QUESTIONS AND 100% CORRECT AND WELL
DETAILED ANSWERS|LATEST 2025/2026|GRADED
Palivizumab (Synagis®) prophylaxis against respiratory syncytial virus is recommended for
which of the following infants?
A. 4 month old born at 32 weeks gestation who required 7 days of supplemental oxygen during
the neonatal hospital stay
B. 5 month old with hemodynamically significant heart disease
C. 6 month old with Down syndrome who is otherwise healthy
D. 9 month old with cystic fibrosis - ANSWER The correct answer is B - 5 month old with
hemodynamically significant heart disease
The most common reason for hospitalization of infants in the first year of life is bronchiolitis.
The most common causative agent for bronchiolitis is respiratory syncytial virus (RSV).
The American Academy of Pediatrics' 2014 guidelines for palivizumab (Synagis®) vaccination
recommend prophylaxis in the first year of life for infants:
born prior to 29 weeks, 0 days gestation; with hemodynamically significant heart disease and;
with chronic lung disease of prematurity, defined as those born prior to 32 weeks 0 days
gestation who required supplemental oxygen for the first 28 days of life or longer.
Other groups may be considered for prophylaxis.
Routine palivizumab prophylaxis is not recommended for children with Down syndrome or
cystic fibrosis who do not meet criteria for prematurity, heart disease, or chronic lung disease.
Infants with cystic fibrosis who have clinical evidence of chronic lung disease and/or nutritional
compromise may be considered for prophylaxis in the first year of life.
1
,Infants with neuromuscular disease or a congenital anomaly that impairs the ability to clear
upper airway secretions may also be considered for palivizumab (Synagis®) administration in
the first year of life.
Additionally, palivizumab (Synagis®) may be considered in the second year of life for children
with cystic fibrosis who have manifestations of severe lung disease or inadequate growth.
A pediatric nurse practitioner is considering a position with a pediatric pulmonologist in a clinic
which specializes in the treatment of cystic fibrosis. However, there are patients in the practice
who are over the age of 21 years.
Which is the BEST action to take?
A. decline the job offer for one in which only pediatric patients will be seen
B. contact the state board of nursing regarding regulations related to patient populations
C. agree to take the job since cystic fibrosis is a pediatric illness regardless of the patient's
chronological age
D. contact the certification agency to determine their rulings regarding patients over the age of
21 - ANSWER The correct answer is B - contact the state board of nursing regarding
regulations related to patient
populations
Pediatric nurse practitioners (PNP) must base practice decisions on national and state
legislation, which
is usually guided by recommendations from organizations such as the American Academy of
Pediatrics (AAP) and the National Association of Pediatric Nurse Practitioners (NAPNAP).
Practice standards and competencies exist for this purpose.
Ultimately, though, individual states determine licensure regulations and the PNP must be
familiar with these rulings in order to practice under a state's jurisdiction.
Some states require various types of physician collaborative agreements which can spell out
specifics such as the age of patients being seen.
2
,The AAP and NAPNAP both offer support in the care of older patients with specific pediatric
problems.
The group of licensing, accreditation, certification and educational organizations known as
LACE who have monitored the implementation of the APRN Consensus Model has also written
guidance on this topic.
Before taking any position, it is important for the PNP to examine specific state guidelines and
be familiar with practice recommendations from all recognized
organizations.
Anticipatory guidance for a caregiver of a 6 month old includes that which of the following
foods is CONTRAINDICATED for introduction at this time?
A. peanut powder
B. raw honey
C. scrambled eggs
D. wheat cereal - ANSWER The correct answer is B - raw honey
Clostridium botulinum is a gram-positive, spore forming anaerobe which lives in dirt, soil and
marine sediments.
Botulinum toxin is the most poisonous toxin known.
The toxin blocks neuromuscular transmission and causes acute, flaccid paralysis causing death
through airway muscle paralysis.
Raw honey can contain Clostridium botulinum spores, which can germinate in an infant's
immature digestive system causing botulism, a rare but potentially fatal illness.
3
, For this reason, honey is never recommended for children less than 1 year of age.
Newer data suggests that the early introduction of other foods may actually prevent individual
food allergies with later introduction actually increasing food sensitization.
Therefore, peanut powder, scrambled eggs, and wheat cereal are all safe and recommended to
be introduced at this time.
A 5-year-old male presents with an intermittent limp exacerbated with exertion and is
associated with mild or intermittent pain.
Which imaging study is BEST ordered to confirm the diagnosis?
A. bone scan
B. MRI of leg
C. pelvic CT
D. radiographs hips and pelvis - ANSWER The correct answer is D - radiographs hips and
pelvis
Legg-Calvé-Perthes disease is an idiopathic, juvenile avascular necrosis of the femoral head,
which is five times more common in boys and occurs between 4-8 years of age.
There is an initial ischemic episode of unknown etiology that interrupts vascular circulation to
the capital femoral epiphysis.
The articular cartilage hypertrophies, and the epiphyseal marrow becomes necrotic.
The area revascularizes, and the necrotic bone is replaced by new bone.
This process can take 18-24 months.
4
DETAILED ANSWERS|LATEST 2025/2026|GRADED
Palivizumab (Synagis®) prophylaxis against respiratory syncytial virus is recommended for
which of the following infants?
A. 4 month old born at 32 weeks gestation who required 7 days of supplemental oxygen during
the neonatal hospital stay
B. 5 month old with hemodynamically significant heart disease
C. 6 month old with Down syndrome who is otherwise healthy
D. 9 month old with cystic fibrosis - ANSWER The correct answer is B - 5 month old with
hemodynamically significant heart disease
The most common reason for hospitalization of infants in the first year of life is bronchiolitis.
The most common causative agent for bronchiolitis is respiratory syncytial virus (RSV).
The American Academy of Pediatrics' 2014 guidelines for palivizumab (Synagis®) vaccination
recommend prophylaxis in the first year of life for infants:
born prior to 29 weeks, 0 days gestation; with hemodynamically significant heart disease and;
with chronic lung disease of prematurity, defined as those born prior to 32 weeks 0 days
gestation who required supplemental oxygen for the first 28 days of life or longer.
Other groups may be considered for prophylaxis.
Routine palivizumab prophylaxis is not recommended for children with Down syndrome or
cystic fibrosis who do not meet criteria for prematurity, heart disease, or chronic lung disease.
Infants with cystic fibrosis who have clinical evidence of chronic lung disease and/or nutritional
compromise may be considered for prophylaxis in the first year of life.
1
,Infants with neuromuscular disease or a congenital anomaly that impairs the ability to clear
upper airway secretions may also be considered for palivizumab (Synagis®) administration in
the first year of life.
Additionally, palivizumab (Synagis®) may be considered in the second year of life for children
with cystic fibrosis who have manifestations of severe lung disease or inadequate growth.
A pediatric nurse practitioner is considering a position with a pediatric pulmonologist in a clinic
which specializes in the treatment of cystic fibrosis. However, there are patients in the practice
who are over the age of 21 years.
Which is the BEST action to take?
A. decline the job offer for one in which only pediatric patients will be seen
B. contact the state board of nursing regarding regulations related to patient populations
C. agree to take the job since cystic fibrosis is a pediatric illness regardless of the patient's
chronological age
D. contact the certification agency to determine their rulings regarding patients over the age of
21 - ANSWER The correct answer is B - contact the state board of nursing regarding
regulations related to patient
populations
Pediatric nurse practitioners (PNP) must base practice decisions on national and state
legislation, which
is usually guided by recommendations from organizations such as the American Academy of
Pediatrics (AAP) and the National Association of Pediatric Nurse Practitioners (NAPNAP).
Practice standards and competencies exist for this purpose.
Ultimately, though, individual states determine licensure regulations and the PNP must be
familiar with these rulings in order to practice under a state's jurisdiction.
Some states require various types of physician collaborative agreements which can spell out
specifics such as the age of patients being seen.
2
,The AAP and NAPNAP both offer support in the care of older patients with specific pediatric
problems.
The group of licensing, accreditation, certification and educational organizations known as
LACE who have monitored the implementation of the APRN Consensus Model has also written
guidance on this topic.
Before taking any position, it is important for the PNP to examine specific state guidelines and
be familiar with practice recommendations from all recognized
organizations.
Anticipatory guidance for a caregiver of a 6 month old includes that which of the following
foods is CONTRAINDICATED for introduction at this time?
A. peanut powder
B. raw honey
C. scrambled eggs
D. wheat cereal - ANSWER The correct answer is B - raw honey
Clostridium botulinum is a gram-positive, spore forming anaerobe which lives in dirt, soil and
marine sediments.
Botulinum toxin is the most poisonous toxin known.
The toxin blocks neuromuscular transmission and causes acute, flaccid paralysis causing death
through airway muscle paralysis.
Raw honey can contain Clostridium botulinum spores, which can germinate in an infant's
immature digestive system causing botulism, a rare but potentially fatal illness.
3
, For this reason, honey is never recommended for children less than 1 year of age.
Newer data suggests that the early introduction of other foods may actually prevent individual
food allergies with later introduction actually increasing food sensitization.
Therefore, peanut powder, scrambled eggs, and wheat cereal are all safe and recommended to
be introduced at this time.
A 5-year-old male presents with an intermittent limp exacerbated with exertion and is
associated with mild or intermittent pain.
Which imaging study is BEST ordered to confirm the diagnosis?
A. bone scan
B. MRI of leg
C. pelvic CT
D. radiographs hips and pelvis - ANSWER The correct answer is D - radiographs hips and
pelvis
Legg-Calvé-Perthes disease is an idiopathic, juvenile avascular necrosis of the femoral head,
which is five times more common in boys and occurs between 4-8 years of age.
There is an initial ischemic episode of unknown etiology that interrupts vascular circulation to
the capital femoral epiphysis.
The articular cartilage hypertrophies, and the epiphyseal marrow becomes necrotic.
The area revascularizes, and the necrotic bone is replaced by new bone.
This process can take 18-24 months.
4
