NURS 6541 / NRNP 6541 PRIMARY CARE
OF ADOLESCENTS & CHILDREN FINAL
EXAM REVIEW QUESTIONS AND
ANSWERS
1. A 4-year-old child presents with a sudden onset of high fever, muffled voice, and drooling.
The child is sitting in a ‘tripod’ position. Which of the following is the most appropriate next
step?
A. Perform a throat culture to confirm Group A Strep
B. Examine the posterior pharynx with a tongue depressor
C. Administer a dose of oral dexamethasone
D. Arrange for immediate transport to the emergency department for airway management
Answer: D
Conceptual Explanation: These symptoms are classic for epiglottitis, a medical
emergency. Examining the throat can trigger a complete airway obstruction.
,2. When evaluating a 14-year-old female for secondary amenorrhea, what is the most
common cause that must be ruled out first?
A. Polycystic Ovary Syndrome (PCOS)
B. Pregnancy
C. Hypothyroidism
D. Anorexia Nervosa
Answer: B
Conceptual Explanation: Pregnancy is the most common cause of secondary amenorrhea
in adolescents and should always be ruled out first with a HCG test.
3. A 2-week-old infant is brought in for a check-up. The mother reports the infant has non-
bilious projectile vomiting after every feeding. On palpation, an olive-shaped mass is felt in
the epigastrium. What is the most likely diagnosis?
A. Pyloric Stenosis
B. Intussusception
C. Hirschsprung Disease
D. Gastroesophageal Reflux Disease (GERD)
Answer: A
Conceptual Explanation: Projectile non-bilious vomiting and an olive-shaped mass are
pathognomonic for hypertrophic pyloric stenosis.
, 4. In the management of a child with Acute Otitis Media (AOM), which of the following is an
indication for immediate antibiotic therapy rather than observation?
A. Age 6 to 23 months with unilateral AOM and mild symptoms
B. Age over 2 years with bilateral AOM and mild symptoms
C. Age 3 years with unilateral AOM and ear tugging
D. Age 6 months and older with severe signs or symptoms (fever >39°C or severe pain)
Answer: D
Conceptual Explanation: Current guidelines recommend immediate antibiotics for
children with severe symptoms or those under 6 months of age.
5. A 6-year-old presents with a ‘slapped cheek’ rash and a lacy, reticular rash on the trunk and
extremities. The child is otherwise afebrile. What is the causative agent?
A. Human Herpesvirus 6
B. Group A Streptococcus
C. Coxsackievirus A16
D. Parvovirus B19
Answer: D
Conceptual Explanation: Parvovirus B19 causes Erythema Infectiosum (Fifth Disease),
characterized by the slapped-cheek appearance.
OF ADOLESCENTS & CHILDREN FINAL
EXAM REVIEW QUESTIONS AND
ANSWERS
1. A 4-year-old child presents with a sudden onset of high fever, muffled voice, and drooling.
The child is sitting in a ‘tripod’ position. Which of the following is the most appropriate next
step?
A. Perform a throat culture to confirm Group A Strep
B. Examine the posterior pharynx with a tongue depressor
C. Administer a dose of oral dexamethasone
D. Arrange for immediate transport to the emergency department for airway management
Answer: D
Conceptual Explanation: These symptoms are classic for epiglottitis, a medical
emergency. Examining the throat can trigger a complete airway obstruction.
,2. When evaluating a 14-year-old female for secondary amenorrhea, what is the most
common cause that must be ruled out first?
A. Polycystic Ovary Syndrome (PCOS)
B. Pregnancy
C. Hypothyroidism
D. Anorexia Nervosa
Answer: B
Conceptual Explanation: Pregnancy is the most common cause of secondary amenorrhea
in adolescents and should always be ruled out first with a HCG test.
3. A 2-week-old infant is brought in for a check-up. The mother reports the infant has non-
bilious projectile vomiting after every feeding. On palpation, an olive-shaped mass is felt in
the epigastrium. What is the most likely diagnosis?
A. Pyloric Stenosis
B. Intussusception
C. Hirschsprung Disease
D. Gastroesophageal Reflux Disease (GERD)
Answer: A
Conceptual Explanation: Projectile non-bilious vomiting and an olive-shaped mass are
pathognomonic for hypertrophic pyloric stenosis.
, 4. In the management of a child with Acute Otitis Media (AOM), which of the following is an
indication for immediate antibiotic therapy rather than observation?
A. Age 6 to 23 months with unilateral AOM and mild symptoms
B. Age over 2 years with bilateral AOM and mild symptoms
C. Age 3 years with unilateral AOM and ear tugging
D. Age 6 months and older with severe signs or symptoms (fever >39°C or severe pain)
Answer: D
Conceptual Explanation: Current guidelines recommend immediate antibiotics for
children with severe symptoms or those under 6 months of age.
5. A 6-year-old presents with a ‘slapped cheek’ rash and a lacy, reticular rash on the trunk and
extremities. The child is otherwise afebrile. What is the causative agent?
A. Human Herpesvirus 6
B. Group A Streptococcus
C. Coxsackievirus A16
D. Parvovirus B19
Answer: D
Conceptual Explanation: Parvovirus B19 causes Erythema Infectiosum (Fifth Disease),
characterized by the slapped-cheek appearance.
