APEA NP MyQbank Pediatrics New Completed Questions with Rationales 2024, Exams of Pediatrics

Download APEA NP MyQbank Pediatrics New Completed Questions with Rationales 2024 and more Exams Pediatrics in PDF only on Docsity! APEA NP MyQbank Pediatrics Completed Questions with Rationales 2024 1. A 6-month-old infant presents with a high fever, irritability, and a bulging fontanelle. Which of the following is the most likely diagnosis? A. Acute otitis media B. Meningitis C. Teething D. Gastroenteritis Correct Answer: B. Meningitis Rationale: The presence of a high fever and bulging fontanelle are indicative of meningitis, a serious infection of the meninges that requires immediate medical attention. 2. A 4-year-old child is brought to the clinic with a barking cough and stridor at rest. What is the most appropriate initial management? A. Prescribe antibiotics B. Administer a nebulized epinephrine treatment C. Perform endotracheal intubation D. Provide reassurance and observe Correct Answer: B. Administer a nebulized epinephrine treatment Rationale: The child's symptoms suggest croup, which can be effectively treated with nebulized epinephrine to reduce airway inflammation and ease breathing. C. Complete blood count (CBC) D. Pulmonary function test Correct Answer: B. Electrocardiogram (ECG) Rationale: An ECG is essential for evaluating potential cardiac causes of chest pain and shortness of breath in an adolescent. 8. A child with asthma is experiencing an acute exacerbation. Which medication should be administered first? A. Inhaled corticosteroid B. Oral corticosteroid C. Short-acting beta-agonist D. Montelukast Correct Answer: C. Short-acting beta-agonist Rationale: A short-acting beta-agonist is the first-line treatment for acute asthma exacerbations to quickly relieve bronchospasm. 9. A 5-year-old child presents with abdominal pain, vomiting, and bloody diarrhea. Which organism is most likely responsible? A. Rotavirus B. Escherichia coli O157:H7 C. Giardia lamblia D. Norovirus Correct Answer: B. Escherichia coli O157:H7 Rationale: E. coli O157:H7 is associated with bloody diarrhea and can lead to hemolytic uremic syndrome, especially in children. 10. A newborn is noted to have a heart murmur. Which of the following is the most common type of congenital heart defect? A. Atrial septal defect (ASD) B. Ventricular septal defect (VSD) C. Patent ductus arteriosus (PDA) D. Tetralogy of Fallot Correct Answer: B. Ventricular septal defect (VSD) Rationale: VSD is the most common congenital heart defect and can present with a murmur in the newborn period. 11. A 12-year-old patient presents with a goiter and symptoms of hyperthyroidism. What is the most likely diagnosis? A. Hashimoto's thyroiditis B. Graves' disease C. Thyroid nodule D. Subacute thyroiditis Correct Answer: B. Graves' disease Rationale: Graves' disease is the most common cause of hyperthyroidism in children and can present with goiter and other symptoms of thyroid hormone excess. 12. A 2-month-old infant with a history of poor feeding and failure to thrive is found to have a systolic murmur. Which diagnostic test would be most informative? A. Echocardiogram B. Chest X-ray C. Electrocardiogram (ECG) D. Blood cultures Correct Answer: A. Echocardiogram Rationale: An echocardiogram is essential for evaluating the presence of congenital heart disease, which could explain the symptoms and murmur. 13. A child with sickle cell disease presents with fever and bone pain. What is the most appropriate initial management? A. Administer analgesics B. Start broad-spectrum antibiotics C. Perform a blood transfusion D. Order a bone scan Correct Answer: B. Start broad-spectrum antibiotics Rationale: Children with sickle cell disease are at increased risk for osteomyelitis and sepsis, so initiating broad-spectrum antibiotics is critical. 14. A 16-year-old patient presents with amenorrhea, weight loss, and bradycardia. What is the most likely diagnosis? A. Pregnancy Question: A 5-year-old child presents with frequent urination, increased thirst, and weight loss. Which condition is most likely affecting the child? A) Diabetes insipidus B) Type 1 diabetes mellitus C) Urinary tract infection D) Hyperthyroidism Correct Answer: B) Type 1 diabetes mellitus Rationale: The classic triad of symptoms (polyuria, polydipsia, weight loss) points towards Type 1 diabetes mellitus in children. Question: A 2-month-old infant is brought in with a high-pitched cry, poor feeding, and irritability. Which condition should be considered? A) Colic B) Gastroesophageal reflux disease (GERD) C) Intussusception D) Meningitis Correct Answer: D) Meningitis Rationale: The symptoms described are indicative of meningitis in infants, necessitating prompt evaluation and treatment. Question: A 3-year-old child is diagnosed with iron-deficiency anemia. Which dietary recommendation is most appropriate for this child? A) Avoid iron-rich foods B) Limit dairy intake C) Increase consumption of green leafy vegetables D) Provide whole milk Correct Answer: C) Increase consumption of green leafy vegetables Rationale: Green leafy vegetables are excellent sources of dietary iron, essential for managing iron-deficiency anemia in children. Question: An 8-year-old child with asthma is prescribed a long-acting beta- agonist (LABA). What education should the nurse provide to the child's parents? A) LABAs are used for acute asthma attacks B) LABAs should not be used as monotherapy C) LABAs are safe for long-term use D) LABAs can be used as a rescue inhaler Correct Answer: B) LABAs should not be used as monotherapy Rationale: LABAs should always be used in conjunction with an inhaled corticosteroid for asthma management to reduce the risk of adverse outcomes. Question: A 6-year-old child presents with a purulent discharge from the left eye and crusting of the eyelids. What is the likely diagnosis? A) Conjunctivitis B) Hordeolum C) Keratitis D) Dacryocystitis Correct Answer: B) Hordeolum Rationale: The symptoms are suggestive of a stye (hordeolum), a common eyelid infection in children. Question: A 10-year-old child is receiving chemotherapy for leukemia. Which laboratory parameter should be monitored closely during treatment? A) Hemoglobin B) Platelet count C) White blood cell count D) Absolute neutrophil count (ANC) Correct Answer: D) Absolute neutrophil count (ANC) Rationale: Chemotherapy-induced neutropenia can increase the risk of infections, making monitoring of ANC crucial during treatment. Question: A 4-year-old child with autism spectrum disorder (ASD) exhibits repetitive behaviors and difficulty with social interactions. Which intervention is most appropriate? A) Implement a strict behavioral modification plan B) Encourage social skills training C) Administer antipsychotic medication D) Limit sensory stimulation Correct Answer: B) Encourage social skills training A) Systolic ejection murmur B) Diastolic rumble C) Continuous murmur D) Late systolic murmur Correct Answer: A) Systolic ejection murmur Rationale: Innocent systolic ejection murmurs are commonly heard in children and are usually benign without underlying cardiac pathology. Question: A 6-month-old infant presents with failure to thrive, irritability, and developmental delays. Which condition should be considered in the differential diagnosis? A) Cystic fibrosis B) Hypothyroidism C) Cerebral palsy D) Failure to bond Correct Answer: A) Cystic fibrosis Rationale: The symptoms described are concerning for cystic fibrosis, a genetic disorder that can affect growth and development in infants. Question: A 3-year-old child is diagnosed with celiac disease. Which dietary modification is essential for managing this condition? A) Low-fat diet B) Gluten-free diet C) High-protein diet D) Dairy-free diet Correct Answer: B) Gluten-free diet Rationale: Celiac disease is an autoimmune disorder triggered by gluten consumption, necessitating a strict gluten-free diet for management. Question: An 11-year-old child with sickle cell anemia presents with acute chest pain and shortness of breath. Which complication should be suspected in this child? A) Acute vaso-occlusive crisis B) Acute chest syndrome C) Aplastic crisis D) Sequestration crisis Correct Answer: B) Acute chest syndrome Rationale: Acute chest syndrome is a severe complication of sickle cell anemia characterized by chest pain and respiratory distress. Question: A 13-year-old adolescent is prescribed isotretinoin for severe acne. What information should the nurse provide regarding this medication? A) Isotretinoin can be taken with calcium-rich foods B) Pregnancy must be avoided while on isotretinoin C) Isotretinoin is a topical medication D) Isotretinoin can be used long-term without monitoring Correct Answer: B) Pregnancy must be avoided while on isotretinoin Rationale: Isotretinoin is teratogenic and requires strict contraception measures to prevent fetal exposure. Question: A 16-year-old adolescent presents with irregular menstrual periods and hirsutism. Which endocrine disorder should be considered in this patient? A) Polycystic ovary syndrome (PCOS) B) Hyperthyroidism C) Cushing's syndrome D) Hypoparathyroidism Correct Answer: A) Polycystic ovary syndrome (PCOS) Rationale: The symptoms described are characteristic of PCOS, a common endocrine disorder in adolescent females. Question: A 17-year-old adolescent is being treated for depression with selective serotonin reuptake inhibitors (SSRIs). What monitoring is essential when initiating SSRI therapy in adolescents? A) Thyroid function tests B) Liver function tests C) Blood pressure monitoring D) Suicidal ideation assessment Correct Answer: D) Suicidal ideation assessment Rationale: Adolescents starting SSRIs should be closely monitored for signs of increased suicidal ideation, especially in the initial weeks of therapy. C. Oral antihistamines D. Emollients Correct Answer: A. Topical corticosteroids Rationale: Topical corticosteroids are the mainstay of treatment for moderate to severe atopic dermatitis in children to reduce inflammation and itching. 4. Which of the following is a risk factor for developmental dysplasia of the hip in infants? A. Female gender B. Firstborn child C. Breech presentation D. Maternal smoking Correct Answer: C. Breech presentation Rationale: Breech presentation is a risk factor for developmental dysplasia of the hip as it increases the likelihood of hip dislocation. 5. What is the recommended schedule for routine childhood immunizations according to the Advisory Committee on Immunization Practices (ACIP)? A. ACIP provides guidelines for immunization schedules but does not recommend specific intervals. B. Vaccines should be given as early as possible regardless of the recommended schedule. C. Vaccines should be given at specific ages and intervals to maximize protection against vaccine-preventable diseases. D. Vaccines should only be administered in emergency situations to prevent adverse effects. Correct Answer: C. Vaccines should be given at specific ages and intervals to maximize protection against vaccine-preventable diseases. Rationale: The ACIP provides specific guidelines for the timing and intervals of childhood immunizations to ensure optimal protection against vaccine-preventable diseases. 6. Which of the following is a common presentation of cystic fibrosis in children? A. Chronic pancreatitis B. Diabetes insipidus C. Hypoparathyroidism D. Chronic respiratory infections Correct Answer: D. Chronic respiratory infections Rationale: Chronic respiratory infections, particularly with Pseudomonas aeruginosa, are a common presentation of cystic fibrosis in children. 7. What is the gold standard test for diagnosing celiac disease in children? A. Endoscopy with biopsy B. Serologic testing for anti-tissue transglutaminase antibodies C. Stool antigen testing D. Genetic testing for HLA-DQ2 and HLA-DQ8 Correct Answer: A. Endoscopy with biopsy Rationale: Endoscopy with biopsy of the small intestine is the gold standard for diagnosing celiac disease in children. 8. Which of the following factors is NOT associated with an increased risk of sudden infant death syndrome (SIDS)? A. Prone sleeping position B. Maternal smoking during pregnancy C. Overheating during sleep D. Pacifier use during sleep Correct Answer: D. Pacifier use during sleep Rationale: Pacifier use during sleep has been shown to reduce the risk of SIDS and is not associated with an increased risk. 9. What is the most common cause of viral meningitis in children? A. Enteroviruses B. Herpes simplex virus C. Varicella zoster virus D. Influenza virus Correct Answer: A. Enteroviruses Rationale: Enteroviruses are the most common cause of viral meningitis in children, with coxsackievirus and echovirus being the most prevalent. 10. Which of the following is a recommended approach for preventing iron deficiency anemia in infants? Rationale: The AAP recommends vision screenings at 6 months, 3 years, and 5 years of age to detect vision problems early. 15. Which of the following is a risk factor for obstructive sleep apnea in children? A. Thin body habitus B. Enlarged tonsils and adenoids C. Female gender D. Mouth breathing during sleep Correct Answer: B. Enlarged tonsils and adenoids Rationale: Enlarged tonsils and adenoids are a common risk factor for obstructive sleep apnea in children, leading to airway obstruction during sleep. 16. What is the first-line pharmacologic treatment for moderate to severe eczema in children? A. Topical calcineurin inhibitors B. Oral antihistamines C. Oral corticosteroids D. Topical corticosteroids Correct Answer: D. Topical corticosteroids Rationale: Topical corticosteroids are the first-line pharmacologic treatment for moderate to severe eczema in children to reduce inflammation and itching. 17. Which of the following is a common complication of type 1 diabetes mellitus in children? A. Diabetic ketoacidosis B. Hyperosmolar hyperglycemic state C. Hypoglycemic coma D. Retinopathy Correct Answer: A. Diabetic ketoacidosis Rationale: Diabetic ketoacidosis is a common and life-threatening complication of type 1 diabetes mellitus in children. 18. What is the recommended age for initiating cholesterol screening in children according to the American Academy of Pediatrics (AAP)? A. 2 years old B. 5 years old C. 8 years old D. 10 years old Correct Answer: C. 8 years old Rationale: The AAP recommends initiating cholesterol screening in children at 8 years old with a follow-up screening at 11-12 years old. 19. Which of the following is NOT a symptom of childhood depression? A. Persistent irritability B. Loss of appetite C. Difficulty concentrating D. Auditory hallucinations Correct Answer: D. Auditory hallucinations Rationale: Auditory hallucinations are not a common symptom of childhood depression and may indicate a different psychiatric condition. 20. What is the recommended treatment for lice infestation in children? A. Topical permethrin cream B. Oral ivermectin C. Topical malathion lotion D. Benzyl alcohol lotion Correct Answer: A. Topical permethrin cream Rationale: Topical permethrin cream is the recommended treatment for lice infestation in children due to its effectiveness and safety profile. 21. Which of the following is a common symptom of bacterial meningitis in infants? A. Nuchal rigidity B. Bulging fontanelle C. Sunken anterior fontanelle D. Photophobia Correct Answer: B. Bulging fontanelle B. Intramuscular epinephrine C. Inhaled corticosteroids D. Oral corticosteroids Correct Answer: B. Intramuscular epinephrine Rationale: Intramuscular epinephrine is the first-line treatment for anaphylaxis in children to rapidly reverse severe allergic reactions. 27. Which of the following is a common symptom of acute otitis media in children? A. Odynophagia B. Vertigo C. Tinnitus D. Otalgia Correct Answer: D. Otalgia Rationale: Otalgia, or ear pain, is a common symptom of acute otitis media in children due to middle ear inflammation and fluid accumulation. 28. What is the first-line treatment for moderate to severe acne vulgaris in adolescents? A. Topical retinoids B. Oral antibiotics C. Oral isotretinoin D. Topical benzoyl peroxide Correct Answer: A. Topical retinoids Rationale: Topical retinoids are the first-line treatment for moderate to severe acne vulgaris in adolescents to unclog pores and reduce acne lesions. 29. Which of the following is a common presenting symptom of pediatric hypertension? A. Irritability B. Palpitations C. Epistaxis D. Chest pain Correct Answer: C. Epistaxis Rationale: Epistaxis, or nosebleeds, is a common presenting symptom of pediatric hypertension and may indicate elevated blood pressure levels. 30. What is the recommended approach for managing acute gastroenteritis in children with mild dehydration? A. Oral rehydration solution (ORS) at home B. Intravenous fluid administration in the emergency department C. Antiemetic medications D. Bowel rest and fasting Correct Answer: A. Oral rehydration solution (ORS) at home Rationale: The recommended approach for managing acute gastroenteritis in children with mild dehydration is to provide oral rehydration solution (ORS) at home to prevent fluid and electrolyte imbalances.