FNP654 | FNP654 Family Primary Care II Midterm
v3 Questions with Correct Answers and Expert
Explanation for Each Question
1. A 4-year-old child presents with a barking cough and inspiratory stridor that worsens at
night. What is the most likely diagnosis?
A. Epiglottitis
B. Bacterial Tracheitis
C. Croup (Laryngotracheobronchitis)
D. Foreign Body Aspiration
Correct Answer: C
Expert Explanation: Croup is typically characterized by a seal-like barking cough and
stridor due to subglottic inflammation. It is most commonly caused by the parainfluenza
virus and usually affects children aged 6 months to 3 years. Management often includes
humidified air or a single dose of dexamethasone for mild to moderate cases.
2. Which of the following physical examination findings is most indicative of Acute Otitis
Media (AOM)?
A. Pain with movement of the pinna
B. Presence of earwax in the canal
C. Bulging of the tympanic membrane
D. Retraction of the tympanic membrane
,Correct Answer: C
Expert Explanation: Bulging of the tympanic membrane is the most specific indicator of
middle ear inflammation and fluid. Other signs include erythema and decreased mobility of
the membrane when using pneumatic otoscopy. Pain with movement of the pinna is more
characteristic of Otitis Externa rather than AOM.
3. According to current guidelines, at what age should the first dose of the Measles, Mumps,
and Rubella (MMR) vaccine be administered?
A. 6 months
B. 9 months
C. 12 to 15 months
D. 4 to 6 years
Correct Answer: C
Expert Explanation: The standard pediatric immunization schedule recommends the first
MMR dose between 12 and 15 months of age. A second dose is then required between 4
and 6 years of age to ensure full immunity. Administering the vaccine earlier than 12
months may result in a sub-optimal immune response due to maternal antibodies.
4. An adolescent presents with painful menstruation that interferes with school attendance.
What is the first-line treatment for primary dysmenorrhea?
A. Oral contraceptive pills
B. Gonadotropin-releasing hormone agonists
, C. Acetaminophen
D. Nonsteroidal anti-inflammatory drugs (NSAIDs)
Correct Answer: D
Expert Explanation: NSAIDs like ibuprofen or naproxen are the gold standard for treating
primary dysmenorrhea because they inhibit prostaglandin production. They should be
started at the onset of menses or a day prior for maximum effectiveness. If NSAIDs are
insufficient after three cycles, hormonal contraceptives can be considered as the next step.
5. Which milestone is typically achieved by a healthy 12-month-old infant?
A. Walking while holding onto furniture (cruising)
B. Jumping with both feet
C. Running well
D. Riding a tricycle
Correct Answer: A
Expert Explanation: By 12 months, most infants are cruising or may even be taking their
first independent steps. They also typically have a fine pincer grasp and can say a few
simple words like ‘mama’ or ‘dada’. Gross motor skills such as running and jumping are
usually achieved closer to 18 to 24 months.
v3 Questions with Correct Answers and Expert
Explanation for Each Question
1. A 4-year-old child presents with a barking cough and inspiratory stridor that worsens at
night. What is the most likely diagnosis?
A. Epiglottitis
B. Bacterial Tracheitis
C. Croup (Laryngotracheobronchitis)
D. Foreign Body Aspiration
Correct Answer: C
Expert Explanation: Croup is typically characterized by a seal-like barking cough and
stridor due to subglottic inflammation. It is most commonly caused by the parainfluenza
virus and usually affects children aged 6 months to 3 years. Management often includes
humidified air or a single dose of dexamethasone for mild to moderate cases.
2. Which of the following physical examination findings is most indicative of Acute Otitis
Media (AOM)?
A. Pain with movement of the pinna
B. Presence of earwax in the canal
C. Bulging of the tympanic membrane
D. Retraction of the tympanic membrane
,Correct Answer: C
Expert Explanation: Bulging of the tympanic membrane is the most specific indicator of
middle ear inflammation and fluid. Other signs include erythema and decreased mobility of
the membrane when using pneumatic otoscopy. Pain with movement of the pinna is more
characteristic of Otitis Externa rather than AOM.
3. According to current guidelines, at what age should the first dose of the Measles, Mumps,
and Rubella (MMR) vaccine be administered?
A. 6 months
B. 9 months
C. 12 to 15 months
D. 4 to 6 years
Correct Answer: C
Expert Explanation: The standard pediatric immunization schedule recommends the first
MMR dose between 12 and 15 months of age. A second dose is then required between 4
and 6 years of age to ensure full immunity. Administering the vaccine earlier than 12
months may result in a sub-optimal immune response due to maternal antibodies.
4. An adolescent presents with painful menstruation that interferes with school attendance.
What is the first-line treatment for primary dysmenorrhea?
A. Oral contraceptive pills
B. Gonadotropin-releasing hormone agonists
, C. Acetaminophen
D. Nonsteroidal anti-inflammatory drugs (NSAIDs)
Correct Answer: D
Expert Explanation: NSAIDs like ibuprofen or naproxen are the gold standard for treating
primary dysmenorrhea because they inhibit prostaglandin production. They should be
started at the onset of menses or a day prior for maximum effectiveness. If NSAIDs are
insufficient after three cycles, hormonal contraceptives can be considered as the next step.
5. Which milestone is typically achieved by a healthy 12-month-old infant?
A. Walking while holding onto furniture (cruising)
B. Jumping with both feet
C. Running well
D. Riding a tricycle
Correct Answer: A
Expert Explanation: By 12 months, most infants are cruising or may even be taking their
first independent steps. They also typically have a fine pincer grasp and can say a few
simple words like ‘mama’ or ‘dada’. Gross motor skills such as running and jumping are
usually achieved closer to 18 to 24 months.
