Primary Care Approaches for Children Practice Exam
Sample Questions and Answers
Which of the following is the most appropriate screening tool for assessing developmental milestones in a 3-year-old child?
A) Denver Developmental Screening Test II
B) Bayley Scales of Infant Development
C) Ages and Stages Questionnaire
D) Stanford-Binet Intelligence Scales
Answer: A) Denver Developmental Screening Test II
Explanation: The Denver Developmental Screening Test II is commonly used for assessing developmental milestones in children, especially between 0 to 6 years. It helps identify developmental delays in motor, language, and social domains.
Which vaccination is recommended at the 12-month well-child visit?
A) Hepatitis B
B) MMR (Measles, Mumps, Rubella)
C) DTaP (Diphtheria, Tetanus, Pertussis)
D) Varicella
Answer: B) MMR (Measles, Mumps, Rubella)
Explanation: The MMR vaccine is typically administered at the 12-month well-child visit, along with the Varicella vaccine. Hepatitis B is given earlier, and DTaP is administered at different intervals.
What is the most common cause of acute otitis media in children?
A) Streptococcus pneumoniae
B) Haemophilus influenzae
C) Moraxella catarrhalis
D) All of the above
Answer: D) All of the above
Explanation: Acute otitis media in children is most commonly caused by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. A bacterial infection is often the source, though viral infections can also play a role.
Which of the following is an appropriate treatment for croup in a 2-year-old child?
A) Intravenous antibiotics
B) Oral steroids
C) Antihistamines
D) Bronchodilators
Answer: B) Oral steroids
Explanation: Croup is commonly treated with oral steroids such as dexamethasone to reduce inflammation in the upper airway. Antibiotics are not indicated unless there is a secondary bacterial infection, and bronchodilators are generally ineffective in croup.
Which of the following is a common sign of dehydration in infants?
A) Dry mucous membranes
B) Increased urinary output
C) Normal fontanel
D) Increased activity level
Answer: A) Dry mucous membranes
Explanation: Dry mucous membranes are a common sign of dehydration in infants. Decreased urine output and a sunken fontanel can also indicate dehydration, while increased activity level would not be a typical finding.
A 6-month-old infant presents with a history of poor weight gain, irritability, and excessive crying. What is the most likely cause?
A) Colic
B) Gastroesophageal reflux disease (GERD)
C) Viral infection
D) Lactose intolerance
Answer: B) Gastroesophageal reflux disease (GERD)
Explanation: GERD is common in infants and can cause irritability, excessive crying, and poor weight gain due to discomfort from acid reflux. Colic typically resolves by 3-4 months, and lactose intolerance usually presents with diarrhea.
At what age should a child begin to use simple phrases like “want cookie” or “go outside”?
A) 9-12 months
B) 12-18 months
C) 18-24 months
D) 24-36 months
Answer: B) 12-18 months
Explanation: By 12-18 months, children typically begin using simple phrases or words to express needs. Full sentence use develops later.
Which of the following is an appropriate management option for a child with mild asthma?
A) Oral corticosteroids
B) Inhaled bronchodilators as needed
C) Long-term antibiotics
D) Daily oral antihistamines
Answer: B) Inhaled bronchodilators as needed
Explanation: Inhaled bronchodilators, such as albuterol, are commonly used as needed for mild asthma to relieve symptoms of wheezing and shortness of breath. Oral corticosteroids are reserved for acute flare-ups.
What is the most effective approach for managing constipation in a 4-year-old child?
A) High-dose laxatives
B) Increased fiber intake and hydration
C) Enemas
D) Restriction of fluid intake
Answer: B) Increased fiber intake and hydration
Explanation: A diet high in fiber and adequate hydration is the most effective approach for treating constipation in children. Laxatives should be used cautiously, and enemas are typically reserved for severe cases.
Which of the following is the most reliable indicator of a child’s nutritional status?
A) Serum albumin levels
B) Body mass index (BMI) for age
C) Total calorie intake
D) Physical appearance
Answer: B) Body mass index (BMI) for age
Explanation: BMI for age is a reliable indicator of a child’s nutritional status, as it takes into account both height and weight. Serum albumin and appearance may not fully reflect nutritional health.
Which condition is characterized by an inability to metabolize phenylalanine, leading to intellectual disability if untreated?
A) Cystic fibrosis
B) Phenylketonuria (PKU)
C) Sickle cell anemia
D) Tay-Sachs disease
Answer: B) Phenylketonuria (PKU)
Explanation: Phenylketonuria (PKU) is an inherited disorder where the body cannot metabolize phenylalanine, which can build up and cause brain damage if not managed through a special diet.
Which of the following conditions should be suspected in a child who presents with a bulging fontanel, irritability, and fever?
A) Meningitis
B) Acute otitis media
C) Colic
D) Gastroenteritis
Answer: A) Meningitis
Explanation: A bulging fontanel, irritability, and fever are classic signs of meningitis in infants. It is a medical emergency that requires immediate treatment.
What is the best first-line treatment for a child with a mild allergic reaction to a bee sting?
A) Antihistamine
B) Oral corticosteroids
C) Epinephrine
D) Antibiotics
Answer: A) Antihistamine
Explanation: Mild allergic reactions can usually be treated with antihistamines to reduce symptoms like itching and swelling. Epinephrine is reserved for severe anaphylaxis.
When should an infant be introduced to solid foods?
A) 4 months
B) 6 months
C) 9 months
D) 12 months
Answer: B) 6 months
Explanation: Solid foods should generally be introduced around 6 months, when the infant’s digestive system is ready and they can sit up and hold their head steady.
Which of the following vaccines should a 6-month-old receive according to the CDC vaccination schedule?
A) DTaP, IPV, Hib, PCV13
B) MMR, Varicella
C) Hepatitis B
D) HPV vaccine
Answer: A) DTaP, IPV, Hib, PCV13
Explanation: At 6 months, infants typically receive DTaP (Diphtheria, Tetanus, Pertussis), IPV (Inactivated Polio Vaccine), Hib (Haemophilus influenzae type b), and PCV13 (Pneumococcal Conjugate Vaccine).
Which of the following is the most common cause of bronchiolitis in infants?
A) Influenza virus
B) Respiratory syncytial virus (RSV)
C) Adenovirus
D) Parainfluenza virus
Answer: B) Respiratory syncytial virus (RSV)
Explanation: Respiratory syncytial virus (RSV) is the leading cause of bronchiolitis in infants and young children, particularly during the winter months.
A 4-year-old child is being evaluated for a developmental delay in speech. Which of the following should be the next step in management?
A) Refer to a speech therapist
B) Obtain an audiology evaluation
C) Start speech therapy immediately
D) Wait for 6 more months to assess further progress
Answer: B) Obtain an audiology evaluation
Explanation: Before starting speech therapy, it is essential to rule out hearing problems, as they are a common cause of speech delay. An audiology evaluation is necessary to ensure that the child’s hearing is normal.
What is the first-line treatment for a 5-year-old child diagnosed with uncomplicated bacterial pharyngitis (strep throat)?
A) Amoxicillin
B) Azithromycin
C) Ceftriaxone
D) Penicillin
Answer: A) Amoxicillin
Explanation: Amoxicillin is the first-line treatment for uncomplicated bacterial pharyngitis (strep throat) in children, as it is effective against the common bacteria, Streptococcus pyogenes.
What is the most appropriate treatment for impetigo in a 3-year-old child?
A) Oral acyclovir
B) Topical mupirocin
C) Oral penicillin
D) Oral fluconazole
Answer: B) Topical mupirocin
Explanation: Impetigo, a common skin infection caused by Streptococcus or Staphylococcus bacteria, is typically treated with topical mupirocin. Oral antibiotics are only necessary for more severe cases.
A 10-year-old child presents with a non-tender, mobile mass in the neck. The most likely diagnosis is:
A) Lymphadenopathy
B) Thyroid nodule
C) Branchial cleft cyst
D) Abscess
Answer: A) Lymphadenopathy
Explanation: Non-tender, mobile masses in the neck are most commonly due to lymphadenopathy, which is often a reaction to infection or inflammation. A thyroid nodule, branchial cleft cyst, or abscess would typically present with different characteristics.
What is the primary treatment for a child diagnosed with celiac disease?
A) High-calcium diet
B) Gluten-free diet
C) Oral corticosteroids
D) Probiotics
Answer: B) Gluten-free diet
Explanation: Celiac disease is treated by removing gluten from the diet. This helps manage symptoms and prevent damage to the small intestine.
A child presents with a fever, cough, and a characteristic “seal bark” cough. What is the most likely diagnosis?
A) Bronchiolitis
B) Croup
C) Asthma
D) Pneumonia
Answer: B) Croup
Explanation: The “seal bark” cough is characteristic of croup, which is caused by a viral infection, often parainfluenza virus, leading to inflammation of the upper airway.
What is the most appropriate intervention for a child with a diagnosis of iron-deficiency anemia?
A) Vitamin C supplementation
B) Oral iron supplements
C) Oral folic acid
D) Intravenous antibiotics
Answer: B) Oral iron supplements
Explanation: Iron-deficiency anemia is most commonly treated with oral iron supplements, which increase iron levels in the body. Vitamin C can help with absorption of iron but is not the primary treatment.
At what age should a child be able to stack 6 blocks, say 4-6 words in a sentence, and follow simple instructions?
A) 18 months
B) 2 years
C) 3 years
D) 4 years
Answer: B) 2 years
Explanation: By age 2, children typically have the fine motor skills to stack 6 blocks, as well as the language skills to form simple sentences and follow basic instructions.
Which of the following is the most appropriate first-line treatment for a child with moderate atopic dermatitis?
A) Oral antihistamines
B) Topical corticosteroids
C) Topical antibiotics
D) Oral steroids
Answer: B) Topical corticosteroids
Explanation: Topical corticosteroids are the most effective first-line treatment for atopic dermatitis to reduce inflammation and itching. Oral steroids may be used for more severe cases.
Which of the following is a common complication of untreated Streptococcus pyogenes infection in children?
A) Rheumatic fever
B) Hepatitis
C) Meningitis
D) Tuberculosis
Answer: A) Rheumatic fever
Explanation: If left untreated, Streptococcus pyogenes can lead to rheumatic fever, a serious condition that affects the heart, joints, and other tissues.
Which of the following conditions is characterized by chronic, severe, and widespread atopic dermatitis, often starting in infancy?
A) Eczema herpeticum
B) Atopic dermatitis
C) Psoriasis
D) Contact dermatitis
Answer: B) Atopic dermatitis
Explanation: Atopic dermatitis is a chronic, severe form of eczema that often starts in infancy and is characterized by dry, itchy, inflamed skin.
A 2-year-old child with a history of recurrent ear infections presents with persistent fever, irritability, and a red, bulging tympanic membrane. What is the most likely diagnosis?
A) Acute otitis media
B) Sinusitis
C) Pharyngitis
D) Meningitis
Answer: A) Acute otitis media
Explanation: Acute otitis media (AOM) is a common diagnosis in children with fever and irritability, especially when accompanied by a red, bulging tympanic membrane, indicating an active middle ear infection.
What is the most appropriate intervention for a 5-year-old child who presents with a sudden onset of a limp, swelling, and fever, and is diagnosed with septic arthritis?
A) Oral antibiotics
B) Surgical drainage and intravenous antibiotics
C) Joint aspiration with corticosteroids
D) Rest and physical therapy
Answer: B) Surgical drainage and intravenous antibiotics
Explanation: Septic arthritis is a medical emergency and requires prompt surgical drainage of the infected joint, along with intravenous antibiotics to treat the infection effectively.
A 3-year-old child presents with a history of difficulty breathing, persistent cough, and a “whooping” sound when coughing. What is the most likely diagnosis?
A) Bronchiolitis
B) Asthma
C) Pertussis (Whooping Cough)
D) Croup
Answer: C) Pertussis (Whooping Cough)
Explanation: Pertussis, or whooping cough, is characterized by severe coughing fits followed by a “whooping” sound as the child breathes in. It can be prevented by vaccination.
Sample Short Questions and Answers
- What is the first-line treatment for acute asthma exacerbations in children?
Answer: The first-line treatment for acute asthma exacerbations in children is the administration of a short-acting beta-agonist (SABA) such as albuterol. This helps to relax the bronchial muscles and relieve symptoms of wheezing and shortness of breath.
- What is a common symptom of hand-foot-and-mouth disease in children?
Answer: A common symptom of hand-foot-and-mouth disease is a rash that appears on the hands, feet, and buttocks, often accompanied by sores or blisters in the mouth and a mild fever.
- What condition is characterized by a “barking” cough and inspiratory stridor in children?
Answer: Croup is characterized by a “barking” cough and inspiratory stridor in children. It is usually caused by a viral infection that leads to swelling in the larynx and trachea.
- What is the typical presentation of otitis media in children?
Answer: Otitis media typically presents with ear pain, irritability, fever, and difficulty hearing. It may also be associated with drainage of fluid from the ear in some cases.
- What is the most common cause of gastroenteritis in children?
Answer: The most common cause of gastroenteritis in children is viral infections, particularly those caused by rotavirus and norovirus.
- How is dehydration typically managed in a child with gastroenteritis?
Answer: Dehydration in children with gastroenteritis is usually managed with oral rehydration solutions (ORS) containing electrolytes and fluids. Severe cases may require intravenous fluids.
- What is a hallmark sign of chickenpox in children?
Answer: A hallmark sign of chickenpox is the appearance of a vesicular rash that starts on the trunk and spreads to the face and extremities. The rash progresses from red spots to blisters and then scabs.
- What is the most important preventive measure for RSV (respiratory syncytial virus) in infants?
Answer: The most important preventive measure for RSV is hand hygiene and limiting exposure to sick individuals. In high-risk infants, a medication called palivizumab may be given to reduce the risk of severe disease.
- What is the primary treatment for a child diagnosed with acute otitis media?
Answer: The primary treatment for acute otitis media is antibiotics, typically amoxicillin, if the infection is bacterial. Pain relief with acetaminophen or ibuprofen may also be recommended.
- What is the primary diagnostic tool for diagnosing appendicitis in children?
Answer: The primary diagnostic tool for diagnosing appendicitis in children is a clinical assessment, including a physical exam, and confirmation through imaging, such as an abdominal ultrasound or CT scan.
- Which childhood vaccine prevents whooping cough (pertussis)?
Answer: The DTaP vaccine (Diphtheria, Tetanus, and Pertussis) prevents whooping cough (pertussis) in children.
- What is a common sign of an allergic reaction in children?
Answer: A common sign of an allergic reaction in children is a rash, itching, swelling (especially around the eyes, lips, or throat), and sometimes wheezing or difficulty breathing.
- What is the primary concern when a child presents with a fever and a rash?
Answer: The primary concern when a child presents with a fever and a rash is the possibility of a viral exanthem, such as measles, rubella, or varicella. Prompt identification is important to prevent complications.
- What is a common symptom of bronchiolitis in infants?
Answer: A common symptom of bronchiolitis in infants is wheezing, along with a cough, nasal congestion, and difficulty breathing, often exacerbated by feeding.
- What is the recommended treatment for constipation in children?
Answer: The recommended treatment for constipation in children includes dietary modifications (increased fiber intake), adequate fluid intake, and the use of laxatives, such as polyethylene glycol, if necessary.
- What are the key signs of meningitis in an infant?
Answer: Key signs of meningitis in an infant include fever, irritability, poor feeding, bulging fontanel, and a high-pitched cry. Prompt medical attention is critical.
- What is the most common cause of acute pharyngitis in children?
Answer: The most common cause of acute pharyngitis in children is viral infections, such as the common cold or influenza. Bacterial causes, like group A Streptococcus, are less common.
- What is the primary treatment for uncomplicated urinary tract infections (UTIs) in children?
Answer: The primary treatment for uncomplicated urinary tract infections (UTIs) in children is oral antibiotics, such as trimethoprim-sulfamethoxazole or amoxicillin, based on the child’s age and health status.
- What is a typical sign of dehydration in a child?
Answer: A typical sign of dehydration in a child includes dry mouth, reduced urine output, lethargy, sunken eyes, and decreased skin elasticity.
- What is a characteristic feature of an inguinal hernia in a child?
Answer: A characteristic feature of an inguinal hernia in a child is a bulge in the groin area that may be more prominent when the child is crying or straining.
- What is the recommended dietary change for children with lactose intolerance?
Answer: The recommended dietary change for children with lactose intolerance is to eliminate or reduce milk and dairy products from their diet, or to use lactose-free alternatives.
- What is a common complication of untreated strep throat in children?
Answer: A common complication of untreated strep throat in children is rheumatic fever, which can cause inflammation of the heart, joints, skin, and nervous system.
- How is eczema typically managed in children?
Answer: Eczema is typically managed by moisturizing the skin regularly, using topical corticosteroids for flare-ups, and avoiding triggers like harsh soaps and allergens.
- What is the first-line treatment for anaphylaxis in children?
Answer: The first-line treatment for anaphylaxis in children is the administration of epinephrine, usually via an auto-injector (EpiPen), followed by emergency medical care.
- What is a common cause of fever and vomiting in children under 2 years old?
Answer: A common cause of fever and vomiting in children under 2 years old is viral gastroenteritis, often caused by rotavirus or norovirus.
- What is the recommended treatment for mild croup in children?
Answer: The recommended treatment for mild croup in children includes humidified air, such as from a cool-mist humidifier or a steamy bathroom, and possibly corticosteroids like dexamethasone to reduce inflammation.
- What is a characteristic feature of Kawasaki disease in children?
Answer: A characteristic feature of Kawasaki disease is a high fever lasting more than 5 days, along with a rash, conjunctivitis, swelling of the hands and feet, and changes to the lips and tongue (strawberry tongue).
- What is the most effective way to prevent the spread of respiratory infections in children?
Answer: The most effective way to prevent the spread of respiratory infections in children is practicing frequent handwashing, covering the mouth when coughing or sneezing, and avoiding close contact with sick individuals.
- What is the treatment of choice for impetigo in children?
Answer: The treatment of choice for impetigo in children is topical antibiotics like mupirocin, or oral antibiotics if the infection is widespread or severe.
- What is the best way to reduce the risk of sudden infant death syndrome (SIDS)?
Answer: The best way to reduce the risk of sudden infant death syndrome (SIDS) is by placing infants on their backs to sleep, avoiding soft bedding, and ensuring a safe sleep environment with no smoking around the infant.