PNCB Examination updated

You are seeing a 4-week old infant whose mother states that the child's right eye is wet all the time and sometime there is thick mucus on the lashes.There has been no fever and the baby is feed￾ing well. Eye exam reveals a normal red reflex bilaterally with no evidence of pu￾rulent drainage, conjunctival erythema, or cloudiness over the cornea. You sus- pect: a) adenovirus conjunctivits b) nasolacrimal stenosis c) chlamydial conjunctivitis d) congenital cataract A 9-month-old infant who was born at 32-weeks reaches for a block with only the left hand. The right arm remains still at the side of her body. The PNP would: a) record these findings as normal for a premature infant b) refer the infant for further evaluation c) refer the child for a muscle biopsy d) record that the child will likely be left-handed During a 2-month-old well child visit you note that the red reflex in one eye seems paler than in the other. What is the most appropriate follow-up step for this obser- vation? a) assess and document a normal corneal light reflex in that eye b) preform the cover/uncover test c) re-evaluate the red re-screening test in 2 weeks d) refer the infant to a pediatric ophthal- mologist immediately Primary dentition erupts between: a) 6-11 years b) nasolacrimal duct stenosis b) refer the infant for further evaluation d) refer the infant to a pediatric ophthal- mologist immediately PNCB Examination 2 / 43 b) 6-30 months c) 1-5 years d) 12-24 months The parent of a 4-year-old points to a picture and says "That's your sister!". The child responds by saying "No! It's my baby!". This is an example of which type of thinking in preschool-age children? a) animism b) artificialism c) egocentrism d) realism The primary care PNP performs a developmental assessment on a 32-month-old child. The child's parent reports that about 70% of the child's speech is intelligible.The pediatric nurse practitioner observes that the child has difficulty pronouncing "t" "d" "k" and "g". Which action is correct? a) evaluate the child's cognitive abilities b) obtain a hearing evaluation c) reassure the parent that this is normal d) refer the child to a speech therapist The primary care PNP is offering anticipatory guidance to the parents of a 12-month-old child.The parents are bilin- gual in Spanish and English and have many Spanish-speaking relatives near- by. They are resisting exposing the child to Spanish out of concern that the child will not learn English well. What will the PNP tell the parents? a) children who learn two languages si- multaneously often confuse them in con- versation b) children with multi-language proficien- cy do not understand that others cannot b) 6-30 months d) realism c) reassure the parent that this is normal d) most bilingual children are able to shift from one language to another when ap- propriate