NSG 5442 Pediatric Primary Care Final Exam
(PDF) | 2026 | South College Pediatrics
1. A 2-month-old infant is brought for a well-child visit. Which
developmental milestone is expected?
A) Rolls over
B) Social smile
C) Sits without support
D) Walks alone
Answer: B
Rationale: Social smile appears at 2 months; rolling over at 4-6 months; sitting at
6-8 months.
2. Which vaccine is contraindicated in a child with severe combined
immunodeficiency?
A) DTaP
B) MMR
C) Hepatitis B
D) IPV
Answer: B
Rationale: Live vaccines are contraindicated in severe immunodeficiency.
,3. A 4-year-old has a fever, barky cough, and inspiratory stridor. What is the
most likely diagnosis?
A) Epiglottitis
B) Croup
C) Bronchiolitis
D) Asthma
Answer: B
Rationale: Croup causes barky cough and stridor; epiglottitis has drooling and
toxic appearance.
4. A 6-month-old with bronchiolitis has RR 60, retractions, and SpO2 92%.
What is the best initial management?
A) Albuterol
B) Supportive care with oxygen and hydration
C) Antibiotics
D) Corticosteroids
Answer: B
Rationale: Bronchiolitis is viral; treatment is supportive.
5. Which is the first-line treatment for acute otitis media in a 2-year-old
without allergy?
A) Azithromycin
,B) High-dose amoxicillin
C) Ciprofloxacin
D) Ceftriaxone
Answer: B
Rationale: Amoxicillin is first-line for AOM; high dose covers resistant S.
pneumoniae.
6. A 5-year-old with asthma uses albuterol daily. What is the best next step?
A) Continue albuterol only
B) Add inhaled corticosteroid
C) Add oral steroid
D) Add montelukast only
Answer: B
Rationale: Daily albuterol indicates uncontrolled asthma; ICS is first-line controller.
7. A 12-year-old has a BMI >95th percentile. What is the most important
initial intervention?
A) Metformin
B) Lifestyle counseling for diet and activity
C) Orlistat
D) Bariatric surgery
Answer: B
Rationale: Family-based lifestyle modification is first-line for pediatric obesity.
, 8. A 15-year-old female has primary dysmenorrhea. What is first-line
treatment?
A) Opioids
B) NSAIDs
C) Oral contraceptives
D) Antispasmodics
Answer: B
Rationale: NSAIDs reduce prostaglandins; OCPs are second-line.
9. A 3-day-old newborn has jaundice to the abdomen. What is the next step?
A) Reassure
B) Check bilirubin level
C) Start phototherapy
D) Exchange transfusion
Answer: B
Rationale: Jaundice after 24 hours requires bilirubin measurement and
monitoring.
10. A 9-month-old has not yet received any vaccines. Which vaccine should
be given first?
A) MMR
(PDF) | 2026 | South College Pediatrics
1. A 2-month-old infant is brought for a well-child visit. Which
developmental milestone is expected?
A) Rolls over
B) Social smile
C) Sits without support
D) Walks alone
Answer: B
Rationale: Social smile appears at 2 months; rolling over at 4-6 months; sitting at
6-8 months.
2. Which vaccine is contraindicated in a child with severe combined
immunodeficiency?
A) DTaP
B) MMR
C) Hepatitis B
D) IPV
Answer: B
Rationale: Live vaccines are contraindicated in severe immunodeficiency.
,3. A 4-year-old has a fever, barky cough, and inspiratory stridor. What is the
most likely diagnosis?
A) Epiglottitis
B) Croup
C) Bronchiolitis
D) Asthma
Answer: B
Rationale: Croup causes barky cough and stridor; epiglottitis has drooling and
toxic appearance.
4. A 6-month-old with bronchiolitis has RR 60, retractions, and SpO2 92%.
What is the best initial management?
A) Albuterol
B) Supportive care with oxygen and hydration
C) Antibiotics
D) Corticosteroids
Answer: B
Rationale: Bronchiolitis is viral; treatment is supportive.
5. Which is the first-line treatment for acute otitis media in a 2-year-old
without allergy?
A) Azithromycin
,B) High-dose amoxicillin
C) Ciprofloxacin
D) Ceftriaxone
Answer: B
Rationale: Amoxicillin is first-line for AOM; high dose covers resistant S.
pneumoniae.
6. A 5-year-old with asthma uses albuterol daily. What is the best next step?
A) Continue albuterol only
B) Add inhaled corticosteroid
C) Add oral steroid
D) Add montelukast only
Answer: B
Rationale: Daily albuterol indicates uncontrolled asthma; ICS is first-line controller.
7. A 12-year-old has a BMI >95th percentile. What is the most important
initial intervention?
A) Metformin
B) Lifestyle counseling for diet and activity
C) Orlistat
D) Bariatric surgery
Answer: B
Rationale: Family-based lifestyle modification is first-line for pediatric obesity.
, 8. A 15-year-old female has primary dysmenorrhea. What is first-line
treatment?
A) Opioids
B) NSAIDs
C) Oral contraceptives
D) Antispasmodics
Answer: B
Rationale: NSAIDs reduce prostaglandins; OCPs are second-line.
9. A 3-day-old newborn has jaundice to the abdomen. What is the next step?
A) Reassure
B) Check bilirubin level
C) Start phototherapy
D) Exchange transfusion
Answer: B
Rationale: Jaundice after 24 hours requires bilirubin measurement and
monitoring.
10. A 9-month-old has not yet received any vaccines. Which vaccine should
be given first?
A) MMR
