GNRS 590 A PREP -PRIMARY CARE OF THE FAMILY
|ACTUAL QUESTIONS AND VERIFIED
ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
Question 1
Caregiver education for an infant with croup includes that urgent medical re-evaluation is
needed if the infant has:
A. audible stridor when calm
B. barky cough in the morning
C. fever of 102˚F (38.9˚C) or higher
D. retractions between ribs with crying
CORRECT ANSWER
A. audible stridor when calm
Question 2
A preschooler is evaluated for a history of fever and intermittent bone pain and is noted to
have an abdominal mass. Which is the MOST likely diagnosis?
A. neuroblastoma
B. non-Hodgkin's lymphoma
C. osteogenic sarcoma
D. Wilms tumor
CORRECT ANSWER
A. neuroblastoma
The median age at diagnosis is 22 months, and approximately 90% of cases have been
diagnosed by 5 years of age.
1
, Signs and symptoms reflect the tumor site and extent of disease, but may include fever,
failure to thrive, bone pain, cytopenia, orbital proptosis, masses, bowel obstruction, or
spinal cord compression.
Wilms tumor is an embryonal malignancy of the kidney that can also present with an
abdominal mass. Sarcomas of the extremities are more likely to occur in older children.
Question 3
An adolescent presenting for a pre-college physical describes herself as a sexually active
lesbian. Which is the MOST immediate action?
A. assess for potential psychosocial difficulties
B. ensure human papilloma virus vaccination is up-to-date
C. provide confidential and nonjudgmental care
D. counsel about sexually transmitted infections and contraception
CORRECT ANSWER
D. counsel about sexually transmitted infections and contraception
Adolescent lesbian and bisexual females are more likely to have been pregnant when
compared to their heterosexual peers
LGB adolescents and young adults are at greater risk for unplanned pregnancy and, it is
important to counsel about accidental pregnancy even with females who have sex with
females. Providing sexual and reproductive health education that includes information
about abstinence, contraception, and sexually transmitted infections (STIs) is necessary
for all adolescents and young adults. Additionally, information about contraception
should be offered to all females regardless of their sexual orientation.
Pre-college visits present an excellent opportunity to ensure that all immunizations are
current, not just the human papilloma virus vaccine. Adolescents and young adults,
including those who know or are unsure about their sexuality, may have psychosocial
concerns. Providing care that is confidential, current, factual, and nonjudgmental is
required with all patients, regardless of their sexual orientation.
2
,Question 4
While some characteristics of an Individualized Education Plan (IEP) and 504 Plan are
similar, the IEP differs in that it uniquely requires
A. a specific medical diagnosis for eligibility.
B. a modification in curriculum to meet the student's needs.
C. an evaluation typically completed through school system resources.
D. a written plan be developed that specifies individualized accommodations.
CORRECT ANSWER
B. a modification in curriculum to meet the student's needs.
Eligibility for both plans requires a medical diagnosis. For a 504 Plan, this can be any
psychologic or physical disorder which "substantially limits" the individual's learning.
These children can follow the curriculum without modification but may require
assistance in the school setting. This may include conditions such as ADHD, diabetes, or
migraines.
In order to be eligible for an IEP, a child has to also have a medical diagnosis, but that
diagnosis must specifically meet criteria as a qualifying disability that seriously affects
learning or behavior and, therefore, requires modification of the school curriculum.
Both a 504 and an IEP require evaluation, although the evaluation for an IEP is more
formalized and is typically completed by a team of professionals. Both an IEP and a 504
plan will include a written plan. There are no legal requirements for what is included in a
504 plan and there is no mandated re-evaluation. An IEP has very specific criteria and
must describe the specific learning problems, detail what services will be provided, set
annual goals and define how progress will be measured. Re-evaluation is mandated
every 3 years.
Question 5
When used in treatment of acne vulgaris, topical retinoids act to
A. normalize desquamation of the follicular epithelium.
B. minimize development of antibiotic-resistant Cutibacterium acnes (formerly
Propionibacterium acnes).
3
, C. generate free radicals to oxidize proteins in the cell wall of Cutibacterium acnes.
D. work within the cell ribosomes to alter upstream signals affecting inflammatory pathways.
CORRECT ANSWER
A. normalize desquamation of the follicular epithelium.
The therapeutic objectives in the management of acne vulgaris are to reduce sebum
production, prevent formation of microcomedones, suppress Cutibacterium acnes
(formerly Propionibacterium acnes), and reduce inflammation to prevent scarring.
Topical retinoids, vitamin A derivatives that bind to retinoid receptors in the skin, are a
key component of primary acne management. Topical retinoids normalize desquamation
of the follicular epithelium to prevent new formation of microcomedones, the precursors
of both comedonal and inflammatory lesions. Additionally, retinoids promote clearing of
existing microcomedones and work within the nucleus to alter downstream signals that
affect inflammatory pathways.
Question 6
A caregiver expresses concern for her 12 month old's lack of interest in playing with other
children, especially due to a family history of autism spectrum disorder. Which of the
following is the MOST appropriate next step?
A. suggest the caregiver attempt to engage the child in imitating behaviors
B. screen for social interactions such as peek-a-boo and pat-a-cake
C. offer reassurance that interactive play begins at age 3
D. refer for a developmental evaluation
CORRECT ANSWER
C. offer reassurance that interactive play begins at age 3
Question 7
A caregiver who is primarily Spanish-speaking reports during a visit that her 24 month old
is bilingual and speaks four words. Which of the following is the BEST initial management?
4
|ACTUAL QUESTIONS AND VERIFIED
ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
Question 1
Caregiver education for an infant with croup includes that urgent medical re-evaluation is
needed if the infant has:
A. audible stridor when calm
B. barky cough in the morning
C. fever of 102˚F (38.9˚C) or higher
D. retractions between ribs with crying
CORRECT ANSWER
A. audible stridor when calm
Question 2
A preschooler is evaluated for a history of fever and intermittent bone pain and is noted to
have an abdominal mass. Which is the MOST likely diagnosis?
A. neuroblastoma
B. non-Hodgkin's lymphoma
C. osteogenic sarcoma
D. Wilms tumor
CORRECT ANSWER
A. neuroblastoma
The median age at diagnosis is 22 months, and approximately 90% of cases have been
diagnosed by 5 years of age.
1
, Signs and symptoms reflect the tumor site and extent of disease, but may include fever,
failure to thrive, bone pain, cytopenia, orbital proptosis, masses, bowel obstruction, or
spinal cord compression.
Wilms tumor is an embryonal malignancy of the kidney that can also present with an
abdominal mass. Sarcomas of the extremities are more likely to occur in older children.
Question 3
An adolescent presenting for a pre-college physical describes herself as a sexually active
lesbian. Which is the MOST immediate action?
A. assess for potential psychosocial difficulties
B. ensure human papilloma virus vaccination is up-to-date
C. provide confidential and nonjudgmental care
D. counsel about sexually transmitted infections and contraception
CORRECT ANSWER
D. counsel about sexually transmitted infections and contraception
Adolescent lesbian and bisexual females are more likely to have been pregnant when
compared to their heterosexual peers
LGB adolescents and young adults are at greater risk for unplanned pregnancy and, it is
important to counsel about accidental pregnancy even with females who have sex with
females. Providing sexual and reproductive health education that includes information
about abstinence, contraception, and sexually transmitted infections (STIs) is necessary
for all adolescents and young adults. Additionally, information about contraception
should be offered to all females regardless of their sexual orientation.
Pre-college visits present an excellent opportunity to ensure that all immunizations are
current, not just the human papilloma virus vaccine. Adolescents and young adults,
including those who know or are unsure about their sexuality, may have psychosocial
concerns. Providing care that is confidential, current, factual, and nonjudgmental is
required with all patients, regardless of their sexual orientation.
2
,Question 4
While some characteristics of an Individualized Education Plan (IEP) and 504 Plan are
similar, the IEP differs in that it uniquely requires
A. a specific medical diagnosis for eligibility.
B. a modification in curriculum to meet the student's needs.
C. an evaluation typically completed through school system resources.
D. a written plan be developed that specifies individualized accommodations.
CORRECT ANSWER
B. a modification in curriculum to meet the student's needs.
Eligibility for both plans requires a medical diagnosis. For a 504 Plan, this can be any
psychologic or physical disorder which "substantially limits" the individual's learning.
These children can follow the curriculum without modification but may require
assistance in the school setting. This may include conditions such as ADHD, diabetes, or
migraines.
In order to be eligible for an IEP, a child has to also have a medical diagnosis, but that
diagnosis must specifically meet criteria as a qualifying disability that seriously affects
learning or behavior and, therefore, requires modification of the school curriculum.
Both a 504 and an IEP require evaluation, although the evaluation for an IEP is more
formalized and is typically completed by a team of professionals. Both an IEP and a 504
plan will include a written plan. There are no legal requirements for what is included in a
504 plan and there is no mandated re-evaluation. An IEP has very specific criteria and
must describe the specific learning problems, detail what services will be provided, set
annual goals and define how progress will be measured. Re-evaluation is mandated
every 3 years.
Question 5
When used in treatment of acne vulgaris, topical retinoids act to
A. normalize desquamation of the follicular epithelium.
B. minimize development of antibiotic-resistant Cutibacterium acnes (formerly
Propionibacterium acnes).
3
, C. generate free radicals to oxidize proteins in the cell wall of Cutibacterium acnes.
D. work within the cell ribosomes to alter upstream signals affecting inflammatory pathways.
CORRECT ANSWER
A. normalize desquamation of the follicular epithelium.
The therapeutic objectives in the management of acne vulgaris are to reduce sebum
production, prevent formation of microcomedones, suppress Cutibacterium acnes
(formerly Propionibacterium acnes), and reduce inflammation to prevent scarring.
Topical retinoids, vitamin A derivatives that bind to retinoid receptors in the skin, are a
key component of primary acne management. Topical retinoids normalize desquamation
of the follicular epithelium to prevent new formation of microcomedones, the precursors
of both comedonal and inflammatory lesions. Additionally, retinoids promote clearing of
existing microcomedones and work within the nucleus to alter downstream signals that
affect inflammatory pathways.
Question 6
A caregiver expresses concern for her 12 month old's lack of interest in playing with other
children, especially due to a family history of autism spectrum disorder. Which of the
following is the MOST appropriate next step?
A. suggest the caregiver attempt to engage the child in imitating behaviors
B. screen for social interactions such as peek-a-boo and pat-a-cake
C. offer reassurance that interactive play begins at age 3
D. refer for a developmental evaluation
CORRECT ANSWER
C. offer reassurance that interactive play begins at age 3
Question 7
A caregiver who is primarily Spanish-speaking reports during a visit that her 24 month old
is bilingual and speaks four words. Which of the following is the BEST initial management?
4
