PNCB PRIMARY CARE QUESTIONS AND
ANSWERS 2026 WITH COMPLETE SOLUTION.
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 - ANSWERS-A. audible stridor when
calm
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 - ANSWERS-A. neuroblastoma
The median age at diagnosis is 22 months, and approximately 90% of cases
have been diagnosed by 5 years of age.
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.
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 -
ANSWERS-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.
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.
- ANSWERS-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.
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).
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. - ANSWERS-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.
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 - ANSWERS-C. offer reassurance that
interactive play begins at age 3
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?
A. refer to a pediatric speech pathologist with access to translators
B. encourage caregiver to choose one language for communication
C. advise the caregiver to read to the child daily
D. refer to audiology for a hearing evaluation - ANSWERS-A. refer to a
pediatric speech pathologist with access to translators
At two years of age a child should be speaking short phrases of two to three
words with a vocabulary of about 50 words, of which 25% are intelligible to
strangers. Children from bilingual homes or who are bilingual tend to develop
language more slowly, mixing words and phrases from the two languages;
however, milestones should continue to fall within expected ranges. Bilingual
children with significant delays in vocabulary require the same evaluation as
monolingual children with language delays.
ANSWERS 2026 WITH COMPLETE SOLUTION.
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 - ANSWERS-A. audible stridor when
calm
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 - ANSWERS-A. neuroblastoma
The median age at diagnosis is 22 months, and approximately 90% of cases
have been diagnosed by 5 years of age.
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.
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 -
ANSWERS-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.
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.
- ANSWERS-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.
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).
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. - ANSWERS-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.
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 - ANSWERS-C. offer reassurance that
interactive play begins at age 3
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?
A. refer to a pediatric speech pathologist with access to translators
B. encourage caregiver to choose one language for communication
C. advise the caregiver to read to the child daily
D. refer to audiology for a hearing evaluation - ANSWERS-A. refer to a
pediatric speech pathologist with access to translators
At two years of age a child should be speaking short phrases of two to three
words with a vocabulary of about 50 words, of which 25% are intelligible to
strangers. Children from bilingual homes or who are bilingual tend to develop
language more slowly, mixing words and phrases from the two languages;
however, milestones should continue to fall within expected ranges. Bilingual
children with significant delays in vocabulary require the same evaluation as
monolingual children with language delays.
