Nr 602 Midterm Exam Paper
• Role-play with equipment during the course of a physical examination would be
most beneficial with which of the following groups?
• Preschoolers/Toddlers
• What is the Ortolani Sign?
-Assess for congenital hip dysplasia
• When performing a physical examination of a toddler, which of the following body
parts would examine last?
• Ears and throat
• What are three findings using Jones criteria for Rheumatic Fever?
–Streptococal infection, carditis, and erythema marginatum
• While examining a 4-month-old boy, you are unable to palpate one of his testes. The next
most appropriate step is:
• Refer the child to a urologist
• Concurrent Otitis media and Conjunctivitis is likely due to which?
• Haemophilus influenza
• What is the appropriate management of a child with asthma who presents with acute
wheezing and/or coughing?
• Administer a short-acting beta agonist
• Sandra, age 12 years, has several vesicles and honey-colored crusted lesions on her face
above the right nares. She has a history of having a bad scratch in the same area several days
ago. What condition do you suspect?
-Impetigo
• The most appropriate management of a 5-year old with a firm nontender nodule in the
mid- upper eyelid for 3 weeks would be:
-Topical ophthalmic ointment
• A 10-month-old child has been diagnosed with gastroenteritis. He attends a child care
facility. What is the most likely cause of illness?
-Rotavirus
• If a child or any patient describes a “pop” in the knee. What is this indicative of?
• Anterior cruciate ligament tear
• A 7-year-old African American female presents with several hyperkeratotic raised,
periungual lesions on the two middle fingers of her left hand. She has a history of nail biting.
The most likely diagnosis is:
• Verruca vulgaris
• Management of scoliosis depends on the severity of curve as well as the age of the
child. Which of the following would require surgical intervention?
• Thoracic curve greater than 50 degrees or lumbar curve greater than 40 degrees.
• Treatment of true central precocious puberty is best achieved with:
• Gonadotropin-releasing hormone agonist
• Baby Sally was in your office last week for her 6-month checkup. Her weight was 7 kg.
Today she presents with diarrhea and vomiting for 4 days. Today her weight is 6.5 kg. What
is her percentage of dehydration?
-7%
• Which of the following would be the most appropriate initial management of a
newborn diagnosed with developmental dysplasia of the hip?
-Pavlik harness
• When considering catch up vaccination in children for IPV vaccinations, it is important
to understand one of the following considerations is NOT a consideration when
administering the vaccine:
• IPV is can be given routinely beyond the age of 18 years of age in the U.S.
• An essential test in the evaluation of a 2-year-old being managed for Kawasaki disease is:
• An echocardiogram
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• A 4-week-old presents to your office in mid=January with a 1-week history of nasal
congestion and occasional cough. On the evening prior to this visit, the infant
developed a temperature of 102, refused to breastfeed, and had proximal coughing and
noisy, labored breathing. On exam, you note an ill-appearing infant who is lethargic
with tachypnea.
• RSV bronchiolitis
• What needs to be included when educating parents about a febrile seizure?
• Children may experience repeated seizures
• A 4-year-old boy is brought in by his mother, who is concerned about the sudden onset of
a painful limp in his right leg 2 days ago? Today he has a low-grade fever. Which of the
following diagnoses is most likely?
• Transient synovitis of the hip
• In addition to penicillin, all of the following antibiotics can be used to treat strep
pharyngitis except:
• Bactrim
• Primary dysmenorrhea is due to:
• Elevated prostaglandin level
• Which behavior would NOT be expected in a two-year old?
• Draws a circle
• The most common congenital heart defect in children is:
• Ventricular septal defect
• Michael is a 15-year-old high school student who presents for a school sports physical.
He appears to be in good health but is concerned about a bad headache he had a few weeks
ago. He is concerned because his mother’s friend dried of a brain tumor. You tell Michael
that the most common type of headache with onset in adolescence is:
-Tension headache
• Treatment for testicular torsion primarily?
• Immediate surgical referral
• What is important to understand about encopresis?
• The DSM 5 describe the condition as a repeated passage of stool into inappropriate places
such as child’s underpants.
• Newborn W.R. has a vascular lesion that will not fade as she gets older. What is
your diagnosis?
• Port-wine stain (nevus flammeus)
• Vomiting in infancy has a long list of differential diagnosis. Which accompanying
symptom would most likely point to pyloric stenosis?
• Acts hungry after vomiting
• Which malignancy is associated with genitourinary anomalies?
• Wilm’s tumor
• A child has mild persistent asthma. Appropriate daily medication should include:
• An inhaled low-dose corticosteroid
• A 3-year-old has an edematous, mildly erythematous right upper eyelid for 1 day with a
fever of 103. An important eye assessment would be:
• Ocular mobility
• What diagnosis should be considered if the infant has not passed meconium in the first
24 hours of life?
• Congenital ganglionic megacolon
• A child with juvenile idiopathic arthritis (JIA) can present with which
asymptomatic condition that warrants close to follow up?
• Uveitus and needs to have routine ophthalmologic screening with slit-lamp every 3 months
if the ANA is positive.
• A 15-month-old failed treatment with amoxicillin for otitis media. At his 2-week recheck,
his TM remained red with distorted landmarks, and he persisted with nasal congestion and
poor nighttime sleeping, and he has had 101 fever for the past 2 days. The next best step
would be to treat with:
• A 10-day course of Augmentin
• Which of the following is an absolute contraindication for use of combined
hormonal contraceptives in adolescent women?
• History of thromboembolism
• The most common trigger for an acute asthma episode in the very young child is:
• Viral respiratory infections
• Which of the following findings could be expected to occur in a baby with intussusception?
• Inconsolable screening
• The appropriate management of Osgood-Schlatter disease includes:
• Decreasing activity, applying ice, and taking prescribing NSAIDS
• In a healthy, 8-month-old with diarrhea but no dehydration, what would be most
appropriate advice to give parents?
• Give bananas and cereal as tolerated
• The most common rheumatoid disease of childhood is:
• Juvenile idiopathic arthritis
• When assessing for croup, what is a common finding on xray?
• Subglottic narrowing (steeple sign)
• Which chromosomal abnormality is associated with short statue in girls?
• Turner syndrome
• Which activities are common in a 4-5 year-old child?
• Independent toileting (may need help to wipe)
• A 14-year-old female presents to the clinic and is demonstrating some hesitancy in
discussing an important issue regarding her self-identity. What is the appropriate actions on
behalf of the clinician?
-The provider should use gender neutral terms to allow the adolescent to feel more
comfortable with discussing this issue
• The most definitive feature or features for a diagnosing of “growing pains” includes:
-Exclusion of other causes of lower extremity pain
• When examining an adolescent between the ages of 10-13 years of age it is important
to remember what characteristic regarding socio-emotional development?
• Feel awkward about their body and self, the examiner should provide privacy for the
patient, and this age group tend to test their environment.
• On exam, an 8 year old being seen at your clinic with complaints of persistent pain to left
leg with limp. What is the most likely cause of this condition?
• Legg-Calve Perthes Disease
• Cara is a 16-year-old adolescent who has been sexually active with… male partner for 6
months. They have used condoms consistently. Cara is interested in a hormonal method as
well. Your advice includes all of the following except which one?
• The vaginal contraceptive ring must be changed weekly
• Role=play with equipment during the course of a physical examination would be
most beneficial with which of the following age groups?
-Preschoolers/Toddlers
• For children 2 to 4 years of age, the most common cause of head injury is:
-Falls
• In a healthy, 8-month-old with diarrhea but no dehydration, what would be the
most appropriate advice to give parents?
• Give bananas and cereal as tolerated
• The appropriate management of Osgood-Schlatter disease includes:
• Decreasing activity, applying ice, and taking prescribing NSAIDS
• The organism that causes hand, foot, mouth syndrome is what virus?
• Coxsackle virus
• Judy has a history of remission and exacerbation of acne that has followed the pattern of
menses for 2 years. However, the condition over the last 6 months has worsened to a
moderate
degree of severity and has been chronic and persistent. You prescribe…
• Hydroquinoa
• Which malignancy is associated with genitourinary anomalies?
-Wilm’s tumor
• A 15-month-old failed treatment with amoxicillin for otitis media. AT his 2-week recheck,
his TM remained red and distorted…..
-A 10-day course of Augmentin
• Which of the following is not considered preventative management for
iron0deficiency anemia?
-No cow’s milk until 1 year of age
• In mild to moderate attacks of asthma, albuterol should be given every 4-5 hours PRN
and routine medications should be:
-Continued as usual
• In addition to penicillin, all of the following antibiotics can be used to treat strep
pharyngitis except:
-Bactrim
• The most definitive feature or features for a diagnosis of “growing pains” includes:
• Exclusion of other causes of lower extremity pain
• Which of the following foods would be appropriate for a child with celiac disease?
• Boiled rice with butter
• When performing a physical examination of a toddler, which of the following body
parts would you examine last?
• Ears and throat
• Daily eyelid cleaning with diluted baby shampoo and a cotton-tipped applicator would
be appropriate in the treatment of which of the following conditions?
• Blepharitis
• Primary dysmenorrhea is due to:
• Elevated prostaglandin level
• Management of scoliosis depends on the severity of curve as well as the age of the
child. Which of the following would require surgical intervention?
• Thoracic curve greater than 50 degrees or lumbar curve than 40 degrees
• A 10-year old has marked ear pain, not wanting anyone to touch his ear. The canal
is edematous and exudate is present. TM Is normal. How should this be managed?
-Topical fluoroquinolone
• Patients with otitis externa should be instructed to do which of the following?
• Keep ear dry until symptoms improve
• A 2-year-old female has lymphedema of the hands and feet, with low posterior hairline,
cubitus valgus, and a history of intrauterine growth restrictions. Which of the following defects
is the most common among the children with these signs?
-Coarctation of the aorta