STU 25SUM1 Pediatric Competency Exam
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Free STU 25SUM1 Pediatric Competency Exam Questions
A thrill palpated in the right clavicular region or in the upper right sternal border area is suggestive of:
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pulmonary valve stenosis
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aortic valve stenosis
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tetralogy of Fallot
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a ventricular septal defect
Explanation
The Correct Answer is:
B. aortic valve stenosis.
Detailed Explanation:
A thrill palpated in the right upper sternal border or right clavicular region is most characteristic of aortic valve stenosis. This condition produces a systolic ejection murmur best heard at the right second intercostal space, which often radiates to the neck and carotid arteries. The thrill occurs due to turbulent blood flow across the narrowed aortic valve. Children with aortic stenosis may present with exertional dyspnea, chest pain, or syncope as the disease progresses.
When assessing an infant suspected of having the most common form of congenital adrenal hyperplasia, the nurse practitioner should expect to observe:
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genital ambiguity
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hyperglycemia
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hypokalemia
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hypernatremia
Explanation
The Correct Answer is:
A. genital ambiguity.
Detailed Explanation:
The most common form of congenital adrenal hyperplasia (CAH) is 21-hydroxylase deficiency, which leads to decreased cortisol and aldosterone production and an overproduction of androgens. In genetic females (46,XX), excess androgens cause genital ambiguity—enlarged clitoris and fused labia—while genetic males (46,XY) usually appear normal at birth but may develop early virilization. Affected infants may also experience hyponatremia, hyperkalemia, and hypoglycemia due to salt-wasting, but genital ambiguity is the hallmark finding in newborn females.
Which of the following heart rates would be of concern in an otherwise healthy 10-year-old patient?
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60 beats per minute
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73 beats per minute
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100 beats per minute
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120 beats per minute
Explanation
The Correct Answer is:
D. 120 beats per minute.
Detailed Explanation:
The normal resting heart rate for a 10-year-old child ranges from 70 to 110 beats per minute. A heart rate of 120 bpm is considered tachycardic and may indicate an underlying issue such as fever, anxiety, dehydration, pain, anemia, or infection. Persistent tachycardia in a calm, afebrile, and otherwise healthy child warrants further evaluation to rule out cardiovascular or metabolic causes.
A 10-year-old patient is suspected of having acute glomerulonephritis. The test that indicates recent streptococcal infection is:
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a throat culture
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an antistreptolysin (ASO) titer
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an erythrocyte sedimentation rate (ESR)
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blood urea nitrogen/creatinine ratio and glomerular filtration rate
Explanation
The Correct Answer is:
B. an antistreptolysin (ASO) titer.
Detailed Explanation:
Acute post-streptococcal glomerulonephritis (APSGN) typically occurs 1–3 weeks after a streptococcal throat or skin infection caused by Group A β-hemolytic Streptococcus (Streptococcus pyogenes). The antistreptolysin O (ASO) titer measures antibodies produced against the streptolysin O enzyme released by the bacteria. An elevated ASO titer confirms a recent streptococcal infection, even if the original infection has resolved.
Children with APSGN often present with hematuria (tea-colored urine), hypertension, periorbital edema, and mild renal impairment. Confirming a recent streptococcal infection helps support the diagnosis and distinguish it from other causes of glomerulonephritis.
When irrigating an open wound with normal saline, it is best to use:
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a bulb syringe
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a 20-mL catheter tip syringe
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an IV bag without pressure
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gauze compresses
Explanation
The Correct Answer is:
B. a 20-mL catheter tip syringe.
Detailed Explanation:
The most effective method for irrigating an open wound is using a 20-mL catheter-tip syringe (or larger, up to 35 mL) with an attached 18- or 19-gauge catheter. This setup produces irrigation pressure between 8 and 12 psi, which is strong enough to remove debris and bacteria without damaging healthy tissue. Using sterile normal saline under controlled pressure promotes optimal wound cleansing, reduces infection risk, and supports proper healing.
The first line of treatment for attention deficit–hyperactivity disorder (ADHD) is:
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an antidepressant
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a stimulant
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a benzodiazepine
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a selective serotonin reuptake inhibitor (SSRI)
Explanation
The Correct Answer is:
B. a stimulant.
Detailed Explanation:
The first-line treatment for ADHD in children and adolescents is stimulant medication, which effectively improves attention, focus, and impulse control in about 70–80% of patients. The most commonly prescribed stimulants are methylphenidate-based (e.g., Ritalin, Concerta) and amphetamine-based (e.g., Adderall, Vyvanse) formulations. These medications increase dopamine and norepinephrine levels in the brain, enhancing executive functioning and attention. Behavioral interventions, classroom modifications, and parental support complement pharmacologic management.
In a fully developed term infant, at age 6 weeks the nurse practitioner should expect the triangular-shaped posterior fontanel to be:
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closed
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open
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pulsatile
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open and pulsatile
Explanation
The Correct Answer is:
A. closed.
Detailed Explanation:
The posterior fontanel is a small, triangular-shaped soft spot located at the junction of the occipital and parietal bones. In a full-term infant, this fontanel is usually closed by 6 to 8 weeks of age. It may still be palpable at birth, but it quickly ossifies during early infancy as cranial sutures fuse.
In contrast, the anterior fontanel (diamond-shaped, between the frontal and parietal bones) remains open much longer—typically closing between 12 and 18 months—and may normally be flat or slightly pulsatile due to underlying cerebral blood flow.
Seborrheic dermatitis in infants is referred to as:
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erythema multiforme
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cradle cap
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hives
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impetigo
Explanation
The Correct Answer is:
B. cradle cap.
Detailed Explanation:
Cradle cap is the common term for seborrheic dermatitis in infants. It presents as greasy, yellowish scales on the scalp, sometimes extending to the face, behind the ears, or diaper area. It results from overactive sebaceous glands influenced by maternal hormones and the presence of Malassezia yeast. Treatment includes gentle washing with mild shampoo and the application of mineral oil or medicated shampoos to soften and remove scales. The condition is benign and self-limiting.
An infant with a continuous inspiratory and expiratory stridor may be exhibiting symptoms of:
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hypocalcemia
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increased intracranial pressure
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an upper airway obstruction
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vocal cord paralysis
Explanation
The Correct Answer is:
D. vocal cord paralysis.
Detailed Explanation:
Continuous inspiratory and expiratory stridor in an infant is most characteristic of bilateral vocal cord paralysis. Stridor that occurs during both phases of respiration indicates an obstruction at or near the level of the vocal cords. In bilateral paralysis, the cords remain partially closed, narrowing the airway and producing a harsh, continuous stridor. This condition can result from central nervous system abnormalities, birth trauma, or postsurgical nerve injury. It is a potentially serious condition requiring airway assessment and referral to an otolaryngologist.
The nurse practitioner is performing a neurological assessment on an infant and places a finger in the infant’s hand. The infant flexes all fingers to grasp the practitioner’s finger. This maneuver assesses the:
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plantar grasp reflex
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palmar grasp reflex
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Landau reflex
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Galant reflex
Explanation
The Correct Answer is:
B. palmar grasp reflex.
Detailed Explanation:
The palmar grasp reflex is a primitive reflex present at birth and serves as an important indicator of normal neurological development. When the nurse practitioner places a finger or object into the infant’s palm, the infant’s fingers flex tightly around it as a reflexive grasp. This reflex typically appears at birth and disappears by 5 to 6 months of age as voluntary motor control develops. Persistent presence beyond that age may suggest neurological impairment such as cerebral palsy.
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