The parent of an infant experiencing colic asks about using a probio c medica on. What will the
primary care pediatric NP tell this parent?
A. Probio c medica ons have demonstrated efficacy in trea ng colic.
B. Probio cs are not safe to use to treat infants who have colic.
C. There are no studies showing usefulness of probio c to manage colic.
D. There is no conclusive evidence about using probio cs to treat colic. -correct answersD.
There is no conclusive evidence about using probio cs to treat colic.
A toddler who was born prematurely refuses most solid foods and has poor weight gain. A
barium swallow study reveals a normal esophagus. What will the primary care pediatric NP
consider the next to manage this child's nutri onal needs?
A. consulta on with die cian
B. Fiberop c endoscopy evalua on.
C. MRI
D. Videofluroscopy swallowing study (VOSS) -correct answersD. Videofluroscopy swallowing
study (VOSS)
A toddler is seen in clinic a er a 2-day hx of intermi ent V/D. An assessment reveals an irritable
child with dry mucous membranes, 3-second cap refill. 2-second recoil of skin, mild tachycardia
and tachypnea, and cool hands and feet. The child has had 2 wet diapers in the past 24 hours.
What will the primary care pediatric NP recommend?
,A. an -diarrheal medica on & clear fluids for 24H
B. Bolus of IV NS in the clinic un l improvement
C. Hospital admission for IV rehydra on & oral fluids
D. Oral rehydra on solu on with f/u in 24H -correct answersD. Oral rehydra on solu on with
f/u in 24H
A 9-year old girl has a hx of frequent vomi ng and her mother has frequent migraine ha. The
child has recently begun having more frequent and prolonged episodes accompanied by
headaches. An exam reveals abnormal eye movement and mild ataxia. What is the correct
ac on?
A. begin using an -migraine meds to prevent HA
B. Prescribe ondansetron and lorazepam to help manage sx
C. Reassure the parent that this is expected with cyclic vomi ng syndrome
D. Refer to a pediatric gastroenterologist for further workup. -correct answersD. Refer to a
pediatric gastroenterologist for further workup.
The parent of a 3-month-old reports that the infant reports that the infant arches and gags
while feeding and spits up undigested formula frequently. The infant's weight gain has dropped
to the 5th percen le from the 12th. What is the best course of tx for this infant?
A. Begin a trial of extensively hydrolyzed protein formula for 2-4 wks.
B. Ins tute an emperic trial of acid suppression with a PPI
C. Perform esophageal pH monitoring to determine the degree of reflux.
D. Reassure the parent that these sx will likely resolved by 12-24 mo. -correct answersA. Begin a
trial of extensively hydrolyzed protein formula for 2-4 wks.
A school-age child has a 3-month hx of dull, aching epigastric pain that worsens with ea ng and
awakens from sleep. A CBC shows a Hgb of 8mg/dL. What is the next step in management.
A. Administra on of H RA or PPI meds
B. Empiric therapy for H. pylori
,C. Ordering an upper GI series
D. Referral for EGD -correct answersD. Referral for EGD
A 2-mo old infant cries up to 4 hours each day and according to the parents, is inconsolable
during crying episodes with fits and legs notes to be tense and s ff. The infant is breas eeding
frequently but is o en fussy during feedings. The PE is normal and the infant is gaining weight
normally. What will the primary care pediatric NP recommend?
A. A complete work-up, including lab and radiologic tests.
B. Elimina ng certain foods from the mother's diet.
C. Empiric tx w/PPI
D. Stopping breas eeding & beginning a hydrolyzed formula -correct answersB. Elimina ng
certain foods from the mother's diet.
A child is in the clinic a er swallowing a metal bead. A radiograph of the GI tract shows a 6 mm
cylindrical object in the child's stomach. The child is able to swallow without difficulty and is not
experiencing pain. What is the correct course of treatment?
a. Administer ipecac to induce vomi ng.
b. Have the parents watch for the object in the child's stool.
c. Insert a nasogastric tube to flush out the object.
d. Refer the child for endoscopic removal of the object. -correct answersb. Have the parents
watch for the object in the child's stool.
A 10-year-old child has had abdominal pain for 2 days, which began in the periumbilical area
and then localized to the RLQ. The child vomited once today and then experienced relief from
pain followed by an increased fever. What is the likely diagnosis?
A. Appendici s w/perf
B. Gastroenteri s
C. Pelvic inflammatory disease (PID)
D. UTI -correct answersA. Appendici s w/perf
, An 18-month-old child has a 1-day hx of intermi ent, cramping abd pain w/non-bilious
vomi ng. The child observed to scream and draw up his legs during pain episodes and becomes
lethargic in between. The primary care pediatric NP notes ta small amount of bloody, mucous
stool in the diaper. What is the most likely diagnosis?
A. Appendici s
B. Gastroenteri s
C. Intussuscep on
D. Tes cular torsion -correct answersC. Intussuscep on
A school-age child has had abd pain for 3 mo htat occurs once to twice weekly and is associated
with a h/a and occ diff sleeping, o en causing the child to stay home from school. The child
does not have V/D & is gaining weight normally. The PE is normal. According to Bishop, what is
included in the ini al diagnos c work-up for this child?
A. CBC, ESR, amylase, lipase, UA, & abd US
B. CBC, ESR, CRP, and fecal calprotec n
C. CBC, ESR, CRP, UA, stool for ova, parasites, and culture
D. Stool for H.pylori an gen and serum IgA, IgG, tTg -correct answersA. CBC, ESR, amylase,
lipase, UA, & abd US
An adolescent is dx with func onal abdominal pain (FAP). The child's sx worsen during stressful
events, esp w/school anxiety. What will be an important part of tx for this child?
A. informing the parents that the pain is most likely not real
B. ins tu ng a lactose-free diet along w/lactobacillus supplements
C. teaching about the brain-gut interac on causing sx
D. using histamine2-blockers to help alleviate sx -correct answersC. teaching about the brain-gut
interac on causing sx
primary care pediatric NP tell this parent?
A. Probio c medica ons have demonstrated efficacy in trea ng colic.
B. Probio cs are not safe to use to treat infants who have colic.
C. There are no studies showing usefulness of probio c to manage colic.
D. There is no conclusive evidence about using probio cs to treat colic. -correct answersD.
There is no conclusive evidence about using probio cs to treat colic.
A toddler who was born prematurely refuses most solid foods and has poor weight gain. A
barium swallow study reveals a normal esophagus. What will the primary care pediatric NP
consider the next to manage this child's nutri onal needs?
A. consulta on with die cian
B. Fiberop c endoscopy evalua on.
C. MRI
D. Videofluroscopy swallowing study (VOSS) -correct answersD. Videofluroscopy swallowing
study (VOSS)
A toddler is seen in clinic a er a 2-day hx of intermi ent V/D. An assessment reveals an irritable
child with dry mucous membranes, 3-second cap refill. 2-second recoil of skin, mild tachycardia
and tachypnea, and cool hands and feet. The child has had 2 wet diapers in the past 24 hours.
What will the primary care pediatric NP recommend?
,A. an -diarrheal medica on & clear fluids for 24H
B. Bolus of IV NS in the clinic un l improvement
C. Hospital admission for IV rehydra on & oral fluids
D. Oral rehydra on solu on with f/u in 24H -correct answersD. Oral rehydra on solu on with
f/u in 24H
A 9-year old girl has a hx of frequent vomi ng and her mother has frequent migraine ha. The
child has recently begun having more frequent and prolonged episodes accompanied by
headaches. An exam reveals abnormal eye movement and mild ataxia. What is the correct
ac on?
A. begin using an -migraine meds to prevent HA
B. Prescribe ondansetron and lorazepam to help manage sx
C. Reassure the parent that this is expected with cyclic vomi ng syndrome
D. Refer to a pediatric gastroenterologist for further workup. -correct answersD. Refer to a
pediatric gastroenterologist for further workup.
The parent of a 3-month-old reports that the infant reports that the infant arches and gags
while feeding and spits up undigested formula frequently. The infant's weight gain has dropped
to the 5th percen le from the 12th. What is the best course of tx for this infant?
A. Begin a trial of extensively hydrolyzed protein formula for 2-4 wks.
B. Ins tute an emperic trial of acid suppression with a PPI
C. Perform esophageal pH monitoring to determine the degree of reflux.
D. Reassure the parent that these sx will likely resolved by 12-24 mo. -correct answersA. Begin a
trial of extensively hydrolyzed protein formula for 2-4 wks.
A school-age child has a 3-month hx of dull, aching epigastric pain that worsens with ea ng and
awakens from sleep. A CBC shows a Hgb of 8mg/dL. What is the next step in management.
A. Administra on of H RA or PPI meds
B. Empiric therapy for H. pylori
,C. Ordering an upper GI series
D. Referral for EGD -correct answersD. Referral for EGD
A 2-mo old infant cries up to 4 hours each day and according to the parents, is inconsolable
during crying episodes with fits and legs notes to be tense and s ff. The infant is breas eeding
frequently but is o en fussy during feedings. The PE is normal and the infant is gaining weight
normally. What will the primary care pediatric NP recommend?
A. A complete work-up, including lab and radiologic tests.
B. Elimina ng certain foods from the mother's diet.
C. Empiric tx w/PPI
D. Stopping breas eeding & beginning a hydrolyzed formula -correct answersB. Elimina ng
certain foods from the mother's diet.
A child is in the clinic a er swallowing a metal bead. A radiograph of the GI tract shows a 6 mm
cylindrical object in the child's stomach. The child is able to swallow without difficulty and is not
experiencing pain. What is the correct course of treatment?
a. Administer ipecac to induce vomi ng.
b. Have the parents watch for the object in the child's stool.
c. Insert a nasogastric tube to flush out the object.
d. Refer the child for endoscopic removal of the object. -correct answersb. Have the parents
watch for the object in the child's stool.
A 10-year-old child has had abdominal pain for 2 days, which began in the periumbilical area
and then localized to the RLQ. The child vomited once today and then experienced relief from
pain followed by an increased fever. What is the likely diagnosis?
A. Appendici s w/perf
B. Gastroenteri s
C. Pelvic inflammatory disease (PID)
D. UTI -correct answersA. Appendici s w/perf
, An 18-month-old child has a 1-day hx of intermi ent, cramping abd pain w/non-bilious
vomi ng. The child observed to scream and draw up his legs during pain episodes and becomes
lethargic in between. The primary care pediatric NP notes ta small amount of bloody, mucous
stool in the diaper. What is the most likely diagnosis?
A. Appendici s
B. Gastroenteri s
C. Intussuscep on
D. Tes cular torsion -correct answersC. Intussuscep on
A school-age child has had abd pain for 3 mo htat occurs once to twice weekly and is associated
with a h/a and occ diff sleeping, o en causing the child to stay home from school. The child
does not have V/D & is gaining weight normally. The PE is normal. According to Bishop, what is
included in the ini al diagnos c work-up for this child?
A. CBC, ESR, amylase, lipase, UA, & abd US
B. CBC, ESR, CRP, and fecal calprotec n
C. CBC, ESR, CRP, UA, stool for ova, parasites, and culture
D. Stool for H.pylori an gen and serum IgA, IgG, tTg -correct answersA. CBC, ESR, amylase,
lipase, UA, & abd US
An adolescent is dx with func onal abdominal pain (FAP). The child's sx worsen during stressful
events, esp w/school anxiety. What will be an important part of tx for this child?
A. informing the parents that the pain is most likely not real
B. ins tu ng a lactose-free diet along w/lactobacillus supplements
C. teaching about the brain-gut interac on causing sx
D. using histamine2-blockers to help alleviate sx -correct answersC. teaching about the brain-gut
interac on causing sx
