STU 25SUM1 Pediatric Competency Exam
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Free STU 25SUM1 Pediatric Competency Exam Questions
A 12-month-old child has a capillary lead level reading of 15 µg/dL. Based on this finding, the nurse practitioner should:
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consider this a normal capillary lead level and rescreen in a year
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confirm the results with a venous blood sample
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refer the child for chelation therapy
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recommend an inspection of the patient’s home for lead contamination
Explanation
The Correct Answer is:
B. confirm the results with a venous blood sample.
Detailed Explanation:
A capillary (finger-stick) lead level of 15 µg/dL is elevated above the CDC reference value of 3.5 µg/dL. However, capillary samples can be contaminated by external sources such as dust or skin residue. Therefore, the next step is to confirm the result with a venous blood sample, which provides a more accurate measure of the child’s lead exposure. If the venous level remains elevated, environmental investigation and intervention are warranted.
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.
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.
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 definitive diagnosis of leukemia is made by:
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bone marrow aspiration with biopsy
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CT scan
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complete blood coun
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lumbar puncture with cerebrospinal fluid analysis
Explanation
The Correct Answer is:
A. bone marrow aspiration with biopsy.
Detailed Explanation:
While a complete blood count (CBC) may suggest leukemia by showing abnormal white blood cell counts, anemia, and thrombocytopenia, the definitive diagnosis requires a bone marrow aspiration with biopsy. This procedure allows for microscopic examination of the marrow to confirm the presence of malignant blast cells and to determine the leukemia type—such as acute lymphoblastic leukemia (ALL) or acute myelogenous leukemia (AML). Cytogenetic and molecular studies performed on the bone marrow sample also help guide prognosis and treatment.
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 child was diagnosed with migraine headaches at a previous visit. Initial treatment included behavioral modifications, lifestyle changes, and a nonsteroidal anti-inflammatory drug (NSAID). The child returns for follow-up and states that interventions are not relieving the headaches. The most helpful medication at this time would be:
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acetaminophen with codeine
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a tricyclic antidepressant
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sumatriptan (Imitrex)
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chloral hydrate (Somnote)
Explanation
The Correct Answer is:
C. sumatriptan (Imitrex).
Detailed Explanation:
When behavioral changes and NSAIDs fail to control migraine attacks in children, the next appropriate step is the use of a triptan, such as sumatriptan (Imitrex). Triptans are serotonin (5-HT₁B/₁D) receptor agonists that relieve migraines by causing cranial vasoconstriction, inhibiting neuropeptide release, and reducing inflammation in trigeminal pathways. In children and adolescents, nasal sumatriptan or rizatriptan are commonly used, as they are both safe and effective for acute migraine relief. Preventive therapy (e.g., amitriptyline or topiramate) is considered if migraines are frequent or disabling.
A 16-year-old patient has been diagnosed and treated for genital warts. The LEAST important action at this time is to:
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screen the patient for other sexually transmitted diseases (STDs)
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perform a Pap test
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test the patient's sexual partners for sexually transmitted diseases
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prescribe another course of imiquimod (Aldara) 5% topical cream
Explanation
The Correct Answer is:
D. prescribe another course of imiquimod (Aldara) 5% topical cream.
Detailed Explanation:
After appropriate treatment for genital warts, immediate retreatment with another course of imiquimod is not necessary unless lesions persist or recur. The focus should instead be on screening for other STDs, counseling on safe sexual practices, and ensuring partner notification and testing. Genital warts are caused by HPV types 6 and 11, which are low-risk for malignancy. Management is usually based on follow-up and recurrence monitoring rather than automatic re-prescription.
A 9-year-old child has been diagnosed with chickenpox. The nurse practitioner should instruct the mother to:
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return to the clinic in 10 days for the child to receive the varicella vaccine (Varivax)
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administer acetaminophen (Tylenol) as needed for discomfort
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apply retapamulin (Altabax) topically twice a day for 5 days
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apply hydrocortisone cream 1% topically as needed for itching
Explanation
The Correct Answer is:
B. administer acetaminophen (Tylenol) as needed for discomfort.
Detailed Explanation:
For a child with chickenpox (varicella), supportive care is the mainstay of treatment. Acetaminophen (Tylenol) can be safely used to manage fever and discomfort. Aspirin and other salicylates must be avoided due to the risk of Reye’s syndrome, a potentially fatal complication. Cool baths, calamine lotion, and keeping the nails short can help relieve itching and prevent secondary bacterial infection from scratching.
A sexually active 18-year-old female presents to the nurse practitioner for abnormal uterine bleeding. A finding that does not usually suggest cervical cancer is:
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Infection with HPV
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Hardening of the cervix
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An irregular, cauliflower-like cervical growth
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A cervical polyp
Explanation
The Correct Answer is:
D. A cervical polyp.
Detailed Explanation:
Cervical polyps are benign growths on the surface of the cervical canal that can cause abnormal bleeding but are not typically associated with cervical cancer. They are usually smooth, red, and fragile, and can easily be removed for histologic evaluation to rule out malignancy, though malignancy is rare.
In contrast, findings such as HPV infection (especially high-risk strains like HPV 16 and 18), hardening of the cervix, and irregular, cauliflower-like growths are all suggestive of cervical cancer or precancerous changes. HPV infection is the primary etiologic factor in most cases of cervical carcinoma.
Thus, the presence of a cervical polyp is generally a benign cause of abnormal bleeding, not an indicator of cervical cancer.
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