PEDSCE PNP-PC EXAM PRACTICE
QUESTIONS & ANSWERS RATED
100% CORRECT
A pediatric primary care nurse practitioner observes multiple oval macules, both
hyperpigmented and hypopigmented, on a child's upper trunk. A fine scale surrounds the
borders of the lesions. The diagnosis is:
a. Atopic dermatitis
b. Keratosis pilaris
c. Pityriasis rosea
d. Tinea versicolor - correct answer ✔✔d. Tinea versicolor
Rationale: Tinea versicolor is a common dermatosis characterized by multiple small, oval, scaly
patches measuring 1 to 3 cm in diameter, usually located in a raindrop pattern on the upper
chest, back, and proximal portions of the upper extremities. In children, atopic dermatitis
lesions are typically dry, papular, and intensely pruritic. Circumscribed scaly patches are
distributed on the wrists, ankles, and antecubital and popliteal fossae. Keratosis Pilaris is
typically distributed on the posterior upper portion of the arms and lesions are dry and papular.
With Pityriasis rosea, a prodrome of malaise, headache, and mild constitutional symptoms
occasionally precedes the rash but is not crucial for diagnosis. The typical eruption begins with
the appearance of one or multiple "herald patches" which are large, isolated, oval lesions,
usually pink in color and slightly scaly; they may occur anywhere on the body. From 5 to 10 days
later, other smaller oval lesions appear on the body, frequently concentrated over the trunk but
also seen on the proximal extremities, especially the thighs. (Zitelli and Davis' Atlas of Pediatric
Physical Diagnosis, Chapter 8)
Which of the following circumstances is most suggestive of excessive stress in a family with a
chronically ill child?
a. The father takes a second job to meet financial responsibilities
,b. The mother provides the majority of the care for the child
c. The parents stop participation in a support group
d. A sibling exhibits decline in school performance - correct answer ✔✔c. The parents stop
participation in a support group
Rationale: Chronic illness takes a significant stress on the family. It can result in changes in roles
as well as the sibling feeling unloved or left out in some way. Can also result in
depression/anxiety of parents and other family members. Positive social networks are a positive
influence on parents and the PNP should be concerned if the family is withdrawing from
supportive social networks. This could indicate depression or extreme stress on the family unit.
(Burns)
The most likely cause of bilateral purulent conjunctivitis in a 1-day old infant is
a. Gonorrheal opthalmia
b. Chlamydia infection
c. Symphilitic opthalmia
d. Adenovirus infection - correct answer ✔✔a. Gonorrheal ophthalmia
Rationale: Gonorrehea usually appears in the first 3-5 days of life. Chlamydia is between days 5-
14. The other 2 are less common in neonates. Most common causes of conjunctivitis in
newborn includes, Chlamydia, Gonorrhea, HSV, and chemical induced conjunctivitis. (Burns)
An otherwise healthy 2-year old boy is brought to the emergency room with a four-week history
of wheezing and persistent cough. Prior to the start of these symptoms, the parent recalls a
coughing event which resolved spontaneously. Of the following the most likely diagnosis is:
a. Viral pneumonia
b. Acute laryngotracheobronchitis
c. Bronchiolitis
, d. Foreign body aspiration - correct answer ✔✔d. Foreign body aspiration
Rationale: An initial choking, gagging, or coughing episode following by spontaneous resolution
is often present in history finding of a child with foreign body aspiration. The episode is typically
followed by respiratory symptoms such as stridor, wheezing, and prolonged cough in the
absence of illness. Acute layngotracheobronchitis, bronchitis, and viral pneumonia are also
associated with coughing and wheezing but also involve other symptoms such as fever,
rhinorrhea, fatigue and usually resolve within 10-14 days. (Nelson Textbook of Pediatrics 20th
edition, Chapter 327)
The sexual development of a 14-year old girl is notably delayed. She is very short, slightly obese,
and complains of constipation and fatigue. Her skin is sallow and coarse in texture, and her hair
is brittle. Which of the following tests should be obtained?
a. Serum leutinizing hormone and chromosome analysis
b. Serum thyroxine and thryroid-stimulating hormone
c. Chromosome analysis and serum thyroxine
d. Serum leutinizing hormone and thyroid stimulating hormone - correct answer ✔✔b. Serum
thyroxine and thryroid-stimulating hormone
Rationale: Classic symptoms of growth failure, goiter, delayed or arrested puberty, delayed
dentition, weight gain, fatigue, dry skin, hyperlipidemia, decline in school performance,
menorrhagia, and fatigue. It would be most appropriate to test for hypothyroidism first in this
patient. If these are normal then you may want to consider the other tests for reasons for her
growth delay etc. (Burns)
Which of the following children requires a language referral for further evaluation?
a. 1-year-old with a 5-word vocabulary
b. 2-year-old who cannot put two words together
QUESTIONS & ANSWERS RATED
100% CORRECT
A pediatric primary care nurse practitioner observes multiple oval macules, both
hyperpigmented and hypopigmented, on a child's upper trunk. A fine scale surrounds the
borders of the lesions. The diagnosis is:
a. Atopic dermatitis
b. Keratosis pilaris
c. Pityriasis rosea
d. Tinea versicolor - correct answer ✔✔d. Tinea versicolor
Rationale: Tinea versicolor is a common dermatosis characterized by multiple small, oval, scaly
patches measuring 1 to 3 cm in diameter, usually located in a raindrop pattern on the upper
chest, back, and proximal portions of the upper extremities. In children, atopic dermatitis
lesions are typically dry, papular, and intensely pruritic. Circumscribed scaly patches are
distributed on the wrists, ankles, and antecubital and popliteal fossae. Keratosis Pilaris is
typically distributed on the posterior upper portion of the arms and lesions are dry and papular.
With Pityriasis rosea, a prodrome of malaise, headache, and mild constitutional symptoms
occasionally precedes the rash but is not crucial for diagnosis. The typical eruption begins with
the appearance of one or multiple "herald patches" which are large, isolated, oval lesions,
usually pink in color and slightly scaly; they may occur anywhere on the body. From 5 to 10 days
later, other smaller oval lesions appear on the body, frequently concentrated over the trunk but
also seen on the proximal extremities, especially the thighs. (Zitelli and Davis' Atlas of Pediatric
Physical Diagnosis, Chapter 8)
Which of the following circumstances is most suggestive of excessive stress in a family with a
chronically ill child?
a. The father takes a second job to meet financial responsibilities
,b. The mother provides the majority of the care for the child
c. The parents stop participation in a support group
d. A sibling exhibits decline in school performance - correct answer ✔✔c. The parents stop
participation in a support group
Rationale: Chronic illness takes a significant stress on the family. It can result in changes in roles
as well as the sibling feeling unloved or left out in some way. Can also result in
depression/anxiety of parents and other family members. Positive social networks are a positive
influence on parents and the PNP should be concerned if the family is withdrawing from
supportive social networks. This could indicate depression or extreme stress on the family unit.
(Burns)
The most likely cause of bilateral purulent conjunctivitis in a 1-day old infant is
a. Gonorrheal opthalmia
b. Chlamydia infection
c. Symphilitic opthalmia
d. Adenovirus infection - correct answer ✔✔a. Gonorrheal ophthalmia
Rationale: Gonorrehea usually appears in the first 3-5 days of life. Chlamydia is between days 5-
14. The other 2 are less common in neonates. Most common causes of conjunctivitis in
newborn includes, Chlamydia, Gonorrhea, HSV, and chemical induced conjunctivitis. (Burns)
An otherwise healthy 2-year old boy is brought to the emergency room with a four-week history
of wheezing and persistent cough. Prior to the start of these symptoms, the parent recalls a
coughing event which resolved spontaneously. Of the following the most likely diagnosis is:
a. Viral pneumonia
b. Acute laryngotracheobronchitis
c. Bronchiolitis
, d. Foreign body aspiration - correct answer ✔✔d. Foreign body aspiration
Rationale: An initial choking, gagging, or coughing episode following by spontaneous resolution
is often present in history finding of a child with foreign body aspiration. The episode is typically
followed by respiratory symptoms such as stridor, wheezing, and prolonged cough in the
absence of illness. Acute layngotracheobronchitis, bronchitis, and viral pneumonia are also
associated with coughing and wheezing but also involve other symptoms such as fever,
rhinorrhea, fatigue and usually resolve within 10-14 days. (Nelson Textbook of Pediatrics 20th
edition, Chapter 327)
The sexual development of a 14-year old girl is notably delayed. She is very short, slightly obese,
and complains of constipation and fatigue. Her skin is sallow and coarse in texture, and her hair
is brittle. Which of the following tests should be obtained?
a. Serum leutinizing hormone and chromosome analysis
b. Serum thyroxine and thryroid-stimulating hormone
c. Chromosome analysis and serum thyroxine
d. Serum leutinizing hormone and thyroid stimulating hormone - correct answer ✔✔b. Serum
thyroxine and thryroid-stimulating hormone
Rationale: Classic symptoms of growth failure, goiter, delayed or arrested puberty, delayed
dentition, weight gain, fatigue, dry skin, hyperlipidemia, decline in school performance,
menorrhagia, and fatigue. It would be most appropriate to test for hypothyroidism first in this
patient. If these are normal then you may want to consider the other tests for reasons for her
growth delay etc. (Burns)
Which of the following children requires a language referral for further evaluation?
a. 1-year-old with a 5-word vocabulary
b. 2-year-old who cannot put two words together
