PEDIATRIC PRIMARY CARE PNCB 2
QUESTIONS AND ANSWERS 2025
A female athlete experiences anaphylaxis during a soccer game. The only significant history is
that she had lunch about 1 hour before the incident. Food-dependent exercise-induced
anaphylaxis is diagnosed. Of the following, the MOST likely cause is:
Chocolate milkshake
Pineapple
Tomatoes
Whole wheat bread - (ANSWERS)whole wheat bread
Exercise is a known co-factor in some children who experience anaphylaxis. Food-dependent
exercise-induced anaphylaxis (FDEIA) is defined as a food induced allergic reaction that occurs
during or soon after exercise. Children should not exercise within 2-3 hours of ingesting the
triggering food. Nuts, wheat, apples, bananas, kiwi, peaches and eggs frequently are the cause
for anaphylaxis.
A healthy 24 month old can be expected to have achieved which of the following language
milestones?
Counts three objects correctly
Speaks using 30 - 50 words
States full name
Tells a story - (ANSWERS)speaks using 30 - 50 words
Utilizing the Early Language Milestone Scale, beginning at the age of 11 months and continuing
to 24 months of age, the child should have a vocabulary of 50 words. This child should be able
to put words together in short, 2 - 3 word sentences and name at least one object in a picture.
The child at age 3 - 4 years will be able to tell a short story and begin to count. A 2 year old may
know his first name, but usually cannot state full name until he/she is older.
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?"
,PEDIATRIC PRIMARY CARE PNCB 2
QUESTIONS AND ANSWERS 2025
"Is there a gun anywhere in your house?" - (ANSWERS)"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. -
(ANSWERS)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
,PEDIATRIC PRIMARY CARE PNCB 2
QUESTIONS AND ANSWERS 2025
Acute appendicitis
Acute gastroenteritis - (ANSWERS)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 -
(ANSWERS)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:
, PEDIATRIC PRIMARY CARE PNCB 2
QUESTIONS AND ANSWERS 2025
Discontinuation of bubble baths.
Instruction on front to back cleansing.
Oral penicillin.
Topical Premarin. - (ANSWERS)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 - (ANSWERS)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
QUESTIONS AND ANSWERS 2025
A female athlete experiences anaphylaxis during a soccer game. The only significant history is
that she had lunch about 1 hour before the incident. Food-dependent exercise-induced
anaphylaxis is diagnosed. Of the following, the MOST likely cause is:
Chocolate milkshake
Pineapple
Tomatoes
Whole wheat bread - (ANSWERS)whole wheat bread
Exercise is a known co-factor in some children who experience anaphylaxis. Food-dependent
exercise-induced anaphylaxis (FDEIA) is defined as a food induced allergic reaction that occurs
during or soon after exercise. Children should not exercise within 2-3 hours of ingesting the
triggering food. Nuts, wheat, apples, bananas, kiwi, peaches and eggs frequently are the cause
for anaphylaxis.
A healthy 24 month old can be expected to have achieved which of the following language
milestones?
Counts three objects correctly
Speaks using 30 - 50 words
States full name
Tells a story - (ANSWERS)speaks using 30 - 50 words
Utilizing the Early Language Milestone Scale, beginning at the age of 11 months and continuing
to 24 months of age, the child should have a vocabulary of 50 words. This child should be able
to put words together in short, 2 - 3 word sentences and name at least one object in a picture.
The child at age 3 - 4 years will be able to tell a short story and begin to count. A 2 year old may
know his first name, but usually cannot state full name until he/she is older.
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?"
,PEDIATRIC PRIMARY CARE PNCB 2
QUESTIONS AND ANSWERS 2025
"Is there a gun anywhere in your house?" - (ANSWERS)"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. -
(ANSWERS)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
,PEDIATRIC PRIMARY CARE PNCB 2
QUESTIONS AND ANSWERS 2025
Acute appendicitis
Acute gastroenteritis - (ANSWERS)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 -
(ANSWERS)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:
, PEDIATRIC PRIMARY CARE PNCB 2
QUESTIONS AND ANSWERS 2025
Discontinuation of bubble baths.
Instruction on front to back cleansing.
Oral penicillin.
Topical Premarin. - (ANSWERS)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 - (ANSWERS)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
