NSG 5442 Pediatric Primary Care Exam 4
(PDF) | 2026/2027 | South College Pediatrics
1. A 2-month-old infant is brought for a well-child visit. Which
developmental milestone is expected?
A) Rolling over
B) Social smile
C) Sitting without support
D) Walking
Answer: B
Rationale: Social smile appears at 2 months. Rolling over at 4-6 months, sitting at
6-8 months, walking at 12-15 months.
2. Which vaccine is contraindicated in a child with a severe allergy to gelatin?
A) DTaP
B) MMR
C) Hepatitis B
D) IPV
Answer: B
Rationale: MMR and varicella vaccines contain gelatin; severe allergy is a
contraindication. DTaP and HepB do not.
,3. A 6-month-old infant is exclusively breastfed. Which supplement should
be recommended?
A) Vitamin C
B) Vitamin D
C) Iron
D) Fluoride
Answer: B
Rationale: Breastfed infants need 400 IU vitamin D daily. Iron supplementation
begins at 4-6 months.
4. A 3-year-old presents with a barking cough and stridor that worsens at
night. What is the most likely diagnosis?
A) Epiglottitis
B) Croup
C) Bronchiolitis
D) Asthma
Answer: B
Rationale: Croup (laryngotracheobronchitis) causes barking cough, stridor, and
hoarseness, often worse at night.
5. A 5-year-old child has a fever, sore throat, and tonsillar exudates. Rapid
strep test is positive. What is the treatment of choice?
,A) Amoxicillin
B) Penicillin V
C) Azithromycin
D) Cephalexin
Answer: B
Rationale: Penicillin V or amoxicillin is first-line for group A strep pharyngitis.
Penicillin allergy: azithromycin or cephalexin.
6. A 4-week-old infant presents with projectile vomiting after feeds. What is
the most likely diagnosis?
A) GERD
B) Pyloric stenosis
C) Intussusception
D) Malrotation
Answer: B
Rationale: Pyloric stenosis presents at 3-6 weeks with projectile vomiting, visible
peristalsis, and olive-shaped mass.
7. Which of the following is a risk factor for sudden infant death syndrome
(SIDS)?
A) Breastfeeding
B) Prone sleeping
C) Pacifier use
, D) Room sharing
Answer: B
Rationale: Prone sleeping increases SIDS risk. Supine sleeping, breastfeeding, and
pacifier use are protective.
8. A 12-year-old presents with a 2-week history of polyuria, polydipsia, and
weight loss. What is the most likely diagnosis?
A) Type 2 diabetes
B) Type 1 diabetes
C) Diabetes insipidus
D) Hyperthyroidism
Answer: B
Rationale: Type 1 diabetes commonly presents in children with polyuria,
polydipsia, weight loss, and possibly DKA.
9. A 2-year-old child has a fever of 39°C and a petechial rash. What is the
most appropriate action?
A) Prescribe amoxicillin
B) Immediately refer to emergency department
C) Recommend acetaminophen
D) Obtain a throat culture
Answer: B
(PDF) | 2026/2027 | South College Pediatrics
1. A 2-month-old infant is brought for a well-child visit. Which
developmental milestone is expected?
A) Rolling over
B) Social smile
C) Sitting without support
D) Walking
Answer: B
Rationale: Social smile appears at 2 months. Rolling over at 4-6 months, sitting at
6-8 months, walking at 12-15 months.
2. Which vaccine is contraindicated in a child with a severe allergy to gelatin?
A) DTaP
B) MMR
C) Hepatitis B
D) IPV
Answer: B
Rationale: MMR and varicella vaccines contain gelatin; severe allergy is a
contraindication. DTaP and HepB do not.
,3. A 6-month-old infant is exclusively breastfed. Which supplement should
be recommended?
A) Vitamin C
B) Vitamin D
C) Iron
D) Fluoride
Answer: B
Rationale: Breastfed infants need 400 IU vitamin D daily. Iron supplementation
begins at 4-6 months.
4. A 3-year-old presents with a barking cough and stridor that worsens at
night. What is the most likely diagnosis?
A) Epiglottitis
B) Croup
C) Bronchiolitis
D) Asthma
Answer: B
Rationale: Croup (laryngotracheobronchitis) causes barking cough, stridor, and
hoarseness, often worse at night.
5. A 5-year-old child has a fever, sore throat, and tonsillar exudates. Rapid
strep test is positive. What is the treatment of choice?
,A) Amoxicillin
B) Penicillin V
C) Azithromycin
D) Cephalexin
Answer: B
Rationale: Penicillin V or amoxicillin is first-line for group A strep pharyngitis.
Penicillin allergy: azithromycin or cephalexin.
6. A 4-week-old infant presents with projectile vomiting after feeds. What is
the most likely diagnosis?
A) GERD
B) Pyloric stenosis
C) Intussusception
D) Malrotation
Answer: B
Rationale: Pyloric stenosis presents at 3-6 weeks with projectile vomiting, visible
peristalsis, and olive-shaped mass.
7. Which of the following is a risk factor for sudden infant death syndrome
(SIDS)?
A) Breastfeeding
B) Prone sleeping
C) Pacifier use
, D) Room sharing
Answer: B
Rationale: Prone sleeping increases SIDS risk. Supine sleeping, breastfeeding, and
pacifier use are protective.
8. A 12-year-old presents with a 2-week history of polyuria, polydipsia, and
weight loss. What is the most likely diagnosis?
A) Type 2 diabetes
B) Type 1 diabetes
C) Diabetes insipidus
D) Hyperthyroidism
Answer: B
Rationale: Type 1 diabetes commonly presents in children with polyuria,
polydipsia, weight loss, and possibly DKA.
9. A 2-year-old child has a fever of 39°C and a petechial rash. What is the
most appropriate action?
A) Prescribe amoxicillin
B) Immediately refer to emergency department
C) Recommend acetaminophen
D) Obtain a throat culture
Answer: B
