NSG 5442 Pediatric Primary Care Exam 2 (PDF) | 2026 | South College Pediatrics

NSG 5442 Pediatric Primary Care Exam 2
(PDF) | 2026 | South College Pediatrics

NSG 5442 Pediatric Primary Care Exam 2
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1. A 4-year-old child is brought to the clinic for a well-
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child visit. The parent expresses concern that the child is not yet able to tie their shoes. W
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hich of the following is the most appropriate response from the nurse practitioner?
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• A) Refer the child for a fine motor skills assessment.
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• B) Reassure the parent that this is a typical 5-
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6 year old milestone and provide anticipatory guidance.
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• C) Recommend an occupational therapy consultation.
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• D) Instruct the parent to practice lacing cards with the child daily.
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2. Which of the following findings in a 2-month-
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old infant's history and physical exam would be of most concern and warrant further inves
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tigation?

• A) Poor head control when pulled to sit.
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• B) Failure to respond to loud noises.
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• C) Social smile.
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• D) Fisting of hands.
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3. You are performing a developmental assessment on a 15-month-
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old toddler. According to the Denver II, which of the following fine motor milestones shou
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ld this child have likely achieved?
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• A) Build a tower of 4 cubes.
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• B) Scribble spontaneously.
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• C) Pincer grasp.
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• D) Turn pages of a book, two or three at a time.
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4. During a well-child visit, a 7-year-
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old child tells the nurse practitioner, "I'm not a kid anymore; I can do things myself." The
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parent reports the child frequently argues and questions rules. This behavior is most consi
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stent with which of Erickson's psychosocial stages?
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, • A) Autonomy vs. Shame and Doubt
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• B) Initiative vs. Guilt
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• C) Industry vs. Inferiority
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• D) Identity vs. Role Confusion
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5. A 16-year-
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old female is at the clinic for a sports physical. What is the single most effective strategy t
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o screen for depression in this adolescent?
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• A) Ask the parent if the adolescent has seemed sad or withdrawn.
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• B) Administer the Beck Depression Inventory.
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• C) Ask the adolescent about changes in sleep, appetite, and mood.
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• D) Use a standardized screening tool like the PHQ-9.
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6. The parents of a 6-month-
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old infant ask about introducing solid foods. Which of the following is the most appropria
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te initial recommendation?
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• A) Introduce honey to help with sleep.
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• B) Start with iron-fortified, single-grain cereal mixed with breastmilk or formula.
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• C) Begin with pureed meats, such as chicken or beef.
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• D) Introduce fruits as the first food because they are easily digested.
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7. A mother calls the clinic concerned about her 9-month-
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old son, who has been pulling on his left ear for the past 24 hours. He has been fussy and
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has had a low-
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grade fever (100.4°F) for 2 days. The mother states he has had clear rhinorrhea. What is th
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e most likely diagnosis?
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• A) Acute Otitis Media (AOM)
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• B) Otitis Media with Effusion (OME)
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• C) Teething pain
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• D) Foreign body in the ear canal
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8. In a young infant with Acute Otitis Media (AOM), which of the following is the most im
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portant physical exam finding that confirms the diagnosis?
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, • A) Erythema of the tympanic membrane.
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• B) Decreased mobility of the tympanic membrane on pneumatic otoscopy.
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• C) A dull, retracted tympanic membrane.
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• D) Cerumen impaction obstructing the view.
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9. A 2-year-old is brought in with a 2-
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day history of high fever (up to 104°F), clear rhinorrhea, and conjunctivitis. On day 3 of th
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e fever, the child develops a maculopapular rash that starts on the face and spreads down
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ward. The rash blanches with pressure. This presentation is most consistent with:
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• A) Rubellafd




• B) Measles (Rubeola)
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• C) Roseola Infantum
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• D) Scarlet Fever
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10. Which of the following immunizations is contraindicated in a child with a known anap
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hylactic allergy to gelatin?fd fd fd




• A) DTaP fd




• B) Varicella (chickenpox) vaccine
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• C) Inactivated Polio Vaccine (IPV)
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• D) Hepatitis B vaccine
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11. A 5-year-
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old child is diagnosed with strep pharyngitis. Which of the following is the most appropria
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te duration of therapy for amoxicillin in this patient?
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• A) 5 days fd fd




• B) 7 days fd fd




• C) 10 daysfd fd




• D) 14 days fd fd




12. The nurse practitioner is prescribing amoxicillin for a 4-year-
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old with acute otitis media. Which of the following is the most appropriate dose range for
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amoxicillin in a child with non-severe AOM? fd fd fd fd fd fd




• A) 30 mg/kg/day divided BID
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, • B) 45-50 mg/kg/day divided BID
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• C) 80-90 mg/kg/day divided BID
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• D) 100-120 mg/kg/day divided TID
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13. Which of the following is the most common cause of bronchiolitis in infants and youn
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g children?
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• A) Influenza virus
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• B) Adenovirus
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• C) Respiratory Syncytial Virus (RSV)
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• D) Parainfluenza virus
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14. An 8-month-old infant presents with acute onset of wheezing, tachypnea, and a "seal-
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like" barky cough that is worse at night. The infant is afebrile and drooling is absent. Whic
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h of the following is the most likely diagnosis?
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• A) Epiglottitis
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• B) Bronchiolitis
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• C) Croup (Laryngotracheobronchitis)
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• D) Foreign body aspiration
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15. A 3-year-
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old child presents with a cough and stridor. Which of the following is a red flag and would
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be concerning for a more serious, life-
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threatening condition like bacterial tracheitis or epiglottitis?
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• A) Barky cough
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• B) Fever
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• C) Drooling and tripod position
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• D) Symptoms worsening at night
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16. A 10-year-
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old male with a history of recurrent respiratory infections presents with a chronic cough, p
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roductive of thick, mucoid sputum, and frequent sinopulmonary infections. He was diagn
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osed with Cystic Fibrosis as an infant. Which of the following is the most common cause of
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death in patients with Cystic Fibrosis?
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