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PEDIATRICS EXAM PRACTICE 2025-2026 WITH
CORRECT VERIFIED QUESTIONS AND ANSWERS
Clubfoot: always requires an urgent neurosurgical referral. involves the foot and lower extremity. involves the foot only. can be corrected with casting and exercises. - correct answer>>involves the foot and lower extremity A 6-week-old is suspected of having developmental dysplasia of the hip (DHH). What test would best assess for this? Barlow and Ortolani Galeazzi and Klisic Trendelenbyrg pelvic tilt test Romberg balance test - correct answer>>Barlow and Ortolani What is the usual recommendation about administering MMR and varicella immunizations? they should not be given on the same day under any circumstance they should be given on the same day or at least one month apart they cannot be given with the flu vaccine they can be given only with live vaccines - correct answer>>they should be given on the same day or at least one month apart A pregnant patient is concerned because her 12 month-old needs an MMR immunization. What should the NP advise this patient? the MMR is a dead virus; therefore is no risk to the mother have the child wait until the mom delivers have the child wait until mom is in her 28th week or later before immunization MMR immunization presents no risk to the child's mother. immunize now. - correct answer>>MMR immunization presents no risk to the child's mother. immunize now. A 9-year-old female has presented to your clinic because of a rash on the left, upper area of her anterior trunk. She is embarrassed and very reticent to lift her blouse because her nipple will be exposed. How should the NP proceed?
examine the patient with the area as covered as possible the NP should lift the blouse to expose the area for the exam ask the accompanying caregiver to expose the area for exam examine all other areas of the trunk, then ask the child to lift her blouse - correct answer>>examine all other areas of the trunk, then ask the child to lift her blouse A positive trendelenburg's test could be used to identify a child with scoloisis Osgood-Schlatter disease nursemaid's elbow slipped capital femoral epiphysis - correct answer>>slipped capital femoral epiphysis A male child has a swelling in the upper thigh below the inguinal ligament with cramping and abdominal pain. What is in the NP's differential diagnosis? testicular torsion femoral hernia varicocele hydrocele - correct answer>>femoral hernia Children with Legg-Calve Perthes disease should: maintain a diet high in protein, vitamins and minerals sleep on a firm mattress to prevent contractures avoid weight bearing on the affected extremity be allowed to play basketball - correct answer>>avoid weight bearing on the affected extremity MMR immunization is safe in children: who are allergic to eggs younger than 1 year of age when given every 5 years if they are at least 5 years of age - correct answer>>who are allergic to eggs A 3-year-old female had a fever of 102F for the last 3 days. Today she woke up from a nap and is afebrile. She has a maculopapular rash. Which statement is true?
probably has just had acute otitis media. has cloudy fluid in the middle ear. - correct answer>>probably has just had acute otitis media. What is the usual age for vision screening in young children? 2 years 3 years 4 years 5 years - correct answer>>3 years What Tanner stage corresponds to an average 8-year-old male? Stage 0 Stage 1 Stage 2 Stage 3 - correct answer>>Stage 1 What of the following is true about metatarsus adductus? This is another term for clubfoot Mild flexible metatarsus usually spontaneously corrects X-rays are usually necessary to diagnose this Infants frequently require casting to correct - correct answer>>Mild flexible metatarsus usually spontaneously corrects Which statement about attention deficit disorder (ADD) is correct? this is more common in girls less than age 9 years family history does not play a role in this disorder hyperactivity must be present for this diagnosis DSM V is used to diagnose a child with ADD - correct answer>>DSM V is used to diagnose a child with ADD A 6-month-old male has a palpable cystic mass in his scrotum. His mother states that sometimes the size of his scrotum varies. What should the nurse practitioner do next? referral to urology as soon as possible referral to urology if this has not resolved in 6 more months scrotal ultrasound should be ordered
order a urine specimen to rule out infection - correct answer>>referral to urology if this has not resolved in 6 more months The nurse practitioner sees a child who reports fatigue and presents with purpura on his lower extremities. His temperature is normal. The differential includes: anemia abuse acute leukemia Kawasaki syndrome - correct answer>>acute leukemia Hirschsprungs disease is characterized by: intermittent constipation in the first year of life inability to absorb carbohydrates failure to pass meconium in the first 48 hours of life chronic fecal incontinence - correct answer>>failure to pass meconium in the first 48 hours of life A 1-year-old patient's mother reports allergy to gelatin. The mother describes the reaction as "lips swelling and breathing difficulties that necessitated a trip to the emergency department". Which immunizations should be avoided? Varicella, DTaP, and MMR Varicella and MMR IPV, DTaP, and Hepatitis B Hepatitis A and B, meningococcal - correct answer>>Varicella and MMR a 7-year-old male presents with encopresis. The NP might expect: constipation delayed maturation urinary tract infection laxative abuse - correct answer>>constipation A contraindication to giving MMR vaccination is: family history of any adverse event after a dose fever of 104F within 72 hours of immunization seizures within 7 days of immunization
injection site soreness lasting greater than 2 days - correct answer>>nonstop crying ( hours or more) within 48 hours of receiving the immunization The age at which a child can first walk backwards is: 12 months 15 months 18 months 24 months - correct answer>>18 months At what age would it be unusual to see thrush? at birth 2 months 6 months 8 months - correct answer>>at birth The initial step in the management of encopresis is: client and family education bowel cleansing dietary changes psychosocial evaluation - correct answer>>client and family education The Sexual Maturity Rating (Tanner Staging) in boys includes 5 stages. Characteristics indicative of Stage 1 would include: the absence of pubic hair; same size and proportion penis, testes, and scrotum as in childhood sparse growth of long, slighted pigmented hair at the base of the penis, slight enlargement of the penis, testes, and scrotum dark, coarse curly hair spreading over the pubic symphysis, enlargement and increased length of the penis and enlargement of the scrotum coarse and curly hair as in the adult covering the pubic area, enlargement in length and breadth of the penis and enlargement of the testes and scrotum with scrotal skin darkened - correct answer>>the absence of pubic hair; same size and proportion penis, testes, and scrotum as in childhood A 4-year-old is being examined today in the NP clinic. He appears shy and does not make eye contact with the examiner. The mother does not make eye contact with the
examiner either. The patient lacks animation and does not smile. What likely possibility must be considered? the patient is depressed sexual abuse is very likely neglect is possible the child probably does not have medical insurance - correct answer>>neglect is possible A 12-month-old is here today to receive the varicella immunization. A patient's mother reports that her 12-month-old child was exposed to chickenpox about a week ago. The NP should recommend that he: be given the vaccine wait 4 weeks to receive the vaccine not receive varicella today because he is not old enough receive MMR only today, not varicella - correct answer>>be given the vaccine A 12-moth-old was screened for iron deficiency anemia and found to be anemic. The nurse practitioner ordered oral iron. In 1 month, the child's hemoglobin was reassessed. It increased greatly. Which answer might account for this? the mother administered it with his bottle of milk the child is drinking apple juice the bone marrow is responding appropriately the child experienced a growth spurt - correct answer>>the bone marrow is responding appropriately the term caput succedaneum refers to: cradle cap atopic dermatitis scalp edema asymmetric head shape - correct answer>>scalp edema At what age would a baby first be expected to locate an object hidden from view? at 4 months of age at 9 months of age at 13 months of age
increase the dose to high-dose azithromycin change antibiotics to a penicillin this is probably viral, stop the antibiotic - correct answer>>change antibiotics to a penicillin A congenital heart abnormality often discovered during the newborn period is cortication of the aorta. How is this assessed? by comparing the right and left femoral pulses by comparing the right and left pedal pulses by comparing upper and lower extremity blood pressures by auscultating an audible bruit in the carotid arteries - correct answer>>by comparing upper and lower extremity blood pressures A child who is 15 months old is referred to as a(n): infant toddler preschooler youngster - correct answer>>toddler The test of choice to confirm and assess developmental dysplasia of the hip (DDH) in a 3 - month-old is: frog leg X-rays plain hip X-rays ultrasounds of the hip CT of the hip - correct answer>>ultrasounds of the hip A 7-year-old boy who was previously unimmunized received his first tetanus, diptheria, and acelluar pertussis (DTaP), Hepatitis A, Hepatitis B, inactivated polio (IPV), measles, mumps, and rubella (MMR), and Varicella vaccinations one month ago. He returns today for his second series of immunizations. He should receive: Hepatitis A, Hepatitis B, TDaP, HiB, IPV, and MMR Hepatitis B, TDaP, IPV, MMR, and Varicella IPV only Hepatitis B, TD, IPV, and MMR - correct answer>>Hepatitis B, TD, IPV, and MMR The first sign that a male child is experiencing sexual maturation is:
increase in testicular size enlargement of the scrotum increase in length of the penis scrotal and penile changes - correct answer>>increase in testicular size What would be age appropriate anticipatory guidance for the parent of a 9-month-old infant? keep syrup of ipecac in case of accidental poisoning stranger anxiety will develop by a year of age your baby should be able to say 10 words before age 1 year discuss weaning from a bottle - correct answer>>discuss weaning from a bottle When is a child first able to stand on one foot? 18 months 2 years 3 years 4 years - correct answer>>3 years A 4-month-old infant has thrush. The mother is breastfeeding. She reports that her nipples have become red, irritated, and sensitive. What should the nurse practitioner advise the mother of this baby to treat thrush? have the mother exercise good hygiene of her nipples administer oral antifungal suspension to the mother administer an oral antifungal suspension to the infant treat the infant with an oral antifungal suspension and the mother's nipples with a topical anitfungal agent - correct answer>>treat the infant with an oral antifungal suspension and the mother's nipples with a topical anitfungal agent A 6-week-old male infant is brought to the nurse practitioner because of vomiting. The mother describes vomiting after feeding and feeling a "knot" in his abdomen especially after he vomits. The child appears adequately nourished. What is the likely etiology? gastroesophageal reflux (GERD) pyloric stenosis constipation Muchausen syndrome by proxy - correct answer>>pyloric stenosis
hypothyroidism diabetes lupus hypertension - correct answer>>diabetes A patient has suspected scarlet fever. He likely has a sandpaper rash and: negative throat swab a positive rapid Strept test diarrhea with abdominal cramps petechiae on the trunk - correct answer>>a positive rapid Strept test A 7-year-old has a complaint of ear pain. If he has otitis externa, which complaint is most likely? he has tragal pain he has difficulty hearing the TV he has fever he has a concurrent upper respiratory infection - correct answer>>he has tragal pain A child's resting heart rate is expected to be between 60 and 100 beats per minute once he reaches: 4 years of age 6 years of age 10 years of age 12 years of age - correct answer>>10 years of age A 6-month-old child comes into the clinic for immunizations. Which item below allows a delay in his getting immunizations today? child is on antibiotics child has otitis media with temperature of 103F mom is pregnant child has a family member on chemotherapy - correct answer>>child has otitis media with temperature of 103F An 8-year-old has a painful limp. He reports that his knee hurts medially. On exam he has pain with internal rotation of the hip. How should the NP manage this situation?
he should be immediately referred to orthopedics the NP should order a hip X-ray, CBC, and ESR the NP should order a hip and knee X-ray he should be referred for synovial fluid aspiration - correct answer>>the NP should order a hip X-ray, CBC, and ESR The nurse practitioner is examining a 3-month-old infant who has normal development. She has identified an alopecic area at the occiput. What should be done? order a TSH order a hydrocortisone cream suspect child abuse encourage the caregiver to change the infant's head position - correct answer>>encourage the caregiver to change the infant's head position The term that describes the urethral opening on the ventral surface of the penis is: cryptorchidism hypospadias inguinal hernia hydrocele - correct answer>>hypospadias a young female has breast buds bilaterally. This represents Tanner Stage: I II III IV - correct answer>>II Which of the following is an appropriate initial intervention for gastroesophageal reflux disease (GERD) in an 8-week old? small, frequent thickened feedings cimetidine every 6 hours change formula to soy based place infant on left side after eating - correct answer>>small, frequent thickened feedings the chest circumference of a 12 month-old is:
What early finding may lead the provider to suspect renal artery stenosis in a 3-year-old male? decreased urine production increased blood pressure decreased glomerular filtration rate (GFR) coarctation of the aorta - correct answer>>increased blood pressure A 3-day-old full-term infant has a bilirubin level of 16 mg/dL. How should this be managed? monitor only increase fluids and stop breastfeeding increase breastfeeding order phototherapy for the infant - correct answer>>order phototherapy for the infant A 4-year-old has been diagnosed with measles. The nurse practitioner identifies Koplik's spots. These are: spots on the skin that are pathognomonic for measles red rings found on the tongue that have a white granular area inside the ring found on the inside of the cheek and are granular blanchable areas on the trunk and extremities - correct answer>>found on the inside of the cheek and are granular An infant is brought to the nurse practitioner because his gaze is asymmetrical. Which finding indicates a need for referral to ophthalmology? he is 2 months of age he is 3 months of age he has persistent strabismus his red reflex is normal - correct answer>>he has persistent strabismus Pharmacologic treatment for children who have hypertension should be initiated for: those who are obese Stage 1 hypertension diabetics with hypertension asymptomatic stage 1 or stage 2 hypertension - correct answer>>diabetics with hypertension
According to the Tanner stages of development (Sexual Maturity Rating), breast development in Stage 5 in females includes the: elevation of breast and nipple enlargement and elevation of breast and areola with no separation of their contours projection of areola and nipple to form a secondary mound above the level of the breast projection of the nipple only - correct answer>>projection of the nipple only An otherwise healthy 6-year-old male has been diagnosed with otitis media. His mother reports that he has not had an ear infection since he was 3 years old. How long should he be treated with an antibiotic? 5 days 5 - 7 days 10 days until the erythema has resolved - correct answer>> 5 - 7 days What is the earliest age that an average child would appropriately receive construction paper and a pair of scissors with rounded points? 3 years 4 years 5 years 6 years - correct answer>>4 years An otherwise healthy two-year-old presents with a heart rate that varies with inspiration and expiration. Which statement is true? The child has ingested too much caffeine A cardiology referral is prudent This is a normal exam There is a need for an echocardiogram. - correct answer>>This is a normal exam Most hypertension in preadolescents and children is: obesity-related primary hypertension secondary hypertension endocrine-related - correct answer>>secondary hypertension
Which infant feeding behavior is least likely related to congenital heart disease (CHD)? limited intake of volume of milk feedings that take a long time to complete feedings that are interrupted by sleeping infants that burp frequently when feeding - correct answer>>infants that burp frequently when feeding When can a child with chickenpox return to daycare? 24 hours after he is fever free 48 hours after he is fever free after all lesions have crusted when he no longer itches - correct answer>>after all lesions have crusted cranial nerve II could be evaluated in a young infant by assessing: squinting response to bright light a blink reflex a pupillary response rapid eye movement - correct answer>>squinting response to bright light which choice below is a risk factor for sudden infant death syndrome (SIDS)? maternal age > 40 years SIDS in a second degree relative low birth weight female gender - correct answer>>low birth weight According to the Tanner stages of development (Sexual Maturity Rating), breast development in Stage 4 in females includes the: elevation of breast and nipple enlargement and elevation of breast and areola with no separation of their contours projection of areola and nipple to form a secondary mound above the level of the breast projection of the nipple only - correct answer>>projection of areola and nipple to form a secondary mound above the level of the breast A 9-year-old has been diagnosed with chickenpox. A drug that should be avoided in him is:
penicillin aspirin ibuprofen sulfa - correct answer>>aspirin A 4-year-old female is brought in to the clinic by her mother, who reports that she is constantly scratching "her private part". The patient states that it itches. On exam, the vagina is red and irritated. How should the NP proceed? call child protection for suspected sexual abuse prescribe a cortisone cream collect a vaginal swab of the external vagina for microscopic evaluation prescribe a topical antifungal - correct answer>>collect a vaginal swab of the external vagina for microscopic evaluation A 4-year-old was diagnosed and treated for acute otitis media in the left ear 4 weeks ago. She is here today for a well-child visit. There is an effusion in the left ear. She denies complaints. How should this be managed? this should be monitored she should be given another antibiotic she should be evaluated with pneumatic otoscopy she needs a tympanogram - correct answer>>this should be monitored A 6 year-old complains that his legs hurt. His mother states that he has complained for the past 2 weeks, and she thought it was from "playing outside too much". When asked to identify the painful areas, the child points to the midshaft of the femurs. He grimaces slightly when asked to walk. What should be part of the differential diagnosis? Osgood-Schlatter disease Growing pains Acute lymphocytic leukemia (ALL) Psychogenic pain - correct answer>>Acute lymphocytic leukemia (ALL) At what age should oral health risk assessment begin? at birth 3 months 6 months
