Pediatric Primary Care PNCB Final Exam Questions & Answers

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Pediatric Primary Care PNCB Final Exam Questions & Answers-You are seeing a 4-week old infant whose mother states that the child's right eye is wet all the time and sometime there is thick mucus on th... e lashes. There has been no fever and the baby is feeding well. Eye exam reveals a normal red reflex bilaterally with no evidence of purulent drainage, conjunctival erythema, or cloudiness over the cornea. You suspect: a) adenovirus conjunctivits b) nasolacrimal stenosis c) chlamydial conjunctivitis d) congenital cataract - b) nasolacrimal duct stenosis A 9-month-old infant who was born at 32-weeks reaches for a block with only the left hand. The right arm remains still at the side of her body. The PNP would: a) record these findings as normal for a premature infant b) refer the infant for further evaluation c) refer the child for a muscle biopsy d) record that the child will likely be left-handed - b) refer the infant for further evaluation During a 2-month-old well child visit you note that the red reflex in one eye seems paler than in the other. What is the most appropriate follow-up step for this observation? a) assess and document a normal corneal light reflex in that eye b) preform the cover/uncover test c) re-evaluate the red re-screening test in 2 weeks d) refer the infant to a pediatric ophthalmologist immediately - d) refer the infant to a pediatric ophthalmologist immediately Primary dentition erupts between: a) 6-11 years b) 6-30 months c) 1-5 years d) 12-24 months - b) 6-30 months The parent of a 4-year-old points to a picture and says "That's your sister!". The child responds by saying "No! It's my baby!". This is an example of which type of thinking in preschool-age children? a) animism b) artificialism c) egocentrism d) realism - d) realism The primary care PNP performs a developmental assessment on a 32-month-old child. The child's parent reports that about 70% of the child's speech is intelligible. The pediatric nurse practitioner observes that the child has difficulty pronouncing "t" "d" "k" and "g". Which action is correct? a) evaluate the child's cognitive abilities b) obtain a hearing evaluation c) reassure the parent that this is normal d) refer the child to a speech therapist - c) reassure the parent that this is normal The primary care PNP is offering anticipatory guidance to the parents of a 12-month-old child. The parents are bilingual in Spanish and English and have many Spanish-speaking relatives nearby. They are resisting exposing the child to Spanish out of concern that the child will not learn English well. What will the PNP tell the parents? a) children who learn two languages simultaneously often confuse them in conversation b) children with multi-language proficiency do not understand that others cannot do this c) learning two languages at an early age prevents children from development a dominant language d) most bilingual children are able to shift from one language to another when appropriate - d) most bilingual children are able to shift from one language to another when appropriate The parents of a 3-year-old child are concerns that the child has begun refusing usual foods and wants to eat mashed potatoes and chicken strips at every meal and snack. The child's rate of weight has slowed, but the child remains at the same percentile for weight on a growth chart. What will the PNP tell the parents to do> a) allow the child to choose foods for meals to improve caloric intake b) place a variety of nutritious foods on the child's plate at each meal c) prepare masked potatoes and chicken strips for the child at mealtimes d) suggest cutting out snacks to improve the child's appetite at mealtimes - b) place a variety of nutritious foods on the child's plate at each meal The PC-PNP is evaluating a 2-year-old with a documented speech delay. Screening s to assess motor skills and cognition are normal, and the child passed a recent hearing test. What will the PNP do next? a) ask the child's parents whether they read to the child b) give parents educational materials to encourage speech c) refer the child to and early intervention program d) suggest that they purchase age-appropriate music videos - a) ask the child's parents whether they read to the child The mother of a 3-year-old child takes the child to play group once a week. She expressed concern that the child plays with toys but does not interact with the other toddlers. What will the PNP counsel the mother? a) the child probably is very shy but will outgrow this tendency with repeated exposure to other children b) the toddler may have a language delay that interferes with socialization with other children c) toddlers may be interested in other children but usually do not engage in interactive play d) toddlers need more structured play to encourage interaction and socialization with others - c) toddlers may be interested in other children but usually do not engage in interactive play Which of the following set of symptoms would be most consistent GABHS infection? a) cough, nasal congestion, cervical lymphadenopathy b) fever, HA, tender cervical lymphadenopathy c) cough, fever, macular papular rash to trunk d) sneezing, rhinorrhea, exudative tonsils - b) fever, HA, tender cervical lymphadenopathy What of the following is the most appropriate treatment for strep throat? a) penicillin V 250mg BID x5days and tylenol for pain or fever b) azithromycin for 5 days and ibuprofen c) penicillin V 500mg bid for 10 days with tylenol for pain and fever d) cephalexin 500mg BID for 10 days - c) penicillin V 500mg bid for 10 days with tylenol for pain and fever The red reflex is done in the newborn to rule out: a) retinoblastoma b) decreased visual acuity c) strabismus d) corneal abrasions - a) retinoblastoma [Show More]

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