NRNP 6541 Primary Care of Adolescents and Children Practice Test
Which of the following is a primary goal in the pediatric primary care setting?
A) To focus exclusively on treating acute illnesses
B) To promote health and prevent illness through early interventions
C) To provide specialized care for chronic conditions only
D) To minimize patient education during visits
At what age should a child begin receiving regular dental check-ups?
A) 3 years
B) 6 months
C) 12 months
D) 1 year
What is the most common cause of otitis media in children?
A) Streptococcus pneumoniae
B) Haemophilus influenzae
C) Respiratory syncytial virus
D) Escherichia coli
The recommended immunization schedule for children includes the administration of which vaccine at 12 months of age?
A) DTaP
B) Measles, Mumps, Rubella (MMR)
C) Rotavirus
D) Varicella
Which of the following is a key developmental milestone for a 2-year-old child?
A) Begins to speak in full sentences
B) Can walk independently
C) Knows full name
D) Can draw circles
A child presents with a persistent cough and wheezing. Which of the following conditions should the nurse practitioner consider?
A) Acute pharyngitis
B) Asthma
C) Bronchiolitis
D) Croup
When assessing growth and development in a child, which of the following is a key component to monitor?
A) Weight gain and motor milestones
B) Social skills only
C) Cognitive milestones exclusively
D) Growth chart alone
The first-line treatment for a pediatric patient diagnosed with uncomplicated bacterial strep throat is:
A) Amoxicillin
B) Azithromycin
C) Ceftriaxone
D) Penicillin
What is a common risk factor for childhood obesity?
A) Poor sleep hygiene
B) Sedentary lifestyle
C) High intake of fruits and vegetables
D) Regular physical activity
Which of the following is considered a “red flag” in pediatric mental health?
A) Mild irritability
B) Difficulty sleeping
C) Sudden decline in academic performance
D) Normal separation anxiety
What is the most effective strategy for preventing sudden infant death syndrome (SIDS)?
A) Placing the infant on their stomach to sleep
B) Ensuring the infant sleeps with a pacifier
C) Placing the infant on their back to sleep
D) Using soft bedding
Which of the following would most likely cause failure to thrive in an infant?
A) Consistent breastfeeding
B) Inadequate caloric intake or malnutrition
C) Consistent weight gain according to growth charts
D) Normal developmental milestones
A 5-year-old child with a fever, sore throat, and rash should be evaluated for which of the following?
A) Scarlet fever
B) Measles
C) Fifth disease
D) Rubella
When providing anticipatory guidance to parents of a toddler, which behavior is typical at this stage?
A) Engaging in parallel play
B) Preferring solitary play
C) Engaging in cooperative play
D) Relying on parents for all decision-making
Which developmental milestone is typical for a 4-year-old child?
A) Can hop on one foot
B) Uses complete sentences with complex grammar
C) Can write their name
D) Can count to 20
What is the recommended treatment for uncomplicated viral croup in a child?
A) Corticosteroids and humidified air
B) Antibiotics
C) Bronchodilators
D) Oxygen therapy
What is the most common cause of bronchiolitis in infants?
A) Influenza virus
B) Parainfluenza virus
C) Respiratory syncytial virus (RSV)
D) Adenovirus
A 7-year-old child presents with a limp and joint pain after a recent viral infection. The most likely diagnosis is:
A) Legg-Calvé-Perthes disease
B) Septic arthritis
C) Post-infectious arthritis
D) Rheumatoid arthritis
What is the recommended first-line treatment for head lice in children?
A) Oral antibiotics
B) Permethrin topical cream
C) Hydrocortisone cream
D) Antihistamines
Which of the following is a typical sign of prepubertal gynecomastia?
A) Excessive hair growth
B) Enlarged breast tissue
C) Lower abdominal pain
D) Increased height velocity
What is a common clinical sign of dehydration in a pediatric patient?
A) Increased urine output
B) Dry mucous membranes
C) Increased appetite
D) Low blood pressure
A child with a history of recurrent urinary tract infections (UTIs) may require:
A) Lifelong antibiotics
B) Imaging studies to evaluate the urinary system
C) Surgical intervention immediately
D) No further evaluation unless symptoms worsen
Which of the following vaccines is recommended for children starting at 12 months of age?
A) Influenza vaccine
B) Pneumococcal vaccine
C) Hepatitis B vaccine
D) Varicella vaccine
A child with asthma is being treated with a corticosteroid inhaler. Which of the following is an important teaching point for parents?
A) The medication should be used only during an asthma attack
B) The child should rinse their mouth after using the inhaler to avoid thrush
C) The medication will cause weight gain
D) No follow-up visits are necessary after starting this medication
Which of the following is a primary prevention strategy for mental health in children?
A) Early intervention programs
B) Use of antidepressants
C) Involuntary hospitalization
D) Regular use of therapy sessions
What is the first-line treatment for mild to moderate atopic dermatitis in children?
A) Oral antihistamines
B) Topical corticosteroids
C) Oral antibiotics
D) Phototherapy
When assessing a child’s developmental progress, what is a significant concern that warrants further evaluation?
A) Difficulty drawing shapes at 4 years old
B) Failure to use sentences by age 3
C) Exhibiting temper tantrums at age 2
D) Preferring to play alone at age 5
Which of the following is a potential complication of untreated streptococcal pharyngitis in children?
A) Acute rheumatic fever
B) Hypertension
C) Diabetes mellitus
D) Cystic fibrosis
What is the recommended management for a child with moderate to severe allergic rhinitis?
A) Oral antibiotics
B) Topical nasal corticosteroids
C) Antihistamines only
D) Decongestants only
Which of the following is a common symptom of a child with a congenital heart defect?
A) Frequent nosebleeds
B) Excessive fatigue and poor feeding
C) Hyperactivity and impulsivity
D) Persistent vomiting
What is the recommended initial approach for a 3-month-old infant with suspected colic?
A) Immediate pharmacological intervention
B) Changing the infant’s formula
C) Parent education on soothing techniques and feeding patterns
D) Hospitalization for observation
At what age should an infant typically begin rolling over?
A) 2 months
B) 4 months
C) 6 months
D) 8 months
Which of the following is a common sign of anemia in a pediatric patient?
A) Jaundice
B) Pale skin and conjunctivae
C) Red, flushed face
D) Weight loss
Which of the following is a primary risk factor for sudden infant death syndrome (SIDS)?
A) Maternal smoking during pregnancy
B) Breastfeeding exclusively
C) Using a firm mattress
D) Placing the baby on their back to sleep
A 12-month-old child is presenting with failure to thrive, poor feeding, and irritability. Which condition should the nurse practitioner be most concerned about?
A) Gastroesophageal reflux disease (GERD)
B) Celiac disease
C) Autism spectrum disorder
D) Iron deficiency anemia
A 4-year-old child presents with frequent episodes of abdominal pain and diarrhea after consuming milk. What is the likely diagnosis?
A) Lactose intolerance
B) Appendicitis
C) Acute gastroenteritis
D) Irritable bowel syndrome
What is the first-line treatment for a 6-year-old diagnosed with uncomplicated acute otitis media?
A) Oral amoxicillin
B) Oral azithromycin
C) Intravenous ceftriaxone
D) Observation without antibiotics
Which developmental milestone is expected for a 9-month-old infant?
A) Begins to say “mama” and “dada”
B) Walks independently
C) Starts to imitate simple words
D) Runs and climbs stairs
A child with a history of frequent asthma exacerbations should be prescribed which of the following for long-term management?
A) Short-acting beta-agonists
B) Oral corticosteroids
C) Inhaled corticosteroids
D) Antibiotics
Which is the most effective way to prevent and manage childhood obesity?
A) Encourage limiting screen time to less than 2 hours a day
B) Focus on weight reduction through strict diets
C) Prescribe medication immediately for weight management
D) Encourage 4 hours of daily physical activity
What is a major risk factor for the development of type 1 diabetes in children?
A) High dietary fat intake
B) Family history of autoimmune diseases
C) Inactivity and sedentary lifestyle
D) Exposure to environmental toxins
The most important consideration when diagnosing an adolescent with a suspected eating disorder is:
A) Ruling out gastrointestinal disorders
B) Conducting a thorough psychosocial evaluation
C) Measuring the BMI only
D) Focusing on physical growth patterns only
What is the recommended management for a 3-year-old child diagnosed with impetigo?
A) Oral antibiotics
B) Topical antibiotics
C) Topical antifungals
D) Steroid creams
At what age should a child receive the first dose of the MMR vaccine?
A) 2 months
B) 4 months
C) 12 months
D) 18 months
A 7-year-old child has a 3-day history of fever, malaise, and a red rash on the face that spreads to the trunk and limbs. The child has also had a dry cough. What is the most likely diagnosis?
A) Chickenpox
B) Measles
C) Fifth disease
D) Scarlet fever
Which of the following is an appropriate treatment for mild to moderate eczema in a child?
A) Topical corticosteroids and emollients
B) Oral antihistamines
C) Oral antibiotics
D) Oral corticosteroids
Which of the following is a typical presentation of attention-deficit/hyperactivity disorder (ADHD) in children?
A) Inability to sit still and difficulty maintaining focus
B) Excessive talking with minimal interaction
C) Sluggish behavior and lack of energy
D) Excessive hand washing and fear of contamination
The first-line treatment for a pediatric patient with impetigo is:
A) Systemic antibiotics
B) Topical antibiotics
C) Antifungal ointments
D) Antiviral medications
What is the recommended treatment for uncomplicated viral conjunctivitis in children?
A) Topical antibiotics
B) Antihistamines
C) Steroid eye drops
D) Supportive care and hygiene measures
A child presenting with a strawberry tongue, a red rash, and a sore throat is most likely suffering from:
A) Scarlet fever
B) Kawasaki disease
C) Strep throat
D) Rheumatic fever
What is a significant concern when assessing a child with a persistent cough and difficulty breathing?
A) Possible foreign body aspiration
B) Acute otitis media
C) Vitamin deficiency
D) Normal viral upper respiratory infection
Which of the following is an important health promotion strategy for adolescents?
A) Encouraging regular screenings for STIs
B) Limiting social media access
C) Emphasizing family meal times
D) Encouraging increased screen time
A 3-year-old child is not meeting developmental milestones related to speech. What is the first step the nurse practitioner should take?
A) Refer the child to a speech-language pathologist
B) Perform a full neurodevelopmental assessment
C) Recommend a hearing test
D) Wait for another year to observe speech development
A 16-year-old male presents with persistent acne despite using over-the-counter products. The nurse practitioner should:
A) Prescribe topical retinoids or oral antibiotics
B) Suggest using stronger over-the-counter products
C) Recommend waiting for natural resolution after puberty
D) Refer for psychiatric evaluation
A 5-year-old child with a fever and red, swollen joints should be evaluated for:
A) Rheumatic fever
B) Juvenile idiopathic arthritis
C) Kawasaki disease
D) Leukemia
When assessing an adolescent’s psychosocial development, it is important to focus on:
A) Peer relationships and self-esteem
B) Ability to read and write
C) Memory and cognitive skills
D) Parental attachment
The nurse practitioner should suspect a child has lead poisoning if they present with:
A) Abdominal pain, constipation, and lethargy
B) Fever and cough
C) Jaundice and weight loss
D) Rashes and joint pain
A 10-year-old child is diagnosed with scabies. Which of the following is the recommended treatment?
A) Topical permethrin cream
B) Oral antibiotics
C) Topical corticosteroids
D) Oral antifungals
What is the most common form of childhood cancer?
A) Leukemia
B) Lymphoma
C) Neuroblastoma
D) Osteosarcoma
A 3-year-old child is found to have a speech delay. Which of the following is an appropriate intervention?
A) Immediate referral for speech therapy
B) Reassess the child in 6 months
C) Begin private tutoring sessions
D) No intervention needed as speech delays resolve with age
At what age should a child begin to display social and cooperative play skills with peers?
A) 1-2 years
B) 2-3 years
C) 3-4 years
D) 5-6 years
A 7-year-old child presents with a history of chronic cough, wheezing, and shortness of breath, especially at night. The nurse practitioner suspects:
A) Bronchiolitis
B) Cystic fibrosis
C) Asthma
D) Acute pneumonia
Which of the following is a key feature of juvenile idiopathic arthritis (JIA)?
A) Symmetric joint involvement
B) Sudden onset of fever and rash
C) Absence of joint swelling
D) Weight gain
Which of the following is the most appropriate treatment for a 3-year-old with an uncomplicated upper respiratory infection (URI)?
A) Antibiotics
B) Decongestants
C) Antihistamines
D) Supportive care and hydration
A child with a fever, sore throat, and a characteristic “sandpaper” rash is most likely suffering from:
A) Measles
B) Rubella
C) Scarlet fever
D) Chickenpox
At what age should a child be able to identify colors and shapes?
A) 18 months
B) 2 years
C) 3 years
D) 4 years
Which of the following is an early sign of autism spectrum disorder (ASD) in children?
A) Inability to walk by age 3
B) Lack of eye contact and social interaction
C) Speech delay with typical play skills
D) Frequent temper tantrums with no developmental delay
What is the first-line treatment for a child diagnosed with mild to moderate allergic rhinitis?
A) Oral antibiotics
B) Topical corticosteroids
C) Nasal decongestants
D) Oral antihistamines
What is the most common cause of gastroenteritis in children?
A) Norovirus
B) Salmonella
C) Giardia lamblia
D) E. coli
A 5-year-old child has developed a characteristic “bull’s eye” rash following a tick bite. What should be suspected?
A) Measles
B) Lyme disease
C) Rocky Mountain spotted fever
D) Scarlet fever
Which of the following is a common complication of varicella (chickenpox) in children?
A) Pneumonia
B) Rheumatic fever
C) Otitis media
D) Asthma exacerbation
What is the first-line treatment for uncomplicated urinary tract infections (UTIs) in children?
A) Intravenous antibiotics
B) Oral amoxicillin
C) Oral trimethoprim-sulfamethoxazole
D) Oral azithromycin
What is the primary cause of rickets in children?
A) Iron deficiency
B) Vitamin C deficiency
C) Vitamin D deficiency
D) Calcium deficiency
A 10-year-old child complains of hip pain and limps when walking. The nurse practitioner suspects:
A) Legg-Calvé-Perthes disease
B) Septic arthritis
C) Hip dysplasia
D) Juvenile rheumatoid arthritis
A 2-year-old child has frequent ear infections and is now presenting with a fever and clear discharge from the ear. What is the most likely diagnosis?
A) Otitis externa
B) Otitis media with effusion
C) Acute otitis media
D) Chronic sinusitis
What is the best approach to preventing dental cavities in children?
A) Daily use of fluoride toothpaste
B) Weekly use of mouthwash
C) Restricting sugary foods and drinks
D) Biannual dental cleanings only
At what age is it recommended for children to begin routine vision screening?
A) At birth
B) 3 years
C) 5 years
D) 7 years
A 4-year-old child presents with a persistent cough, stridor, and difficulty breathing. Which of the following conditions should be considered?
A) Croup
B) Pneumonia
C) Asthma
D) Bronchiolitis
What is the most common type of diabetes found in children and adolescents?
A) Type 1 diabetes
B) Type 2 diabetes
C) Maturity onset diabetes of the young (MODY)
D) Gestational diabetes
A 9-year-old child presents with sudden onset of facial paralysis and drooping of the eyelid. The nurse practitioner suspects:
A) Bell’s palsy
B) Stroke
C) Migraine
D) Cerebral palsy
Which of the following is a classic symptom of Kawasaki disease?
A) Strawberry tongue
B) Blue lips
C) Bloody stools
D) Abdominal distension
A 5-year-old child who has been in daycare presents with a fever, sore throat, and red, swollen tonsils with white exudates. What is the likely diagnosis?
A) Viral pharyngitis
B) Strep throat
C) Hand, foot, and mouth disease
D) Mononucleosis
At what age can a child typically speak in simple sentences (e.g., “I want cookie”)?
A) 12 months
B) 18 months
C) 2 years
D) 3 years
A 4-year-old child presents with itchy, raised red bumps on the arms and trunk. The mother reports the child has had contact with other children who have a similar rash. What is the most likely diagnosis?
A) Chickenpox
B) Scabies
C) Measles
D) Impetigo
A 6-year-old child who is underweight presents with irritability, fatigue, and dizziness. The nurse practitioner suspects iron deficiency anemia. What is the first step in treatment?
A) Oral iron supplements
B) Intravenous iron infusion
C) Blood transfusion
D) Vitamin B12 injections
A 2-month-old infant presents with projectile vomiting after feeding. The infant is not showing signs of weight gain. What condition should be considered?
A) Gastroesophageal reflux disease (GERD)
B) Pyloric stenosis
C) Lactose intolerance
D) Celiac disease
Which of the following is a common complication of untreated celiac disease in children?
A) Iron deficiency anemia
B) Jaundice
C) Gallstones
D) Hyperglycemia
A 3-year-old child with a history of frequent colds and respiratory infections should be evaluated for:
A) Immunodeficiency
B) Asthma
C) Cystic fibrosis
D) Sinusitis
Which of the following is an expected developmental milestone for a 4-year-old child?
A) Ability to dress and undress without help
B) Ability to count to 100
C) Ability to draw a person with three parts
D) Ability to recognize letters and read simple words
Which vaccine is recommended for all adolescents aged 11-12 years?
A) Hepatitis A vaccine
B) Meningococcal vaccine
C) Rotavirus vaccine
D) Hepatitis B vaccine
A 12-year-old child presents with painful joints, especially in the knees and wrists, and a characteristic butterfly-shaped rash across the cheeks. What should be suspected?
A) Juvenile idiopathic arthritis
B) Systemic lupus erythematosus
C) Rheumatic fever
D) Lyme disease
A 10-year-old child is diagnosed with chickenpox. Which of the following is the most appropriate advice for the caregiver?
A) Keep the child isolated until all the blisters are scabbed over
B) Administer aspirin to reduce fever
C) Send the child back to school as soon as fever subsides
D) Use topical antibiotics to prevent secondary infection
A 15-year-old female presents with a sudden, severe headache, neck stiffness, and photophobia. What is the most likely diagnosis?
A) Migraine
B) Meningitis
C) Tension headache
D) Sinusitis
Which of the following is an early sign of type 1 diabetes in children?
A) Rapid weight gain
B) Excessive thirst and frequent urination
C) Vomiting and diarrhea
D) Increased appetite and fatigue
Which of the following vaccines is recommended for children to receive at age 4-6 years?
A) DTaP
B) MMR
C) IPV (Polio vaccine)
D) All of the above
A 9-year-old child presents with abdominal pain, bloating, and diarrhea after consuming dairy products. What is the most likely diagnosis?
A) Irritable bowel syndrome
B) Lactose intolerance
C) Celiac disease
D) Gastroesophageal reflux disease (GERD)
A 16-year-old male presents with acne vulgaris. What is the first-line treatment for moderate acne in adolescents?
A) Oral antibiotics
B) Topical retinoids
C) Oral corticosteroids
D) Topical antifungals
Which of the following is the best approach for preventing dental caries in children?
A) Encourage the child to brush twice daily with fluoride toothpaste
B) Limit sugary snacks to once a day
C) Provide fluoride supplements to children under 5 years
D) Avoid routine dental check-ups
A 13-year-old girl presents with absent or irregular menstrual periods. What is the most likely diagnosis?
A) Polycystic ovary syndrome (PCOS)
B) Primary amenorrhea
C) Hyperthyroidism
D) Stress-related amenorrhea
A 5-year-old child presents with a complaint of frequent headaches, nausea, and vomiting in the morning. What is the most likely diagnosis?
A) Migraine headache
B) Brain tumor
C) Tension headache
D) Sinus infection
What is the most common cause of bronchiolitis in infants and young children?
A) Streptococcus pneumoniae
B) Respiratory syncytial virus (RSV)
C) Haemophilus influenzae
D) Rhinovirus
A 3-year-old child with a history of chronic diarrhea, poor growth, and a distended abdomen may be suffering from:
A) Celiac disease
B) Appendicitis
C) Viral gastroenteritis
D) Lactose intolerance
What is the first-line treatment for a child diagnosed with impetigo?
A) Oral antibiotics
B) Topical antibiotics
C) Antifungal ointments
D) Antiviral therapy
A 6-month-old infant who is unable to lift its head, has weak muscle tone, and poor feeding should be evaluated for:
A) Cerebral palsy
B) Infantile botulism
C) Meningitis
D) Failure to thrive
What is the primary treatment for a child with mild to moderate eczema?
A) Oral corticosteroids
B) Topical corticosteroids and emollients
C) Antihistamines
D) Topical antifungal agents
What is the most common cause of chronic cough in children?
A) Asthma
B) Sinusitis
C) Allergies
D) Postnasal drip
A 4-year-old child presents with symptoms of a runny nose, sneezing, and mild cough. The child’s caregiver reports that the child has been exposed to sick classmates. The most likely diagnosis is:
A) Allergic rhinitis
B) Acute viral upper respiratory infection
C) Streptococcal pharyngitis
D) Influenza
At what age can most children begin using a spoon independently?
A) 6 months
B) 9 months
C) 12 months
D) 18 months
A 10-year-old child presents with a rash and a sore throat. The caregiver reports that the child has recently had close contact with a sibling who has strep throat. The most likely diagnosis is:
A) Measles
B) Scarlet fever
C) Fifth disease
D) Chickenpox
A 15-year-old male presents with a persistent cough, wheezing, and difficulty breathing. The nurse practitioner suspects asthma. What is the first-line treatment for acute asthma exacerbation?
A) Inhaled corticosteroids
B) Short-acting beta-agonists
C) Oral corticosteroids
D) Long-acting beta-agonists
Which of the following is a primary prevention measure for preventing obesity in children?
A) Promoting physical activity and healthy eating habits
B) Prescribing weight loss medications
C) Limiting caloric intake through fasting
D) Restricting screen time for older children only
A 5-year-old child is diagnosed with strep throat. Which of the following is an appropriate intervention?
A) Prescribe amoxicillin for 10 days
B) Prescribe a topical throat numbing agent
C) Recommend no antibiotics and monitor for improvement
D) Prescribe antihistamines to reduce swelling
What is the most important aspect of managing a child with a suspected foreign body aspiration?
A) Perform a chest x-ray
B) Immediate endoscopy to remove the object
C) Listen for wheezing during auscultation
D) Encourage the child to cough forcefully
A 7-year-old child has been experiencing difficulty sleeping and frequent night terrors. The most likely cause is:
A) Stress or anxiety
B) Sleep apnea
C) Sleepwalking
D) A neurologic disorder
A 9-year-old child with a history of frequent urinary tract infections (UTIs) presents with fever, chills, and back pain. What is the likely diagnosis?
A) Pyelonephritis
B) Vesicoureteral reflux
C) Cystitis
D) Acute glomerulonephritis
A 12-year-old girl presents with a sudden onset of chest pain, shortness of breath, and wheezing. The most likely diagnosis is:
A) Asthma exacerbation
B) Costochondritis
C) Panic attack
D) Pleurisy
A 3-year-old child presents with severe abdominal pain, vomiting, and blood in the stool. What should be suspected?
A) Intussusception
B) Gastroenteritis
C) Acute appendicitis
D) Pyloric stenosis
Which of the following is the best method for evaluating vision in a child under 3 years of age?
A) Visual acuity test
B) Parent report of vision difficulties
C) Use of a Snellen chart
D) Retinal examination
A 4-month-old infant has a flat head, a preference for turning to one side, and no interest in reaching for toys. The most likely diagnosis is:
A) Torticollis
B) Developmental delay
C) Cerebral palsy
D) Plagiocephaly
What is the most important consideration when treating a child with asthma in the school setting?
A) Ensuring the child has an individualized asthma action plan
B) Limiting physical activity during recess
C) Reducing the number of students in the classroom
D) Administering antibiotics during every cold
A 3-year-old child is brought to the clinic for a routine checkup. The child is able to follow simple commands, has a vocabulary of about 200 words, and can build a tower of six blocks. Which developmental milestone is this child demonstrating?
A) Fine motor skills
B) Cognitive development
C) Speech development
D) Social development
A 7-year-old child presents with difficulty swallowing, a sore throat, and a fever. Upon examination, the tonsils appear enlarged with white patches. What is the most likely diagnosis?
A) Viral pharyngitis
B) Streptococcal pharyngitis
C) Tonsillitis
D) Mononucleosis
A 5-year-old child presents with painful, swollen joints and a fever. The nurse practitioner suspects juvenile idiopathic arthritis (JIA). Which of the following lab tests would be most useful in confirming the diagnosis?
A) Complete blood count (CBC)
B) Erythrocyte sedimentation rate (ESR)
C) Thyroid function tests
D) Liver function tests
A 3-month-old infant has a history of poor feeding, projectile vomiting, and dehydration. The most likely diagnosis is:
A) Gastroesophageal reflux disease (GERD)
B) Pyloric stenosis
C) Lactose intolerance
D) Gastroenteritis
A 10-year-old child presents with complaints of lower abdominal pain, bloating, and intermittent diarrhea after eating dairy products. The nurse practitioner suspects:
A) Celiac disease
B) Lactose intolerance
C) Appendicitis
D) Gastroesophageal reflux disease (GERD)
Which of the following conditions is characterized by the sudden loss of motor skills and speech regression in a child between 6 and 18 months of age?
A) Rett syndrome
B) Autism spectrum disorder
C) Duchenne muscular dystrophy
D) Down syndrome
A 4-year-old child is brought to the clinic for a well-child exam. The child has a developmental delay in motor skills and exhibits a lack of interest in socializing. Which of the following conditions should be considered?
A) Cerebral palsy
B) Autism spectrum disorder
C) Down syndrome
D) Attention-deficit hyperactivity disorder (ADHD)
A 2-year-old child presents with a persistent cough, wheezing, and difficulty breathing. What is the most likely diagnosis?
A) Asthma
B) Bronchiolitis
C) Pneumonia
D) Acute sinusitis
A 5-year-old child presents with fever, a red throat with white exudates, and a history of recent exposure to a sibling with a sore throat. What is the most likely diagnosis?
A) Strep throat
B) Viral pharyngitis
C) Hand, foot, and mouth disease
D) Croup
A 16-year-old girl presents with severe abdominal cramps, nausea, and vomiting after missing her period. A urine pregnancy test is positive. What is the first step in managing this patient?
A) Order an ultrasound to confirm the pregnancy
B) Refer to an obstetrician for prenatal care
C) Provide counseling on pregnancy options
D) Order a complete blood count to check for infection
A 4-year-old child is having trouble speaking in full sentences and struggles to make eye contact with others. The parent is concerned that the child may have autism. Which of the following actions is most appropriate?
A) Refer for developmental evaluation and early intervention
B) Provide reassurance and monitor developmental progress
C) Recommend speech therapy and monitor for a few months
D) Begin behavioral therapy immediately
A 10-year-old child presents with swollen, painful knees and a fever. The nurse practitioner suspects juvenile rheumatoid arthritis (JRA). Which of the following interventions is most appropriate?
A) Oral corticosteroids
B) Methotrexate
C) Nonsteroidal anti-inflammatory drugs (NSAIDs)
D) Biologic agents
A 2-year-old child presents with a history of difficulty urinating, a fever, and foul-smelling urine. The nurse practitioner suspects a urinary tract infection (UTI). What is the most appropriate next step in management?
A) Start empiric antibiotics while awaiting urine culture results
B) Order a renal ultrasound
C) Order a urine dipstick and treat based on results
D) Refer to a pediatric nephrologist
Which of the following is an appropriate treatment for a 12-year-old with moderate to severe acne vulgaris?
A) Topical retinoids
B) Oral isotretinoin
C) Oral antibiotics
D) Phototherapy
A 7-year-old child presents with a history of chronic cough, wheezing, and shortness of breath, especially at night. The nurse practitioner suspects asthma. What is the most appropriate first-line therapy?
A) Inhaled corticosteroids
B) Leukotriene receptor antagonists
C) Short-acting beta-agonists (albuterol)
D) Long-acting beta-agonists (salmeterol)
A 5-year-old child presents with a sudden, high fever and a red rash that started on the face and spread to the trunk. What is the most likely diagnosis?
A) Measles
B) Rubella
C) Scarlet fever
D) Chickenpox
A 3-year-old child presents with a persistent cough, stridor, and difficulty breathing. The nurse practitioner suspects croup. What is the first-line treatment for moderate croup?
A) Oral antibiotics
B) Nebulized epinephrine
C) Inhaled corticosteroids
D) Intravenous fluids
A 6-month-old infant is brought to the clinic for a routine checkup. The infant has gained weight appropriately, is making sounds, and can lift its head. What developmental milestone is this infant demonstrating?
A) Motor development
B) Speech development
C) Social development
D) Cognitive development
A 4-year-old child is being seen for a routine checkup. The child is able to dress and undress independently, is able to ride a tricycle, and can draw simple shapes. What is this child demonstrating?
A) Cognitive development
B) Gross motor skills
C) Fine motor skills
D) Speech development
A 14-year-old female presents with irregular menstrual periods, excessive hair growth, and acne. The most likely diagnosis is:
A) Polycystic ovary syndrome (PCOS)
B) Hyperthyroidism
C) Addison’s disease
D) Hypothyroidism
A 10-year-old child presents with fever, sore throat, and a characteristic “sandpaper” rash. What is the most likely diagnosis?
A) Scarlet fever
B) Measles
C) Rubella
D) Fifth disease
A 4-month-old infant is not meeting expected developmental milestones, such as not smiling or making sounds. The nurse practitioner suspects failure to thrive. Which of the following is the most common cause of failure to thrive in infants?
A) Organic causes, such as metabolic or gastrointestinal disorders
B) Abuse or neglect
C) Maternal depression
D) Poverty and lack of resources
A 6-year-old child presents with a productive cough, fever, and difficulty breathing. The child has a history of asthma. What is the most appropriate management?
A) Start oral antibiotics
B) Prescribe bronchodilators and monitor for improvement
C) Administer nebulized albuterol
D) Refer to a pulmonologist for further evaluation
A 7-year-old child is brought in for a routine checkup. The child is unable to hop on one foot, but can walk up and down stairs without help. What is the most likely explanation for this developmental delay?
A) The child may have developmental coordination disorder
B) This is within the normal range for this age
C) The child is likely experiencing a motor delay due to inadequate nutrition
D) The child should be referred for a developmental assessment
A 15-year-old male presents with unexplained weight loss, extreme fatigue, and excessive thirst. The nurse practitioner suspects type 1 diabetes. Which of the following tests is most appropriate for confirming the diagnosis?
A) Hemoglobin A1c
B) Fasting blood glucose
C) Oral glucose tolerance test
D) Random blood glucose
A 4-year-old child presents with a fever, sore throat, and difficulty swallowing. The child has a history of recent exposure to a sibling with hand, foot, and mouth disease. What is the most likely diagnosis?
A) Hand, foot, and mouth disease
B) Viral pharyngitis
C) Strep throat
D) Herpangina
A 6-month-old infant is brought to the clinic with a cough, nasal congestion, and fever. The nurse practitioner suspects a viral respiratory infection. Which of the following is the most likely causative agent?
A) Respiratory syncytial virus (RSV)
B) Streptococcus pneumoniae
C) Haemophilus influenzae
D) Influenza virus
A 10-year-old child presents with sudden onset of leg pain after an injury during a soccer game. The child is unable to bear weight on the affected leg. The nurse practitioner suspects a fracture. What is the first step in management?
A) Perform a radiograph to assess for fracture
B) Apply an ice pack to reduce swelling
C) Prescribe analgesics for pain relief
D) Encourage weight-bearing on the affected leg
A 2-year-old child presents with a fever, a red, itchy rash that starts on the face and spreads to the trunk, and a history of exposure to a sibling with a rash. What is the most likely diagnosis?
A) Measles
B) Rubella
C) Chickenpox
D) Fifth disease
A 7-year-old child is diagnosed with a simple febrile seizure. Which of the following is the most appropriate management?
A) Start anticonvulsant therapy
B) Perform a lumbar puncture
C) Reassure the parents and provide fever management
D) Refer to a neurologist immediately
A 16-year-old girl presents with weight loss, anxiety, and excessive exercise. The nurse practitioner is concerned about an eating disorder. Which of the following is the most likely diagnosis?
A) Anorexia nervosa
B) Bulimia nervosa
C) Binge eating disorder
D) Body dysmorphic disorder
A 4-month-old infant has a flat head, especially on one side, and prefers to turn the head to one side. The most likely diagnosis is:
A) Plagiocephaly
B) Torticollis
C) Cerebral palsy
D) Hydrocephalus
A 6-year-old child presents with a history of unexplained bruising, bleeding gums, and fatigue. The nurse practitioner suspects a bleeding disorder. Which test should be ordered first?
A) Complete blood count (CBC)
B) Coagulation profile
C) Bleeding time
D) Platelet count
A 12-year-old child presents with excessive thirst, frequent urination, and blurred vision. The nurse practitioner suspects type 1 diabetes. What is the most appropriate diagnostic test?
A) Hemoglobin A1c
B) Fasting blood glucose
C) Oral glucose tolerance test
D) Random blood glucose
A 5-year-old child presents with a high fever, red eyes, and a rash that started on the face and spread. The child also has a history of conjunctivitis. What is the most likely diagnosis?
A) Measles
B) Mumps
C) Rubella
D) Fifth disease
A 3-year-old child is brought to the clinic for a well-child exam. The child has not started speaking and is not making eye contact with others. The most appropriate next step is:
A) Refer for a speech and language evaluation
B) Reassure the parents, as this is normal for a child of this age
C) Recommend that the child participate in more social activities
D) Refer to a developmental pediatrician for further evaluation
A 10-year-old child presents with sudden onset of pain and swelling in the knee joint, especially after a soccer game. The child has no fever or other systemic symptoms. What is the most likely diagnosis?
A) Osgood-Schlatter disease
B) Juvenile rheumatoid arthritis
C) Patellar tendinitis
D) Osteomyelitis
A 14-year-old girl presents with a 3-month history of weight loss, excessive exercise, and fear of gaining weight. What is the most appropriate diagnosis?
A) Anorexia nervosa
B) Bulimia nervosa
C) Depression
D) Body dysmorphic disorder
A 5-year-old child presents with a fever, sore throat, and a bright red rash on the trunk and extremities. The most likely diagnosis is:
A) Scarlet fever
B) Measles
C) Chickenpox
D) Hand, foot, and mouth disease
A 2-year-old child is brought in for a routine checkup. The child has gained weight appropriately, is making sounds, and can lift its head. What developmental milestone is this infant demonstrating?
A) Motor development
B) Speech development
C) Cognitive development
D) Emotional development
A 9-year-old child presents with pain in the abdomen, bloating, and diarrhea. The child reports that symptoms worsen after eating dairy products. What is the most likely diagnosis?
A) Celiac disease
B) Lactose intolerance
C) Acute gastroenteritis
D) Irritable bowel syndrome
A 15-year-old male presents with excessive urination, increased thirst, and unexplained weight loss. The nurse practitioner suspects diabetes mellitus. What is the most appropriate first diagnostic test?
A) Random blood glucose
B) Fasting blood glucose
C) Oral glucose tolerance test
D) Hemoglobin A1c
A 4-year-old child presents with a fever, sore throat, and a characteristic sandpaper-like rash. What is the most likely diagnosis?
A) Scarlet fever
B) Measles
C) Rubella
D) Chickenpox
A 6-month-old infant presents with symptoms of severe dehydration, vomiting, and abdominal distension. The nurse practitioner suspects pyloric stenosis. What is the next step in diagnosis?
A) Ultrasound of the abdomen
B) Barium swallow study
C) CT scan of the abdomen
D) Blood culture
A 3-year-old child is brought to the clinic with complaints of abdominal pain, bloating, and diarrhea. The child has a history of frequent, foul-smelling stools. What is the most likely diagnosis?
A) Lactose intolerance
B) Celiac disease
C) Irritable bowel syndrome
D) Giardiasis
A 4-year-old child is diagnosed with a viral upper respiratory infection and presents with a fever and difficulty breathing. What is the first-line treatment for this condition?
A) Antibiotics
B) Oral antihistamines
C) Intravenous fluids
D) Antipyretics and supportive care
A 16-year-old female presents with a missed period, nausea, and fatigue. A urine pregnancy test is positive. What is the most appropriate next step in management?
A) Order a serum beta-hCG test
B) Refer to an obstetrician for prenatal care
C) Order an ultrasound to confirm the pregnancy
D) Provide counseling and discuss options
A 5-year-old child presents with abdominal pain, vomiting, and diarrhea. The caregiver reports that the child recently returned from a family trip to a developing country. What is the most likely diagnosis?
A) Traveler’s diarrhea
B) Rotavirus
C) Celiac disease
D) Acute appendicitis
A 14-year-old girl presents with irregular menstrual cycles, excessive hair growth, and obesity. The nurse practitioner suspects polycystic ovary syndrome (PCOS). Which test should be ordered first to confirm the diagnosis?
A) Pelvic ultrasound
B) Serum testosterone levels
C) Fasting blood glucose
D) Thyroid function tests
A 7-year-old child presents with a history of severe headaches, vomiting, and blurred vision. The nurse practitioner suspects a brain tumor. Which diagnostic test should be ordered first?
A) MRI of the brain
B) CT scan of the head
C) Lumbar puncture
D) EEG
A 6-year-old child presents with a rash on the hands and feet, along with fever and mouth sores. The most likely diagnosis is:
A) Hand, foot, and mouth disease
B) Measles
C) Scarlet fever
D) Chickenpox
A 4-year-old child presents with a cough, wheezing, and difficulty breathing. The nurse practitioner suspects asthma. What is the first-line therapy for an acute asthma attack in this child?
A) Short-acting beta-agonists (e.g., albuterol)
B) Long-acting beta-agonists
C) Oral corticosteroids
D) Inhaled corticosteroids
A 3-year-old child presents with irritability, poor feeding, and vomiting. The child’s fontanel is bulging, and there is a fever. The nurse practitioner suspects meningitis. What is the most appropriate next step in management?
A) Start intravenous antibiotics immediately
B) Perform a lumbar puncture to confirm diagnosis
C) Obtain a CT scan of the brain
D) Order a chest x-ray
A 5-year-old child presents with itchy, scaly, circular patches of hair loss on the scalp. What is the most likely diagnosis?
A) Tinea capitis
B) Alopecia areata
C) Psoriasis
D) Atopic dermatitis
A 3-year-old child presents with a red, swollen, painful joint in the knee and a fever. The nurse practitioner suspects juvenile arthritis. What is the most appropriate next step in management?
A) Refer to a pediatric rheumatologist
B) Start nonsteroidal anti-inflammatory drugs (NSAIDs)
C) Order a complete blood count (CBC) and erythrocyte sedimentation rate (ESR)
D) Recommend physical therapy
A 12-year-old child presents with frequent episodes of itchy, watery eyes, sneezing, and nasal congestion. These symptoms are often worse during spring and fall. What is the most likely diagnosis?
A) Allergic rhinitis
B) Sinusitis
C) Acute viral upper respiratory infection
D) Acute otitis media
A 9-year-old child presents with difficulty concentrating in school, fidgeting, and an inability to stay seated for long periods. The child’s teacher also reports similar behavior in the classroom. What is the most likely diagnosis?
A) Generalized anxiety disorder
B) Attention-deficit hyperactivity disorder (ADHD)
C) Depression
D) Oppositional defiant disorder
A 7-year-old child presents with a productive cough, fever, and abdominal pain. The child has a history of asthma. What is the most likely diagnosis?
A) Pneumonia
B) Bronchiolitis
C) Acute sinusitis
D) Cystic fibrosis
A 16-year-old female presents with severe abdominal cramps, nausea, and vomiting. She also reports a missed period. A urine pregnancy test is positive. What is the next step in management?
A) Obtain a complete blood count (CBC)
B) Order an ultrasound to confirm the pregnancy
C) Start prenatal vitamins and refer to an obstetrician
D) Prescribe oral contraceptives
A 3-year-old child presents with difficulty breathing, a persistent cough, and a high fever. The child has a history of asthma. What is the most appropriate first step in management?
A) Administer nebulized albuterol
B) Prescribe antibiotics
C) Start systemic corticosteroids
D) Order a chest x-ray
A 10-year-old child presents with abdominal pain, weight loss, and diarrhea. The child has a history of celiac disease in the family. What is the most appropriate diagnostic test?
A) Serum tissue transglutaminase antibody (tTG-IgA)
B) Stool culture
C) Abdominal ultrasound
D) Colonoscopy
A 5-year-old child presents with a rash that began on the face and spread to the trunk. The child also has a fever and a cough. What is the most likely diagnosis?
A) Measles
B) Chickenpox
C) Rubella
D) Fifth disease
A 3-year-old child presents with a history of poor feeding, irritability, and vomiting. The child’s fontanel is bulging, and there is a high fever. What is the most likely diagnosis?
A) Meningitis
B) Hydrocephalus
C) Brain tumor
D) Encephalitis
A 7-year-old child presents with swollen, painful knees, and difficulty walking. The child also has a fever. The nurse practitioner suspects juvenile idiopathic arthritis (JIA). What is the most appropriate first-line treatment?
A) Methotrexate
B) Nonsteroidal anti-inflammatory drugs (NSAIDs)
C) Biologic agents
D) Oral corticosteroids
A 4-month-old infant presents with poor feeding, vomiting, and dehydration. The nurse practitioner suspects pyloric stenosis. What is the most appropriate next step in diagnosis?
A) Ultrasound of the abdomen
B) Barium swallow
C) Complete blood count (CBC)
D) CT scan of the abdomen
A 6-year-old child presents with a rash on the hands and feet, along with mouth sores and a fever. What is the most likely diagnosis?
A) Hand, foot, and mouth disease
B) Measles
C) Chickenpox
D) Scarlet fever
A 5-year-old child presents with sudden onset of fever, sore throat, and a bright red rash on the neck and chest. The child also has a white coating on the tongue. What is the most likely diagnosis?
A) Scarlet fever
B) Measles
C) Rubella
D) Fifth disease
A 2-year-old child is brought to the clinic with difficulty breathing and a barking cough. The child also has a low-grade fever. What is the most likely diagnosis?
A) Croup
B) Bronchiolitis
C) Asthma
D) Acute sinusitis
A 13-year-old child presents with a swollen, painful knee after a fall during a soccer game. The child is unable to bear weight on the affected leg. What is the most appropriate first step in management?
A) Apply ice and elevate the leg
B) Order an x-ray to assess for fracture
C) Refer to an orthopedic specialist
D) Start nonsteroidal anti-inflammatory drugs (NSAIDs)
A 5-year-old child presents with abdominal pain, bloating, and intermittent diarrhea. The nurse practitioner suspects irritable bowel syndrome (IBS). What is the most appropriate next step in management?
A) Refer to a gastroenterologist
B) Prescribe a probiotic
C) Order a stool culture
D) Start a high-fiber diet and monitor symptoms
A 6-year-old child presents with a persistent cough and wheezing, especially at night. The child also has a family history of asthma. What is the most likely diagnosis?
A) Asthma
B) Bronchiolitis
C) Pneumonia
D) Allergic rhinitis
A 16-year-old female presents with irregular menstrual cycles, excessive hair growth on the face and abdomen, and acne. The nurse practitioner suspects polycystic ovary syndrome (PCOS). What is the most appropriate first-line treatment?
A) Oral contraceptives
B) Metformin
C) Spironolactone
D) Clomiphene
A 10-year-old child presents with pain, swelling, and stiffness in the wrist and knee joints. The child also has a low-grade fever. The nurse practitioner suspects juvenile rheumatoid arthritis (JRA). What is the most appropriate diagnostic test?
A) Rheumatoid factor
B) Antinuclear antibody (ANA)
C) Complete blood count (CBC)
D) Erythrocyte sedimentation rate (ESR)
A 14-year-old male presents with a painful, swollen ankle after playing basketball. The nurse practitioner suspects a sprain. What is the most appropriate first step in management?
A) Apply ice and elevate the ankle
B) Order an x-ray to rule out a fracture
C) Start a course of oral corticosteroids
D) Refer to an orthopedic specialist
A 6-month-old infant presents with a cough, wheezing, and fever. The child has a history of respiratory syncytial virus (RSV) infection. What is the most appropriate next step in management?
A) Hospitalize for supportive care and monitor oxygenation
B) Start oral antibiotics
C) Administer nebulized epinephrine
D) Prescribe bronchodilators and monitor for improvement
A 5-year-old child presents with a red, swollen ear and tenderness to touch. The child has no fever or other systemic symptoms. What is the most likely diagnosis?
A) Acute otitis media
B) Otitis externa
C) Mastoiditis
D) Cholesteatoma
A 12-year-old child presents with fatigue, pallor, and shortness of breath. The nurse practitioner suspects anemia. What is the most appropriate first step in management?
A) Order a complete blood count (CBC)
B) Start iron supplementation
C) Refer to a hematologist
D) Order a stool culture for occult blood
A 4-year-old child presents with a persistent cough, fever, and nasal congestion. The nurse practitioner suspects a viral upper respiratory infection. What is the most appropriate treatment?
A) Prescribe antibiotics
B) Recommend saline nasal drops and supportive care
C) Order a chest x-ray
D) Administer oral steroids
A 16-year-old male presents with severe chest pain, shortness of breath, and swelling in the lower extremities. The nurse practitioner suspects a cardiac condition. What is the most appropriate next step in management?
A) Order an electrocardiogram (ECG)
B) Refer to a cardiologist for further evaluation
C) Order a chest x-ray
D) Start treatment for asthma
A 3-year-old child is brought to the clinic with a cough, fever, and difficulty breathing. The child has a history of asthma. What is the most appropriate first-line treatment?
A) Nebulized albuterol
B) Oral antibiotics
C) Intravenous fluids
D) Intravenous corticosteroids
A 5-year-old child presents with a persistent cough, wheezing, and difficulty breathing. The child has a family history of asthma. What is the most likely diagnosis?
A) Asthma
B) Bronchiolitis
C) Acute pneumonia
D) Cystic fibrosis
A 14-year-old adolescent presents with excessive thirst, frequent urination, and unexplained weight loss. A random blood glucose test shows a level of 225 mg/dL. What is the most likely diagnosis?
A) Type 2 diabetes mellitus
B) Type 1 diabetes mellitus
C) Diabetes insipidus
D) Hyperthyroidism
A 10-year-old child presents with a red, itchy rash that started on the face and has spread to the trunk and limbs. The child has a fever and a sore throat. What is the most likely diagnosis?
A) Rubella
B) Measles
C) Chickenpox
D) Fifth disease
A 6-month-old infant presents with poor feeding, projectile vomiting, and dehydration. The most likely diagnosis is:
A) Gastroesophageal reflux disease (GERD)
B) Pyloric stenosis
C) Lactose intolerance
D) Viral gastroenteritis
A 4-year-old child presents with severe abdominal pain, vomiting, and a distended abdomen. The child’s mother reports that the child has not been passing stool. What is the most likely diagnosis?
A) Intussusception
B) Acute appendicitis
C) Pyloric stenosis
D) Hirschsprung disease
A 13-year-old female presents with excessive hair growth on the face, acne, and irregular menstrual cycles. The most likely diagnosis is:
A) Polycystic ovary syndrome (PCOS)
B) Hyperthyroidism
C) Cushing syndrome
D) Hypothyroidism
A 4-year-old child presents with a history of chronic cough, wheezing, and difficulty breathing. The child also has a family history of asthma. What is the most appropriate first-line treatment?
A) Inhaled corticosteroids
B) Leukotriene inhibitors
C) Short-acting beta-agonists (SABA)
D) Oral antibiotics
A 9-year-old child presents with complaints of joint pain, particularly in the knees and wrists. The child also has a rash and fever. The most likely diagnosis is:
A) Rheumatic fever
B) Juvenile idiopathic arthritis (JIA)
C) Systemic lupus erythematosus (SLE)
D) Lyme disease
A 7-year-old child presents with a history of frequent headaches, vomiting, and blurred vision. The child also reports a worsening headache in the morning. What is the most likely diagnosis?
A) Migraines
B) Brain tumor
C) Tension headaches
D) Sinusitis
A 12-year-old child presents with painful urination, increased frequency, and a fever. The nurse practitioner suspects a urinary tract infection (UTI). What is the most appropriate first-line treatment?
A) Amoxicillin
B) Trimethoprim-sulfamethoxazole
C) Nitrofurantoin
D) Ciprofloxacin
A 4-year-old child is brought to the clinic with a history of persistent coughing and a “barking” sound, especially at night. The child has a low-grade fever. What is the most likely diagnosis?
A) Croup
B) Bronchiolitis
C) Acute asthma exacerbation
D) Upper respiratory infection
A 3-year-old child presents with a fever, irritability, and a red rash that starts on the face and spreads to the trunk. The child’s parents are concerned that the child may have measles. What is the most likely diagnosis?
A) Rubella
B) Fifth disease
C) Measles
D) Chickenpox
A 10-year-old child presents with complaints of abdominal pain and bloating. The child’s stool is loose and frothy. The most likely diagnosis is:
A) Lactose intolerance
B) Irritable bowel syndrome
C) Celiac disease
D) Appendicitis
A 15-year-old male presents with swelling and tenderness in the knee after a soccer injury. The child is unable to bear weight on the leg. What is the most likely diagnosis?
A) Meniscal tear
B) Patellar tendinitis
C) Osgood-Schlatter disease
D) Ligament sprain
A 7-year-old child presents with difficulty breathing, cough, and wheezing. The child has a history of recurrent respiratory infections and a family history of asthma. What is the most likely diagnosis?
A) Bronchitis
B) Asthma
C) Pneumonia
D) Cystic fibrosis
A 6-year-old child presents with a rash on the hands and feet, as well as mouth sores and a fever. What is the most likely diagnosis?
A) Hand, foot, and mouth disease
B) Measles
C) Chickenpox
D) Scarlet fever
A 9-year-old child presents with fever, sore throat, and a white coating on the tonsils. The nurse practitioner suspects strep throat. What is the most appropriate next step in management?
A) Perform a rapid strep test
B) Prescribe antibiotics without testing
C) Recommend supportive care only
D) Order a throat culture
A 4-year-old child presents with irritability, poor feeding, and vomiting. The child’s fontanel is bulging, and there is a fever. What is the most likely diagnosis?
A) Meningitis
B) Hydrocephalus
C) Gastroenteritis
D) Brain tumor
A 13-year-old female presents with sudden onset of severe lower abdominal pain, nausea, and vomiting. She also has a fever. The most likely diagnosis is:
A) Appendicitis
B) Pelvic inflammatory disease (PID)
C) Ovarian torsion
D) Ectopic pregnancy
A 6-month-old infant is brought to the clinic for a routine checkup. The child is unable to sit up or crawl and has not started babbling. What is the most appropriate next step?
A) Refer for a developmental evaluation
B) Reassure the parents, as this is normal for this age
C) Start physical therapy
D) Order an MRI of the brain
A 14-year-old adolescent presents with a history of excessive thirst, increased urination, and unexplained weight loss. The nurse practitioner suspects type 1 diabetes mellitus. What is the most appropriate diagnostic test?
A) Hemoglobin A1c
B) Fasting blood glucose
C) Oral glucose tolerance test
D) Random blood glucose
A 5-year-old child presents with a red, swollen ear and tenderness on palpation. The child has a fever and irritability. What is the most likely diagnosis?
A) Otitis externa
B) Otitis media
C) Mastoiditis
D) Cholesteatoma
A 12-year-old child presents with recurrent nosebleeds, especially in the winter months. The child has no other significant medical history. What is the most likely diagnosis?
A) Allergic rhinitis
B) Vitamin C deficiency
C) Idiopathic thrombocytopenic purpura (ITP)
D) Dry mucous membranes
A 10-year-old child presents with a red, itchy rash that is concentrated around the cheeks, chin, and mouth. The child has a history of asthma and seasonal allergies. What is the most likely diagnosis?
A) Eczema
B) Impetigo
C) Acne
D) Psoriasis
A 16-year-old female presents with irregular menstrual cycles, excessive hair growth, and acne. The nurse practitioner suspects polycystic ovary syndrome (PCOS). What is the most appropriate diagnostic test?
A) Serum testosterone levels
B) Pelvic ultrasound
C) Thyroid function tests
D) Complete blood count (CBC)
A 3-year-old child presents with irritability, poor feeding, and vomiting. The child’s fontanel is bulging, and the child has a high fever. What is the most likely diagnosis?
A) Meningitis
B) Encephalitis
C) Acute otitis media
D) Hydrocephalus
A 7-year-old child presents with a cough, fever, and difficulty breathing. The child has a history of asthma. What is the most likely diagnosis?
A) Bronchiolitis
B) Pneumonia
C) Acute sinusitis
D) Acute asthma exacerbation
A 12-year-old child presents with joint pain in the knees and elbows. The child also has a red rash on the trunk. What is the most likely diagnosis?
A) Systemic lupus erythematosus
B) Juvenile idiopathic arthritis
C) Rheumatic fever
D) Infectious arthritis
A 5-year-old child presents with a persistent cough, wheezing, and shortness of breath. The child has a family history of asthma. What is the most appropriate first-line treatment?
A) Inhaled corticosteroids
B) Beta-agonists
C) Leukotriene inhibitors
D) Oral corticosteroids
A 6-month-old infant is brought in with a history of vomiting, poor feeding, and weight loss. The child is unable to pass stool for several days. What is the most likely diagnosis?
A) Cystic fibrosis
B) Hirschsprung disease
C) Intussusception
D) Pyloric stenosis
A 10-year-old child presents with a sudden onset of severe headache, vomiting, and photophobia. The most likely diagnosis is:
A) Tension headache
B) Migraine
C) Meningitis
D) Sinusitis
A 6-year-old child presents with red, itchy, and swollen eyelids. The child also has a clear watery discharge from the eyes. What is the most likely diagnosis?
A) Bacterial conjunctivitis
B) Viral conjunctivitis
C) Allergic conjunctivitis
D) Blepharitis
A 4-month-old infant presents with projectile vomiting and poor weight gain. The nurse practitioner suspects pyloric stenosis. What is the most appropriate diagnostic test?
A) Ultrasound of the abdomen
B) Abdominal x-ray
C) Upper gastrointestinal (GI) series
D) MRI of the abdomen
A 13-year-old adolescent presents with severe right lower quadrant abdominal pain, fever, and nausea. The most likely diagnosis is:
A) Acute appendicitis
B) Gastroenteritis
C) Ovarian torsion
D) Urinary tract infection (UTI)
A 7-year-old child presents with complaints of leg pain that is worse at night and improves with movement. The child also has a history of growing pains. What is the most likely diagnosis?
A) Osgood-Schlatter disease
B) Juvenile idiopathic arthritis
C) Growing pains
D) Rheumatic fever
A 5-year-old child presents with a cough, fever, and difficulty breathing. The child has a history of recurrent respiratory infections. The nurse practitioner suspects cystic fibrosis. What is the most appropriate diagnostic test?
A) Sweat chloride test
B) Chest x-ray
C) Pulmonary function test
D) Complete blood count (CBC)
A 15-year-old female presents with irregular menstrual cycles, excessive hair growth, and acne. The most likely diagnosis is:
A) Hypothyroidism
B) Polycystic ovary syndrome (PCOS)
C) Cushing syndrome
D) Anorexia nervosa
A 9-year-old child presents with a persistent cough, wheezing, and shortness of breath. The child has a family history of asthma. What is the most appropriate first-line treatment?
A) Inhaled corticosteroids
B) Leukotriene receptor antagonists
C) Oral corticosteroids
D) Beta-agonist inhaler
A 6-year-old child presents with frequent episodes of itchy, watery eyes, sneezing, and nasal congestion. These symptoms are most prominent in the spring and fall. The most likely diagnosis is:
A) Acute sinusitis
B) Allergic rhinitis
C) Viral upper respiratory infection
D) Acute otitis media
A 12-year-old child presents with low-grade fever, sore throat, and a white coating on the tonsils. The child also has swollen lymph nodes. What is the most likely diagnosis?
A) Mononucleosis
B) Streptococcal pharyngitis
C) Viral pharyngitis
D) Tonsillitis
A 4-year-old child presents with persistent diarrhea, weight loss, and malabsorption. The nurse practitioner suspects celiac disease. What is the most appropriate first-line diagnostic test?
A) Stool culture
B) Serum tissue transglutaminase antibody (tTG-IgA)
C) Colonoscopy
D) Endoscopy with biopsy
A 10-year-old child presents with a swollen, painful knee after a fall while playing soccer. The child is unable to bear weight on the affected leg. What is the most appropriate next step in management?
A) Apply ice and elevate the leg
B) Order an x-ray to rule out fracture
C) Refer to an orthopedic specialist
D) Start nonsteroidal anti-inflammatory drugs (NSAIDs)
A 6-month-old infant presents with poor feeding, vomiting, and dehydration. The child has a bulging fontanel and a fever. What is the most likely diagnosis?
A) Meningitis
B) Hydrocephalus
C) Acute gastroenteritis
D) Encephalitis
A 5-year-old child presents with a red, itchy rash on the face and trunk. The rash is maculopapular and has started to peel. The child also has a sore throat and fever. What is the most likely diagnosis?
A) Scarlet fever
B) Measles
C) Rubella
D) Chickenpox
A 14-year-old male presents with a painful, swollen ankle after playing basketball. The child is unable to bear weight on the leg. What is the most appropriate next step in management?
A) Apply ice and elevate the ankle
B) Order an x-ray to rule out fracture
C) Start nonsteroidal anti-inflammatory drugs (NSAIDs)
D) Refer to an orthopedic specialist
A 3-year-old child presents with a barking cough and stridor. The child has a low-grade fever and difficulty breathing. What is the most likely diagnosis?
A) Croup
B) Bronchiolitis
C) Acute asthma exacerbation
D) Respiratory syncytial virus (RSV)
A 10-year-old child presents with complaints of frequent, painful urination and a foul-smelling urine. The child has a fever and lower abdominal pain. What is the most likely diagnosis?
A) Urinary tract infection (UTI)
B) Pyelonephritis
C) Bladder stones
D) Interstitial cystitis
A 2-year-old child presents with difficulty breathing, a persistent cough, and wheezing. The child has a family history of asthma. What is the most likely diagnosis?
A) Asthma
B) Bronchiolitis
C) Cystic fibrosis
D) Allergic rhinitis
A 5-year-old child presents with a red, swollen ear, tenderness to touch, and fever. The most likely diagnosis is:
A) Otitis externa
B) Otitis media
C) Mastoiditis
D) Cholesteatoma
A 16-year-old female presents with a history of irregular periods, acne, and excessive hair growth. The nurse practitioner suspects polycystic ovary syndrome (PCOS). What is the most appropriate next step in management?
A) Oral contraceptives
B) Metformin
C) Spironolactone
D) Clomiphene
A 4-year-old child presents with irritability, poor feeding, and vomiting. The child’s fontanel is bulging, and there is a fever. What is the most likely diagnosis?
A) Meningitis
B) Hydrocephalus
C) Encephalitis
D) Brain tumor
A 7-year-old child presents with complaints of pain in the knees and wrists. The child also has a rash and a fever. The most likely diagnosis is:
A) Rheumatic fever
B) Systemic lupus erythematosus
C) Juvenile idiopathic arthritis
D) Infectious arthritis
A 3-year-old child is brought to the clinic with a history of persistent coughing and a “barking” sound, especially at night. The child has a low-grade fever. What is the most likely diagnosis?
A) Croup
B) Bronchiolitis
C) Acute asthma exacerbation
D) Upper respiratory infection
A 9-year-old child presents with a rash on the hands and feet, as well as mouth sores and a fever. What is the most likely diagnosis?
A) Hand, foot, and mouth disease
B) Measles
C) Chickenpox
D) Scarlet fever
A 12-year-old child presents with recurrent abdominal pain and bloating, as well as diarrhea. The child has a family history of irritable bowel syndrome. What is the most appropriate next step in management?
A) Refer to a gastroenterologist
B) Order a stool culture
C) Start a high-fiber diet
D) Prescribe a probiotic
A 16-year-old female presents with irregular menstrual cycles, acne, and excessive hair growth on the face and abdomen. The most likely diagnosis is:
A) Polycystic ovary syndrome (PCOS)
B) Hyperthyroidism
C) Cushing syndrome
D) Hypothyroidism