.5°C. The
child
currently takes penicillin V prophylaxis 125 mg orally twice daily. What will the primary care
pediatric nurse practitioner do?
a. Admit the child to the hospital to evaluate for sepsis.
b. Give intravenous fluids and antibiotics in clinic.
c. Increase the penicillin V dose to 250 mg.
d. Order a chest radiograph to rule out pneumonia.
- Correct Answer :ANS: A
A+ TEST BANK 1
, Pediatric Comat Exam
Fever and pulmonary symptoms are two conditions warranting referral or emergency admission
to the
hospital to rule out sepsis and acute chest syndrome. Increasing the dose of penicillin V or giving
IV
antibiotics is not indicated.
3. The primary care pediatric nurse practitioner evaluates a 5-year-old child who presents with
pallor and
obtains labs revealing a hemoglobin of 8.5 g/dL and a hematocrit of 31%. How will the nurse
practitioner manage this patient?
a. Prescribe elemental iron and recheck labs in 1 month.
b. Reassure the parent that this represents mild anemia.
c. Recommend a diet high in iron-rich foods.
d. Refer to a hematologist for further evaluation.
- Correct Answer :ANS: A
The child has mild to moderate iron-deficiency anemia and will need iron supplementation. The
hemoglobin, hematocrit, and reticulocytes should be reevaluated in 4 weeks after initiation of
treatment.
The child needs iron supplementation, so reassurance alone is not indicated. It is difficult to get
iron from
foods, so supplementation will be needed. Children with hemoglobin levels less than 4 g/dL and
some
children with hemoglobin levels less than 7 g/dL must be referred.
4. The primary care pediatric nurse practitioner is examining a 5-year-old child who has had
recurrent
fevers, bone pain, and a recent loss of weight. The physical exam reveals scattered petechiae,
lymphadenopathy, and bruising. A complete blood count shows thrombocytopenia, anemia, and
an
elevated white cell blood count. The nurse practitioner will refer this child to a specialist for
a. bone marrow biopsy.
b. corticosteroids and IVIG.
c. hemoglobin electrophoresis.
d. immunoglobulin testing.
- Correct Answer :ANS: A
This child has symptoms and initial lab tests consistent with leukemia and should be referred to a
pediatric hematologist-oncologist for a bone marrow biopsy for a definitive diagnosis.
Corticosteroids and
IVIG are given for severe ITP. Hgb electrophoresis is used to diagnose SCA. Immunoglobulins are
evaluated when immune deficiency syndromes are suspected.
A+ TEST BANK 2
, Pediatric Comat Exam
5. The pediatric nurse practitioner provides primary care for a 30-month-old child who has sickle
cell
anemia who has had one dose of 23-valent pneumococcal vaccine. Which is an appropriate
action for
health maintenance in this child?
a. Administer an initial meningococcal vaccine.
b. Begin folic acid dietary supplementation.
c. Decrease the dose of penicillin V prophylaxis.
d. Give a second dose of 23-valent pneumococcal vaccine.
- Correct Answer :ANS: A
Invasive bacterial infection is the leading cause of death in young children with SCA.
Meningococcal
vaccine should be given initially for all children over the age of 2 years and a booster dose given
every 5
years after that. Folic acid supplementation is often used for adults but not for children unless
there is a
documented deficiency. Penicillin V prophylaxis is started at 2 months of age, with the dose
increased at
age 3 years. The 23-valent pneumococcal polysaccharide second dose is given 5 years after the
first.
6. The primary care pediatric nurse practitioner reviews hematology reports on a child with beta-
thalassemia minor and notes an Hgb level of 8 g/dL. What will the nurse practitioner do?
a. Evaluate serum ferritin.
b. Order Hgb electrophoresis.
c. Prescribe supplemental iron.
d. Refer for RBC transfusions.
- Correct Answer :ANS: A
Children with beta-thalassemia minor may have low hemoglobin without iron deficiency so,
before
prescribing iron, the PNP should measure serum iron levels or serum ferritin. Hgb
electrophoresis is
indicated in a child whose diagnosis is unknown to diagnose this disorder. Supplemental iron
should only
be ordered when there is documented iron deficiency. RBC transfusions are controversial and
used only
for more severe iron deficiency.
A+ TEST BANK 3
, Pediatric Comat Exam
7. A school-age child comes to the clinic for evaluation of excessive bruising. The primary care
pediatric
nurse practitioner notes a history of an upper respiratory infection 2 weeks prior. The physical
exam is
negative for hepatosplenomegaly and lymphadenopathy. Blood work reveals a platelet count of
60,000/mm3 with normal PT and aPTT. How will the nurse practitioner manage this child's
condition?
a. Admit to the hospital for IVIG therapy.
b. Begin a short course of corticosteroid therapy.
c. Refer to a pediatric hematologist.
d. Teach to avoid NSAIDs and contact sports
. - Correct Answer :ANS: D
This child has symptoms, a history, and lab work that indicate idiopathic thrombocytopenic
purpura.
Since platelets are greater than 20,000/mm3, management without specific therapy may be
done on an
outpatient basis by teaching the family to avoid things that contribute to bleeding. IVIG therapy
is used
for children with active, severe bleeding. Corticosteroids are given for platelet counts less than
20,000/mm3. Referral to a hematologist is necessary for more severe cases.
8. A toddler who presents with anemia and reticulocytopenia has a history of a gradual decrease
in
energy and increase in pallor beginning after a recent viral infection. How will the primary care
pediatric nurse practitioner treat this child?
a. Closely observe the child's symptoms and lab values.
b. Consult with a pediatric hematologist.
c. Prescribe supplemental iron for 4 to 6 months.
d. Refer for transfusions to correct the anemia.
- Correct Answer :ANS: A
This child has symptoms and a history consistent with transient erythroblastopenia of childhood
(TEC),
which is usually self-limited. The PNP should monitor the child closely without treatment unless
the
anemia gets worse. Any of the other options may be necessary if the child's condition worsens.
9. The primary care pediatric nurse practitioner is managing care for a child diagnosed with iron-
deficiency anemia who had an initial hemoglobin of 8.8 g/dL and hematocrit of 32% who has
been
A+ TEST BANK 4
