NR-509-APEA-3P-Exam Week-8 Advanced Physical
Assessment | Questions and Verified/Explained
Answers 2025/2026 QUESTIONS WITH COMPLETE
SOLUTIONS | GRADED A+
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Question 1
What is the most common age group for Group A Streptococcus (GAS)
pharyngitis?
A) Children 1-4 years old
B) Children 5-15 years old
C) Adolescents 16-18 years old
D) Adults 19-40 years old
E) Children under 1 year old
ANSWER>>>B
RATIONALE: GAS pharyngitis is most common in children aged 5-15 years.
This age group has the highest incidence due to increased exposure in school
settings. Infants and toddlers rarely get GAS pharyngitis. Adults can get GAS but
at lower rates. The peak incidence is in winter and early spring.
Question 2
Which clinical finding best differentiates strep throat from viral sore throat?
A) Fever and cough
B) Absence of cough with presence of tonsillar exudate, anterior cervical
lymphadenopathy, and fever
C) Conjunctivitis
D) Diarrhea
E) Nasal congestion
ANSWER>>>B
,RATIONALE: The absence of cough with the presence of tonsillar exudate,
anterior cervical lymphadenopathy, and fever is the classic presentation of GAS
pharyngitis. Viral pharyngitis typically presents with cough, rhinorrhea, and
conjunctivitis. The Centor criteria (fever, tonsillar exudate, tender anterior cervical
lymphadenopathy, absence of cough) help differentiate bacterial from viral
pharyngitis.
Question 3
What diagnostic test is recommended to confirm strep pharyngitis?
A) Rapid antigen detection test (RADT) and/or throat culture
B) Complete blood count
C) Chest X-ray
D) Monospot test
E) Erythrocyte sedimentation rate
ANSWER>>>A
RATIONALE: The rapid antigen detection test (RADT) is recommended as the
primary diagnostic test for GAS pharyngitis. Throat culture is the gold standard
and is recommended if RADT is negative in children and adolescents. Antibiotics
should not be prescribed without diagnostic confirmation.
Question 4
A 7-year-old male presents with fever, sore throat, and absence of cough. On
examination, he has tonsillar exudate and tender anterior cervical
lymphadenopathy. What is the most appropriate management?
A) Rapid strep test and antibiotics if positive
B) Antibiotics without testing
C) Supportive care and observation
D) Viral culture
E) Chest X-ray
ANSWER>>>A
,RATIONALE: This patient has features suggestive of GAS pharyngitis. A rapid
strep test should be performed. If positive, antibiotics (penicillin or amoxicillin)
should be prescribed to prevent rheumatic fever. Antibiotics should not be given
without confirmation. Supportive care alone is insufficient if strep is confirmed.
Question 5
A 4-year-old female presents with fever, sore throat, and strawberry tongue. What
is the most likely diagnosis?
A) GAS pharyngitis
B) Scarlet fever
C) Viral pharyngitis
D) Kawasaki disease
E) Infectious mononucleosis
ANSWER>>>B
RATIONALE: Scarlet fever is caused by GAS that produces erythrogenic toxin.
It presents with fever, sore throat, strawberry tongue, and a characteristic
sandpaper-like rash. Kawasaki disease also presents with strawberry tongue but
without pharyngitis. Viral pharyngitis does not cause strawberry tongue.
Question 6
A 6-year-old male with GAS pharyngitis is started on amoxicillin. What is the
most important counseling point?
A) Complete the full 10-day course
B) Stop antibiotics after 3 days
C) Antibiotics are optional
D) No follow-up needed
E) Take with grapefruit juice
ANSWER>>>A
RATIONALE: The full 10-day course of penicillin or amoxicillin is essential to
eradicate GAS and prevent rheumatic fever. Incomplete treatment increases the
, risk of complications. Penicillin is the drug of choice; amoxicillin is preferred for
children due to better taste and compliance.
Question 7
A 9-year-old female with strep pharyngitis develops red, swollen, painful joints 2
weeks later. What is the most likely complication?
A) Acute rheumatic fever
B) Post-streptococcal glomerulonephritis
C) Scarlet fever
D) Otitis media
E) Sinusitis
ANSWER>>>A
RATIONALE: Acute rheumatic fever can occur 1-5 weeks after untreated or
inadequately treated GAS pharyngitis. It presents with migratory polyarthritis,
carditis, chorea, erythema marginatum, and subcutaneous nodules. Post-
streptococcal glomerulonephritis typically presents with hematuria and edema 1-2
weeks after infection.
Question 8
A 10-year-old male with strep pharyngitis develops tea-colored urine and
periorbital edema 2 weeks later. What is the most likely complication?
A) Acute rheumatic fever
B) Post-streptococcal glomerulonephritis
C) Scarlet fever
D) Acute kidney injury
E) Urinary tract infection
ANSWER>>>B
RATIONALE: Post-streptococcal glomerulonephritis typically presents 1-2
weeks after GAS pharyngitis (or 2-6 weeks after skin infection) with hematuria
(tea-colored urine), edema, and hypertension. It is more common after skin
infections in children. Treatment is supportive; most children recover fully.
Assessment | Questions and Verified/Explained
Answers 2025/2026 QUESTIONS WITH COMPLETE
SOLUTIONS | GRADED A+
Leave your honest rating⭐⭐⭐⭐⭐
Question 1
What is the most common age group for Group A Streptococcus (GAS)
pharyngitis?
A) Children 1-4 years old
B) Children 5-15 years old
C) Adolescents 16-18 years old
D) Adults 19-40 years old
E) Children under 1 year old
ANSWER>>>B
RATIONALE: GAS pharyngitis is most common in children aged 5-15 years.
This age group has the highest incidence due to increased exposure in school
settings. Infants and toddlers rarely get GAS pharyngitis. Adults can get GAS but
at lower rates. The peak incidence is in winter and early spring.
Question 2
Which clinical finding best differentiates strep throat from viral sore throat?
A) Fever and cough
B) Absence of cough with presence of tonsillar exudate, anterior cervical
lymphadenopathy, and fever
C) Conjunctivitis
D) Diarrhea
E) Nasal congestion
ANSWER>>>B
,RATIONALE: The absence of cough with the presence of tonsillar exudate,
anterior cervical lymphadenopathy, and fever is the classic presentation of GAS
pharyngitis. Viral pharyngitis typically presents with cough, rhinorrhea, and
conjunctivitis. The Centor criteria (fever, tonsillar exudate, tender anterior cervical
lymphadenopathy, absence of cough) help differentiate bacterial from viral
pharyngitis.
Question 3
What diagnostic test is recommended to confirm strep pharyngitis?
A) Rapid antigen detection test (RADT) and/or throat culture
B) Complete blood count
C) Chest X-ray
D) Monospot test
E) Erythrocyte sedimentation rate
ANSWER>>>A
RATIONALE: The rapid antigen detection test (RADT) is recommended as the
primary diagnostic test for GAS pharyngitis. Throat culture is the gold standard
and is recommended if RADT is negative in children and adolescents. Antibiotics
should not be prescribed without diagnostic confirmation.
Question 4
A 7-year-old male presents with fever, sore throat, and absence of cough. On
examination, he has tonsillar exudate and tender anterior cervical
lymphadenopathy. What is the most appropriate management?
A) Rapid strep test and antibiotics if positive
B) Antibiotics without testing
C) Supportive care and observation
D) Viral culture
E) Chest X-ray
ANSWER>>>A
,RATIONALE: This patient has features suggestive of GAS pharyngitis. A rapid
strep test should be performed. If positive, antibiotics (penicillin or amoxicillin)
should be prescribed to prevent rheumatic fever. Antibiotics should not be given
without confirmation. Supportive care alone is insufficient if strep is confirmed.
Question 5
A 4-year-old female presents with fever, sore throat, and strawberry tongue. What
is the most likely diagnosis?
A) GAS pharyngitis
B) Scarlet fever
C) Viral pharyngitis
D) Kawasaki disease
E) Infectious mononucleosis
ANSWER>>>B
RATIONALE: Scarlet fever is caused by GAS that produces erythrogenic toxin.
It presents with fever, sore throat, strawberry tongue, and a characteristic
sandpaper-like rash. Kawasaki disease also presents with strawberry tongue but
without pharyngitis. Viral pharyngitis does not cause strawberry tongue.
Question 6
A 6-year-old male with GAS pharyngitis is started on amoxicillin. What is the
most important counseling point?
A) Complete the full 10-day course
B) Stop antibiotics after 3 days
C) Antibiotics are optional
D) No follow-up needed
E) Take with grapefruit juice
ANSWER>>>A
RATIONALE: The full 10-day course of penicillin or amoxicillin is essential to
eradicate GAS and prevent rheumatic fever. Incomplete treatment increases the
, risk of complications. Penicillin is the drug of choice; amoxicillin is preferred for
children due to better taste and compliance.
Question 7
A 9-year-old female with strep pharyngitis develops red, swollen, painful joints 2
weeks later. What is the most likely complication?
A) Acute rheumatic fever
B) Post-streptococcal glomerulonephritis
C) Scarlet fever
D) Otitis media
E) Sinusitis
ANSWER>>>A
RATIONALE: Acute rheumatic fever can occur 1-5 weeks after untreated or
inadequately treated GAS pharyngitis. It presents with migratory polyarthritis,
carditis, chorea, erythema marginatum, and subcutaneous nodules. Post-
streptococcal glomerulonephritis typically presents with hematuria and edema 1-2
weeks after infection.
Question 8
A 10-year-old male with strep pharyngitis develops tea-colored urine and
periorbital edema 2 weeks later. What is the most likely complication?
A) Acute rheumatic fever
B) Post-streptococcal glomerulonephritis
C) Scarlet fever
D) Acute kidney injury
E) Urinary tract infection
ANSWER>>>B
RATIONALE: Post-streptococcal glomerulonephritis typically presents 1-2
weeks after GAS pharyngitis (or 2-6 weeks after skin infection) with hematuria
(tea-colored urine), edema, and hypertension. It is more common after skin
infections in children. Treatment is supportive; most children recover fully.
