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Reaching for a desired object.

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Question 1

When advising a patient about the influenza nasal spray vaccine, the NP considers the following:

Question options:

1) Its use is acceptable during pregnancy.

2) Its use is limited to children younger than 6 years.

3) It contains live, attenuated virus.

4) This is the preferred method of influenza protection in the presence of airway disease.

Question 2

Which of the following is true about the MMR vaccine?

Question options:

1) This vaccine contains live virus.

2) Its use is contraindicated in persons with a history of egg allergy.

3) Revaccination of an immune person is associated with risk of allergic reaction.

4) One dose is recommended for young adults who have not been previously immunized.

Question 3

Which of the following is the most prudent first-line treatment choice for an otherwise well toddler with acute otitis media (AOM) who requires antimicrobial therapy?

Question options:

1) Ceftibuten.

2) Amoxicillin.

3) Cefuroxime.

4) Azithromycin.

Question 4

The most common causative organism of bronchiolitis is:

Question options:

1) haemophilus influenzae.

2) parainfluenza virus.

3) respiratory syncytial virus.

4) coxsackievirus.

Question 5

At which of the following ages in an infant’s life is parental anticipatory guidance about teething most helpful?

Question options:

1) 1–2 months.

2) 2–4 months.

3) 4–6 months.

4) 8–10 months.

Question 6

A young child should use a rear-facing car seat until at least age:

Question options:

1) 12 months.

2) 18 months.

3) 24 months.

4) 30 months.

Question 7 1 / 2 points

Risk factors for dyslipidemia in children include which of the following? Select all that apply.

Question options:

1) Blood pressure at the 70th to 80th percentile for age.

2) Breastfeeding into the toddler years.

3) Family history of lipid abnormalities.

4) Family history of type 2 diabetes mellitus.

Question 8

Which of the following laboratory tests can identify the causative organism of bronchiolitis?

Question options:

1) Nasal washing antigen test.

2) Antibody test via blood sample.

3) Urine culture.

4) A laboratory test is not available.

Question 9

Physical examination findings in otitis externa include:

Question options:

1) tympanic membrane immobility.

2) increased ear pain with tragus palpation.

3) tympanic membrane erythema.

4) tympanic membrane bullae.

Question 10

Which of the following findings is most consistent with the diagnosis of acute bacterial rhinosinusitis (ABRS)?

Question options:

1) Upper respiratory tract infection symptoms persisting beyond 7 to 10 days.

2) Mild midfacial fullness and tenderness.

3) Preauricular lymphadenopathy.

4) Marked eyelid edema.

Question 11

Aortic stenosis in a 15-year-old male is most likely:

Question options:

1) a sequela of rheumatic fever.

2) a result of a congenital defect.

3) calcific in nature.

4) found with atrial septal defect.

Question 12

Which of the following do you expect to find in an examination of a 2-week-old infant?

Question options:

1) A visual preference for the human face.

2) A preference for low-pitched voices.

3) Indifference to the cry of other neonates.

4) Poorly developed sense of smell.

Question 13

An 18-year-old woman has a chief complaint of a “sore throat and swollen glands” for the past 3 days. Her physical examination includes a temperature of 101° F (38. 3° C), exudative pharyngitis, and tender anterior cervical lymphadenopathy. Right and left upper quadrant abdominal tenderness is absent. The most likely diagnosis is:

Question options:

1) streptococcus pyogenes pharyngitis.

2) infectious mononucleosis.

3) viral pharyngitis.

4) vincent angina.

Question 14

At which of the following ages in a young child’s life is parental anticipatory guidance about infant sleep position most helpful?

Question options:

1) Birth.

2) 2 weeks.

3) 2 months.

4) 4 months.

Question 15

With regard to seasonal influenza prevention in well children, the NP considers that:

Question options:

1) compared with school-aged children, younger children (? 24 months old) have an increased risk of seasonal influenza-related hospitalization.

2) a full adult dose of seasonal influenza vaccine should be given starting at age 4 years.

3) the use of the seasonal influenza vaccine in well children is discouraged.

4) widespread use of the vaccine is likely to increase the risk of eczema and antibiotic allergies.

Question 16

Rebound tenderness is best described as abdominal pain that worsens with:

Question options:

1) light palpation at the site of the discomfort.

2) release of deep palpation at the site of the discomfort.

3) palpation on the contralateral side of the abdomen.

4) deep palpation at the site of the discomfort.

Question 17

A Still murmur:

Question options:

1) is heard in the presence of cardiac pathology.

2) has a humming or vibratory quality.

3) is a reason for denying sports participation clearance.

4) can become louder when the patient is standing.

Question 18

Common causative organisms of acute suppurative conjunctivitis include all of the following except:

Question options:

1) staphylococcus aureus.

2) haemophilus influenzae.

3) streptococcus pneumoniae.

4) pseudomonas aeruginosa.

Question 19

Which of the following imaging studies potentially exposes the patient being evaluated for abdominal pain to the lowest ionizing radiation burden?

Question options:

1) Ultrasound.

2) Barium enema.

3) CT scan.

4) Abdominal flat plate.

Question 20

At which age is a child at greatest risk of death from pertussis?

Question options:

1) <1 year. 2) 2–4 years. 3) 5–10 years. 4) >10 years.

Question 21

A healthy 3-year-old child is in your office for well-child care. You expect this child to be able to:

Question options:

1) name five colors.

2) alternate feet when climbing stairs.

3) speak in two-word phrases.

4) tie shoelaces.

Question 22

Treatment options in acute and recurrent allergic conjunctivitis include all of the following except:

Question options:

1) cromolyn ophthalmic drops.

2) oral antihistamines.

3) ophthalmological antihistamines.

4) corticosteroid ophthalmic drops.

Question 23

Rectal bleeding associated with anal fissure is usually described by the patient as:

Question options:

1) drops of blood noticed when wiping.

2) dark brown to black in color and mixed in with normal-appearing stool.

3) a large amount of brisk red bleeding.

4) significant blood clots and mucus mixed with stool.

Question 24

Concerning the MMR vaccine, which of the following is true?

Question options:

1) The link between use of MMR vaccine and childhood autism has been firmly established.

2) There is no credible scientific evidence that MMR use increases the risk of autism.

3) The use of the combined vaccine is associated with increased autism risk, but giving the vaccine’s three components as separate vaccines minimizes this risk.

4) The vaccine contains thimerosal, a mercury derivative.

Question 25

You are examining an 18-year-old man who is seeking a sports clearance physical examination. You note a mid-systolic murmur that gets louder when he stands. This may represent:

Question options:

1) aortic stenosis.

2) hypertrophic cardiomyopathy.

3) a physiologic murmur.

4) a Still’s murmur.

Question 26

Which of the following statements is correct about the varicella vaccine?

Question options:

1) This vaccine contains killed varicella-zoster virus (VZV).

2) A short febrile illness is common during the first days after vaccination.

3) Children should have a varicella titer drawn before receiving the vaccine.

4) Rarely, mild cases of chickenpox have been reported in immunized patients.

Question 27

A healthy 6-year-old girl presents for care. Her parents request that she receive vaccination for influenza and report that she has not received this vaccine in the past. How many doses of influenza vaccine should she receive this flu season?

Question options:

1) 1.

2) 2.

3) 3.

4) 4.

Question 28

At which of the following ages in a young child’s life is parental anticipatory guidance about toilet-training readiness most helpful?

Question options:

1) 12 months.

2) 15 months.

3) 18 months.

4) 24 months.

Question 29

The murmur of atrial septal defect is usually:

Question options:

1) found in children with symptoms of cardiac disease.

2) first found on a 2–6-month well-baby examination.

3) found with mitral valve prolapse.

4) presystolic in timing.

Question 30

You are examining an 18-month-old boy who is not speaking any discernible words. Mom tells you he has not said “mama or dada” yet or babbled or smiled responsively. You:

Question options:

1) encourage the mother to enroll her son in daycare to increase his socialization.

2) conduct further evaluation of milestone attainment.

3) reassure the parent that delayed speech is common in boys.

4) order audiogram and tympanometry.

Question 31

Treatment options for streptococcal pharyngitis for a patient with penicillin allergy include all of the following except:

Question options:

1) azithromycin.

2) trimethoprim-sulfamethoxazole.

3) clarithromycin.

4) clindamycin.

Question 32

Which of the following is one of the more common sources of hepatitis A infection in the United States?

Question options:

1) Receiving blood products.

2) Ingestion of raw shellfish.

3) Drinking municipally sourced tap water drinking water.

4) Exposure to fecally contaminated food.

Question 33

Juice intake is acceptable in children 6 months and older per which of the following recommendations? Select all that apply.

Question options:

1) The juice is mixed in small amounts to flavor water.

2) Only 100% juice is used.

3) Juice replaces no more than one serving of milk.

4) The juice is consumed in the morning with breakfast.

5) No more than 6 oz. (177 mL) per day is recommended for children 6 months to 5 years.

Question 34

Treatment of viral conjunctivitis can include:

Question options:

1) moxifloxacin ophthalmic drops.

2) polymyxin B ophthalmic drops.

3) oral acyclovir.

4) no antibiotic therapy needed.

Question 35 1 / 2 points

Which of the following benchmarks indicate normal development by a healthy child born at term who is now 12 months of age? Select all that apply.

Question options:


Talking in two-word sentences.


Pointing to a desired object.


Reaching for a desired object.


Walking backward.

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