PNCB Primary Care questions Actual Exam
PNCB PRIMARY CARE QUESTIONS ACTUAL EXAM NEWEST
2025/2026 COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS |ALREADY GRADED A+||ALREADY GRADED A+
A caregiver expresses concern for her 12 month old’s lack of interest in playing
with other children, especially due to a family history of autism spectrum disorder.
Which of the following is the MOST appropriate next step?
A. suggest the caregiver attempt to engage the child in imitating behaviors
B. screen for social interactions such as peek-a-boo and pat-a-cake
C. offer reassurance that interactive play begins at age 3
D. refer for a developmental evaluation
C. offer reassurance that interactive play begins at age 3
A caregiver who is primarily Spanish-speaking reports during a visit that her 24
month old is bilingual and speaks four words. Which of the following is the BEST
initial management?
A. refer to a pediatric speech pathologist with access to translators
B. encourage caregiver to choose one language for communication
C. advise the caregiver to read to the child daily
D. refer to audiology for a hearing evaluation
A. refer to a pediatric speech pathologist with access to translators
At two years of age a child should be speaking short phrases of two to three
words with a vocabulary of about 50 words, of which 25% are intelligible to
strangers. Children from bilingual homes or who are bilingual tend to develop
language more slowly, mixing words and phrases from the two languages;
however, milestones should continue to fall within expected ranges. Bilingual
children with significant delays in vocabulary require the same evaluation as
monolingual children with language delays.
1|Page
, PNCB Primary Care questions Actual Exam
Appropriate instruction for a young adolescent male considering strength training
to enhance muscle mass includes that
A. workouts should focus on 1-2 muscle groups on any exercise day.
B. powerlifting should be delayed until later in reproductive maturation.
C. strength training should occur at least five times a week to be effective.
D. other forms of exercise should be avoided on days that strength training is
done.
B. powerlifting should be delayed until later in reproductive maturation.
Powerlifting should be avoided in prepubescent children due to possible injury to
long bones and growth plates as well as the back.
A school-age child is seen for a skin rash that began about 6 weeks ago along with
bilateral limping, and a recent 2-week history of fever. Examination reveals
inflammation of knee joints. Which is the MOST likely diagnosis?
A. Acute rheumatic fever
B. dermatomyositis
C. systemic juvenile idiopathic arthritis
D. systemic lupus erythematosus
C. systemic juvenile idiopathic arthritis
Systemic JIA causes inflammation in one or more joints for 6 weeks’ duration in a
child younger than 16 years of age and is often accompanied by fatigue,
inflammation of joints, skin rash, and a high fever (103° F [39.4° C] or higher)
that lasts at least 2 weeks. Pericarditis, pleuritis, anemia, or enlargement of
lymph nodes, liver or the spleen may also occur.
Systemic lupus erythematosus (SLE) is a chronic systemic rheumatic disease.
Symptoms include fatigue, skin rashes, fever, and joint involvement with non-
deforming arthritis but with effusion and tenderness. SLE can involve many organ
systems (kidney, skin, blood cells, and nervous system). A malar rash across the
2|Page
, PNCB Primary Care questions Actual Exam
cheeks and bridge of the nose in the shape of a butterfly is seen in 95% of SLE
cases.
The most common manifestation of acute rheumatic fever is polyarthritis of large
joints. The latency period from infection with group A streptococcal
infection until the onset of arthritis is about 2-6 weeks.
Dermatomyositis is an autoimmune myopathic illness affecting the pediatric
population. Proximal muscle weakness in addition to thick scaling on extensor
surfaces, known as Gottron papules, are characteristic of dermatomyositis.
An adolescent used a prescribed emergency contraceptive after having
unprotected sexual intercourse. A return visit and pregnancy test should be
advised if there is no menstrual period within:
A. 1 week
B. 2 weeks
C. 3 weeks
D. 4 weeks
C. 3 weeks
Guidance should include that after taking an emergency contraceptive, the
adolescent should return for a pregnancy test within 3 weeks if menses have not
started. In the meantime, the adolescent should use condoms or refrain from
sexual intercourse until the next cycle starts. Emergency contraceptives may also
alter the schedule of menses but, in general, menses will likely come sooner than
expected. Although ectopic pregnancy is rare, guidance should also include the
importance of seeking immediate evaluation should severe abdominal pain occur
3-5 weeks after use of emergency contraception.
An adolescent reports daily headaches for the past 6 months that are immediately
preceded by nausea and changes to vision in the right eye, seen as wavy lines. The
patient self-medicates by taking Ibuprofen with each headache but only gets
partial pain relief. The neurological exam is normal. What is the BEST NEXT step in
management?
3|Page
, PNCB Primary Care questions Actual Exam
A. obtain MRI
B. prescribe sumatriptan
C. discontinue analgesics
D. recommend feedback therapy
C. discontinue analgesics
Ibuprofen is an effective analgesic in the treatment of migraines, but analgesic use
should be limited to no more than 3 uses per week.
Medication-overuse headaches are caused by using analgesics too
frequently. Use of analgesics more than 3 times per week for headaches can
actually cause headaches. Treatment of medication-overuse headaches requires
discontinuation of the analgesics.
If there are neurological abnormalities on examination or a history of headaches
that awaken the individual from sleep, an MRI is the most appropriate imaging
strategy.
Triptan medications can be an effective abortive therapy for migraines and
feedback therapy can be effective in acute and preventative management to
provide the individual with some self-control.
A parent is concerned about how to address the needs of 4-year-old son who has
expressed a desire to be a girl. Which guidance is MOST appropriate?
A. prevent dressing in feminine clothes
B. promote group activities with other boys
C. discourage play with gender-targeted toys
D. encourage participation in activities of interest
D. encourage participation in activities of interest
Acceptance of the child and management of stigma are most helpful to the child
as he/she explores this. Pressure to suppress non-conforming feelings and to
4|Page
PNCB PRIMARY CARE QUESTIONS ACTUAL EXAM NEWEST
2025/2026 COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS |ALREADY GRADED A+||ALREADY GRADED A+
A caregiver expresses concern for her 12 month old’s lack of interest in playing
with other children, especially due to a family history of autism spectrum disorder.
Which of the following is the MOST appropriate next step?
A. suggest the caregiver attempt to engage the child in imitating behaviors
B. screen for social interactions such as peek-a-boo and pat-a-cake
C. offer reassurance that interactive play begins at age 3
D. refer for a developmental evaluation
C. offer reassurance that interactive play begins at age 3
A caregiver who is primarily Spanish-speaking reports during a visit that her 24
month old is bilingual and speaks four words. Which of the following is the BEST
initial management?
A. refer to a pediatric speech pathologist with access to translators
B. encourage caregiver to choose one language for communication
C. advise the caregiver to read to the child daily
D. refer to audiology for a hearing evaluation
A. refer to a pediatric speech pathologist with access to translators
At two years of age a child should be speaking short phrases of two to three
words with a vocabulary of about 50 words, of which 25% are intelligible to
strangers. Children from bilingual homes or who are bilingual tend to develop
language more slowly, mixing words and phrases from the two languages;
however, milestones should continue to fall within expected ranges. Bilingual
children with significant delays in vocabulary require the same evaluation as
monolingual children with language delays.
1|Page
, PNCB Primary Care questions Actual Exam
Appropriate instruction for a young adolescent male considering strength training
to enhance muscle mass includes that
A. workouts should focus on 1-2 muscle groups on any exercise day.
B. powerlifting should be delayed until later in reproductive maturation.
C. strength training should occur at least five times a week to be effective.
D. other forms of exercise should be avoided on days that strength training is
done.
B. powerlifting should be delayed until later in reproductive maturation.
Powerlifting should be avoided in prepubescent children due to possible injury to
long bones and growth plates as well as the back.
A school-age child is seen for a skin rash that began about 6 weeks ago along with
bilateral limping, and a recent 2-week history of fever. Examination reveals
inflammation of knee joints. Which is the MOST likely diagnosis?
A. Acute rheumatic fever
B. dermatomyositis
C. systemic juvenile idiopathic arthritis
D. systemic lupus erythematosus
C. systemic juvenile idiopathic arthritis
Systemic JIA causes inflammation in one or more joints for 6 weeks’ duration in a
child younger than 16 years of age and is often accompanied by fatigue,
inflammation of joints, skin rash, and a high fever (103° F [39.4° C] or higher)
that lasts at least 2 weeks. Pericarditis, pleuritis, anemia, or enlargement of
lymph nodes, liver or the spleen may also occur.
Systemic lupus erythematosus (SLE) is a chronic systemic rheumatic disease.
Symptoms include fatigue, skin rashes, fever, and joint involvement with non-
deforming arthritis but with effusion and tenderness. SLE can involve many organ
systems (kidney, skin, blood cells, and nervous system). A malar rash across the
2|Page
, PNCB Primary Care questions Actual Exam
cheeks and bridge of the nose in the shape of a butterfly is seen in 95% of SLE
cases.
The most common manifestation of acute rheumatic fever is polyarthritis of large
joints. The latency period from infection with group A streptococcal
infection until the onset of arthritis is about 2-6 weeks.
Dermatomyositis is an autoimmune myopathic illness affecting the pediatric
population. Proximal muscle weakness in addition to thick scaling on extensor
surfaces, known as Gottron papules, are characteristic of dermatomyositis.
An adolescent used a prescribed emergency contraceptive after having
unprotected sexual intercourse. A return visit and pregnancy test should be
advised if there is no menstrual period within:
A. 1 week
B. 2 weeks
C. 3 weeks
D. 4 weeks
C. 3 weeks
Guidance should include that after taking an emergency contraceptive, the
adolescent should return for a pregnancy test within 3 weeks if menses have not
started. In the meantime, the adolescent should use condoms or refrain from
sexual intercourse until the next cycle starts. Emergency contraceptives may also
alter the schedule of menses but, in general, menses will likely come sooner than
expected. Although ectopic pregnancy is rare, guidance should also include the
importance of seeking immediate evaluation should severe abdominal pain occur
3-5 weeks after use of emergency contraception.
An adolescent reports daily headaches for the past 6 months that are immediately
preceded by nausea and changes to vision in the right eye, seen as wavy lines. The
patient self-medicates by taking Ibuprofen with each headache but only gets
partial pain relief. The neurological exam is normal. What is the BEST NEXT step in
management?
3|Page
, PNCB Primary Care questions Actual Exam
A. obtain MRI
B. prescribe sumatriptan
C. discontinue analgesics
D. recommend feedback therapy
C. discontinue analgesics
Ibuprofen is an effective analgesic in the treatment of migraines, but analgesic use
should be limited to no more than 3 uses per week.
Medication-overuse headaches are caused by using analgesics too
frequently. Use of analgesics more than 3 times per week for headaches can
actually cause headaches. Treatment of medication-overuse headaches requires
discontinuation of the analgesics.
If there are neurological abnormalities on examination or a history of headaches
that awaken the individual from sleep, an MRI is the most appropriate imaging
strategy.
Triptan medications can be an effective abortive therapy for migraines and
feedback therapy can be effective in acute and preventative management to
provide the individual with some self-control.
A parent is concerned about how to address the needs of 4-year-old son who has
expressed a desire to be a girl. Which guidance is MOST appropriate?
A. prevent dressing in feminine clothes
B. promote group activities with other boys
C. discourage play with gender-targeted toys
D. encourage participation in activities of interest
D. encourage participation in activities of interest
Acceptance of the child and management of stigma are most helpful to the child
as he/she explores this. Pressure to suppress non-conforming feelings and to
4|Page
