Burns Pediatric Primary Care 7th
Page | 1 Edition Test Bank – 300 Questions with
Rationales (Maaks,
2020)
1. Which developmental milestone is expected in a 9-month-old infant?
A. Rolls from back to front
B. Says “mama” and “dada” specifically
C. Walks independently
D. Uses a spoon
Answer: B. Says “mama” and “dada” specifically
Rationale: By 9 months, infants often begin using “mama” and “dada” in
reference to their parents. Rolling typically occurs by 6 months, walking begins
closer to 12 months, and utensil use around 15–18 months.
2. What is the first-line treatment for mild persistent asthma in a 7-year-old?
A. Short-acting beta agonist (SABA) PRN
B. Inhaled corticosteroid (ICS) daily
C. Oral corticosteroids
D. Montelukast alone
Answer: B. Inhaled corticosteroid (ICS) daily
Rationale: Daily ICS is the mainstay for controlling mild persistent asthma.
SABAs are used for symptom relief. Montelukast may be added but not first-line
alone.
, 3. At what age should autism-specific screening be conducted?
A. 6 months
B. 12 months
Page | 2 C. 18 and 24 months
D. 36 months
Answer: C. 18 and 24 months
Rationale: The AAP recommends autism-specific screening at 18 and 24 months
during well-child visits using tools like the M-CHAT-R/F.
4. Which physical finding is most concerning in a 3-day-old newborn?
A. Milia on the nose
B. Epstein pearls in the mouth
C. Jaundice below the chest
D. Blue hands and feet
Answer: C. Jaundice below the chest
Rationale: Jaundice progressing below the chest on day 3 may indicate rising
bilirubin levels and risk of kernicterus. Milia, Epstein pearls, and acrocyanosis are
normal findings.
5. Which vaccine is contraindicated in a child with severe egg allergy?
A. MMR
B. Varicella
C. Influenza (live attenuated)
D. Hepatitis B
Answer: C. Influenza (live attenuated)
Rationale: Live attenuated influenza vaccine (nasal spray) is contraindicated in
severe egg allergy. Inactivated flu vaccines are typically safe under observation.
, 6. What is the most appropriate test for diagnosing streptococcal pharyngitis?
A. Rapid strep test
B. Throat culture
Page | 3 C. CBC
D. Monospot test
Answer: A. Rapid strep test
Rationale: Rapid antigen detection tests are highly specific and used first-line. A
culture may follow if rapid test is negative but clinical suspicion is high.
7. Which condition is associated with a “machine-like” murmur in infants?
A. Atrial septal defect
B. Ventricular septal defect
C. Patent ductus arteriosus (PDA)
D. Coarctation of the aorta
Answer: C. Patent ductus arteriosus (PDA)
Rationale: PDA presents with a continuous "machine-like" murmur best heard at
the left infraclavicular area.
8. What anticipatory guidance should be given to parents of a 4-month-old?
A. Introduction of cow’s milk
B. Use of walkers
C. Rolling over precautions
D. Toilet training strategies
Answer: C. Rolling over precautions
Rationale: Rolling begins around 4–6 months. Cow’s milk should not be
introduced until 12 months. Walkers are discouraged due to injury risk, and toilet
training begins after 18 months.
, 9. Which lab is most appropriate for screening anemia in a 12-month-old?
A. Hemoglobin
B. Hematocrit
Page | 4 C. Ferritin
D. Reticulocyte count
Answer: A. Hemoglobin
Rationale: Universal screening with hemoglobin is recommended at 12 months to
detect iron deficiency anemia. Further testing may follow if low.
10. What is the recommended treatment for otitis media with effusion (OME)
lasting 3 months in a 2-year-old with hearing loss?
A. Observation
B. Oral antibiotics
C. Referral for tympanostomy tubes
D. Decongestants
Answer: C. Referral for tympanostomy tubes
Rationale: OME >3 months with hearing loss warrants ENT referral for evaluation
of tubes to prevent speech delay.
11. Which condition is characterized by a harsh, barking cough and inspiratory
stridor?
A. Asthma
B. Epiglottitis
C. Croup
D. Bronchiolitis
Answer: C. Croup
Rationale: Croup (laryngotracheobronchitis) presents with a barking cough and
stridor. Epiglottitis presents with drooling and toxic appearance. Asthma and
bronchiolitis do not cause barking cough.
Page | 1 Edition Test Bank – 300 Questions with
Rationales (Maaks,
2020)
1. Which developmental milestone is expected in a 9-month-old infant?
A. Rolls from back to front
B. Says “mama” and “dada” specifically
C. Walks independently
D. Uses a spoon
Answer: B. Says “mama” and “dada” specifically
Rationale: By 9 months, infants often begin using “mama” and “dada” in
reference to their parents. Rolling typically occurs by 6 months, walking begins
closer to 12 months, and utensil use around 15–18 months.
2. What is the first-line treatment for mild persistent asthma in a 7-year-old?
A. Short-acting beta agonist (SABA) PRN
B. Inhaled corticosteroid (ICS) daily
C. Oral corticosteroids
D. Montelukast alone
Answer: B. Inhaled corticosteroid (ICS) daily
Rationale: Daily ICS is the mainstay for controlling mild persistent asthma.
SABAs are used for symptom relief. Montelukast may be added but not first-line
alone.
, 3. At what age should autism-specific screening be conducted?
A. 6 months
B. 12 months
Page | 2 C. 18 and 24 months
D. 36 months
Answer: C. 18 and 24 months
Rationale: The AAP recommends autism-specific screening at 18 and 24 months
during well-child visits using tools like the M-CHAT-R/F.
4. Which physical finding is most concerning in a 3-day-old newborn?
A. Milia on the nose
B. Epstein pearls in the mouth
C. Jaundice below the chest
D. Blue hands and feet
Answer: C. Jaundice below the chest
Rationale: Jaundice progressing below the chest on day 3 may indicate rising
bilirubin levels and risk of kernicterus. Milia, Epstein pearls, and acrocyanosis are
normal findings.
5. Which vaccine is contraindicated in a child with severe egg allergy?
A. MMR
B. Varicella
C. Influenza (live attenuated)
D. Hepatitis B
Answer: C. Influenza (live attenuated)
Rationale: Live attenuated influenza vaccine (nasal spray) is contraindicated in
severe egg allergy. Inactivated flu vaccines are typically safe under observation.
, 6. What is the most appropriate test for diagnosing streptococcal pharyngitis?
A. Rapid strep test
B. Throat culture
Page | 3 C. CBC
D. Monospot test
Answer: A. Rapid strep test
Rationale: Rapid antigen detection tests are highly specific and used first-line. A
culture may follow if rapid test is negative but clinical suspicion is high.
7. Which condition is associated with a “machine-like” murmur in infants?
A. Atrial septal defect
B. Ventricular septal defect
C. Patent ductus arteriosus (PDA)
D. Coarctation of the aorta
Answer: C. Patent ductus arteriosus (PDA)
Rationale: PDA presents with a continuous "machine-like" murmur best heard at
the left infraclavicular area.
8. What anticipatory guidance should be given to parents of a 4-month-old?
A. Introduction of cow’s milk
B. Use of walkers
C. Rolling over precautions
D. Toilet training strategies
Answer: C. Rolling over precautions
Rationale: Rolling begins around 4–6 months. Cow’s milk should not be
introduced until 12 months. Walkers are discouraged due to injury risk, and toilet
training begins after 18 months.
, 9. Which lab is most appropriate for screening anemia in a 12-month-old?
A. Hemoglobin
B. Hematocrit
Page | 4 C. Ferritin
D. Reticulocyte count
Answer: A. Hemoglobin
Rationale: Universal screening with hemoglobin is recommended at 12 months to
detect iron deficiency anemia. Further testing may follow if low.
10. What is the recommended treatment for otitis media with effusion (OME)
lasting 3 months in a 2-year-old with hearing loss?
A. Observation
B. Oral antibiotics
C. Referral for tympanostomy tubes
D. Decongestants
Answer: C. Referral for tympanostomy tubes
Rationale: OME >3 months with hearing loss warrants ENT referral for evaluation
of tubes to prevent speech delay.
11. Which condition is characterized by a harsh, barking cough and inspiratory
stridor?
A. Asthma
B. Epiglottitis
C. Croup
D. Bronchiolitis
Answer: C. Croup
Rationale: Croup (laryngotracheobronchitis) presents with a barking cough and
stridor. Epiglottitis presents with drooling and toxic appearance. Asthma and
bronchiolitis do not cause barking cough.
