Question 1
0 out of 0 points
When completing this quiz, did you comply with Walden University’s Code of Conduct including the
expectations for academic integrity?
Selected Answer: Yes
Question 2
0 out of 1 points
Which of the following would not suggest an eating disorder with a purging component?
Selected Answer: d.
Finger calluses
Question 3
1 out of 1 points
Which of the following screenings should adolescents have done annually?
Selected Answer: d.
Psychosocial screening, blood pressure, body mass index
Question 4
0 out of 1 points
A healthy, well-developed 6-year-old child arrives as a new patient to your clinic. His immunization
card reveals that he received an immunization at birth and some when he was 2 months old, but
none sense. Which of the following statements about him is correct?
Selected
Answer:
b.
His vaccinations at birth and 2 months are repeated because too much time has
elapsed for them to be effective.


ORDER FOR AN EXAM HERE

Question 5
1 out of 1 points
You see a young child who has tripled her birth weight and looks for hidden objects. When given
blocks, she places one in each hand. She has a fine pincer grasp. On the floor, she walks around
holding objects and is trying to take independent steps. This child is most likely how old?
Selected Answer: d.
12 months
Question 6
1 out of 1 points
You see a 30-month-old who speaks in mixed Spanish and English. The child’s vocabulary is normal
but at the low end of the normal language spectrum. The parent is worried the child’s development
will not be normal because she mixes up the two languages. You respond:
Selected
Answer:
b.
“Your child’s speech is normal and bilingual children commonly intermix the words
from both languages until about 3 years of age.”
Question 7
0 out of 1 points
A breastfed infant is expected to have a lower incidence of which of the following?
Selected Answer: d.
Asthma
Question 8
1 out of 1 points
An 8-year-old female is brought into the office by her mother. She has complaints of fever and sore
throat for the past 2 days. She denies difficulty swallowing but has loss of appetite and mild
diarrhea. A few classmates have similar symptoms. A review of systems reveals clear nasal drainage,
dry cough, and hoarseness. On exam she has a 101.5 temperature, 3+ erythematous tonsils, and
anterior cervical lymphadenopathy. What is the likely diagnosis?
Selected Answer: a.
Viral pharyngitis
Question 9
0 out of 1 points
Acute otitis media can be diagnosed when there is
Selected Answer: a.
Fluid in the middle ear accompanied by fever and otalgia.
Question 10
1 out of 1 points
A 4-month-old presents with both eyes turning inward. What is this called?
Selected Answer: b.
Esotropia
Question 11
1 out of 1 points
Which of the following represents normal sequencing of development in a toddler?
Selected Answer: c.
Feeds self, can undress self with help, washes hands, imitates housework.
Question 12
1 out of 1 points
Which of the following foreign body in the nose requires immediate removal?
Selected Answer: c.
battery
Question 13
0 out of 1 points
During a “well-child” visit, the parents of a healthy 5-month-old offer a great amount of information.
Which of the following bits of information is of most concern?
Selected Answer: e.
Consuming 32 ounces of infant formula per day.
Question 14
0 out of 1 points
Which of the following children should be referred for a comprehensive developmental evaluation?
Selected
Answer:
c.
A 3-year-old who consistently tracks at the 5th percentile for height and weight
since birth.
Question 15
1 out of 1 points
Which of the following is a true contraindication of vaccinating a child?
Selected Answer: d.
Previous vaccination reaction that consisted of wheezing and hypotension
Question 16
1 out of 1 points
A 2-year-old boy has been slightly less than the 50th percentile for weight, height and head
circumference, but in the last 6 months he has fallen to slightly less than the 25th percentile for
weight. The pregnancy was normal, his development is as expected, and the family reports no
psychosocial problems. The mother says that he is now a finicky eater (wants only macaroni and
cheese at all meals), but she insists that he eat a variety of foods. The meals are marked by much
frustration for everyone. His examination is normal. Which of the following is the best next step in
his care?
Selected
Answer:
c.
Reassurance and counseling for family about childhood normal developmental
stage
Question 17
1 out of 1 points
Which is the correct order for introduction of solid foods to an infant?
Selected Answer: c.
Cereal, vegetables, fruits, and meats
Question 18
0 out of 1 points
At what age would a child be expected to remember a string of numbers and repeat them
backwards?
Selected Answer: b.
6 years
Question 19
1 out of 1 points
Epiglottitis has decreased due to which immunization?
Selected Answer: b.
Hib
Question 20
1 out of 1 points
Sarah, 7 years old, is in the office today. All of the following are acceptable management options for
allergic rhinitis, except
Selected Answer: d.
Nasal neosynephrine
Question 21
1 out of 1 points
Josh, age 13, has some enlargement of the scrotum and testes, a reddened scrotal sac, and some
hair texture alteration. His penis is not enlarged. He is in Tanner stage
Selected Answer: b.
II
Question 22
1 out of 1 points
Which of the following issues or concepts is relevant to the school-age child?
Selected Answer: d.
Erikson’s initiative versus guilt
Question 23
1 out of 1 points
Hannah, age 4, is brought into the office by her father. She complains of a sore throat, difficulty
swallowing, copious oral secretions, stridor, and a temperature of 102F. She does not have
pharyngeal erythema or cough. What do you suspect?
Selected Answer: c.
Epiglottitis
Question 24
0 out of 1 points
Sally, age 4, presents to the office with her mother for a well-child visit. To assess for age-appropriate
fine motor skills, what activity would you ask her to perform?
Selected Answer: d.
String beads.
Question 25
1 out of 1 points
Which of the following eye findings would be considered an ophthalmic emergency?
Selected Answer: c.
Unilateral vesicular lesions on the upper eyelid in a 3-week old.
Question 26
1 out of 1 points
Which of the following signs may indicate a baby is not receiving sufficient breastmilk?
Selected Answer: a.
Sleepiness, jaundice, and vomiting
Question 27
0 out of 1 points
Which of the following statements is true regarding lying and stealing by the school-age child?
Selected Answer: b.
They are highly correlated with later criminal behavior.
Question 28
1 out of 1 points
Upon eye examination of a newborn, you note inner canthal folds and Brushfield spots. What do you
suspect?
Selected Answer: a.
Down syndrome
Question 29
0 out of 1 points
Miguel, age 14, was hit in the eye with a baseball and developed eye pain, decreased visual acuity,
and injection of the globe. Upon exam you note blood in the anterior chamber and confirm
diagnosis of hyphema. What treatment do you recommend while Miguel is waiting to see the
ophthalmologist
Selected Answer: d.
Wake him every 30 minutes to assess mental status.
Question 30
1 out of 1 points
A 4-month-old child has poor weight gain. Her current weight is less than the 5th percentile, height
about the 10th percentile, and head circumference at the 50th percentile. The planned pregnancy
resulted in a normal, spontaneous, vaginal delivery; mother and child were discharged after a 48-
hour hospitalization. Feeding is via breast and bottle; the quantity seems sufficient. The child has
had no illness. The examination is unremarkable except for the child’s small size. Screening
laboratory shows the hemoglobin and hematocrit are 11 mg/dL and 33% respectively, with a platelet
count of 198,000/mm3. Serum electrolyte levels are sodium 140, chloride 105, potassium 3.5,
bicarbonate 17, blood urea nitrogen 15, and creatinine 0.3. Liver function tests are normal.
Urinalysis reveals a pH of 8 with occasional epithelial cells but no white blood cells, bacteria, protein,
ketones, or reducing substances. Which of the following is the most appropriate therapy for this
child?
Selected Answer: c.
Oral supplementation with bicarbonate
Question 31
1 out of 1 points
Mark, a 10-year-old, has a lot of ear pain. He does not want anyone to touch it and is crying in pain.
The ear canal is swollen and exudate is present. The TM is normal. Mark should be instructed to do
which of the following?
Selected Answer: d.
Keep ear dry until symptoms improve.
Question 32
1 out of 1 points
Appropriate advice for a mother of a 2-week-old child here for a “well child” visit includes which of
the following?
Selected Answer: e.
Sleep in the supine position is recommended
Question 33
1 out of 1 points
A 9-year-old who weighs 70 pounds asks why she can’t sit in the front passenger seat of the family
car. Your best response is
Selected
Answer:
b.
The safest place for children under 12 years old and 100 pounds is in the
backseat of the car.
Question 34
1 out of 1 points
Which of the following statements about bullying is true?
Selected Answer: d.
It occurs most commonly during unstructured times (lunch, recess, etc.).
Question 35
1 out of 1 points
The parent of a 2-year-old tells you her daughter recently started having breath-holding spells. She
tells you the older sibling “did the same thing” and asks you for help. You advise her that after a
breath-holding event:
Selected Answer: b.
Act as if nothing abnormal happened.
Question 36
1 out of 1 points
Which adolescent would be at greatest risk for developing anorexia nervosa?
Selected Answer: a.
14-year-old female gymnast
Question 37
1 out of 1 points
An 11-year-old girl has dizziness, pupillary dilation, nausea, fever, techycardia, and facial flushing.
She says she can “see” sound and “hear” colors. The agent likely to be responsible is which of the
following?
Selected Answer: d.
Lysergic acid diethylamide (LSD)
Question 38
1 out of 1 points
You see a 13-year-old who reports she is learning some basic geometry (areas, volume etc.). The
ability to successfully master these concepts occurs during which Piaget developmental stage?
Selected Answer: a.
Formal operational
Question 39
1 out of 1 points
The nurse practitioner role was initially established to
Selected Answer: c.
Improve access to care and partially solve physician shortage.
Question 40
0 out of 1 points
You would be concerned about the language development of a child who:
Selected Answer: a.
Pronounces words that are not understandable at 2 years of age
Question 41
0 out of 1 points
Which of the following are important considerations when screening child refugees for tuberculosis?
SELECT TWO (2)
Selected
Answers:
a.
IGRA may be falsely positive in children who have autoimmune disorders.
c.
Interferon gamma release assay (IGRA) is not recommended for use in children
younger than 5 years.
Question 42
1 out of 1 points
You diagnose a 16-year-old with acute otitis media and need to prescribe an antibiotic with betalactamase coverage. What do you choose?
Selected Answer: b.
amoxicillin and potassium clavulanate (Augmentin)
Question 43
1 out of 1 points
A 12-year-old male states he noticed an enlargement of his testes and scrotum. When counseling
him about the next step in pubertal development, you state:
Selected Answer: b.
The penis will grow in length and width.
Question 44
1 out of 1 points
A differential diagnosis for child abuse would include all of the following except.
Selected Answer: c.
Prader-Wlli syndrome
Question 45
1 out of 1 points
Which of the following complication of strep pharyngitis cannot be prevented with antibiotics?
Selected Answer: c.
Glomerulonephritis
Question 46
0 out of 1 points
A 4-year-old believes there is more juice in a tall, thin glass than a shorter, wider one. The child has
not yet achieved which of the principles of Piaget?
Selected Answer: d.
Abstract reasoning
Question 47
1 out of 1 points
The first sign of the onset of female puberty is usually:
Selected Answer: b.
Breast buds
Question 48
1 out of 1 points
Which of the following injuries is most likely to be caused by abuse of a toddler?
Selected Answer: d.
A displaced posterior rib fracture.
Question 49
1 out of 1 points
During a domestic health assessment, the CDC recommends screening every refugee child for which
of the following diseases?
Selected Answer: b.
tuberculosis
Question 50
1 out of 1 points
Conductive hearing loss can be caused by
Selected Answer: b.
Serous otitis
Question 51
1 out of 1 points
A 2-day-old infant has significant nasal and rectal bleeding. He was delivered by a midwife at home;
the pregnancy was without complications. His Apgar scores were 9 at 1 minute and 9 at 5 minutes.
He has breastfed well and has not required a health care professional visit since birth. Which of the
following vitamin deficiencies might explain his condition?
Selected Answer: c.
Vitamin K
Question 52
1 out of 1 points
The mother of a 4-year-old tells you he likes to “play with himself” while playing and watching
television. You advise the mother to
Selected
Answer:
d.
Explain to the child that masturbation is something that should be done in
private.
Question 53
0 out of 1 points
Which of the following children has abnormal language development?
Selected Answer: a.
Repeats simple phrases at 32 months
Question 54
1 out of 1 points
Which of the following strategies would not be appropriate to include as part of your treatment plan
of an 8-year-old boy who is obese?
Selected Answer: a.
Referral to nutritionist for weight reduction plan.
Question 55
1 out of 1 points
Luke, a 17-month-old, failed treatment with amoxicillin for otitis media. At the two-week recheck,
his TM was still erythematous and you cannot see the landmarks. He has persistent nasal
congestion, he is not sleeping at night, and he has a 101°F fever. What is the next best step for Luke?
Selected Answer: d.
A 1-day course of Augmentin
Question 56
0 out of 1 points
The appropriate lab tests in assessment of cervical adenitis include all of the following except:
Selected Answer: a.
PPD
Question 57
1 out of 1 points
What method can be safely used to remove cerumen in a 15-month-old child’s ear?
Selected Answer: c.
Irrigation using warm water from a soft bulb syringe
Question 58
1 out of 1 points
The most common substance used in middle school is
Selected Answer: d.
Alcohol
Question 59
1 out of 1 points
Role-play with equipment during the course of the physical exam would be the most beneficial with
which age group?
Selected Answer: c.
Preschoolers
Question 60
1 out of 1 points
An 8-year-old female has an edematous, mildly erythematous right upper eyelid for 2 days with a
fever of 102.9 (F). Which important eye assessment do you need to consider?
Selected Answer: d.
Ocular mobility
Question 61
1 out of 1 points
A 7-year-old has just been diagnosed with attention deficit hyperactivity disorder (ADHD). Her
parents report that she is doing poorly in school and is disruptive in the classroom. They ask you
what they can do. Your best response is:
Selected Answer: d.
“Use a consistent approach with behavioral cues both at home and at school.”
Question 62
1 out of 1 points
Which of the following is a priority nurse practitioner role to help children and adolescents to have
healthy sexual development?
Selected
Answer:
c.
Begin anticipatory guidance related to sexuality and normal pubertal development
in the early school-age visits.
Question 63
0 out of 1 points
Initial screening tests for an 11-year-old with a family history of hyperlipidemia and weight at the
97th percentile include:
Selected Answer: c.
fasting glucose, postprandial glucose, fasting lipid profile
Question 64
1 out of 1 points
You see a 6-month-old for a well-child visit and the mother tells you the child’s grandmother
recommends that she give the infant whole milk and eggs when he starts solids. What should you
tell the mother?
Selected
Answer:
c.
The baby should remain on infant formula and stage 2 and 3 baby foods for
now.
Question 65
0 out of 1 points
Early reflexive responses that are not related to survival include all but:
Selected Answer: d.
Babinski
Question 66
1 out of 1 points
The father of a 3-year-old is concerned because the child stutters. What should your approach be?
Selected Answer: b.
Explain that this can be normal until 4 years of age.
Question 67
0 out of 1 points
A common feature of 2-year-old behavior is:
Selected Answer: d.
a and b
Question 68
1 out of 1 points
A child’s head circumference is routinely measured on each well visit until what age?
Selected Answer: c.
2 years
Question 69
1 out of 1 points
A teenage female who is overweight has moderate acne on the face and chest, and irregular
menses. Elevation of which laboratory test provides the test evidence of polycystic ovarian
syndrome?
Selected Answer: a.
free testosterone
Question 70
1 out of 1 points
Parents bring their 6-month-old son to see you. He is symmetrically less than the 5th percentile for
height, weight and head circumference. He was born at 30 weeks’ gestation and weighed 1000g. He
was a planned pregnancy, and his mother’s prenatal course was uneventful until an automobile
accident initiated the labor. He was ventilated for 3 days in the intensive care unit but otherwise did
well without ongoing problems. He was discharged at 8 weeks of life. Which of the following is the
most likely explanation for his small size?
Selected Answer: d.
Normal ex-preemie infant growth
Question 71
0 out of 1 points
For adolescent girls, peak height velocity should occur by Tanner Stage (SMR):
Selected Answer: a.
4
Question 72
1 out of 1 points
A 2-year-old child weighs 34 lb. What type of car seat should the child use?
Selected Answer: d.
A forward-facing car seat in the back of the vehicle.
Question 73
1 out of 1 points
Head and chest circumferences should be equal at:
Selected Answer: b.
1 year of age
Question 74
1 out of 1 points
You see a healthy 18-month-old for a well-child visit. At the 12-month visit he received the
diphtheria, tetanus, and acellular pertussis (DTaP) third dose; hepatitis B second dose; measles,
mumps, and rubella (MMR) first dose; injected poliovirus (IPV) second dose; pneumococcal
conjugate (PCV13) fourth dose; and Haemophilus influenzae type B (Hib) fourth dose. Which of the
following do you order today?
Selected Answer: d.
DTaP, varicella, hepatitis A, and hepatitis B
Question 75
1 out of 1 points
A 14-year old has ataxia. He is brought to the local emergency department, where he appears
euphoric, emotionally labile, and a bit disoriented. He has nystagmus and hypersalivation. Many
notice his abusive language. Which of the following agents is most likely responsible for his
condition?
Selected Answer: a.
Alcohol
Question 76
1 out of 1 points
FIRST-LINE therapy for preschoolers (4-5 years of age) diagnosed with attention-deficit hyperactive
disorder is:
Selected Answer: c.
Behavior therapy
Question 77
1 out of 1 points
You see a 5-month-old who is fussy, has interrupted sleep, and is drooling. You note large lower
lateral incisor bulges. You recommend:
Selected Answer: e.
A and D
Question 78
1 out of 1 points
A new mom calls the NP on postpartum day 5. She reports her newborn wants to nurse for 30
minutes every 1-1/2 to 2 hours. Which of these is the best response?
Selected
Answer:
c.
“This is a very healthy breastfeeding pattern. Be sure to rest when you can. You
are doing a great job.”
Question 79
1 out of 1 points
Sandy, age 18 months, crosses her legs when lifted from behind rather than pulling them up. Her
legs are also hard to separate, making diaper changing difficult. She persistently uses only one hand.
What condition do you suspect?
Selected Answer: c.
Cerebral palsy
Question 80
1 out of 1 points
By what age should most children be able to sit well without support?
Selected Answer: d.
9 months
Question 81
1 out of 1 points
Flourescein staining of the eye is used to detect a
Selected Answer: a.
Corneal abrasion
Question 82
1 out of 1 points
An eye that deviates in when covered but that returns to midline when uncovered is an
Selected Answer: d.
esophoria
Question 83
1 out of 1 points
You are doing a kindergarten physical on a 5-year-old girl. Which of the following scenarios would
suggest the child is not ready to start kindergarten in the fall?
Selected Answer: a.
Counts to 4 and draws a person with three parts.
Question 84
1 out of 1 points
The diagnostic criteria for autism spectrum disorder include all of the following except
Selected Answer: b.
Tolerance of flexibility with routines
Question 85
1 out of 1 points
A 14-year-old female comes into the office for an urgent visit after taking 10 valium tablets.
Following the initial emergent care and stailization, the most important part of the management is:
Selected Answer: a.
Assessing the family supports available to the child.
Question 86
0 out of 1 points
A 19-month-old says “mama” and “dada,” points and gestures if he wants things, and follows simple
one-step commands. Your best response is which of the following?
Selected
Answer:
c.
Tell parent, “Boys typically have delayed speech compared with girls at this
age.”
Question 87
1 out of 1 points
Which of the following substances is associated with pupillary constriction?
Selected Answer: d.
Heroin
Question 88
1 out of 1 points
Blood pressure should be measured at well-child visits starting at age:
Selected Answer: b.
3 years
Question 89
0 out of 1 points
Which of the following statements about “routine” screening tests is true?
Selected Answer: a.
Lead testing is obtained on all 12- and 14-month-old children.
Question 90
1 out of 1 points
You see a 3-year-old for a well-child visit. His mother informs you that potty training has been very
easy because he “has an amazing internal clock. He falls asleep, gets hungry, and has bowel
movements at the same time every day.” This describes which aspect of temperament?
Selected Answer: a.
Rhythmicity
Question 91
1 out of 1 points
Chelsea, age 8, complains that she feels as if something is stuck in her ear. What action is
contraindicated?
Selected Answer: d.
Flushing the ear with water.
Question 92
1 out of 1 points
A Mantoux test in a child with no risk factors is considered positive with a reaction of:
Selected Answer: b.
at least 15 mm induration
Question 93
1 out of 1 points
Please interpret the following labs for an adolescent. The adolescent has a history of obesity and
acanthosis nigricans.
Test Results
Fasting blood glucose 112 mg/dL
2 hour postprandial glucose 138 mg/dL
Selected Answer: a.
Impaired fasting glucose, postprandial glucose within normal limits
Question 94
1 out of 1 points
A mother states that her 4-year-old son constantly grinds his teeth at night. You document this as:
Selected Answer: c.
Bruxism
Question 95
1 out of 1 points
Max, a 9-year-old boy, is a very active child with limited self-control. He is easily distracted and has
difficulty staying on task. You determine that he should have a neurodevelopmental evaluation
because he is showing signs of
Selected Answer: a.
ADHD
Question 96
0 out of 1 points
A 6-month-old infant has been growing poorly. His parents have changed his formula three times
without success. His examination is remarkable for a pale, emaciated child with little subcutaneous
fat and anterior fontanelle fullness. His laboratory test results are notable for a hemolytic anemia
and prolonged bleeding times. Which of the following is the most appropriate next step?
Selected Answer: e.
Measure serum factor IX levels
Question 97
1 out of 1 points
The parents of a 7-year-old are concerned their son does not want to attend school. Which of the
historical findings are not usually associated with the diagnosis of school phobia?
Selected Answer: b.
Chronic medical illness
Question 98
1 out of 1 points
Mark is in the exam room. You are concerned he may have epiglottitis. In what position do these
patients prefer to sit?
Selected Answer: d.
Sitting up and leaning forward
Question 99
1 out of 1 points
Which of the following statements regarding adolescent substance use is true?
Selected Answer: a.
Tobacco is the most commonly abused substance during adolescence.
Question 100
0 out of 1 points
I like to use my pincer grasp that involves the ablitily to pick up a small object such as a raisin or
piece of cereal with the thumb and forefinger, and that is mastered around what age?
Selected Answer: a.
12 months
Question 101
1 out of 1 points
A mother brings her 4-week-old infant into the office because she noticed small yellow-white
glistening bumps on her infant’s gums. She says they look like teeth but is concerned that they may
be cancer. You diagnose these bumps as
Selected Answer: a.
Epstein’s pearls