“NRNP 6541 – Primary Care of Children and Adolescents
| 100 Comprehensive Multiple-Choice Quiz Questions
with Answers & Rationales (Latest Edition)”
Pediatric Primary Care — 100 Question Quiz (Multiple
Choice)
1. A 2-month-old infant presents for well-child care. Which milestone is expected by 2
months?
A. Walks alone
B. Says two-word phrases
C. Social smile and lifts head while prone
D. Runs without falling
E. Uses a pincer grasp
2. Which immunization is contraindicated in a child with a severe, life-threatening allergic
reaction to a prior dose?
A. Inactivated poliovirus vaccine (IPV)
B. Measles-mumps-rubella (MMR) vaccine
C. Hepatitis B vaccine
D. Inactivated influenza vaccine (IIV)
E. Tdap
3. A 6-year-old with acute otitis media most likely benefits from which initial management
if nonsevere and reliable follow-up is available?
A. Immediate IV antibiotics
B. Immediate tympanostomy tube placement
C. Watchful waiting (observe) for 48–72 hours
D. Oral antihistamines only
E. Immediate oral amoxicillin-clavulanate in all cases
4. A 14-year-old female presents with primary amenorrhea. Which finding requires further
evaluation?
A. Normal secondary sexual characteristics with no menses by age 15
B. Menarche at age 12 previously then amenorrhea for 2 months
C. Regular menses since age 13
D. Menarche at age 11 with heavy periods
E. Mild dysmenorrhea with regular cycles
,5. Which symptom is most suggestive of asthma exacerbation in a 7-year-old?
A. Sore throat and rhinorrhea only
B. Episodic wheeze, cough worse at night, and shortness of breath
C. Isolated nasal congestion
D. Painless hematuria
E. Generalized rash
6. For a febrile infant aged 28 days (1 month) with fever ≥38°C, best next step is:
A. Reassurance and outpatient follow-up in 1 week
B. Empiric oral antibiotics at home
C. Full sepsis workup and hospital admission for IV antibiotics
D. Prescribe antipyretic and discharge
E. Start inhaled bronchodilator
7. A 9-year-old with suspected ADHD — which screening is most appropriate first?
A. MRI brain
B. Conners’ Rating Scales completed by parent and teacher
C. Start methylphenidate immediately without evaluation
D. Serum lead level only
E. Head CT
8. Which finding is a red flag for developmental delay in a 12-month-old?
A. Says “mama” and “dada” and uses simple gestures
B. Walks independently
C. No single words spoken
D. Points to desired objects
E. Cruises along furniture
9. A child presents with croup (viral laryngotracheobronchitis) with barky cough and
inspiratory stridor at rest. Best initial therapy is:
A. Nebulized epinephrine and oral dexamethasone
B. Oral antibiotics
C. IV steroids only
D. Oral antihistamines
E. Immediate intubation in every case
10. Which is the leading cause of death in adolescents aged 15–19 in many countries?
A. Congenital heart disease
B. Motor vehicle crashes (unintentional injury)
C. Pneumonia
D. Drowning in infancy
E. Alzheimer disease
11. A 4-year-old with diaper-area erythema that spares skin folds — most likely cause?
A. Irritant dermatitis (contact dermatitis)
B. Candidal (yeast) diaper dermatitis
C. Psoriasis
D. Scabies
E. Atopic dermatitis
12. Which lab test is first-line when evaluating suspected iron-deficiency anemia in a 9-
month-old?
A. Serum ferritin
, B. Serum creatinine
C. TSH
D. Vitamin B12 level
E. Serum amylase
13. A toddler with viral bronchiolitis (RSV) is hypoxic (SpO2 88%). Best management:
A. Supportive care with supplemental oxygen and hydration
B. Empiric oral antibiotics at home
C. Immediate corticosteroids
D. Give inhaled cromolyn sodium
E. Discharge home without oxygen
14. A 15-year-old male with scrotal pain and high-riding tender testis — suspect:
A. Testicular torsion — urgent urology evaluation
B. Epididymitis — treat with NSAIDs only
C. Hydrocele — reassurance
D. Varicocele — urgent antibiotics
E. Hematocele — start steroids
15. When should universal newborn screening for hearing loss ideally occur?
A. Before discharge from the nursery (by 1 month ideally)
B. At age 6 months only
C. At 2 years
D. Only if parental concern arises
E. At school entry
16. Which vaccine is recommended for all adolescents (11–12 years) to protect against
meningococcal disease?
A. Hemophilus influenzae type b (Hib)
B. Meningococcal conjugate vaccine (MenACWY)
C. Rotavirus vaccine
D. Varicella vaccine
E. Hepatitis A vaccine
17. A 10-year-old with generalized urticaria after eating peanuts — immediate management
in clinic:
A. Oral antihistamine only, no further action
B. IM epinephrine if signs of anaphylaxis (respiratory compromise or hypotension)
C. Give peanut butter to confirm diagnosis
D. Prescribe long-term steroids only
E. Immediate skin biopsy
18. Which of the following is the most common cause of acute diarrhea in children
worldwide?
A. Rotavirus (historically common; vaccination changed epidemiology)
B. E. coli O157:H7 in all settings
C. Cytomegalovirus
D. Giardia lamblia primarily in infants
E. Mycobacterium tuberculosis
19. A 2-week-old infant with persistent jaundice, pale stools, and dark urine — which
condition is most concerning?
A. Physiologic neonatal jaundice
| 100 Comprehensive Multiple-Choice Quiz Questions
with Answers & Rationales (Latest Edition)”
Pediatric Primary Care — 100 Question Quiz (Multiple
Choice)
1. A 2-month-old infant presents for well-child care. Which milestone is expected by 2
months?
A. Walks alone
B. Says two-word phrases
C. Social smile and lifts head while prone
D. Runs without falling
E. Uses a pincer grasp
2. Which immunization is contraindicated in a child with a severe, life-threatening allergic
reaction to a prior dose?
A. Inactivated poliovirus vaccine (IPV)
B. Measles-mumps-rubella (MMR) vaccine
C. Hepatitis B vaccine
D. Inactivated influenza vaccine (IIV)
E. Tdap
3. A 6-year-old with acute otitis media most likely benefits from which initial management
if nonsevere and reliable follow-up is available?
A. Immediate IV antibiotics
B. Immediate tympanostomy tube placement
C. Watchful waiting (observe) for 48–72 hours
D. Oral antihistamines only
E. Immediate oral amoxicillin-clavulanate in all cases
4. A 14-year-old female presents with primary amenorrhea. Which finding requires further
evaluation?
A. Normal secondary sexual characteristics with no menses by age 15
B. Menarche at age 12 previously then amenorrhea for 2 months
C. Regular menses since age 13
D. Menarche at age 11 with heavy periods
E. Mild dysmenorrhea with regular cycles
,5. Which symptom is most suggestive of asthma exacerbation in a 7-year-old?
A. Sore throat and rhinorrhea only
B. Episodic wheeze, cough worse at night, and shortness of breath
C. Isolated nasal congestion
D. Painless hematuria
E. Generalized rash
6. For a febrile infant aged 28 days (1 month) with fever ≥38°C, best next step is:
A. Reassurance and outpatient follow-up in 1 week
B. Empiric oral antibiotics at home
C. Full sepsis workup and hospital admission for IV antibiotics
D. Prescribe antipyretic and discharge
E. Start inhaled bronchodilator
7. A 9-year-old with suspected ADHD — which screening is most appropriate first?
A. MRI brain
B. Conners’ Rating Scales completed by parent and teacher
C. Start methylphenidate immediately without evaluation
D. Serum lead level only
E. Head CT
8. Which finding is a red flag for developmental delay in a 12-month-old?
A. Says “mama” and “dada” and uses simple gestures
B. Walks independently
C. No single words spoken
D. Points to desired objects
E. Cruises along furniture
9. A child presents with croup (viral laryngotracheobronchitis) with barky cough and
inspiratory stridor at rest. Best initial therapy is:
A. Nebulized epinephrine and oral dexamethasone
B. Oral antibiotics
C. IV steroids only
D. Oral antihistamines
E. Immediate intubation in every case
10. Which is the leading cause of death in adolescents aged 15–19 in many countries?
A. Congenital heart disease
B. Motor vehicle crashes (unintentional injury)
C. Pneumonia
D. Drowning in infancy
E. Alzheimer disease
11. A 4-year-old with diaper-area erythema that spares skin folds — most likely cause?
A. Irritant dermatitis (contact dermatitis)
B. Candidal (yeast) diaper dermatitis
C. Psoriasis
D. Scabies
E. Atopic dermatitis
12. Which lab test is first-line when evaluating suspected iron-deficiency anemia in a 9-
month-old?
A. Serum ferritin
, B. Serum creatinine
C. TSH
D. Vitamin B12 level
E. Serum amylase
13. A toddler with viral bronchiolitis (RSV) is hypoxic (SpO2 88%). Best management:
A. Supportive care with supplemental oxygen and hydration
B. Empiric oral antibiotics at home
C. Immediate corticosteroids
D. Give inhaled cromolyn sodium
E. Discharge home without oxygen
14. A 15-year-old male with scrotal pain and high-riding tender testis — suspect:
A. Testicular torsion — urgent urology evaluation
B. Epididymitis — treat with NSAIDs only
C. Hydrocele — reassurance
D. Varicocele — urgent antibiotics
E. Hematocele — start steroids
15. When should universal newborn screening for hearing loss ideally occur?
A. Before discharge from the nursery (by 1 month ideally)
B. At age 6 months only
C. At 2 years
D. Only if parental concern arises
E. At school entry
16. Which vaccine is recommended for all adolescents (11–12 years) to protect against
meningococcal disease?
A. Hemophilus influenzae type b (Hib)
B. Meningococcal conjugate vaccine (MenACWY)
C. Rotavirus vaccine
D. Varicella vaccine
E. Hepatitis A vaccine
17. A 10-year-old with generalized urticaria after eating peanuts — immediate management
in clinic:
A. Oral antihistamine only, no further action
B. IM epinephrine if signs of anaphylaxis (respiratory compromise or hypotension)
C. Give peanut butter to confirm diagnosis
D. Prescribe long-term steroids only
E. Immediate skin biopsy
18. Which of the following is the most common cause of acute diarrhea in children
worldwide?
A. Rotavirus (historically common; vaccination changed epidemiology)
B. E. coli O157:H7 in all settings
C. Cytomegalovirus
D. Giardia lamblia primarily in infants
E. Mycobacterium tuberculosis
19. A 2-week-old infant with persistent jaundice, pale stools, and dark urine — which
condition is most concerning?
A. Physiologic neonatal jaundice
