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Pediatric Primary Care PNCB 2 EXAM QUESTIONS AND VERIFIED ANSWERS

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Pediatric Primary Care PNCB 2 EXAM QUESTIONS AND VERIFIED ANSWERS Pediatric Primary Care PNCB 2 EXAM QUESTIONS AND VERIFIED ANSWERS Pediatric Primary Care PNCB 2 EXAM QUESTIONS AND VERIFIED ANSWERS

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Pediatric Primary Care PNCB 2
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A female athlete experiences anaphylaxis whole wheat bread
during a soccer game. The only significant
history is that she had lunch about 1 hour Exercise is a known co-factor in some children who experience anaphylaxis. Food-
before the incident. Food-dependent dependent exercise-induced anaphylaxis (FDEIA) is defined as a food induced
exercise-induced anaphylaxis is diagnosed. allergic reaction that occurs during or soon after exercise. Children should not
Of the following, the MOST likely cause is: exercise within 2-3 hours of ingesting the triggering food. Nuts, wheat, apples,
bananas, kiwi, peaches and eggs frequently are the cause for anaphylaxis.
chocolate milkshake


pineapple


tomatoes


whole wheat bread

A healthy 24 month old can be expected speaks using 30 - 50 words
to have achieved which of the following
language milestones? 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
counts three objects correctly 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
speaks using 30 - 50 words 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.
states full name


tells a story

,Which is the MOST important safety "Do you always wear a seat belt when driving or riding in a car?"
question to ask a 17 year old?
Motor vehicle accidents are the leading cause of death among children in the United
"Are you aware of ways to avoid States, with 78% of all unintentional injury deaths related to MVA among adolescents.
accidents?" 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
"Do you play violent video games more and carry peer passengers, it is especially important to remind them of basic safety
than 2 hours a day?" 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
"Do you always wear a seat belt when safety is another important issue with adolescents. Firearm injuries have decreased
driving or riding in a car?" over recent years, especially among older children, and there is no link between
violent video games and increased accidents.
"Is there a gun anywhere in your house?"

The parent of an 8 month old, reports Cow's milk does not contain adequate nutrition, and poses a higher risk for allergy.
switching the baby's formula to cow's milk
due to the continued expense of formula. During the first year of life, infants should receive only formula or breast milk. The
Which is the BEST response? 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
Cow's milk does not contain adequate gastrointestinal bleeding and allergic reactions. If an infant is switched sooner than
nutrition, and poses a higher risk for allergy. 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
Cow's milk has a lower protein and fat solid foods, formula and breast milk are still the dietary mainstay.
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.

A 10 month old has had apparent intussusception
abdominal pain for the past 4 hours. During
episodes of pain, the infant screams Acute onset of abdominal pain requires immediate investigation. The nurse
inconsolably and draws his legs towards practitioner must be able to distinguish between conditions that can safely be
the abdomen, has vomited twice, but has managed at home and those requiring immediate referral. Meckel's diverticulum
had no diarrhea. Between episodes the usually involves painless rectal bleeding. Acute appendicitis can occur in infants and
infant is calm and quiet. The MOST likely must be considered in the differential diagnosis. The pain history of acute
diagnosis is: appendicitis is usually more continuous, and there is no palpable mass. Acute
gastroenteritis may involve intermittent pain and cramping, but more typically the
Meckel's diverticulum 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
intussusception 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
acute appendicitis quadrant and aids in diagnosis.


acute gastroenteritis

, For the parents of an 8 month old, the keep medications out of reach, continue to use car seat in rear-facing position, cover
MOST appropriate age-related anticipatory electrical outlets
guidance regarding safety includes which
of the following? 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
cover electrical outlets, keep small objects avoiding choking or toxic ingestions. Covering electrical outlets helps to prevent
out of reach, turn car seat to forward- accidental electrocution while the infant is exploring his surroundings. An infant
facing position should maintain the rear-facing position of the car seat until the age of one year. An
8 month old is not at a developmental level to understand stranger caution nor Mr.
keep medications out of reach, continue to Yuk stickers. Keeping matches out of reach is important, although it is not as likely
use car seat in rear-facing position, cover that an 8 month old would have the dexterity to strike a match.
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

instruction on front to back cleansing.
The INITIAL treatment for a school-age
female with well-demarcated erythema and
Vulvovaginitis is the most common genital complaint among prepubertal girls due to
mucoid discharge in the vulva area
the thin hypo estrogenized mucosal tissue with an alkaline pH, small labia minora,
includes:
and location proximal to the anus. Vulvovaginitis, caused by streptococcal bacterial
infections, is identified by well-demarcated areas of erythema with a mucoid
discontinuation of bubble baths.
discharge. A 10-day regimen of oral penicillin or amoxicillin is the treatment for a
streptococcal infection which is the most common organism. Vulvovaginitis can be
instruction on front to back cleansing.
caused by poor hygiene in girls who may be wiping inadequately or inappropriately
(e.g. from back to front), leading to local irritation. Prepubertal females should be
oral penicillin.
instructed in proper hygiene and wiping of perianal area. Soaps, shampoos, and
bubble baths are the most common cause of dysuria due to chemical urethritis.
topical Premarin.
Topical Premarin is used in the initial treatment of labial adhesions.

Emphasis on promoting healthy behavioral establishing family goals
changes for the overweight child should
include which of the following? Effective weight loss planning and implementation need to involve the entire family.
Emphasis should be placed on family change and family goals as children will copy
establishing family goals their parents' behaviors. In addition, parents have control over some aspects of the
change process that can occur in relation to goals and meals in the home. Daily
maintaining family holiday meal rituals weights are not recommended, and weight loss should not be used as the measure
of success. Changing behaviors is a success by itself and should be celebrated. New
weighing child daily family and holiday rituals should be established for a focus on non-food related
events.
using weight loss as a sign of success

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