NRNP 6541 PEDIATRIC AND ADOLESCENT PRIMARY
CARE ACROSS THE LIFESPAN WALDEN UNIVERSITY –
NEWEST 2026 TEST BANK MIDTERM & FINAL EXAM –
300 ACTUAL QUESTIONS WITH CORRECT VERIFIED
ANSWERS (A+ GRADED)
1. What is the most common form of child abuse seen in pediatric primary care?
A) Physical neglect
B) Sexual abuse
C) Shaken baby syndrome
D) Emotional abuse
✅ Correct Answer: C. Shaken baby syndrome
Rationale: Shaken baby syndrome is the most common form of fatal child abuse
and is frequently seen in pediatric primary care settings, often presenting with
nonspecific symptoms such as irritability, vomiting, and seizures.
2. Which of the following conditions requires urgent inpatient admission?
A) Acute otitis media
B) Cervical adenitis
C) Viral upper respiratory infection
D) Mild dehydration
✅ Correct Answer: B. Cervical adenitis
Rationale: Cervical adenitis, especially when bilateral or associated with systemic
symptoms, can progress to airway compromise and requires urgent evaluation
and admission for intravenous antibiotics and monitoring.
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,3. An eye that deviates in when covered but returns to midline when uncovered is
an:
A) Exotropia
B) Esophoria
C) Hypertropia
D) Strabismus
✅ Correct Answer: B. Esophoria
Rationale: Esophoria is a latent inward deviation that appears when binocular
vision is disrupted (cover test) and corrects itself when both eyes are open.
4. All of the following are consistent with peritonsillar abscess EXCEPT:
A) Trismus
B) Hot potato voice
C) Unilateral swelling of the tonsil
D) Bilateral cervical lymphadenopathy
✅ Correct Answer: D. Bilateral cervical lymphadenopathy
Rationale: Peritonsillar abscess typically presents with unilateral tonsillar swelling,
trismus (difficulty opening the mouth), hot potato voice, and unilateral cervical
lymphadenopathy. Bilateral cervical lymphadenopathy is not characteristic and
suggests a different process such as infectious mononucleosis or viral pharyngitis.
5. Which adolescent would be at greatest risk for developing anorexia nervosa?
A) 12-year-old male swimmer
B) 14-year-old female gymnast
C) 16-year-old female basketball player
D) 15-year-old male wrestler
✅ Correct Answer: B. 14-year-old female gymnast
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,Rationale: Adolescent females involved in aesthetic or weight‑sensitive sports
(gymnastics, ballet, figure skating) have the highest risk of anorexia nervosa.
6. A mother states that her 4-year-old son constantly grinds his teeth at night. You
document this as:
A) Bruxism
B) Pica
C) Enuresis
D) Encopresis
✅ Correct Answer: A. Bruxism
Rationale: Bruxism is the involuntary grinding or clenching of teeth, most
commonly during sleep, and is common in preschool‑aged children.
7. First-line therapy for preschoolers (4–5 years of age) diagnosed with
attention‑deficit hyperactive disorder is:
A) Methylphenidate
B) Behavior therapy
C) Combined medication and therapy
D) Dietary modification
✅ Correct Answer: B. Behavior therapy
Rationale: According to AAP guidelines, behavior therapy (parent training,
classroom management) is the first‑line treatment for ADHD in children aged 4–5
years before initiating medication.
8. A 7-year-old has just been diagnosed with attention deficit hyperactivity
disorder (ADHD). Her parents report that she is doing poorly in school and is
disruptive in the classroom. They ask you what they can do. Your best response is:
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, A) “She should start medication immediately.”
B) “We will try a combination of parent training and classroom behavioral
interventions first.”
C) “ADHD usually resolves by adolescence without treatment.”
D) “Dietary changes are the most effective treatment.”
✅ Correct Answer: B. “We will try a combination of parent training and classroom
behavioral interventions first.”
Rationale: For children ≥6 years, a combination of medication and behavior
therapy is recommended, but initial response should include behavioral supports
and parent education.
9. A 14-year-old female presents with weight loss, amenorrhea, and a fear of
gaining weight. Her BMI is 16.5. Which laboratory finding is most consistent with
anorexia nervosa?
A) Elevated luteinizing hormone (LH)
B) Elevated follicle‑stimulating hormone (FSH)
C) Low triiodothyronine (T3)
D) Elevated erythrocyte sedimentation rate (ESR)
✅ Correct Answer: C. Low triiodothyronine (T3)
Rationale: In anorexia nervosa, the body adapts to starvation by lowering T3
levels (euthyroid sick syndrome). LH and FSH are low, not elevated.
10. A previously healthy 2-year-old presents with fever, irritability, and pulling at
his right ear. Otoscopy reveals a bulging, erythematous tympanic membrane with
decreased mobility. What is the most appropriate next step?
A) Observe for 48 hours without antibiotics
B) Prescribe amoxicillin 80‑90 mg/kg/day
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CARE ACROSS THE LIFESPAN WALDEN UNIVERSITY –
NEWEST 2026 TEST BANK MIDTERM & FINAL EXAM –
300 ACTUAL QUESTIONS WITH CORRECT VERIFIED
ANSWERS (A+ GRADED)
1. What is the most common form of child abuse seen in pediatric primary care?
A) Physical neglect
B) Sexual abuse
C) Shaken baby syndrome
D) Emotional abuse
✅ Correct Answer: C. Shaken baby syndrome
Rationale: Shaken baby syndrome is the most common form of fatal child abuse
and is frequently seen in pediatric primary care settings, often presenting with
nonspecific symptoms such as irritability, vomiting, and seizures.
2. Which of the following conditions requires urgent inpatient admission?
A) Acute otitis media
B) Cervical adenitis
C) Viral upper respiratory infection
D) Mild dehydration
✅ Correct Answer: B. Cervical adenitis
Rationale: Cervical adenitis, especially when bilateral or associated with systemic
symptoms, can progress to airway compromise and requires urgent evaluation
and admission for intravenous antibiotics and monitoring.
1|Page
,3. An eye that deviates in when covered but returns to midline when uncovered is
an:
A) Exotropia
B) Esophoria
C) Hypertropia
D) Strabismus
✅ Correct Answer: B. Esophoria
Rationale: Esophoria is a latent inward deviation that appears when binocular
vision is disrupted (cover test) and corrects itself when both eyes are open.
4. All of the following are consistent with peritonsillar abscess EXCEPT:
A) Trismus
B) Hot potato voice
C) Unilateral swelling of the tonsil
D) Bilateral cervical lymphadenopathy
✅ Correct Answer: D. Bilateral cervical lymphadenopathy
Rationale: Peritonsillar abscess typically presents with unilateral tonsillar swelling,
trismus (difficulty opening the mouth), hot potato voice, and unilateral cervical
lymphadenopathy. Bilateral cervical lymphadenopathy is not characteristic and
suggests a different process such as infectious mononucleosis or viral pharyngitis.
5. Which adolescent would be at greatest risk for developing anorexia nervosa?
A) 12-year-old male swimmer
B) 14-year-old female gymnast
C) 16-year-old female basketball player
D) 15-year-old male wrestler
✅ Correct Answer: B. 14-year-old female gymnast
2|Page
,Rationale: Adolescent females involved in aesthetic or weight‑sensitive sports
(gymnastics, ballet, figure skating) have the highest risk of anorexia nervosa.
6. A mother states that her 4-year-old son constantly grinds his teeth at night. You
document this as:
A) Bruxism
B) Pica
C) Enuresis
D) Encopresis
✅ Correct Answer: A. Bruxism
Rationale: Bruxism is the involuntary grinding or clenching of teeth, most
commonly during sleep, and is common in preschool‑aged children.
7. First-line therapy for preschoolers (4–5 years of age) diagnosed with
attention‑deficit hyperactive disorder is:
A) Methylphenidate
B) Behavior therapy
C) Combined medication and therapy
D) Dietary modification
✅ Correct Answer: B. Behavior therapy
Rationale: According to AAP guidelines, behavior therapy (parent training,
classroom management) is the first‑line treatment for ADHD in children aged 4–5
years before initiating medication.
8. A 7-year-old has just been diagnosed with attention deficit hyperactivity
disorder (ADHD). Her parents report that she is doing poorly in school and is
disruptive in the classroom. They ask you what they can do. Your best response is:
3|Page
, A) “She should start medication immediately.”
B) “We will try a combination of parent training and classroom behavioral
interventions first.”
C) “ADHD usually resolves by adolescence without treatment.”
D) “Dietary changes are the most effective treatment.”
✅ Correct Answer: B. “We will try a combination of parent training and classroom
behavioral interventions first.”
Rationale: For children ≥6 years, a combination of medication and behavior
therapy is recommended, but initial response should include behavioral supports
and parent education.
9. A 14-year-old female presents with weight loss, amenorrhea, and a fear of
gaining weight. Her BMI is 16.5. Which laboratory finding is most consistent with
anorexia nervosa?
A) Elevated luteinizing hormone (LH)
B) Elevated follicle‑stimulating hormone (FSH)
C) Low triiodothyronine (T3)
D) Elevated erythrocyte sedimentation rate (ESR)
✅ Correct Answer: C. Low triiodothyronine (T3)
Rationale: In anorexia nervosa, the body adapts to starvation by lowering T3
levels (euthyroid sick syndrome). LH and FSH are low, not elevated.
10. A previously healthy 2-year-old presents with fever, irritability, and pulling at
his right ear. Otoscopy reveals a bulging, erythematous tympanic membrane with
decreased mobility. What is the most appropriate next step?
A) Observe for 48 hours without antibiotics
B) Prescribe amoxicillin 80‑90 mg/kg/day
4|Page
