ABFM + KSA Care of Children Exam |
Questions & Answers | Grade A+ | 100%
Correct | Verified Answers and Rationale
| Latest 2025/2026 Guide
The mother of a 4-year-old male brings him to your office for a
well child visit. She had an uncomplicated pregnancy and
delivery, and his newborn, infant, and early childhood growth and
development have been progressing normally without significant
illness. Both parents were diagnosed with hypertension as adults.
Which one of the following statements is true regarding current
American Academy of Pediatrics guidelines for screening for
hypertension in children younger than age 13?
A. The incidence of hypertension in children has been stable over
the past 30 years
B. Screening for elevated blood pressure should begin annually at
3 years of age in healthy children and at every visit in children
with risk factors
C. Children with hypertension are less likely to have secondary
hypertension than adults with hypertension
D. Blood pressure should be measured in the left arm only
,-CORRECT ANSWER-B
Hypertension in children is increasing in prevalence as overweight
and obesity increase. Along with this trend, primary hypertension
is now the most common cause of elevated blood pressure in
children, although a child with high blood pressure is significantly
more likely than an adult to have secondary hypertension.
The U.S. Preventive Services Task Force and the American
Academy of Family Physicians have cited insufficient evidence to
recommend screening for high blood pressure in average-risk
children. In 2017, the American Academy of Pediatrics (AAP)
published new clinical practice guidelines, based on expert
opinion, which recommended annual screening for elevated blood
pressure starting at 3 years of age in healthy children and at
every visit in children with risk factors (e.g., obesity, known kidney
disease, aortic arch obstruction, coarctation of the aorta, or
diabetes mellitus). The AAP guidelines rely on suggested
screening thresholds and percentile-based diagnostic tables for
children under the age of 13. These guidelines also update the
2004 National Heart, Lung, and Blood Institute's Fourth Report on
the Diagnosis, Evaluation, and Treatment of High Blood Pressure
in Children and Adolescents by replacing the term
"prehypertension" with "elevated blood pressure," utilizing new
,pediatric blood pressure tables based on children with a normal
weight, providing a screening table for identifying blood pressures
that need further evaluation, simplifying the classification of blood
pressures in adolescents to align with adult blood pressure
guidelines, and streamlining recommendations for the initial
evaluation and management of abnormal blood pressures. The
AAP updated categories of normal and elevated blood pressures
for children ages 1 to 12 are shown with corresponding stages
below:
Normal blood pres
A healthy 5-year-old male is brought to your office by his mother
for a well child visit. His birth history and past medical history
reveal no concerns and his immunizations are up to date. The
mother has no specific concerns.For patients such as this, the
U.S. Preventive Services Task Force recommends routine
screening for
A. hypertension
B. proteinuria
C. scoliosis
D. vision problems
, -CORRECT ANSWER-D
Although there is no direct evidence demonstrating that vision
screening in children leads to an improvement in ultimate visual
acuity, various screening tests are known to be effective in
detecting common childhood visual problems. Addressing these
problems does improve vision. Therefore, the U.S. Preventive
Services Task Force (USPSTF) recommends that screening be
offered at least once in all children 3-5 years of age to detect
amblyopia, strabismus, and defects in visual acuity (B
recommendation). Age-appropriate screening tools, such as the
Snellen, Lea Symbols, and HOTV charts, may be used in children
older than 3 years of age. Additional tests that can be considered
in the primary care office include the red reflex test, the cover-
uncover test for strabismus, and the corneal light reflex test. While
the USPSTF recommendations do not address screening beyond
age 5, the American Academy of Pediatrics recommends starting
vision screening around age 3 and annual screening at well child
visits at ages 4, 5, and 6. Subsequent screenings are suggested
for children and adolescents at ages 8, 10, 12, and 15.
In 2020, the USPSTF updated its 2013 recommendation for blood
pressure screening of children and adolescents 3-18 years of age
who are asymptomatic and not known to have hypertension. They
Questions & Answers | Grade A+ | 100%
Correct | Verified Answers and Rationale
| Latest 2025/2026 Guide
The mother of a 4-year-old male brings him to your office for a
well child visit. She had an uncomplicated pregnancy and
delivery, and his newborn, infant, and early childhood growth and
development have been progressing normally without significant
illness. Both parents were diagnosed with hypertension as adults.
Which one of the following statements is true regarding current
American Academy of Pediatrics guidelines for screening for
hypertension in children younger than age 13?
A. The incidence of hypertension in children has been stable over
the past 30 years
B. Screening for elevated blood pressure should begin annually at
3 years of age in healthy children and at every visit in children
with risk factors
C. Children with hypertension are less likely to have secondary
hypertension than adults with hypertension
D. Blood pressure should be measured in the left arm only
,-CORRECT ANSWER-B
Hypertension in children is increasing in prevalence as overweight
and obesity increase. Along with this trend, primary hypertension
is now the most common cause of elevated blood pressure in
children, although a child with high blood pressure is significantly
more likely than an adult to have secondary hypertension.
The U.S. Preventive Services Task Force and the American
Academy of Family Physicians have cited insufficient evidence to
recommend screening for high blood pressure in average-risk
children. In 2017, the American Academy of Pediatrics (AAP)
published new clinical practice guidelines, based on expert
opinion, which recommended annual screening for elevated blood
pressure starting at 3 years of age in healthy children and at
every visit in children with risk factors (e.g., obesity, known kidney
disease, aortic arch obstruction, coarctation of the aorta, or
diabetes mellitus). The AAP guidelines rely on suggested
screening thresholds and percentile-based diagnostic tables for
children under the age of 13. These guidelines also update the
2004 National Heart, Lung, and Blood Institute's Fourth Report on
the Diagnosis, Evaluation, and Treatment of High Blood Pressure
in Children and Adolescents by replacing the term
"prehypertension" with "elevated blood pressure," utilizing new
,pediatric blood pressure tables based on children with a normal
weight, providing a screening table for identifying blood pressures
that need further evaluation, simplifying the classification of blood
pressures in adolescents to align with adult blood pressure
guidelines, and streamlining recommendations for the initial
evaluation and management of abnormal blood pressures. The
AAP updated categories of normal and elevated blood pressures
for children ages 1 to 12 are shown with corresponding stages
below:
Normal blood pres
A healthy 5-year-old male is brought to your office by his mother
for a well child visit. His birth history and past medical history
reveal no concerns and his immunizations are up to date. The
mother has no specific concerns.For patients such as this, the
U.S. Preventive Services Task Force recommends routine
screening for
A. hypertension
B. proteinuria
C. scoliosis
D. vision problems
, -CORRECT ANSWER-D
Although there is no direct evidence demonstrating that vision
screening in children leads to an improvement in ultimate visual
acuity, various screening tests are known to be effective in
detecting common childhood visual problems. Addressing these
problems does improve vision. Therefore, the U.S. Preventive
Services Task Force (USPSTF) recommends that screening be
offered at least once in all children 3-5 years of age to detect
amblyopia, strabismus, and defects in visual acuity (B
recommendation). Age-appropriate screening tools, such as the
Snellen, Lea Symbols, and HOTV charts, may be used in children
older than 3 years of age. Additional tests that can be considered
in the primary care office include the red reflex test, the cover-
uncover test for strabismus, and the corneal light reflex test. While
the USPSTF recommendations do not address screening beyond
age 5, the American Academy of Pediatrics recommends starting
vision screening around age 3 and annual screening at well child
visits at ages 4, 5, and 6. Subsequent screenings are suggested
for children and adolescents at ages 8, 10, 12, and 15.
In 2020, the USPSTF updated its 2013 recommendation for blood
pressure screening of children and adolescents 3-18 years of age
who are asymptomatic and not known to have hypertension. They
