Barkley Acute Care Nurse Practitioner Certification Exam Review 2022: Liberty University (172QBank)
1. A 59-year-old is having a follow-up evaluation two
... [Show More] years after the successful conclusion of radiation therapy for leukemia. He tells you that he has been feeling run-down and reports unexplained weight loss and night sweats. Upon examination, you determine that he also has a fever and pain below his ribs and the left side. You know that he is at risk for chronic lymphotic leukemia. Which of the following results is considered the hallmark of this disease?
A. Philadelphia chromosome in leukemic cells
B. Lymphocytosis
C. Non-circulating blast cells in bone marrow
D. Pancytopenia with circulating blasts.
2. A 28-year-old single mother arrives at your office inquiring about alternative options for contraception. The woman mentions that she has been having an oral contraception for the last 10 years but is curious about the hormonal intrauterine device (IUD) option she read about in an article. Which of the following is one of the advantages of using a hormonal IUD?
A. Prevention of depression
B. Prevention of Asherman’s syndrome
C. Increased menstrual loss
D. Spotting
3. You are monitoring a toddler who has serous otitis media. The patients want to understand the treatment their child will receive. Which of the following would be the appropriate way to manage this condition?\
A. Oral antibiotics
B. Antihistamines
C. Decongestants
D. Monitor and re-evaluate in 3 months
4. Which of the following seizure patients would most likely benefit from lumbar puncture?
A. Any child with a tonic-clonic seizure
B. An 11 year old with a fever of 101.5 F
C. A four-month-old without fever
D. A two-year-old with a known seizure disorder
5. You take a serological test on a patient with hepatitis. Checking over the results, you discover the patient’s serology is positive for the following: surface antigen of the Hepatitis-B (HbsAg), antibody to the antigen of the hepatitis B virus (Anti-Hbe), immunoglobulin M (IgM0, immunoglobulin G (IgG0. What is the proper diagnosis?
A. Chronic hepatitis B
B. Recovered hepatitis B
C. Acute hepatitis A
D. Acute hepatitis B
6. Robert, a good friend of your, has called you to advice on obtaining a medical certification. He wants to know his various options. Which statement is true regarding the difference between licensure and certification?
A. Certification signifies that a person is qualified to perform a particular role and is granted by a government agency.
B. Licensure signifies mastery of specialized knowledge and is granted by a government agency.
C. Certification signifies mastery of specialized knowledge and is granted by a non-governmental agency.
D. Licensure signifies that a person is qualified to perform a particular role and is granted by a non- governmental agency.
7. A mother brings her 3-month-old baby to your clinic to screen for failure to thrive (FTT). Which of the following is not a sign or symptom that would cause you to associate the infant with FTT?
A. Absolute length/width are below the 5th percentile
B. Weight falling greater than 2nd percentiles below the standard
C. Avoids eye contact
D. Commonly cries for more food or milk
8. Which of the following is not true of progestin-only birth control?
A. It has excellent reversibility
B. It most likely changes tubal transport of female and male gametes
C. Its mechanism of action affects the cervical mucus and the endometrium
D. It is typically more effective than combination pulls but has more side effects
9. The parents of a 1-year-old patient presents to you with concerns regarding their daughter’s health. At birth, they were told that their daughter had abnormal features and decreased muscle tone. They hope that their daughter would “grow out” of some these defects but, to their disappointment, she has not. They report that their daughter is having trouble walking and sitting up by herself. Furthermore, they state that no matter how much they feed their baby, she is always crying out for more food and, as a result, has been rapidly gaining weight. You suspect a chromosomal condition. Which of the following would be most likely?
A. Prader-Willi Syndrome
B. Hurler syndrome
C. Down syndrome
D. DiGeorge syndrome
10. The mother of a toddler complains that her 2-year-old child is picky eater, and despite evidence of a healthy growth pattern, she is concerned about her child’s appropriate food intake. Which of the following is the most accurate regarding toddler nutrition?
A. Your toddler’s diet is appropriate if he consumes 70 to 100 kcal/kg/day
B. Toddlers should consume more protein and a total of 120 kcal/kg/day
C. Toddlers must consume a least 45 kcal/kg/day
D. Parent of toddlers should insist that their children clean their plate and consume 100 to 110 kcal/kg/day
11. During a check-up with a 6-year-old, you wish to conduct an interview the child and his parents. He is a new patient, and you want to establish the proper doctor-patient relationship. Which of the following is a necessary component of your interview?
A. Assess child’s cholesterol
B. Informing the parents ahead of time if you are recording data
C. Assess liver function
D. Measure the child’s hematocrit
12. According to Jean Piaget, between the age of seven and 11, a child’s psychological development will be marked by:
A. Development of intuitive thought
B. Capability of logical thought
C. Trial and error learning
D. Capable of complex problem solving
13. After years of not conceiving, Kelly and Ed finally have a child, a girl named Beverly. They often check with you about what to expect as Beverly ages. In a month she will be 2 ½ years old. Which of the following is typically present in a 2 ½ -year-old child?
A. All primary teeth have erupted
B. Birth weight has doubled
C. Anterior fontanel is open
D. The child will be in the industry versus inferiority stage of psychosocial development
14. You are doing a well-child check on an infant. Currently, the baby can lifts his head when on his stomach, laughs aloud, and can crawl to you. When asked to say “mama,” however, the baby just smiles. Based on this description, what is his approximate age?
A. 6 months
B. 10 months
C. 4 months
D. 2 months
15. A mother visits you with her 13-month-old daughter, Vicky. The mother tells you that Vicky had Hib conjugate vaccine (Hib) and that she needs her booster. The mother wants to know if Vicky can still get her Hib booster. Which of the following should you tell the mother?
A. Hib booster is typically given at 12 months of age.
B. Hib booster is typically not recommended until two years of age
C. Hib booster must be given in a series of three before 5 months of age
D. The child does not need a booster until 5 years of age
16. Maggie, 2-month-old, is planning to receive the polio vaccine. Which of the following statements is true regarding polio vaccine administration to the patient?
A. The inactivated polio vaccine would be given at 3, 6, and 9 months of age, with the last dose received by 4 years of age.
B. The oral polio vaccine should be started at 6 years old.
C. The final dose of the inactivated polio vaccine would typically be given when the patient is 6 years old.
D. The inactivated polio vaccine should be given in a single dose at 2 months of age.
17. A parent brings her young infant into the clini, asking questions, about the administration of the rotavirus vaccine to her child. Which of the following is true regarding the rotavirus vaccine? A. The series of doses should begin before 14 weeks of age
B. The rotavirus vaccine may be administered before 14 weeks of age
C. Feedings should be limited after the child received the vaccine
D. The first dose should be administered at 1 year of age.
18. A new mother who is HBsAg-positive has just delivered her first child. Knowing that the baby will need to be protected from hepatitis, what would be your best plan of action for his new born?
A. Administer the hepatitis B vaccine and 1.0 mL hepatitis B immune globulin within six hours of birth.
B. Administer the hepatitis B vaccine and 0.75 mL hepatitis B immune globulin within 8 hrs of birth.
C. Test for HBsAg and antibody to HBsAg immediately after birth
D. Administer the hepatitis B vaccine and 0.5mL hepatitis B immune globulin within 12 hrs of birth.
19. Which of the following is not an event that must be reported to the Vaccine Adverse Events Reposting System?
A. Anaphylaxis
B. Death
C. Pneumonia
D. Encephalitis
20. You have a patient with a genetic disorder. The physical finding on this patient are an abnormal head, flattened nose, and upward slating eyes. Based on the physical findings, which would be the most likely genetic disorder?
A. DiGeorge syndrome
B. Down syndrome
C. Marfan syndrome
D. Turner’s syndrome
21. A 3-month-old infant, who was born healthy and weighed 7 lbs 5 oz at birth, presents with hypotonia, decreased vocalization and suspected seizures, which are all characteristics of Tay-Sachs disease. Which of the following would most predispose the infant to this condition?
A. Family history of hyperlipidemia
B. Ashkenazic Jewish ethnicity
C. African ethnicity
D. Family history of drug addiction
22. A 2-year-old female patient has a webbed neck, lymphedema, and low hair line. Additionally, you note the child’s blood pressure to be above the 95th percentile for children her age. The mother also mentions the child has difficulty grasping concepts at home, especially with learning to use a toilet. With which of the following genetic syndromes does the child most likely present?
A. Marfan
B. Turner’s
C. DiGeorge
D. Klinefeller’s
23. DiGeorge syndrome causes congenital defects in all of the following except:
A. Basal ganglia
B. Conotruncal region of the heart
C. Parathyroid gland
D. Thymus
24. When interviewing an expectant mother regarding family history for the purpose of genetic evaluation, which is not necessary to ask about?
A. Neurologic conditions
B. Birth defects
C. Growth retardation
D. Drug addiction
25. You are assessing a newborn who presents with a reddish-purple vascular malformation of the skin consisting of dilated capillaries. You recognize this as which of the following skin variations?
A. Café au lait spots
B. Port-wine stain
C. Strawberry mark
D. Mongolian spots
26. A Caucasian newborn delivered via Caesarean section at 38 weeks gestation, without complication, is in the nursery for an initial assessment. As the nurse practitioner, which of the following measurements should you most expect?
A. Weight of 1.8 kg, head circumference of 33 cm, and length 52 cm
B. Weight of 4 kg, head circumference of 36 cm, and length 51 cm
C. Weight of 3 kg, head circumference of 30 cm, and length 50 cm
D. Weight of 3 kg, head circumference of 33 cm, and length 51 cm
27. Of the following, which is the appropriate ratio of occurrence of galactoemia? A. 1:3,600 to 5,000
B. 1:400
C. 1:10,000 to 25,000
D. 1:60,000 to 80,000
28. When examining a newborn, which of the following is the best used to diagnose hip dislocation?
A. Uneven skin folds
B. Allis’ sign
C. Ortolani-Barlow maneuver
D. Turned in toes
29. A child is born in the 97th percentile for birth weight. It is surprising since the parents are of normal weight and the mother does not have diabetes. This seems to be the infant’s only abnormality, until it is discovered that the child also has an enlarged tongue. Which of the following is the most likely diagnosis?
A. Perlman syndrome
B. Beckwith-Wiedemann syndrome
C. Costello syndrome
D. Simpson-Golabi-Behmel syndrome.
30. After giving birth to Tabitha, her first child, 28-year-old Samantha and her husband, Darrin, leave the hospital after a day. The conception was without complication. When should Tabitha come back for a follow-up well-child check?
A. Four to six days
B. Two to three days
C. Three to five days
D. One to two days
31. Which of the following is not a supplement typically provided for infants?
A. Fluoride
B. Vitamin K
C. Vitamin D
D. Iron
32. A 3-month-old boy with a fever is brought to your clinic by his parents. You take the infant’s temperature and find that it is slightly higher than 101.8 F, which suggests serious bacterial infection, however, you are unable to find the local site of infection. Which of the following should be your next step?
A. Prescribe ibuprofen to manage the infant’s condition
B. Prescribe alternating doses of ibuprofen and acetaminophen
C. Admit the infant to a hospital
D. Consider the diagnosis of a urinary tract infection
33. By what age should a child have his first dental visit?
A. 2 years
B. 10 months
C. 8 months
D. 1 year
34. Which of the following is a developmental warning sign in infants?
A. An APGAR score of nine
B. Does not try to pick up a toy by two months of age
C. Does not raise head when lying on stomach by 3 months of age
D. Does not try to pick up a toy by three months of age
35. Of the choices, which is typically a result of allergic rhinitis?
A. Orbital edema
B. Mouth breathing
C. Fissures at lip corners
D. Nasal quality voice
36. A four-year-old boy comes to your office accompanied by his mother, who states that she has been concerned about frequent pauses and repetitions in her son’s speech. After conducting differential diagnosis for hearing and visual impairment, you diagnose the child with stuttering. You assure his mother that no immediate treatment is needed and that stuttering frequently resolves on its own, however, her son may require a future referral. Which of the following conditions would not require a referral?
A. The child speaks but has a vocabulary of less than 1000 words
B. Avoidance of speaking
C. Patient age of six years or older
D. Stuttering lasting more than six months
37. The Bayley-Ill test is the standard for the diagnosis of developmental delays in children until what age/
A. 30 months
B. 42 months
C. 24 months
D. 36 months
38. A father brings in his 6-month-old girl, Hannah, because he is concerned that her development has slowed down considerably in the past month. For example, Hannah no longer makes babbling sounds like she used to, and she now drools excessively. She also used to flex her legs and reach for her mother’s hair with her hands, but now her legs and arms are floppy. You eventually diagnose Hannah with a pervasive development disorder that is diagnosed only in females. Which is it?
A. Autistic disorder
B. Asperger’s syndrome
C. Childhood disintegrative disorder
D. Rett’s disorder
39. Mary and David bring their child, Sarah, to your office, and they tell you that they want to begin potty training her. The child is showing signs that she is ready to begin her training. Which of the following signs is the nest indicator that she is ready?
A. The child’s bowel movement are irregular
B. The child’s seems comfortable with wet diapers
C. The child can walk and transfer objects between her hands
D. The child stays dry after naps
40. A mother brings her 5-year-old son in for a check-up. He is about to enter school for the first time and must go through some screenings before the school will permit him to participate. After reviewing the family history, you learn that his grandfather has a myocardial infarction at the age of 50. Which of the following is specifically indicated by this aspect of the patient’s history?
A. Measles, mumps, and rubella immunization
B. Purified protein derivative screening
C. Cholesterol screening
D. Hematocrit screening
41. The parents of 6-year-old Morris are worried about his adjustment to school. He has not exhibited dysfunctional behavior yet, but his older brother, now 20 years old, did. Which of the following is a likely warning sign in younger, school age children?
A. Disinterested in any extra academic activity
B. Cannot make or keep friends
C. Not working to ability
D. Destructive behavior to express self
42. When considering a school-age child’s nutritional development, which of the following is not typical average, annual height gain for the child?
A. 2 inches
B. 1 ½ inches
C. 3 inches
D. 2 ½ inches
43. A report of suspected child abuse must be made if certain signs or symptoms are observed. Your suspicion of child abuse would be further supported if the child exhibits bruising and the following except?
A. Soft tissue markings with the outline of a hand
B. Child is beneath 30th percentile for weight
C. Partial thromboplastin time of 90 seconds
D. Prothrombin time of 11 seconds
44. There are three general strategies when interviewing an adolescent. Which of the following is not one of the strategies used when interviewing adolescents?
A. PACES format
B. SAFETEENS format
C. HEADSS format
D. CAGE format
45. A 17-year-old patient, Maria, comes to your office with her mother. You notice, comparing her to last year, she has lost weight and looks very unhealthy. She reports that she has an eating disorder and wants help. You conduct a brief test and find that her teeth look transparent and that she has cotton-like hairs on her arms. It is determined that she has an eating disorder. Which of the following would not be a good management option for Maria’s condition?
A. Institutionalization
B. Interdisciplinary management
C. Behavior modification
D. Psychotherapy
46. You are examining a boy whose penis has begun to elongate. The physical development is indicative of what Tanner stage?
A. II
B. IV
C. I
D. III
47. When performing a physical exam on an adolescent patient, you should keep in mind that hormone surging can affect which of the following part of the body?
A. Tooth eruption
B. Motor skills
C. Visual acuity
D. Liver function
48. Between what Tanner stages does menarche usually occur in girls?
A. III and IV
B. I and II
C. II and III
D. IV and V
49. You are checking up on a 6-year-old Arnold, whom you saw last month for strep throat. You want to ensure that this patient is not experiencing a complication that can occur as a result of the strep throat infection after approximately 20 days of the infection. Which of the following would indicate the patient is more than likely experiencing this complication?
A. Polymorphous rash
B. Inflammatory changes of the lips
C. Polyarthitis
D. Inflammatory changes of the oral cavity
50. A 14-year-old patient comes to your office showing signs of fever, painful tender joints, and strep throat. Laboratory findings show positive throat culture and a positive rapid strep assay. Based on the findings of this patient, which of the following would not be a good treatment for the patient’s condition?
A. Prophylactic antibiotics for invasive procedures
B. High dose acetyl salicylic acid therapy
C. Aggressive management of the strep infection
D. Bed rest if acute carditis is present
51. Kawasaki disease is an acute febrile syndrome that causes vasculitis. It is also known for all the following
except?
A. A persistent evaluation of average systolic and diastolic blood pressure
B. The leading cause of coronary artery disease in children of an infectious etiology
C. Occurs most commonly in children of Asia ethnicity
D. Most commonly noted in children under the age of two.
52. A diabetic mother, 41 years old bring her 2 week-old male infant into your office. A chest x-ray reveals a boot- shaped heart, with normal size and pulmonary vascular marking. These finding are most indicative of which of the following cardiac defects?
A. Tetralogy of Fallot
B. Atrial Septal Defect
C. Transposition of great arteries
D. Ventricular septal defect
53. James and Devin’s first son, Anderson, is diagnosed with Down syndrome. Amongst their many concerns, they want to know if this could affect Anderson’s physical well-being. Down syndrome is associated with heart conditions. Which of the following is the most common heart defect associated with Down syndrome?
A. Tetralogy of Fallot
B. Patent ductus arteriosus
C. Atrioventricular septal defect
D. Transposition of the great arteries
54. The nurse practitioner is examining Martin, a 3-month-old whose mother brought in because he has not been gaining weight. A physical examination indicates a palpable olive-shaped mass in the patient’s abdomen. Which of the following would the NP expect to find in Martin’s case?
A. Abdominal distention
B. Chocking and coughing
C. Projectile vomiting after feeding
D. Hematemesis
55. You are treating a 1-month-old whose presentation includes jaundice, malnutrition, and distention of the abdomen. His mother adds that the infant experiences infrequent bowel movement and that bile appears in his vomit. Which of the following is the best diagnosis?
A. Intussusception
B. Hirschsprung’s disease
C. Pyloric stenosis
D. Appendicitis
56. You have just diagnosed a 10-year-old with gastroenteritis, nut now the parents are concerned that it may have spread to their newborn girl. Since babies cannot tolerate gastroenteritis as long as older children, what symptoms present in the infant should cause the parents to immediately bring their baby to see you?
A. The child has a fever of 101F with vomiting
B. The child has bouts of colicky pain every evening from 8pm to 8pm
C. The child cries with pain, is difficult to comfort, and has diarrhea three times in a day
D. The child has bloody stools, no wet diaper in 6 hours, and cries without tears
57. Evan 14-yeard-old presents with complaints of stomach pain that has concentrated in the lower right portion of his abdomen. Evan reports that his abdominal pain worsens when he coughs and that he vomited soon after the pain began, however, he denies any subsequent vomiting episodes. Suspecting appendicitis you begin physical examination and find that Evan experiences pain when he extends his right thigh. This finding is known as:
A. Obturator sign
B. McBurney’s sign
C. String sign
D. Psoas sign
58. You are treating Jake, a 2-month-old infant who was born with a low birth weight. Jake’s parents are concerned that he appears to be losing further weight and frequently chokes and wheezes. Additionally, they state that he vomits on a recurring basis. You suspect a diagnosis of gastroesophageal reflux disease (GERD), however, you also know that Jake’s presentation may also be indicative of Pyloric stenosis, and thus, you must conduct laboratory tests to rule out this diagnosis. Which of the following laboratory tests is most helpful in distinguishing GERD from pyloric stenosis?
A. Stoof for occult blood
B. Urinalysis
C. Abdominal ultrasonography
D. Complete blood count
59. Max, the infant son of Mel and Anne, has exhibited a red rash on his pelvis due to the type of diaper he wears. Now raised bumps have appeared, although with no discoloration. Which of the following would best treat bumps
A. Emollients
B. Hydrocortisone
C. Topical antifungal
D. Domeboro
60. An 18-month-old boy is diagnosed with Coxsackie virus, also known as hand, foot and mouth disease. Which of the following is the most appropriate management for this condition?
A. Steroids
B. Acetaminophen
C. Doxycycline
D. Acyclovir
61. In July, Marian brings in her 5-year-old son, Jensen, who has just started presenting with Varicella zoster virus. His contraction of the virus was intentional as Marian brought, Jensen to a “chicken pox party” where a child with the virus can spread it to other kids, so all the children can get the virus now and not when school is in session. Marian asks you for a treatment that specifically reduces the duration of his signs and symptoms. Which of the following is the best recommendation for treatment?
A. Antihistamine
B. Acetaminophen
C. Acyclovir
D. Calamine
62. After 3-month-old Jeremy was exposed to pollen found in the backyard, the parents bring him in because of red scabbing on his skin. Which of the following should Jeremy’s parents avoid using for his treatment?
A. Topical steroids
B. Ultraviolet bright light
C. Oil-based products
D. Soap and water
63. Which of the following categories of burns present as moist?
A. First and second
B. First
C. Second and third
D. Second
64. The father of a 7-year-old bring his child in with complaints of purulent discharge and pain to left ear. Upon examination you notice that the child is to be in pain upon manipulation of the auricle, but the tympanic membrane appears normal and shows evidence of mobility. Which of the following is the most likely diagnosis?
A. Acute otitis media
B. Serous otitis media
C. Otitis externa
D. Mastoiditis
65. Jimmy comes to your office for a checkup. During the physical exam, his nose begins to bleed. You begin to apply pressure to which part of the nasal septum?
A. Anterosuperior
B. Anteroinferior
C. Posterosuperior
D. Posteroinferior
66. Melissa brings her 10-year-old son Alex for a checkup. His medical history includes corticosteroid treatment for juvenile rheumatoid arthritis (JRA) with which he was diagnosed last month. Melissa was told by the immunologist that Alex would need periodic checkups with an ophthalmologist, however, she notes her son has yet to mention any problems with his eyes. Which of the following should you tell her?
A. The inflammation due to JRA often inflames the conjunctiva, causing gradual strabismus.
B. The resulting weakened immune system usually leads to recurrent conjunctivitis
C. Juvenile rheumatoid arthritis leads to glaucoma
D. Prolonged use of corticosteroids may lead to cataracts
67. What are the 2 most common presentations of mononucleosis on the 16 to 20-yeail-old group?
A. Fatigue, sore throat
B. Swollen lymph nodes, nausea
C. Swollen lymph nodes, joint aches
D. Fatigue, nausea.
68. An adolescent presents with copious mucopurulent discharge from his right eye. Given the most likely diagnosis, which of the following is the most appropriate first-line treatment?
A. Penicillin
B. Zithromax
C. Ceftriaxone
D. Erythromycin
69. You are treating a 9-year-old patient with asthma. Her symptoms, which include coughing and chest tightness, occur three times a week during the day and three times a month during the night. Additionally, she also has a forced expiratory volume in the one second of 80%. Which of the following is the most likely severity level of the asthma condition?
A. Mild persistent
B. Moderate persistent
C. Severe persistent
D. Mild intermittent
70. A 1-month-old patient presents with symptoms of chronic cough, nasal passages filled with mucus, and a respiratory infection. You find an obstructive pattern in the pulmonary function test and try to look for more signs to confirm your suspected diagnosis. Which of the following findings, if encountered at sometime, would not help you confirm the most likely diagnosis?
A. Fever
B. Delayed puberty
C. Large, liquid, bulky, foul stool
D. Salt-tasting skin
71. You are seeing a 2-year-old who has an upper respiratory infection. Findings include a fever of 102 F, grunting, and prolonged expiration. Based on these signs, which of the following would be the most likely laboratory finding for this patient?
A. Slight WBC elevation with eosinophilia
B. Abnormalities typical of obstructive dysfunction
C. Productive cough
D. Chest x-ray with hyperinflated lungs
72. The nurse practitioner conducts a physical exam on a 15-year-old patient presenting with symptoms of respiratory infection. During ausculatation, she hears decreased breath sounds in the right lower lobe. To confirm this finding, she asks the patient to say “EEE” and you hear “AAA”. What respiratory assessment is the nurse practitioner conducting on the patient?
A. Type and location of breath sounds
B. Egophony
C. Testing for heart murmur
D. Pulmonary function test
73. Which of the following is not a bacterial pneumonia?
A. Klebsiella
B. Haemophilus influenza
C. Pseudomonas
D. Rickettsia
74. Seven-year-old Will is brought to your office after developing a limp. His parents state Will has begun to experience pain in his groin, hip, and left knee since the limp began. Moreover, they express concern about their son’s growth as Will is shorter in stature than most of his peers. Physical examination finding include abduction of the hip joint and passive internal rotation of the hip. Given the patient’s age and presentation, which of the following is the most appropriate form of treatment?
A. Limitation of physical activity
B. Referral to orthopedics
C. Observation
D. Analgesics
75. The parents on a 13 year old girl come to your office concerned about the risk of scoliosis in their daughter given a family history of the condition. The daughter is developing asymmetry in her posture and is slightly shorter in stature than most her peers. Which of the following aspects of the patient’s presentation is not a risk factor for scoliosis?
A. Age
B. Gender
C. Stature
D. Family history
76. Twelve year old Adam comes to your office after having experienced a recent, sudden growth spurt. He complains of pain in the area just below his right knee and reports tenderness when you apply pressure to the area. These findings indicate which of the following as the most likely diagnosis?
A. Osgood-Schlatter disease
B. Slipped capital femoral epiphysis
C. Toxic synovitis
D. Legg-Calve-Perthes disease
77. Which of the following is not a component of the physical examination for developmental dysplasia of the hip?
A. Galeazzi’s sign
B. Barlow’s maneuver
C. Ortalani test
D. Adam’s forward bend test
78. A concerned mother brings her four-year-old son, Kevin, to the office. The mother is worried about Kevin’s weakness and clumsiness compared to other children his age as well as his abnormal posture. Further, she notes unusual movements from her son such as moving his hands up his legs when rising to stand. As you begin laboratory testing to confirm your suspected diagnosis, which of the following would you not expect to see?
A. Decreased creatine kinase
B. Necrotic degenerating fibers
C. Abnormal electrocardiogram
D. Myopathy
79. Bell’s palsy is associated with the malfunction of which cranial nerve?
A. VII
B. IV
C. VIII
D. XII
80. A mother brings her 6-year-old son, Glenn, to the clinic for a check-up. She is concerned that her son constantly says that he smells “peppermint.” Upon physical examination, you notice the child’s mouth starts twitching to the right. After a minute, the twitching stops and Glenn asks why everybody is looking at him. The child is exhibiting signs of which of the following conditions?
A. Complex partial seizures
B. Clonic seizures
C. Simple partial seizures
D. Tic disorders
81. A 5-month-old infant is brought to your office by her mother, who states that the infant has lately seemed lethargic and has been vomiting and feeding poorly. Upon examination, you note a bulging fontanel and fever. Which of the following laboratory tests would help confirm your suspected diagnosis?
A. Complete blood count
B. Computed axial tomography scan
C. Erythrocyte sedimentation rate
D. Cerebrospinal fluid analysis
82. Sixteen-year-old Jeffrey complains of having debilitating pain once a week. H states that during or after the episodes of abdominal pain, he gets so nauseous that he has to vomit. The results of a stool sample are guiac negative and do not reveal occult blood. Which of the following is the most likely diagnosis?
A. Basilar migraine
B. Gastroesophageal reflux disease
C. Gastroenteritis
D. Abdominal migraine
83. You are examining Cody, 8 years old, who has recently begun to experience morning headaches followed by vomiting. Cary states that these headaches have become more frequent since they began. You note numerous findings including head tilt, failure to thrive, and loss of fine motor control. Moreover, Cody tests positive when you administer the Babinski reflex test. Which of the following laboratory tests would not confirm the most likely diagnosis?
A. Lumbar puncture
B. Magnetic resonance imaging
C. Electroencephalogram
D. Computerized axial tomography.
84. You are examining a 2-year-old who present with a low grade fever. During physical examination, you note the child is responding as though he has excruciating pain in his back, chest, and abdomen. A lab test reveals his white blood cell count is elevated to 14,000. Which of the following would you also expect to be revealed?
A. Poikilocylosis and basophilic stippling
B. Howell-Jolly bodies
C. Heinz bodies
D. Blast cells
85. You have been seeing Larry and Shawna during Shawna’s pregnancy. You did a genotype test for Shawna, but Larry was adopted and, therefore, has no knowledge his biological parents. Now they report that their child has a strange growth on his forehead as well as a pale coloring to his skin. Which of the following is the most likely diagnosis?
A. Iron deficiency anemia
B. Hemophilia A
C. Thalassemia
D. Sickle cell anemia
86. You are examining 2-year-old Donald after his parents tell you he has been vomiting and experiencing diarrhea the past week, leading to him losing an alarming amount of weight. Moreover, his gums are blue. During the examination, Donald rapidly jerks his right arm back. When you ask why he did this, he replies that his “arm moved on its own.” Which of the following is the most likely diagnosis?
A. Pyloric stenosis
B. Lead poisoning
C. Appendicitis
D. Gastroenteritis
87. While she is pregnant, you discover that Sharon is a carrier for hemophilia A. She asks you what the chance is that she could pass the disorder on to her daughter. Which of the following should you tell her? A. 10%
B. 75%
C. 25%
D. 50%
88. You are seeing a 24-month-old African-American female whose parents complains that she is “unusually tired” however, she has no history of chronic illness. The child’s history reveals that she was switched to whole milk at 12 months and is currently drinking 32 ounces per day. Upon physical exam, you notice pale conjunctiva, and the laboratory results reveal microcytic hypochromic anemia with normal white blood cell (WBC), platelet, and reticulocyte counts. Which of the following is the most likely diagnosis? A. Iron deficiency anemia
B. Sickle cell anemia
C. Vitamin B12 deficiency
D. Alpha-thalassemia minor
89. Eddie, 15 years old, is diagnosed with Type 1 diabetes mellitus (DM). Which of the following would not
be a step to take into consideration when managing Eddie’s DM?
A. Metformin prescription
B. Dietary teachings
C. Beginning insulin
D. Establishing baseline studies such as family history.
90. Which of the following is not a common cause of hypothyroidism in children and adolescents?
A. Pituitary deficiency of thyroid-stimulating hormone
B. Hashimoto’s syndrome
C. Iodine deficiency
D. Graves’ Disease [Show Less]