Sample Questions and Answers
Which of the following is the most critical aspect of developing a pediatric care plan for a child with asthma?
A) Focusing on environmental control
B) Providing detailed family education
C) Prescribing medication immediately
D) Scheduling regular follow-up visits
Answer: B) Providing detailed family education
Explanation: While medication and follow-up care are important, educating the family on managing asthma triggers, medication adherence, and emergency action plans is critical in pediatric asthma care.
In pediatric primary care, which of the following is an essential component when assessing developmental milestones?
A) Observation of the child’s behavior in the waiting room
B) Reviewing the family history of developmental delays
C) Conducting standardized developmental screening tools at regular intervals
D) Asking the parents if they are concerned about development
Answer: C) Conducting standardized developmental screening tools at regular intervals
Explanation: Using standardized developmental screening tools helps to identify any developmental delays early in the child’s life, enabling timely intervention.
Which immunization is recommended at 2 months of age?
A) Hepatitis B
B) Rotavirus
C) MMR
D) Varicella
Answer: B) Rotavirus
Explanation: The rotavirus vaccine is typically administered at 2 months of age as part of the recommended immunization schedule, along with other vaccines like DTaP, Hib, IPV, and PCV13.
A 3-year-old child is brought to the office with complaints of a sore throat and fever. Upon examination, the tonsils appear red and swollen. Which of the following is the most likely diagnosis?
A) Acute otitis media
B) Viral pharyngitis
C) Streptococcal pharyngitis
D) Sinusitis
Answer: C) Streptococcal pharyngitis
Explanation: Streptococcal pharyngitis, or strep throat, is common in young children and presents with fever, sore throat, and red, swollen tonsils. A throat culture or rapid strep test would be needed to confirm.
A 6-year-old child presents with a limp and complains of knee pain. There is no history of trauma, but the pain worsens with activity. Which condition should be suspected?
A) Osgood-Schlatter disease
B) Hip dysplasia
C) Septic arthritis
D) Legg-Calvé-Perthes disease
Answer: A) Osgood-Schlatter disease
Explanation: Osgood-Schlatter disease is common in active children aged 8-15, often presenting with knee pain due to inflammation of the patellar tendon at the tibial tuberosity.
A 12-year-old child is found to be overweight with a BMI above the 95th percentile. What is the most appropriate initial step in management?
A) Prescribe weight loss medication
B) Refer for bariatric surgery
C) Initiate dietary and exercise changes
D) Schedule a follow-up in six months
Answer: C) Initiate dietary and exercise changes
Explanation: The first-line treatment for childhood obesity is lifestyle modification, including dietary changes and increased physical activity. Referral to a nutritionist or pediatric weight management program is often beneficial.
Which of the following should be included in the care of an infant born prematurely?
A) Encouraging immediate breastfeeding
B) Delaying immunizations until the child is older
C) Ensuring regular growth monitoring and developmental screening
D) Starting solid foods early to support growth
Answer: C) Ensuring regular growth monitoring and developmental screening
Explanation: Premature infants require close monitoring for growth and development due to their increased risk of delayed milestones. Breastfeeding is encouraged when possible, and solid foods are typically introduced at the recommended age.
A 5-year-old child presents with a persistent cough, wheezing, and shortness of breath. The child’s mother reports a history of seasonal allergies. What is the first-line treatment for suspected allergic asthma?
A) Oral corticosteroids
B) Inhaled corticosteroids
C) Leukotriene receptor antagonists
D) Antihistamines
Answer: B) Inhaled corticosteroids
Explanation: Inhaled corticosteroids are the first-line treatment for allergic asthma in children. They help to reduce inflammation and prevent exacerbations.
Which of the following is an appropriate screening tool for autism spectrum disorder (ASD) in a child?
A) Denver Developmental Screening Test
B) Modified Checklist for Autism in Toddlers (M-CHAT)
C) Edinburgh Postnatal Depression Scale
D) Ages and Stages Questionnaire (ASQ)
Answer: B) Modified Checklist for Autism in Toddlers (M-CHAT)
Explanation: The M-CHAT is a widely used screening tool to detect early signs of autism spectrum disorder in toddlers, typically administered at 18 and 24 months of age.
Which of the following is the most appropriate first-line treatment for a child diagnosed with uncomplicated otitis media?
A) Amoxicillin
B) Azithromycin
C) Observation without antibiotics
D) Tympanostomy tube placement
Answer: A) Amoxicillin
Explanation: Amoxicillin is the first-line antibiotic for uncomplicated acute otitis media. However, in cases of mild symptoms or uncertainty, watchful waiting may also be appropriate.
What is the most common cause of bronchiolitis in infants and young children?
A) Influenza virus
B) Respiratory syncytial virus (RSV)
C) Adenovirus
D) Parainfluenza virus
Answer: B) Respiratory syncytial virus (RSV)
Explanation: RSV is the most common cause of bronchiolitis, a viral infection that affects the small airways in the lungs, primarily in children under 2 years of age.
A 2-year-old child presents with a history of chronic diarrhea, abdominal distension, and failure to thrive. The child’s family history is significant for celiac disease. What test is most likely to confirm the diagnosis?
A) Stool culture
B) Serum anti-tissue transglutaminase antibodies
C) Complete blood count (CBC)
D) Abdominal ultrasound
Answer: B) Serum anti-tissue transglutaminase antibodies
Explanation: Serum anti-tissue transglutaminase antibodies are a common and reliable test for diagnosing celiac disease, particularly in children with gastrointestinal symptoms and a family history.
Which of the following should be considered a red flag when evaluating a child’s speech and language development?
A) Limited vocabulary at 24 months
B) Difficulty understanding simple directions at 18 months
C) Inability to form sentences by 3 years of age
D) Saying a few words by 12 months
Answer: C) Inability to form sentences by 3 years of age
Explanation: By age 3, most children should be able to form simple sentences. Difficulty with this is a red flag for potential speech and language delays that may require further evaluation.
Which vaccine should be administered at 12 months of age?
A) Hepatitis B
B) MMR (Measles, Mumps, Rubella)
C) DTaP
D) Hib
Answer: B) MMR (Measles, Mumps, Rubella)
Explanation: The MMR vaccine is typically administered at 12-15 months of age as part of the routine immunization schedule for children.
A 10-year-old child presents with a chronic cough, weight loss, and a history of night sweats. A chest X-ray reveals hilar adenopathy. Which of the following is the most likely diagnosis?
A) Cystic fibrosis
B) Tuberculosis
C) Bronchopulmonary dysplasia
D) Asthma
Answer: B) Tuberculosis
Explanation: The symptoms of chronic cough, weight loss, night sweats, and hilar adenopathy are suggestive of tuberculosis, which requires further testing such as a tuberculin skin test or sputum culture for diagnosis.
Which of the following is the best approach to managing a child with newly diagnosed type 1 diabetes mellitus?
A) Prescribing oral hypoglycemic agents
B) Initiating insulin therapy with a focus on basal and bolus doses
C) Starting the child on a gluten-free diet
D) Monitoring blood glucose every other day
Answer: B) Initiating insulin therapy with a focus on basal and bolus doses
Explanation: Insulin therapy is essential for managing type 1 diabetes. The child requires a combination of basal insulin (long-acting) and bolus insulin (short-acting) with careful monitoring of blood glucose levels.
A 4-year-old child is brought to the clinic with a sudden onset of a limp and refusal to bear weight on the right leg. On examination, the leg is held in slight flexion, and the child has no fever. What is the most likely diagnosis?
A) Legg-Calvé-Perthes disease
B) Transient synovitis
C) Septic arthritis
D) Osgood-Schlatter disease
Answer: B) Transient synovitis
Explanation: Transient synovitis is a common cause of hip pain and limping in children, typically presenting after a viral infection. It often resolves with supportive care.
Which of the following is most important in the management of a child with severe dehydration?
A) Administering oral rehydration solutions
B) Intravenous (IV) fluid resuscitation
C) Restricting fluid intake to avoid overhydration
D) Starting the child on an antibiotic regimen
Answer: B) Intravenous (IV) fluid resuscitation
Explanation: Severe dehydration requires IV fluid resuscitation to restore circulating volume and electrolyte balance quickly. Oral rehydration is used for mild dehydration.
At what age should a child’s first dental visit occur?
A) 1 year
B) 2 years
C) 3 years
D) 4 years
Answer: A) 1 year
Explanation: The American Academy of Pediatrics recommends that a child should have their first dental visit by their first birthday to promote oral health and prevent dental issues.
A 13-year-old child presents with complaints of a headache and blurry vision. On examination, the child’s blood pressure is significantly elevated. What is the most likely cause?
A) Migraine
B) Hypertension
C) Brain tumor
D) Sinusitis
Answer: B) Hypertension
Explanation: Hypertension in children can cause symptoms such as headaches and blurry vision. This is a serious condition that requires urgent evaluation and management.
A 9-year-old child presents with a rash on the face, hands, and feet. The rash is red and bumpy, and the child also has a low-grade fever. What is the most likely diagnosis?
A) Chickenpox
B) Fifth disease (erythema infectiosum)
C) Hand, foot, and mouth disease
D) Measles
Answer: B) Fifth disease (erythema infectiosum)
Explanation: Fifth disease, caused by parvovirus B19, presents with a “slapped cheek” appearance on the face, followed by a lacy rash on the body. It is common in school-aged children and typically resolves without treatment.
Which of the following is an appropriate first-line treatment for mild to moderate atopic dermatitis in a 2-year-old?
A) Topical corticosteroids
B) Oral antihistamines
C) Oral antibiotics
D) Wet wraps
Answer: A) Topical corticosteroids
Explanation: Topical corticosteroids are the first-line treatment for atopic dermatitis in young children. They help to reduce inflammation and itching. Moisturizers and avoiding triggers are also important parts of care.
Which screening test is recommended for all newborns before discharge from the hospital?
A) Hearing screening
B) Vision screening
C) Genetic screening for Down syndrome
D) Lead screening
Answer: A) Hearing screening
Explanation: Newborns are typically screened for hearing loss before discharge from the hospital. Early detection of hearing impairment is crucial for language and cognitive development.
A 4-year-old child presents with a cough and wheezing. The child has a history of eczema and food allergies. Which of the following is the most likely diagnosis?
A) Asthma
B) Bronchiolitis
C) Cystic fibrosis
D) Pneumonia
Answer: A) Asthma
Explanation: Asthma is commonly associated with a personal or family history of allergic conditions such as eczema or food allergies. Cough and wheezing are hallmark symptoms of asthma in children.
At what age should a child be able to jump in place with both feet off the ground?
A) 18 months
B) 2 years
C) 3 years
D) 4 years
Answer: C) 3 years
Explanation: By age 3, most children develop the gross motor skill of jumping in place. This is an important milestone in physical development.
Which of the following is a common side effect of methylphenidate (Ritalin) in children with attention-deficit hyperactivity disorder (ADHD)?
A) Weight loss
B) Sedation
C) Increased appetite
D) Diarrhea
Answer: A) Weight loss
Explanation: Methylphenidate (Ritalin) is a stimulant commonly used to treat ADHD. One common side effect is decreased appetite, which can lead to weight loss in children.
A 2-year-old child has a fever of 102°F (38.9°C), irritability, and a rash that starts on the face and spreads down the body. The child also has a cough and runny nose. What is the most likely diagnosis?
A) Chickenpox
B) Measles
C) Scarlet fever
D) Roseola
Answer: B) Measles
Explanation: Measles is characterized by a high fever, cough, runny nose, conjunctivitis, and a characteristic rash that starts on the face and spreads down the body. Koplik spots in the mouth are a hallmark early sign.
A 10-year-old child is brought in for evaluation of a non-tender, rubbery mass in the neck that has been present for several weeks. The child has no systemic symptoms. What is the most likely diagnosis?
A) Lymphadenopathy due to viral infection
B) Branchial cleft cyst
C) Thyroid nodule
D) Abscess
Answer: B) Branchial cleft cyst
Explanation: A branchial cleft cyst is a common benign mass in the neck that is often discovered incidentally. It is typically non-tender and rubbery and can present in children without signs of infection.
Which of the following vaccines should be delayed or avoided in a child with an egg allergy?
A) MMR vaccine
B) Influenza vaccine (inactivated)
C) Varicella vaccine
D) DTaP vaccine
Answer: B) Influenza vaccine (inactivated)
Explanation: The inactivated influenza vaccine is typically prepared using egg-derived culture media. While many children with egg allergies can receive this vaccine, it should be administered with caution, and an alternative may be recommended.
Which of the following is a sign of dehydration in a 3-month-old infant?
A) Irritability
B) Increased urine output
C) Fontanel bulging
D) Rapid weight gain
Answer: A) Irritability
Explanation: Dehydration in infants is often associated with irritability, dry mouth, and reduced urine output. Fontanel depression and a lack of tears are also common signs of dehydration.
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