Pediatric Primary Care PNCB 1 2026
Updated Nursing Exam Pack - Questions
& Verified Answers
The child at highest risk for having an elevated blood lead
level is a:
3 month old exclusively breastfed infant
6 month old who lives in a home built after 1970
2 year old with iron deficiency anemia
2 year old who is a picky eater
D. - Correct Answers ✅2 year old with iron deficiency
anemia
The amount of lead absorbed from the gut is increased in
children with nutritional deficiencies such as iron deficiency
anemia (IDA). Iron deficiency anemia is often a comorbidity of
lead poisoning. The hand-to-mouth behavior of infants and
young children increases their lead exposure. However, living
in a home built after 1970 reduces the risk since residential
paint used in that era should not have been lead based.
Infants more than 4 months of age exclusively breast fed
without supplemental iron are at increased risk of IDA. A child
who is a picky eater may or may not be at high risk for IDA,
,Pediatric Primary Care PNCB 1 2026
Updated Nursing Exam Pack - Questions
& Verified Answers
depending on foods actually eaten.Which laboratory
assessment is the BEST indicator of vitamin D deficiency?
Which laboratory assessment is the BEST indicator of vitamin
D deficiency?
25(OH)-D (cholecalciferol)
1,25(OH)2-D (calcitriol)
PTH (parathyroid hormone)
25(OH)-D (cholecalciferol) - Correct Answers ✅25(OH)-D
(cholecalciferol)
The best diagnostic study of vitamin D deficiency is the level
of 25(OH)-D (cholecalciferol). 1,25(OH)2-D (calcitriol) is the
active metabolite of 25(OH)-D, but due to its short half-life it
is not a good indicator of vitamin D sufficiency. The
parathyroid hormone releases calcium from bone. Rachitic
changes can be seen at growth plates and decreased
,Pediatric Primary Care PNCB 1 2026
Updated Nursing Exam Pack - Questions
& Verified Answers
calcification leads to thickening of the growth plate. Serum
calcium and phosphorous are initial screening tests but not
the best indicator of vitamin D deficiency.
In a 2 month old with visible rib fractures on radiograph, the
NEXT most critical evaluation to obtain is a:
CT scan of the head
long bone series
coagulation profile
retinal ophthalmologic exam - Correct Answers ✅CT scan
of the head
Posterior rib fractures associated with accidental trauma are
rare. Posterior fractures can be seen in infants who have
been shaken as the perpetrator hands are typically wrapped
around the infant's thorax during the shaking, with the
vertebrae acting as a fulcrum. These findings should alert the
provider to consider shaken baby syndrome (SBS). Subdural
and subarachnoid hemorrhages are the most common acute
, Pediatric Primary Care PNCB 1 2026
Updated Nursing Exam Pack - Questions
& Verified Answers
intracranial injuries seen in SBS and are associated with high
rates of morbidity and mortality. Thus, the most important
study to do next is a CT scan. Studies have shown that nearly
one third of confirmed abusive head trauma cases were
missed on initial presentation, and many infants then sustain
additional brain injury along with poorer neurologic outcomes
because of the delay in diagnosis. Long bone studies will be
needed as part of a thorough work-up of non-accidental
trauma, but the skull would be the most critical area to image
first. Coagulation studies are done to rule out any coagulation
problem associated with injury to the brain and are important
for medico-legal reasons, but again, brain studies take
precedence. A thorough ophthalmologic exam is needed in
suspected cases of SBS—preferably done by a pediatric
ophthalmologist.
The MOST common barrier related to transitioning health care
for an adolescent with special needs or chronic illness is
finding an adult health care provider for transition.
resistance of the family and adolescent to transition of care.
lack of health care provider time to plan for transition of care.
Updated Nursing Exam Pack - Questions
& Verified Answers
The child at highest risk for having an elevated blood lead
level is a:
3 month old exclusively breastfed infant
6 month old who lives in a home built after 1970
2 year old with iron deficiency anemia
2 year old who is a picky eater
D. - Correct Answers ✅2 year old with iron deficiency
anemia
The amount of lead absorbed from the gut is increased in
children with nutritional deficiencies such as iron deficiency
anemia (IDA). Iron deficiency anemia is often a comorbidity of
lead poisoning. The hand-to-mouth behavior of infants and
young children increases their lead exposure. However, living
in a home built after 1970 reduces the risk since residential
paint used in that era should not have been lead based.
Infants more than 4 months of age exclusively breast fed
without supplemental iron are at increased risk of IDA. A child
who is a picky eater may or may not be at high risk for IDA,
,Pediatric Primary Care PNCB 1 2026
Updated Nursing Exam Pack - Questions
& Verified Answers
depending on foods actually eaten.Which laboratory
assessment is the BEST indicator of vitamin D deficiency?
Which laboratory assessment is the BEST indicator of vitamin
D deficiency?
25(OH)-D (cholecalciferol)
1,25(OH)2-D (calcitriol)
PTH (parathyroid hormone)
25(OH)-D (cholecalciferol) - Correct Answers ✅25(OH)-D
(cholecalciferol)
The best diagnostic study of vitamin D deficiency is the level
of 25(OH)-D (cholecalciferol). 1,25(OH)2-D (calcitriol) is the
active metabolite of 25(OH)-D, but due to its short half-life it
is not a good indicator of vitamin D sufficiency. The
parathyroid hormone releases calcium from bone. Rachitic
changes can be seen at growth plates and decreased
,Pediatric Primary Care PNCB 1 2026
Updated Nursing Exam Pack - Questions
& Verified Answers
calcification leads to thickening of the growth plate. Serum
calcium and phosphorous are initial screening tests but not
the best indicator of vitamin D deficiency.
In a 2 month old with visible rib fractures on radiograph, the
NEXT most critical evaluation to obtain is a:
CT scan of the head
long bone series
coagulation profile
retinal ophthalmologic exam - Correct Answers ✅CT scan
of the head
Posterior rib fractures associated with accidental trauma are
rare. Posterior fractures can be seen in infants who have
been shaken as the perpetrator hands are typically wrapped
around the infant's thorax during the shaking, with the
vertebrae acting as a fulcrum. These findings should alert the
provider to consider shaken baby syndrome (SBS). Subdural
and subarachnoid hemorrhages are the most common acute
, Pediatric Primary Care PNCB 1 2026
Updated Nursing Exam Pack - Questions
& Verified Answers
intracranial injuries seen in SBS and are associated with high
rates of morbidity and mortality. Thus, the most important
study to do next is a CT scan. Studies have shown that nearly
one third of confirmed abusive head trauma cases were
missed on initial presentation, and many infants then sustain
additional brain injury along with poorer neurologic outcomes
because of the delay in diagnosis. Long bone studies will be
needed as part of a thorough work-up of non-accidental
trauma, but the skull would be the most critical area to image
first. Coagulation studies are done to rule out any coagulation
problem associated with injury to the brain and are important
for medico-legal reasons, but again, brain studies take
precedence. A thorough ophthalmologic exam is needed in
suspected cases of SBS—preferably done by a pediatric
ophthalmologist.
The MOST common barrier related to transitioning health care
for an adolescent with special needs or chronic illness is
finding an adult health care provider for transition.
resistance of the family and adolescent to transition of care.
lack of health care provider time to plan for transition of care.
