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PNP ACTUAL EXAM WITH CORRECT
ACTUAL QUESTIONS AND CORRECTLY
WELL DEFINED ANSWERS LATEST 2025
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Mrs. B has brought 5 yo Julio to the clinic. She reports that he has been lethargic and has been running a low-grade fever for about two weeks. Physical exam reveals no significant findings other than pallor and lymphadenopathy. A CBC reveals a decreased hematocrit, neutropenia, and thrombocytopenia. The practitioners next action should be to:
A. Prescribe a broad spectrum antibiotic and ferrous sulfate B. Instruct Mrs. B on the appropriate use of Acetaminophen to treat Julio's fever C. Reassure Mrs. B that Julio's signs and symptoms are indicative of a viral infection D. Refer Julio to a pediatric hematologist/oncologist for further evaluation - ANSWERS-D
Routine lab studies have revealed that a two-year-old child has a decreased level of serum ferritin. Red cell count and indices are within normal limits for age. Based on this information, you may assume that the child:
A. May have stage I iron deficiency anemia B. Likely has stage II iron deficiency anemia C. Likely has stage III iron deficiency anemia D. Does not have any stage of anemia - ANSWERS-A
You have ordered red blood cell indices for a 10-year-old girl. Results reveal a decrease in both the mean corpuscular hemoglobin MCH and the mean corpuscular volume MCV. Differential diagnosis should include:
A. Sickle cell anemia B. Vitamin B 12 deficiency anemia C. Pernicious anemia D. Iron deficiency anemia - ANSWERS-D
When planning screening protocols, it is important for the practitioner to know that iron deficiency anemia is most common in which life period(s)?
A. The first month of life B. The period when the child is most sedentary
a. encourage the parent to use 5 minute time-outs when cheating occurs b. explain that DW is developmentally unable to comprehend rigid rules c. make sure that DW understands the rules before starting to play the game d. explain to DW that cheating is like lying and is not acceptable behavior - ANSWERS-b
Which of the following is not a sign of readiness to toilet train? a. can sit for extended periods b. can follow directions c. occasional waking from naps with dry diapers d. regularity of bowel movements - ANSWERS-d
Which of the following physical findings in a 2 month old child warrants an immediate referral to a neurologist/neurosurgeon? a. head circumference growing faster than height and weight b. unresolved cephalhematoma c. rigid and immobile sagittal suture d. snapping sensation when pressure is applied to parietal bone - ANSWERS-c
While listening to 2.5 yo KL talk, you note that she frequently omits final consonants and her sentences are two and three words in length. The appropriate plan of care would be. a. routine follow up at next well child visit
b. referring for hearing screening c. assessing for developmental delays d. referring to a speech pathologist - ANSWERS-a
H.O. is a 5 yo Vietnamese child who has fallen off of his growth curve. The best intervention would be to: a. Suggest high-calorie breakfast drinks as supplements b. incorporate traditional foods into a management plan that will provide increased calories and nutrients c. educate the family on the need for increased calories and nutrients d. refer the family to growth clinic for evaluation - ANSWERS-B
While taking the history of 6-month old E.M. you learn that she is not sleeping through the night and will not fall back to sleep without the parents rocking or feeding her. This is an example of: a. somnambulism b. pavor nocturnus c. learned behavior d. delayed sleep phase - ANSWERS-C
Which of the following scenarios is suggestive of a child who may not be ready to enter first grade? An inability to:
b. suggest play activities that require using both hands c. present toys more often to the right hand d. perform a careful neurological exam - ANSWERS-d
At 12 yo, Peter has been dx with constitutional growth delay. Appropriate management would include: a. starting low-dose testosterone therapy now b. counseling regarding delayed onset of puberty c. thyroxine replacement d. nutritional counseling - ANSWERS-b
Which of the following best describes behavior associated with Piaget's concrete operations? a. learning primarily by trial and error b. interpreting events in relationship to themselves c. categorizing information into lower to higher classes d. drawing logical conclusions from observations - ANSWERS-c
Jeffrey, at 8 years of age, has been diagnosed with ADHD and is receiving stimulant medication. Which of the following interventions would be least helpful? a. monthly ht and wt checks b. small frequent meals and snack
c. high-calorie supplemental drinks d. elimination of refined sugar from diet - ANSWERS-d
The principle that growth and development becomes increasingly integrated is best demonstrated by: a. gaining head control before raising the chest b. bringing the cup to mouth, tipping and swallowing c. rolling over before sitting d. grasping with fist before using fingers - ANSWERS-b
In males, Tanner stage III can be distinguished from tanner stage II by: a. fine downy pubic hair at the base of penis b. adultlike pubic hair not extending to thighs c. penile growth in width d. penile growth in length - ANSWERS-d
TJ, 13 yo, reluctantly shares with you that his "chest hurts." On physical exam, you note unilateral breast enlargement, which is tender to palpation. You suspect physiolgic gynecomastia. Which tanner stage would support that diagnosis? a. tanner stage I b. tanner stage III c. tanner stage IV
You detect a hear murmur while examining a 3 yo child. In determining whether of not a referral is necessary, you determine it is an "innocent" heart murmur for which of the following reasons? a. It is best heard during diastole b. it radiates to the axilla c. the intensity is no greater than I or II/VI d. there is no variation with change in child's position - ANSWERS-c
When providing anticipatory guidance about infant development, you might teach parents that a normal infant could first transfer an object from hand to hand at which age? a. 2 mos b. 4 mos c. 7 mos d. 9 mos - ANSWERS-c
A 2 mos old infant at your clinic received a combined Dtap/HepB/IPV vaccine and the parents are in need of teaching about possible side effects. Which of the following is not an adverse effect following administrations of the Dtap vaccination? a. local reaction b. fever c. increased fussiness
d. transient morbilliform rash - ANSWERS-d
When reviewing immunization protocols at your clinic, you are aware that the varicella vaccine can be administered to susceptible children beginning at what age a. 4 mos b. 6 mos c. 12 mos d. 15 mos - ANSWERS-c
A 2 wk old infant is in the clinic for a scheduled weight check. The best indication that a 2 wk old infant is receiving adequate breastmilk is that the baby: a. passes a least 4 stools a day b. feeds every 3 hrs c. voids 4 times a day d. has regained birth wt - ANSWERS-d
A mother of an 8 month old infant asks you for advice about continued introduction of solids. Which of the following food groups do you recommend be introduce to the baby last? a. egg yolk b. egg white c. fruits
You are seeing a 15 mos old boy with leukemia for a check up. If indicated, this child may receive all of the following vaccines except: a. inactivated polio vaccine (IPV) b. H. influenzae type B (Hib) c. DTap d. Varicella (VAR) - ANSWERS-d
While conducting the Denver II developmental screening test, the mother of an 18 mos old child reports to you that the toddler doesn't imitate activities. You decide to assess the child's development further by giving him tasks from which sector? a. personal-social b. fine motor-adaptive c. language d. gross motor - ANSWERS-a
You have ordered routine blood screening for a 2yo girl who because of dietary habits, is at risk for iron deficiency anemia. Which of the following findings is not associated with iron deficiency anemia? a. hypochromic RBC b. microcytic RBC c. low reticulocyte count d. low free erythrocyte protoporphyrin (FEP) level - ANSWERS-d
During a prenatal visit, you review the mother's record for routine prenatal screening results. While education the mother, you explain that the screening of maternal serum for alpha-fetoprotein (MSAFP) between the 15th - 21st weeks of pregnancy is done primarily to screen for: a. phenylketonuria b. galactosemia c. cystic fibrosis d. neural tube defects - ANSWERS-d
A tenderness is detected over the tibial tuberosity of a 10 year old boy during a routine exam at a school based clinic. The PNP knows this may be a sign of: a. osgood-schlatter dz b. blount's dz c. plantar fasciitis d. effusion in the joint space - ANSWERS-a
The parents of a 1 wk old infant are concerned about the unusual shape of their child's head. In the physical exam of the infant, which of the following signs would not support a diagnosis of craniosynostosis? a. palpation of a ridge along a given suture line b. unusual skull configuration c. a palpable lesion at the occipital region d. abnormal head cirumference - ANSWERS-c
c. laboratory studies d. observation of family interactions - ANSWERS-a
A 7yo child in your caseload has recently been placed on methylphenidate for behavioral concerns associated with ADHD. Which of the following side effects are not associated with this drugs? a. decreased appetite b. weight loss c. irritability d. decreased heart rate - ANSWERS-d
The parents of an 8yo child are concerned that their son does not want to attend school. Which of the following historical findings aren't usually associated with the diagnosis of school phobia? a. sporadic school absence b. chronic medical illness c. vague physical symptoms d. depression and anxiety - ANSWERS-b
A 17yo girl is referred to your clinic by the school nurse to be assessed for an eating disorder. Which of the following dynamics is not characteristic of anorexia nervosa? a. excessive eating followed by purging b. a pervasive sense of helplessness and ineffectiveness
c. wt loss that gives the patient a sense of mastery and control d. low body temp, pulse, and bp - ANSWERS-a
Following an episode of meningitis, it is most important to assess the child for: a: hearing loss b. changes in taste c. cervical lymphadenopathy d. tinnitus - ANSWERS-a
An 8 yo boy has been brought to the clinic with a chief c/o ear pain. When you grasp the pinna of he ear, he says "that hurts real bad." These findings are consistent with a diagnosis of: a. serous otitis media b. mastoiditis c. otitis externa d. cholesteatoma - ANSWERS-c
Steven, at 10 years of age, as been diagnosed with otitis externa twice this year. Health teaching for Steven and his mother should include: a. emphasis on consistent use of low-dose prophylactic antibiotics b. sleeping with affected ear in the dependent position c. info on the use of decongestants to open the eustachian tube d. info on the use of acetic acid after ear canal contact with water - ANSWERS-d
severe pharyngeal pain of 2 days duration and says he has been sweating and thinks he has fever. Physical exam reveals a temp of 102 and erythematous and edematous pharynx and soft palate. The right tonsil is swollen and inflammed without exudate and the uvula is displaced to the left. Right cervical nodes are tender. Lungs are clear to auscultation. Brian's signs and symptoms are suggestive of: a. acute uvulitis b. viral pharyngitis c. epiglottitis d. peritonsillar abscess - ANSWERS-d
Which of the following is an expected finding after treatement of acute suppurative otitis media? a. otitis externa b. central auditory dysfunction c. functional hearing loss d. middle ear effusion - ANSWERS-d
The mother of 2yo Shanda has brought her to the clinic bc she thinks the child is having trouble hearing. Your evaluation of the compliant should start with: a. asking detailed questions related to Shanda's medical history b. examination of the ear c. tympanometry and hearing tests
d. assuring the mother that transient hearing loss in childhood is common - ANSWERS-a
Assessment of the red reflex may be used to rule out which of the following: a. opacities b. myopia or hyperopia c. decreased visual acuity d. blindness - ANSWERS-a
The mother of 2yo Bridget has brought her to the clinic because "she got bathroom cleaner in her eye." Hx reveals that about 30 min ago, Bridget was sitting on the floor playing with a squeeze bottle of bathroom cleaner, when the bottle accidentally opened and the liquid splashed into her right eye. Physical exam reveals a reddened right eye with an edematous lid. Initial treatment should include: a. allowing the natural tearing process to cleanse the eye b. performing a retinal fundoscopic exam to assess for burns c. irrigating the eye with copious amount of normal saline d. referring Bridget to an opthalmologist - ANSWERS-c
The mother of a 5yo boy has brought him to the clinic bc she thinks he has pinkeye. Which of the following would lead you to consider a dx other than bacterial conjunctivitis? a. hyperemic conjunctiva
