NURS6541 PEDIATRIC PRIMARY CARE
EXAM 2 PRACTICE QUESTIONS AND
ANSWERS
1. A 4-year-old presents with a ‘barking’ cough and inspiratory stridor that worsens at night.
Which of the following is the most appropriate initial treatment for moderate croup?
A. Albuterol nebulizer treatment
B. Chest X-ray to rule out pneumonia
C. Amoxicillin for 10 days
D. Oral dexamethasone
Answer: D
Conceptual Explanation: Dexamethasone is the mainstay of treatment for croup
(laryngotracheobronchitis) as it reduces airway inflammation. Albuterol is not effective for
upper airway swelling.
2. Which of the following physical exam findings is most suggestive of coarctation of the aorta
in a child?
A. Holosystolic murmur at the lower left sternal border
,B. Wide pulse pressure
C. Cyanosis that improves with oxygen
D. Diminished or delayed femoral pulses compared to brachial pulses
Answer: D
Conceptual Explanation: Coarctation involves narrowing of the aorta, typically causing
hypertension in the upper extremities and lower blood pressure/weak pulses in the lower
extremities.
3. A 6-week-old infant presents with projectile, non-bilious vomiting after every feeding and
appears hungry. On exam, a small, firm mass is felt in the right upper quadrant. What is the
most likely diagnosis?
A. Intussusception
B. Gastroesophageal Reflux Disease
C. Hirschsprung Disease
D. Pyloric Stenosis
Answer: D
Conceptual Explanation: Pyloric stenosis typically presents between 3-6 weeks of life
with projectile non-bilious vomiting and an ‘olive-shaped’ mass in the epigastrium.
, 4. In the management of a child with Acute Otitis Media (AOM), which of the following
scenarios permits ‘watchful waiting’ for 48-72 hours?
A. A 6-month-old with bilateral AOM and fever
B. A 5-year-old with severe otalgia for 48 hours
C. A 12-month-old with otorrhea
D. A 3-year-old with mild ear pain and temperature <102.2 F (39 C)
Answer: D
Conceptual Explanation: AAP guidelines allow watchful waiting in children >6 months
with non-severe, unilateral symptoms, or >24 months with mild symptoms.
5. What is the gold standard diagnostic test for Cystic Fibrosis?
A. Chest X-ray
B. Fecal fat collection
C. Quantitative sweat chloride test
D. Genetic testing for the BRCA1 mutation
Answer: C
Conceptual Explanation: A sweat chloride concentration of 60 mmol/L or greater is
diagnostic for Cystic Fibrosis.
EXAM 2 PRACTICE QUESTIONS AND
ANSWERS
1. A 4-year-old presents with a ‘barking’ cough and inspiratory stridor that worsens at night.
Which of the following is the most appropriate initial treatment for moderate croup?
A. Albuterol nebulizer treatment
B. Chest X-ray to rule out pneumonia
C. Amoxicillin for 10 days
D. Oral dexamethasone
Answer: D
Conceptual Explanation: Dexamethasone is the mainstay of treatment for croup
(laryngotracheobronchitis) as it reduces airway inflammation. Albuterol is not effective for
upper airway swelling.
2. Which of the following physical exam findings is most suggestive of coarctation of the aorta
in a child?
A. Holosystolic murmur at the lower left sternal border
,B. Wide pulse pressure
C. Cyanosis that improves with oxygen
D. Diminished or delayed femoral pulses compared to brachial pulses
Answer: D
Conceptual Explanation: Coarctation involves narrowing of the aorta, typically causing
hypertension in the upper extremities and lower blood pressure/weak pulses in the lower
extremities.
3. A 6-week-old infant presents with projectile, non-bilious vomiting after every feeding and
appears hungry. On exam, a small, firm mass is felt in the right upper quadrant. What is the
most likely diagnosis?
A. Intussusception
B. Gastroesophageal Reflux Disease
C. Hirschsprung Disease
D. Pyloric Stenosis
Answer: D
Conceptual Explanation: Pyloric stenosis typically presents between 3-6 weeks of life
with projectile non-bilious vomiting and an ‘olive-shaped’ mass in the epigastrium.
, 4. In the management of a child with Acute Otitis Media (AOM), which of the following
scenarios permits ‘watchful waiting’ for 48-72 hours?
A. A 6-month-old with bilateral AOM and fever
B. A 5-year-old with severe otalgia for 48 hours
C. A 12-month-old with otorrhea
D. A 3-year-old with mild ear pain and temperature <102.2 F (39 C)
Answer: D
Conceptual Explanation: AAP guidelines allow watchful waiting in children >6 months
with non-severe, unilateral symptoms, or >24 months with mild symptoms.
5. What is the gold standard diagnostic test for Cystic Fibrosis?
A. Chest X-ray
B. Fecal fat collection
C. Quantitative sweat chloride test
D. Genetic testing for the BRCA1 mutation
Answer: C
Conceptual Explanation: A sweat chloride concentration of 60 mmol/L or greater is
diagnostic for Cystic Fibrosis.
