The parent of an infant experiencing colic asks about using a probiotic medication. What will the primary
care pediatric NP tell this parent?
A. Probiotic medications have demonstrated efficacy in treating colic.
B. Probiotics are not safe to use to treat infants who have colic.
C. There are no studies showing usefulness of probiotic to manage colic.
D. There is no conclusive evidence about using probiotics to treat colic. - ANSWER💫✔️--D. There is no
conclusive evidence about using probiotics to treat colic.
A toddler who was born prematurely refuses most solid foods and has poor weight gain. A barium
swallow study reveals a normal esophagus. What will the primary care pediatric NP consider the next to
manage this child's nutritional needs?
A. consultation with dietician
B. Fiberoptic endoscopy evaluation.
C. MRI
D. Videofluroscopy swallowing study (VOSS) - ANSWER💫✔️--D. Videofluroscopy swallowing study (VOSS)
A toddler is seen in clinic after a 2-day hx of intermittent V/D. An assessment reveals an irritable child
with dry mucous membranes, 3-second cap refill. 2-second recoil of skin, mild tachycardia and
tachypnea, and cool hands and feet. The child has had 2 wet diapers in the past 24 hours. What will the
primary care pediatric NP recommend?
A. anti-diarrheal medication & clear fluids for 24H
B. Bolus of IV NS in the clinic until improvement
C. Hospital admission for IV rehydration & oral fluids
D. Oral rehydration solution with f/u in 24H - ANSWER💫✔️--D. Oral rehydration solution with f/u in 24H
,A 9-year old girl has a hx of frequent vomiting and her mother has frequent migraine ha. The child has
recently begun having more frequent and prolonged episodes accompanied by headaches. An exam
reveals abnormal eye movement and mild ataxia. What is the correct action?
A. begin using anti-migraine meds to prevent HA
B. Prescribe ondansetron and lorazepam to help manage sx
C. Reassure the parent that this is expected with cyclic vomiting syndrome
D. Refer to a pediatric gastroenterologist for further workup. - ANSWER💫✔️--D. Refer to a pediatric
gastroenterologist for further workup.
The parent of a 3-month-old reports that the infant reports that the infant arches and gags while
feeding and spits up undigested formula frequently. The infant's weight gain has dropped to the 5th
percentile from the 12th. What is the best course of tx for this infant?
A. Begin a trial of extensively hydrolyzed protein formula for 2-4 wks.
B. Institute an emperic trial of acid suppression with a PPI
C. Perform esophageal pH monitoring to determine the degree of reflux.
D. Reassure the parent that these sx will likely resolved by 12-24 mo. - ANSWER💫✔️--A. Begin a trial of
extensively hydrolyzed protein formula for 2-4 wks.
A school-age child has a 3-month hx of dull, aching epigastric pain that worsens with eating and awakens
from sleep. A CBC shows a Hgb of 8mg/dL. What is the next step in management.
A. Administration of H RA or PPI meds
B. Empiric therapy for H. pylori
C. Ordering an upper GI series
D. Referral for EGD - ANSWER💫✔️--D. Referral for EGD
A 2-mo old infant cries up to 4 hours each day and according to the parents, is inconsolable during
crying episodes with fits and legs notes to be tense and stiff. The infant is breastfeeding frequently but is
often fussy during feedings. The PE is normal and the infant is gaining weight normally. What will the
primary care pediatric NP recommend?
A. A complete work-up, including lab and radiologic tests.
B. Eliminating certain foods from the mother's diet.
C. Empiric tx w/PPI
, D. Stopping breastfeeding & beginning a hydrolyzed formula - ANSWER💫✔️--B. Eliminating certain foods
from the mother's diet.
A child is in the clinic after swallowing a metal bead. A radiograph of the GI tract shows a 6 mm
cylindrical object in the child's stomach. The child is able to swallow without difficulty and is not
experiencing pain. What is the correct course of treatment?
a. Administer ipecac to induce vomiting.
b. Have the parents watch for the object in the child's stool.
c. Insert a nasogastric tube to flush out the object.
d. Refer the child for endoscopic removal of the object. - ANSWER💫✔️--b. Have the parents watch for
the object in the child's stool.
A 10-year-old child has had abdominal pain for 2 days, which began in the periumbilical area and then
localized to the RLQ. The child vomited once today and then experienced relief from pain followed by an
increased fever. What is the likely diagnosis?
A. Appendicitis w/perf
B. Gastroenteritis
C. Pelvic inflammatory disease (PID)
D. UTI - ANSWER💫✔️--A. Appendicitis w/perf
An 18-month-old child has a 1-day hx of intermittent, cramping abd pain w/non-bilious vomiting. The
child observed to scream and draw up his legs during pain episodes and becomes lethargic in between.
The primary care pediatric NP notes ta small amount of bloody, mucous stool in the diaper. What is the
most likely diagnosis?
A. Appendicitis
B. Gastroenteritis
C. Intussusception
D. Testicular torsion - ANSWER💫✔️--C. Intussusception
A school-age child has had abd pain for 3 mo htat occurs once to twice weekly and is associated with a
h/a and occ diff sleeping, often causing the child to stay home from school. The child does not have V/D
& is gaining weight normally. The PE is normal. According to Bishop, what is included in the initial
diagnostic work-up for this child?
care pediatric NP tell this parent?
A. Probiotic medications have demonstrated efficacy in treating colic.
B. Probiotics are not safe to use to treat infants who have colic.
C. There are no studies showing usefulness of probiotic to manage colic.
D. There is no conclusive evidence about using probiotics to treat colic. - ANSWER💫✔️--D. There is no
conclusive evidence about using probiotics to treat colic.
A toddler who was born prematurely refuses most solid foods and has poor weight gain. A barium
swallow study reveals a normal esophagus. What will the primary care pediatric NP consider the next to
manage this child's nutritional needs?
A. consultation with dietician
B. Fiberoptic endoscopy evaluation.
C. MRI
D. Videofluroscopy swallowing study (VOSS) - ANSWER💫✔️--D. Videofluroscopy swallowing study (VOSS)
A toddler is seen in clinic after a 2-day hx of intermittent V/D. An assessment reveals an irritable child
with dry mucous membranes, 3-second cap refill. 2-second recoil of skin, mild tachycardia and
tachypnea, and cool hands and feet. The child has had 2 wet diapers in the past 24 hours. What will the
primary care pediatric NP recommend?
A. anti-diarrheal medication & clear fluids for 24H
B. Bolus of IV NS in the clinic until improvement
C. Hospital admission for IV rehydration & oral fluids
D. Oral rehydration solution with f/u in 24H - ANSWER💫✔️--D. Oral rehydration solution with f/u in 24H
,A 9-year old girl has a hx of frequent vomiting and her mother has frequent migraine ha. The child has
recently begun having more frequent and prolonged episodes accompanied by headaches. An exam
reveals abnormal eye movement and mild ataxia. What is the correct action?
A. begin using anti-migraine meds to prevent HA
B. Prescribe ondansetron and lorazepam to help manage sx
C. Reassure the parent that this is expected with cyclic vomiting syndrome
D. Refer to a pediatric gastroenterologist for further workup. - ANSWER💫✔️--D. Refer to a pediatric
gastroenterologist for further workup.
The parent of a 3-month-old reports that the infant reports that the infant arches and gags while
feeding and spits up undigested formula frequently. The infant's weight gain has dropped to the 5th
percentile from the 12th. What is the best course of tx for this infant?
A. Begin a trial of extensively hydrolyzed protein formula for 2-4 wks.
B. Institute an emperic trial of acid suppression with a PPI
C. Perform esophageal pH monitoring to determine the degree of reflux.
D. Reassure the parent that these sx will likely resolved by 12-24 mo. - ANSWER💫✔️--A. Begin a trial of
extensively hydrolyzed protein formula for 2-4 wks.
A school-age child has a 3-month hx of dull, aching epigastric pain that worsens with eating and awakens
from sleep. A CBC shows a Hgb of 8mg/dL. What is the next step in management.
A. Administration of H RA or PPI meds
B. Empiric therapy for H. pylori
C. Ordering an upper GI series
D. Referral for EGD - ANSWER💫✔️--D. Referral for EGD
A 2-mo old infant cries up to 4 hours each day and according to the parents, is inconsolable during
crying episodes with fits and legs notes to be tense and stiff. The infant is breastfeeding frequently but is
often fussy during feedings. The PE is normal and the infant is gaining weight normally. What will the
primary care pediatric NP recommend?
A. A complete work-up, including lab and radiologic tests.
B. Eliminating certain foods from the mother's diet.
C. Empiric tx w/PPI
, D. Stopping breastfeeding & beginning a hydrolyzed formula - ANSWER💫✔️--B. Eliminating certain foods
from the mother's diet.
A child is in the clinic after swallowing a metal bead. A radiograph of the GI tract shows a 6 mm
cylindrical object in the child's stomach. The child is able to swallow without difficulty and is not
experiencing pain. What is the correct course of treatment?
a. Administer ipecac to induce vomiting.
b. Have the parents watch for the object in the child's stool.
c. Insert a nasogastric tube to flush out the object.
d. Refer the child for endoscopic removal of the object. - ANSWER💫✔️--b. Have the parents watch for
the object in the child's stool.
A 10-year-old child has had abdominal pain for 2 days, which began in the periumbilical area and then
localized to the RLQ. The child vomited once today and then experienced relief from pain followed by an
increased fever. What is the likely diagnosis?
A. Appendicitis w/perf
B. Gastroenteritis
C. Pelvic inflammatory disease (PID)
D. UTI - ANSWER💫✔️--A. Appendicitis w/perf
An 18-month-old child has a 1-day hx of intermittent, cramping abd pain w/non-bilious vomiting. The
child observed to scream and draw up his legs during pain episodes and becomes lethargic in between.
The primary care pediatric NP notes ta small amount of bloody, mucous stool in the diaper. What is the
most likely diagnosis?
A. Appendicitis
B. Gastroenteritis
C. Intussusception
D. Testicular torsion - ANSWER💫✔️--C. Intussusception
A school-age child has had abd pain for 3 mo htat occurs once to twice weekly and is associated with a
h/a and occ diff sleeping, often causing the child to stay home from school. The child does not have V/D
& is gaining weight normally. The PE is normal. According to Bishop, what is included in the initial
diagnostic work-up for this child?
