Aquifer Peds EXAM QUESTIONS WITH COMPLETE
SOLUTION GUIDE (A+ GRADED 100% VERIFIED)
LATEST VERSION 2025!!
What is your assessment of Tyler's feeding? Choose the single best answer. - The feeding
history suggests a problem with Tyler's ability to feed adequately.
What would you tell the mother now, in answer to her question? Choose the single best answer.
- I am concerned that Tyler's feedings do not seem to be going well. Can I ask you a few
more questions about Tyler to help us find out if there is a problem?
Based on the history, it sounds as if Tyler is having some real difficulties with his feeds. Which of
the following might be causing Tyler's difficulty feeding, respiratory distress, and diaphoresis?
Select all that apply. - CHD/CHF, respiratory infection, sepsis, metabolic disorder
Which of his vital signs is abnormal? Choose the single best answer. - RR
What do you hear in the audio of Tyler's heart sounds? Choose the single best answer. -
Holosystolic murmur
Based on what you know about the patient so far, write a one- to three-sentence summary
statement to communicate your understanding of the patient to other providers. - Tyler is a
6-week-old former term infant who has recent onset of progressive dyspnea with feedings,
diaphoresis, and poor weight gain (having only gained 300 grams from his birth weight). He is
acyanotic with a normal temperature, but exam reveals tachypnea, an active precordium, Grade
III holosystolic murmur, and hepatomegaly.
,With your summary statement in mind, what etiologies now remain in your differential
diagnosis? - CHF
What is the most common cause of a murmur in childhood? Choose the single best answer -
Innocent murmur
What congenital heart defects are more likely to be detected in school-age children than in
neonates? Select all that apply. - ASD, bicuspid aortic valve
Which of these sounds most like Tyler's murmur? Choose the single best answer. - VSD
What other common congenital heart defects can present with signs of congestive heart failure
and a murmur? Select all that apply. - Aortic stenosis, Coarctation of Aorta, PDA
Which of these diagnostic tests should you order to help you assess Tyler's clinical status? Select
all that apply. - ECG, Echo, CXR
This is the chest x-ray you ordered on Tyler. What do you think this film shows? Choose the
single best answer. - Increased heart size, increased pulmonary vascular markings
While Tyler was in the newborn nursery, his parents were told that the initial exam was normal,
with no murmur noted. They ask why the murmur was not noted in the nursery. - There is
elevated pulmonary vascular resistance in a newborn
What medications might be effective at improving Tyler's symptoms of heart failure? -
Furosemide, digoxin, elanapril
,A 5-week-old infant is brought to the pediatrician for failure to thrive with a history of prolonged
feeding time and tachypnea. What other features does this infant most likely have? -
Hyperdynamic precordium with holosystolic murmur
You have accepted a part-time tutoring job for first-year medical students. One of your students
asks if you would please clarify the details of normal fetal circulation. Which of the following
best describes the path oxygenated blood takes to reach the fetal brain? - RA > foramen
ovale > LA > LV > systemic circulation
A 5-year-old boy is noted to have a grade II systolic murmur and a widely split S2 murmur on
cardiac exam. His vital signs are stable and he has been asymptomatic. Which of the following
statement is accurate regarding this child's presentation and likely condition? - This patient's
murmur is caused by excessive flow through the pulmonary outflow tract and should be
evaluated
A 6-week-old infant presents to your office for a check-up. The baby was born full-term by NSVD
to a 29-year-old G1P0 mother with no complications. Mother states the baby was feeding well
until a week ago, when he developed increased sleepiness, prolonged feeding, and greater
duration between feeds. His mother notes he stops to take breaks during feeds because he
seems to be trying to catch his breath. He has four to six wet diapers per day and stools three or
four times per day. Vital signs: Te - ASD
After reviewing the chart, what are some of the important details that you already know about
Sunita? - Chronic cough, Sunita's age, new to the practice and presently on no meds,
appropriate growth parameters, normal vitals
Based on what you know about Sunita, what other elements in the history would you like to
specifically ask about? - History of eczema, nasal congestion, palpitations, presence of fever,
vomiting
, Based on what you know about the patient so far, write a one- to three-sentence summary
statement to communicate your understanding of the patient to other providers. - Sunita is a
6-year-old girl with chronic nasal congestion and a history of eczema who presents with a
chronic cough that is often worse at night, with exercise, and with exposure to cold air. She has
no fever, shortness of breath, or history of wheezing, but has a family history of asthma.
Now that you have completed Sunita's physical exam, you consider what information you will
present to Dr. Law. Based on Sunita's history and physical findings, what do you think are the
most likely diagnoses? Select all that apply. - Asthma, allergies
Which of the following tests would be most useful in establishing a diagnosis of asthma for
Sunita? Choose the single best answer. - Spirometry
Based on your reading about asthma and thinking about the history and exam findings from
your time with Sunita, how would you classify her asthma? - Moderate persistent
Based on your classification, which of the following medications could be used in treatment? -
All of the above
A 4-year-old male who lived internatinally presents with his mother to your general pediatrics
clinic. His mother reports that he has a chronic nonproductive cough during the day and night,
mild wheezing for one month and failure to gain weight (his weight has dropped from the 50th
to the 10th percentile for his age). He does not have high fevers, rhinorrhea, congestion or night
sweats. Which of the following are the next best diagnostic tests? - Chest X-ray and
tuberculin skin test
An 11-year old boy presents to the clinic with wheezing. His mother states that in the past he
has used inhaled albuterol and it has helped with wheezing and shortness of breath. His mother
also reports that the patient experiences shortness of breath three times a week and is
awakened at night by these symptoms once a week. What is the most appropriate outpatient
SOLUTION GUIDE (A+ GRADED 100% VERIFIED)
LATEST VERSION 2025!!
What is your assessment of Tyler's feeding? Choose the single best answer. - The feeding
history suggests a problem with Tyler's ability to feed adequately.
What would you tell the mother now, in answer to her question? Choose the single best answer.
- I am concerned that Tyler's feedings do not seem to be going well. Can I ask you a few
more questions about Tyler to help us find out if there is a problem?
Based on the history, it sounds as if Tyler is having some real difficulties with his feeds. Which of
the following might be causing Tyler's difficulty feeding, respiratory distress, and diaphoresis?
Select all that apply. - CHD/CHF, respiratory infection, sepsis, metabolic disorder
Which of his vital signs is abnormal? Choose the single best answer. - RR
What do you hear in the audio of Tyler's heart sounds? Choose the single best answer. -
Holosystolic murmur
Based on what you know about the patient so far, write a one- to three-sentence summary
statement to communicate your understanding of the patient to other providers. - Tyler is a
6-week-old former term infant who has recent onset of progressive dyspnea with feedings,
diaphoresis, and poor weight gain (having only gained 300 grams from his birth weight). He is
acyanotic with a normal temperature, but exam reveals tachypnea, an active precordium, Grade
III holosystolic murmur, and hepatomegaly.
,With your summary statement in mind, what etiologies now remain in your differential
diagnosis? - CHF
What is the most common cause of a murmur in childhood? Choose the single best answer -
Innocent murmur
What congenital heart defects are more likely to be detected in school-age children than in
neonates? Select all that apply. - ASD, bicuspid aortic valve
Which of these sounds most like Tyler's murmur? Choose the single best answer. - VSD
What other common congenital heart defects can present with signs of congestive heart failure
and a murmur? Select all that apply. - Aortic stenosis, Coarctation of Aorta, PDA
Which of these diagnostic tests should you order to help you assess Tyler's clinical status? Select
all that apply. - ECG, Echo, CXR
This is the chest x-ray you ordered on Tyler. What do you think this film shows? Choose the
single best answer. - Increased heart size, increased pulmonary vascular markings
While Tyler was in the newborn nursery, his parents were told that the initial exam was normal,
with no murmur noted. They ask why the murmur was not noted in the nursery. - There is
elevated pulmonary vascular resistance in a newborn
What medications might be effective at improving Tyler's symptoms of heart failure? -
Furosemide, digoxin, elanapril
,A 5-week-old infant is brought to the pediatrician for failure to thrive with a history of prolonged
feeding time and tachypnea. What other features does this infant most likely have? -
Hyperdynamic precordium with holosystolic murmur
You have accepted a part-time tutoring job for first-year medical students. One of your students
asks if you would please clarify the details of normal fetal circulation. Which of the following
best describes the path oxygenated blood takes to reach the fetal brain? - RA > foramen
ovale > LA > LV > systemic circulation
A 5-year-old boy is noted to have a grade II systolic murmur and a widely split S2 murmur on
cardiac exam. His vital signs are stable and he has been asymptomatic. Which of the following
statement is accurate regarding this child's presentation and likely condition? - This patient's
murmur is caused by excessive flow through the pulmonary outflow tract and should be
evaluated
A 6-week-old infant presents to your office for a check-up. The baby was born full-term by NSVD
to a 29-year-old G1P0 mother with no complications. Mother states the baby was feeding well
until a week ago, when he developed increased sleepiness, prolonged feeding, and greater
duration between feeds. His mother notes he stops to take breaks during feeds because he
seems to be trying to catch his breath. He has four to six wet diapers per day and stools three or
four times per day. Vital signs: Te - ASD
After reviewing the chart, what are some of the important details that you already know about
Sunita? - Chronic cough, Sunita's age, new to the practice and presently on no meds,
appropriate growth parameters, normal vitals
Based on what you know about Sunita, what other elements in the history would you like to
specifically ask about? - History of eczema, nasal congestion, palpitations, presence of fever,
vomiting
, Based on what you know about the patient so far, write a one- to three-sentence summary
statement to communicate your understanding of the patient to other providers. - Sunita is a
6-year-old girl with chronic nasal congestion and a history of eczema who presents with a
chronic cough that is often worse at night, with exercise, and with exposure to cold air. She has
no fever, shortness of breath, or history of wheezing, but has a family history of asthma.
Now that you have completed Sunita's physical exam, you consider what information you will
present to Dr. Law. Based on Sunita's history and physical findings, what do you think are the
most likely diagnoses? Select all that apply. - Asthma, allergies
Which of the following tests would be most useful in establishing a diagnosis of asthma for
Sunita? Choose the single best answer. - Spirometry
Based on your reading about asthma and thinking about the history and exam findings from
your time with Sunita, how would you classify her asthma? - Moderate persistent
Based on your classification, which of the following medications could be used in treatment? -
All of the above
A 4-year-old male who lived internatinally presents with his mother to your general pediatrics
clinic. His mother reports that he has a chronic nonproductive cough during the day and night,
mild wheezing for one month and failure to gain weight (his weight has dropped from the 50th
to the 10th percentile for his age). He does not have high fevers, rhinorrhea, congestion or night
sweats. Which of the following are the next best diagnostic tests? - Chest X-ray and
tuberculin skin test
An 11-year old boy presents to the clinic with wheezing. His mother states that in the past he
has used inhaled albuterol and it has helped with wheezing and shortness of breath. His mother
also reports that the patient experiences shortness of breath three times a week and is
awakened at night by these symptoms once a week. What is the most appropriate outpatient
