Pediatric Nurse Practitioner Practice Exam

These questions are part of the practice quiz. Start practicing

• Hemolysis does not contribute to which problem in sickle cell disease?
• In a child with known risk factors for TB, a Mantoux reaction of what induration is considered positive?
• A 5-year-old who received BCG vaccine as an infant has a 10-mm PPD after 48 hours. How should this PPD be interpreted?
• A 14-year-old with cerebral palsy who is nonambulatory but uses a wheelchair and can perform self-care tasks best fits which CP subtype?
• Which antibiotic is not a typical first-line option for strep pharyngitis?
• Which of the following is not a common source of lead exposure?
• What is the cause of molluscum contagiosum?
• Which diagnostic step is used to visualize a corneal abrasion after staining?
• Which finding would be most likely associated with asymmetric intrauterine growth retardation?
• Which of the following does not suggest a urinary tract infection?
• Which treatment is appropriate for Hirschsprung disease?
• A neonate with abnormal newborn screening showing low T4 and elevated TSH should be managed by which step?
• Which is proper management for pityriasis alba?
• A 5-year-old presents with a 3-day history of sore throat, fever of 101–103 F, headache, and one episode of vomiting. Exam shows enlarged tonsils with erythema and palatal petechiae; the nose is clear. The best course of action is to:
• Sally, a 9-year-old with moderate persistent asthma, is still having mild symptoms. You alter this treatment to include which of the following?
• A 2-year-old child presents with periumbilical abdominal pain and vomiting that began this morning. The examination is noncontributory except for tenderness around the umbilicus. The differential includes appendicitis. What should you do next?
• Which age range best describes when the Moro reflex typically disappears?
• When asked at a prenatal visit how to feed an infant—breast or bottle—how should the PNP respond?
• For a 12-year-old with acute diarrhea, which test is used to confirm the diagnosis?
• A new parent asks why a light is shined in the infant's eyes. The PNP tells the parent that the infant must be checked for a red reflex in each eye to rule out:
• A 5-year-old presents with a drop-foot gait and lifts the leg to clear the toes. Which condition is most consistent?
• Which of the following would not be associated with an uncomplicated concussion?
• Public Laws 94-142 and 101-476 mandate that a child with disabilities is entitled to:
• Concurrent otitis media & conjunctivitis is likely due to which organism?
• A child diagnosed with HIV can best be monitored by assessing which of the following?
• Role-play with equipment during the course of a physical exam would be most beneficial with which age group?
• Duchenne muscular dystrophy typically leads to wheel-chair dependence by which age range?
• Appropriate laboratory tests to obtain in assessment of cervical adenitis include all of the following except:
• An 8-year-old afebrile child presents with a sore throat; on exam, his tonsils are 4+ without exudate. Differential diagnosis includes which of the following?
• Which feature is characteristic of erythema multiforme lesions?
• Which institution legally defines the scope of practice for pediatric nurse practitioners?
• When counseling a family about congenital cytomegalovirus (CMV) infection and hearing, which statement is MOST accurate?
• Which of the following is an appropriate long-term management strategy for pityriasis alba?
• Which of the following is not commonly used to treat condylomata acuminata?
• Which symptom listed in the case is characteristic of diabetic ketoacidosis?
• Which of the following does not characterize the lesion of malignant melanoma?
• A 3-week-old infant is being breastfed and the mother wants to know signs of adequate intake besides weight gain. Which sign would the mother observe?
• When approaching adolescents about sensitive issues, such as drug use and sex, an effective interviewing approach is to:
• For preterm infants, immunizations should begin based on corrected age. Which statement is true?
• Which combination should be administered at the 23-month visit given the child’s immunization history (9 months and 13 months schedules described)?
• Which statement about acute osteomyelitis is true?
• A 3-year-old who sucks his thumb raises concerns about dental problems. The nurse explains which of the following?
• A parent presents after a newborn evaluation with hypotonia; what is the best next step for the clinician?
• Which statement is true for idiopathic scoliosis, which occurs primarily in adolescents?
• In the case of a 13-year-old with difficulty walking and a cold 2 weeks ago, what is the most appropriate initial action?
• In assessing a 6-year-old with lifelong fruit allergies, which history question should be asked FIRST?
• Which of the following is appropriate advice for the mother of a newborn?
• An adolescent with painful vesicular skin lesions has the most likely diagnosis. Which is it?
• Which fine motor milestone is most characteristic of a 12-month-old?
• What is the most common chromosomal pattern found in Turner syndrome?
• Which of the following is not a typical clinical feature of Kawasaki disease?
• RSV infection in infants and young children commonly presents with which combination?
• The most important diagnostic measure for identifying tuberous sclerosis is:
• A parent requests that her 6mo old child receive immunoglobulin as protection against hepatitis A prior to international travel. Which of the following does this parent need to know?
• In evaluating a child with growth failure, which screening tests are most relevant and cost-effective?
• Which finding is commonly associated with pediatric Cushing syndrome?
• Which management measure would you not prescribe to treat diaper dermatitis?
• A teenager sustains a puncture wound in the sole of a foot after stepping on a protruding nail. The most appropriate INITIAL management of this injury would be
• For a two-year-old twins where one twin is verbal and the other is nonverbal and fearful, the most appropriate intervention is
• Which characteristic is most concerning in a school-age patient with a cardiac murmur?
• In adolescent acne, which statement is NOT true?
• Fragile X syndrome is inherited in which pattern?
• During a well-child visit, what should the pediatric nurse practitioner do first when the infant is asleep in the parent's arms?
• Which environmental management step is recommended in scabies treatment?
• Which option best describes the purpose of a Mantoux tuberculin skin test in pediatric care?
• A 4-year-old child with chickenpox has vesicles on the skin of the right eyelid and eye pain with blurred vision. The PNP should treat the condition by:
• Which statement is most accurate about inhaled corticosteroids in pediatric asthma?
• Which of the following describes the weight pattern for a baby who weighs 6.5 lb at birth when weighing around 12 months?
• In a 5.5-year-old Asian child who has fallen off the growth curve, the best intervention is to:
• Which observation during a pediatric exam demonstrates the function of the oculomotor nerve?
• If Monospot test is negative in a presentation suggestive of infectious mononucleosis, which test would most reliably confirm EBV infection?
• In a 9-month-old with sensorineural hearing loss, which diagnostic test offers the highest cost-benefit ratio to determine etiology?
• According to the material, at what age should Pap testing begin?
• A child with upper respiratory symptoms and a grayish-white pseudomembrane in the throat most suggests diphtheria when accompanied by which fever/airway findings?
• Which factor does NOT predispose a pediatric patient to thrush?
• Which symptom is commonly associated with rubella infection in adults?
• What is the most common cause of tic disorders in children?
• Which of the following is not found in an adolescent with untreated Graves disease?
• A 12-year-old presents with peri-umbilical pain that limits standing and fever to 102°F. What is the most appropriate FIRST action?
• A 1-year-old with fever and left flank pain, nitrates and leukocyte esterase on dipstick; which action is correct?
• SBE prophylaxis is recommended for which of the following groups?
• A principal clinical feature of Kawasaki disease includes:
• An 18-month-old child has rash and fever (103ºF) for 5 days with bilateral conjunctivitis, dry cracked lips, and strawberry-like tongue. Cervical lymphadenopathy and a heart murmur are noted. The PNP should:
• Internationally adopted children should be tested for which combination of infections?
• When evaluating a 12-year-old with rhinitis and facial pain, which statement about testing for sinusitis is most accurate?
• Which organism is most likely to cause Bordetella pertussis infection in a school-aged child?
• When switching from short-acting to long-acting methylphenidate, which factor is a key consideration?
• Which medication is primarily used for absence seizures?
• Which statement is true about the risk of cervical injury from induced abortion as discussed?
• A typical febrile seizure is most likely to be the problem of which of the following children?
• Which statement best describes siblings' experience when a child is seriously ill or injured?
• Which adolescent is considered the MOST likely to abuse illicit drugs?
• Pinworms can cause which of the following?
• Regarding pityriasis alba in AF, which statement about prognosis is correct?
• Which statement best describes hyperthyroidism in adolescence?
• A 12-year-old girl with enlarged breasts and areolas and curly pubic hair is classified using Tanner staging as which stage?
• Blood pressure measurement should begin at well-child visits at what age?
• The MOST important rationale for using combined oral contraceptives in an adolescent with primary dysmenorrhea includes that hormones do what?
• Which symptom is not typical of ADHD?
• Which laboratory test is routinely included in the evaluation of metabolic disorders in the newborn period?
• Which clinical finding would not suggest an eating disorder with purging component?
• In suspected infantile botulism, which diagnostic approach is commonly pursued to identify the etiologic agent?
• Which of the following is a major contributor to asthma morbidity and mortality?
• Which physical finding is often seen in adolescents with Fragile X syndrome?
• Varicella zoster infection is most commonly associated with which skin lesion?
• In a child with suspected acute bacterial sinusitis, which finding would most strongly suggest antibiotics are indicated?
• Cafe au lait spots are present and evaluation is often performed to rule out which associated disorder?
• In a child with chronic sinusitis, the most accurate method of identifying abnormalities is:
• A 9-year-old with primary enuresis asks about treatment options. The family should be told which statement is true?
• Which presenting symptom might alert the PNP to the presence of a possible genetic disorder?
• Which description best captures the ADHD symptom pattern in a school-age child?
• S/S associated with Duchenne muscular dystrophy are:
• The incidence of epiglottitis has decreased because of which vaccine?
• Which finding is not typically associated with allergic rhinitis?
• For licensed day care centers, which infant-to-adult ratio is appropriate when caring for infants?
• What is the best management for erythema toxicum neonatorum?
• A preschool child who says the sky is blue because it is his favorite color demonstrates which concept?
• A postterm neonate in the nursery is being examined. Which finding would you expect?
• Antonio is a newborn and both feet turn in. When attempting ROM, both feet move relatively freely in all directions. Antonio has:
• Renal tubular acidosis type 1 true statement: which of the following?
• In a child with knee pain, which area should also be examined to assess referred pain?
• The mother is concerned that her 3-year-old child has begun stuttering over the past 4 to 6 weeks. The PNP should:
• Which statement best describes licensure?
• Which of the following is an atypical behavior trait in autistic children?
• A 15-year-old pregnant test is positive. The PNP should advise the adolescent to first:
• After one month of ferrous sulfate therapy for iron deficiency anemia in an infant, what is the recommended course of action?
• In an afebrile 3-year-old with limp after a viral illness, which diagnosis is MOST likely?
• Which statement is NOT a contraindication to routine vaccination?
• Which exposure increases melanoma risk in childhood?
• In a malpractice claim, which statement completes the triad alongside duty and breach of standard of care?
• A 10 month old has had apparent abdominal pain for the past 4 hours. During episodes of pain, the infant screams inconsolably and draws his legs towards the abdomen, has vomiting but no diarrhea. Between episodes the infant is calm. The MOST LIKELY diagnosis is
• An at-risk 10-year-old with a history of anaphylactic reactions to stings is prescribed an epinephrine auto-injector (1:1000) 0.3 mg. Which instruction is MOST appropriate?
• A 5.5-year-old child who has fallen off the growth curve—another valid intervention is to:
• Which medication should be avoided in a child with ITP?
• In which child would you most suspect hyperthyroidism?
• Wheezing in a child may not be found in which of the following conditions:
• A neonate with a spongy area over the parietal region is diagnosed with craniotabes. The best next step is to
• A conjunctivitis appearing in a 2 day old newborn is likely due to:
• A 3-month-old infant cannot elicit a red reflex in the right eye. What is the most appropriate next step?
• Which of the following features is most closely associated with paralytic poliomyelitis?
• What is the peak incidence age range for osteosarcoma?
• A 6-year-old with attention difficulties and disruptive behavior: what is the most appropriate initial action in evaluation for ADHD?
• A 12-month-old with developmental concerns should be followed for readiness and screening in which area?
• A 6-year-old in foster care is brought to the clinic; which immunizations are recommended today based on the record provided?
• The time of ovulation is usually:
• A 7-year-old with type 1 diabetes has a morning blood glucose elevated to 250 mg/dL with ketones in the urine after several days; what advice would the PNP give?
• A 2.5-year-old is brought to the clinic because of vomiting, low-grade fever, and frequent watery stools for the past 24 hours. The PNP suggests:
• Which statement reflects one of a young child's greatest fears?
• When describing levothyroxine administration for congenital hypothyroidism to parents, which is important to reinforce?
• A 4-year-old is unable to sit cross-legged and rise without using the hands; the pediatric nurse practitioner is concerned that the child may have a:
• The virus that causes hand, foot, and mouth syndrome is:
• Erythema toxicum neonatorum most commonly appears during which period of life?
• Which imaging study is best to confirm hip dysplasia in a 4-week-old infant with positive Barlow and Ortolani tests?
• For a child with intermittent asthma, which therapy is used only to treat symptoms?
• An 11-year-old girl is concerned about breast size and has noticed uneven development since it began. Which statement is the most appropriate reassurance?
• A 9-year-old boy with fever to 102 F and leg pains; tender swollen knees; a blowing systolic murmur at the apex. The most likely diagnosis is:
• Which statement best describes caput succedaneum?
• Which patient is NOT at increased risk for developing otitis media?
• For children 1-4 yrs of age, the most common cause of head injury is:
• What is the appropriate initial step when a parent declines immunizations?
• Daily eyelid cleansing with diluted baby shampoo and a cotton-tipped applicator would be appropriate in the treatment of which condition?
• The Dubowitz tool is used to estimate what?
• The mother of a 4-year-old female patient reports that the child frequently awakens screaming and agitated about 1 hour after falling asleep and does not appear to recognize her mother. The child falls asleep again within 10 minutes and does not recall these events in the morning. The pediatric nurse practitioner should:
• A 4 week old has short palpebral fissures, hypoplastic philtrum and low nasal bridge with current symptoms of a poor suck and jitteriness. Which of the following in-utero exposures is most likely?
• Which criteria is essential for the diagnosis of obsessive-compulsive disorder (OCD) for children?
• Which of the following statements would be considered subjective data obtained from the client during the review of systems for the skin?
• Which feature is characteristic of rubella infection?
• Which vaccine is contraindicated for an immunocompromised child?
• A newborn of an HIV-positive mother; priority for neonatal care?
• Which statement best reflects the migratory pattern of abdominal pain in acute appendicitis based on the vignette?
• Chest pain in young children is usually?
• Which physical finding is a recognized diagnostic criterion for NF1?
• Which option best describes the primary purpose of standards of practice in healthcare?
• Which patient group is explicitly listed as needing endocarditis prophylaxis despite prior repair?
• The most important evaluation of a 6-year-old male with an acute, palpable varicocele is to
• Which laboratory finding would support a diagnosis of pertussis in an adolescent?
• Which is not part of the initial treatment of a sprain?
• A 16-year-old adolescent who was jogging in 90°F heat is found confused. What is the initial management by the pediatric nurse practitioner?
• A 5-year-old child is brought for a prekindergarten physical. The child has an egg allergy with GI symptoms. Which immunizations would be appropriate today?
• Which food would be appropriate for a child with celiac disease?
• Which POST competition guidance is most helpful for best nutrition practices for the athlete?
• The BEST option for a 2-year-old with public temper tantrums is to:
• After tympanostomy tube insertion, which method may be used to determine patency?
• Hypercholesterolemia in children over 2 years is defined as total cholesterol at or above:
• Which finding would you expect to occur in a baby with intussusception?
• At a 4-month well-child visit, which vaccine combination is appropriate for an infant who has already received Hep B at birth and at 1 month?
• In a term infant with unilateral undescended testis, when should pediatric surgery be considered if the testis remains undescended?
• In suspected appendicitis, which of the following may occur?
• In an infant with vomiting and thriving weight gain, which finding supports overfeeding rather than pyloric stenosis?
• Which of the following is NOT an acceptable management option for allergic rhinitis?
• In routine workup for developmental delays, which test is included?
• Which statement represents a key benefit of physical therapy for a moderate-to-severe ankle sprain?
• All but which of the following conditions requires urgent inpatient admission?
• Which statement describes a recommended approach to managing pityriasis rosea?
• Billy's family eats at fast food restaurants 4-5x/week. If you suspect the diarrhea is infectious in nature, which organism is likely causative?
• In pediatric glomerulonephritis, which of the following is not typically part of standard care?
• An 15-year-old girl with delayed puberty: which current finding would support the diagnosis of delayed puberty?
• Which statement correctly describes autosomal dominant inheritance?
• A 3-year-old child has hypochromic, microcytic anemia. Which condition should be included in the differential diagnosis?
• For monitoring an infant on an aminoglycoside, which type of monitoring is essential?
• Which finding on physical examination is most consistent with meningitis in a neonate being evaluated for infection?
• The described familial pattern of von Willebrand disease across multiple generations is best described as which inheritance pattern?
• In a febrile child, when is antipyretic treatment commonly considered?
• A painless, non-tender scrotal mass that transilluminates on exam is most consistent with which diagnosis?
• In performing a physical examination on a 9-month-old infant, which developmental fear would not be appropriate to consider?
• Which statement about MMR vaccination timing is supported by the immunization history?
• Which vaccine is given at birth?
• When counseling an adolescent vegetarian, which nutrient combination is most essential to ensure adequate intake?
• In a child with suspected elbow dislocation after a fall, what is the most appropriate action?
• An 8-year-old with moderate persistent asthma continues to have a daily cough despite using a short-acting inhaled beta2 agonist and cromolyn sodium. Which change should be added to the management plan?
• A young child has had nasal congestion and a runny nose with a green discharge for 3 weeks. Which physical finding would be particularly worrisome and indicate the need for further evaluation?
• A 15-year-old with acne; an appropriate plan of care would include
• Which finding is most specific to purging behaviors in eating disorders?
• The past history should include
• A 2-year-old uncircumcised boy presents with retracting foreskin, discoloration, and glans swelling. The most likely diagnosis is?
• Which factor is a reason why adolescent parents are at greater risk for abusing their newborns?
• Which scenario does not meet the criteria for selective screening for hyperlipidemia?
• Which statement best describes the CBC pattern consistent with iron deficiency anemia in a toddler?
• Which statement about type 1 diabetes in children is true?
• A patient has folliculitis caused by the most common organism. Which antibiotic is most appropriate to prescribe?
• Which testing should internationally adopted children receive?
• Classic malaria symptoms include which of the following?
• Muscle spasms in tetanus are aggravated by what?
• An infant who recognizes parents, sits independently for 1-2 minutes, rolls over from supine or prone, drops one object when another is offered, and babbles one-syllable sounds is approximately how old?
• At the 4-month well-child visit, which vaccine combination is recommended?
• Which is a sign that may indicate seizures in a child with cerebral palsy?
• Adam’s forward bend test is used to screen for scoliosis by observing which of the following findings during forward bending?
• Management of the infant with suspected heart disease and cyanotic spell should include which of the following?
• Patients with epiglottitis prefer to sit in which position?
• Which finding in a 6-month-old is most suggestive of cerebral palsy?
• Which treatment option is most appropriate for pediculosis capitis in a school-age child?
• A patient presents with a thin, white, malodorous vaginal discharge. What is the most likely diagnosis?
• Which parental characteristic is associated with an increased risk of child maltreatment?
• At 12 months, an HIV-positive child with the described immunization history should receive which vaccines today?
• A 3-year-old with non-severe acute otitis media is seen in the clinic. Which management is appropriate?
• Which method would best confirm chlamydia conjunctivitis in a newborn?
• Which immunization guideline applies to a 3-year-old who recently completed chemotherapy for acute lymphoblastic leukemia (ALL) two months ago?
• Johnny, a 16-year-old, is told that the most common type of headache with onset in adolescents is which of the following?
• In addition to penicillin, which antibiotic is NOT appropriate for treating strep pharyngitis?
• A previously healthy 4-year-old with acute sinusitis should be treated with which therapy first-line?
• The parents of a 3-year-old child have noticed that the child experiences episodes of abrupt, brief loss of consciousness many times during the day. The PNP suspects that the child is having:
• Which vaccine provides protection against a common cause of sepsis and meningitis in children?
• A 2-week-old infant is brought to clinic by a 15-year-old mother. What is the primary goal of this visit?
• Which description best matches Tanner stage 3 pubertal development?
• Which milestone is the earliest in the typical infant motor development sequence?
• Licensure is:
• Infants under 6 months with pertussis are often hospitalized for which combination of symptoms?
• For a child with four episodes of acute otitis media in the past five months, what management is currently advised?
• In acute uncomplicated sinusitis, which statement is true?
• In suspected testicular torsion, the primary management is...
• During a 2-week-old well-child visit, which question would be most appropriate to address safety counseling?
• Which of the following is NOT a characteristic feature of DiGeorge syndrome in the provided material?
• A 15-year-old with jaundice and nausea raises concern for a pregnancy-related condition. Which diagnosis is most likely?
• Standards of practice may be used to:
• For children aged 5–11 years with diabetes, the recommended blood glucose range is:
• Which ocular finding is commonly associated with Down syndrome?
• For a 10-month-old who weighs 21 pounds, what is the most appropriate instruction regarding car seats?
• A parent reports that her 18-month-old cries during the entire aerosol asthma treatment with albuterol and budesonide. What is an alternative management?
• A mother calls after her 2-year-old has had fever and diarrhea for 5 days with multiple stools. What is the most appropriate initial advice?
• Which statement about antipyretic use in a feverish toddler is most appropriate?
• Ascaris lumbricoides is transmitted primarily through which route?
• Which term is used to describe nasal discharge in congenital syphilis?
• Jamil has had diarrhea for 3 days. Which of the following would not be helpful advice?
• Standards for well child care and health promotion are set forth by the:
• Malignant melanoma not characteristic. Which of the following is not characteristic of this condition?
• In ADHD management, which nonpharmacologic approach is commonly recommended as part of initial treatment?
• Which BEST represents the description of Tanner stage 3 in an adolescent female?
• To prevent transmission of tinea corporis, which measure is most important?
• Inheritance of tuberous sclerosis is by:
• If a 6-month-old exclusively breastfed infant's solid foods are delayed until 12 months, which nutrient is most likely deficient?
• Which physical finding is not consistent with gestation of less than 12 weeks?
• During a preadmission college physical, which vaccine is typically discussed as needed?
• What is the single most predictive factor in the development of bronchopulmonary dysplasia?
• Which statement about the pediatric nurse practitioner's scope of practice is most accurate?
• According to Erik Erikson, which is the cornerstone of vital personality?
• A birth dose of Hep B vaccine is given with HBIG because the mother is HBsAg positive. HBIG provides which type of immunity?
• The Denver II screening tool is designed for children within which age range?
• Which feature is commonly associated with Down's syndrome in a neonate?
• A term newborn with birth weight below the 10th percentile but length at the 50th percentile most likely represents which type of IUGR?
• For a 7-year-old with type 1 diabetes, the diet should consist of which macronutrient distribution?
• A patient with acne is being treated with various antibiotics. Which antibiotic would you not consider using?
• In regards to generalized anxiety disorder (GAD), evidence has shown that
• Which statement is most accurate concerning pain assessment in the pediatric patient?
• Which statement correctly describes fifth disease?
• Which congenital bleeding disorder is most commonly diagnosed?
• Klinefelter's syndrome in adolescence typically presents with which finding?
• Which management step is NOT recommended for scabies?
• An 8-year-old with precocious puberty has abdominal cramps and increased vaginal discharge while on hormone therapy and has missed 6 months of treatment. Which intervention is most appropriate to address the abdominal pain?
• In a 19-month-old with a five-minute generalized shaking episode followed by brief unresponsiveness, the initial appropriate management includes which of the following?
• A 9-year-old presents with a 10-day history of nasal symptoms consistent with sinusitis. Management should include:
• For a well-appearing toddler, what is the recommended approach to the physical examination?
• A 17-year-old adolescent attended a party and returned home. The grandmother reports the eyes look puffy, the pupils are slow to react or nonreactive, and tearing is present. Which substance is most likely involved?
• A toddler has remained in the 5th percentile for height and weight since birth without crossing percentiles. What is the most accurate interpretation?
• What is the typical appearance of molluscum contagiosum lesions?
• Which health problem is most commonly seen among children in foster care?
• A dark-skinned 14-year-old adolescent presents with a nonpruritic rash with loss of pigment; The PNP diagnoses tinea versicolor and treats with:
• When a mother of a 5-month-old breastfed infant asks about weaning, what is the recommended approach?
• An 18-year-old female presents with abdominal pain that began around the periumbilical area and migrated to the right lower quadrant, with guarding and tenderness but normal vitals. What is the most likely diagnosis?
• A 5-year-old child has sudden onset of nonblanching purpuric lesions scattered over the body and petechiae, with a platelet count of 20,000/mm3. What should the PNP do next?
• Which symptom pattern is most characteristic of intussusception in an infant?
• Which statement about immunizations during active chemotherapy is correct?
• Which statement best describes alarm therapy for enuresis, based on the material?
• The most definitive feature for a diagnosis of growing pains includes:
• An example of a genetic disorder occurring because of genomic imprinting is:
• PSAGN statement: which is correct?
• Which test is the most sensitive early indicator for musculoskeletal inflammatory disorders?
• A 3-month-old who cannot remain seated upright without support will most likely achieve a seated position with support by which age?
• A 2-month-old with a 3-day history of stuffy nose and poor sleep but no fever or respiratory difficulty. What is the most appropriate guidance?
• During a newborn eye examination you note white specks around the iris circumference. Which finding is appropriate to assess next?
• In a child with headaches, nausea, and vomiting, which symptom would most strongly suggest a brain tumor?
• During the preschool years, which type of play is likely to decrease?
• Which should be included in the plan of care for preterm infants?
• The pediatric nurse practitioner suspects domestic violence; the best approach is to?
• The most accurate test to determine whether a 6-week-old HIV-exposed neonate is HIV positive is:
• Which motor development milestone is typical for a 2-month-old infant?
• Unilateral wheezing in a child is most suggestive of which condition?
• Premenstrual syndrome management: which option is most appropriate for a teen who declines NSAIDs?
• In Tanner staging, which features define Tanner stage II in girls?
• Head and chest circumferences should be equal by about which age?
• A 9-year-old with a rash and detected speech dysfluency requires which of the following actions?
• In evaluating pityriasis rosea in an adolescent, screening should include which condition?
• Jerry has folliculitis. What is the most common cause of this condition?
• An 8-year-old child with an eye injury shows a vertical linear abrasion after a foreign body. The fluorescein test is positive, pupils are equal and reactive, and no foreign body is visible. An appropriate plan of care would include:
• Which combination of findings is most consistent with fetal alcohol effects in a child with unknown prenatal history?
• Which statement about family-centered care is NOT accurate?
• Which agency administers the School Lunch, WIC, and Food Stamp programs?
• Which statement about genital warts management is true?
• Buffalo-type adiposity of face, neck, & trunk is a characteristic finding in which condition?
• Conductive hearing loss can be caused by:
• If an infant with vomiting and diarrhea has stopped and oral replacement therapy is needed today, what is the appropriate amount to recommend over 4 hours?
• Adolescent girls are especially prone to developing which of these disorders?
• What is the preferred treatment of choice for syphilis?
• Which sign is commonly associated with Graves disease in adolescents?
• In a child with lipomyelomeningocele, new back pain with changes in bowel and bladder function suggests tethered cord.
• Which of the following conditions would be most likely to occur in a 4-year-old boy?
• Nephrogenic diabetes insipidus is caused by:
• At a party, which item is a common latex trigger that should be avoided in a latex-allergic child?
• Which accompanying finding most supports pyloric stenosis in an infant with vomiting?
• The Moro reflex typically disappears during infancy in which approximate age range?
• Which regimen is appropriate for streptococcal pharyngitis in a child with no penicillin allergy?
• In autism diagnostic criteria, which core feature is described alongside social communication deficits?
• A 7-year-old child with no history of immunizations and no varicella history is seen. Which immunizations are required at this visit?
• A mother asks how to decrease discomfort in her 9-year-old with an upper respiratory infection. Which instruction is appropriate?
• When evaluating a preschooler with bifid uvula and palatal contour abnormalities, which assessment is most appropriate to assess potential speech issues?
• Giardia infection is caused by which organism?
• A 3-year-old begins waking at night frightened with nightmares. What is the best approach?
• The peak incidence for adolescent gynecomastia occurs at which age range?
• A 6-year-old presenting with fever, cough, and left lower chest findings has left base decreased breath sounds. Which diagnostic test is most appropriate to order next?
• Medical professionals are legally required to report abuse when:
• Labial adhesions have their highest incidence in which age group?
• Which of the following is a differential diagnosis to consider when evaluating ADHD symptoms?
• A parent calls regarding the use of over-the-counter medications for a 2-year-old with fever of 101.2°F who has been alternating acetaminophen and ibuprofen every 3 to 4 hours. Which counseling is appropriate?
• A teen who frequently eats fast food is most likely deficient in which nutrients?
• Pain produced by manipulation of the auricle or pressure on the tragus suggests which condition?
• The MOST appropriate treatment for documented Lyme disease in a 5-year-old who weighs 55 lb (25 kg) is
• A 2-year-old child with bowing of the legs; the PNP should
• The inheritance pattern described by several generations in a family with von Willebrand disease is best called what?
• Which entity is responsible for legally defining the scope of practice for pediatric nurse practitioners?
• The most common skull fracture in children with excellent prognosis is:
• A 9-month-old presents with irritability and developmental concerns; an exam reveals a cherry-red spot on the retina. Which disease is most consistent?
• Which statement best describes pediatric syncope in most cases?
• Prior to splenectomy, which preventive measure is recommended to reduce infection risk?
• An 8.5-year-old boy presents with penile length of 6.2 cm. Which additional finding is associated with precocious puberty?
• A 6-year-old child with asthma is brought to the clinic because the parents have noticed daily wheezing for the past week, especially during the night. The PNP recognizes that this may indicate the child has:
• Standards for well-child care and health promotion are set forth by which organization?
• Which diagnostic finding is consistent with X-linked agammaglobulinemia?
• Which statement is not correct regarding the etiology or incidence of psoriasis vulgaris?
• Informed consent is characterized by which duty?
• According to NIH guidelines for management of moderate-persistent asthma in a school-aged child, which daily plan is the BEST INITIAL recommendation?
• Which infant reflex should not disappear by 6 months?
• One of the most appropriate agents used to treat influenza A is which antiviral medication?
• Which statement is not characteristic of constitutional growth delay?
• Two irregular blue-gray discolorations over the sacral area of a 4-week-old infant are most likely due to which etiology?
• When evaluating a child with suspected inflammatory bowel disease, which of the following diagnostic tests would not be helpful?
• Once a child is started on oral iron therapy for iron-deficiency anemia, what changes are evident in laboratory studies?
• Which statement about spacer use with a metered‑dose inhaler in children is accurate?
• A 16-year-old female adolescent with Down's syndrome, healthy and mainstreamed, who has Tanner stage III breast development and pubic hair, today the PNP should:
• A 14-year-old adolescent has early hypothyroidism. The management plan includes which of the following?
• A preterm infant born at 31 weeks’ gestation, now 4 months old, with no major complications other than a minor intraventricular hemorrhage at birth. If the local RSV season is approaching, what RSV prophylaxis schedule should the PNP consider today?
• Which murmur is commonly described as vibratory murmur or Still's murmur in children?
• In a full-term neonate with early-onset jaundice and a large cephalohematoma, which is least likely to be the cause?
• At what age should Pap testing begin, according to the material?
• In male puberty, Tanner stage III is distinguished from stage II by which change?
• A 2.5-week-old infant has irritability when lifted and an asymmetrical Moro reflex, with a spasm of the left sternocleidomastoid. The most likely diagnosis is:
• Which bleeding manifestation is most characteristic of severe factor VIII deficiency?
• At a 5-month-old well-child visit, today the infant should receive which immunizations?
• In a 5-year-old who has not received any immunizations, which vaccine is not routinely indicated at this age?
• Which statement about HPV infection is true?
• Which diagnostic finding is consistent with Wiskott-Aldrich syndrome?
• The most likely weight of a 1-year-old child with birth weight 6.5 pounds is:
• The common practice using 'time outs' with young children is direct application of:
• What is the best treatment for the described burn?
• When approaching adolescents about sensitive issues, which interviewing approach is recommended?
• The nighttime waking of a 12-month-old: which option best helps prevent reinforcing the habit?
• A pediatric nurse practitioner suspects autism spectrum disorder in a 2-year-old. What is the best immediate course of action?
• In evaluating a child for suspected growth delay, which test best assesses skeletal maturity?
• The most common hematological presentation of leukemia in children is anemia along with which of the following?
• Which finding in an adolescent with pelvic inflammatory disease (PID) is an indication for hospitalization?
• A 16-year-old adolescent presents with chest pain. Based on common pediatric data, which is the most likely cause of cardiac pain?
• Individals with chronic adrenal insufficiency often have which symptom?
• Which statement regarding slipped capital femoral epiphysis is true?
• At what age does separation anxiety typically peak?
• A 12-month-old with non-retractile foreskin and a prior urinary tract infection; what is the recommended action?
• In adolescent confidentiality discussions, which statement is correct for an adolescent who is 18 years old or older or under the state age of majority?
• A 12-month-old child is brought to the clinic for routine anemia screening. The hemoglobin level is 9.5 g/dL, and iron sulfate is prescribed at a dosage of:
• Which technique is most effective in communicating with a shy, 4- to 5-year-old patient?
• Appropriate management of a full-term, 3-day-old, breastfed infant with a bilirubin level of 16 mg/L would consist of:
• Which statement about pediatric asthma management goals is accurate?
• In pediatric primary care, what is the most common form of child abuse seen?
• An infant with polydipsia, polyuria, irritability, and failure to thrive should be evaluated for:
• Adolescent with signs of hyperthyroidism; which lab pattern is expected in hyperthyroidism?
• A 7-year-old who fell and had a negative initial wrist X-ray is treated with a sling. Ten days later, pain persists with point tenderness. What is the NEXT step?
• After a first febrile UTI, which imaging strategy is recommended if the child experiences a second febrile UTI?
• According to the National Asthma Education and Prevention Program (NAEPP) Expert Panel 3 Update, potential long-term adverse effects of chronic inhaled corticosteroids use in children includes
• Which level of E/M service is best described by a history focused on the presenting problem with a moderately detailed examination and straightforward management?
• The expected clinical severity of hemoglobin sickle C disease (Hgb SC) is:
• Which statement about alternating doses of ibuprofen and acetaminophen for fever is most accurate?
• Which instruction should be given to patients with otitis externa?
• What percent of factor VII/IX is associated with severe hemophilia A & B?
• Which statement best describes a simple partial seizure?
• Which patient profile among these has the highest risk of progression for a 20-degree adolescent idiopathic scoliosis curve?
• For primary dysmenorrhea in a 14-year-old, which treatment is recommended first?
• In a family with a known carrier mother for hemophilia, what is the probability that a male child will be affected?
• In mild hypospadias, which is part of management?
• The initial attack of acute rheumatic fever is preceded by:
• Which statement best reflects a privacy-respecting approach to discussing sensitive topics with teens during health visits?
• Which organism is most likely responsible for septicemia in the newborn period?
• Which management measure would you not recommend for acute atopic dermatitis?
• The PNP is completing the ROS on a 4mo. What response from the mother might indicate a cardiac problem in the infant & require a more thorough history?
• A 5-year-old presents with a painful left eye after a sibling scratch; fluorescein exam shows a small central corneal abrasion. What is the most appropriate management during the first 24 hours?
• For a 2-week-old infant seen with a 15-year-old mother, which of the following is the most appropriate focus of the visit?
• A painless mass on the right side of the scrotum in a young male most likely represents which condition?
• Which of the following best demonstrates the oral behavior of a 12 month old in relation to readiness for feeding?
• Meatal stenosis is most commonly seen after which procedure?
• In a 3-month-old infant with absent red reflex, which condition should be considered as a possible cause that warrants urgent evaluation?
• The father of a 10-day-old neonate calls about a continually watery left eye without redness or swelling; which response is most appropriate?
• Which of the following is not characteristic of an apparent life-threatening event (ALTE)?
• In a 9-month-old with sensorineural hearing loss, which diagnostic approach provides the highest cost-benefit ratio for etiologic determination?
• Which combination of findings is most consistent with fetal alcohol effects in a child with unknown prenatal history?
• In diagnosing osteomyelitis, which statement is not accurate or recommended?
• If a neonate presents with craniotabes, the recommended parental reassurance is that this finding is
• Which newborn presentation warrants orthopedic referral for a foot deformity?
• An adolescent male who fails to develop secondary sex characteristics at puberty and who has small, underdeveloped testes should be suspected of having:
• What is the most common condition seen with sudden exercise-associated cardiac death in young athletes?
• In acute sinusitis, which statement about antibiotic duration is correct?
• A newborn delivered at 3 weeks premature has a macular erythematous lacy appearance on undressing; which condition is most likely?
• Higher-functioning adolescents with autism are at increased risk for which condition?
• For a 2-year-old with thumb-sucking, which action is appropriate?
• A cobblestone appearance of the palpebral conjunctiva usually indicates which of the following?
• For a recently adopted infant from Eastern Europe with unknown family history, which initial screening tests should be included?
• Which statement about milk choices for a 16-month-old is supported by the referenced guidance?
• Tanner staging helps differentiate puberty in which group?
• Which statement about Wood’s lamp fluorescence in dermatophyte infections is true?
• In an adolescent with a rash suggestive of pityriasis rosea, which STI serology is most appropriate to screen for due to the differential diagnosis?
• Which condition is a known contributor to microcephaly?
• In young athletes, which condition is most commonly associated with sudden exercise-related cardiac death?
• Parotitis is a classic feature of which illness?
• Medicaid reimbursement is available to an APRN:
• For a newborn, the correct management of hip dislocation should include:
• Which statement describes the goal of physical therapy after an ankle sprain?
• Which finding is not a sign or symptom of diabetes onset in children?
• Education of sexually active adolescents concerning use of condoms to prevent STI's would include:
• Which Eriksonian concept is described as the foundational trust important for later self-confidence?
• Prophylaxis for secondary prevention following a definitive diagnosis of rheumatic fever includes which regimen?
• An 18-month-old with a second-degree glove distribution burn in the emergency department prompts consideration of possible child abuse. Which history would most strongly suggest abuse?
• Role play with equipment during the course of a physical exam would be most beneficial with which age group?
• Congenital complete heart block may be associated with?
• What is an appropriate management approach for a child with acute sinusitis who is otherwise well?
• In evaluating an adolescent with delayed puberty, which combination of tests is most informative initially?
• What is the average daily sleep time for a 12-month-old infant?
• Which infant disease is not associated with exposure in the first trimester of pregnancy?
• An adolescent presents with chronic nasal congestion and fatigue; examination reveals a small perforation in the nasal septum. The patient reports an antihistamine was tried without relief. The PNP suspects:
• In bronchiolitis from RSV in infants, which finding is most characteristic?
• For a foreign-born child recently immigrated to the United States, when is PPD testing recommended?
• Good communication between families, schools, and primary care providers is an example of which ecological concept?
• In pediatric primary care, which injury type is most commonly observed in cases of suspected abuse?
• Which of the following is NOT a goal for appropriate asthma management in children?
• In girls, menarche typically occurs after which pubertal event?
• Which statement about pediatric sinus development is true?
• the preferred name now for insulin dependent diabetes mellitus (IDDM) is:
• Which symptom cluster is core to the diagnosis of ADHD?
• In adolescents with anorexia nervosa, which finding is commonly observed?
• A child with Marfan syndrome features should be referred for which reason?
• What is the primary purpose of bone age assessment in pediatric endocrinology?
• Which statement describes psoriasis vulgaris pathophysiology?
• An adolescent who has tall stature, increased arm span, arachnodactyly, laxity of joints, pectus excavatum, and abnormal echocardiogram would be suspected of having:
• The Dubowitz tool is:
• When discussing the cause of impetigo with the parents of a child just diagnosed, the pediatric nurse practitioner tells them it is caused by:
• In a 2-month-old infant with leukocoria, which diagnosis is most commonly associated?
• In girls entering puberty, which information is most accurate regarding timing?
• J.D. is a postterm infant with lesions of varying morphology including wheals, vesicles, and pustules on her trunk. You suspect J.D. has:
• Which risk factor is common to many psychosocial pediatric problems including depression and conduct disorders?
• In an adolescent with suspected systemic lupus erythematosus, which test is most useful as an initial screening test?
• The most appropriate agent for treating varicella zoster infection in an immunocompromised host is which?
• When advising families about antipyretic use for a 2-year-old with fever, which statement is most accurate?
• Erythema toxicum neonatorum most commonly presents with lesions on which areas of a newborn?
• Which early Lyme disease skin manifestation is most characteristic?
• For a child with mild intermittent asthma, which item is NOT a routine part of management?
• What is the MOST important safety question to ask a 17-year-old patient?
• Which statement about the use of combined oral contraceptives in adolescents with dysmenorrhea reflects the most important rationale?
• Clinical jaundice of the distal extremities would be noted at a bilirubin level of:
• Congenital defects are present in approximately 3-5% of infants. Which factor is the lowest contributor to defects?
• Which antibiotic is commonly used as the drug of choice for urinary tract infections in most children?
• Following hepatitis A immunoglobulin administration for travel, what is the recommended interval before giving a measles-containing vaccine?
• A potential childhood risk factor for development of atherosclerotic or coronary heart disease as adults is:
• Which would not be an appropriate recommendation to prevent diaper dermatitis?
• Which diagnostic finding should be referred to a specialist immediately?
• Which adolescent profile is most strongly associated with higher likelihood of illicit drug use?
• A fair-skinned 17-year-old adolescent presents with a maculopapular red scaling rash on the trunk that later forms lesions following a line of cleavage. The most likely diagnosis is
• In the newborn period, infants of diabetic mothers are particularly at risk for:
• Which of the following is not a major factor influencing healthcare delivery services?
• The murmur heard when a child has rheumatic heart disease is the result of:
• Long-term inhalant use in an adolescent most commonly leads to which consequence?
• What is the best approach for conducting a physical examination of the 2- to 3-year-old child?
• For mild hypospadias management, which step is often involved?
• Cytogenetic testing is used to detect which genetic condition?
• Congenital hypothyroidism has a higher incidence in which populations?
• What is the best initial management for roseola?
• Routine pediatric office developmental testing is conducted to:
• Hypertrophied adenoids are most likely associated with which finding?
• The Moro reflex typically disappears at about which age range?
• Cat scratch disease typically presents with fever, malaise, and what?
• In an X-linked dominant inheritance pattern, an affected father transmits the condition to which offspring?
• In the nursery, the cremasteric reflex is absent and the right testicle cannot be palpated in the scrotum. The PNP should:
• In a child with persistent fever and sore throat after negative rapid antigen tests for GABHS, what is the most appropriate next step?
• A 14-year-old adolescent has a second-degree burn along the hairline from using a curling iron. The lesions are erythematous and blistering. The PNP advises:
• The first nurse practitioner program was designed to:
• In the pediatric corneal abrasion case, which of the following is an appropriate antibiotic management approach?
• A 5-year-old presents with a 2 cm abscess on the thigh with purulent discharge; what is the first step in management?
• Which strategy is recommended to reduce sibling rivalry when a new infant enters the family?
• Postpartum counseling for a mother who is HIV-positive should include which item?
• The PNP evaluates an infant born to a mother known to have autoimmune thyroid disease. Congenital hypothyroidism in infants is associated with which of the following?
• Which immunizations would be appropriate to administer today for a 5-year-old with egg allergy?
• In a child with suspected streptococcal pharyngitis, which finding among Centor criteria most supports testing?
• A 10-year-old child presents with non-genital warts on the hand. Which management is most appropriate for the primary care nurse practitioner?
• A 4-year-old child presents with ulcers on the tongue and oral mucosa, with vesicles on the palms, soles, and interdigital spaces. Which diagnosis is most likely?
• Which factor is most commonly associated with sports injuries?
• For strep pharyngitis in a penicillin-allergic patient, which antibiotic is a common alternative?
• A CBC shows normal all values except eosinophil count elevated. This finding supports which diagnosis?
• Nurse practitioners can best assist teens in reducing health-risk behaviors by which approach during regular health visits?
• 16yo Sarah makes the following statements to you during a health visit. Which of the following pieces of information should not be kept confidential?
• Which statement about type 1 diabetes is true?
• Anticipatory guidance for a parent of a child with a venous lead level of 15 mcg/dL should include which action?
• A 3-year-old child presents with noisy respirations. Which finding would indicate the need for immediate referral and hospitalization?
• A 12-month-old with an eye that drifts nasally has a complication that may develop if not treated; which is most likely?
• Seborrheic dermatitis is common in both infants and adolescents. Which statement is not correct about this condition?
• Which feature is characteristic of a venous hum?
• A 4 year old with close contact 10 days ago to a school classmate, now hospitalized with meningococcemia, currently has no symptoms and a normal physical exam. No other cases have been reported in the community. Appropriate management would include
• Which value defines an elevated blood lead level in pediatrics in many guidelines?
• Prematurity is associated with an increased risk of which refractive error?
• Credentialing of the pediatric nurse practitioner requires which of the following?
• Which statement about childhood lead exposure is most accurate?
• Which precaution should be emphasized when prescribing metronidazole for trichomoniasis?
• Precocious puberty is defined as development of secondary sexual characteristics in boys before age 9 years and menses in girls before age 9.5 years. Which pair of ages corresponds to this definition?
• The most common cause of hyperthyroidism in children and adolescents is:
• A child presents with irritability, agitation, muscle pain, and cramping in the large leg muscles. Exam reveals a target lesion with an erythematous ring around a pale center. The child was playing in a garage and does not recall insect bites. What is the most likely cause?
• A previously healthy 4-year-old with acute sinusitis should be treated with which agent?
• A neonate with failure to thrive, persistent growth deficiency of the head, and facial abnormalities with maternal alcohol use is suspected to have which syndrome?
• Isotretinoin therapy requires which precaution due to teratogenic risk?
• If a child has consistently tracked in the 5th percentile for growth since birth, which statement best describes this pattern?
• An 8-year-old with growing pains and a normal exam: which test would be most appropriate to order?
• A child who completed chemotherapy for ALL two months ago — which immunization guideline applies?
• An appropriate intervention for a dried pea lodged in a child’s nose past the first turbinate is to:
• In a 14-year-old adolescent who is sexually active and wants to prevent pregnancy, which birth control method is best?
• A pathognomonic skin finding in children with chronic adrenal insufficiency (Addison's) is:
• For a two-week-old neonate, approximately how many calories per day are needed for growth?
• Which statement about erythema toxicum neonatorum is true?
• Which statement is true about children of parents who smoke cigarettes?
• A 3-year-old refuses to use the toilet and continues to pass stools in a diaper in a secluded corner. The most appropriate explanation is:
• Which contraception method is placed inside the uterus?
• Which nasal exam finding most strongly supports allergic rhinitis in a child?
• A 7-year-old who recently started immunizations should return for the second set in what time frame?
• Which statement about innocent pediatric heart murmurs is true?
• Quality improvement activities include which combination?
• What would you not advise regarding the management or treatment of psoriasis vulgaris?
• In a child with neurogenic bladder from myelomeningocele, what is the most critical long-term goal?
• Young infants with cerebral palsy often show:
• A 2-year-old presents with a history of limping, fever, and refusal to walk or bear weight on an extremity. INITIAL management includes
• Which factor is MOST suggestive of an organic cause of recurrent abdominal pain?
• According to Erikson, the major psychosocial task between ages 1 and 2 is the development of which concept?
• A 23-month-old child's immunization history shows 9 months: DTaP, HIB, HepB, IPV, PCV7; 13 months: DTaP, HIB, HepB, IPV, PCV7, MMR, Var. The most appropriate recommendation is to now administer which combination of vaccines?
• Rubella may have uncommon sequelae that include which combination?
• Piaget's concrete operational stage is best described by:
• Implications for nurse practitioners who counsel adolescents on health risks related to smoking are based on current research concluding that which statement is true?
• Which item is typically documented as part of a review of systems (ROS) in pediatric assessment?
• Prescriptive privileges for nurse practitioners are legally granted by which authority?
• A 14-year-old adolescent presents in acute distress with high fever, chills, malaise, pharyngitis, vomiting, peripheral cyanosis, tachypnea, tachycardia, hypotension, and erythroderma. The PNP recognizes toxic shock syndrome and:
• What is the most appropriate treatment for axillary adenitis in a 3-year-old after dog puncture wounds?
• A 10-year-old with a cholesterol level of 186 mg/dL was evaluated. What is the most appropriate next step?
• A newborn presents with white papular lesions on the cheeks; distinguishing milia from neonatal acne, which finding supports milia?
• In evaluating pityriasis alba in a 9-year-old, which finding would not confirm the diagnosis?
• Which of the following is NOT an appropriate management option for a port-wine stain?
• When speaking to a fifth grade class about injury prevention, based on the national top five causes for fatal injuries in this age group, which topic would the PNP emphasize?
• A mother reports a rebellious two-year-old; the child repeatedly takes items from the mother's purse despite 'no.' The PNP's most appropriate suggestion is
• Which item is not among the National Institutes of Health diagnostic criteria for NF1?
• The leading cause of death for children 1-18 years of age in the United States is:
• Which of the following is not a complication of mumps?
• In a 4-week-old neonate with greasy stools and poor weight gain, which diagnosis is most likely?
• For pediculosis, which statement is true?
• A 13-month-old with iron deficiency anemia has completed one month of ferrous sulfate therapy. What is the best management now?
• Which statement is not true about type 1 diabetes?
• A 4-year-old Romanian child adopted with no medical records. Today's visit should include which of the following?
• A 9-year-old child with reactive airway disease has had three exacerbations in the past two weeks. The most appropriate medication is:
• A macrobiotic diet can best be described as a diet containing:
• Which statement best describes toilet-training readiness in toddlers?
• In an adolescent presenting with signs that may indicate drug use, which testing approach is most appropriate?
• A common presenting symptom of new-onset type 1 diabetes in children is:
• Which of the following methods is best for diagnosing obesity?
• A 2-year-old presents with anal fissures but no history of constipation. The clinician should be most concerned about which possibility?
• When craniosynostosis is suspected in a 6-month-old, what is the most appropriate initial action by the primary care provider?
• With winter approaching, a grandfather plans to keep cough syrups on hand for family colds. The PNP should warn that cough suppressants should be used only for:
• Which daily caloric amount is appropriate for a 2-week-old neonate during growth?
• Which finding is most significant for pertussis in an adolescent patient?
• The progression to wheel-chair dependence in Duchenne muscular dystrophy is best described as which?
• Which statement about reporting child abuse is true?
• Which statement best describes the APRN Consensus Model?
• Managed care is a term that describes:
• What is the most important factor in determining toilet-training readiness in a toddler?
• If an APRN practices beyond scope, which statement is true?
• A nurse practitioner considers a position at a pediatric CF clinic with patients over 21. What is the BEST action to determine regulatory scope?
• In a child with a positive tuberculin skin test, which test should be used to evaluate for active tuberculosis disease?
• Which feature is characteristic of Marfan syndrome?
• A 3-week-old infant has difficulty breathing and feeding. The mother reports that the infant's cry has become hoarse. The infant is bottle-fed and is not offered honey with feedings. The most likely diagnosis is:
• A child with a vocabulary of about 250 words and using three-word sentences is approximately how old?
• Which description best fits pityriasis rosea?
• A dark-skinned adolescent with non-itching hypopigmented patches on the trunk is most likely diagnosed with which condition?
• A pediatric nurse practitioner evaluating an established patient for fever documents history and a review of systems across three organ systems, with a final diagnosis of fever with lower respiratory tract infection. Which level of E/M service is most appropriate?
• Which statement about scope of practice is true?
• Which immunization combination should be given in one visit to a 5-year-old who has never had vaccines?
• What is the most important factor in reducing a child's risk of urinary tract infections?
• A 14-year-old adolescent has an asthma exacerbation with peak expiratory flow 50% to 80% of personal best. This corresponds to which zone on a peak flow meter?
• Which laboratory test is considered the most sensitive early indicator of musculoskeletal inflammatory disorders?
• Which organism is often associated with congenital infections presenting with snuffles and hepatosplenomegaly?
• A 17-year-old basketball player has burning and itching between the toes on both feet. The PNP diagnoses tinea pedis and treats with:
• An infant presents with cataracts, congenital glaucoma, congenital heart disease, hepatosplenomegaly, thrombocytopenia, blueberry muffin rash, and growth retardation. What is the most likely diagnosis?
• At a 4-month well-child visit, which immunizations should be given today?
• The "incident to" billing concept is most relevant to which billing requirement?
• Which antibiotic is appropriate for axillary infection after dog bite puncture wounds?
• Which CBC pattern is most typical of iron deficiency anemia?
• Menarche typically occurs after which pubertal event?
• Which hormone is primarily responsible for sexual maturation of males?
• A father reports that his 4-year-old child with lipomyelomeningocele has had back pain for 3 months and a change in bowel movements; the most likely cause is:
• Which combination of vaccines is typically administered at the 2-month vaccination visit?
• An eye that deviates inward when covered and returns to midline when uncovered is called:
• Before filing such report for potential neglect in a 3-year-old with severe asthma when a parent continues to smoke around the child, what is the most important preliminary step?
• A 9-month-old with diarrhea has a slightly depressed anterior fontanel and normal capillary refill. What percent dehydration is most likely?
• A school-age athletic male presents with a recurrent episode of hematuria. A urinalysis shows nitrite and leukocyte esterase negative; greater than 50 RBCs per high power field; and protein greater than 100 mg/L. The MOST likely diagnosis is
• Which is the first sign of puberty in girls?
• Which of the following is not part of the differential diagnosis for child abuse?
• Dislocation in the hip of a child 6 months or older may typically present with which sign?
• A 12-month-old with esotropia is at risk for which vision problem if not treated promptly?
• A parent asks for guidance on fever management in a 3-year-old. Which statement reflects best practice?
• For a child with primary nocturnal enuresis, the first recommended approach is to:
• A 4-year-old boy presents with a sudden painful limp and low-grade fever. Which diagnosis is most likely?
• Which of the following is NOT true regarding the use of acyclovir in the treatment of herpes simplex virus?
• The most significant finding in the case of Chlamydia infection is:
• Which approach to cultural differences between healthcare providers and patients/families is most effective?
• A child with gastroesophageal reflux is discharged with a nasogastric tube for feeding. Which home-teaching approach is most effective?
• In educational health programs for chronic illness, which approach is most effective?
• In a child with intermittent asthma with symptoms less than twice weekly and a normal peak flow, which therapy is recommended?
• Which statement about lead exposure in children is most accurate?
• Oophoritis is a potential complication of which disease?
• A toddler presents with a second-degree glove distribution burn; which scenario would raise suspicion for nonaccidental injury?
• In a febrile toddler with bilateral otitis media who experiences a brief seizure-like event, the initial management should prioritize treating which condition?
• Which screening test requires a 12-hour fast before testing?
• A mother brings a 1-year-old child with Down's syndrome to the clinic. The initial plan should be to:
• An 18-month-old with fever, conjunctivitis, strawberry tongue; what is the most appropriate initial action?
• By 8 months of age, which immunizations should have been administered?
• Which of the following abnormalities is not multifactorially inherited?
• The described major first- and second-degree burn should appear as which of the following?
• Diagnostic findings consistent with beta-thalassemia are:
• Which symptom is not typical of ADHD in a child?
• Which of the following likely indicates paraphimosis in a boy with a retractile foreskin?
• What treatment would be appropriate for Jamie's Hirschsprungs Disease?
• A 1-year-old child presents with fever of 102ºF and left flank pain. Urine dipstick shows nitrates and leukocyte esterase. The presenting signs suggest left pyelonephritis. What is the most appropriate action for the PNP?
• Compared to single-component vaccines, combination vaccines:
• When discussing laser therapy for a capillary vascular malformation, which statement is most accurate about treatment?
• Which symptoms are most common in the early phase of appendicitis in children?
• Adolescent parents may be at greater risk for abusing their child because:
• Medicaid provides health insurance coverage to:
• A child hit in the head with a hockey stick now has profuse rhinorrhea and a hemotympanum. This finding most strongly suggests which diagnosis?
• Adolescents who receive teaching about condoms should also have information about which of the following lubricants or spermicides?
• What is the MOST common side effect noted when oxybutynin chloride (Ditropan) is used in the management of dysfunctional voiding?
• An infant brought to the clinic is diagnosed with failure to thrive (FTT), persistent growth deficiency of the head, and delayed development. Some unusual facial abnormalities are noted. The mother has a history of consuming large amounts of alcohol. The PNP suspects fetal alcohol syndrome (FAS) and refers the infant:
• At a physical examination for Head Start, a mother reports being concerned about her 4-year-old child's speech. She worries that the child's speech is unclear and that the child is not saying enough words. The PNP explains to the mother that the child should:
• Systemic-onset JIA is most commonly associated with:
• Which of the following is NOT a characteristic finding in a child with scabies?
• Which statement best describes common fears in preschool children?
• A 2-week-old neonate with suspected Down's syndrome exhibits phenotypic features including:
• Which diagnostic test is most appropriate to confirm Giardia lamblia infection?
• The most common congenital heart defect in children is:
• In primary health care, what is the major perceived barrier to utilization of pediatric nurse practitioner services?
• A nine-year-old with signs of acute otitis media; most appropriate management is:
• A 3-year-old recently develops breath-holding spells. After an event, what is the recommended parental response?
• At 2 months, which vaccines are given?
• A newborn or infant with birth length below the 50th percentile and microphallus should be suspected of having:
• Regarding pectus excavatum repair and asthma outcomes, which statement is most accurate?
• A 10-year-old child with pneumonia undergoes imaging. The clinician orders an anteroposterior and lateral chest view and which laboratory tests?
• Which scenario would not typically prompt chromosomal analysis?
• In a child with esotropia, what is a potential vision-related complication if untreated?
• Medicare Part B covers:
• What is the appropriate initial intervention if the parent refuses immunizations?
• When performing a physical examination on a toddler, which of the following body parts would you examine last?
• Which of the following may cause microcephaly?
• What is the predominant characteristic of a young infant with bronchopulmonary dysplasia?
• Which of the following sign or symptom is seen in students most often associated with anorexia nervosa (AN)?
• In evaluating Billy, a child with bloody diarrhea, which of the following would not be appropriate first action?
• Which statement about emancipated minors is true?
• Which of the following physical stigmata is common in newborns with Down syndrome?
• Which antibiotic is the primary treatment for gonorrhea in the provided material?
• In which situation should treatment of a healthy child who is an asymptomatic carrier of Giardia lamblia be considered?
• Regarding childhood obesity, which statement is true?
• What protective measure is recommended to reduce Lyme disease risk in endemic areas?
• At an 18-month well-child visit, the father reports the child drinks 4 oz of milk at nap time and 8 oz at bedtime, with the rest of fluids taken by cup. Which information is most pertinent for the PNP to obtain to assess the child’s diet?
• In the differential diagnosis for suspected child abuse, which finding would be least expected based on medical conditions rather than abuse?
• Medicare Part A covers:
• The diagnostic criteria for Tourette syndrome require which of the following?
• Which hemorrhage pattern is most characteristic of severe factor VIII deficiency?
• Which analgesic regimen is appropriate for a 4-year-old recovering from tonsillectomy?
• A 2.5-year-old with fever who remains well hydrated and playful: which approach is appropriate?
• A 12-year-old has a four-week history of a paroxysmal cough with occasional post-tussive emesis. The MOST LIKELY causative organism is?
• Seborrheic dermatitis affects which age groups?
• During development, a child first transfers an object from one hand to another at approximately what age?
• Which immunologic finding is most consistent with X-linked agammaglobulinemia?
• A 3-year-old child has painful sores in the mouth. On examination there are two to five pin-sized vesicles covered with a yellow-gray membrane on the lips and inside the mouth. Which diagnosis is most likely?
• Which data would be most helpful in diagnosing erythema migrans (Lyme disease) in a teen?
• In a postterm neonate, which skin finding is most characteristic?
• Which vaccine is documented as being administered at 9 months of age in the immunization history?
• An infected naval piercing in a 15-year-old, with lake swimming history, the MOST appropriate management is?
• Which statement about the incidence of acute atopic dermatitis in children is not correct?
• A 10-month-old infant presents with a large bulging umbilical mass that is easily reducible, especially when crying. The PNP should:
• To reduce sibling rivalry after the birth of a new sibling, what is recommended?
• Trauma to the eye increases the risk of developing all but which one of the following?
• Which disease is prevented by the MMR vaccine?
• A 6-year-old presents with limp and knee pain, with limited passive internal rotation and abduction of the hip. The most likely diagnosis is which?
• A 2-year-old with lead exposure at 14 mcg/dL—what is the appropriate public health action?
• A 6-year-old child with suspected corneal abrasion: which diagnostic test is used?
• The mother of a 1-year-old child requests information about the child's speech and language development. The PNP explains that vocabulary acquisition may be slow during certain periods and that a vocabulary spurt is most common between ages:
• Tina, 12 years old, presents with a lateral curvature of her spine. Which of the following tests would diagnose scoliosis?
• In girls, peak height velocity is most closely associated with which timing relative to menarche?
• The PNP is employed by a physician and performs services under direct supervision; these services provided by the PNP are billed under the physician's name and are called
• Which exposure history would most support a diagnosis of Lyme disease in a teen with an annular rash?
• A typical febrile seizure is most likely to be the problem of which of the following children?
• Cafe au lait spots have which characteristic?
• An ill-appearing 10-month-old infant presents with fever, tachypnea, and cough. Which laboratory test would be most useful in the initial evaluation?
• Which management statement is most consistent with gastroesophageal reflux in infants?
• The most appropriate initial management of a toddler with persistent post-infectious diarrhea is to
• In a 14-year-old adolescent with delayed puberty and underdeveloped genitalia, which initial diagnostic tests are most appropriate?
• KOH is positive for hyphae and Wood’s lamp does not fluoresce. You are sure Paul’s condition was not caused by which organism?
• Which statement best explains why combined oral contraceptives are considered for dysmenorrhea in adolescents?
• In a well-appearing infant with acute diarrhea, the recommended initial management is
• All of the following are permitted uses or disclosures of an individual's protected health information under HIPAA except which one?
• A 2-year-old girl presents with painful urination, frequency, and occasional incontinence; fever is present. Which specimen collection is most appropriate for urine culture?
• In a newborn with conjunctivitis on day 2, which diagnosis is most likely?
• An 8-year-old with influenza-like illness presents within 48 hours of symptoms onset. Which statement is correct regarding antiviral treatment?
• The American Academy of Pediatrics recommends that a child ASSENT to participate in clinical research requires evidence of which of the following?
• A 4-year-old with a productive cough; which statement best describes the likely cause?
• Which of the following is the most common type of congenital bleeding disorder?
• Which statement about infant gastroesophageal reflux management is most consistent with the source information?
• Which beverage inhibits the absorption of nonheme iron when consumed with iron-rich meals?
• Which finding suggests a need for further evaluation for glomerular disease?
• In assessing a preschool-age child, which factor is the best predictor and most frequently noted indicator of intellectual giftedness?
• At what age should prophylactic penicillin be initiated in children with sickle cell anemia?
• Which of the following are most often associated with hemoglobin C?
• Which presentation least warrants sweat chloride testing?
• Which imaging or regulatory action is most appropriate when considering a CF clinic with patients older than 21?
• A 10-year-old child has been referred for evaluation of scoliosis, which was identified in a school screening program. On physical examination the PNP finds a curvature of the spine when it is anteriorly flexed from the trunk. There is slight shoulder asymmetry, with prominence of the scapula. The curvature is at 10 degrees. The PNP should:
• A 3-year-old child is suspected of fetal alcohol effects (FAE); which physical findings support this diagnosis?
• Which vaccine is specifically designed to protect against Haemophilus influenzae type B meningitis?
• Infant cradle cap presents with which description?
• What activity should patients with sinusitis be instructed to avoid?
• Which statement about insect stings from bees, wasps, and fire ants is NOT true?
• Spasticity in an infant may be an early sign of which condition?
• A 10-month-old child attending a child care facility with gastroenteritis is most likely infected with which pathogen?
• If head lag persists beyond 6 months, this could indicate delayed motor development.
• Which of the following is not a sign or symptom of congenital hypothyroidism?
• Newborn screening most accurate statement:
• Which of the following is not associated with Rh incompatibility?
• A 5-day-old neonate with trisomy 21 has an elevated TSH on newborn screening performed at day 3. What should the clinician do next?
• In the evaluation of HPV-related genital lesions in a teenage patient, which statement is correct about HPV?
• In a 14-year-old girl with pubertal development described as breast development starting about 18 months ago and pubic hair starting about 2 years ago, which statement about the timing of menarche is MOST accurate?
• In the immunization history of the foster child, which vaccination was documented at birth?
• A 14-month-old with a 7-day history of cough and yellow-green nasal discharge. The father has given OTC cold medications regularly and suspects a sinus infection. What is the most appropriate action by the PNP?
• Which statement is not typically true for migraines in a 4-year-old?
• The PNP is counseling the parents of a child with recurrent episodes of acute otitis media. The PNP informs the parents of environmental risk factors for acute otitis media. Which factors are correct?
• Which clinical feature most strongly suggests pinworms infection in a preschool child?
• Which anticipatory guidance statement is most appropriate for parents with a colicky baby?
• Tuberous sclerosis typically presents with which combination?
• Which test is not appropriate for developmental dysplasia of the hip in an 18-month-old?
• Which statement best describes imaging after a first urinary tract infection in a child?
• Which of the following would not elevate the pulse of a child?
• A full-term newborn has birth weight below the 10th percentile, length at the 50th percentile, and a maternal history positive for anemia, preeclampsia, and two prior miscarriages. Most likely diagnosis is:
• A newborn with blue-gray sacral spots in a Hispanic infant most likely has Mongolian spots. Which option best describes this condition?
• Standards of practice are best described as which?
• Why should caregivers be counseled about decongestant and antihistamine side effects in infants with URI?
• In counseling about a 13-month-old's nutrition, which statement best reflects appropriate guidance?
• Most risk management programs are based on the assumption that:
• Which statement about slipped capital femoral epiphysis is true?
• A 15-month-old who failed amoxicillin for otitis media and has persistent fever and a red tympanic membrane on recheck. What is the next step in treatment?
• One of a toddler's greatest fears is:
• Which condition would not cause an elevated pulse of a child?
• A newborn at 2 weeks has head circumference 2 SDs below the norm, with normal neurologic findings. What is the most appropriate recommendation?
• Which statement reflects the current expert consensus about syrup of ipecac?
• The most common form of reimbursement for services provided by PNPs is:
• One of the major psychosocial tasks of infancy is:
• An 8-month-old missed the 4- and 6-month visits and immunizations; parents are substance abusers. Which plan is appropriate?
• Which statement about the earliest Nurse Practitioner program is accurate?
• A parent brings a 1-week-old neonate into the clinic. The mother is concerned that the infant's testicles do not seem 'even.' The PNP notes that the cremasteric reflex is absent and the right testicle cannot be palpated in the scrotum. The PNP should:
• A mildly ill 4-year-old presents with exudative pharyngitis and erythematous nonblanching lesions on the legs. Rapid strep test is positive. What is the most likely diagnosis?
• Which sign marks the transition from Tanner stage II to III in male puberty?
• Tourette syndrome commonly begins at what age range?
• A 12-year-old boy is brought to the office for a yearly physical and has recently noticed enlargement of his testes and scrotum. When counseling the boy about what to expect next in pubertal development, which change is likely to occur first?
• What is the recommended management for cutis marmorata aside from monitoring?
• Which of the following is a characteristic physical sign of fragile X syndrome in adolescent males?
• The most common form of reimbursement for services provided by PNPs is
• A 4-week-old neonate with greasy stools and poor weight gain most likely has which condition?
• Which vaccine is contraindicated in an immunocompromised pediatric patient?
• One difference between the lesions of primary syphilis (chancre) and HSV genital lesions that may help in differentiating the two is:
• At a routine health maintenance visit, an 11-year-old patient with Tourette Syndrome informs the nurse practitioner that he is struggling both socially and academically at school. His parents have spoken with his teacher at school, but the problems have continued. He confides that he often goes to the school nurse's office with vague complaints to avoid some of his regular school day. The pediatric nurse practitioner's next action should be to:
• Which maternal factor is most likely associated with asymmetric intrauterine growth restriction?
• Unintentional injuries are a major cause of death in preschool-aged children. Which cause accounts for the most deaths?
• Which radiographic finding is classic for croup?
• Penicillin is the drug of choice for syphilis because it is effective against which organism?
• The cover test reveals which condition when the left eye is covered and the right eye moves outward to fix on a near object?
• For Lyme disease in a child under 8 years old, which antibiotic is preferred?
• Absence seizures are best described by which statement?
• An 18-month-old is evaluated for a cough and runny nose lasting seven days. The nasal discharge is yellow-green. The mother has been using over-the-counter cold medications every six hours. There is no fever. What is the most appropriate step for the PNP to take?
• Which of the following findings is not characteristic of hyperadrenocortism?
• An infant with atopic dermatitis often has dry patches located on the cheeks and extensor surfaces of the arms and legs. Which option best reflects this location?
• The type of head injury that is easily treatable but potentially the most lethal is:
• Which parental history is most strongly associated with an increased risk of child maltreatment?
• Which birth order is most associated with pyloric stenosis presenting in infancy?
• A pelvic exam should not be performed on which of the following adolescents?
• The parents of a child with cystic fibrosis are considering another pregnancy. They want to know what their chances are of having another child with cystic fibrosis. The PNP explains that cystic fibrosis is an autosomal recessive disorder and that each conception of carrier parents has a:
• A 7-year-old with a 10-day history of green, thick rhinorrhea is diagnosed with sinusitis. Which treatment is most appropriate?
• Head and chest circumferences should be equal at which age?
• Which urine finding would most strongly prompt evaluation for glomerular disease?
• Which statement about nocturnal enuresis is true?
• Appropriate anticipatory guidance for the parents of an 8-year-old girl should not include which statement?
• Which term describes nasal discharge seen in congenital syphilis?
• Which child does not need Pneumocystis carinii pneumonia (PCP) prophylaxis?
• Which antibiotic class is commonly used to treat pertussis?
• To receive Medicare reimbursement, APRN must:
• At a 6-month well-child visit, which immunizations should be given today?
• A 1-year-old child presents with a fever of 102°F and left flank pain. Urine dipstick is positive for nitrates and leukocyte esterase. The presentation suggests left pyelonephritis. What is the most appropriate action for the pediatric nurse practitioner?
• For a 6-month-old with suspected infantile botulism, which intervention would be inappropriate?
• Children in child-care facilities are at greater risk of being exposed to which infection?
• In avoidant attachment, which underlying emotion is most associated?
• For a 7-year-old child with type 1 diabetes, which blood glucose target range is commonly recommended?
• Which organism is most likely the cause of congenital syphilis?
• A 6-week-old infant has a bright red, raised, rubbery lesion about 2 cm in diameter on the occiput. Which condition is most likely?
• Which of the following is included in the diagnostic criteria for migraine headache in postpubertal children?
• The most common rheumatoid disease of childhood is which of the following?
• During a routine sports physical, a 13-year-old is asked about tobacco use. Which rationale best justifies this question?
• Which of the following may occur with suspected appendicitis?
• A 16-year-old female adolescent with Down's syndrome presents for a well-child visit with Tanner stage III breast development and pubic hair. The nurse practitioner should:
• Which item is included in the past history of a pediatric patient?
• In a pediatric patient with suspected rheumatic heart disease, the disorder most commonly involves which structure?
• Luke has a mild persistent asthma. Appropriate daily medication should include:
• One of the major psychosocial tasks of infancy is:
• An 8-year-old child has a vertical linear corneal abrasion seen on fluorescein staining; Pupils are equal and reactive. Which plan of care is appropriate?
• A child presents with a barking cough and inspiratory stridor. Neck radiographs show subglottic narrowing. This finding is most consistent with which condition?
• A mother brings her 2-year-old child to the clinic for a well-child visit. The mother's chief complaint is the child's rebellious behavior. The mother says that she has tried time-out, yelling, and spanking but nothing has worked. The child has never slept through the night and still gets a bottle in the middle of the night. In the examination room the PNP observes as the child repeatedly gets into the mother's purse when she is not paying attention, despite the mother telling the child no. Based on the history and observation, the PNP suggests that:
• What is the major cause of death among adolescents and young adults aged 15 to 24 years?
• The PNP is testing a 10-month-old for ocular alignment with the corneal light reflex test. The test is used to screen for which condition?
• Which counseling for parents of a 2-year-old with an elevated lead level would be effective in decreasing lead exposure?
• A 15-year-old comes to clinic with painful vesicular skin lesions. The most likely diagnosis is:
• Preventative health guidelines typically include which elements?
• Decreased platelets may not be found in which condition?
• The major psychosocial task of adolescence is the development of which?
• In Jale’s contact dermatitis, which symptom is most characteristic?
• An adolescent with Achilles tendonitis who runs long distances several times a week is advised to rest and elevate. What additional measure is recommended?
• The primary treatment for bronchopulmonary dysplasia is which of the following?
• A 2-year-old with chronic serous otitis media has pearly white opacity in the upper outer quadrant of the tympanic membrane and no symptoms. Most likely diagnosis and management?
• Of the following, the MOST effective method to prevent childhood gun injuries and death is
• Which physical finding is not usually associated with talipes equinovarus congenita?
• Which statement about scope of practice is true in most states?
• During puberty in girls, which finding marks a milestone typically years after breast development?
• Which option best represents the correct sequence for adolescent female development?
• Which of the following are symptoms of cat scratch disease?
• Which long-term adverse effect is associated with chronic inhaled corticosteroid use in children?
• Which vaccine is a live attenuated vaccine?
• The etiologic cause of meningitis in the newborn is most likely:
• Which finding is most characteristic of Trichomonas vaginalis infection?
• Which primary drug is used for treatment of generalized tonic-clonic seizures?
• Which imaging modality provides the most accurate assessment of sinus abnormalities in chronic sinusitis?
• An infant should no longer have a head lag when pulled from the supine to sitting position at what age?
• A PNP is following a child placed in foster care. The most common health problem of children in foster care is:
• Which finding is most characteristic of pinworm infection in children?
• Which finding is most characteristic of hand-foot-and-mouth disease?
• In a 3-year-old with labial adhesions, what is the most appropriate initial management?
• Autosomal recessive trait transmission: which statement is accurate?
• Which statement about child abuse and maltreatment is correct?
• A 2-year-old with a 2-day history of a harsh, predominantly nocturnal cough and fever 100°F is diagnosed with croup. What should the PNP tell the parent?
• Which vocabulary size is typical for a 24-month-old?
• A 4-year-old is brought in for a preschool physical. Immunization records show that DTaP, IPV, and MMR are due. The child had Kawasaki syndrome treated with IVIG 9 months ago. Which immunizations should be administered today?
• Beta-chain synthesis is absent in:
• Sheryl, a 12-year-old with vaginal discharge for months, is most consistent with which diagnosis?
• A preteen girl notices breast asymmetry during puberty. What is the best counseling?
• Hashimoto's thyroiditis is best described as which type of disease?
• A 20-month-old child experienced a brief episode of shaking after a fever of 102°F but returned to normal. What should be undertaken first?
• What general advice should a pediatric practitioner give adolescents who are using herbal remedies?
• Prader-Willi syndrome is a congenital genetic disorder characterized by:
• Which alternative therapy is most likely to be explored by parents of a child with attention deficit hyperactivity disorder (ADHD)?
• In adolescent migraine evaluation, which symptom pair is most characteristic?
• A 10-year-old child has persistent fever of 102°F for 5 days, sore throat, and a faint pink rash on the abdomen and groin. An earlier rapid antigen-detection test for GABHS was negative. The most appropriate next step is to:
• During auscultation of a 3-year-old's chest, you note an irregular heartbeat of 90 bpm that slows when respiratory rate slows and accelerates when the child breathes faster. The rest of the exam is normal. What is the appropriate response to this finding?
• The 10-year-old's asthma classification described would be categorized as:
• In a child with functional abdominal pain, which approach is most appropriate during episodes?
• In evaluating a healthy toddler with asymptomatic microcytic anemia, which laboratory test is most diagnostic?
• A 3-year-old boy is toilet trained and the urine stream is not directed straight from the meatus at the tip of the penis. This supports hypospadias because:
• In evaluating suspected Kawasaki disease, which diagnostic test is essential to assess possible cardiac involvement?
• Which statement describes a normal developmental aspect for a 2-year-old?
• In educational health programs for patients with chronic illness, the most effective model involves:
• In early puberty, which change typically appears first in girls?
• A 7-year-old child with opaque tympanic membranes, visible landmarks, and a fluid line is diagnosed with otitis media with effusion. Which management is most appropriate?
• Which of the following would not be consistent with a diagnosis of functional constipation in an infant?
• When considering growing pains, which finding supports excluding other causes?
• A newly adopted 4-year-old from Romania with no medical records: Today's visit should include which of the following?
• Developmental milestones for a 5-month-old typically include which of the following?
• Which blood lead level is not considered lead poisoning?
• The father of a 10-month-old is concerned because of the lack of eruption of primary teeth. The PNP suggests:
• Title V amendments in 1981 and 1986 expanded coverage for children with special health care needs under which program?
• Which language milestone is expected for a healthy 24-month-old?
• At what age is the pincer grasp typically mastered?
• Which assessment tool is appropriate for screening articulation in a 4-year-old with language delay?
• In suspected craniosynostosis, which finding would most strongly support the diagnosis?
• For an HIV-exposed neonate, which combination would be used in addition to ZDV for PCP prophylaxis?
• A 4-year-old scheduled for a tonsillectomy and adenoidectomy has a prolonged active partial thromboplastin time (aPTT) on preoperative testing. The PNP should suggest that they:
• A 2-month-old infant with spina bifida and shunted hydrocephalus has gagging with feeds, spit-up, intermittent stridor, and failure to thrive. The most likely explanation is:
• Physiological splitting of the second heart sound during inspiration in a child:
• A 3-month-old infant presents with white, cottage cheese-like patches on the inner cheeks. The appropriate treatment is:
• Which statement about pediatric urinary tract infections is not true?
• In assessing ADHD in a 7-year-old, which symptom pattern is most descriptive of the disorder?
• Certification is a process in which a nongovernmental agency or group verifies that an APRN has met certain predetermined standards for specialty practice.
• Beyond the neonatal period, which set of signs is most consistent with bacterial sepsis in a child?
• Which of the following is a potential childhood risk factor for development of adult cardiovascular disease?
• Which statement about Chlamydia infection is most accurate?
• Current prescriptive authority for APRN:
• Cholesterol screening should be done in children who have which scenario?
• A 17-year-old adolescent asks if it is possible that any future children will have sickle cell disease. The intended spouse has sickle cell trait. Which statement is most accurate?
• A well-child CBC shows hemoglobin 7.8, low MCV, elevated RDW; most likely cause of anemia?
• Which option best reflects the key contagious period of mumps as described in the case material?
• In pediatric research, assent is the child's affirmative agreement to participate, when capable.
• Which test is required to diagnose leukemia?
• Herpes Zoster is characterized by clustered vesicles; which area/nerves is it often associated with?
• The concept of health promotion focuses on preventing disease rather than curing it. This description best describes which type of prevention?
• Which seizure type is defined by brief lapses of consciousness that are most common in preschool children?
• Which factor is most predictive of suicide in an adolescent?
• A deficiency of which vitamin may cause night blindness, xerophthalmia, or keratomalacia?
• An 18-month-old child exposed to HIV in utero had negative HIV DNA at 2 weeks and 8 weeks. What is indicated at the 18-month visit?
• A 6-month-old with increased tone and lower leg scissoring is most indicative of which condition?
• Complications of SLE commonly include which of the following?
• If a female adolescent has breast development at Tanner stage II and pubic hair at Tanner stage III, what is the overall Tanner stage?
• Medicare Part B covers:
• Pityriasis alba is more apparent in which population or season?
• A 5‑year‑old shows a desire to choose clothing. Which parent statement best promotes self-esteem?
• Which statement about emancipated minors is accurate?
• Which condition among the following is least likely to present with steatorrhea?
• A pearly white plaque on the tympanic membrane—prior infection—most likely indicates which condition?
• The anterior fontanel usually closes by which age?
• A 2‑month‑old formula-fed infant who vomits after nearly every feeding, but is thriving, most likely has which cause?
• Which physical finding supports a diagnosis of costochondritis in a patient with chest pain?
• Which is NOT an appropriate management option for a port-wine stain?
• KC, age 13, has firm, small umbilicated papules on the neck. What is the most likely diagnosis?
• A child presents with a 7-year-old slapped-cheek rash that blanches and a lacy body rash. Which diagnosis is most consistent with this presentation?
• Which diagnosis is associated with contracture of one sternocleidomastoid muscle?
• Which statement describes the not part of initial management for adolescent hypertension?
• Which statement about puberty timing in girls is correct?
• Which statement is most appropriate anticipatory guidance for colic?
• An adolescent with recurrent respiratory tract infections. The complete blood count shows a WBC of 20,500 with 35% blasts. The next step in management is:
• A 17-year-old presents to the fast-track with respiratory distress, headache, and euphoria. Which exposure is most likely suspected?
• Which congenital anomaly feature is most characteristic of Edwards syndrome?
• A grade II musical or vibratory murmur heard best at the left sternal border that changes with positioning is suggestive of a:
• A well-appearing 18-month-old child has 6 weeks of progressively looser stools and a diet that includes 12 ounces of cow's milk and 24 ounces of apple juice daily. The most likely diagnosis is?
• The parachute reflex is expected to appear by which age range?
• Which of the following is a fine motor skill example achieved by preschool-aged children?
• Which symptom is not typically associated with acute glomerulonephritis?
• In pediatric diabetes, ketone testing should be performed under which circumstance?
• Which muscle is involved in torticollis?
• What is the most appropriate initial management for a newborn diagnosed with developmental dysplasia of the hip?
• In an allergic reaction after a party, which question would be most appropriate to identify a possible cause?
• Which statement is NOT a recommended approach for a 2-year-old's bedtime management?
• Which action best addresses concerns about a preschooler's frequent grounding for chores?
• Which of the following should not be included in the differential diagnosis for diaper dermatitis?
• Which statement best describes the relationship between Down syndrome and endocardial cushion defects?
• Which of the following should be included when educating a family regarding the care of children with atopic dermatitis?
• Therapeutic level in antibiotic therapy refers to which concept?
• Capillary hemangioma typically enlarges during which period?
• The most common side effects of Retin-A cream which include erythema, dryness, and burning can be minimized by applying the medication
• Which one of the following is not found in children with growth hormone excess?
• In evaluating bruising for possible maltreatment or nonaccidental trauma, which aspect is most important?
• For this condition, the pediatric nurse practitioner prescribes:
• Mumps contagion period described in the case material is when?
• In counseling about herbal remedies for adolescents, which statement is most appropriate?
• Which vision screening result should be referred for further testing?
• Which child should not have tuberculin skin testing?
• Foods containing high levels of iron appropriate for a 2-year-old with iron deficiency anemia include which of the following?
• A 3-week-old infant with irritability, pallor, poor feeding; afebrile; heart rate 240/min while asleep. The most likely diagnosis is:
• A PNP has been asked by the emergency room physician to evaluate a child for costochondritis. The PNP would expect to find:
• Infants identified as IUGR are prone to developing hypoglycemia due to which cause?
• Which test best reflects long-term glycemic control in a child with diabetes?
• In a physician-supervised practice, nurse practitioner services billed under the physician's name are called:
• A 7-month-old who previously babbled and imitated sounds now shows reduced babbling. What is the recommended response?
• Which immunization combination is listed as given at age 4 years in the foster care record?
• A child just beginning to reach for objects placed in front of him is approximately how old?
• Which statement best reflects the impact of parental smoking on SIDS risk?
• School-aged children involved in athletic activities may not be at increased risk for which condition?
• Which statement is true about enuresis management, reflecting the priority described in the material?
• Which of the following would usually not be considered a sign of a pituitary tumor in an adolescent female?
• At 15 months, which vaccines are routinely given?
• For a child with acute sinusitis after 10 days of persistent symptoms, which management is most appropriate?
• Which statement about febrile seizure prophylaxis is true?
• For a febrile seizure in a 20-month-old, what is the first essential step in evaluation?
• In evaluating syncope in pediatric patients, which factor is considered most important in establishing the diagnosis?
• A preschool-aged child with Giardia infection; the appropriate treatment is
• After eight weeks of antifungal treatment for tinea corporis, new larger lesions have developed. Which option would you not consider?
• An adolescent presents with fatigue, morning stiffness, anorexia, weight loss, and a butterfly rash across the cheeks. Which test is most appropriate to order first when evaluating for systemic lupus erythematosus?
• In Legg-Calve-Perthes disease, which sign is seen?
• The initial attack of acute rheumatic fever is most commonly preceded by which infection?
• Which food would be appropriate for a child with celiac disease?
• Meatal stenosis is identified by which of the following signs?
• An 13-month-old drinks 23 oz skim milk and 20 oz juice daily. What guidance is appropriate?
• Which rash characteristic and travel history would most strongly indicate Lyme disease?
• Which malignancy is associated with genitourinary anomalies?
• A characteristic feature of polyarticular juvenile idiopathic arthritis (JIA) is:
• A 1-week-old infant has a papular rash with clustered lesions, some vesicular, and is otherwise healthy. What is the most likely diagnosis?
• For a teenager who has had two sexual encounters and is concerned about pregnancy and STDs, which condom option is recommended?
• Which sequence best represents the standard motor development progression in infancy?
• Which of the following is associated with alcohol use in adolescence?
• Which statement is supported by the material regarding puberty timing in girls?
• Not a precipitating factor for hemolysis in G6PD deficiency?
• A macrobiotic diet can best be described as which of the following?
• What sinusitis complication are adolescent males more prone to?
• Which of the following is a characteristic feature of simple partial seizures?
• Which statement about discussing confidential topics with adolescents is correct?
• Dysmenorrhea duration is typically described as lasting how long?
• Which statement about condylomata acuminata is true?
• The PNP suspects that a sexually active adolescent has pityriasis rosea. Based on the differential diagnosis, the PNP screens for:
• Which type of play is most sophisticated and advanced?
• The expected hemoglobin range for sickle cell anemia is:
• Prader-Willi syndrome is most commonly caused by which genetic mechanism?
• In Turner syndrome, which assessment has a specific indication?
• Children born with cleft lip/palate are prone to:
• Which statement about the evaluation of a suspected learning disorder is NOT routinely included?
• Abdominal pain and vomiting in a child with diabetes may indicate the onset of which condition?
• Legal authority for APRN practice is granted by:
• The most common cause of chest pain in children and adolescents is
• Which chest radiographic finding is most consistent with pediatric asthma?
• A 7.5-year-old Hispanic girl has prepubertal pubic hair with no other secondary sex characteristics. Which statement is most appropriate?
• The family history should include:
• The Pediatric Nurse Practitioner encounters a 6-month-old with suspected craniosynostosis showing prominent ridges over the occipital and coronal sutures. The appropriate action is to:
• A 14-year-old with PMS should be advised to...
• Which is the BEST initial counseling for a family of a 5 year old with nocturnal enuresis?
• An 10-month-old infant presents with a circumscribed, dry, pruritic rash on the cheeks and flexor surfaces of the arms. What treatment should be prescribed?
• Steatorrhea is not consistent with which of the following?
• Which program includes the Maternal and Child Health Services Block Grant as part of Title V amendments in 1981 and 1986?
• Which developmental theory best explains the multifactorial etiology of failure to thrive?
• Kawasaki disease is most common in:
• If erythema multiforme major is suspected, which management is most indicated?
• The PNP is evaluating a postterm neonate (42 weeks gestation) in the nursery. On examination, which finding would be expected?
• Which statement about meningococcal disease risk for college freshmen living in dorms is true?
• Most patients with uncomplicated UTI can be treated on an outpatient basis. The first antibiotic you would consider using is which?
• If Trina delivers her baby, which is not a focus of care in the first weeks after delivery?
• A child with urinary obstruction shows hydronephrosis on imaging. Which diagnosis is most likely?
• Tuberous sclerosis is a progressive, neurocutaneous syndrome in which there is a combination of:
• Antimicrobials will improve the condition of a 4-year-old child with diarrhea caused by which organism?
• Which cluster of symptoms would make Lyme disease a likely diagnosis?
• "Incident to" billing is specific to:
• The most common congenital heart defect in children is which of the following?
• During play, a 4-year-old's arm is grabbed as the child darts away, and the child begins crying immediately. Which injury is most likely and requires immediate examination?
• A 7-year-old who was playing outside in a grassy, wooded area presents with two small red puncture marks surrounded by blanching and an erythematous border on the leg. Which insect bite is most likely?
• Which statement about newborn screening is described as most accurate in the material?
• What is the most common agent for nonviral pneumonia from older preschool to young adulthood?
• For a nonverbal infant or toddler, which pain assessment method is most appropriate?
• A 3-year-old child with sickle cell disease is brought for a well-child visit. What is an appropriate intervention to decrease the child’s risk of infection?
• The most common cause of primary amenorrhea is:
• Which statement about chickenpox transmission is NOT true?
• Which of the following is appropriate postpartum counseling regarding the infant of an HIV-positive mother?
• At 7 months, when concerns arise about hearing milestones that may come and go, what is the recommended approach?
• A mother of a 10-week-old asks about managing hard stools. Which suggestion is appropriate?
• Which of the following is usually elevated with viral infections?
• For a preschool child with immune thrombocytopenia purpura and platelets around 45,000/mm3 without mucocutaneous bleeding, what is the NEXT step?
• What is the first physical sign indicating the onset of female puberty?
• In a neonate diagnosed with trisomy 21, which follow-up is included in the recommended panel?
• Which symptom pattern is most typical for urinary tract infections in infants?
• Which of the following is not considered best prevention education for malignant melanoma?
• A 16-month-old should be switched to whole milk rather than skim milk because which of the following is true?
• A neonatal male has ventrally displaced urethral opening along the glans consistent with mild hypospadias. What should the parents be told?
• The parents of an 18 month old are both overweight. When counseling them about prevention of overweight in their child, suggestions should include
• In evaluating abdominal pain in this patient, which test is least helpful?
• A 7-year-old child with no record of prior immunizations receives initial immunizations including Td, IPV, MMR, Var, and Hep B today. When should the child return for the second set of immunizations?
• Which adolescent would be at greatest risk for developing anorexia nervosa?
• A toddler is unable to use the right arm normally after the parent pulled the arm to prevent the child from falling. Which finding would confirm the diagnosis of subluxation of the radial head?
• Which statement is NOT typical of the erythema multiforme reaction?
• In pediatric asthma management, long-acting beta2 agonists are used as part of combination therapy with inhaled corticosteroids.
• In the Native American population described, which maternal factor is associated with increased risk for adverse neonatal outcomes such as SIDS?
• Transient neonatal hypoglycemia is:
• A 2-week-old neonate weighing 3.18 kg at birth now weighs 2.95 kg. The infant is breastfeeding about every 2 hours; how many calories per day does this infant need for growth?
• Which symptom is commonly experienced in pityriasis rosea?
• Adolescent gynecomastia most commonly peaks at which age range?
• A patient with asthma is prescribed salmeterol (Serevent) by inhalation. The family should be warned about which side effects?
• An 8-year-old presents after playing on a rock wall with arm pain and inability to lift the arm. The most likely diagnosis is:
• During the 4-month well-child visit, what is advised about fruit juice?
• Scope of practice is defined as which of the following statements?
• Which imaging study is essential to assess for intra-abdominal pathology in a child with a palpable varicocele?
• At a well-child visit, a 5-year-old is grounded frequently for chores. How should the PNP respond?
• In a child with sickle cell disease, which statement best describes an infection-prevention strategy at a well visit?
• For the parents of an 8 month old, the MOST appropriate age-related anticipatory guidance related to safety should include which of the following?
• A 9-year-old child is brought to the clinic for a rash. During examination, a speech dysfluency is detected. The most appropriate plan of treatment should include:
• Which finding helps distinguish obesity from a large body frame in an adolescent concerned about weight?
• Which of the following is not an expected finding in a child with myocarditis?
• A sexually active 17-year-old boy reports unprotected sex recently. Which care approach is most appropriate?
• The most appropriate management of a 5yo with a firm, nontender nodule in the mid-upper eyelid for 3 weeks would be:
• During treatment for childhood cancer, which statement is true regarding immunizations?
• In sports evaluation, which history question is most important to assess during exercise?
• From the immunization history, which vaccine is scheduled at 20 months but not at 5 years?
• Which statement best describes a cyanotic spell associated with tetralogy of Fallot?
• A term infant born by C-section, with birthweight of 5 lbs 5 oz (2.4 kg), develops tachypnea with a respiratory rate of 68 at 2 hours of life. The most likely diagnosis is
• A 5-year-old who occasionally reverses letters with no other learning problems: what is the likely course?
• Which feature suggests a non-cardiac cause of syncope in a pediatric patient?
• Which factor increases the risk of developing hydrocephalus?
• What is the most common pediatric urinary tract problem seen in primary care?
• During ROS focused on the skin, which finding is an objective observation?
• During a visit, Mitch, 2 years old, presents with large muscular calves and difficulty rising from a sitting position. Which lab test should you order?
• Which statement is true about innocent murmurs in children during evaluation?
• Which topic would not be appropriate to include when providing anticipatory guidance to the parent of a 4-month-old infant?
• Which component of identity develops first?
• What is the MOST appropriate treatment for children with uncomplicated obstructive sleep apnea (OSA)?
• A neonate with suspected fetal alcohol syndrome and developmental delays should be referred to which early intervention program?
• Nutrition assessment of the child on a strict vegan diet should include regular growth monitoring, diet analysis, and laboratory assessment of
• Which statement about congenital HIV infection is true?
• When a 10-day-old neonate has mildly low T4 and elevated TSH but is feeding well, what is the recommended management?
• For a mother who adopted a child at birth, when is the most appropriate time to tell the child they are adopted?
• Which statement about the honeymoon period in type 1 diabetes is true?
• The PNP is evaluating a 2-year-old child with a 48-hour history of a dry, coarse cough and fever. Upon examination the child appears ill but non-toxic. The child has a harsh, forceful cough with intermittent stridorous breaths after a coughing spasm but no stridor at rest. The parents have been giving the child an expectorant and cough suppressant that have provided little relief. The PNP makes the diagnosis of croup without respiratory distress. Treatment for this child should include:
• A 13-year-old adolescent with a new unilateral headache that is increasing in intensity. What type of headache is it most likely?
• An 8-year-old with hard, painless neck and axillary lymph nodes; frequent nursing home exposure; the PNP suspects which diagnosis?
• Prematurity increases the risk of developing which one of the following?
• The PNP is obtaining a review of systems on a healthy 8yo girl. It would be important to include:
• In boys, lack of secondary sexual characteristics after 17 years of age suggests:
• Which finding would most strongly support a diagnosis of precocious puberty in an 8-year-old boy?
• What is the primary safety concern with alternating doses of acetaminophen and ibuprofen for pediatric fever?
• What is an appropriate treatment for herpes simplex stomatitis in a child?
• A vibratory systolic murmur heard between the lower left sternal border and the apex in a healthy 4-year-old with otherwise normal cardio exam. The most likely diagnosis is:
• During a health maintenance visit, which screening test is most important for a 15-year-old Vietnamese adolescent who recently immigrated?
• Which of the following is not a characteristic of innocent heart murmurs in children?
• Which statement about pediculosis humanus is NOT correct?
• A 7-year-old with otitis media with effusion persists for months with hearing concerns. The most appropriate next step is:
• Infants of diabetic mothers are at risk for hypoglycemia in the newborn period primarily due to maternal hyperglycemia causing fetal insulin overproduction.
• Dwayne, a senior in high school, suffers a concussion playing football. Immediately following the event, a typical clinical picture would include:
• In adolescent confidentiality discussions, which statement is correct for an adolescent who is 18 years old or older or under the state age of majority?
• When assessing the heart of a healthy 4-year-old child, which finding would you expect?
• The least likely physical finding in a 2-month-old with congestive heart failure is?
• An 18-month-old presents with irritability and nightmares after a URI and OTC cold medication; what is the most appropriate counseling point?
• Which finding is not a typical feature of rubella?
• A 14-month-old child with no vaccine reactions is brought to the clinic. Which immunization combination should be given today?
• Rubeola (measles) is which of the following statements?
• At 1 month, an infant with a mother who is hepatitis B surface antigen (HBsAg) positive has received both Hep B vaccine and HBIG at birth. At this visit, the PNP should:
• A 2-year-old with anal fissures and no constipation: which concern should be considered?
• The nurse practitioner role was initially established to:
• In a 2-week-old neonate with excessive lacrimation and hazy corneas but clear conjunctiva, which diagnosis is most likely and requires ophthalmology referral?
• A 5-year-old child is due for immunizations; the record suggests uncertain varicella status. What is the most appropriate action?
• A 7-year-old child with cerebral palsy is brought to the clinic. The child is unable to walk but is able to use a wheelchair. The child uses the arms and hands to eat and perform self-care tasks. The PNP diagnoses this child with:
• Which organization is primarily responsible for pediatric preventive care guidelines?
• At age 6 months, which vaccines are listed in the immunization schedule described?
• A foster mother suspects the adolescent is using drugs and wants separate testing. The most appropriate response is:
• A 10-year-old child is seen for recurrent UTIs but the urologic workup is normal. To help prevent future UTIs, which measure should the pediatric NP suggest?
• An 18‑month‑old with moderate croup symptoms requires treatment. Which option is the MOST appropriate therapy?
• Which statement best completes a malpractice claim alongside duty and breach?
• When counseling about obesity prevention for an 18-month-old, which recommendation is most appropriate?
• In a child presenting with suspected ITP, which is the most appropriate initial step?
• Which dietary recommendation is appropriate for a toddler with acute gastroenteritis?
• The mother of a 3yo states that her son was completely toilet trained at 18mo. The PNP explores further, asking:
• For a 2-year-old with fever who has been alternating acetaminophen and ibuprofen every 3 to 4 hours, counseling should include which statement?
• Which of the following factors is not usually present in a 4-year-old with migraine headaches?
• A newly delivered mother wants to breastfeed but admits to using marijuana occasionally. She reports last using marijuana over 6 weeks ago. Her drug toxicology screen is positive for marijuana. What would the PNP advise regarding breastfeeding?
• A 9-year-old child is brought to the clinic with facial pain, purulent nasal discharge, and tenderness over the maxillary sinus for the past 4 days. After completing the physical examination, the PNP should:
• National certification of PNPs has been offered since the 1970s. Which credential identifies nurses who have national specialty certification?
• In neonatal newborn screening panels, which condition is most commonly screened for after birth?
• During a first-trimester discussion about abortion, which statement reflects a misconception about the procedure?
• In acute osteomyelitis, femur and tibia are commonly involved. Which option shows this correctly?
• One of the most commonly suggested reasons for primary enuresis is:
• A 10-month-old infant shows cranial asymmetry during a well-child visit. The appropriate next step is to:
• During evaluation of a child with abdominal pain, which symptom most suggests an organic etiology?
• A 16-year-old with tinea versicolor is treated with which regimen?
• In the typical infant motor development sequence, which milestone occurs first?
• What is an appropriate recommendation for a 3-month-old with hard stools?
• What represents the best organizational approach when changing one's practice based on clinical evidence?
• Infant immunizations for hepatitis B often raises many parental questions about the disease. Which of the following is not true about Hep B virus?
• Paul has four superficial lesions on the abdomen that are scaly with erythematous borders. What condition do you suspect?
• All definitions of primary health care include which combination?
• The mother of a 3-year-old child questions the PNP regarding areas in North America where roundworms are a prevalent parasitic infection. Ascaris lumbricoides (roundworm) is most prevalent in what part of the United States?
• Which immunizations should be given at a 4-year-old preschool physical if DTaP, IPV, and MMR are due?
• A toddler with chronic loose stools and high juice intake is most likely diagnosed with which condition?
• A child with an initial total cholesterol of 205 mg/dL on screening for hyperlipidemia should have which test next?
• For a child with a history of egg allergy, which statement about MMR and Varicella vaccines is true?
• Which is the MOST appropriate management for a 14-year-old sexually active patient who tests positive for Neisseria gonorrhoeae and Chlamydia trachomatis?
• In a 3-month-old with mild asymmetry of the corneal light reflex, the most appropriate initial plan?
• For a toddler with fear of the dark, which statement about fears is most accurate?
• In epiglottitis, patients typically prefer which position to ease breathing?
• In pediatric research assent, which concept is essential for an adolescent to participate?
• Which scenario would raise concern about a preschooler's language development?
• In autism screening for a 17‑month‑old, which test is listed as not typically useful beyond screening?
• Congenital hypothyroidism in infants is associated with which clinical sign?
• A 10-year-old presents with a central, painless swelling on the left upper eyelid with mild erythema. The most likely diagnosis is:
• In accidental genitourinary trauma, which finding is not commonly seen?
• Which test best supports a diagnosis of a recent group A streptococcal infection in suspected acute rheumatic fever?
• Which disease has a characteristic rash that begins on the wrists and ankles and spreads proximally, often involving the palms and soles?
• Of the pathogens causing otitis media, which is MOST LIKELY to require antibiotic therapy?
• Which concept is described by stage-based theories as shaping development through environmental influences?
• What is identified as the major perceived barrier to using a nurse practitioner in a primary health care setting?
• A 5-year-old child is brought to the clinic for a 'bad cold.' On physical examination a grade II/VI sharp, systolic murmur that had not previously been documented is noted. The radial and femoral pulses are 2+ and equal. The heart rhythm and tempo do not change with position, and the remainder of the examination is normal. An appropriate plan of care should include:
• A 4-year-old child with a bifid uvula and an abnormal contour on the back of the hard palate should have which assessment performed?
• A 16‑year‑old with long QT syndrome after syncope should be managed by which measure?
• Which of the following responses during a tonic-clonic seizure is most important to teach family members of a child who has these seizures?
• A 9-year-old child is evaluated for a rash. During the exam, a speech dysfluency is detected. What is the most appropriate plan of treatment?
• Corneal abrasions can be managed with topical application of which one of the following?
• Which type of headache requires immediate referral to a physician?
• What clinical signs would you expect in a 7% dehydration on examination?
• Which condition is required for Medicare reimbursement by an APRN?
• Which symptoms would prompt the ordering of a genetic test for Prader-Willi syndrome?
• An 18-year-old with epilepsy seeks contraception. Which method is recommended?
• Which of the following is not a proposed etiologic factor in premenstrual syndrome?
• Leukotriene modifiers in children with asthma have been efficacious in preventing exercise-induced symptoms in adolescents. Which option best reflects this?
• An adolescent in a school-based clinic states they are a member of a gang. What response would be appropriate in the initial discussion?
• Which finding may accompany macrocephaly?
• Which daily medication is appropriate for a child with mild persistent asthma?
• In counseling about lead exposure, what is the most common source of lead exposure in children?
• In the United States, parasitic gastroenteritis is most commonly caused by which organism?
• Which statement about anticipatory guidance for an 8-year-old is most appropriate?
• Which topic is not appropriate to include when providing anticipatory guidance to the parent of an 18-month-old?
• Among toddlers with chronic diarrhea, which dietary pattern is most associated?
• The term "incident to" refers to:
• Tibial Torsion is commonly associated with which finding?
• Which test is not a specific exam test for detecting a dislocated hip?
• Which test is NOT routinely included in newborn screening for metabolic disorders?
• The pediatric nurse practitioner evaluates an injured pediatric patient and suspects abuse. The nurse practitioner should:
• A 9-year-old with circumscribed, coalescent, erythematous raised lesions of various sizes; The most common cause of hives is:
• Among survivors of meningitis, which sequela is most frequently observed in older infants and children?
• Which presentation most strongly suggests diabetes insipidus in an infant?
• Which finding is considered an ophthalmic emergency in a neonate?
• In infants born to mothers with diabetes or gestational diabetes, which cluster of findings is most characteristic?
• A 12-month-old infant tested HIV positive with no history of allergies or reactions to vaccines. The PNP should administer the following immunizations today:
• A 9-month-old infant with diarrhea shows dehydration estimated at about what percent?
• A 7-year-old child with factor IX deficiency who hits his head on the ground. What action should the PNP take first?
• Which of the following is the most appropriate first-choice management for a 30-month-old child with learning difficulties and ADD/ADHD?
• Endocardial cushion defect is a synonym for which congenital heart defect?
• A preschool boy whose parents are separating and beginning divorce procedures may:
• An important assumption underlying family systems theory is?
• Deon is a 4yo male with a history of atopic dermatitis and recurrent pneumonias. He presents with a persistent nighttime cough. His most likely diagnosis is:
• In counseling a parent regarding possible lead poisoning in the child, the PNP states that the most common source of lead is:
• A 16yo was hit in the eye 1 day ago and now has ecchymoses on the upper & lower lids with 5/10 eye pain. All but which one of the following would be appropriate to obtain at this time?
• A 2-year-old child is screened for lead poisoning. The blood level is 16 mg/dL. The PNP discusses nutritional needs, including a diet high in:
• The intervention currently advised for a child with four episodes of acute otitis media in the past five months is
• Which statement best describes postoperative outcomes after pectus excavatum repair?
• Cutis marmorata is best described as which pattern on the newborn’s skin?
• Which concept is considered the cornerstone of vital personality in infancy according to Erikson?
• A 12-year-old with chest pain radiating to the back and abdomen has tenderness over the costochondral junction. The most likely diagnosis is?
• A parent of a 2-week-old infant switched from iron-containing Enfamil LIPIL to a soy-based ProSobee LIPIL due to concern about allergies in an older child. What is the BEST response?
• Which of the following is NOT a typical presentation of neonatal disseminated herpes infection?
• Which screening instrument is specifically designed to assess articulation in preschool children?
• During a track meet, a 14-year-old pole vaulter experiences sudden severe testicular pain and vomiting. The most likely diagnosis is?
• Typical migraine symptoms in a 14‑year‑old usually include which combination?
• In a child with diabetes, sweating, hunger, drowsiness, and confusion are most consistent with which condition?
• What is the percent risk that an autosomal dominant gene is passed on to each offspring?
• Shelby, a 4-week-old infant, presents with fever, poor feeding, paroxysmal coughing, and labored breathing during winter. What is the most likely cause?
• Which statement about hepatitis B virus is true?
• Most healthy infants are able to reach, grasp, & hold onto a rattle or other small toy by about:
• The MOST APPROPRIATE management of an infant or young child with recurrent wheezing is
• The test most commonly used to elicit strabismus in infants and children older than 6 months is the:
• A 17-year-old adolescent reports taking 1200 mg of ibuprofen every 4–6 hours for the first 3 days of menses. What is the best counseling point?
• Which scenario requires the use of an inactivated (not live) vaccine?
• A 2-year-old child is brought to the clinic with wheezing after a cookout episode; the clinician suspects which diagnosis?
• Pinworm infestation is common in children. The PNP discusses the signs and symptoms of pinworm infestation with a mother. Which of the following parasites is responsible for this disorder?
• In an infant with rib fractures, which imaging study is considered most critical initially?
• Which statement best identifies the recommended long-term controller therapy for persistent mild-to-moderate asthma in a child?
• Lyme disease is most closely associated with which skin lesion?
• A parent reports that the child awakens crying and agitated during the last half of night sleep; the child is awake and can be comforted; the parent denies this child is experiencing:
• A positive Adam’s sign indicates which clinical finding?
• A 9-year-old patient whose father recently had an acute myocardial infarction should undergo which screening test next?
• A 7-year-old with recurrent epistaxis; which finding on exam would suggest an underlying medical cause?
• A 13-year-old asks when she will start menstruating. The best response is:
• Which sign is most characteristic of congenital hypothyroidism in infants?
• A 15-month-old with chronic nasal congestion and recurrent otitis media; what should the PNP do next?
• Which description best describes psoriasis vulgaris lesions?
• Fifth disease is usually seen in which age group?
• A 2-year-old child screened for lead poisoning has a lead level of 14 mcg/dL. The intervention should include which action?
• An 18-month-old child is being evaluated in the clinic for falling with increasing frequency and loss of speaking ability. The PNP considers:
• In a 5-year-old with allergic rhinitis and pale boggy nasal mucosa, which non-sedating antihistamine is appropriate?
• Traveling to a measles-endemic area with an infant: what is the best preventive action?
• What is an effective disciplinary approach for a preschooler who struggles with chores?
• The purpose of administering acidophilus while taking antibiotics is to
• Which immunization plan is most appropriate for a child who recently had Kawasaki disease and was treated with IVIG?
• In a 5-year-old with a gross motor deficit but normal language, which statement best reflects the association between language skills and school success?
• In a 10-year-old with fever of 102°F and palatal petechiae presenting with sore throat, the BEST management is?
• A 2-week-old presents with mucopurulent eye discharge with conjunctival injection and edema. The mother had no prenatal care. What is the most likely organism?
• Which professional team is typically involved in the initial evaluation for an IEP?
• A 2.5-year-old child has anal itching and has been awakening at night. The diagnosis is:
• Leukotriene modifiers in children with asthma: which statement is true?
• In a child with macrocephaly, which imaging study would be most appropriate to evaluate intracranial structures?
• In the context of parental separation, a preschool child may believe the divorce has occurred due to which of the following?
• For an infant with suspected fetal alcohol syndrome and developmental concerns, which service is appropriate to obtain early intervention?
• A 10-year-old obese child with a total cholesterol of 205 on initial screening for hyperlipidemia. What is the MOST appropriate next step?
• A 10-year-old with unilateral chest pain that radiates to the back and abdomen has tenderness over the costochondral junction. The PNP diagnoses chest pain due to:
• In pediatric patients, inflammatory bowel disease most commonly presents during which age range?
• An infant with suspected fetal alcohol syndrome should be referred to which program for early intervention?
• A three-year-old with intermittent abdominal pain and vomiting; examination is otherwise benign. Which management is most appropriate?
• In suspected infantile botulism, which option would be inappropriate?
• A 14-year-old cross-country runner has a 3- to 4-week history of knee pain that worsens with activity. Exam shows tenderness over the tibial tubercle. What is the BEST management strategy?
• Role-play with equipment during the course of a physical exam would be most beneficial for which age group?
• What action should the pediatric nurse practitioner take when a pregnant patient who smokes requests guidance?
• Children with Down syndrome have 15 to 20 times incidence of developing which of the following as compared to other children?
• A 3yo has an edematous, mildly erythematous right upper eyelid for one day with a fever of 103F. An important eye assessment would be:
• In the initial evaluation for suspected ADHD, which test is NOT routinely recommended?
• Communicating hydrocele is best differentiated from the noncommunicating type by which finding?
• Which age is recommended to introduce iron-fortified cereal to prevent iron deficiency anemia?
• Which sign describes softening of the lower uterine segment during early pregnancy?
• Which statement about combination vaccines is true?
• Which factor has the strongest association with malignant melanoma?
• An 8-year-old with chronic intermittent nasal congestion; which finding would support allergic rhinitis?
• A 4-year-old child with a vesicular eyelid eruption and eye pain should be managed by which of the following as the best immediate step?
• What type of hemorrhage would be expected with severe factor VIII deficiency?
• Which statement is true about true precocity or incomplete (pseudoprecocity)?
• Retropharyngeal abscess is typically seen in which age group, and treatment mainstay includes:
• A newborn presents with cranial asymmetry but no signs of illness. What is the most appropriate next step?
• Tammy has mild persistent asthma. Appropriate daily medications for this 4-year-old preschooler should include:
• An essential test in the evaluation of a 2-year-old being managed for Kawasaki disease is:
• Drug therapy commonly used to treat absence seizures, in addition to valproic acid, includes:
• A Down syndrome newborn has an elevated TSH on newborn screening. What is the appropriate counseling and plan?
• Which statement about the pediatric nurse practitioner's scope of practice is correct?
• A 6-month-old well-child visit with fever and otitis media; which immunizations should be administered today?
• Which of the following is not included as part of the initial therapy for ALL?
• Asplenia commonly predisposes to infection with which type of organism?
• For a 2-year-old with a barking cough and no respiratory distress due to croup, which treatment plan is appropriate?
• Which congenital infection is classically associated with a blueberry muffin rash due to extramedullary hematopoiesis?
• Which problem is common in a child with Hurler's syndrome?
• During a well-child visit, a 3-year-old girl is noted to have labial adhesions. What topic should the PNP discuss with the mother?
• The most appropriate laboratory tests to obtain for evaluation of a neonate with jaundice presenting in the first 36 hours of life include:
• Which vaccine was documented at birth in the case presentation?
• In a child with painless lymphadenopathy and recent nursing home exposure, which diagnosis should be high on the differential?
• Which of the following is not a characteristic of capillary hemangioma?
• Renal tubular acidosis type 1 is characterized by which of the following?
• A 15-year-old with hypothyroidism is tested. Which laboratory pattern defines early hypothyroidism?
• What does SPF 6 indicate on sunscreen?
• Insect stings are most commonly reported in which season?
• Which statement about HbA2 in beta-thalassemia trait is true?
• Regarding delivery of inhaled albuterol in children, which statement is MOST appropriate?
• The first nurse practitioner program was designed to
• A previously healthy 10-month-old has vomiting, intermittent periods of intense crying, and the passage of red stool. Which would be considered FIRST in the child?
• The pediatric nurse practitioner is evaluating a one-month-old infant male with a unilateral undescended testicle (cryptorchidism). The patient was born at term after an uncomplicated pregnancy and physical examination reveals no other abnormalities. The pediatric nurse practitioner should:
• A 10-year-old with a 12-day history of rash and intermittent fever has an annular indurated lesion on the thigh and two small papules with surrounding erythema. An appropriate treatment approach is:
• Which vaccine is associated with a decreased incidence of epiglottitis?
• Which statement best defines health literacy?
• When labial adhesions are observed in a child, which counseling point is most appropriate for the parent?
• For a 4-week-old with positive Barlow and Ortolani tests, which study best confirms the diagnosis?
• The PNP is managing the case of a 2.5-year-old child with otitis media with effusion after an episode of acute otitis media. The effusion has now been present for 3 months. The most appropriate step is to:
• In the evaluation of a school-aged child with prolonged QT interval, which test should be included in the initial workup?
• In the diagnostic approach to tuberous sclerosis, which test is most definitive for identifying brain involvement?
• Which complication of strep pharyngitis cannot be prevented with antibiotics?
• Which genetic testing is used to detect Fragile X syndrome as part of the screening process for developmental delays?
• For a 2-year-old who thumbsucks, which approach is recommended by the clinician?
• A 13-month-old child is brought for routine immunizations; which immunizations should be given today?
• Which symptom is typical of scabies?
• A 2-month-old infant with a history of sacral myelomeningocele repair shows head circumference rising from the 75th to the 95th percentile. What is the most appropriate first action?
• Which statement about Tourette syndrome is not true?
• Which statement about sports-related injuries in adolescents is true?
• Which clinical feature most strongly suggests epiglottitis in a child presenting with fever and drooling?
• In a community with a teen pregnancy rate of 3 in 100 among ages 15 to 19, what is the most important area to explore when the patient is 12 years old and possibly pregnant?
• A parent of a 7-year-old is concerned about the child's school absence; what is the FIRST challenge for the parent?
• What is the most appropriate immediate action for suspected testicular torsion?
• Inflammatory bowel disease in pediatric patients most likely presents in which age group?
• When providing asthma education regarding the use of long-acting beta2 agonist, it is important to stress:
• Which radiographic change is most characteristic of Legg-Calvé-Perthes disease?
• At an 18-month well-child visit, a mother reports a 4 oz milk bottle at nap time and 8 oz at bedtime, with other fluids in a cup. Which information is most pertinent to obtain?
• Which of the following is not typically a urinary tract indicator?
• Which murmur is commonly described as a vibratory murmur in children?
• Which of the following is not likely to cause secondary hypercholesterolemia?
• Which nasal foreign body requires immediate removal?
• Which represents information obtained during a review of systems (ROS)?
• Which treatment would you not recommend for molluscum contagiosum?
• At 18 months, which vaccines are routinely given?
• In pediatric OCD, which feature is essential for diagnosis?
• A 9-year-old with heel pain that begins with football practice, with infectious or inflammatory causes ruled out, most likely has which condition?
• A 4-month-old infant has not had other immunizations besides Hep B; Which vaccines should be given today?
• The steeple sign on a neck radiograph is associated with subglottic narrowing in which pediatric condition?
• Malpractice insurance:
• The first step in developing an individualized education program (IEP) for a child with disabilities is to:
• A 3-year-old child refuses to use the toilet and squats in a corner to pass stool despite encouragement. The clinician should respond that:
• Which exam finding would you expect on rectal examination in Hirschsprung disease?
• If solids are delayed beyond 12 months, which nutrient is most likely deficient?
• A 10-year-old presents with a single painful ulcer on the inner cheek mucosa; most likely diagnosis and treatment?
• All but which assessment is used to determine the presence of a strabismus?
• In HIV testing for a neonate, which test is most accurate?
• Which option best reflects rotavirus vaccination's role in preventing gastroenteritis in children?
• A 15-year-old adolescent routine examination shows no varicella history. The immunization plan includes prior DTP and OPV. Which should be administered today?
• For a 10-year-old with borderline hyperlipidemia, which plan is appropriate to pursue before considering pharmacologic therapy?
• Which test provides the most definitive diagnosis for suspected syphilis?
• For a 10-month-old infant, which car-seat guideline is appropriate?
• In preterm infants born at 32 weeks gestation, when is the earliest recommended time to begin immunizations?
• In a patient with a hyphema, which outcome is considered the greatest risk for further complication?
• What is the first step in developing an Individualized Education Program for a child with disabilities?
• Secondary hypothyroidism results from which cause?
• A 14-year-old presents with chest pain. Among the differential diagnoses, which is the most common cause of cardiac pain in children and adolescents?
• A 3-year-old child is brought to the clinic with vomiting, low-grade fever, and watery, frequent stools for the past 24 hours. What is the recommended management?
• For a child with type 1 diabetes, which macronutrient distribution is recommended in a well-balanced diet?
• Which parental behavior would discourage sibling rivalry?
• At what age do children generally begin to exhibit fear of strangers?
• Which statement best describes 'incident-to' billing in pediatric primary care?
• A 4-year-old with a history of Kawasaki disease treated with intravenous immune globulin (IVIG) 2 months ago presents for immunizations. Which immunizations should be administered today?
• A hypernasal voice and snoring in a child is suggestive of which condition?
• Which of the following is NOT a characteristic feature of DiGeorge syndrome?
• Which condition would exclude a child from participating in contact collision sports?
• Which concept is relevant to the school-aged child?
• Which hepatitis virus vaccines are available and approved for use in children?
• Cystitis or pyelonephritis in childhood is most commonly caused by which mechanism?
• For a 2-month-old breastfed infant and a mother nursing on demand, what is the recommended approach?
• In adolescent acne, which statement is most consistent with its pathophysiology?
• Which test is most appropriate to assess skeletal maturation in pediatric patients?
• Which finding is most suggestive of the likely diagnosis in this patient?
• A 5-year-old female presents with hyperactivity, mild developmental delay, gaze aversion, hand mannerisms, a long narrow face and slightly dysmorphic ears. Which diagnosis is most likely?
• A 12-year-old girl presents with enlarged breasts and areolas and curly, dark, coarse pubic hair. Using Tanner staging, this child is classified as which stage?
• When giving injury prevention education to a sixth-grade class, which topic should be emphasized?
• Which substance is most likely to cause immediate euphoria and hyperactivity after a party in a teenager?
• A 7-year-old with recurrent epistaxis and a mother with heavy menses; most likely diagnosis?
• When calculating oral replacement therapy for a child with moderate dehydration from gastroenteritis, which guideline should be followed?
• Which statement best describes catch-up growth in premature infants?
• Which of the following is a common cause of acquired coronary artery disease during childhood?
• During a well-child visit for a 2.5-year-old who rocks back and forth since 6 months, with normal development, what is the most likely explanation?
• Under federal laws, a child with disabilities is entitled to an individualized education program. Which option reflects that entitlement?
• At a 6-month well-child visit, which statement about cow's milk is correct?
• Which timing is recommended for initiating acyclovir therapy after the onset of HSV lesions?
• TMP-SMX should not be prescribed to infants of which age group?
• In a 16-year-old male with acute scrotal pain lasting three hours, what is the FIRST course of action?
• An 8-year-old with cough; immunization status; which is the suggested course?
• Which statement accurately describes certification for APRNs?
• Which nutrient combination is most essential to ensure adequate intake for a vegetarian adolescent?
• Which statement about scope of practice is true?
• Absence seizures are best described by which statement?
• By what age does the anterior fontanel typically close?
• What is the best treatment of seborrhea in the infant?
• Regarding normal development of pediatric sinuses, which statement is correct?
• In a pediatric patient with pneumonia, which assessment tools best evaluate oxygenation status?
• A 9-year-old with joint pain, trunk rash, and a sore throat 3 weeks ago would lead you to order which test?
• Meatal stenosis features: which statement is true?
• Which factor is NOT a risk factor for otitis media?
• A 3-month-old has a mild asymmetrical corneal light reflex on physical exam. What is the next appropriate step?
• Which finding is most consistent with Edwards syndrome in a newborn?
• Which strategy would not be appropriate to include as part of your management of a 9-year-old boy who is obese?
• Which of the following is a focus of care in the first weeks after delivery?
• For a 12-year-old with a red, swollen eyelid, what is the most appropriate initial management?
• Which of the following is the MOST effective primary intervention to prevent adolescent depression?
• During a genital examination of a prepubescent girl after penile penetration, which finding would a pediatric nurse practitioner most likely observe?
• Which of the following is an appropriate goal for a child being treated for osteomyelitis?
• A white reflex instead of a red reflex upon eye examination of a 1-year-old would suggest which condition?
• Which injury-prevention topic would a pediatric nurse practitioner emphasize when addressing a group of children?
• A 12-month-old child is brought to the clinic with the right eye drifting toward the nasal side. The clinician notes this misalignment and explains that a common complication may be:
• VZIG should be administered to which group after exposure to varicella?
• Which of the following is least helpful in evaluating epilepsy?
• Duchenne muscular dystrophy is characterized by which of the following s/s?
• Which of the following factors associated with poor health outcomes would be least attributable to lack of health insurance?
• Which insulin type is considered short-acting?
• In managing bedtime resistance for a 2-year-old, which approach aligns with best practice?
• In a 4-month-old with hypotonia and motor delay since birth, which finding most strongly suggests lower motor neuron involvement?
• An 18-month-old child with asthma and egg allergy; which immunizations should be given today?
• In the context of aminoglycoside use in an infant, which complication is most associated?
• Which statement about nutrition in school-age children is most accurate?
• During a sports physical, a 13-year-old girl has urinary frequency and dark vaginal discharge. Dipstick shows +1 blood with no protein, leukocytes, or nitrites. What is the most appropriate management?
• In infants of diabetic mothers, which combination of findings is most likely?
• In a 12-year-old girl who may be pregnant, what is the most important area to explore?
• An 18 month old with a history of recurrent otitis media and prolonged febrile seizures—Which management is most appropriate?
• Which statement about pediatric phimosis management is true?
• The rash that begins on the wrists and ankles and often involves the palms and soles is most characteristic of which disease?
• Systemic-onset JIA is most characteristically associated with which fever pattern?
• The parents of a 6-month-old report the infant is 'different' from their previous child. Which behavior would alert the PNP to a diagnosis of autism?
• A 2-month-old infant has persistent vomiting; gastroesophageal reflux is suspected. During a feeding, the PNP observes for:
• Which suggestion should the PNP make to reduce medical errors in the clinical area, according to a health care quality report?
• Which instrument is a caregiver-report measure of adaptive behavior and social functioning?
• Which substance is associated with pupillary constriction?
• Radiographic findings of disease progression and sphericity of the femoral head are useful in the diagnosis and follow-up of which hip disorder?
• In addition to airway hyper-responsiveness and reversible airway obstruction, asthma is a chronic lung disease characterized by which of the following?
• Historically, the APRN role has primarily focused on delivering what level of care?
• Which medication should be avoided in a child with chickenpox due to the risk of Reye syndrome?
• A 4-year-old child sustained an insect bite near the left eye. The area is now red, warm to the touch, tender, and not well demarcated. The PNP:
• Fluorescein dye is used to detect which of the following ocular issues?
• After an ALTE, management and treatment are based on findings from which source?
• A 15-year-old mother brings a 3-month-old infant; to obtain accurate information about the infant's routine, the PNP should first:
• Which statement reflects mandatory reporting in most jurisdictions when abuse is suspected?
• Which of the following Is not a frequent sign of a gonorrhea infection:
• ANA seropositivity for antibodies in juvenile idiopathic arthritis is:
• Which combination of findings is most suggestive of congenital syphilis?
• The role of the APRN has traditionally focused on:
• Glucagon should be used to treat which level of hypoglycemia?
• An adoptive family brings a 10-month-old with unknown medical history for a first well-child visit. Which initial screening tests are indicated?
• Which diagnostic test would not be helpful when evaluating a child with suspected inflammatory bowel disease?
• A mother reports her 4-year-old 'plays with himself in front of the TV.' What guidance should the PNP give?
• Which symptom is most compatible with pediatric sinusitis in a child with persistent sinus symptoms?
• Which rhythm disturbance in a neonate is most likely when the heart rate is around 240/min at rest during sleep?
• When introducing solid foods to an infant’s diet, which food is typically introduced last?
• For which of the following individuals is there no indication for obtaining a chromosomal analysis?
• Your patient has inflammatory bowel disease. Which finding is most consistent with ulcerative colitis?
• Which medication is commonly used to increase fetal hemoglobin production in sickle cell disease, reducing vaso-occlusive events?
• A Wright’s stained smear in erythema toxicum neonatorum is expected to show which cell type?
• In idiopathic scoliosis, which statement about family history is true?
• The mother has been identified as a carrier of the hemophilia gene. What chance does each female offspring have of having hemophilia?
• In learning disabilities, which combination is commonly associated with perceptual-motor impairments?
• The parachute developmental reflex in infants occurs at which age?
• A child would warrant referral for a comprehensive developmental evaluation if which occurs?
• Gynecomastia in a male may not be a finding in which of the following?
• Which statement describes slipped capital femoral epiphysis most accurately?
• Impetigo is described as which characteristic lesion?
• Which of the following is not a characteristic sign of fragile X syndrome in adolescent males?
• If a child has a mild upper respiratory infection and is otherwise well, should routine vaccines be given today?
• The APRN Consensus Model is described as:
• A father brings his 9-month-old because the infant is tugging on the right ear. Cranial and facial asymmetry are noted, but there is no evidence of otitis media. What is the most appropriate next step for the PNP?
• A 7.5-year-old presents with inspiratory stridor, drooling, and a fever of 105F. He insists on sitting up during the exam. What is your diagnosis?
• In evaluating a child with signs of attention problems and learning difficulties at 30 months, which approach is most appropriate as an initial step?
• Which child is at greatest risk for influenza complications and should be prioritized for vaccination?
• Infant seborrheic dermatitis (cradle cap) is best described by which statement?
• A newborn's head appears proportionally large compared with the rest of the body. How should the clinician respond to the parent?
• A 13-year-old adolescent complains of difficulty walking and arms feeling weak. The adolescent had a cold 2 weeks ago. On examination, deep tendon reflexes cannot be elicited. The PNP knows the most appropriate course of action is to:
• In a 2-month-old with visible rib fractures on radiograph, the next most critical evaluation to obtain is which study?
• What statement best describes dysfluency in preschoolers?
• Which discipline approach is recommended as an additional method when a young child frequently misses chores?
• Management of a patient who undergoes splenectomy does not include which of the following?
• In a child presenting with headaches, which pattern is most concerning for a brain tumor?
• Diffuse edema of the soft tissue of the scalp crossing suture lines in the newborn is called what?
• A 6-year-old child is evaluated after seizures. Which test is most relevant for screening?
• A 4 month old with congenital nasolacrimal duct obstruction (CNLDO) had several episodes of dacryocystitis and is currently hospitalized for cellulitis. What is the appropriate follow up?
• Which diagnosis is not more common among males?
• The most appropriate car-seat anticipatory guidance for a foster infant weighing 20 pounds at 10 months is:
• A 15-month-old child undergoing leukemia treatment has IPV and MMR due today. What immunizations should be given?
• A newborn presents with lymphadenopathy, a decrease in the ability to move the left leg, Coombs-negative hemolytic anemia, hepatomegaly, & snuffles. What is the most likely diagnosis?
• Preventative health guidelines typically include guidance on which of the following?
• The type of seizure that first presents during infancy in which the infant goes into a 'jack knife' posture is:
• Which set of findings best matches the diagnostic criteria for autistic disorders?
• Which temperamental profile is most common in children?
• Which statement accurately reflects the risk profile for leukemia in children with Down syndrome?
• The most judicious recommendation for therapy for primary hypertension in a 15-year-old is:
• Providing reassurance of 'normalcy' during the course of an exam would be most important for which age group?
• A 2-year-old with nasal congestion and runny nose is seen. What is the most appropriate initial management?
• Painful vesicular skin lesions in an adolescent most likely indicate which infection?
• Which organism is commonly associated with infectious diarrhea following exposure to contaminated food?
• Which presentation is consistent with neonatal disseminated herpes disease?
• Which statement best describes a healthy breastfeeding pattern on day 5 postpartum?
• For a 2-year-old with suspected hearing deficit, which assessment is most appropriate to evaluate hearing?
• In a 14-year-old with dilated pupils, diaphoresis, and panic-like behavior, the most appropriate initial testing would be
• Which diagnostic evaluation warrants the MOST attention when evaluating autism?
• Which is not a proposed etiologic factor in premenstrual syndrome?
• A 12-year-old with a dry, unproductive cough, a low-grade fever, and copious sputum; coarse breath sounds and moist rales in the upper lungs. The PNP diagnoses bronchitis and treats with:
• During an acute episode of urticaria, which management measure is NOT appropriate?
• The primary treatment for Neisseria gonorrhoeae would be?
• A 2-week-old infant is breastfed exclusively and at the 1-week checkup weighed 4 oz more than at birth. The infant has not had a bowel movement in 4 days but has had more than eight wet diapers each day, is nursing vigorously, and has no signs or symptoms of illness. What counseling is appropriate for the mother?
• 'Boggy' nasal mucous membranes with serous drainage upon examination usually suggests which condition?
• A parent asks what intervention you would recommend for a 6-year-old who wets the bed (primary nocturnal enuresis).
• Consistent with Hirschsprungs Disease, rectal exam would be which finding?
• Topical conjugated estrogen cream for labial adhesions is best described as...
• Which of the following signs indicates that a baby is not receiving sufficient breastmilk?
• An 11-year-old presents with a 3-day history of cough at night, tachypnea, and URI symptoms. Exam shows loud inspiratory and expiratory wheezing. What is the FIRST course of action?
• You see Jack, a 20-month-old toddler with diarrhea. He passes up to three loose stools a day and drinks 20 oz of apple juice per day. What is the most likely diagnosis?
• A neonate is diagnosed with trisomy 21 based on karyotyping. What type of follow-up will the infant need?
• Which should always be included in the evaluation of a child with a suspected learning disorder?
• Reimbursement under managed care:
• All but which one of the following is consistent with glaucoma?
• What is the probability of having a child with cystic fibrosis if the mother carries the △F508 gene and the father does not?
• Which statement about feeding infants is supported by guidelines?
• Which statement about erythema toxicum neonatorum is true?
• Asplenic children are at increased risk for which of the following?
• Significant progression of a 20 degree scoliotic curve is most likely to occur in a female who is
• What is the recommended approach when immunizing a child for measles, mumps, and rubella (MMR) in relation to a TB skin test (PPD)?
• Which statement about pityriasis alba is most accurate?
• Which of the following is not considered preventative management for iron deficiency anemia?
• Which statement best describes polyarticular juvenile idiopathic arthritis?
• A 16-year-old adolescent is brought to the emergency room with bradycardia, miosis, depressed respiration, and stupor; the adolescent does not respond to verbal stimulation. On examination, possible needle tracks are noted between the toes. The PNP suspects a heroin overdose and after consulting with a physician begins treatment with:
• In evaluating cervical adenitis, which test is least likely to yield diagnostic value?
• Congenital hypothyroidism in infants is most commonly associated with which finding?
• Which combination is listed for vaccines at 2 months and 4 months in the infant immunization schedule?
• Which factor is not usually perceived as a risk factor for adolescent pregnancy?
• Which is the appropriate return-to-child-care guidance for a child with mumps?
• A 14-year-old girl with delayed menarche asks for guidance. Which statement is MOST accurate?
• Why are blood glucose targets slightly higher in younger children with diabetes compared to older children?
• Koplik spots are pathognomonic for which disease?
• Management for physiologic leucorrhea includes which of the following?
• What is an appropriate approach during a night terror episode?
• Which disease is explicitly prevented by the MMR vaccine?
• Which sign would you expect in a child with dehydration?
• The most useful test for evaluation of suspected acute rheumatic fever is:
• A 14-year-old adolescent has knee pain that worsens with activity and improves with rest. The PNP diagnoses Osgood-Schlatter disease. Which management plan is most appropriate?
• What is an appropriate strategy to instruct the parents of an 18-month-old child who has just been diagnosed with a febrile seizure and who has a fever of 104F?
• Which approach best respects patient autonomy and cultural beliefs when delivering pediatric care?
• For a 16-year-old with a latex allergy, which contraception option would be advised?
• What is the most sensitive physical finding for the diagnosis of testicular torsion?
• An 18-month-old child has irritability, nightmares, and fatigue for several nights. Grandmother gave OTC medication for rhinorrhea. The child is afebrile with clear rhinorrhea. Which action should the PNP take?
• A 4-year-old unable to sit cross-legged on the floor and rise without using the hands may indicate which issue?
• An adolescent with juvenile rheumatoid arthritis is taking NSAIDs and develops epigastric pain. What management is appropriate?
• A 3-year-old in daycare with three days of low-grade fever and foul-smelling watery stools followed by abdominal distention. Which organism is most probable?
• Which foods are most commonly associated with food allergies in children?
• Blepharitis in a child should be treated with which initial management?
• In addition to a developmental evaluation, which baseline studies should be included for an infant diagnosed with 22q11 deletion syndrome?
• Which is the correct regimen for a single dose of pinworm medication with a follow-up dose in two weeks?
• Counseling regarding meningococcal disease for a prospective college freshman who plans to live in a dormitory should include that
• Which combination is appropriate to administer at the 15-month visit according to the schedule?
• The most effective method to prevent childhood gun injuries is:
• According to Erikson, the major psychosocial task of adolescence is the achievement of:
• A neonate in the nursery has an absent cremasteric reflex and the right testicle cannot be palpated in the scrotum. The most appropriate next step is to:
• Diagnostic studies included in routine screening of a child with developmental delays of unknown etiology include which of the following?
• Which statement helps differentiate night terrors from nightmares in preschoolers?
• An example of a pleiotropic genetic disorder is:
• A 12-month-old child has an abnormal urine culture at the 12-month well-child visit. The child is uncircumcised with non-retractile foreskin, and the parents have not routinely retracted or cleaned under the foreskin. What is the most appropriate treatment?
• Which statement best describes innocent murmurs in children?
• Which of the following is not an absolute contraindication for oral contraceptive?
• Which inherited disorder is most associated with seizures and cognitive deficits?
• The most likely weight of a 1-year-old child whose birth weight was 6.5 lb would be:
• The most important PRIMARY care goal for a school aged child with a prosthetic heart valve is to
• National certification of PNPs has been offered since the 1970s. Which credential identifies nurses who have national specialty certification?
• Which hematologic profile is typical of beta-thalassemia major?
• A risk factor that is common to many psychosocial pediatric problems including failure to thrive, conduct or oppositional disorders, and childhood depression is:
• Which clinical scenario requires the use of an inactivated vaccine rather than a live vaccine?
• In adolescents, which type of primary headache is most common?
• Which chronic illness should be considered in a child with recurrent perirectal abscesses?
• Which neonatal presentation is most indicative of Prader-Willi syndrome?
• You would expect a school-age child to:
• A 5-year-old child born at 28 weeks gestation has mild spastic diplegia. Which evaluation is important before the child is placed in regular kindergarten?
• Which is considered the strongest level of evidence among the following choices?
• The PNP examines a 4-month-old infant with hypotonia and motor delay since birth. The most significant finding indicating lower motor neuron involvement in this infant would be:
• Regarding complete or central precocious puberty, which statement is most accurate?
• Which statement is most accurate regarding pediatric head injuries?
• Which of the following is most likely to cause foul smelling vaginal discharge in a child?
• Which acne medication requires strict pregnancy prevention counseling due to teratogenicity?
• A 3-year-old afebrile with a one-day history of limp after a viral illness: what is the most likely diagnosis?
• Vulvovaginitis may be caused by all of the following except which?
• When performing a preemployment physical on a 16-year-old adolescent, given that the girlfriend was recently treated for a vaginal infection, the PNP should:
• Among a child with hemophilia who injures a knee, what is the highest priority in emergency care?
• At what age is the MMR vaccine first given in the immunization schedule described?
• A MOST concerning cardiac finding in the initial newborn assessment is which of the following?
• What is the most likely interpretation for a 13-year-old with Tanner stage 4 and no menarche?
• The most common clinical presentation of pneumonia includes which of the following?
• Which approach best supports early identification of a language disorder in a child who shows speech dysfluency?
• The knowledge base of the APRN is based on:
• Which imaging study would be indicated to evaluate intracranial structures in a child with macrocephaly?
• A criterion for Kawasaki disease includes fever for at least 5 days plus which extremity finding?
• During the ROS, which statement would be considered subjective data?
• Which Kawasaki disease statement is most accurate?
• Which of the following genetic disorders can be detected by cytogenic testing?
• Regarding folliculitis etiologies, which statement is not correct?
• In an adolescent with signs of major depressive disorder but no safety concerns, which is the most appropriate initial management?
• The PNP sees a 6-week-old HIV-exposed neonate; which prophylaxis would be appropriate in conjunction with the HIV specialist managing the infant?
• Which statement best describes Duchenne muscular dystrophy?
• Which sign is least likely to be seen with a peritonsillar abscess?
• Which of the following is not characteristic of Jale's condition (contact dermatitis)?
• The greatest risk in a patient with a hyphema is which one of the following?
• Which statement is NOT an appropriate part of anticipatory guidance for a child newly started on thyroid hormone therapy?
• Kawasaki disease most commonly affects which age group?
• A 10-month-old infant presents with a large bulging umbilical mass that is easily reducible and more prominent when the child cries. The PNP should:
• Which sign describes softening of the cervix during early pregnancy?
• A 2-year-old with microcephaly and Denver II showing delays is brought to clinic. What is the recommended action?
• An 8-year-old with scaly, hyperpigmented lesions in a fir-tree distribution on the trunk, with one large buttock lesion, most likely has which diagnosis?
• Jerry has a condition that most commonly occurs on which body surface (folliculitis)?
• If thumb-sucking continues beyond age 3, which statement best describes the importance of intervention?
• Which item is included in the differential diagnosis for seizures?
• A 2-year-old girl with lymphedema of the hands and feet, a low posterior hairline, cubitus valgus, and a history of intrauterine growth retardation. Which cardiac defect is most commonly associated?
• Endocardial cushion defect is the same as which term?
• During a health maintenance visit for a 15-year-old female who is sexually active, which screenings, labs, and immunizations are indicated?
• For a 2-year-old who may have swallowed a watch battery, what is the initial action for the PNP?
• For a child presenting with suspected acute idiopathic thrombocytopenia purpura (ITP) and a platelet count around 20,000/mm3, what is the most appropriate initial management?
• Fluorescein screening of the eye is used to detect a:
• A 6-month-old with gastroenteritis has mild dehydration. What is the best initial management?
• Which statement best describes the classic presentation of malaria?
• Which of the following is the earliest screening test used in managing Trina's care during her first trimester?
• In pediatric obesity, which factor best predicts progression to adult obesity?
• A 10-year-old child presents with a puncture wound to the buttocks after contact with rusty metal. Which action is most appropriate for the PNP to perform at the visit?
• A 12-year-old girl asks about getting much taller. In examining puberty timing, which statement is consistent with the typical pattern in girls?
• At 6 months, which vaccines are given?
• A 13-month-old healthy well-child visit; immunization record shows age 5 months DTaP, IPV, Hib, Prevnar, and Hep B. The child should receive today:
• At a 12-year-old's annual checkup, which pubertal change will begin next?
• A 16-year-old girl reports a frothy, malodorous discharge after first sexual intercourse. Which infection is most likely?
• Which vaccines are routinely given at 6 months of age?
• In Duchenne muscular dystrophy, which history is most commonly noted?
• A 6-month-old presents with four days of diarrhea and vomiting. Weighing 7 kg at check, now 6.5 kg. What is the percent dehydration?
• Which anatomical region is most commonly injured in youths who skateboard?
• In screening for developmental delays of unknown etiology, which genetic test is considered part of normal evaluation?
• A 4-year-old child presents with ulcers on the tongue and oral mucosa, and vesicles on the palms, soles, and interdigital areas. Which diagnosis is most likely?
• Which infant reflex is a survival reflex aiding feeding?
• Which finding is most important to confirm erythema multiforme major rather than erythema multiforme minor?
• Most stage-based theories of development focus primarily:
• Treatment of a child with glomerulonephritis would include:
• A 13-year-old adolescent complains of difficulty walking and weakness in the arms after a recent cold. On exam, deep tendon reflexes cannot be elicited. What is the most appropriate course of action?
• In an adolescent health maintenance visit, which screening is appropriate for a sexually active teenager?
• An infant with a severe cough following a recent URI is suspected of having pertussis. Which antibiotic is started?
• A 16-year-old adolescent has evidence of weight loss. The PNP notes on the chart documentation of frequent loose stools for 2 weeks. The differential diagnosis includes hyperthyroidism. What additional clinical finding would suggest this diagnosis?
• Which lifestyle modification is most appropriate for a 14-year-old with PMS?
• A neonate screen shows low T4 and elevated TSH. The recommended course of action is to:
• Recommendations regarding the current management of croup with increased work of breathing include the use of:
• In early male puberty, which event is typically the first physical change?
• A 17-year-old adolescent comes to the clinic because of weight loss, irritability, insatiable hunger, and heat intolerance. The PNP screens for hyperthyroidism. In the patient with hyperthyroidism:
• Scoliosis management: which finding would require surgical intervention?
• Certification is:
• Which description best matches psoriasis vulgaris lesions?
• Medicare reimbursement for services:
• In implementing evidence-based practice, which is the initial step?
• Which management would you not recommend for pityriasis rosea?
• A 10yo has marked ear pain, not wanting anyone to touch his ear. The canal is edematous & exudate is present. TM is normal. How would this be managed?
• A low-birth-weight neonate whose mother is Native American and smoked heavily during pregnancy has an increased incidence of which condition?
• Which statement best describes innocent murmurs in children?
• Which statement about melanoma spread is correct?
• What is the first clinical sign of puberty in girls?
• A new mom calls on postpartum day 5. She reports her newborn wants to nurse for 30 minutes every 2 hours. Which of the following is your best response?
• Meatal stenosis is a potential complication most commonly associated with which procedure?
• During a clinic visit, a mother reports vague reporting of the infant’s routine. which question best elicits accurate information about the infant’s daily care?
• Which infection is not typically associated with hypogammaglobulinemia?
• The most appropriate analgesia for a 4-year-old with post-operative tonsillectomy pain would include which of the following?
• In evaluating a 3-year-old with sudden onset high fever and stridor, the child sits forward with the mouth open and drooling. The safest and most helpful diagnostic test to order now would be:
• Which drug is important in symptom management and prevention of complications in Kawasaki disease?
• Which term describes the outward signs of puberty in males?
• A 5-year-old with acute gastroenteritis is thirsty but tolerates oral fluids well. What is the best initial management?
• Which group is at higher risk for nicotine dependence?
• Which situation does not necessarily warrant immediate mental health assessment and/or referral?
• In Marfan syndrome, which skeletal feature is commonly observed?
• A 9-month-old with bifed uvula has increased risk for which problem?
• Learning disabilities are typically associated with perceptual-motor impairments and which behavioral trait?
• A shift to the left is present when which cells are elevated?
• A 13-year-old adolescent complains of having difficulty walking and the arms feeling weak. The adolescent had a cold 2 weeks ago. On examination, the PNP is not able to elicit deep tendon reflexes. The PNP knows that the most appropriate course of action is to:
• In a child with moderate persistent asthma, the most appropriate daily controller therapy is which of the following?
• A 4-year-old with sore throat and fever; what is the best course of action?
• A 5-year-old is frequently grounded for chores. How should the PNP respond?
• The Denver II screening tool is described as which of the following?
• What is considered minimal weight gain in a normal newborn after hospital discharge?
• In a 10-year-old presenting with fever, sore throat, cervical lymphadenopathy, and splenomegaly, if throat culture and Monospot test are negative, which diagnostic test is most appropriate next?
• What action is most appropriate when counseling a pregnant patient who continues to smoke?
• Which statement about precocious puberty is most accurate?
• The most accurate test on a vaginal swab to identify Chlamydia trachomatis in a 3-year-old girl with vaginal discharge is?
• An integrated delivery system:
• Asthma is best described as a chronic lung disease characterized by which feature?
• Providing reassurance of 'normalcy' during the course of an exam would be most important for which of the following age groups?
• What is the most sensitive physical finding for the diagnosis of testicular torsion?
• A child presents with 10 macular tan lesions of varying sizes and you suspect cafe au lait spots. What kind of lesion is this?
• Cryptorchidism is more prevalent in which group?
• At 4 months, which vaccines are given?
• Which finding is most suggestive of gastroesophageal reflux in a 2-month-old with frequent vomiting?
• The ECG in a school-age child presenting with syncope shows a prolonged QT interval. The initial clinical evaluation should always include which test?
• Findings consistent with a peritonsillar abscess include all of the following except:
• Symmetric intrauterine growth retardation is typically characterized by which pattern?
• The incidence of cryptorchidism at one year of age is about 1%. The best explanation for this is:
• Appropriate interventions for a 3-month-old infant diagnosed with sickle cell anemia include which of the following?
• Which symptom would prompt consideration of Ascaris lumbricoides (roundworm) infection?
• You are evaluating a 3-year-old who acutely sustained a burn involving 5% of body surface, with injury limited to the epidermis and upper part of the dermis. How would you rate this burn?
• Which physical finding is not usually associated with talipes equinovarus congenita (clubfoot)?
• Labial adhesions are most likely to resolve without intervention. Which statement reflects this?
• A father asks whether an opioid cough suppressant (eg, promethazine with codeine) could help his school-aged child with a nagging cough during recovery from a cold. The PNP explains possible problems with opioid cough suppressants include:
• Which statement about epinephrine auto-injector use in pediatric patients is correct?
• Two days after diagnosing sinusitis, the child returns with swelling of the eye, redness, inflammation, and impaired extraocular movement in the right eye. Which action is most appropriate?
• Which Piagetian stage characterizes the way preschoolers think?
• A classic physical finding in pediatric pyloric stenosis is
• The most common thyroiditis in children is:
• In neonates with ABO incompatibility, baseline management includes serial monitoring of bilirubin and hemoglobin levels.
• Which immunoglobulin level is reported as normal in Wiskott-Aldrich syndrome according to the provided material?
• Which behavior would you expect to decrease during the preschool years?
• In a patient with suspected appendicitis, which finding would most strongly support the diagnosis?
• Which topic would be least appropriate for anticipatory guidance for a 4-month-old (rephrased from prior guidance)?
• A thick, purulent vaginal discharge that is greenish-yellow is most likely an infection caused by:
• Which condition is thought to be more apparent in darker-skinned individuals or during the summer?
• The most typical chest radiographic finding consistent with the diagnosis of asthma is:
• Newborn screening for congenital hypothyroidism is performed by measuring which combination of hormones?
• In premature infants, catch-up growth is best described as which statement?
• A 9-year-old patient has several circular scaly patches on the scalp with overlying hair loss, consistent with tinea capitis. The pediatric nurse practitioner prescribes:
• A newborn presents with a large VSD, rocker bottom feet, overlapping second & third fingers, & fourth & fifth fingers with hypotonia. What is the most likely diagnosis?
• In insecurely attached avoidant relationships, what is the underlying emotion?
• Individuals living with an infant who has pertussis should receive which prophylaxis or vaccine?
• A pediatric patient has a positive PPD (12 mm) 48 hours after placement. What is the next best action?
• A healthy 12-year-old girl presents with a 20-degree scoliosis and a thoracic hump. What is the most appropriate action?
• A 2-year-old child is receiving chemotherapy for neuroblastoma. The older sibling is due to receive a poliovirus vaccine before starting kindergarten. The appropriate action is:
• For an 18‑month‑old who completed antibiotics for a first febrile UTI and is asymptomatic, which management option is MOST appropriate?
• After exposure to meningococcal disease, which approach is appropriate for an asymptomatic close contact?
• Which foods are among the most common allergies in children?
• Which condition presents with a persistent limp and hip symptoms during early school age and is associated with avascular necrosis of the femoral head?
• A 4-month-old preterm infant (birth weight 2.0 kg) presents for vaccination today. Which immunizations are appropriate?
• A 13 year old has repeatedly exhibited behaviors of purposeful cruelty to younger children, property destruction, and school truancy. These behaviors fit BEST the diagnostic criteria for
• A 2-year-old child is evaluated for language development. Which finding would indicate a language delay?
• Which test is used to evaluate vesicoureteral reflux after a suspected urinary tract infection in a child?
• Early nursing research focused on which outcome?
• Which statement about Piaget's theory best describes preschool thinking?
• According to family systems theory, which statement best reflects the impact of a change in one family member?
• Family-centered care is characterized by which of the following?
• A 16-year-old with pallor and fatigue; CBC consistent with iron deficiency anemia. What should the PNP tell the teen?
• During school-age years, typical annual weight gain is approximately:
• Which statement about onset of autistic behaviors is not consistent with typical autism presentation?
• Which CBC finding is most commonly associated with viral infections?
• A child who is able to run, kick a ball, wash and dry the hands, tower two cubes, and use pronouns indiscriminately is probably aged:
• During a well-child visit for a 3-year-old, labial adhesions are noted; which management should be discussed with the mother first?
• Which vaccine is inactivated (non-live)?
• An 11-year-old boy is diagnosed with constitutional growth delay. Which management is most appropriate?
• A child has developed her 2nd perirectal abscess in 6 months. She should be evaluated for which condition?
• What would you not recommend as management and treatment of Jale's condition (contact dermatitis)?
• When a mother asks about infant formula for iron content, what is the key message?
• In a breastfed newborn, which combination of stools and wet diapers suggests adequate intake?
• The presence of motile flagellated organisms on vaginal wet mount in an adolescent with frothy discharge indicates infection with:
• Which credential may identify nurses who have national specialty certification?
• If an 8-month-old shows stranger anxiety, what is the typical clinical guidance?
• Which of the following statements about dysmenorrhea is not true?
• Quality improvement activities commonly include which set of actions?
• Which action should be taken when a child presents with a prenatal or early-life craniosynostosis sign and the clinician is unsure of the diagnosis?
• The PNP is discussing with the father of a child in day care the issues related to treating head lice. The PNP stresses the following:
• Which of the following tests is not an appropriate test for developmental dysplasia of the hip in an 18-month-old?
• Which practice helps prevent diaper dermatitis recurrence?
• For a 13-year-old with a partial-thickness burn, which immunizations should be administered today?
• If a child with atopic dermatitis develops a secondary bacterial infection at several lesions, what is the best management for the infection?
• At a 6-month well-child visit, today the infant should receive which immunizations?
• A 13-year-old female patient with Tanner stage 4 breasts and pubic hair who has not had menarche: the pediatric nurse practitioner suspects:
• A parent has questions about over-the-counter fever medications for a 2-year-old with a fever of 101.2°F for one day. The child is well-appearing and active. Appropriate counseling involves:
• At what age is it expected that an infant no longer has a head lag when pulled from supine to sitting?
• Which condition is described by a fir-tree pattern of lesions on the trunk in a child?
• Which infant reflex is described as not disappearing by 6 months in the provided material?
• The PNP is examining a neonate with a heart murmur. The S2 sound is loudest at the apex. The respiratory rate is 65 breaths per minute, and the heart rate is 180 beats per minute. Which of the following would be an appropriate action?
• A pustular eruption on a newborn’s face and trunk that is transient is most consistent with which diagnosis?
• A common cause of congestive heart failure in the first year of life is?
• A child with chickenpox and a fever of 102 F should receive which medication for fever?
• During anticipatory guidance with parents of a 5-year-old child with diabetes, which symptom cluster indicates hypoglycemia?
• Which set of vaccines is typically administered at a 4-month vaccination visit?
• Which test on a vaginal swab is used to identify Chlamydia trachomatis in a preschooler with vaginal discharge?
• Legal authority for APRN practice is granted by state law and regulations.
• Which statement about slipped capital femoral epiphysis is not true?
• A mother asks if screaming, falling on the floor, and kicking are normal tantrum behaviors in a 2-year-old. What is the most accurate explanation?
• What is the most useful diagnostic tool for diagnosing epilepsy?
• The most likely organism to cause urinary tract infection in the pediatric population is:
• At which point of life is UTIs more common in males?
• Which statement about iron in infant formula is correct?
• Genu varum is considered abnormal when which of the following occurs?
• A 7-year-old child in the emergency department presents with an acute asthma attack. Which medication is most appropriate to administer first?
• Which diagnostic criterion is MOST consistent with a finding of acute otitis media (AOM)?
• In most cases the PNP is covered by employee professional liability for which scenario?
• A 15-day-old infant with respiratory distress, mild cyanosis, hepatosplenomegaly, and features consistent with Down syndrome. Which congenital heart defect is most likely?
• In Turner syndrome, which ongoing assessment has no specific clinical indication?
• Which of the following children need an orthopedic referral?
• Which of the following is NOT a reliable predictor of intellectual giftedness?
• Cholesterol screening should be done:
• A toddler presents after a parent pulled the arm to prevent a fall. Which position is most characteristic of radial head subluxation?
• Which serological finding indicates a carrier state for hepatitis B?
• Individuals who have spina bifida are at high risk for allergy to:
• Which eye finding would be considered an ophthalmic emergency?
• Which of the following is the most appropriate approach to help a toddler who frequently wakes at night for a bottle?
• For an 8-month-old with diarrhea but no dehydration, which statement best reflects appropriate management for parents?
• The siblings of a child who develops a serious illness, injury, or disability:
• A 9-year-old with irritability and multiple seasonal allergies; the suspected cause is which?
• Initial exposure to herpes virus may produce all except:
• The antibiotic trimethoprim/sulfamethoxazole (Bactrim) should not be prescribed in infants 2 months old and younger because:
• Which newborn rash is erythema toxicum neonatorum?
• Title V funding for children with special health care needs is provided through which mechanism?
• The PNP teaches new parents that when breastfeeding is well established they can expect the baby to have:
• Early reflexive responses that are not r/t survival include all but:
• Which immunization combination should be given in one visit to a 5-year-old who has never had vaccines?
• Which vaccine is not listed as part of the 2-month immunizations described in the case?
• Which disorder is usually associated with adduction of the forefoot?
• Which of the following contraceptive methods would be least suitable for adolescents?
• The pediatric nurse practitioner examines a 4-year-old child who is home-schooled and immunization-delayed. The child has pain when chewing; a fever; and enlarged, tender salivary nodes. The pediatric NP diagnoses mumps and informs the mother that mumps is contagious for:
• A wide pulse pressure resulting from high systolic blood pressure is usually not due to which of the following?
• Vulvovaginitis in children is not caused by which of the following?
• A 4-year-old child is being assessed for language delays. Which screening tool would the clinician most likely select?
• In assessing a 17‑month‑old with suspected autism, which test is NOT typically included beyond screening?
• At a 15-month well visit, which vaccination combination is most appropriate to administer?
• A 2-year-old with vomiting, diarrhea, fever, and tender abdomen; The PNP should:
• Which statement is true regarding childhood obesity?
• Two day old baby not passed meconium. This is a red flag for which condition?
• The PNP is in the nursery to examine a neonate. The results of the neonatal screen are noted in the chart. The T4 level is low, and the TSH level is elevated. The PNP should:
• In school-aged children, which cognitive operation is characteristic?
• Which statement is not a recommended sun exposure precaution?
• During discussion of breast self-examination in a 16-year-old, which statement is correct?
• Which of the following is emphasized as part of promoting healthy behavioral changes for an overweight child?
• Which of the following is the best written chief complaint?
• Neurofibromatosis can be used as an example of influencing factors in Mendelian inheritance patterns except for which?
• What is the most common cause of myocarditis?
• During a visit with a 13-year-old, the patient discusses sexual activity and depressive symptoms. What should be the first priority in care?
• If persistent wrist pain persists after an initial negative X-ray, what is the next recommended step?
• In initial therapy for ALL, which treatment is not typically included?
• A 3-year-old adopted child with suspected fetal alcohol effects (FAE). Which physical finding would most strongly suggest FAE?
• A 15 year old previously healthy teen is having school problems, feelings of sadness, insomnia, and disinterest in activities previously enjoyed. The parents report the teen spends hours alone, avoiding social situations. When questioned, the teen denies any desire or plan to hurt himself or others. Which would be the MOST appropriate INITIAL management of this patient?
• Circumscribed, coalescent, generalized, erythematous raised lesions of various sizes occur in a child. The most common cause of hives is:
• Which diagnosis would not be part of the differential for recurrent lobar pneumonia in a 2-year-old?
• Which of the following explains physiologic jaundice (unconjugated hyperbilirubinemia)?
• Physiologic jaundice mechanism in newborns is described as which of the following?
• What is the primary public health measure to decrease the incidence of bacterial meningitis in infants and children?
• Vitamin D–resistant rickets is inherited as X-linked dominant; which statement is true?
• Legg-Calve-Perthes disease most commonly presents with which symptom?
• An 8-year-old child with no TB risk factors has a PPD induration of 7 mm with redness. How should this be interpreted?
• Which credential identifies nurses who have national specialty certification?
• In Neurofibromatosis type 1 (NF1), which problem is most likely to require medical/educational intervention?
• Which scenario represents an example of child ASSENT in health care research?
• An 11-month-old well-appearing and well-dressed with a long philtrum, midface hypoplasia, microcephaly, mild developmental delay, and myopia. The mother denies drinking alcohol. What is the next best step?
• A 12-year-old girl in late puberty asks about height growth. Which statement is most accurate?
• A 15-year-old adolescent has pallor and fatigue. The CBC results are consistent with iron-deficiency anemia. What would be appropriate information to give this adolescent?
• A 15-year-old basketball player returns home from a postgame party euphoric, hostile, and hyperactive. Which substance is most likely used?
• Which symptom is not commonly associated with Legg-Calvé-Perthes disease?
• In a newborn, a diagnosis of hip dislocation is suspected when
• A 2-year-old presents with a history of limping, fever, and refusal to bear weight on an extremity. Which initial management step is most appropriate?
• The following test is required to diagnose leukemia:
• A 5-year-old with clear rhinorrhea and pale, boggy nasal mucosa is treated with which therapy?
• A large, reducible umbilical hernia in infancy is best managed by which plan?
• Initial treatment of a sprain includes which of the following?
• Which of the following is not a specific exam test for a dislocated hip?
• What is the most common form of glomerulonephritis in children?
• Which of the following is not a risk factor for infantile botulism?
• A CBC for a 10-year-old shows decreased MCHC and decreased MCV. Differential diagnosis should include which condition?
• Which organism is most commonly associated with concurrent otitis media and conjunctivitis in children?
• In a head injury, bruising or tearing of the cerebral structures occurs in a:
• In what Tanner stage for girls would the PNP expect to see enlargement of the breasts and areolae, as well as curly, coarse pubic hair?
• In an 8-year-old health maintenance visit, which item would be important to include in the review of systems?
• Which child should be referred for developmental evaluation?
• Which statement best describes peak height velocity in girls in relation to menarche?
• A child who is just starting to reach for objects placed in front of him is around how old?
• Which term describes services provided by a nurse practitioner under physician supervision billed to the physician's name?
• A newborn with a vascular lesion that will not fade with age has which diagnosis?
• An 8-year-old afebrile child presents with 4+ tonsils without exudate; which item is included in the differential diagnosis?
• Which management approach is NOT used in pediatric phimosis?
• An infant born to a mother with chronic hepatitis B should receive which treatment within the first hours of life?
• In a 4-month-old with atopic dermatitis, which is an important consideration in management?
• What is the correct order for introducing solid foods to an infant?
• Which of the following is not a good goal of appropriate asthma management?
• Which nutrition counseling point is appropriate for a 13-month-old with continued use of milk and juice?
• Precocious puberty is defined as sexual development beginning before the youngest acceptable age. Which statement is true regarding precocious puberty?
• A child with a cyanotic spell and a systolic murmur best heard at the left sternal border most likely has which condition?
• A 6-month-old with increased tone and leg scissoring is most consistent with which condition?
• A 4-month-old infant with cyanotic spells and a systolic murmur best heard at the left sternal border most likely has which condition?
• Separation anxiety is a common developmental stage and is most often expected at which age?
• What is the American Academy of Pediatrics' recommendation for routine TB skin testing for a child with no risk factors living in a low-prevalence area of the country?
• A newborn evaluation for unilateral choanal atresia is BEST achieved by which method?
• For toilet training readiness in a 2-year-old, what is the most important factor?
• An 8-year-old girl presents with a 2 week history of brownish-red, foul smelling vaginal discharge. It is most likely caused by:
• In education for parents whose child has sickle cell disease, which factor is most commonly associated with triggering pain crises?
• If both parents are carriers for cystic fibrosis, what is the chance that a child will be unaffected and not a carrier?
• The most common trigger for acute asthma episode in the very young child is:
• Anticipatory guidance for a child newly diagnosed with hypothyroidism should include which of the following?
• Which description best characterizes urticaria lesions?
• A mother with Marfan syndrome comes with her 5-year-old for a checkup. The child has myopia & a + wrist & thumb sign. What is the next best step?
• When supporting parents of a school‑aged child with a learning disability, what is the most important PNP role?
• A 12-year-old presents with several vesicles and honey-colored crusted lesions on the face above the right nares after scratching the area. What condition is most likely?
• Six-year-old with fever and sore throat with exudative tonsils and no cough. The most appropriate next step is:
• A Mantoux test in a child with no risk factors is considered positive with a reaction of:
• During a well-visit for a 16-year-old with Down syndrome, which screenings and education are appropriate?
• When examining a 10-year-old's dentition, upper incisors overlap lower incisors slightly and some molars are absent. This most likely indicates:
• Which statement about inhaled corticosteroid therapy in children is most accurate?
• In evaluating bloody diarrhea, which stool test helps screen for occult blood?
• In adolescent health care, under which scenario would a pelvic examination be deferred?
• When teaching adolescents about condoms, which statement should be included regarding lubricants?
• In the initial evaluation of an adolescent with recent eye trauma, which item is commonly assessed to monitor ocular integrity?
• A 9-month-old infant with fever of 103.2°F is reported by the mother. The best response to the mother is:
• What is the approximate average age at which tobacco use begins?
• Which finding is commonly associated with Kawasaki disease?
• A 12-year-old girl with a blood pressure of 140/90 at a routine visit is asymptomatic. The initial management would include:
• Which statement best reflects a risk factor for adolescent pregnancy among the listed items?
• Regular insulin
• A foster mother calls about a 10-year-old child who has knocked out a permanent tooth. The PNP instructs: