ACUTE CARE PNCB FULL QUESTIONS AND
CORRECT ANSWERS FINAL PAPER
●● Otoscope: how to straighten canal
Answer: ≥ 3 y/o: Up & back
< 3 y/o: Down & out
●● Phenylketonuria (PKU): definition, SSx, c/b
Answer: Autosomal recessive disorder (two carrier parents affected one
child):
inability to break down amino acid phenylalanine
SSx: Musty urine odor
c/b: untreated, can lead to albinism (b/c phenylalanine can't convert to
melanin), neurologic changes (nonadherence to diet of low-protein)
●● Congenital Adrenal Hyperplasia: definition; SSx (x4)
Answer: enzyme deficiency for synthesis of cortisol
SSx:
,- ambiguous genitalia
- lethargy, poor feeding/FTT
- metabolic acidosis = hyperK, hypoNa, hypoglycemia
- hypotension, hypothermia
●● Anterior and Posterior Fontanels closures
Answer: P: 1-3mos; A: 18-24mos
●● Erickson's 8 Stages of Psychosocial Development
Answer: 1) INFANT: trust vs mistrust
2) TODDLER: autonomy vs shame and doubt
3) PRESCHOOL: initiative vs.guilt
4) GRADE SCHOOL: industry vs. inferiority
5) TEENAGER: identity vs role confusion.
6) YOUNG ADULT: intimacy vs isolation
7) MIDDLE AGE: generativity vs. stagnation
8) OLDER ADULT: integrity vs. despair
●● MMR vaccine contraindication
Answer: severely compromised
●● % of understandable language: 1-4yrs
,Answer: 1 yo: 1-word sentences, 25%
2 yo: 2-word sentences, 50%
3 yo: 3-word sentences, 75%
4 yo: 5-6+ word sentences, 100%
●● Laryngotracheobronchitis (Croup): common age/gender, causative
virusus, SSx (x2), Dx, Tx
Answer: 6mos- 3yrs, males>females
Parainfluenza 1&2, RSV
SSx: seal/barky cough, stridor
Dx: steeple sign
Tx: steroids (dexamethasone 0.6 mg/kg IV/IM)
●● pneumonia: common organisms, school-age, SSx (x2), Dx, Tx
Answer: community acquired: strep pneumoniae
school-age: atypical viral mycoplasma pneumoniae (low fever)
, SSx: rales/crackles, focal diminished breath sounds
Dx: focal infiltrates on XR
Tx: high-dose Amoxicillin or Ceftriaxone; Azithromycin (atypical
mycoplasma p.)
●● Pertussis (whooping cough): pathophys, SSx (x2), Dx, Tx
Answer: bacteria attaches to cilia in resp tract
→ produces toxins
→ causes inflammation and loss of surfactant
SSx:
- paroxysmal (violent/painful/uncontrollable) cough
- post-tussive emesis
Dx: pertussis PCR + Cx
Tx:
- Azithryomycin (infants)
- Bactrim (older)
- no longer: Erythromycin & Clarithromycin d/t high risk of IHPS
(infantile hypertrophic pyloric stenosis)
CORRECT ANSWERS FINAL PAPER
●● Otoscope: how to straighten canal
Answer: ≥ 3 y/o: Up & back
< 3 y/o: Down & out
●● Phenylketonuria (PKU): definition, SSx, c/b
Answer: Autosomal recessive disorder (two carrier parents affected one
child):
inability to break down amino acid phenylalanine
SSx: Musty urine odor
c/b: untreated, can lead to albinism (b/c phenylalanine can't convert to
melanin), neurologic changes (nonadherence to diet of low-protein)
●● Congenital Adrenal Hyperplasia: definition; SSx (x4)
Answer: enzyme deficiency for synthesis of cortisol
SSx:
,- ambiguous genitalia
- lethargy, poor feeding/FTT
- metabolic acidosis = hyperK, hypoNa, hypoglycemia
- hypotension, hypothermia
●● Anterior and Posterior Fontanels closures
Answer: P: 1-3mos; A: 18-24mos
●● Erickson's 8 Stages of Psychosocial Development
Answer: 1) INFANT: trust vs mistrust
2) TODDLER: autonomy vs shame and doubt
3) PRESCHOOL: initiative vs.guilt
4) GRADE SCHOOL: industry vs. inferiority
5) TEENAGER: identity vs role confusion.
6) YOUNG ADULT: intimacy vs isolation
7) MIDDLE AGE: generativity vs. stagnation
8) OLDER ADULT: integrity vs. despair
●● MMR vaccine contraindication
Answer: severely compromised
●● % of understandable language: 1-4yrs
,Answer: 1 yo: 1-word sentences, 25%
2 yo: 2-word sentences, 50%
3 yo: 3-word sentences, 75%
4 yo: 5-6+ word sentences, 100%
●● Laryngotracheobronchitis (Croup): common age/gender, causative
virusus, SSx (x2), Dx, Tx
Answer: 6mos- 3yrs, males>females
Parainfluenza 1&2, RSV
SSx: seal/barky cough, stridor
Dx: steeple sign
Tx: steroids (dexamethasone 0.6 mg/kg IV/IM)
●● pneumonia: common organisms, school-age, SSx (x2), Dx, Tx
Answer: community acquired: strep pneumoniae
school-age: atypical viral mycoplasma pneumoniae (low fever)
, SSx: rales/crackles, focal diminished breath sounds
Dx: focal infiltrates on XR
Tx: high-dose Amoxicillin or Ceftriaxone; Azithromycin (atypical
mycoplasma p.)
●● Pertussis (whooping cough): pathophys, SSx (x2), Dx, Tx
Answer: bacteria attaches to cilia in resp tract
→ produces toxins
→ causes inflammation and loss of surfactant
SSx:
- paroxysmal (violent/painful/uncontrollable) cough
- post-tussive emesis
Dx: pertussis PCR + Cx
Tx:
- Azithryomycin (infants)
- Bactrim (older)
- no longer: Erythromycin & Clarithromycin d/t high risk of IHPS
(infantile hypertrophic pyloric stenosis)
