PED Exam FNP Questions with
Complete Solutions
A well 12-year-old child recently arrived from South Africa presents for a school
physical. She received BCG immunization shortly after birth and is up to date with
required immunizations. A PPD is placed and read at 48 hours. Likely findings include
which of the following? - ANSWER-Positive PPD, child requires a follow-up chest X-ray
The BCG, or bacilli Calmette-Guérin, is a vaccine for TB. Many foreign-born persons
have been vaccinated with the BCG vaccine, especially in countries where there is a
high incidence of TB. It is likely that this child will have a positive PPD test. It is not
possible to determine in this case, however, if the child has active TB without a chest X-
ray.
What behavior in a 2-year-old would be considered worrisome? - ANSWER-Unable to
walk downstairs holding a rail:
The nurse practitioner should always be aware of typical expected growth and
development parameters. At two years of age, normal expected gross motor skills
include having the ability to walk up and down stairs without difficulty. The child should
be evaluated further for other delays in gross motor, fine motor, or language/social
skills.
Baby Sabrina presents for her 6 month well child check-up. At 40 weeks gestation her
documented birth weight was 6 lbs 6 oz, and length of 20 inches. Currently her weight is
10 lbs, 4 oz and length is 24 inches. The nurse practitioner concludes the following: -
ANSWER-The infant is failing to meet expected gains in both weight and length.:
Infants age 0-3 months gain approximately 1.4 inches in height per month. Baby
Sabrina would be expected to have achieved 24 inches in height by 3 months of age. At
5-6 months of age, infants have usually doubled their birth weight.
During a sports physical for an 18-year-old male high school student, which finding
would require further follow-up? - ANSWER-Tanner stage of 4:
Typically, males age 13-18 will have developed to Tanner stage 5. An 18-year-old male
that is in Tanner stage 4 should be evaluated for further growth and development
deficits. Scoliosis of the spine of 10-15 degrees is generally not considered to be a
problem unless the patient expressed concern or discomfort.
A 7-year-old male child is brought to the clinic by his parents for evaluation. The child
has no significant PMH. Approximately seven days ago he developed a cold and since
,then has had a persistent cough and fever. His older sister was also ill with cold
symptoms at the same time. The NP performs a physical exam and notes that the child
has mild tachypnea, with crackles in both bases and a pulse oximeter of 90%. His
temperature is 100.8 °F. There are no wheezes auscultated. The NP suspects that the
child has which of the following? - ANSWER-Viral pneumonia: The child presents
clinically with pneumonia. Viral pneumonia generally has a gradual onset with less
acute symptoms and a low-grade fever. It is usually preceded by an upper respiratory
infection. Wheezes are not present in children with pneumonia.
" 7-year-old male child is brought to the clinic by his parents for evaluation. The child
has no significant PMH. Approximately seven days ago he developed a cold and since
then has had a persistent cough and fever. His older sister was also ill with cold
symptoms at the same time. The NP performs a physical exam and notes that the child
has mild tachypnea, with crackles in both bases and a pulse oximeter of 90%. His
temperature is 100.8 °F. There are no wheezes auscultated."
What does the FNP expect to find on auscultation of the lungs? - ANSWER-Crackles in
a portion of a lung field, no wheezing:
The absence of wheezing is a positive predictor for children with pneumonia.
" 7-year-old male child is brought to the clinic by his parents for evaluation. The child
has no significant PMH. Approximately seven days ago he developed a cold and since
then has had a persistent cough and fever. His older sister was also ill with cold
symptoms at the same time. The NP performs a physical exam and notes that the child
has mild tachypnea, with crackles in both bases and a pulse oximeter of 90%. His
temperature is 100.8 °F.
There are no wheezes auscultated what will the FNP have as part of the plan of care? -
ANSWER-CXR now, supportive care at home; call in one day or if any worsening of
symptoms; return to office in 2 days for follow-up evaluation
All children with a diagnosis of pneumonia should be carefully monitored. The child has
a classic viral pneumonia presentation, which tends to be less severe and can be cared
for at home.
A 6-month-old male is being seen with his caretaker for a barking cough which is
making the caretaker anxious. The baby seems to have mild respiratory distress and
the oximetry reads at 94%. The FNP sends the baby for - ANSWER-Steeple-shaped
appearance with narrowing in upper airway
Children with croup will usually present with a brassy bark sounding cough, inspiratory
stridor, and a steeple sign (or wineglass) appearance on a chest X-ray.
the most common organism responsible for otitis media is which of the following? -
ANSWER-Streptococcus pneumonia
Streptococcus pneumonia is the most common organism responsible for otitis media.
Amoxicillin
remains the first choice of treatment for otitis media with a suspected bacterial etiology.
,A 19-year-old mother brings her 2 1/2-month-old-boy to your clinic with a concern that
the baby has become less interested in his feedings over the past 2 or 3 days, taking in
only about half the normal amount of formula before becoming tired and falling asleep.
His birth history is normal and he has normal development and weight gain. His
temperature is 100.2 °F (axillary) now. He has no respiratory symptoms and your
physical examination reveals no identifiable source of fever. Which of the following
questions/observations would be MOST helpful in establishing a diagnosis? -
ANSWER-"Is anyone else at home ill at this time?"
The child's symptoms are consistent with the prodromal phase of a viral or bacterial
infection. Asking if there are sick contacts would provide the most valuable information
at this point in time.
Which of the following infants are susceptible to respiratory syncytial virus (RSV) and
bronchitis in the first year of life? - ANSWER-Very low birth weight infants
Although all infants are at risk for RSV, low birth weight infants, infants younger than 6
months of age, premature infants, and infants with an underlying condition such as
heart or lung disease are at highest risk. By two years of age, almost all children will
have had RSV.
A 4-week-old infant presents to the office in mid-January with a one-week history of
nasal congestion and occasional cough. On the evening prior to this visit, she
developed a temperature of 102 °F, refused to breast feed, had paroxysmal coughing,
and noisy, labored breathing. Patient is an ill-appearing infant who is lethargic with
tachypnea and intercostal retractions. She has a 4-year-old sibling who is in day care
and who recently had a "cold." Considering the clinical presentation, what is the most
likely cause of this infant's illness? - ANSWER-RSV bronchiolitis
The child has many risk factors associated with RSV, including a sibling in day care,
along with the time of year. The child's clinical presentation is consistent with RSV
bronchiolitis.
A 9-year-old child's symptoms occur four times a week during the day and three times
during the night, with an FEV1 of 80%. What would be the severity classification per the
National Asthma Education and Prevention Program? - ANSWER-Moderate persistent
The child's symptoms are consistent with the diagnosis of moderate persistent asthma
per the GINA (Global Initiative for Asthma) guidelines.
An 8-year-old male has mild persistent asthma. Appropriate daily medication should
include which of the following? - ANSWER-An inhaled low-dose corticosteroid
A child with mild persistent asthma should be using the stepwise approach to
management. Per GINA guidelines, the child with mild persistent asthma should be
using an inhaled low-dose corticosteroid to control symptoms.
A 3-month-old female is brought to the office for a routine examination and numerous
bruises in varying stages are noted on the infant's back and legs. The mother gets very
, upset when asked about the bruises and starts to cry. She refuses to talk any more
about the bruises or how this may have happened. A necessary next step for this
scenario is which of the following? - ANSWER-Explain to the mother that bruises such
as these are uncommon in a 4-month-old, and further assessment, including a skeletal
body scan, is required.
Any child with unexplained bruises (especially in children who are not yet mobile) is
required to have a full skeletal body scan.
According to the developmental theory of Erikson, if the needs of the infant are met in a
consistent manner, the infant will develop which of the following? - ANSWER-TRUST
According to the developmental theorist, Erikson, it is essential for an infant's needs to
be met so they may develop trust in the world around them (Trust vs. Mistrust stage).
The ability of an infant to turn his head to the side when lying prone occurs during the
_______ month of life. - ANSWER-1st
A neonate's normal gross motor skill development should include the ability to turn
his/her head during the first month of life when placed in a prone position.
According to the vaccination schedule recommendations, the IPV (polio) vaccine, the
DTaP (diptheria—tetanus-acellular pertussis), Haemophilis influenzae type B (HIB),
Rotavirus (RSV1) pneumoccal vaccine (Prevnar-13), and second hepatitis B vaccine
are given at _______ month(s) of age. - ANSWER-2
This is in accordance with the recommended vaccination schedule for children, as
defined by the CDC.
An infant would be expected to begin babbling and laughing by what age? - ANSWER-
13-6 months of age
Normal social development includes the ability for the infant to laugh and babble
between the ages of 3 and 6 months. Infants that are not performing this behavior
should be evaluated for further developmental delays.
Most infants will begin to crawl around at ___________. - ANSWER-7=9 months
This is the most common age for development of this gross motor skill.
21. The first solid food item that should be introduced into an infant's diet is
____________. - ANSWER-cereal
Rice cereal is the least likely food to cause an allergic reaction in an infant and is
generally considered to be the first recommended solid food.
22. The initial MMR (measles, mumps, rubella) vaccine is recommended at
_____________. - ANSWER-12-15 months of age
Per CDC guidelines for childhood vaccinations.
23. An infant develops increased coordination between his index finger and thumb and
is now able to pick up small objects. This is known as what? - ANSWER-Pincer reflex
Complete Solutions
A well 12-year-old child recently arrived from South Africa presents for a school
physical. She received BCG immunization shortly after birth and is up to date with
required immunizations. A PPD is placed and read at 48 hours. Likely findings include
which of the following? - ANSWER-Positive PPD, child requires a follow-up chest X-ray
The BCG, or bacilli Calmette-Guérin, is a vaccine for TB. Many foreign-born persons
have been vaccinated with the BCG vaccine, especially in countries where there is a
high incidence of TB. It is likely that this child will have a positive PPD test. It is not
possible to determine in this case, however, if the child has active TB without a chest X-
ray.
What behavior in a 2-year-old would be considered worrisome? - ANSWER-Unable to
walk downstairs holding a rail:
The nurse practitioner should always be aware of typical expected growth and
development parameters. At two years of age, normal expected gross motor skills
include having the ability to walk up and down stairs without difficulty. The child should
be evaluated further for other delays in gross motor, fine motor, or language/social
skills.
Baby Sabrina presents for her 6 month well child check-up. At 40 weeks gestation her
documented birth weight was 6 lbs 6 oz, and length of 20 inches. Currently her weight is
10 lbs, 4 oz and length is 24 inches. The nurse practitioner concludes the following: -
ANSWER-The infant is failing to meet expected gains in both weight and length.:
Infants age 0-3 months gain approximately 1.4 inches in height per month. Baby
Sabrina would be expected to have achieved 24 inches in height by 3 months of age. At
5-6 months of age, infants have usually doubled their birth weight.
During a sports physical for an 18-year-old male high school student, which finding
would require further follow-up? - ANSWER-Tanner stage of 4:
Typically, males age 13-18 will have developed to Tanner stage 5. An 18-year-old male
that is in Tanner stage 4 should be evaluated for further growth and development
deficits. Scoliosis of the spine of 10-15 degrees is generally not considered to be a
problem unless the patient expressed concern or discomfort.
A 7-year-old male child is brought to the clinic by his parents for evaluation. The child
has no significant PMH. Approximately seven days ago he developed a cold and since
,then has had a persistent cough and fever. His older sister was also ill with cold
symptoms at the same time. The NP performs a physical exam and notes that the child
has mild tachypnea, with crackles in both bases and a pulse oximeter of 90%. His
temperature is 100.8 °F. There are no wheezes auscultated. The NP suspects that the
child has which of the following? - ANSWER-Viral pneumonia: The child presents
clinically with pneumonia. Viral pneumonia generally has a gradual onset with less
acute symptoms and a low-grade fever. It is usually preceded by an upper respiratory
infection. Wheezes are not present in children with pneumonia.
" 7-year-old male child is brought to the clinic by his parents for evaluation. The child
has no significant PMH. Approximately seven days ago he developed a cold and since
then has had a persistent cough and fever. His older sister was also ill with cold
symptoms at the same time. The NP performs a physical exam and notes that the child
has mild tachypnea, with crackles in both bases and a pulse oximeter of 90%. His
temperature is 100.8 °F. There are no wheezes auscultated."
What does the FNP expect to find on auscultation of the lungs? - ANSWER-Crackles in
a portion of a lung field, no wheezing:
The absence of wheezing is a positive predictor for children with pneumonia.
" 7-year-old male child is brought to the clinic by his parents for evaluation. The child
has no significant PMH. Approximately seven days ago he developed a cold and since
then has had a persistent cough and fever. His older sister was also ill with cold
symptoms at the same time. The NP performs a physical exam and notes that the child
has mild tachypnea, with crackles in both bases and a pulse oximeter of 90%. His
temperature is 100.8 °F.
There are no wheezes auscultated what will the FNP have as part of the plan of care? -
ANSWER-CXR now, supportive care at home; call in one day or if any worsening of
symptoms; return to office in 2 days for follow-up evaluation
All children with a diagnosis of pneumonia should be carefully monitored. The child has
a classic viral pneumonia presentation, which tends to be less severe and can be cared
for at home.
A 6-month-old male is being seen with his caretaker for a barking cough which is
making the caretaker anxious. The baby seems to have mild respiratory distress and
the oximetry reads at 94%. The FNP sends the baby for - ANSWER-Steeple-shaped
appearance with narrowing in upper airway
Children with croup will usually present with a brassy bark sounding cough, inspiratory
stridor, and a steeple sign (or wineglass) appearance on a chest X-ray.
the most common organism responsible for otitis media is which of the following? -
ANSWER-Streptococcus pneumonia
Streptococcus pneumonia is the most common organism responsible for otitis media.
Amoxicillin
remains the first choice of treatment for otitis media with a suspected bacterial etiology.
,A 19-year-old mother brings her 2 1/2-month-old-boy to your clinic with a concern that
the baby has become less interested in his feedings over the past 2 or 3 days, taking in
only about half the normal amount of formula before becoming tired and falling asleep.
His birth history is normal and he has normal development and weight gain. His
temperature is 100.2 °F (axillary) now. He has no respiratory symptoms and your
physical examination reveals no identifiable source of fever. Which of the following
questions/observations would be MOST helpful in establishing a diagnosis? -
ANSWER-"Is anyone else at home ill at this time?"
The child's symptoms are consistent with the prodromal phase of a viral or bacterial
infection. Asking if there are sick contacts would provide the most valuable information
at this point in time.
Which of the following infants are susceptible to respiratory syncytial virus (RSV) and
bronchitis in the first year of life? - ANSWER-Very low birth weight infants
Although all infants are at risk for RSV, low birth weight infants, infants younger than 6
months of age, premature infants, and infants with an underlying condition such as
heart or lung disease are at highest risk. By two years of age, almost all children will
have had RSV.
A 4-week-old infant presents to the office in mid-January with a one-week history of
nasal congestion and occasional cough. On the evening prior to this visit, she
developed a temperature of 102 °F, refused to breast feed, had paroxysmal coughing,
and noisy, labored breathing. Patient is an ill-appearing infant who is lethargic with
tachypnea and intercostal retractions. She has a 4-year-old sibling who is in day care
and who recently had a "cold." Considering the clinical presentation, what is the most
likely cause of this infant's illness? - ANSWER-RSV bronchiolitis
The child has many risk factors associated with RSV, including a sibling in day care,
along with the time of year. The child's clinical presentation is consistent with RSV
bronchiolitis.
A 9-year-old child's symptoms occur four times a week during the day and three times
during the night, with an FEV1 of 80%. What would be the severity classification per the
National Asthma Education and Prevention Program? - ANSWER-Moderate persistent
The child's symptoms are consistent with the diagnosis of moderate persistent asthma
per the GINA (Global Initiative for Asthma) guidelines.
An 8-year-old male has mild persistent asthma. Appropriate daily medication should
include which of the following? - ANSWER-An inhaled low-dose corticosteroid
A child with mild persistent asthma should be using the stepwise approach to
management. Per GINA guidelines, the child with mild persistent asthma should be
using an inhaled low-dose corticosteroid to control symptoms.
A 3-month-old female is brought to the office for a routine examination and numerous
bruises in varying stages are noted on the infant's back and legs. The mother gets very
, upset when asked about the bruises and starts to cry. She refuses to talk any more
about the bruises or how this may have happened. A necessary next step for this
scenario is which of the following? - ANSWER-Explain to the mother that bruises such
as these are uncommon in a 4-month-old, and further assessment, including a skeletal
body scan, is required.
Any child with unexplained bruises (especially in children who are not yet mobile) is
required to have a full skeletal body scan.
According to the developmental theory of Erikson, if the needs of the infant are met in a
consistent manner, the infant will develop which of the following? - ANSWER-TRUST
According to the developmental theorist, Erikson, it is essential for an infant's needs to
be met so they may develop trust in the world around them (Trust vs. Mistrust stage).
The ability of an infant to turn his head to the side when lying prone occurs during the
_______ month of life. - ANSWER-1st
A neonate's normal gross motor skill development should include the ability to turn
his/her head during the first month of life when placed in a prone position.
According to the vaccination schedule recommendations, the IPV (polio) vaccine, the
DTaP (diptheria—tetanus-acellular pertussis), Haemophilis influenzae type B (HIB),
Rotavirus (RSV1) pneumoccal vaccine (Prevnar-13), and second hepatitis B vaccine
are given at _______ month(s) of age. - ANSWER-2
This is in accordance with the recommended vaccination schedule for children, as
defined by the CDC.
An infant would be expected to begin babbling and laughing by what age? - ANSWER-
13-6 months of age
Normal social development includes the ability for the infant to laugh and babble
between the ages of 3 and 6 months. Infants that are not performing this behavior
should be evaluated for further developmental delays.
Most infants will begin to crawl around at ___________. - ANSWER-7=9 months
This is the most common age for development of this gross motor skill.
21. The first solid food item that should be introduced into an infant's diet is
____________. - ANSWER-cereal
Rice cereal is the least likely food to cause an allergic reaction in an infant and is
generally considered to be the first recommended solid food.
22. The initial MMR (measles, mumps, rubella) vaccine is recommended at
_____________. - ANSWER-12-15 months of age
Per CDC guidelines for childhood vaccinations.
23. An infant develops increased coordination between his index finger and thumb and
is now able to pick up small objects. This is known as what? - ANSWER-Pincer reflex
