PEDIATRICS PRACTICE QUESTIONS
A 4-year-old child presents with fever; exudative pharyngitis; anterior cervical lymphadenopathy; and a fine, raised, pink rash. The most likely diagnosis is: A. scarlet fever. B. roseola. C. rubella. D. rubeola.
A
A 6-year-old boy presents with a 1-day history of a fiery red, maculopapular facial rash concentrated on the cheeks. He has had mild headache and myalgia for the past week. The most likely diagnosis is: A. erythema infectiosum. B. roseola. C. rubella. D. scarlet fever.
A
A healthy 2 yo is able to: A. speak in phrases of 2 words or more B. throw a ball at a target C. scribble spontaneously D. ride a tricycle
A
A healthy 3 yo child is expected to: A. give his or her first and last name B. use pronouns C. kick a ball D. name a best friend
A
A healthy 6 to 7 month old is able to: A. roll from back to stomach B. confidently feed self a cracker C. reach for an object D. crawl on abdomen
A
An acceptable level of total cholesterol (mg/dL) in children and teens is: A. <170 mg/dL or 9.4 mmol/L. B. <130 mg/dL or 7.2 mmol/L. C. 110-130 mg/dL or 6.2 mmol/L-7.2 mmol/L. D. 130-199 mg/dL or 7.2 mmol/L-11 mmol/L.
A
As part of the evaluation in a febrile 3-year-old boy, the following white blood cell count with differential is obtained: ● WBCs = 22,100/mm3 ● Neutrophils = 75% (normal 40% to 70%) with toxic granulation ● Bands = 15% (normal 0% to 4%) ● Lymphocytes = 4% (normal 30% to 40%) Which of the following best describes the WBC with differential results? A. Leukocytosis with neutrophilia B. Leukopenia with lymphocytosis C. Lymphopenia with neutropenia D. Leukopenia with neutropenia
A
At 3 weeks of age, the average-weight, formula-fed infant should be expected to take: mL A. 2 to 3 oz, or 60 to 90 mL, every 2 to 3 hours. B. 2 to 3 oz, or 60 to 90 mL, every 3 to 4 hours. C. 3 to 4 oz, or 90 to 118 mL, every 2 to 3 hours. D. 3 to 4 oz, or 90 to 118 mL, every 3 to 4 hours.
A
At what age is it appropriate to recommend dietary changes to parents if overweight or obesity is a concern? A. 12 months old B. 5 years old C. 10 years old D. 18 years old
A
At which age is a child at greatest risk of death from pertussis? A. <1 year B. 2-4 years C. 5-10 years D. >10 years
A
At which age would a child likely start to imitate housework? A. 18 months B. 24 months C. 30 months D. 36 months
A
At which of the following ages in a young child's life is parental anticipatory guidance about protection from falls most helpful? A. birth B. 2 months C. 4 months D. 6 months
A
Characteristics of M. catarrhalis include: A. high rate of beta-lactamase production. B. antimicrobial resistance because of altered protein binding sites. C. difficult to eradicate even with antimicrobial therapy. D. gram-positive organism.
A
Family members and caregivers of an international adoptee should be given the hepatitis A vaccine per the following schedule: A. two doses 6 months apart, one dose before the child arrives. B. two doses 3 months apart, one dose before the child arrives. C. two doses 1 year apart, one dose before the child arrives. D. one dose before the child arrives into the USA.
A
Gina is 2 years old and presents with a 3-day history of fever, crankiness, and congested cough. Her respiratory rate is more than 50% of the upper limits of normal for age. Tubular breath sounds are noted at the right lung base. Skin turgor is normal, and she is wearing a wet diaper. She is alert, is resisting the examination as age appropriate, and engages in eye contact. Temperature is 38.3°C (101°F). Gina's diagnostic evaluation should include: A. chest x-ray. B. urine culture and sensitivity measurement. C. lumbar puncture. D. sputum culture.
A
How is the varicella virus most commonly transmitted? A. droplet transmission B. contact with inanimate reservoirs C. contact transmission D. waterborne transmission
A
Intervention for a child with a lead level of 40 to 50 mcg/dL usually includes: A. chelation therapy. B. calcium supplementation. C. exchange transfusion. D. iron depletion therapy.
A
Jason is a healthy 18 year old who presents for primary care. According to his immunization record, he received two doses of HBV vaccine 1 month apart at age 14 years. Which of the following best describes his HBV vaccination needs? A. He should receive a single dose of HBV vaccine now. B. A three-dose HBV vaccine series should be started during today's visit. C. He has completed the recommended HBV vaccine series. D. He should be tested for HBsAb and further immunization recommendations should be made according to the test results.
A
Klinefelter syndrome is most commonly marked by: A. language impairment in males. B. fine motor delay in males. C. hip and breast enlargement in women. D. attention deficit disorder in males.
A
Milia are treated by the following method: A. no special skin care B. a topical retinoid. C. cryotherapy. D. a topical antimicrobial
A
Most AOM is caused by: A. certain gram-positive and gram-negative bacteria and respiratory viruses. B. atypical bacteria and pathogenic fungi. C. rhinovirus and methicillin-resistant Staphylococcus aureus. D. predominately beta-lactamase-producing organisms.
A
Nursing infants generally maximally receive about which percentage of the maternal dose of a drug? A. 1% B. 3% C. 5% D. 10%
A
Poorly controlled asthma in children can lead to: A. attenuated lung development. B. chronic tracheitis. C. sleep apnea. D. alveolar destruction.
A
Which of the following is considered the ideal method for obtaining a urine sample for culture and sensitivity in an 18-month-old-old girl with suspected UTI? A. suprapubic aspiration B. transurethral bladder catheterization C. bag collection D. diaper sample
A
Which of the following is not seen during body temperature increase found in fever? A. lower rate of viral replication B. toxic effect on select bacteria C. negative effect on S. pneumoniae growth D. increased rate of atypical pneumonia pathogen replication
A
Which of the following is noted in a child with premature thelarche? A. breast enlargement. B. accelerated linear growth. C. pubic hair. D. body odor.
A
Which of the following is the most appropriate antimicrobial for treatment of CAP in a 2 year old who is clinically stable and able to be treated in the outpatient setting? A. amoxicillin. B. doxycycline C. TMP-SMX D. levofloxacin
A
Which of the following is the most compelling reason to use RBUS instead of VCUG? A. This is a noninvasive test. B. Results are available more rapidly. C. The test is less technically demanding. D. RBUS is less expensive.
A
Which of the following is the route of transmission of the poliovirus? A. fecal-oral B. droplet C. blood and body fluids D. skin-to-skin contact
A
Which of the following is true about the MMR vaccine? A. This vaccine contains live virus. B. Its use is contraindicated in persons with a history of egg allergy. C. Revaccination of an immune person is associated with risk of allergic reaction. D. One dose is recommended for young adults who have not been previously immunized.
A
Fruit juice intake is acceptable in children 6 months and older per the following recommendations: A. The juice is mixed in small amounts to flavor water. B. Only 100% juice is used. C. Juice replaces no more than 1 serving of milk. D. The juice is consumed in the morning with breakfast. E. No more than 6 oz per day is recommended for children 6 months to 5 yo.
A, B, E
The following are risk factors for HTN in children and teens: A. being obese B. drinking whole milk C. being exposed to second hand smoke D. watching 2 or more hours of television per day
A, C
Which of the following must be present for the diagnosis of AOM? A. bulging TM B. TM retraction C. otalgia D. anterior cervical lymphadenopathy
A, C
Eczema is thought to be caused by: A. overactive mucous glands. B. allergic reaction. C. degradation of mast cells. D. dry air.
C
The preferred treatment option for a 6-year-old boy with pertussis is: A. amoxicillin. B. ceftriaxone. C. azithromycin. D. levofloxacin.
C
You anticipate that adult car seat belts fit correctly when a child is approximately _____ tall and is____ old. A. 51 inches (129.5 cm), 6 to 8 years B. 53 inches (134.6 cm), 5 to 7 years C. 57 inches (144.8 cm), 8 to 12 years D. 59 inches (150 cm), 12 to 14 years
C
You examine a healthy 9 month old and expect to find: A. sits without support B. cruises C. has the ability to recognize his own name D. imitates a razzing noise
C
Clinical features of shigellosis include all of the following except: A. bloody diarrhea. B. high fever. C. malaise. D. vomiting.
D
When evaluating a child who has bacterial meningitis, the NP expects to find cerebrospinal fluid (CSF) results of: A. low protein. B. predominance of lymphocytes. C. glucose at about 30% of serum levels. D. low opening pressure.
c
A 10-day-old child presents with multiple raised lesions resembling flea bites over the trunk and nape of the neck. The infant is nursing well and has no fever or exposure to animals. These lesions likely represent: A. erythema toxicum neonatorum. B. milia. C. acne neonatorum. D. staphylococcal skin infection.
A
A 15-year-old male is found to be at Tanner stage 1 on exam. The least likely cause of this finding is: A. A variation of normal based on ethnicity or familial factors. B. human growth hormone abnormality. C. Klinefelter syndrome. D. nutritional factors.
A
A 2-year-old girl presents with pustular, ulcerating lesions on the hands and feet and oral ulcers. The child is cranky, well hydrated, and afebrile. The most likely diagnosis is: A. hand-foot-and-mouth disease. B. aphthous stomatitis. C. herpetic gingivostomatitis. D. Vincent angina.
A
At which of the following ages in a young child's life is parental anticipatory guidance about infant sleep position most helpful? A. birth B. 2 weeks C. 2 months D. 4 months
A
Problems after tetanus immunization typically include: A. localized reaction at site of injection B. myalgia and malaise C. low-grade fever D. diffuse rash
A
Routine adolescent vaccination against HBV was recommended in what year? A. 1996 B. 1991 C. 1982 D. 1978
A
Screening children with a known risk factor for type 2 diabetes mellitus is recommended at age 10 or at onset of puberty, and should be repeated how often? A. every other year. B. every year. C. every six months. D. If child presents with a body mass index in the 85th percentile or higher.
A
Sepsis is defined as the: A. clinical manifestation of systemic infection. B. presence of bacteria in the blood. C. circulation of pathogens. D. allergenic response to infection.
A
Sources of lead that can contribute to plumbism include select traditional remedies such as azarcon and greta. A. true B. false
A
The preferred urinary tract imaging study for a 22-month-old girl with first-time febrile UTI is: A. renal-bladder ultrasound (RBUS). B. renal scan. C. voiding cystogram (VCUG). D. none unless a second UTI occurs.
A
The presumptive diagnosis of fragile X syndrome can be confirmed by a blood test. A. true B. false
A
To obtain the most accurate hydration status in a child with acute gastroenteritis, the NP should ask about: A. the time of last urination. B. thirst. C. quantity of liquids taken. D. number of episodes of vomiting and diarrhea.
A
Treatment of otitis media with effusion usually includes: A. symptomatic therapy. B. antimicrobial therapy. C. an antihistamine. D. a mucolytic.
A
When considering a person's risk for measles, mumps, and rubella, the NP considers the following: A. Children should have two doses of the measles, mumps, and rubella (MMR) vaccine before their sixth birthday. B. Considerable mortality and morbidity occur with all three diseases. C. Most cases in the United States occur in infants. D. The use of the vaccine is often associated with protracted arthralgia.
A
When giving influenza vaccine to a 7-year-old who has not received this immunization in the past, the NP considers that: A. two doses 4 weeks or more apart should be given. B. a single dose is adequate. C. children in this age group have the highest rate of influenza-related hospitalization. D. the vaccine should not be given to a child with shellfish allergy.
A
Which do you expect to find in a 2 week old infant? A. visual preference for human face B. preference for low pitched noises C. indifference to the cry of other neonates D. poorly developed sense of smell
A
Which is most appropriate in examination of a healthy 5 yo? A. being able to name a best friend B. giving gender correctly C. naming an intended career D. hopping on one foot
A
Which is not a reason for the delayed onset of puberty in a 13-year-old boy? A. report of a high level of physical activity B. Kallmann syndrome C. familial trait D. history of radiation exposure
A
Which of the following findings is most consistent with the diagnosis of acute bacterial rhinosinusitis (ABRS) in children? A. upper respiratory tract infection symptoms persisting beyond 10 days B. nasal discharge progresses from clear to purulent to clear without antibiotics C. headaches and myalgias that resolve in 24 to 48 hours as the respiratory symptoms worsen D. persistent cough
A
Which of the following is a first-line therapy option for the treatment of ABRS in an otherwise well child? A. amoxicillin-clavulanate. B. clindamycin with cefixime. C. doxycycline. D. levofloxacin.
A
Which of the following laboratory tests can identify the causative organism of bronchiolitis? : A. nasal washing antigen test B. antibody test via blood sample. C. urine culture D. a laboratory test is not available.
A
Which wound presents the greatest risk for tetanus infection? A. a puncture wound obtained while playing in a garden B. a laceration obtained from a knife used to trim raw beef C. a human bite D. an abrasion obtained by falling on a sidewalk
A
With regard to seasonal influenza prevention in well children, the NP considers that: A. compared with school-aged children, younger children (≤24 months old) have an increased risk of seasonal influenza-related hospitalization. B. a full adult dose of seasonal influenza vaccine should be given starting at age 4 years. C. the use of the seasonal influenza vaccine in well children is discouraged. D. widespread use of the vaccine is likely to increase the risk of eczema and antibiotic allergies.
A
You are devising a program to screen preschoolers for lead poisoning. The most sensitive component of this campaign is: A. environmental history. B. physical examination. C. hematocrit level. D. hemoglobin electrophoresis.
A
You examine a newborn with a capillary hemangioma on her thigh. You advise her parents that this lesion: A. is likely to increase in size over the first year of life. B. should be treated to avoid malignancy. C. usually resolves within the first months of life. D. is likely to develop a superimposed lichenification.
A
Prediabetes in children is defined as: A. IFG >/=100 but </=125 B. IGT >/=140-199 C. BMI in the 85th percentile D. BMI in the 60th percentile
A, B
When counseling the family of an otherwise healthy 2 yo who just had a febrile seizure, you consider the following regarding whether the child is at risk for future febrile seizures. A. The occurrence of one febrile seizure is predictive of having another B. Intermittent diazepam can be used to prophylactically during febrile illness to reduce risk of recurrence C. A milder temperature elevation in a child with a history of a febrile seizure poses a significant risk for future recurrent febrile and nonfebrile seizures D. Consistent use of antipyretics during a febrile illness will significantly reduce the risk of a future febrile seizure
A, B
You examine a 10 yo boy with suspected strep pharyngitis. his mother asks if he can get a "shot of penicillin". Which of the following statements is true regarding the use of intramuscular penicillin? A. Injectable benzathine PCN, oral amoxicillin, and cephalexin are each strongly recommended for as treatment of Strep pyogenes pharyngitis. B. Injectable benzathing PCN would be indicated for treatment of GAS if poor adherence to recommended therapy or inability to take full course of oral antibiotics is anticipated. C. The risk of severe allergic reaction with IM products is similar to that of oral preparations. D. Injectable penicillin has a superior spectrum of antimicrobial coverage compared with the oral form of the drug
A, B
Signs of severe dehydration include: A. anuria B. tears absent C. capillary refill of approximately 3 seconds D. elevated BP
A, B, C
Hydration status can be determined by evaluating: A. BP B. HR C. skin turgor D. HR E. presence of dry lips and oral mucosa
A, B, C, D, E
The following are risk factors for T2DM in children and teens: A. hyperinsulinemia B. abnormal height to weight ratio C. onset of nonorganic failure to thrive in toddler years D. Native American ancestry
A, B, D
The following criteria should be met for a child to be treated for AOM with observation and analgesia but no antimicrobial therapy? A, age greater than 6 months B. bilateral infection C. moderate illness D. presumptively caused by bacterial infection
A, C
Acne neonatorum treatment options include which of the following? A. no special skin care is needed because these lesions are self resolving B. topical retinoids C. oral antibiotic D. low dose benzoyl peroxide
A, D
In evaluating a 9 yo child with a healthy BMI during a well visit, a comprehensive CV evaluation should be conducted by: A. Obtain fasting lipid profile B. Screen for T2DM by measuring HBA1C C. Assess for family history of thyroid disorder. D. Assess diet and physical activity.
A, D
A 23-year-old woman is breastfeeding her healthy newborn. She wishes to start using hormonal contraception. Which of the following represents the best regimen? A. combined oral contraception initiated at 2 weeks B. progesterone-only oral contraception initiated at 3 weeks C. medroxyprogesterone acetate (Depo-Provera) given day 1 postpartum D. use of all forms of hormonal contraception is discouraged during lactation
B
A 5-year-old girl presents with ABRS. She has a penicillin allergy but is otherwise well and is going to be treated with an antimicrobial. You prescribe: A. no medication; continue observation. B. cefdinir. C. levofloxacin. D. amoxicillin.
B
A Still murmur: A. is heard in the presence of cardiac pathology. B. has a humming or vibratory quality. C. is a reason for denying sports participation clearance. D. can become louder when the patient is standing.
B
A child needs to demonstrate more than one developmental red flag to warrant further evaluation. A. true B. false
B
A common site for eczema in infants is the: A. dorsum of the hand. B. face. C. neck. D. flexor surfaces.
B
A healthy 3 yo is able to: A. name five colors B. alternate feet when climbing stairs C. speak in 2 word phrases D. tie shoelaces
B
A healthy full term infant at 3 to 5 months should be able to: A. gesture to an object B. brings hands together C. reach for an object with one hand D. feed self a biscuit
B
An 18-year-old woman has a chief complaint of "a sore throat and swollen glands" for the past 3 days. Her physical examination reveals exudative pharyngitis, minimally tender anterior and posterior cervical lymphadenopathy, and maculopapular rash. Abdominal examination reveals right and left upper quadrant abdominal tenderness. The most likely diagnosis is: A. group A beta-hemolytic streptococcal pharyngitis. B. infectious mononucleosis. C. rubella. D. scarlet fever.
B
An Asian couple comes in with their 4-week-old infant, who has blue-black macules scattered over the buttocks. These most likely represent: A. benign mottling. B. mongolian spots. C. ecchymosis. D. hemangioma.
B
An infant is born with port wine stains and Sturge-Weber syndrome. These are unlikely related. A. true B. false
B
At which of the following ages in a young child's life is parental anticipatory guidance about temper tantrums most helpful? A. 8 to 10 months B. 10 to 12 months C. 12 to 14 months D. 14 to 16 months
B
At which of the following ages in a young child's life is parental anticipatory guidance about using "time out" as a discipline method most helpful? A. 12 to 18 months B. 18 to 24 months C. 24 to 30 months D. 30 to 36 months
B
At which of the following ages should screening begin for a child who has significant risk of lead poisoning? A. 3 months B. 6 months C. 1 year D. 2 years
B
Bronchiolitis commonly occurs in the US during warm weather months. A. true B. false
B
Celeste is a 9-year-old girl with moderate persistent asthma. She is not taking a prescribed inhaled corticosteroid but is using albuterol PRN to relieve her cough and wheeze. According to her mother, she currently uses about six albuterol doses per day, in particular for cough and wheeze after active play. You consider that: A. albuterol use can continue at this level. B. excessive albuterol use is a risk factor for asthma death. C. she should also use salmeterol (Serevent) to reduce her albuterol use. D. active play should be limited to avoid triggering cough and wheeze.
B
Characteristics of S. pneumoniae include: A. beta-lactamase production common. B. antimicrobial resistance because of altered protein binding sites. C. causative organism of skin infection associated with acute otitis media. D. gram-negative organism.
B
Compared with albuterol, levalbuterol (Xopenex): A. has a different mechanism of action. B. has the ability to provide greater bronchodilation with a lower dose. C. has an anti-inflammatory effect similar to an inhaled corticosteroid. D. is contraindicated for use in children.
B
Compared with the use of infant formula, advantages for the baby of breastfeeding include all of the following except: A. lower incidence of diarrheal illness. B. greater weight gain in the first few weeks of life. C. reduced risk of allergic disorders. D. lower occurrence of constipation.
B
Evidence demonstrates that the MMR virus acquired via vaccine can be shed during lactation. A. True B. False
B
Hepatitis B vaccine should not be given to a child with a history of anaphylactic reaction to: A. egg. B. baker's yeast. C. neomycin. D. streptomycin.
B
How many doses of the MMR vaccine should a child 6 to 11 months of age receive before traveling outside of the United States? A. none B. one dose C. two doses D. depends on where the child is traveling
B
In caring for a child with an acute asthma flare, the NP considers that, according to the National Asthma Education and Prevention Program, Expert Panel Report 3 guidelines, antibiotic use is recommended: A. routinely. B. with evidence of concomitant bacterial infection. C. when asthma flares are frequent. D. with sputum production.
B
In healthy children, the second and third doses of the HBV vaccine should be separated by at least how much time? A. 4 weeks B. 8 weeks C. 6 months D. 1 year D. 1 year
B
In most children with bronchiolitis, intervention includes: A. aerosolized ribavirin therapy. B. supportive care. C. oral theophylline therapy. D. oral corticoid steroid therapy.
B
In the treatment of asthma, leukotriene modifiers should be used as: A. long-acting bronchodilators. B. an inflammatory inhibitor. C. a rescue drug. D. intervention in acute inflammation.
B
Infants who have been infected perinatally with HBV have an estimated ___% lifetime chance of developing hepatocellular carcinoma or cirrhosis. A. 10 B. 25 C. 50 D. 75
B
It is a developmental red flag if a child does not respond to his name by 9 months old. A. true B. false
B
Long-term consequences of Kawasaki disease include: A. renal insufficiency. B. coronary artery obstruction. C. hepatic failure. D. hypothyroidism.
B
Maria is a 28 year-old well woman who is 6 weeks pregnant and voices her intent to breastfeed her infant for at least 6 months. Her routine prenatal laboratory testing reveals she is not immune to varicella. Which of the following represents the best advice for Maria? A. She should receive VZV vaccine once she is in her second pregnancy trimester. B. Maria should be advised to receive two appropriately timed doses of VZV vaccine after giving birth. C. Once Maria is no longer breastfeeding, she should receive one dose of VZV vaccine. D. A dose of VZIG should be administered now.
B
Milia is typically caused by: A. low levels of androgen. B. enlarged sebaceous glands. C. excessive oil production in the skin follicles. D. an unknown etiology.
B
One physical sign of fragile X syndrome in males includes: A. large eyes. B. large forehead. C. small head. D. recessive jaw
B
Post-polio syndrome is commonly marked by: A. muscular hypertrophy. B. muscle atrophy C. flulike symptoms D. increased mortality
B
Potential adverse events of acetaminophen in a child with fever and mild dehydration include: A. seizure. B. hepatotoxicity. C. petechial rash. D. gastric ulcer.
B
Rates of urinary tract infection (UTI) among uncircumcised infant boys are how much higher than those in circumcised boys? A. as much as 10% B. as much as 20% C. as much as 30% D. less than 10%
B
Screening cholesterol levels in children with one or more risk factors begins at what age? A. birth B. 2 years C. 5 years D. 10 years
B
The clinician anticipates that a child with Mongolian spots will cry out because of discomfort when the area is gently pressed or palpated. A. true B. false
B
The hepatitis A vaccine should be administered in childhood per the following schedule: A. two doses 3 months apart. B. two doses 6 months apart. C. two doses 1 year apart. D. two doses are not recommended because of efficacy of a single dose.
B
The incubation period for measles caused by the rubeola virus is: A. 7-10 days. B. 10-14 days. C. 1-2 weeks. D. 2-3 weeks.
B
The main risk factor for AOM in infants is: A. undiagnosed dairy allergy B. eustachian tube dysfunction. C. cigarette smoke exposure D. use of soy-based infant formula.
B
The mechanism of action in fever includes which of the following? A. an increase in systematic vascular resistance B. endogenous pyrogens increase prostaglandin synthesis C. immature neutrophil forms in circulation D. atypical or reactive lymphocytes
B
The most common causative bacterial pathogen in ABRS is: A. M. pneumoniae. B. S. pneumoniae. C. M. catarrhalis. D. unidentified virus.
B
The most common mode of influenza virus transmission is via: A. contact with a contaminated surface. B. respiratory droplet. C. saliva contact. D. skin-to-skin contact.
B
The most common reason for precocious puberty in boys is: A. testicular tumor. B. a select number of relatively uncommon health problems. C. exogenous testosterone. D. early onset of normal puberty.
B
The murmur of atrial septal defect is usually: A. found in children with symptoms of cardiac disease. B. first found on a 2- to 6-month well-baby examination. C. found with mitral valve prolapse. D. presystolic in timing.
B
The onset of symptoms of food poisoning caused by Staphylococcus species is typically how many hours after the ingestion of the offending substance? A. 0.5 to 1 B. 1 to 4 C. 4 to 8 D. 8 to 12
B
VCUG only is indicated: A. after UTI diagnosis is confirmed to determine course of antimicrobial therapy. B. when UTI is recurrent. C. to confirm high-grade reflux. D. as an alternative to RBUS to assure accurate detection of scarring.
B
What advice should you give to the parents of a toddler with gastroenteritis? A. Give the child sips of room temperature cola. B. Give the child sips of an oral rehydration solution. C. Give the child sips of a sports drink such as Gatorade. D. Try sips of apple juice mixed 1;1 with tap water.
B
When answering questions about hepatitis A vaccine, you consider stating that it: A. contains live virus. B. should be given to all children unless contraindicated. C. frequently causes systemic postimmunization reaction. D. is nearly 100% protective after a single injected dose.
B
When assessing a febrile child, the NP considers that: A. even minor temperature elevation is potentially harmful. B. nuchal rigidity is usually not found in early childhood meningitis. C. fever-related seizures usually occur at the peak of the temperature. D. most children with temperatures of 38.3°C to 40°C (101°F to 104°F) have a potentially serious bacterial infection
B
When choosing an antimicrobial agent for the treatment of UTI in a febrile female child who is 16 months old, the NP considers that: A. gram-positive organisms are the most likely cause of infection. B. a parenteral aminoglycoside is the preferred treatment choice. C. the use of an oral third-generation cephalosporin is acceptable if gastrointestinal function is intact. D. nitrofurantoin use is considered first-line therapy.
B
When evaluating a child who has aseptic or viral meningitis, the NP expects to find CSF results of: A. low protein. B. predominance of lymphocytes. C. glucose at about 30% of serum levels. D. low opening pressure.
B
When providing care for a febrile patient, the NP bears in mind that all of the following are true except that: A. the use of antipyretics is potentially associated with prolonged illness. B. consistent use of an antipyretic provides a helpful way to shorten the course of infectious illnesses. C. fever increases metabolic demand. D. in a pregnant woman, increased body temperature is a potential first-trimester teratogen.
B
When treating a 3-year-old well child with community-acquired pneumonia (CAP), the NP realizes that the most likely causative pathogen is: A. Mycoplasma pneumoniae. B. a respiratory virus. C. H. influenzae. D. S. pneumoniae.
B
Which is most consistent with a normal developing 3 month old infant born at 40 weeks gestation? A. sitting briefly with support B. experimenting with sound C. rolling over D. having a social smile
B
Which is most consistent with a normal developing 5 month old born at 32 weeks gestations? A. sitting briefly with support B. experimenting with sound C. rolling over D. performing hand to hand transfers
B
Which of the following can be used to differentiate pertussis from acute bronchitis or asthma exacerbation? A. presence of fever B. PCR assay C. presence of productive cough D. evidence of consolidation on chest x-ray
B
Which of the following is appropriate advice to give to a mother who is breastfeeding her 12-hour-old infant? A. "You will likely have enough milk to feed the baby within a few hours of birth." B. "The baby might need to be awakened to be fed." C. "Supplemental feeding is needed unless the baby has at least four wet diapers in the first day of life." D. "The baby will likely have a seedy yellow bowel movement today."
B
Which of the following is most likely to be found in the laboratory data of a child who has infectious mononucleosis? A. neutrophilia B. lymphocytosis C. positive antinuclear antibody D. macrocytic anemia
B
Which of the following is most likely to be part of the clinical presentation of UTI in a 20-month-old child? A. urinary frequency and urgency B. fever C. suprapubic tenderness D. nausea and vomiting
B
Which of the following is not consistently performed as part of the workup for sepsis? A. CBC with WBC differential B. stool culture C. blood culture D. urine culture
B
Which of the following is the most common UTI organism in children? A. Pseudomonas aeruginosa B. Escherichia coli C. Klebsiella pneumonia D. Proteus mirabilis
B
Which of the following is the most prudent first-line treatment choice for an otherwise well toddler with acute otitis media (AOM) who requires antimicrobial therapy? A. ceftibuten B. amoxicillin C. cefuroxime D. azithromycin
B
Which of the following represents the best choice of clinical agents for a child who has had a history of penicillin allergy who requires antimicrobial therapy? A. ciprofloxacin B. cefdinir C. amoxicillin D. trimethoprim-sulfamethoxazole (TMP-SMX)
B
Which of the following statements is true about inactivated poliovirus vaccine (IPV)? A. It contains live virus. B. It is the preferred method of immunization in North America. C. Two doses should be administered by a child's fourth birthday. D. After administration of IPV, live poliovirus is usually shed from the stool.
B
You are examining a 18 month old boy who is not speaking any discernible words. Mom tells you he has not said mama or dada yet or babbled or smiled responsively. You: A. encourage mother to enroll him in daycare to increase socialization B. conduct further evaluation of milestone attainment C. reassure the parent that delayed speech is common in boys D. order audiogram and tympanometry
B
You examine a 15-year-old boy who has infectious mononucleosis with marked tonsillar hypertrophy, exudative pharyngitis, significantly difficulty swallowing, and a patent airway. You consider prescribing a course of oral: A. amoxicillin. B. prednisone. C. ibuprofen. D. acyclovir.
B
You examine a 2-month-old infant with a port-wine lesion over her right cheek. You advise the parents that this lesion: A. needs to be surgically excised. B. grows proportionally with the child. C. becomes lighter over time. D. can become malignant.
B
Double sickening is defined as: A. nasal discharge progressing form clear to purulent to clear without antibiotic use B. acute worsening of respiratory symptoms C. new fever occurring 6 to 7 days after signs of URI D. persistent cough
B, C
The benchmarks that indicate normal development in a healthy child born at term who is now 12 months old are: A. talking in 2 word sentencs B. pointing to a desired object C. reaching for a desired object D. walking backward
B, C
The most helpful tests to support the diagnosis of pertussis include which of the following? A. CXR B. nasopharyngeal culture C. blood culture D. PCR testing
B, D
Which groups with no history of varicella infection or previous immunization should be targeted for vaccination? A. those born before 1980 B. > 8 yo with HIV and CD4 > 200 C. adults and children with history of anaphylactic reaction to neomycin D. day care workers
B, D
A 6-year-old boy has a 1-year history of moderate persistent asthma that is normally well controlled with budesonide via dry powder inhaler (DPI) twice a day and the use of albuterol once or twice a week as needed for wheezing. Three days ago, he developed a sore throat, clear nasal discharge, and a dry cough. In the past 24 hours, he has had intermittent wheezing, necessitating the use of albuterol two puffs with use of an age-appropriate spacer every 3 hours) with partial relief. Your next most appropriate action is to obtain: A. a chest radiograph. B. an oxygen saturation measurement. C. a peak expiratory flow (PEF) measurement. D. a sputum smear for WBCs.
C
A 7-year-old child with type 1 diabetes mellitus is about to receive injectable influenza vaccine. His parents and he should be advised that: A. the vaccine is more than 90% effective in preventing influenza. B. use of the vaccine is contraindicated during antibiotic therapy. C. localized immunization reactions are common. D. a short, intense, flu-like syndrome typically occurs after immunization.
C
A 9 year-old child with no documentation of vaccinations comes in for an MMR immunization update. Her parent states that child has received "some" vaccinations, but no documentation is available. How many doses of MMR should the child receive and at what frequency? A. one MMR dose B. two MMR doses together at the same time C. two MMR doses 1 month apart D. no MMR immunization is needed
C
A healthy child with no evidence of immunity is exposed to chickenpox at school. How soon after exposure will a dose of the varicella vaccine prevent or modify the disease in the child? A. only if given the same day B. only if given within 2 to 3 days C. if given within 3 to 5 days D. if given within 1 week
C
A healthy infant at age 9 to 11 months is expected to: A. roll from back to stomach B. imitate bye-bye C. play peek a boo D. hand toy on request
C
A middle-school student presents, asking for a letter stating that he should not participate in gym class because he has asthma. The most appropriate response is to: A. write the note because gym class participation could trigger an asthma flare. B. excuse him from outdoor activities only to avoid pollen exposure. C. remind him that with appropriate asthma care, he should be capable of participating in gym class. D. excuse him from indoor activities only to avoid dust mite exposure.
C
A young child should use a rear-facing car seat until at least age ____. A. 12 months B. 18 months C. 24 months D. 30 months
C
After inhaled corticosteroid or leukotriene modifier therapy is initiated, clinical effects are seen: A. immediately. B. within the first week. C. in about 1 to 2 weeks. D. in about 1 to 2 months.
C
An 11-year-old well child presents with no documented primary tetanus immunization series. Which of the following represents the immunization needed? A. three doses of DTaP (diphtheria, tetanus, acellular pertussis) vaccine 2 months apart B. tetanus immune globulin now and two doses of tetanus-diphtheria (Td) 1 month apart C. one dose of Tdap (tetanus, diphtheria, acellular pertussis vaccine) followed by two doses of Td (tetanus, diphtheria) in 1 and 6 months D. Td (tetanus, diphtheria) as a single dose
C
An early indicator of hypoperfusion is: A. an elevation in total white blood cell count. B. dehydration. C. capillary refill of >2 seconds. D. nonresponsive child.
C
An important part of the treatment of Kawasaki disease includes the use of: A. antibiotics. B. antivirals. C. immune globulin. D. antifungals.
C
An innocent heart murmur has which of the following characteristics? A. occurs late in systole B. has localized area of auscultation C. becomes softer when the patient moves from supine to standing position D. frequently obliterates the second heart sound (S2)
C
At what point after childbirth can a combined oral contraceptive be started without other risk factors for venous thrombosis in a woman who is not breastfeeding? A. 1 day B. 1 week C. 3 weeks D. 6 weeks
C
At which of the following ages in a young child's life is parental anticipatory guidance about toilet-training readiness most helpful? A. 12 months B. 15 months C. 18 months D. 24 months
C
At which of the following ages in an infant's life is parental anticipatory guidance about teething most helpful? A. 1 to 2 months B. 2 to 4 months C. 4 to 6 months D. 8 to 10 months
C
Characteristics of H. influenzae include: A. rare beta-lactamase production. B. antimicrobial resistance because of altered protein binding sites. C. organism most commonly isolated from mucoid middle ear effusion. D. gram-positive organism.
C
Common clinical findings in a young child with bronchiolitis include all of the following except: A. pharyngitis. B. tachypnea. C. bradycardia. D. conjunctivitis.
C
Expected outcomes with the use of varicella vaccine include a reduction in the rate of all of the following except: A. shingles. B. Reye syndrome. C. aspirin sensitivity. D. invasive varicella.
C
Girls typically grow to their adult height by: A. menarche. B. 1 year before menarche. C. 1 year after onset of menstruation. D. by their sixteenth birthday.
C
Guidelines recommend that a breastfeeding mother waits until breastfeeding is well established for approximately 6 months before using combined oral contraceptives (COC) because: A. in early breastfeeding, the amount of hormone in COC could cause significant harm to the nursing infant. B. efficacy of COC could be compromised by breastfeeding. C. milk flow could be compromised by COC. D. COC oral contraceptive use could affect mother's sleep patterns.
C
In children 2 months to 2 years old with UTI, antimicrobial therapy should be prescribed for: A. 3 to 5 days. B. 5 to 10 days. C. 7 to 14 days. D. 14 to 21 days.
C
In infants, solid foods are best introduced no earlier than: A. 1 to 3 months. B. 3 to 5 months. C. 4 to 6 months. D. 6 to 8 months.
C
In whom is serological documentation of immunity to rubella advised? A. school-aged children B. government employees C. pregnant women and women of childbearing age who could become pregnant D. healthcare workers
C
Infection with Corynebacterium diphtheriae usually causes: A. a diffuse rash. B. meningitis. C. pseudomembranous pharyngitis. D. a gastroenteritis-like illness.
C
Intervention for a child with a lead level of 5 to 44 mcg/dL usually includes all of the following except: A. removal from the lead source. B. iron supplementation. C. chelation therapy. D. encouraging a diet high in vitamin C.
C
Laboratory findings in Kawasaki disease include all of the following except: A. sterile pyuria. B. elevated liver enzyme levels. C. blood cultures positive for offending bacterial pathogen. D. elevated erythrocyte sedimentation rate.
C
Most cases of roseola caused by human herpesvirus-6 occur in: A. newborns who contracted the virus in utero. B. infants younger than 3 months old. C. children younger than 24 months old. D. children older than 2 years.
C
Most drugs pass into breast milk through: A. active transport. B. facilitated transfer. C. simple diffusion. D. creation of a pH gradient.
C
One of the most prominent clinical features of bronchiolitis is: A. fever. B. vomiting. C. wheezing. D. conjunctival inflammation.
C
Sam is a 4-year-old boy who presents with a 1-week history of intermittent fever, rash, and "watery, red eyes." Clinical presentation is of an alert child who is cooperative with examination but irritable, with a temperature of 38°C(100.4°F), pulse rate of 132 bpm, and respiratory rate of 38/min. Physical examination findings include nasal crusting; dry, erythematous, cracked lips; red, enlarged tonsils without exudate; and elevated tongue papillae. The diagnosis of Kawasaki disease is being considered. Additional findings are likely to include: A. vesicular-form rash. B. purulent conjunctivitis. C. peeling hands. D. occipital lymphadenopathy.
C
The average required caloric intake in an infant from age 0 to 3 months is usually: A. 40 to 60 kcal/kg/d. B. 60 to 80 kcal/kg/d. C. 80 to 100 kcal/kg/d. D. 100 to 120 kcal/kg/d.
C
The incidence of AOM has decreased in the past decade in part because of: A. earlier detection and treatment. B. more effective treatment options. C. an increase in select vaccination use. D. lower rates of viral infections.
C
The most common causative organism of bronchiolitis is: A. Haemophilus influenzae. B. parainfluenza virus. C. respiratory syncytial virus. D. coxsackievirus.
C
The most important aspect of skin care for children with eczema is: A. frequent bathing with antibacterial soap. B. consistent use of medium- to high-potency topical steroids. C. application of lubricants. D. treatment of dermatophytes
C
The onset of symptoms in food poisoning caused by Salmonella species is typically how many hours after the ingestion of the offending substance? A. 2 to 8 B. 8 to 12 C. 12 to 24 D. 24 to 36
C
This chromosomal syndrome is a common etiology of social and verbal developmental delays in boys: A. Tay-Sachs B. cystic fibrosis C. Fragile X D. Trisomy 18
C
To remove a drug from breast milk through "pump and dump," the nursing mother should refrain from taking the offending medication and the process must be continued for: A. two infant feeding cycles. B. approximately 8 hours. C. three to five half-lives of the drug. D. a period of time that is highly unpredictable.
C
Typical distribution of acne neonatorum consists of open and closed comedones and pustules: A. on the hands and wrists. B. on the neck and chest. C. on the forehead and cheeks. D. on the neck and ears.
C
What advice should you give to a breastfeeding mother whose 4-month-old has gastroenteritis and reports 2 loose stools and 2 episodes of vomiting within the past 4 hours? A. Switch to soy-based formula. B. Give the infant oral rehydration solution only. C. Continue breastfeeding. D. Supplement with a sugar water solution.
C
What percentage of body weight is typically lost in a child with moderate dehydration? A. 2% to 3% B. 3% to 5% C. 6% to 10% D. 11% to 15%
C
What percentage of children have an episode of pneumonia before the age of age 5? A. 18% to 20% B. 9% to 10% C. 3% to 4% D. 20% to 30%
C
When advising a patient about immunization with the nasal spray flu vaccine, the NP considers the following: A. its use is acceptable during pregnancy. B. its use is limited to children younger than age 2 years. C. it contains live virus. D. A potentially harmful virus can be shed to vulnerable household members post vaccination.
C
When counseling a breastfeeding woman about alcohol use during lactation, you relate that: A. drinking a glass of wine or beer will enhance the let-down reflex. B. because of its high molecular weight, relatively little alcohol is passed into breast milk. C. maternal alcohol use causes a reduction in the amount of milk ingested by the infant. D. infant intoxication can be seen with mother's having as few as one to two alcoholic drinks.
C
Which group is shown to have the highest rate of varicella mortality? A. children aged 6 and younger B. teenagers aged 12-19 C. adults aged 30-49 D. health-care workers
C
Which of the following best describes the pathophysiology and resulting clinical presentation of asthma? A. intermittent airway inflammation with occasional bronchospasm B. a disease of bronchospasm leading to airway inflammation C. chronic airway inflammation with superimposed bronchospasm D. relatively fixed airway constriction
C
Which of the following children is most likely to have lead poisoning? A. a developmentally disabled 5-year-old child who lives in a 15-year-old house in poor repair B. an infant who lives in a 5-year-old home with copper plumbing C. a toddler who lives in an 85-year-old home D. a preschooler who lives nears an electric generating plant
C
Which of the following is absent in otitis media with effusion (OME)? A. fluid in the middle ear B. otalgia C. fever D. itch
C
Which of the following is inconsistent with the diagnosis of asthma? A. a troublesome nocturnal cough B. cough or wheeze after exercise C. morning sputum production D. colds "go to the chest" or take more than 10 days to clear
C
Which of the following is noted in a child with premature adrenarche? A. breast development. B. accelerated linear growth. C. pubic hair. D. menstruation.
C
Which of the following is the most appropriate way to relieve fever and discomfort in a child with varicella? A. ibuprofen B. aspirin C. acetaminophen D. cold bath
C
Which of the following represents a therapeutic option for ABRS in an otherwise well 7-year-old child who has not had significant clinical improvement but is not worse after 72 hours of observation? A. continued observation B. oral levofloxacin C. oral clindamycin and cefixime D. injectable ceftriaxone
C
Which of the following should not receive vaccination against influenza? A. a 19 year old with a history of hive-form reaction to eating eggs B. A 24-year-old woman who is 8 weeks pregnant C. a 4-month-old infant who was born at 32 weeks' gestation D. A 28-year-old woman who is breastfeeding a 2 week old
C
Which of the following signs indicates possible AOM diagnosis in a preverbal child? A. loss of appetite B. colic C. tugging on the ear D. fever
C
Which of the following statements is true about the hepatitis B virus (HBV) vaccine? A. The vaccine contains live HBV. B. Children should have hepatitis B surface antibody (HBsAb, anti-HBs) titers drawn after three doses of vaccine. C. Hepatitis B immunization series should be offered to all children. D. Serological testing for HBsAb should be checked before HBV vaccination is initiated in children.
C
Which of the following viruses is a potent teratogen? A. measles B. mumps C. rubella D. influenza
C
Without intervention, approximately 40% of infants born to mothers with HBV infection will go on to: A. develop acute hepatitis B infection. B. die from chronic liver disease. C. develop chronic hepatitis B. D. develop lifelong immunity to the hepatitis B virus.
C
You examine a 15-year-old presenting with a 1-day history of sore throat, low-grade fever, maculopapular rash, and posterior cervical and occipital lymphadenopathy. The most likely diagnosis is: A. scarlet fever. B. roseola. C. rubella. D. rubeola.
C
You see a 4-year-old girl who has a 2-day history of signs and symptoms of an acute asthma flare resulting from viral upper respiratory tract infection. She is using inhaled budesonide and albuterol as directed and continues to have difficulty with increased occurrence of coughing and wheezing. Her respiratory rate is within 50% of upper limits of normal for her age. Her medication regimen should be adjusted to include: A. oral theophylline. B. inhaled salmeterol (Serevent). C. oral prednisolone. D. oral montelukast (Singulair).
C
A diet low in these nutrients encourages lead absorption: A. protein B. carbohydrates C. zinc D. magnesium
C, D
Klinefelter syndrome and risk for having a child with this condition can be accurately identified by: A. urine test B. literacy assessment C. amniocentesis D. blood test for carrier state
C, D
Regarding physiologic jaundice in the newborn, select all that are correct. A. It occurs between 12 and 24 hours of life. B. It progresses from the abdomen toward the head of the infant C. Unconjugated bilirubin is elevated. D. Risk of development of hyperbilirubinemia can be reduced in a breastfed infant with frequent breastfeeding every 2 to 3 hours per 24 hours. E. It can be avoided by supplemental water and dextrose feedings between breastfeeding in the first 3 to 4 days of life to increase hydration while mother's milk come in.
C, D
Risk factors for dyslipidemia in children include: A. BP at 70-80th percentile B. breastfeeding into the toddler years C. family history of lipid abnormalities D. family history of T2DM
C, D
A 12-month-old boy with fever who has a suspected UTI who has vomited 5 times in the past 7 hours. His last wet diaper was approximately 6 hours ago. He is accompanied by his parents. The following action should be taken: A. Recommend continued observation at home. B. Recommend antimicrobial therapy. C. Conduct renal ultrasound. D. Arrange for the child to be admitted to the hospital.
D
A 3-year-old boy with AOM continues to have otalgia and fever (≥39°C [≥102.2°F]) after 3 days of amoxicillin 80 mg/kg/d with an appropriate dose of clavulanate (Augmentin) therapy. Which of the following is recommended? A. Watch and wait while using analgesics. B. Start antimicrobial therapy with oral azithromycin. C. Initiate therapy with oral clindamycin. D. Administer intramuscular ceftriaxone.
D
A parent asks about varicella-zoster immune globulin, and you reply that it is a: A. synthetic product that is well tolerated. B. derived blood product that has been known to transmit infectious disease. C. blood product obtained from a single donor. D. pooled blood product with an excellent safety profile.
D
All of the following uropathogens are capable of reducing urinary nitrates to nitrites except: A. E. coli. B. Proteus species. C. K. pneumoniae. D. S. saprophyticus.
D
Common signs and symptoms of pertussis in a 3-year-old child include all of the following except: A. uncontrollable cough. B. vomiting. C. fatigue. D. diffuse rash.
D
Concerning the use of antipyretics in a febrile young child, which of the following statements is false? A. A child with a serious bacterial infection usually does not have fever reduction with an antipyretic. B. The degree of temperature reduction in response to antipyretic therapy is not predictive of presence or absence of bacteremia. C. Compared with ibuprofen, acetaminophen has a shorter duration of antipyretic action. D. Ibuprofen should not be used if a child is also taking a macrolide antimicrobial.
D
In general, children should ride in the back seat of the car until age: A. 10 years. B. 11 years. C. 12 years. D. 13 years.
D
In the treatment of acute otitis media in the child, which of the following antimicrobial agents affords the most effective activity against Streptococcus pneumoniae? A. nitrofurantoin. B. cefixime C. trimethoprim-sulfamethoxazole (TMP-SMX) D. cefuroxime
D
Kawasaki disease most commonly occurs in what age group? A. infants B. children aged 2 to 3 years. C. children approaching puberty D. children aged 1 to 8 years
D
Milia is usually marked by white pinpoint papular lesions found: A. on the back and buttocks. B. across the chest. C. in the underarms. D. on the nose and cheeks.
D
Patients with plumbism present with which kind of anemia? A. macrocytic, hyperchromic B. normocytic, normochromic C. hemolytic D. microcytic, hypochromic
D
Rates of sepsis in children have lowered in recent years mainly because of: A. more stringent screening and diagnosis of febrile illness. B. increased use of antipyretics. C. longer obseVrvation period in children with febrile illness. D. higher rates of select immunization.
D
Risk factors for ABRS include all of the following except: A. viral infection. B. environmental allergies. C. tobacco smoke exposure. D. beta-thalassemia minor.
D
The anticipated average daily weight gain during the first 3 months of life is approximately: A. 15 g or 0.53 oz. B. 20 g or 0.7 oz. C. 25 g or 0.88 oz. D. 30 g or 1 oz.
D
The cause of Kawasaki disease is: A. fungal. B. viral. C. bacterial. D. unknown.
D
The following symptom indicates possible acute human immunodeficiency virus (HIV) infection: A. pustular lesions in a scattered pattern. B. red wheals that begins on the face and spreads to the truck and extremities. C. vesicular-form skin lesion. D. maculopapular rash.
D
The most common reason for precocious puberty in girls is: A. ovarian tumor. B. adrenal tumor. C. exogenous estrogen. D. early onset of normal puberty.
D
The rate of bronchiolitis is highest in which age group: A. toddlers. B. school-aged children. C. preschool children. D. infants younger than age 2 years.
D
The urinary tract abnormality most often associated with UTI in younger children is: A. bladder neck stricture. B. ureteral stenosis. C. urethral stricture. D. vesicoureteral reflux.
D
These results increase the likelihood that the cause of the above-mentioned child's infection is: A. viral. B. parasitic. C. fungal. D. bacterial.
D
Universal infant vaccination against HBV was recommended in what year? A. 1972 B. 1978 C. 1982 D. 1991
D
Usual treatment option for a child with hepatitis A includes: A. interferon alpha. B. ribavirin. C. acyclovir. D. supportive care.
D
When advising parents about injectable influenza immunization, the clinician considers the following about the vaccine: A. The vaccine is contraindicated with a personal history of an anaphylactic reaction to eggs. B. Its use is limited to children older than 2 years. C. The vaccine contains live virus. D. Its use is recommended for members of households of high-risk patients.
D
When evaluating the urinalysis of a 10-month-old infant with UTI, the NP considers that: A. leukocytes would be consistently noted. B. proteinuria is usually absent. C. the presence of urobilinogen is commonly noted. D. 20% of urinalyses can be normal.
D
Which is possible reason for delayed onset of puberty in a 13-year-old girl? A. history of abdominal irradiation B. obesity. C. report of a high level of physical activity D. Turner syndrome
D
Which of the following antimicrobials provides effective activity against atypical pathogens? A. amoxicillin B. cefprozil C. ceftriaxone D. clarithromycin
D
Which of the following does not represent a risk factor for recurrent AOM in younger children? A. pacifier use after age 10 months B. history of first episode of AOM before age 3 months C. exposure to second-hand smoke D. beta-lactam allergy
D
Which of the following is appropriate advice to give to a mother who is breastfeeding her 10-day-old infant? A. "Your milk will come in today." B. "To minimize breast tenderness, the baby should not be kept on either breast for more than 5 to 10 minutes." C. "A clicking sound made by the baby during feedings signifies a good latch and suck." D. "The baby's urine should be light or colorless."
D
Which of the following is most likely to be noted in a 3 year old with CAP? A. complaint of pleuritic chest pain B. sputum production C. report of dyspnea D. tachypnea
D
Which of the following is not a risk factor for asthma death? A. hospitalization or an emergency department visit for asthma in the past month. B. current use of systemic corticosteroids or recent withdrawal from systemic corticosteroids. C. difficulty perceiving airflow obstruction or its severity. D. rural residence.
D
Which of the following is one of the more common sources of hepatitis A infection in the United States? A. receiving blood products B. ingestion of raw shellfish C. drinking municipally sourced tap water drinking water D. exposure to fecally contaminated food
D
Which of the following statements is correct about the varicella vaccine? A. This vaccine contains killed varicella-zoster virus (VZV). B. A short febrile illness is common during the first days after vaccination. C. Children should have a varicella titer drawn before receiving the vaccine. D. Rarely, mild cases of chickenpox have been reported in immunized patients.
D
Which of the following statements is true about oral poliovirus vaccine (OPV)? A. It contains killed virus. B. It is the preferred method of immunization in North America. C. Two doses should be administered by a child's fourth birthday. D. After administration of OPV, attenuated live poliovirus can be shed from the stool.
D
Which would not be found in newborns? A. best vision at a range of 8-12 inches B. presence of red reflex C. light sensitive eyes D. lack of defensive blink
D
You are making rounds in the nursery and examine the neonate of a mother who is HBsAg-positive. Your most appropriate action is to: A. administer hepatitis B immune globulin (HBIG). B. isolate the infant. C. administer hepatitis B immunization. D. give hepatitis B immunization and HBIG.
D
