STU 25SUM1 Pediatric Competency Exam

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Free STU 25SUM1 Pediatric Competency Exam Questions

1.

In the adolescent population, the leading cause of death is:

  • cancer

  • motor vehicle crashes

  • drug overuse

  • suicide

Explanation

The Correct Answer is:

B. motor vehicle crashes.

Detailed Explanation:

Motor vehicle crashes are the leading cause of death among adolescents in the United States. Contributing factors include inexperience, distracted driving (especially from cell phone use), speeding, alcohol or drug use, and failure to wear seat belts. Preventive education focusing on safe driving practices, seat belt use, avoidance of impaired driving, and parental supervision of early drivers can significantly reduce risk.


2.

Assessment findings consistent with dysmenorrhea might include:

  • headaches and breast tenderness

  • nausea, vomiting, and back pain

  • urinary frequency and burning

  • vaginal dryness and pruritus

Explanation

The Correct Answer is:

B. nausea, vomiting, and back pain.

Detailed Explanation:

Dysmenorrhea refers to painful menstrual cramps that occur with menstruation, typically due to increased prostaglandin production causing uterine contractions, ischemia, and inflammation. Common associated symptoms include lower abdominal pain, nausea, vomiting, diarrhea, fatigue, and low back pain. These symptoms usually begin shortly before or at the onset of menstruation and resolve within a few days. Primary dysmenorrhea occurs in the absence of pelvic pathology, while secondary dysmenorrhea may result from conditions like endometriosis or fibroids.


3.

Temperature instability in a newborn could result from:

  • hypoxia

  • congenital heart disease

  • polycythemia

  • sepsis

Explanation

The Correct Answer is:

D. sepsis.

Detailed Explanation:

Temperature instability—which may present as hypothermia or hyperthermia—is a classic early sign of neonatal sepsis. Newborns have immature immune systems and limited ability to regulate body temperature. When infection occurs, the hypothalamic thermoregulatory center is disrupted, and metabolic processes are altered. Instead of mounting a fever, neonates often develop low body temperature, poor perfusion, lethargy, feeding difficulties, and respiratory distress. Because of this, any newborn with unexplained temperature instability must be evaluated for sepsis immediately, including obtaining blood, urine, and cerebrospinal fluid cultures if indicated.


4.

When irrigating an open wound with normal saline, it is best to use:

  • a bulb syringe

  • a 20-mL catheter tip syringe

  • an IV bag without pressure

  • 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.


5.

By the time a child is 3 years old, they are expected to:

  • distinguish between real and make believe

  • cooperate with other children

  • take turns when playing games

  • prefer playing with others rather than alone

Explanation

The Correct Answer is:

D. prefer playing with others rather than alone.

Detailed Explanation:

By age 3, children typically transition from parallel play (playing alongside other children) to associative play, where they begin to show interest in interacting and playing with others. They start to enjoy group activities, imitate peers, and form early friendships. This social shift reflects growing emotional awareness, communication skills, and empathy. Cooperative play, turn-taking, and understanding complex social rules develop later, typically between ages 4 and 5.


6.

The first and most obvious sign of precocious puberty in a 7-year-old female is:

  • Pubarche

  • Leukorrhea

  • Rapid onset acne

  • Breast enlargement

Explanation

The Correct Answer is:

D. Breast enlargement.

Detailed Explanation:

The first and most obvious sign of precocious puberty in girls is usually thelarche, or breast development. This occurs due to premature activation of the hypothalamic-pituitary-gonadal axis, leading to increased estrogen secretion. It is the earliest visible indication that puberty has begun before the age of 8 in females.

Pubarche (appearance of pubic hair) and leukorrhea (vaginal discharge) occur later as estrogen effects progress. Rapid onset acne is not a primary sign of precocious puberty but may develop later as androgen levels increase.

Therefore, breast enlargement (thelarche)
is the earliest and most distinct clinical marker of precocious puberty in a 7-year-old girl.


7.

A 16-year-old patient diagnosed and treated for chlamydia infection should return for retesting:

  • 4 weeks following treatment completion

  • 6 weeks following treatment completion

  • 2 months following treatment completion

  • 3 months following treatment completion

Explanation

The Correct Answer is:

D. 3 months following treatment completion.

Detailed Explanation:

According to the Centers for Disease Control and Prevention (CDC) guidelines, all patients treated for chlamydia infection—especially sexually active adolescents—should be retested approximately 3 months after completing therapy, regardless of whether they believe their sexual partners were treated. This is called retesting (not test-of-cure) and is performed to detect reinfection, which is common among adolescents. A test-of-cure (checking for eradication of infection) is only recommended in pregnant patients, typically 4 weeks after treatment.


8.

The CDC’s recommendation for the initial administration of HPV vaccine in males is:

  • age 11–12 years

  • between 13 and 16 years

  • between 13 and 26 years

  • 8–9 years of age

Explanation

The Correct Answer is:

A. age 11–12 years.

Detailed Explanation:

The Centers for Disease Control and Prevention (CDC) recommends routine administration of the human papillomavirus (HPV) vaccine at ages 11–12 years for both males and females. Vaccination can begin as early as age 9, but 11–12 is the preferred age because the immune response is strongest and protection is established before potential exposure to HPV through sexual activity. For those who start later (ages 13–26), catch-up vaccination is advised if they have not been previously vaccinated.


9.

An adolescent has been treated for bulimia for the past 3 months and presents for a follow-up visit. To determine if the adolescent is still purging, the nurse practitioner should order:

  • a hematocrit and hemoglobin

  • serum albumin levels

  • bicarbonate and sodium levels

  • serum potassium, chloride, and magnesium levels

Explanation

The Correct Answer is:

D. serum potassium, chloride, and magnesium levels.

Detailed Explanation:

The most useful laboratory tests to detect ongoing purging behavior (vomiting, laxative, or diuretic use) in bulimia nervosa are serum potassium, chloride, and magnesium levels. Frequent vomiting or diuretic abuse leads to hypokalemia, hypochloremia, and metabolic alkalosis, while laxative abuse can cause hypomagnesemia and metabolic acidosis. Monitoring these electrolytes helps determine whether the adolescent continues to purge, even if they deny doing so. Persistent electrolyte abnormalities suggest ongoing purging and require prompt management to prevent cardiac arrhythmias.


10.

A 2-year-old patient has been diagnosed with acute bronchiolitis. In the home instructions, the nurse practitioner specifies that the child:

  • should stay home from daycare for 7 days.

  • should be given antipyretics every 4 hours for the next 5 days

  • will be free of acute symptoms within 1 to 3 days, and complete resolution of symptoms should occur within 10–14 days.

  • should be given an antibiotic if the nasal discharge becomes purulent.

Explanation

The Correct Answer is:

C. will be free of acute symptoms within 1 to 3 days, and complete resolution of symptoms should occur within 10–14 days.

Detailed Explanation:

Acute bronchiolitis, commonly caused by the respiratory syncytial virus (RSV), is a viral infection of the lower respiratory tract. Symptoms typically peak within 1 to 3 days and gradually resolve over 10 to 14 days. Management is primarily supportive, focusing on hydration, nasal suctioning, and maintaining airway patency. Caregivers should be reassured that gradual improvement is expected, and antibiotics are not indicated unless there is evidence of a secondary bacterial infection.


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