1
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 - (ANSWER)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
, 2
speaks using 30 - 50 words
states full name
tells a story - (ANSWER)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?"
"Is there a gun anywhere in your house?" - (ANSWER)"Do you always wear a seat
belt when driving or riding in a car?"
, 3
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. - (ANSWER)Cow's milk does not contain adequate nutrition, and poses a
higher risk for allergy.
, 4
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 - (ANSWER)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
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 - (ANSWER)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
, 2
speaks using 30 - 50 words
states full name
tells a story - (ANSWER)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?"
"Is there a gun anywhere in your house?" - (ANSWER)"Do you always wear a seat
belt when driving or riding in a car?"
, 3
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. - (ANSWER)Cow's milk does not contain adequate nutrition, and poses a
higher risk for allergy.
, 4
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 - (ANSWER)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
