Pediatric Respiratory Disorders Practice Exam
150 questions, answers, and rationales
1. What is the most common cause of bronchiolitis in infants?
Respiratory syncytial virus (RSV)
Rationale: RSV is the leading viral cause of bronchiolitis and
hospitalization in infants, especially those under 12 months.
2. A 3-year-old child presents with a barking cough, inspiratory
stridor, and hoarseness. The most likely diagnosis is:
Croup (laryngotracheitis)
Rationale: Classic symptoms of croup include a barking cough, stridor,
and hoarseness, typically caused by parainfluenza virus.
3. The first-line treatment for mild croup in children is:
Dexamethasone
Rationale: Corticosteroids reduce airway inflammation and are
effective in mild to moderate croup.
4. A 6-year-old presents with wheezing after exposure to pollen. The
best initial management includes:
Short-acting beta-agonist (SABA)
Rationale: SABAs like albuterol provide rapid relief of acute
bronchospasm in asthma exacerbations.
5. The hallmark of cystic fibrosis in children is:
Thick, sticky mucus production
Rationale: CF causes abnormal chloride transport, leading to thick
mucus affecting lungs and pancreas.
6. Which diagnostic test is most specific for cystic fibrosis?
Sweat chloride test
,Rationale: A sweat chloride level >60 mmol/L is diagnostic for CF in
children.
7. A child presents with sudden onset of fever, chills, and productive
cough with green sputum. The likely diagnosis is:
Bacterial pneumonia
Rationale: High fever, chills, and purulent sputum indicate bacterial
etiology rather than viral.
8. The most common bacterial cause of community-acquired
pneumonia in children over 5 years is:
Streptococcus pneumoniae
Rationale: S. pneumoniae is the leading cause of bacterial pneumonia
in school-aged children.
9. A child with asthma is using a metered-dose inhaler incorrectly.
What is the most effective teaching strategy?
Demonstrate and have the child perform return demonstration
Rationale: Hands-on demonstration ensures proper inhaler technique
and optimal drug delivery.
10. Which sign indicates severe respiratory distress in children?
Nasal flaring and intercostal retractions
Rationale: These are objective signs of increased work of breathing in
pediatric patients.
11. The preferred imaging study for suspected foreign body aspiration
in a child is:
Chest X-ray
Rationale: Chest X-ray can identify radiopaque objects and
hyperinflation; however, bronchoscopy may be needed for
diagnosis/removal.
, 12. Which is a characteristic feature of epiglottitis in children?
Drooling and tripod position
Rationale: Epiglottitis causes severe airway obstruction; children often
sit leaning forward and drooling due to difficulty swallowing.
13. The most common cause of epiglottitis in children is:
Haemophilus influenzae type b (Hib)
Rationale: Hib used to be the primary cause; incidence has decreased
significantly due to vaccination.
14. What is the primary treatment for epiglottitis?
Airway management and IV antibiotics
Rationale: Securing the airway is critical, followed by IV antibiotics
targeting Hib and other pathogens.
15. Which chronic respiratory condition in children is characterized by
reversible airway obstruction?
Asthma
Rationale: Asthma is marked by episodic wheezing, cough, and
reversible bronchoconstriction.
16. A 7-year-old with asthma presents with wheezing, cough, and
difficulty speaking. The appropriate immediate action is:
Administer nebulized albuterol and oxygen
Rationale: Severe exacerbations require rapid bronchodilation and
oxygen therapy.
17. The most reliable method to monitor long-term asthma control in
children is:
Peak expiratory flow measurement
Rationale: Peak flow monitoring helps track airway obstruction trends
over time.
150 questions, answers, and rationales
1. What is the most common cause of bronchiolitis in infants?
Respiratory syncytial virus (RSV)
Rationale: RSV is the leading viral cause of bronchiolitis and
hospitalization in infants, especially those under 12 months.
2. A 3-year-old child presents with a barking cough, inspiratory
stridor, and hoarseness. The most likely diagnosis is:
Croup (laryngotracheitis)
Rationale: Classic symptoms of croup include a barking cough, stridor,
and hoarseness, typically caused by parainfluenza virus.
3. The first-line treatment for mild croup in children is:
Dexamethasone
Rationale: Corticosteroids reduce airway inflammation and are
effective in mild to moderate croup.
4. A 6-year-old presents with wheezing after exposure to pollen. The
best initial management includes:
Short-acting beta-agonist (SABA)
Rationale: SABAs like albuterol provide rapid relief of acute
bronchospasm in asthma exacerbations.
5. The hallmark of cystic fibrosis in children is:
Thick, sticky mucus production
Rationale: CF causes abnormal chloride transport, leading to thick
mucus affecting lungs and pancreas.
6. Which diagnostic test is most specific for cystic fibrosis?
Sweat chloride test
,Rationale: A sweat chloride level >60 mmol/L is diagnostic for CF in
children.
7. A child presents with sudden onset of fever, chills, and productive
cough with green sputum. The likely diagnosis is:
Bacterial pneumonia
Rationale: High fever, chills, and purulent sputum indicate bacterial
etiology rather than viral.
8. The most common bacterial cause of community-acquired
pneumonia in children over 5 years is:
Streptococcus pneumoniae
Rationale: S. pneumoniae is the leading cause of bacterial pneumonia
in school-aged children.
9. A child with asthma is using a metered-dose inhaler incorrectly.
What is the most effective teaching strategy?
Demonstrate and have the child perform return demonstration
Rationale: Hands-on demonstration ensures proper inhaler technique
and optimal drug delivery.
10. Which sign indicates severe respiratory distress in children?
Nasal flaring and intercostal retractions
Rationale: These are objective signs of increased work of breathing in
pediatric patients.
11. The preferred imaging study for suspected foreign body aspiration
in a child is:
Chest X-ray
Rationale: Chest X-ray can identify radiopaque objects and
hyperinflation; however, bronchoscopy may be needed for
diagnosis/removal.
, 12. Which is a characteristic feature of epiglottitis in children?
Drooling and tripod position
Rationale: Epiglottitis causes severe airway obstruction; children often
sit leaning forward and drooling due to difficulty swallowing.
13. The most common cause of epiglottitis in children is:
Haemophilus influenzae type b (Hib)
Rationale: Hib used to be the primary cause; incidence has decreased
significantly due to vaccination.
14. What is the primary treatment for epiglottitis?
Airway management and IV antibiotics
Rationale: Securing the airway is critical, followed by IV antibiotics
targeting Hib and other pathogens.
15. Which chronic respiratory condition in children is characterized by
reversible airway obstruction?
Asthma
Rationale: Asthma is marked by episodic wheezing, cough, and
reversible bronchoconstriction.
16. A 7-year-old with asthma presents with wheezing, cough, and
difficulty speaking. The appropriate immediate action is:
Administer nebulized albuterol and oxygen
Rationale: Severe exacerbations require rapid bronchodilation and
oxygen therapy.
17. The most reliable method to monitor long-term asthma control in
children is:
Peak expiratory flow measurement
Rationale: Peak flow monitoring helps track airway obstruction trends
over time.
