Pediatric Primary Care PNCB 1 Actual Exam
PEDIATRIC PRIMARY CARE PNCB 1 ACTUAL EXAM NEWEST
2025/2026 COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS |ALREADY GRADED A+||ALREADY GRADED A+
A school-age male athlete presents with a recurrent episode of hematuria. A
urinalysis shows: nitrite and leukocyte esterase negative; greater than 50 RBC per
high power field; and protein greater than 100 mg/L. The MOST likely diagnosis is:
myoglobinuria
glomerulonephritis
drug/medication use
urinary tract infection - ANSWER-glomerulonephritis
Glomerulonephritis is a noninfectious process characterized by findings of
hematuria and proteinuria. Myoglobinuria is ruled out by the number of red blood
cells present, and the negative nitrite and leukocyte esterase make a urinary tract
infection unlikely. Although drug/medication use can discolor urine, the findings
of blood and protein in the urinalysis suggest another etiology.
1|Page
, Pediatric Primary Care PNCB 1 Actual Exam
Which of the following signs or symptoms is MOST often associated with anorexia
nervosa?
salivary gland enlargement
hypothermia
hypertension
elevated erythrocyte sedimentation rate - ANSWER-hypothermia
Disordered or dysfunctional eating occurs along a spectrum. Both anorexia
nervosa and bulimia nervosa are characterized by a distortion of body perception,
often accompanied by depression. Anorexia nervosa's physical signs and
symptoms are related to chronic malnutrition; hence amenorrhea, hypothermia,
hypotension, and bradycardia are often seen. Bulimia nervosa involves episodes of
binge eating and compensatory behavior to prevent weight gain, often purging. If
the purging behavior is vomiting, salivary gland enlargement can be present.
In addition to hypoglycemia, the MOST common complications found in infants
born to mothers with diabetes or gestational diabetes include:
LGA, neural tube defects, anemia, and renal vein thrombosis
2|Page
, Pediatric Primary Care PNCB 1 Actual Exam
SGA, cardiomegaly, polycythemia, and hyperthermia
LGA, cardiomegaly, renal vein thrombosis, and polycythemia
SGA, hepatosplenomegaly, hypotonia, and anemia - ANSWER-LGA, cardiomegaly,
renal vein thrombosis, and polycythemia
Infants born to mothers with diabetes or gestational diabetes are generally large
for gestational age (LGA) and predisposed to many anomalies and metabolic
disorders related to diabetic control during the first trimester and throughout the
pregnancy. Hypoglycemia develops in about 25 - 50% of these infants, with only a
small percentage actually demonstrating symptoms of jitteriness, hyperexcitability
and poor feeding. Cardiomegaly is common in infants of diabetic mothers,
occurring about 30% of the time and associated with many different congenital
anomalies including asymmetrical septal hypertrophy, subaortic stenosis, atrial
septal defect, transposition, and others. Additional anomalies include neural tube
defects, and defects of the GI tract and kidneys. These infants have a higher risk of
tachypnea for many reasons, and an increased incidence of hyperbilirubinemia,
renal vein thrombosis, and polycythemia.
Which is the BEST next step for an adolescent with scaly patches limited to the
torso, palms of hands, and soles of feet?
active nonintervention
3|Page
, Pediatric Primary Care PNCB 1 Actual Exam
treponemal antibody test
topical steroids
oral antifungals - ANSWER-treponemal antibody test
Non-specific scaly rashes are common in children and adolescents; it is important
to differentiate possible causes so that management is appropriate. Scaly patches
that involve the torso, palms of the hands, and soles of feet should prompt
consideration of secondary syphilis for which the treponemal antibody test is
appropriate. Active nonintervention is appropriate for pityriasis rosea, although
oral antihistamines may be used for those who have associated itching. While
topical steroids are effective for eczematous lesions, eczema is rarely found on the
palms of hands and soles of feet. Oral antifungal medications may be used in the
treatment of tinea versicolor.
Which is the INITIAL approach for a healthy 5 year old with a BMI of 30 and a
fasting low density lipoprotein (LDL) of 120 mg/dL?
counseling regarding nutrition and physical exercise
obtaining annual blood pressure measurements
4|Page
PEDIATRIC PRIMARY CARE PNCB 1 ACTUAL EXAM NEWEST
2025/2026 COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS |ALREADY GRADED A+||ALREADY GRADED A+
A school-age male athlete presents with a recurrent episode of hematuria. A
urinalysis shows: nitrite and leukocyte esterase negative; greater than 50 RBC per
high power field; and protein greater than 100 mg/L. The MOST likely diagnosis is:
myoglobinuria
glomerulonephritis
drug/medication use
urinary tract infection - ANSWER-glomerulonephritis
Glomerulonephritis is a noninfectious process characterized by findings of
hematuria and proteinuria. Myoglobinuria is ruled out by the number of red blood
cells present, and the negative nitrite and leukocyte esterase make a urinary tract
infection unlikely. Although drug/medication use can discolor urine, the findings
of blood and protein in the urinalysis suggest another etiology.
1|Page
, Pediatric Primary Care PNCB 1 Actual Exam
Which of the following signs or symptoms is MOST often associated with anorexia
nervosa?
salivary gland enlargement
hypothermia
hypertension
elevated erythrocyte sedimentation rate - ANSWER-hypothermia
Disordered or dysfunctional eating occurs along a spectrum. Both anorexia
nervosa and bulimia nervosa are characterized by a distortion of body perception,
often accompanied by depression. Anorexia nervosa's physical signs and
symptoms are related to chronic malnutrition; hence amenorrhea, hypothermia,
hypotension, and bradycardia are often seen. Bulimia nervosa involves episodes of
binge eating and compensatory behavior to prevent weight gain, often purging. If
the purging behavior is vomiting, salivary gland enlargement can be present.
In addition to hypoglycemia, the MOST common complications found in infants
born to mothers with diabetes or gestational diabetes include:
LGA, neural tube defects, anemia, and renal vein thrombosis
2|Page
, Pediatric Primary Care PNCB 1 Actual Exam
SGA, cardiomegaly, polycythemia, and hyperthermia
LGA, cardiomegaly, renal vein thrombosis, and polycythemia
SGA, hepatosplenomegaly, hypotonia, and anemia - ANSWER-LGA, cardiomegaly,
renal vein thrombosis, and polycythemia
Infants born to mothers with diabetes or gestational diabetes are generally large
for gestational age (LGA) and predisposed to many anomalies and metabolic
disorders related to diabetic control during the first trimester and throughout the
pregnancy. Hypoglycemia develops in about 25 - 50% of these infants, with only a
small percentage actually demonstrating symptoms of jitteriness, hyperexcitability
and poor feeding. Cardiomegaly is common in infants of diabetic mothers,
occurring about 30% of the time and associated with many different congenital
anomalies including asymmetrical septal hypertrophy, subaortic stenosis, atrial
septal defect, transposition, and others. Additional anomalies include neural tube
defects, and defects of the GI tract and kidneys. These infants have a higher risk of
tachypnea for many reasons, and an increased incidence of hyperbilirubinemia,
renal vein thrombosis, and polycythemia.
Which is the BEST next step for an adolescent with scaly patches limited to the
torso, palms of hands, and soles of feet?
active nonintervention
3|Page
, Pediatric Primary Care PNCB 1 Actual Exam
treponemal antibody test
topical steroids
oral antifungals - ANSWER-treponemal antibody test
Non-specific scaly rashes are common in children and adolescents; it is important
to differentiate possible causes so that management is appropriate. Scaly patches
that involve the torso, palms of the hands, and soles of feet should prompt
consideration of secondary syphilis for which the treponemal antibody test is
appropriate. Active nonintervention is appropriate for pityriasis rosea, although
oral antihistamines may be used for those who have associated itching. While
topical steroids are effective for eczematous lesions, eczema is rarely found on the
palms of hands and soles of feet. Oral antifungal medications may be used in the
treatment of tinea versicolor.
Which is the INITIAL approach for a healthy 5 year old with a BMI of 30 and a
fasting low density lipoprotein (LDL) of 120 mg/dL?
counseling regarding nutrition and physical exercise
obtaining annual blood pressure measurements
4|Page
