NURS6541 PEDIATRIC PRIMARY CARE
EXAM 1 ADVANCED PRACTICE
1. A 4-day-old newborn presents with a total serum bilirubin (TSB) of 15 mg/dL. The infant is
breastfed and has lost 9% of birth weight. What is the most appropriate initial management?
A. Assess breastfeeding adequacy and increase feeding frequency to 8-12 times per day
B. Discontinue breastfeeding and start soy-based formula
C. Immediate exchange transfusion
D. Administer phenobarbital to induce glucuronosyltransferase
Answer: A
Conceptual Explanation: Initial management for breastfeeding jaundice includes
improving breastfeeding technique and increasing frequency to facilitate bilirubin
excretion through stools. Weight loss of 9% indicates inadequate intake.
2. According to the AAP, at what age should universal screening for autism spectrum disorder
(ASD) using a tool like the M-CHAT occur?
A. 12 and 18 months
B. 18 and 24 months
,C. 9 and 15 months
D. 24 and 36 months
Answer: B
Conceptual Explanation: The AAP recommends universal ASD screening at the 18-month
and 24-month well-child visits to ensure early intervention.
3. A 6-month-old infant has not yet achieved which of the following developmental
milestones?
A. Pincer grasp
B. Transferring objects from hand to hand
C. Sitting with support
D. Babbling with consonant sounds
Answer: A
Conceptual Explanation: A pincer grasp is typically developed between 9 and 12 months.
Sitting with support, transferring objects, and babbling are 6-month milestones.
4. Which of the following is a contraindication to the administration of the Live Attenuated
Influenza Vaccine (LAIV)?
A. A 5-year-old receiving long-term aspirin therapy
B. A 10-year-old with well-controlled asthma
C. A child with a history of mild egg allergy (hives only)
, D. Household contact with a pregnant woman
Answer: A
Conceptual Explanation: Children on aspirin therapy should not receive LAIV due to the
risk of Reye syndrome. Asthma is a precaution/contraindication for LAIV in certain age
groups as well.
5. A 12-month-old presents for a well-check. The mother notes the child drinks 32 oz of cow’s
milk daily. The child is at highest risk for:
A. Hypercalcemia
B. Vitamin D toxicity
C. Iron-deficiency anemia
D. Type 1 Diabetes Mellitus
Answer: C
Conceptual Explanation: Excessive cow’s milk intake (more than 24 oz/day) replaces
iron-rich foods and can cause microscopic intestinal bleeding, leading to iron-deficiency
anemia.
6. In Tanner Staging for boys, which stage is characterized by enlargement of the penis
(length) and further growth of the testes and scrotum?
A. Stage 2
B. Stage 3
EXAM 1 ADVANCED PRACTICE
1. A 4-day-old newborn presents with a total serum bilirubin (TSB) of 15 mg/dL. The infant is
breastfed and has lost 9% of birth weight. What is the most appropriate initial management?
A. Assess breastfeeding adequacy and increase feeding frequency to 8-12 times per day
B. Discontinue breastfeeding and start soy-based formula
C. Immediate exchange transfusion
D. Administer phenobarbital to induce glucuronosyltransferase
Answer: A
Conceptual Explanation: Initial management for breastfeeding jaundice includes
improving breastfeeding technique and increasing frequency to facilitate bilirubin
excretion through stools. Weight loss of 9% indicates inadequate intake.
2. According to the AAP, at what age should universal screening for autism spectrum disorder
(ASD) using a tool like the M-CHAT occur?
A. 12 and 18 months
B. 18 and 24 months
,C. 9 and 15 months
D. 24 and 36 months
Answer: B
Conceptual Explanation: The AAP recommends universal ASD screening at the 18-month
and 24-month well-child visits to ensure early intervention.
3. A 6-month-old infant has not yet achieved which of the following developmental
milestones?
A. Pincer grasp
B. Transferring objects from hand to hand
C. Sitting with support
D. Babbling with consonant sounds
Answer: A
Conceptual Explanation: A pincer grasp is typically developed between 9 and 12 months.
Sitting with support, transferring objects, and babbling are 6-month milestones.
4. Which of the following is a contraindication to the administration of the Live Attenuated
Influenza Vaccine (LAIV)?
A. A 5-year-old receiving long-term aspirin therapy
B. A 10-year-old with well-controlled asthma
C. A child with a history of mild egg allergy (hives only)
, D. Household contact with a pregnant woman
Answer: A
Conceptual Explanation: Children on aspirin therapy should not receive LAIV due to the
risk of Reye syndrome. Asthma is a precaution/contraindication for LAIV in certain age
groups as well.
5. A 12-month-old presents for a well-check. The mother notes the child drinks 32 oz of cow’s
milk daily. The child is at highest risk for:
A. Hypercalcemia
B. Vitamin D toxicity
C. Iron-deficiency anemia
D. Type 1 Diabetes Mellitus
Answer: C
Conceptual Explanation: Excessive cow’s milk intake (more than 24 oz/day) replaces
iron-rich foods and can cause microscopic intestinal bleeding, leading to iron-deficiency
anemia.
6. In Tanner Staging for boys, which stage is characterized by enlargement of the penis
(length) and further growth of the testes and scrotum?
A. Stage 2
B. Stage 3
