Pediatric Primary Care PNCB 2 COMPREHENSIVE QUESTIONS
AND VERIFIED ANSWERS (DETAILED & ELABORATED) ACTUAL
EXAM TEST 100% SOLVED 2024/2025
1. A female athlete experiences anaphylaxis during a soccer game. The only
significant history is that she had lunch about 1 hour before the incident.
Food-dependent exercise-induced anaphylaxis is diagnosed. Of the
following, the MOST likely cause is:
chocolate milkshake
pineapple
tomatoes
whole wheat bread: whole wheat bread
Exercise is a known co-factor in some children who experience anaphylaxis. Food-
dependent exercise-induced anaphylaxis (FDEIA) is defined as a food induced
allergic reaction that occurs during or soon after exercise. Children should not
exercise within 2-3 hours of ingesting the triggering food. Nuts, wheat, apples,
bananas, kiwi, peaches and eggs frequently are the cause for anaphylaxis.
,2. A healthy 24 month old can be expected to have achieved which of the
following language milestones?
counts three objects correctly
speaks using 30 - 50 words
states full name
tells a story: speaks using 30 - 50 words
Utilizing the Early Language Milestone Scale, beginning at the age of 11 months
and continuing to 24 months of age, the child should have a vocabulary of 50 words.
This child should be able to put words together in short, 2 - 3 word sentences and
name at least one object in a picture. The child at age 3 - 4 years will be able to tell
a short story and begin to count. A 2 year old may know his first name, but usually
cannot state full name until he/she is older.
3. Which is the MOST important safety question to ask a 17 year old?
"Are you aware of ways to avoid accidents?"
"Do you play violent video games more than 2 hours a day?"
"Do you always wear a seat belt when driving or riding in a car?"
"Is there a gun anywhere in your house?": "Do you always wear a seat belt when
driving or riding in a car?"
Motor vehicle accidents are the leading cause of death among children in the United
States, with 78% of all unintentional injury deaths related to MVA among
adolescents. When correctly used, restraint systems can prevent fatalities and
reduce the number and severity of injuries to children and adolescents. As
adolescents begin to drive and carry peer passengers, it is especially important to
remind them of basic safety issues, including the use of seat belts, emphasizing the
danger of driving, drinking and drug use as well as appropriate behavior while in the
car. Reinforcing pedestrian safety is another important issue with adolescents.
,Firearm injuries have decreased over recent years, especially among older children,
and there is no link between violent video games and increased accidents.
4. The parent of an 8 month old, reports switching the baby's formula to cow's
milk due to the continued expense of formula. Which is the BEST response?
Cow's milk does not contain adequate nutrition, and poses a higher risk for
allergy.
Cow's milk has a lower protein and fat content, which will impede growth of
the baby.
Switching to cow's milk sooner than 1 year will not cause any harm.
There is no need to continue formula as long as the child is receiving other
baby foods.: Cow's milk does not contain adequate nutrition, and poses a higher
risk for allergy.
During the first year of life, infants should receive only formula or breast milk. The
use of cow's milk is contraindicated because of its high protein content,
inappropriate nutrition composition, especially lack of iron sources, and the risk of
gastrointestinal bleeding and allergic reactions. If an infant is switched sooner than
one year, the practitioner should encourage the family to resume use of formula or
breast milk until the one year birthday. Despite the addition of table foods or baby
solid foods, formula and breast milk are still the dietary mainstay.
5. A 10 month old has had apparent abdominal pain for the past 4 hours.
During episodes of pain, the infant screams inconsolably and draws his legs
towards the abdomen, has vomited twice, but has had no diarrhea. Between
episodes the infant is calm and quiet. The MOST likely diagnosis is:
Meckel's diverticulum
intussusception
acute appendicitis
, acute gastroenteritis: intussusception
Acute onset of abdominal pain requires immediate investigation. The nurse
practitioner must be able to distinguish between conditions that can safely be
managed at home and those requiring immediate referral. Meckel's diverticulum
usually involves painless rectal bleeding. Acute appendicitis can occur in infants
and must be considered in the differential diagnosis. The pain history of acute
appendicitis is usually more continuous, and there is no palpable mass. Acute
gastroenteritis may involve intermittent pain and cramping, but more typically the
child appears ill, and vomiting and diarrhea play a more prominent role. The pain
of intussusception is very severe, with periods of well-being in between. There is
frequently vomiting, however stools initially are normal. Later stools can be like red
jelly in appearance. A sausage shaped mass is frequently palpable in the right
upper quadrant and aids in diagnosis.
6. For the parents of an 8 month old, the MOST appropriate age-related
anticipatory guidance regarding safety includes which of the following?
cover electrical outlets, keep small objects out of reach, turn car seat to
forward-facing position
keep medications out of reach, continue to use car seat in rear-facing
position, cover electrical outlets
avoid finger foods that can be easily aspirated, teach stranger safety, place
Mr. Yuk stickers on toxic materials
keep matches out of reach, place Mr. Yuk stickers on toxic materials, teach
stranger safety: keep medications out of reach, continue to use car seat in rear-
facing position, cover electrical outlets
An 8 month old is beginning to cruise, crawl and develop a fine pincer grasp.
Keeping medications and small objects out of reach in this age group assists in
avoiding choking or toxic ingestions. Covering electrical outlets helps to prevent
accidental electrocution while the infant is exploring his surroundings. An infant
AND VERIFIED ANSWERS (DETAILED & ELABORATED) ACTUAL
EXAM TEST 100% SOLVED 2024/2025
1. A female athlete experiences anaphylaxis during a soccer game. The only
significant history is that she had lunch about 1 hour before the incident.
Food-dependent exercise-induced anaphylaxis is diagnosed. Of the
following, the MOST likely cause is:
chocolate milkshake
pineapple
tomatoes
whole wheat bread: whole wheat bread
Exercise is a known co-factor in some children who experience anaphylaxis. Food-
dependent exercise-induced anaphylaxis (FDEIA) is defined as a food induced
allergic reaction that occurs during or soon after exercise. Children should not
exercise within 2-3 hours of ingesting the triggering food. Nuts, wheat, apples,
bananas, kiwi, peaches and eggs frequently are the cause for anaphylaxis.
,2. A healthy 24 month old can be expected to have achieved which of the
following language milestones?
counts three objects correctly
speaks using 30 - 50 words
states full name
tells a story: speaks using 30 - 50 words
Utilizing the Early Language Milestone Scale, beginning at the age of 11 months
and continuing to 24 months of age, the child should have a vocabulary of 50 words.
This child should be able to put words together in short, 2 - 3 word sentences and
name at least one object in a picture. The child at age 3 - 4 years will be able to tell
a short story and begin to count. A 2 year old may know his first name, but usually
cannot state full name until he/she is older.
3. Which is the MOST important safety question to ask a 17 year old?
"Are you aware of ways to avoid accidents?"
"Do you play violent video games more than 2 hours a day?"
"Do you always wear a seat belt when driving or riding in a car?"
"Is there a gun anywhere in your house?": "Do you always wear a seat belt when
driving or riding in a car?"
Motor vehicle accidents are the leading cause of death among children in the United
States, with 78% of all unintentional injury deaths related to MVA among
adolescents. When correctly used, restraint systems can prevent fatalities and
reduce the number and severity of injuries to children and adolescents. As
adolescents begin to drive and carry peer passengers, it is especially important to
remind them of basic safety issues, including the use of seat belts, emphasizing the
danger of driving, drinking and drug use as well as appropriate behavior while in the
car. Reinforcing pedestrian safety is another important issue with adolescents.
,Firearm injuries have decreased over recent years, especially among older children,
and there is no link between violent video games and increased accidents.
4. The parent of an 8 month old, reports switching the baby's formula to cow's
milk due to the continued expense of formula. Which is the BEST response?
Cow's milk does not contain adequate nutrition, and poses a higher risk for
allergy.
Cow's milk has a lower protein and fat content, which will impede growth of
the baby.
Switching to cow's milk sooner than 1 year will not cause any harm.
There is no need to continue formula as long as the child is receiving other
baby foods.: Cow's milk does not contain adequate nutrition, and poses a higher
risk for allergy.
During the first year of life, infants should receive only formula or breast milk. The
use of cow's milk is contraindicated because of its high protein content,
inappropriate nutrition composition, especially lack of iron sources, and the risk of
gastrointestinal bleeding and allergic reactions. If an infant is switched sooner than
one year, the practitioner should encourage the family to resume use of formula or
breast milk until the one year birthday. Despite the addition of table foods or baby
solid foods, formula and breast milk are still the dietary mainstay.
5. A 10 month old has had apparent abdominal pain for the past 4 hours.
During episodes of pain, the infant screams inconsolably and draws his legs
towards the abdomen, has vomited twice, but has had no diarrhea. Between
episodes the infant is calm and quiet. The MOST likely diagnosis is:
Meckel's diverticulum
intussusception
acute appendicitis
, acute gastroenteritis: intussusception
Acute onset of abdominal pain requires immediate investigation. The nurse
practitioner must be able to distinguish between conditions that can safely be
managed at home and those requiring immediate referral. Meckel's diverticulum
usually involves painless rectal bleeding. Acute appendicitis can occur in infants
and must be considered in the differential diagnosis. The pain history of acute
appendicitis is usually more continuous, and there is no palpable mass. Acute
gastroenteritis may involve intermittent pain and cramping, but more typically the
child appears ill, and vomiting and diarrhea play a more prominent role. The pain
of intussusception is very severe, with periods of well-being in between. There is
frequently vomiting, however stools initially are normal. Later stools can be like red
jelly in appearance. A sausage shaped mass is frequently palpable in the right
upper quadrant and aids in diagnosis.
6. For the parents of an 8 month old, the MOST appropriate age-related
anticipatory guidance regarding safety includes which of the following?
cover electrical outlets, keep small objects out of reach, turn car seat to
forward-facing position
keep medications out of reach, continue to use car seat in rear-facing
position, cover electrical outlets
avoid finger foods that can be easily aspirated, teach stranger safety, place
Mr. Yuk stickers on toxic materials
keep matches out of reach, place Mr. Yuk stickers on toxic materials, teach
stranger safety: keep medications out of reach, continue to use car seat in rear-
facing position, cover electrical outlets
An 8 month old is beginning to cruise, crawl and develop a fine pincer grasp.
Keeping medications and small objects out of reach in this age group assists in
avoiding choking or toxic ingestions. Covering electrical outlets helps to prevent
accidental electrocution while the infant is exploring his surroundings. An infant
