NSG 554 EXAM 4 V3: ADVANCED
PEDIATRIC PRIMARY CARE
QUESTIONS AND ANSWERS
1. A 4-year-old child presents with a barking cough, inspiratory stridor, and hoarseness. The
NP suspects Croup. What is the most common causative organism for this condition?
A. Respiratory Syncytial Virus (RSV)
B. Mycoplasma pneumoniae
C. Haemophilus influenzae type b
D. Parainfluenza virus type 1
Answer: D
Conceptual Explanation: Parainfluenza virus type 1 is the most common cause of viral
croup (laryngotracheobronchitis).
2. A 6-year-old is diagnosed with Acute Otitis Media (AOM). According to current guidelines,
what is the first-line antibiotic treatment for a child with no penicillin allergy?
A. Azithromycin 10mg/kg on day 1
B. Cephalexin 40mg/kg/day
C. Amoxicillin-Clavulanate 90mg/kg/day
,D. Amoxicillin 80-90 mg/kg/day
Answer: D
Conceptual Explanation: High-dose Amoxicillin (80-90 mg/kg/day) is the first-line
recommendation for AOM in children without penicillin allergy.
3. A 10-year-old presents with a history of intermittent wheezing, occurring 3 times per week,
and nighttime awakenings 3 times per month. How would you classify this child’s asthma
severity?
A. Intermittent
B. Moderate Persistent
C. Mild Persistent
D. Severe Persistent
Answer: C
Conceptual Explanation: Mild persistent asthma is characterized by symptoms >2
days/week but not daily, and nighttime awakenings 3-4 times per month.
4. During a well-child exam, a 2-week-old infant is found to have a positive Ortolani
maneuver. What is the most appropriate next step?
A. Re-evaluate in 2 months
B. Order a pelvic X-ray immediately
C. Instruct parents to use double-diapering technique
, D. Refer to pediatric orthopedics for suspected developmental dysplasia of the hip
Answer: D
Conceptual Explanation: A positive Ortolani maneuver indicates a dislocated hip that is
reducible, requiring prompt orthopedic referral.
5. Which of the following findings on a physical exam is most characteristic of Pyloric Stenosis
in an infant?
A. Sausage-shaped mass in the right upper quadrant
B. Abdominal distension with visible peristalsis in the lower quadrants
C. Rebound tenderness at McBurney’s point
D. Palpable olive-shaped mass in the epigastrium
Answer: D
Conceptual Explanation: The classic physical finding for pyloric stenosis is an olive-
shaped mass in the epigastric area, often felt after the infant vomits.
6. A 15-year-old male athlete presents with pain below the knee that worsens with activity
and improves with rest. Exam reveals tenderness at the tibial tuberosity. What is the most
likely diagnosis?
A. Legg-Calve-Perthes disease
B. Slipped Capital Femoral Epiphysis
C. Osgood-Schlatter disease
PEDIATRIC PRIMARY CARE
QUESTIONS AND ANSWERS
1. A 4-year-old child presents with a barking cough, inspiratory stridor, and hoarseness. The
NP suspects Croup. What is the most common causative organism for this condition?
A. Respiratory Syncytial Virus (RSV)
B. Mycoplasma pneumoniae
C. Haemophilus influenzae type b
D. Parainfluenza virus type 1
Answer: D
Conceptual Explanation: Parainfluenza virus type 1 is the most common cause of viral
croup (laryngotracheobronchitis).
2. A 6-year-old is diagnosed with Acute Otitis Media (AOM). According to current guidelines,
what is the first-line antibiotic treatment for a child with no penicillin allergy?
A. Azithromycin 10mg/kg on day 1
B. Cephalexin 40mg/kg/day
C. Amoxicillin-Clavulanate 90mg/kg/day
,D. Amoxicillin 80-90 mg/kg/day
Answer: D
Conceptual Explanation: High-dose Amoxicillin (80-90 mg/kg/day) is the first-line
recommendation for AOM in children without penicillin allergy.
3. A 10-year-old presents with a history of intermittent wheezing, occurring 3 times per week,
and nighttime awakenings 3 times per month. How would you classify this child’s asthma
severity?
A. Intermittent
B. Moderate Persistent
C. Mild Persistent
D. Severe Persistent
Answer: C
Conceptual Explanation: Mild persistent asthma is characterized by symptoms >2
days/week but not daily, and nighttime awakenings 3-4 times per month.
4. During a well-child exam, a 2-week-old infant is found to have a positive Ortolani
maneuver. What is the most appropriate next step?
A. Re-evaluate in 2 months
B. Order a pelvic X-ray immediately
C. Instruct parents to use double-diapering technique
, D. Refer to pediatric orthopedics for suspected developmental dysplasia of the hip
Answer: D
Conceptual Explanation: A positive Ortolani maneuver indicates a dislocated hip that is
reducible, requiring prompt orthopedic referral.
5. Which of the following findings on a physical exam is most characteristic of Pyloric Stenosis
in an infant?
A. Sausage-shaped mass in the right upper quadrant
B. Abdominal distension with visible peristalsis in the lower quadrants
C. Rebound tenderness at McBurney’s point
D. Palpable olive-shaped mass in the epigastrium
Answer: D
Conceptual Explanation: The classic physical finding for pyloric stenosis is an olive-
shaped mass in the epigastric area, often felt after the infant vomits.
6. A 15-year-old male athlete presents with pain below the knee that worsens with activity
and improves with rest. Exam reveals tenderness at the tibial tuberosity. What is the most
likely diagnosis?
A. Legg-Calve-Perthes disease
B. Slipped Capital Femoral Epiphysis
C. Osgood-Schlatter disease
