NR 602 Primary Care of the Childbearing
and Childrearing Family Practicum
Midterm Review
1. A 7-year-old African American female presents with several hyperkeratotic
raised, periungual lesions on the two middle fingers of her left hand. She has a
history of nail biting. The most likely diagnosis is:
A) Herpetic whitlow
B) Paronychia
C) Verruca vulgaris (warts)
D) Molluscum contagiosum
Correct Answer: C) Verruca vulgaris (warts)
Rationale: Periungual warts are caused by HPV and commonly occur in children
who bite their nails. They appear as hyperkeratotic, raised lesions around the
nails. Molluscum contagiosum presents as dome-shaped papules with central
umbilication. Herpetic whitlow causes painful vesicles. Paronychia presents with
erythema and swelling of the nail fold .
2. Sandra, age 12 years, has several vesicles and honey-colored crusted lesions
on her face above the right nares. She has a history of having a bad scratch in
the same area several days ago. What condition do you suspect?
A) Herpes simplex
B) Impetigo
C) Contact dermatitis
D) Folliculitis
Correct Answer: B) Impetigo
,Rationale: Impetigo is a superficial bacterial skin infection commonly caused by
Staphylococcus aureus or Streptococcus pyogenes. It presents with vesicles that
rupture and form characteristic honey-colored crusted lesions. It often occurs at
sites of minor trauma such as scratches. Herpes simplex presents with grouped
vesicles on an erythematous base .
3. What is the first-line treatment for scarlet fever?
A) Amoxicillin
B) Penicillin
C) Azithromycin
D) Cephalexin
Correct Answer: B) Penicillin
Rationale: Scarlet fever is caused by erythrogenic exotoxin released by
Streptococcus pyogenes (Group A Strep). Penicillin is the treatment of choice. The
rash feels rough during palpation and typically appears a few days after the onset
of illness .
4. What is a key finding for diagnosis of scabies?
A) Erythematous papules on the trunk
B) Itching that is worse at night
C) Honey-colored crusted lesions
D) Fever and lymphadenopathy
Correct Answer: B) Itching that is worse at night
Rationale: Scabies is caused by the mite Sarcoptes scabiei. The hallmark symptom
is intense pruritus that worsens at night due to the mite's nocturnal activity.
Complaints are often more significant than physical findings. Treatment includes
permethrin 5% cream .
,5. A 5-year-old presents with eye redness, itching, and clear watery discharge.
Both eyes are involved. The child has a history of seasonal allergies. What is the
most likely diagnosis?
A) Bacterial conjunctivitis
B) Viral conjunctivitis
C) Allergic conjunctivitis
D) Blepharitis
Correct Answer: C) Allergic conjunctivitis
Rationale: Allergic conjunctivitis presents with bilateral eye involvement, intense
itching, and clear watery discharge. A history of seasonal allergies supports this
diagnosis. Bacterial conjunctivitis typically presents with purulent discharge; viral
conjunctivitis usually starts unilaterally with watery discharge .
6. What is the most common cause of viral conjunctivitis?
A) Herpes simplex virus
B) Adenovirus
C) Enterovirus
D) Rhinovirus
Correct Answer: B) Adenovirus
Rationale: Adenovirus is the most common cause of viral conjunctivitis. It typically
presents with unilateral eye involvement initially, watery discharge, and itching.
Bacterial conjunctivitis is commonly caused by Staphylococcus aureus,
Streptococcus pneumoniae, and Haemophilus influenzae .
7. A school-age child presents with a painless, non-tender bump on the upper
eyelid that has been present for several weeks. There is no redness or discharge.
What is the diagnosis?
, A) Hordeolum (stye)
B) Chalazion
C) Blepharitis
D) Periorbital cellulitis
Correct Answer: B) Chalazion
Rationale: A chalazion is a painless, non-tender bump on the eyelid caused by a
blocked meibomian gland. Unlike a hordeolum (stye), which is acute, tender, and
erythematous, a chalazion is chronic and painless. Warm compresses are first-line
treatment; surgical referral may be needed for persistent cases .
8. What is the treatment for pediculosis (lice infestation) in a child >1 month
old?
A) Lindane
B) Permethrin 1%
C) Oral ivermectin
D) Malathion
Correct Answer: B) Permethrin 1%
Rationale: Permethrin 1% is the first-line treatment for pediculosis in children 1
month and older. It is a pediculicide that effectively kills lice and nits. Lindane is no
longer recommended due to neurotoxicity concerns. Oral ivermectin is a second-
line option .
9. Concurrent otitis media and conjunctivitis in a child is most likely caused by
which organism?
A) Streptococcus pneumoniae
B) Haemophilus influenzae
C) Moraxella catarrhalis
D) Staphylococcus aureus
and Childrearing Family Practicum
Midterm Review
1. A 7-year-old African American female presents with several hyperkeratotic
raised, periungual lesions on the two middle fingers of her left hand. She has a
history of nail biting. The most likely diagnosis is:
A) Herpetic whitlow
B) Paronychia
C) Verruca vulgaris (warts)
D) Molluscum contagiosum
Correct Answer: C) Verruca vulgaris (warts)
Rationale: Periungual warts are caused by HPV and commonly occur in children
who bite their nails. They appear as hyperkeratotic, raised lesions around the
nails. Molluscum contagiosum presents as dome-shaped papules with central
umbilication. Herpetic whitlow causes painful vesicles. Paronychia presents with
erythema and swelling of the nail fold .
2. Sandra, age 12 years, has several vesicles and honey-colored crusted lesions
on her face above the right nares. She has a history of having a bad scratch in
the same area several days ago. What condition do you suspect?
A) Herpes simplex
B) Impetigo
C) Contact dermatitis
D) Folliculitis
Correct Answer: B) Impetigo
,Rationale: Impetigo is a superficial bacterial skin infection commonly caused by
Staphylococcus aureus or Streptococcus pyogenes. It presents with vesicles that
rupture and form characteristic honey-colored crusted lesions. It often occurs at
sites of minor trauma such as scratches. Herpes simplex presents with grouped
vesicles on an erythematous base .
3. What is the first-line treatment for scarlet fever?
A) Amoxicillin
B) Penicillin
C) Azithromycin
D) Cephalexin
Correct Answer: B) Penicillin
Rationale: Scarlet fever is caused by erythrogenic exotoxin released by
Streptococcus pyogenes (Group A Strep). Penicillin is the treatment of choice. The
rash feels rough during palpation and typically appears a few days after the onset
of illness .
4. What is a key finding for diagnosis of scabies?
A) Erythematous papules on the trunk
B) Itching that is worse at night
C) Honey-colored crusted lesions
D) Fever and lymphadenopathy
Correct Answer: B) Itching that is worse at night
Rationale: Scabies is caused by the mite Sarcoptes scabiei. The hallmark symptom
is intense pruritus that worsens at night due to the mite's nocturnal activity.
Complaints are often more significant than physical findings. Treatment includes
permethrin 5% cream .
,5. A 5-year-old presents with eye redness, itching, and clear watery discharge.
Both eyes are involved. The child has a history of seasonal allergies. What is the
most likely diagnosis?
A) Bacterial conjunctivitis
B) Viral conjunctivitis
C) Allergic conjunctivitis
D) Blepharitis
Correct Answer: C) Allergic conjunctivitis
Rationale: Allergic conjunctivitis presents with bilateral eye involvement, intense
itching, and clear watery discharge. A history of seasonal allergies supports this
diagnosis. Bacterial conjunctivitis typically presents with purulent discharge; viral
conjunctivitis usually starts unilaterally with watery discharge .
6. What is the most common cause of viral conjunctivitis?
A) Herpes simplex virus
B) Adenovirus
C) Enterovirus
D) Rhinovirus
Correct Answer: B) Adenovirus
Rationale: Adenovirus is the most common cause of viral conjunctivitis. It typically
presents with unilateral eye involvement initially, watery discharge, and itching.
Bacterial conjunctivitis is commonly caused by Staphylococcus aureus,
Streptococcus pneumoniae, and Haemophilus influenzae .
7. A school-age child presents with a painless, non-tender bump on the upper
eyelid that has been present for several weeks. There is no redness or discharge.
What is the diagnosis?
, A) Hordeolum (stye)
B) Chalazion
C) Blepharitis
D) Periorbital cellulitis
Correct Answer: B) Chalazion
Rationale: A chalazion is a painless, non-tender bump on the eyelid caused by a
blocked meibomian gland. Unlike a hordeolum (stye), which is acute, tender, and
erythematous, a chalazion is chronic and painless. Warm compresses are first-line
treatment; surgical referral may be needed for persistent cases .
8. What is the treatment for pediculosis (lice infestation) in a child >1 month
old?
A) Lindane
B) Permethrin 1%
C) Oral ivermectin
D) Malathion
Correct Answer: B) Permethrin 1%
Rationale: Permethrin 1% is the first-line treatment for pediculosis in children 1
month and older. It is a pediculicide that effectively kills lice and nits. Lindane is no
longer recommended due to neurotoxicity concerns. Oral ivermectin is a second-
line option .
9. Concurrent otitis media and conjunctivitis in a child is most likely caused by
which organism?
A) Streptococcus pneumoniae
B) Haemophilus influenzae
C) Moraxella catarrhalis
D) Staphylococcus aureus
