NGR6001
Pediatrics
LATEST EXAM
2026
,1. Which of the following is a key component of the pediatric primary care model?
a) Providing comprehensive and coordinated care for children and their families
b) Focusing on acute and episodic care for children with common illnesses
c) Referring children to specialists for most of their health needs
d) Limiting preventive and developmental services to well-child visits
Answer: A. The pediatric primary care model emphasizes providing comprehensive and
coordinated care for children and their families, including preventive, acute, chronic,
and developmental services.
2. A 4-year-old child presents to the clinic with a fever of 38.5°C, sore throat, and
enlarged cervical lymph nodes. The nurse practitioner suspects streptococcal
pharyngitis and orders a rapid antigen detection test (RADT). The test result is
negative. What is the most appropriate next step for the nurse practitioner?
a) Prescribe antibiotics empirically based on the clinical presentation
b) Order a throat culture to confirm the diagnosis
c) Reassure the parents that the child has a viral infection and provide symptomatic
treatment
d) Repeat the RADT in 24 hours to rule out a false negative result
Answer: B. A throat culture is the gold standard for diagnosing streptococcal pharyngitis
and should be performed when the RADT result is negative and the clinical suspicion is
high.
3. A 12-year-old child with type 1 diabetes mellitus comes to the clinic for a routine
follow-up visit. The nurse practitioner reviews the child's blood glucose logs and notes
that the child has frequent episodes of hypoglycemia, especially before lunch and after
physical activity. The nurse practitioner also notes that the child's hemoglobin A1c level
is 9.5%, indicating poor glycemic control. What is the most likely explanation for this
paradoxical finding?
a) The child is experiencing the Somogyi effect, a rebound hyperglycemia caused by
excessive insulin dosage or action
b) The child is experiencing the dawn phenomenon, an early morning rise in blood
glucose due to increased growth hormone secretion
c) The child is experiencing diabetic ketoacidosis, a life-threatening complication of
insulin deficiency
d) The child is experiencing insulin resistance, a reduced response of peripheral tissues
to insulin action
Answer: A. The Somogyi effect is a phenomenon in which excessive insulin dosage or
action leads to hypoglycemia, which triggers counter-regulatory hormones such as
glucagon, cortisol, and epinephrine to raise blood glucose levels, resulting in rebound
hyperglycemia. This can mask poor glycemic control and cause wide fluctuations in
blood glucose levels.
4. A 6-month-old infant is brought to the clinic for a well-child visit. The nurse
practitioner assesses the infant's growth and development using standardized charts
and tools. Which of the following developmental milestones would be expected for an
infant of this age?
a) Sitting without support, babbling, transferring objects from one hand to another
b) Rolling over, cooing, grasping objects with the whole hand
c) Crawling, saying "mama" and "dada", picking up small objects with thumb and index
, finger
d) Pulling up to stand, waving bye-bye, pointing to objects of interest
Answer: A. Sitting without support, babbling, and transferring objects from one hand to
another are typical developmental milestones for a 6-month-old infant.
5. A 10-year-old child with asthma comes to the clinic for an asthma action plan review.
The nurse practitioner asks the child about his asthma symptoms, medication use, and
peak expiratory flow (PEF) readings over the past month. The child reports having
asthma symptoms more than twice a week, but not daily; using his short-acting beta-
agonist (SABA) inhaler more than twice a week, but not daily; and having a PEF of 80%
of his personal best on most days. According to the National Asthma Education and
Prevention Program (NAEPP) guidelines, what is the child's current level of asthma
control?
a) Well controlled
b) Not well controlled
c) Very poorly controlled
d) Intermittent
Answer: B. The NAEPP guidelines classify asthma control into three levels: well
controlled, not well controlled, and very poorly controlled. A child with not well
controlled asthma has symptoms more than twice a week, but not daily; uses SABA
more than twice a week, but not daily; has any limitation in normal activity; has a PEF
of 60-80% of personal best; or has one or more nighttime awakenings per month.
6. A 15-year-old adolescent girl comes to the clinic for a sports physical examination.
The nurse practitioner performs a comprehensive history and physical examination,
including a sexual and reproductive health assessment. The adolescent girl reports that
she is sexually active with one male partner and that they use condoms inconsistently.
She denies any history of sexually transmitted infections (STIs) or pregnancy. She also
states that she has regular menstrual cycles of 28 days, with her last menstrual period
starting 10 days ago. What is the most appropriate contraceptive method for this
adolescent girl?
a) Combined oral contraceptive pills (COCs)
b) Progestin-only pills (POPs)
c) Depot medroxyprogesterone acetate (DMPA) injection
d) Levonorgestrel-releasing intrauterine device (LNG-IUD)
Answer: D. The LNG-IUD is a long-acting reversible contraceptive (LARC) method that
is highly effective, safe, and convenient for adolescents. It has a failure rate of less than
1% and can prevent pregnancy for up to 5 years. It also has non-contraceptive benefits,
such as reducing menstrual bleeding and dysmenorrhea. The LNG-IUD does not
protect against STIs, so condom use is still recommended.
7. A 2-year-old toddler is brought to the clinic for a routine immunization visit. The nurse
practitioner reviews the toddler's immunization record and notes that the toddler has
received the following vaccines: three doses of DTaP, three doses of IPV, three doses
of Hib, three doses of PCV13, two doses of HepB, two doses of RV, one dose of MMR,
and one dose of Var. Which of the following vaccines should the nurse practitioner
administer to the toddler at this visit?
a) DTaP, IPV, Hib, PCV13, HepA
b) DTaP, IPV, Hib, PCV13, HepB
DTaP, IPV, MMR, Var, HepA
DTaP, IPV, MMR, Var, HepB
Pediatrics
LATEST EXAM
2026
,1. Which of the following is a key component of the pediatric primary care model?
a) Providing comprehensive and coordinated care for children and their families
b) Focusing on acute and episodic care for children with common illnesses
c) Referring children to specialists for most of their health needs
d) Limiting preventive and developmental services to well-child visits
Answer: A. The pediatric primary care model emphasizes providing comprehensive and
coordinated care for children and their families, including preventive, acute, chronic,
and developmental services.
2. A 4-year-old child presents to the clinic with a fever of 38.5°C, sore throat, and
enlarged cervical lymph nodes. The nurse practitioner suspects streptococcal
pharyngitis and orders a rapid antigen detection test (RADT). The test result is
negative. What is the most appropriate next step for the nurse practitioner?
a) Prescribe antibiotics empirically based on the clinical presentation
b) Order a throat culture to confirm the diagnosis
c) Reassure the parents that the child has a viral infection and provide symptomatic
treatment
d) Repeat the RADT in 24 hours to rule out a false negative result
Answer: B. A throat culture is the gold standard for diagnosing streptococcal pharyngitis
and should be performed when the RADT result is negative and the clinical suspicion is
high.
3. A 12-year-old child with type 1 diabetes mellitus comes to the clinic for a routine
follow-up visit. The nurse practitioner reviews the child's blood glucose logs and notes
that the child has frequent episodes of hypoglycemia, especially before lunch and after
physical activity. The nurse practitioner also notes that the child's hemoglobin A1c level
is 9.5%, indicating poor glycemic control. What is the most likely explanation for this
paradoxical finding?
a) The child is experiencing the Somogyi effect, a rebound hyperglycemia caused by
excessive insulin dosage or action
b) The child is experiencing the dawn phenomenon, an early morning rise in blood
glucose due to increased growth hormone secretion
c) The child is experiencing diabetic ketoacidosis, a life-threatening complication of
insulin deficiency
d) The child is experiencing insulin resistance, a reduced response of peripheral tissues
to insulin action
Answer: A. The Somogyi effect is a phenomenon in which excessive insulin dosage or
action leads to hypoglycemia, which triggers counter-regulatory hormones such as
glucagon, cortisol, and epinephrine to raise blood glucose levels, resulting in rebound
hyperglycemia. This can mask poor glycemic control and cause wide fluctuations in
blood glucose levels.
4. A 6-month-old infant is brought to the clinic for a well-child visit. The nurse
practitioner assesses the infant's growth and development using standardized charts
and tools. Which of the following developmental milestones would be expected for an
infant of this age?
a) Sitting without support, babbling, transferring objects from one hand to another
b) Rolling over, cooing, grasping objects with the whole hand
c) Crawling, saying "mama" and "dada", picking up small objects with thumb and index
, finger
d) Pulling up to stand, waving bye-bye, pointing to objects of interest
Answer: A. Sitting without support, babbling, and transferring objects from one hand to
another are typical developmental milestones for a 6-month-old infant.
5. A 10-year-old child with asthma comes to the clinic for an asthma action plan review.
The nurse practitioner asks the child about his asthma symptoms, medication use, and
peak expiratory flow (PEF) readings over the past month. The child reports having
asthma symptoms more than twice a week, but not daily; using his short-acting beta-
agonist (SABA) inhaler more than twice a week, but not daily; and having a PEF of 80%
of his personal best on most days. According to the National Asthma Education and
Prevention Program (NAEPP) guidelines, what is the child's current level of asthma
control?
a) Well controlled
b) Not well controlled
c) Very poorly controlled
d) Intermittent
Answer: B. The NAEPP guidelines classify asthma control into three levels: well
controlled, not well controlled, and very poorly controlled. A child with not well
controlled asthma has symptoms more than twice a week, but not daily; uses SABA
more than twice a week, but not daily; has any limitation in normal activity; has a PEF
of 60-80% of personal best; or has one or more nighttime awakenings per month.
6. A 15-year-old adolescent girl comes to the clinic for a sports physical examination.
The nurse practitioner performs a comprehensive history and physical examination,
including a sexual and reproductive health assessment. The adolescent girl reports that
she is sexually active with one male partner and that they use condoms inconsistently.
She denies any history of sexually transmitted infections (STIs) or pregnancy. She also
states that she has regular menstrual cycles of 28 days, with her last menstrual period
starting 10 days ago. What is the most appropriate contraceptive method for this
adolescent girl?
a) Combined oral contraceptive pills (COCs)
b) Progestin-only pills (POPs)
c) Depot medroxyprogesterone acetate (DMPA) injection
d) Levonorgestrel-releasing intrauterine device (LNG-IUD)
Answer: D. The LNG-IUD is a long-acting reversible contraceptive (LARC) method that
is highly effective, safe, and convenient for adolescents. It has a failure rate of less than
1% and can prevent pregnancy for up to 5 years. It also has non-contraceptive benefits,
such as reducing menstrual bleeding and dysmenorrhea. The LNG-IUD does not
protect against STIs, so condom use is still recommended.
7. A 2-year-old toddler is brought to the clinic for a routine immunization visit. The nurse
practitioner reviews the toddler's immunization record and notes that the toddler has
received the following vaccines: three doses of DTaP, three doses of IPV, three doses
of Hib, three doses of PCV13, two doses of HepB, two doses of RV, one dose of MMR,
and one dose of Var. Which of the following vaccines should the nurse practitioner
administer to the toddler at this visit?
a) DTaP, IPV, Hib, PCV13, HepA
b) DTaP, IPV, Hib, PCV13, HepB
DTaP, IPV, MMR, Var, HepA
DTaP, IPV, MMR, Var, HepB
