2025 HESI RN PEDIATRIC (PEDS) ACTUAL EXAM QUESTIONS AND ANSWERS GRADED A+

What is the average weight range of a term newborn? a) 1500 - 2500g b) g c) g d) g e) 3000 - 3500g - b) g 2 At what age does the anterior fontanelle typically close? a) 2-4 months b) 6-8 months c) 12-18 months d) 24-30 months e) 36 months - c) 12-18 months 3 Which of the following is not a primitive reflex in newborns? a) Rooting reflex b) Moro reflex c) Galant reflex d) Babinski reflex e) Knee-jerk reflex - e) Knee-jerk reflex 4 Which factor does not influence the growth of a child? a) Genetic factors b) Hormonal factors c) Psychosocial environment d) Sleep patterns e) Nutrition - d) Sleep patterns 5 What is the normal range for heart rate in a term newborn? a) 100-120/min b) 120-140/min c) 140-160/min d) 160-180/min e) 180-200/min - c) 140-160/min 6 Which of the following is not a developmental milestone in the first 2 years? a) Steadiness of the head b) Sits without support c) Walks holding on to things d) Recites the alphabet e) Fine pincer grasp - d) Recites the alphabet 7 Which condition is not associated with a delayed closure of the fontanelles? a) Achondroplasia b) Down Syndrome c) Increased intracranial pressure d) Hyperthyroidism e) Rickets - d) Hyperthyroidism 8 At what age do children typically develop handedness? a) 6-12 months b) 12-18 months c) 18-24 months d) 24-30 months e) 30-36 months - c) 18-24 months 9 Which is not a common cause of gross motor delay in children? a) Normal variation b) Mental retardation c) Cerebral palsy d) Visual impairment e) Myopathies - d) Visual impairment 10 What is a characteristic of physiological jaundice in newborns? a) Appears within 24 hours b) Direct bilirubin more than 2.0 mg/dl c) Total bilirubin could be more than 13 mg/dl d) Peaks around the 3rd to 5th day e) Caused by Rh incompatibility - d) Peaks around the 3rd to 5th day 11 What is the significance of a high-pitched cry in a newborn? a) Indicates hunger b) Indicates CNS disease c) Indicates a healthy baby d) Indicates sleepiness e) Indicates gastrointestinal distress - b) Indicates CNS disease 12 How is the Apgar score used? a) To predict long-term health outcomes b) To evaluate the immediate health of a newborn c) To determine the exact birth weight d) To assess the mother's health during delivery e) To measure genetic conditions - b) To evaluate the immediate health of a newborn 13 What is a common finding in the neurological system of a term newborn? a) Extension of extremities b) Absence of primitive reflexes c) Flexion of the upper and lower extremities d) Delayed Moro reflex e) Hypotonia - c) Flexion of the upper and lower extremities 14 What is the average length range of a term newborn? a) 40-46 cm b) 48-54 cm c) 54-60 cm d) 46-50 cm e) 50-56 cm - b) 48-54 cm 15 Which of the following is not included in the Apgar score? a) Heart rate b) Muscle tone c) Reflex irritability d) Blood pressure e) Skin color - d) Blood pressure 1 What stimulates the first breath in a newborn? a) Acidosis and hypoxia during delivery b) Hypoglycemia c) Hyperthermia d) Elevated blood pressure after feeding e) Increased heart rate - a) Acidosis and hypoxia during delivery 2 At what gestational age are mature levels of surfactant typically present? a) 22 weeks b) 28 weeks c) 30 weeks d) 35 weeks e) 40 weeks - d) 35 weeks 3 What is the normal respiratory rate for a newborn? a) 20-30/min b) 30-60/min c) 60-80/min d) 80-100/min e) 100-120/min - b) 30-60/min 4 What is the function of the ductus venosus in fetal circulation? a) Shunts blood from the right to the left atrium b) Connects the pulmonary artery to the aortic arch c) Shunts blood directly to the inferior vena cava d) Delivers oxygenated blood to the liver e) Bypasses the lungs to protect them from overload - c) Shunts blood directly to the inferior vena cava 5 What condition is associated with the failure to produce surfactant? a) Congenital stridor b) Meconium aspiration syndrome c) Hyaline membrane disease d) Transient tachypnea e) Patent ductus arteriosus - c) Hyaline membrane disease 6 Which of the following does not contribute to the transition from fetal to neonatal circulation? a) Closure of the ductus arteriosus b) Closure of the foramen ovale c) Increased pulmonary vascular resistance d) Increase of O2 to the lungs e) Decrease in right atrial pressure - c) Increased pulmonary vascular resistance 7 What is the significance of IgM in a newborn? a) Indicates passive immunity from the mother b) Suggests intrauterine infection c) Demonstrates developed active immunity d) Correlates with allergic reactions e) Shows nutritional adequacy - b) Suggests intrauterine infection 8 How do newborns typically respond to cold stress? a) Shivering b) Sweating c) Thermogenesis using brown fat d) Increased urination e) Decreased heart rate - c) Thermogenesis using brown fat 9 Which reflex is considered a primitive reflex in newborns? a) Knee-jerk reflex b) Moro reflex c) Patellar reflex d) Corneal reflex e) Achilles reflex - b) Moro reflex 10 What is the primary cause of neonatal jaundice? a) Immature liver function b) High-fat diet c) Excessive iron intake d) Increased physical activity e) High levels of protein in the blood - a) Immature liver function 11 What is the recommended treatment to prevent hemorrhagic disease in newborns? a) Oral iron supplements b) Intramuscular vitamin K c) High protein diet d) Regular physical exercise e) Oral vitamin D - b) Intramuscular vitamin K 12 Which of the following is a common cause of prematurity? a) Maternal hypertension b) Paternal age over 50 c) Twin pregnancies d) Maternal smoking e) Excessive maternal weight gain - c) Twin pregnancies 13 What is the function of the lower esophageal sphincter in newborns? a) Prevents regurgitation b) Aids in nutrient absorption c) Stimulates bile production d) Enhances peristalsis e) Regulates acid secretion - a) Prevents regurgitation 14 At what age does the first micturition usually occur in newborns? a) Within 1 hour b) 6-24 hours c) 24-48 hours d) 48- 72 hours e) 72-96 hours - b) 6-24 hours 15 What is the definition of a low birth weight infant? a) Birth weight less than 2500g b) Birth weight less than 3000g c) Birth weight less than 3500g d) Birth weight less than 4000g e) Birth weight less than 4500g - a) Birth weight less than 2500g 1 What defines a newborn as small for gestational age (SGA)? a) Birth weight below the 50th percentile for gestational age b) Birth weight below the 10th percentile for gestational age c) Birth weight above the 90th percentile for gestational age d) Birth weight above the 50th percentile for gestational age e) Birth weight between the 10th and 90th percentiles for gestational age - b) Birth weight below the 10th percentile for gestational age 2 Which condition is not typically a predisposing factor for intrauterine growth restriction (IUGR)? a) Severe anemia b) Maternal diabetes mellitus c) Maternal smoking d) High maternal BMI e) Eclampsia - d) High maternal BMI 3 What is the primary cause of respiratory distress syndrome (RDS) in newborns? a) Prematurity and surfactant deficiency b) Full-term delivery with high birth weight c) Hyperglycemia in the mother d) Fetal alcohol syndrome e) Neonatal sepsis - a) Prematurity and surfactant deficiency 4 What characteristic is associated with symmetric IUGR? a) Disproportionate growth with normal length and head circumference b) Proportionate growth but smaller than normal size c) Only decreased weight with normal length and head circumference d) Better prognosis compared to asymmetric IUGR e) Growth restriction beginning after 28 weeks - b) Proportionate growth but smaller than normal size 5 Which intrauterine shunt allows oxygenated blood to bypass the liver? a) Foramen ovale b) Ductus arteriosus c) Umbilical vein d) Ductus venosus e) Aortic arch - d) Ductus venosus 6 What is a common complication of postmaturity in newborns? a) Hyperglycemia b) Hypoglycemia c) Hypercalcemia d) Meconium ileus e) Neonatal abstinence syndrome - b) Hypoglycemia 7 Which of the following is a feature of large for gestational age (LGA) newborns? a) Birth weight less than 2500g b) Poor motor skills c) Small body and face d) Increased risk of growth retardation e) Low risk of delivery complications - b) Poor motor skills 8 What is the recommended treatment for respiratory distress syndrome (RDS) in newborns? a) High-dose corticosteroids b) Intravenous antibiotics c) Surfactant replacement therapy d) Immediate surgical intervention e) High-calorie formula feeding - c) Surfactant replacement therapy 9 What is the primary role of surfactant in the lungs? a) To increase surface tension in the alveoli b) To prevent the collapse of the alveoli c) To decrease the oxygen content in the blood d) To facilitate mucus production e) To regulate blood pressure - b) To prevent the collapse of the alveoli 10 Which factor does not contribute to the development of intrauterine growth restriction (IUGR)? a) Maternal hypertension b) High maternal protein intake c) Maternal smoking d) Placental insufficiency e) Chromosomal abnormalities - b) High maternal protein intake 11 What is a typical feature of asymmetric IUGR? a) Normal weight but decreased length and head circumference b) Decreased weight but normal length and head circumference c) Better prognosis compared to symmetric IUGR d) Growth restriction beginning before 28 weeks e) Equal reduction in weight, length, and head circumference - b) Decreased weight but normal length and head circumference 12 What is the primary reason for inducing labor in post-term pregnancies? a) To increase birth weight b) To prevent maternal hypertension c) To avoid complications from placental insufficiency d) To reduce the risk of preeclampsia e) To enhance lung maturity - c) To avoid complications from placental insufficiency 13 What is the gestational age for defining a post-term newborn? a) >37 weeks b) >38 weeks c) >39 weeks d) >40 weeks e) >42 weeks - e) >42 weeks 14 What is a common long-term complication of prematurity? a) Congenital heart disease b) Chronic lung disease c) Hyperbilirubinemia d) Neonatal hypoglycemia e) Intrauterine growth restriction - b) Chronic lung disease 15 Which diagnostic tool is used to assess lung maturity in the fetus? a) Ultrasound b) Chest X-ray c) Amniocentesis d) Echocardiography e) MRI - c) Amniocentesis 1 What is the primary route of transmission for congenital TORCH infections? a) Contact with contaminated surfaces b) Respiratory droplets c) Transplacental spread d) Ingestion of contaminated food e) Blood transfusion - c) Transplacental spread 2 Which of the following is part of the classic triad of congenital toxoplasmosis? a) Blueberry muffin lesions b) Snuffles c) Chorioretinitis d) Periventricular calcifications e) Deafness - c) Chorioretinitis 3 Which infection is characterized by "blueberry muffin" lesions in newborns? a) Toxoplasmosis b) Syphilis c) Rubella d) CMV e) HIV - c) Rubella 4 Which of the following TORCH infections is the most common? a) Toxoplasmosis b) Syphilis c) Rubella d) CMV e) HSV - d) CMV 5 Which TORCH infection presents with snuffles? a) Toxoplasmosis b) Syphilis c) Rubella d) CMV e) HSV - b) Syphilis 6 What is the primary treatment for congenital syphilis? a) Acyclovir b) Penicillin G c) Ganciclovir d) Spiramycin e) Zidovudine - b) Penicillin G 7 What is the preferred method to diagnose congenital CMV infection? a) Maternal IgG serology b) PCR of viral DNA from amniotic fluid c) Cultures of maternal lesions d) Neonatal skin biopsy e) Ultrasound - b) PCR of viral DNA from amniotic fluid 8 Which congenital infection is associated with intracranial calcifications predominantly in the periventricular area? a) Toxoplasmosis b) Syphilis c) Rubella d) CMV e) HSV - d) CMV 9 Which TORCH infection can be effectively prevented through maternal immunization? a) Toxoplasmosis b) Syphilis c) Rubella d) CMV e) HSV - c) Rubella 10 What clinical feature is common in congenital toxoplasmosis? a) Cataracts b) Hydrocephalus c) Saddle nose d) Hutchinson teeth e) Perioral fissures - b) Hydrocephalus 11 Which TORCH infection is treated with high-dose acyclovir for disseminated CNS disease? a) Toxoplasmosis b) Syphilis c) Rubella d) CMV e) HSV - e) HSV 12 What maternal history finding increases suspicion for congenital varicella syndrome? a) Recurrent HSV infections b) Primary varicella infection during pregnancy c) Previous child with CMV infection d) Recent rubella vaccination e) Unexplained jaundice - b) Primary varicella infection during pregnancy 13 What is the primary risk of untreated maternal parvovirus B19 infection during pregnancy? a) Microcephaly b) Hydrops fetalis c) Congenital cataracts d) Neonatal sepsis e) Intrauterine growth restriction - b) Hydrops fetalis 14 Which clinical feature is not typically associated with congenital rubella syndrome? a) Sensorineural hearing loss b) Chorioretinitis c) Cardiac malformations d) Cataracts e) Microcephaly - b) Chorioretinitis 15 What is the recommended treatment for pregnant mothers diagnosed with acute toxoplasmosis? a) High-dose acyclovir b) Penicillin G c) Spiramycin d) Zidovudine e) Ganciclovir - c) Spiramycin 1 What is a common feature of physiological jaundice in newborns? a) Appears within 24 hours of birth b) Peaks on days 2-5 c) Disappears after day 14 in term infants d) Direct bilirubin more than 2.0 mg/dL e) Bilirubin level > 18 mg/dL - b) Peaks on days 2-5 2 Which of the following conditions is not associated with nonphysiologic jaundice? a) Appears within 24 hours of birth b) Increases in total bilirubin by more than 5 mg/dL per 24 hours c) Total bilirubin more than 18 mg/dL d) Direct bilirubin more than 2.0 mg/dL e) Bilirubin level peaks on day 5 - e) Bilirubin level peaks on day 5 3 What percentage of hemolytic disease of the newborn is due to ABO incompatibility? a) 10% b) 25% c) 50% d) 65% e) 80% - d) 65% 4 Which statement about Rh incompatibility is true? a) It is commonly a problem during the first pregnancy b) It occurs when the mother is Rh-positive and the baby is Rh-negative c) Sensitization typically occurs at birth d) Rh antibodies are produced only during subsequent pregnancies e) All Rh-negative mothers are at risk regardless of the father's Rh status - c) Sensitization typically occurs at birth 5 What is kernicterus? a) A condition characterized by mild jaundice b) Hemolytic anemia in newborns c) Bilirubin-induced brain damage d) A type of congenital infection e) Hypoglycemia in newborns - c) Bilirubin-induced brain damage 6 Which of the following is not a symptom of kernicterus? a) High-pitched cry b) Hypotonia c) Seizures d) Arching of the back e) Hyperglycemia - e) Hyperglycemia 7 What laboratory finding is indicative of severe isoimmunization in newborns? a) Cord blood bilirubin > 2 mg/dL b) Cord blood bilirubin > 4 mg/dL c) Cord blood bilirubin > 6 mg/dL d) Cord blood bilirubin > 8 mg/dL e) Cord blood bilirubin > 10 mg/dL - b) Cord blood bilirubin > 4 mg/dL 8 Which blood test can be used to confirm the presence of antibodies against fetal red blood cells in a newborn? a) Indirect Coombs test b) Direct Coombs test c) Blood smear d) Reticulocyte count e) Complete blood count (CBC) - b) Direct Coombs test 9 What condition is characterized by an accumulation of fluid in at least two fetal compartments? a) Kernicterus b) Hydrops fetalis c) Rh incompatibility d) ABO incompatibility e) Physiological jaundice - b) Hydrops fetalis 10 Which of the following is a treatment option for preventing Rh sensitization in pregnant women? a) Acyclovir b) Ganciclovir c) Zidovudine d) Rh immune globulin (RhIG) e) Penicillin - d) Rh immune globulin (RhIG) 11 Which therapeutic intervention involves exchanging the newborn's blood to reduce bilirubin levels? a) Phototherapy b) Intravenous immunoglobulin (IVIG) c) Exchange transfusion (ExTx) d) Erythropoietin therapy e) Plasma exchange - c) Exchange transfusion (ExTx) 12 What is the purpose of phototherapy in the treatment of neonatal jaundice? a) To increase the production of red blood cells b) To destroy bilirubin in the blood c) To convert bilirubin into a nontoxic form d) To stimulate the immune system e) To enhance oxygenation - c) To convert bilirubin into a nontoxic form 13 What complication is associated with untreated severe hyperbilirubinemia? a) Respiratory distress b) Hypoglycemia c) Kernicterus d) Hypercalcemia e) Hypotension - c) Kernicterus 14 What is a common laboratory finding in ABO incompatibility? a) Increased hemoglobin b) Decreased reticulocyte count c) Microspherocytosis d) Elevated serum ferritin e) Decreased white blood cell count - c) Microspherocytosis 15 What treatment is recommended for a newborn with hemolytic disease due to Rh incompatibility and a rapidly rising bilirubin level? a) Oral antibiotics b) Intravenous fluids c) Exchange transfusion d) Steroid therapy e) Antiviral medications - c) Exchange transfusion 1 What is the recommended duration for exclusive breastfeeding according to WHO and AAP? a) 3 months b) 6 months c) 9 months d) 12 months e) 18 months - b) 6 months 2 Which of the following is not a benefit of breastfeeding for the infant? a) Lower incidence of Type I and II diabetes b) Higher rates of otitis media c) Increased intelligence scores d) Reduced risk of necrotizing enterocolitis e) Lower risk of respiratory tract infections - b) Higher rates of otitis media 3 What maternal hormone is stimulated by breastfeeding to help prevent postpartum hemorrhage? a) Estrogen b) Progesterone c) Oxytocin d) Prolactin e) Testosterone - c) Oxytocin 4 Which condition is a contraindication to breastfeeding? a) Maternal hypertension b) Active untreated tuberculosis c) Gestational diabetes d) Postpartum depression e) Hyperthyroidism - b) Active untreated tuberculosis 5 What is the primary benefit of colostrum for newborns? a) High carbohydrate content b) Rich in Vitamin D c) Contains high levels of antibodies d) High fat content e) Increased lactose concentration - c) Contains high levels of antibodies 6 Which nutrient is particularly abundant in human milk and supports the establishment of bifidobacteria in the infant's gut? a) Proteins b) Lipids c) Oligosaccharides d) Vitamins e) Minerals - c) Oligosaccharides 7 What is the main difference between colostrum and mature milk? a) Colostrum has higher lactose content b) Colostrum contains more fat c) Colostrum has a higher protein content d) Colostrum is lower in vitamins e) Colostrum has lower antibody levels - c) Colostrum has a higher protein content 8 Which health benefit is associated with breastfeeding for mothers? a) Increased risk of ovarian cancer b) Decreased risk of iron-deficiency anemia c) Higher risk of postpartum depression d) Delayed uterine involution e) Increased incidence of hypertension - b) Decreased risk of iron-deficiency anemia 9 What common breastfeeding problem is characterized by pain and flu-like symptoms and often requires antibiotic treatment? a) Sore nipples b) Engorgement c) Mastitis d) Yeast infection e) Nipple confusion - c) Mastitis 10 Which of the following is not an indication for stopping breastfeeding? a) Maternal use of street drugs b) Infant diagnosed with galactosemia c) Mother with active untreated TB d) Infant with lactose intolerance e) Mother undergoing chemotherapy - d) Infant with lactose intolerance 11 What is the primary function of prolactin in breastfeeding? a) Stimulates uterine contractions b) Regulates milk production c) Increases maternal appetite d) Reduces postpartum depression e) Enhances maternal bonding - b) Regulates milk production 12 Which component of breast milk provides passive immunity to the infant? a) Carbohydrates b) Proteins c) Lipids d) sIgA antibodies e) Lactose - d) sIgA antibodies 13 What is the impact of breastfeeding on the infant's microbiome? a) Reduces bifidobacteria b) Increases pathogenic bacteria c) Dominates the gut with bifidobacteria d) Decreases gut diversity e) Increases antibiotic resistance - c) Dominates the gut with bifidobacteria 14 Which factor does not contribute to insufficient milk supply in breastfeeding mothers? a) Infrequent breastfeeding b) Breast augmentation surgery c) Breast reduction surgery d) High caloric intake e) Insufficient glandular tissue - d) High caloric intake 15 How can healthcare workers support breastfeeding? a) Promoting the use of infant formula b) Encouraging early weaning c) Protecting and promoting breastfeeding practices d) Discouraging maternity leave e) Limiting breastfeeding to less than 6 months - c) Protecting and promoting breastfeeding practices 1 What is the primary reason for using formula feeding instead of breastfeeding? a) Higher nutritional value b) Insufficient maternal breast milk c) Better bonding with the baby d) Lower cost e) Easier digestion for the infant - b) Insufficient maternal breast milk 2 Which of the following is not a recommended practice by WHO and UNICEF for breastfeeding? a) Exclusive breastfeeding for the first 6 months b) Breastfeeding on demand c) Use of bottles and pacifiers d) Initiation of breastfeeding within the first hour of life e) No supplementation with any type of food or drink - c) Use of bottles and pacifiers 3 What is the primary nutritional difference between breast milk and cow's milk? a) Cow's milk has higher lactose content b) Cow's milk has higher protein content c) Breast milk has higher fat content d) Breast milk has higher mineral content e) Cow's milk has higher carbohydrate content - b) Cow's milk has higher protein content 4 Which component of infant formula is added to support brain and eye development? a) Lactose b) Vitamin D c) Iron d) DHA and ARA e) Calcium - d) DHA and ARA 5 What type of formula is recommended for infants with galactosemia? a) Cow's milk-based formula b) Lactose-free formula c) Soy-based formula d) Protein hydrolyzate formula e) Antireflux formula - c) Soy-based formula 6 Which type of formula is specifically designed for infants with protein allergies? a) Cow's milk-based formula b) Lactose-free formula c) Soy-based formula d) Protein hydrolyzate formula e) Antireflux formula - d) Protein hydrolyzate formula 7 What is the main disadvantage of using plain cow's milk for infant feeding before 12 months of age? a) Low lactose content b) High mineral content causing renal load c) High vitamin D content d) Low protein content e) High fat content - b) High mineral content causing renal load 8 What are the recommended age ranges for introducing solid foods to infants? a) Before 4 months b) Between 4-6 months c) Between 17-26 weeks d) After 6 months e) After 12 months - c) Between 17-26 weeks 9 Which food is not recommended for infants under 12 months due to the risk of allergic reactions? a) Rice cereal b) Applesauce c) Eggs d) Bananas e) Green beans - c) Eggs 10 What is the primary reason for avoiding fruit juice in infants younger than 6 months? a) High protein content b) Low vitamin content c) High sugar content leading to dental caries d) Low caloric value e) High fat content - c) High sugar content leading to dental caries 11 Which nutrient is important for iron absorption when consumed with food? a) Vitamin A b) Vitamin C c) Vitamin D d) Vitamin E e) Vitamin K - b) Vitamin C 12 Which sign indicates that an infant is ready for solid foods? a) Presence of tongue thrust reflex b) Less than 4 months old c) Can move food from the front to the back of the mouth d) Has not doubled birth weight e) Wants to breastfeed less than 8 times in 24 hours - c) Can move food from the front to the back of the mouth 13 What is the recommended frequency of feedings for a newborn in the first few weeks of life? a) 2-4 feedings per day b) 4-6 feedings per day c) 6-8 feedings per day d) 8-12 feedings per day e) 12-14 feedings per day - d) 8-12 feedings per day 14 Which type of formula is designed for infants with gastroesophageal reflux (GER)? a) Cow's milk-based formula b) Soy-based formula c) Protein hydrolyzate formula d) Antireflux formula e) Hypoallergenic formula - d) Antireflux formula 15 What is the recommended action if an infant shows signs of allergy after introducing a new food? a) Continue feeding the same food b) Introduce another new food immediately c) Stop feeding the new food and consult a healthcare provider d) Mix the new food with breast milk or formula e) Increase the amount of the new food gradually - c) Stop feeding the new food and consult a healthcare provider 1 What is the most common cause of acute laryngotracheobronchitis (viral croup)? a) Haemophilus influenzae type b b) Parainfluenza virus type 1 and 3 c) Rhinovirus d) Streptococcus pneumoniae e) Epstein-Barr virus - b) Parainfluenza virus type 1 and 3 2 Which age group is most commonly affected by viral croup? a) Newborns b) 1-3 months c) 3 months to 5 years d) 5-10 years e) Adolescents - c) 3 months to 5 years 3 What is a characteristic clinical feature of viral croup? a) High fever b) Barky cough c) Severe abdominal pain d) Hematuria e) Diarrhea - b) Barky cough 4 Which clinical sign on a neck x-ray is indicative of viral croup? a) Thumb sign b) Steeple sign c) Cherry-red epiglottis d) Pseudomembrane e) Enlarged tonsils - b) Steeple sign 5 What is the recommended treatment for severe cases of viral croup? a) Sedatives b) Opioids c) Racemic epinephrine nebulizations d) Bronchodilators e) Antihistamines - c) Racemic epinephrine nebulizations 6 Which condition is characterized by recurrent episodes of inspiratory stridor that occur at night and subside quickly? a) Acute laryngotracheobronchitis b) Acute spasmotic laryngitis c) Acute infectious laryngitis d) Acute epiglottitis e) Diphtheria - b) Acute spasmotic laryngitis 7 What is the primary treatment for acute spasmotic laryngitis at home? a) Antibiotics b) Antihistamines c) Exposure to steam or cool night air d) Corticosteroids e) Sedatives - c) Exposure to steam or cool night air 8 Which organism is a rare cause of acute infectious laryngitis but can cause significant airway obstruction? a) Haemophilus influenzae type b b) Parainfluenza virus c) Influenza A d) Rhinovirus e) Corynebacterium diphtheriae - e) Corynebacterium diphtheriae 9 What is the mainstay of treatment for acute epiglottitis? a) Racemic epinephrine b) Intubation and mechanical ventilation c) Bronchodilators d) Oral hydration e) Expectorants - b) Intubation and mechanical ventilation 10 Which clinical sign on a lateral neck x-ray is indicative of acute epiglottitis? a) Steeple sign b) Thumb sign c) Ground glass appearance d) Honeycomb pattern e) Air-fluid levels - b) Thumb sign 11 What is the primary causative agent of acute epiglottitis in children? a) Parainfluenza virus b) Rhinovirus c) Influenza A d) Haemophilus influenzae type b e) Adenovirus - d) Haemophilus influenzae type b 12 Which symptom is not typically associated with acute infectious laryngitis? a) Sore throat b) Hoarseness c) Barky cough d) Severe respiratory distress e) Mild inspiratory stridor - d) Severe respiratory distress 13 What is the characteristic position a child with acute epiglottitis might assume to maintain airway patency? a) Supine position b) Lying on their side c) Leaning forward with mouth open and chin extended d) Sitting upright with neck flexed e) Lying prone with head turned to the side - c) Leaning forward with mouth open and chin extended 14 What is the recommended antibiotic treatment for acute epiglottitis? a) Amoxicillin b) Erythromycin c) Ampicillin + chloramphenicol or cephalosporins like ceftriaxone d) Azithromycin e) Doxycycline - c) Ampicillin + chloramphenicol or cephalosporins like ceftriaxone 15 Which of the following complications is not commonly associated with croup syndromes? a) Otitis media b) Pneumonia c) Adenitis d) Meningitis e) Hypertension - e) Hypertension 1 What is the primary age group most commonly affected by acute otitis media (AOM)? a) Newborns b) 1-2 years c) 3-5 years d) 5- 10 years e) Adolescents - b) 1-2 years 2 Which bacterium is the most common cause of acute otitis media? a) Haemophilus influenzae b) Streptococcus pneumoniae c) Moraxella catarrhalis d) Staphylococcus aureus e) Pseudomonas aeruginosa - b) Streptococcus pneumoniae 3 What is a common risk factor for developing acute otitis media in infants? a) High birth weight b) Exclusive breastfeeding c) Prematurity d) Living in rural areas e) Absence of siblings - c) Prematurity 4 Which of the following is a characteristic clinical feature of acute otitis media? a) High-grade fever b) Severe abdominal pain c) Barky cough d) Ear pain and purulent discharge e) Diarrhea - d) Ear pain and purulent discharge 5 What is the recommended initial antibiotic therapy for acute otitis media? a) Azithromycin b) Amoxicillin c) Ciprofloxacin d) Doxycycline e) Vancomycin - b) Amoxicillin 6 Which of the following is a potential complication of untreated acute otitis media? a) Otitis externa b) Temporal lobe abscess c) Gastroenteritis d) Bronchitis e) Appendicitis - b) Temporal lobe abscess 7 What is the purpose of tympanocentesis in the management of acute otitis media? a) To relieve pain b) To drain fluid from the middle ear c) To diagnose hearing loss d) To administer antibiotics e) To measure middle ear pressure - b) To drain fluid from the middle ear 8 Which symptom is commonly associated with otitis media with effusion (OME)? a) Severe ear pain b) High fever c) Painless ear fullness d) Vomiting e) Diarrhea - c) Painless ear fullness 9 Which bacterial pathogen is least likely to cause acute otitis media in newborns? a) Escherichia coli b) Staphylococcus aureus c) Klebsiella pneumoniae d) Haemophilus influenzae e) Mycoplasma pneumoniae - e) Mycoplasma pneumoniae 10 What is the common outcome following the spontaneous rupture of the tympanic membrane in acute otitis media? a) Immediate hearing loss b) Persistent ear pain c) Resolution of symptoms and drainage of pus d) Development of meningitis e) Onset of seizures - c) Resolution of symptoms and drainage of pus 11 Which virus is not typically associated with viral otitis media? a) Respiratory syncytial virus (RSV) b) Parainfluenza virus c) Adenovirus d) Influenza A e) Human papillomavirus (HPV) - e) Human papillomavirus (HPV) 12 What is a significant risk factor for developing otitis media in children? a) Low socioeconomic status b) Exclusive breastfeeding c) Living in high altitudes d) Single-child households e) Absence of day care attendance - a) Low socioeconomic status 13 What clinical feature distinguishes otitis media with effusion from acute otitis media? a) High fever b) Severe pain c) Presence of ear discharge d) Painless sensation of ear fullness e) Barky cough - d) Painless sensation of ear fullness 14 Which antibiotic is used as a second-line treatment for acute otitis media if there is no improvement with initial therapy? a) Amoxicillin/clavulanate b) Tetracycline c) Gentamicin d) Metronidazole e) Chloramphenicol - a) Amoxicillin/clavulanate 15 What is the definition of acute otitis media (AOM)? a) Chronic inflammation of the middle ear b) Acute inflammation of the middle ear lasting more than 3 months c) First 3 weeks of acute inflammation of the middle ear d) Inflammation of the external ear canal e) Recurrent episodes of ear pain without infection - c) First 3 weeks of acute inflammation of the middle ear 1 What is the most common etiology of acute rhinopharyngitis in children? a) Bacterial infection b) Fungal infection c) Viral infection d) Parasitic infection e) Allergic reaction - c) Viral infection 2 Which virus is not commonly associated with acute rhinopharyngitis? a) Rhinovirus b) Adenovirus c) Influenza virus d) Epstein-Barr virus e) Respiratory syncytial virus (RSV) - d) Epstein-Barr virus 3 What is a common clinical manifestation of acute rhinopharyngitis in infants? a) Low-grade fever b) High fever (39-40°C) c) Severe abdominal pain d) Skin rash e) Hematuria - b) High fever (39-40°C) 4 What symptom differentiates allergic rhinitis from acute rhinopharyngitis? a) Sneezing b) Nasal discharge c) Absence of fever d) Cough e) Headache - c) Absence of fever 5 Which treatment is not recommended for acute rhinopharyngitis? a) Antibiotics b) Air humidifiers c) Hydration d) Nasal decongestion e) Acetaminophen for fever - a) Antibiotics 6 What is a key preventive measure for acute rhinopharyngitis? a) Regular use of antibiotics b) Avoiding vaccinations c) Hand washing d) Daily multivitamins e) Regular exercise - c) Hand washing 7 Which of the following is a complication that can arise from acute rhinopharyngitis? a) Gastroenteritis b) Otitis media c) Dermatitis d) Conjunctivitis e) Urinary tract infection - b) Otitis media 8 How long do symptoms of uncomplicated viral rhinopharyngitis typically last? a) 1-2 days b) 3-5 days c) 6-10 days d) 11-14 days e) More than 15 days - c) 6-10 days 9 Which of the following is not a clinical feature of acute rhinopharyngitis in older children? a) Moderate fever b) Myalgia c) Cough d) Severe respiratory distress e) Headaches - d) Severe respiratory distress 10 What is the role of acetaminophen in the management of acute rhinopharyngitis? a) To treat bacterial infection b) To reduce fever and alleviate pain c) To hydrate the child d) To decongest nasal passages e) To prevent secondary infections - b) To reduce fever and alleviate pain 11 What risk is associated with administering aspirin to children with influenza or varicella? a) Reye syndrome b) Stevens- Johnson syndrome c) Kawasaki disease d) Toxic shock syndrome e) Guillain-Barré syndrome - a) Reye syndrome 12 Which clinical feature is not commonly seen in uncomplicated viral rhinopharyngitis in infants? a) Irritability b) Vomiting c) Diarrhea d) Severe dehydration e) Mild respiratory failure - d) Severe dehydration 13 What is the typical evolution of fever in children with viral rhinopharyngitis? a) Fever persists for less than 24 hours b) Fever persists for 5 or more days c) Fever resolves within 48 hours d) Fever does not exceed 37°C e) Fever requires immediate hospitalization - b) Fever persists for 5 or more days 14 What is the differential diagnosis for persistent rhinorrhea not associated with acute rhinopharyngitis? a) Acute bronchitis b) Nasal foreign body c) Acute gastroenteritis d) Conjunctivitis e) Dermatitis - b) Nasal foreign body 15 Which symptom is typically absent in allergic rhinitis but present in acute rhinopharyngitis? a) Sneezing b) Nasal congestion c) Fever d) Itchy eyes e) Runny nose - c) Fever 1 What is the most common cause of bronchiolitis in infants? a) Rhinovirus b) Influenza virus c) Respiratory syncytial virus (RSV) d) Adenovirus e) Coronavirus - c) Respiratory syncytial virus (RSV) 2 What is the primary age group most commonly affected by bronchiolitis? a) Newborns b) 1-3 months c) 3-6 months d) 6-12 months e) 1-2 years - c) 3-6 months 3 Which of the following is a clinical manifestation of bronchiolitis? a) Productive cough b) High-grade fever c) Wheezing and crepitations d) Severe abdominal pain e) Hematuria - c) Wheezing and crepitations 4 What is the typical seasonal occurrence of RSV infections leading to bronchiolitis? a) Summer b) Fall c) Winter and early spring d) Late spring e) Year-round - c) Winter and early spring 5 Which diagnostic test provides rapid and accurate detection of RSV in bronchiolitis? a) Blood culture b) Chest X-ray c) Antigen tests of nasal washings d) Sputum culture e) Pulmonary function test - c) Antigen tests of nasal washings 6 What is a major risk factor for severe bronchiolitis in infants? a) Exclusive breastfeeding b) High birth weight c) Prematurity d) Absence of siblings e) Living in rural areas - c) Prematurity 7 Which of the following treatments is not recommended for routine use in bronchiolitis? a) Oxygen therapy b) Hydration c) Antibiotics d) Antipyretics e) Bronchodilators - c) Antibiotics 8 Which of the following is a complication of bronchiolitis? a) Gastroenteritis b) Otitis media c) Urinary tract infection d) Conjunctivitis e) Dermatitis - b) Otitis media 9 What is the primary method of transmission for RSV? a) Airborne droplets b) Bloodborne c) Direct contact with nasal secretions d) Ingestion of contaminated food e) Vector-borne - c) Direct contact with nasal secretions 10 What is the typical duration of the disease course for bronchiolitis? a) 1-2 days b) 3-5 days c) 7-10 days d) 11-14 days e) More than 15 days - c) 7-10 days 11 Which physical examination finding is common in severe bronchiolitis? a) Bradycardia b) Hypotension c) Hyperinflated chest d) Cyanosis e) Stridor - c) Hyperinflated chest 12 What is the first-line treatment for maintaining oxygen saturation in infants with bronchiolitis? a) Mechanical ventilation b) High-flow nasal cannula oxygen c) Oral bronchodilators d) Intravenous antibiotics e) Nebulized corticosteroids - b) High-flow nasal cannula oxygen 13 Which medication is recommended for infants with bronchiolitis who have severe underlying conditions? a) Ribavirin b) Amoxicillin c) Oseltamivir d) Doxycycline e) Acyclovir - a) Ribavirin 14 Which viral infection is the most common cause of viral pneumonia in children? a) Rhinovirus b) Influenza virus c) RSV d) Adenovirus e) Coronavirus - c) RSV 15 What is a characteristic radiological finding in viral pneumonia? a) Lobar consolidation b) Perihilar streaking c) Pleural effusion d) Pneumatoceles e) Lung abscess - b) Perihilar streaking 1 What is the primary causative agent of streptococcal pharyngitis? a) Streptococcus pneumoniae b) Group A betahemolytic streptococcus c) Haemophilus influenzae d) Staphylococcus aureus e) Corynebacterium diphtheriae - b) Group A beta-hemolytic streptococcus 2 What is the typical age range for peak incidence of streptococcal pharyngitis? a) 1-3 years b) 3-5 years c) 5-15 years d) 15-20 years e) 20-30 years - c) 5-15 years 3 Which clinical feature is commonly associated with streptococcal pharyngitis? a) Skin rash b) Productive cough c) Exudates on the tonsils d) Wheezing e) Severe abdominal pain - c) Exudates on the tonsils 4 What is the gold standard diagnostic test for streptococcal pharyngitis? a) Rapid strep test b) Throat culture c) Complete blood count (CBC) d) Chest X-ray e) Urinalysis - b) Throat culture 5 Which complication can arise from untreated streptococcal pharyngitis? a) Pneumonia b) Acute rheumatic fever c) Meningitis d) Bronchitis e) Conjunctivitis - b) Acute rheumatic fever 6 What is the recommended antibiotic treatment for streptococcal pharyngitis in penicillin-allergic patients? a) Amoxicillin b) Ceftriaxone c) Erythromycin d) Vancomycin e) Doxycycline - c) Erythromycin 7 Which sign is not typically associated with streptococcal pharyngitis? a) Tonsillopharyngeal erythema b) Petechiae on the palate c) Lymphadenopathy d) Wheezing e) Beefy red swollen uvula - d) Wheezing 8 What is the incubation period for streptococcal pharyngitis? a) 1-3 hours b) 1-3 days c) 3-5 days d) 5-7 days e) 7-10 days - b) 1- 3 days 9 Which physical finding is characteristic of scarlet fever associated with streptococcal pharyngitis? a) Maculopapular rash b) Scarlatiniform rash c) Vesicular rash d) Erythema migrans e) Purpuric rash - b) Scarlatiniform rash 10 What is a major virulence factor of group A beta-hemolytic streptococcus? a) Exotoxin A b) M protein c) Lipopolysaccharide d) Hyaluronidase e) Coagulase - b) M protein 11 Which of the following is not a minor criterion for diagnosing acute rheumatic fever? a) Fever b) Polyarthralgia c) Elevated erythrocyte sedimentation rate (ESR) d) Carditis e) Prolonged PR interval - d) Carditis 12 What is the recommended duration of antibiotic therapy for streptococcal pharyngitis to prevent rheumatic fever? a) 3 days b) 5 days c) 7 days d) 10 days e) 14 days - d) 10 days 13 Which antibiotic is first-line treatment for streptococcal pharyngitis in developing countries where the risk of rheumatic fever is high? a) Amoxicillin b) Penicillin V c) Ceftriaxone d) Benzathine penicillin G e) Azithromycin - d) Benzathine penicillin G 14 What local complication can result from streptococcal pharyngitis? a) Otitis media b) Pneumonia c) Gastroenteritis d) Conjunctivitis e) Dermatitis - a) Otitis media 15 Which prevention measure is most effective in reducing the transmission of streptococcal pharyngitis? a) Regular use of antibiotics b) Vaccination c) Effective hand hygiene d) Isolation of infected individuals e) Routine tonsillectomy - c) Effective hand hygiene 1 What is the most common etiological agent of pneumonia in children under 5 years old? a) Group B streptococci b) Haemophilus influenzae type B c) Streptococcus pneumoniae d) Mycoplasma pneumoniae e) Chlamydia spp. - c) Streptococcus pneumoniae 2 What is a common risk factor for pneumonia in children? a) Exclusive breastfeeding b) High socioeconomic status c) Living in a rural area d) Chronic pulmonary diseases e) Absence of siblings - d) Chronic pulmonary diseases 3 Which age group is most susceptible to pneumonia? a) Newborns b) 1-2 years c) 3-5 years d) 5-10 years e) Adolescents - b) 1-2 years 4 What is a characteristic clinical feature of pneumonia in infants? a) Sudden onset of high fever and chills b) Dry, unproductive cough c) Gradual onset of mild fever and cough d) Abrupt onset of fever (>39°C) with respiratory distress e) Absence of respiratory symptoms - d) Abrupt onset of fever (>39°C) with respiratory distress 5 Which pathogen is a common cause of pneumonia in children over 5 years old? a) Streptococcus pneumoniae b) Mycoplasma pneumoniae c) Haemophilus influenzae type B d) Pseudomonas aeruginosa e) Listeria monocytogenes - b) Mycoplasma pneumoniae 6 What is a typical radiological finding in pneumonia caused by Streptococcus pneumoniae? a) Ground-glass opacities b) Lobar consolidation c) Bronchial wall thickening d) Diffuse interstitial patterns e) Hyperinflation - b) Lobar consolidation 7 Which treatment is the first line for uncomplicated communityacquired pneumonia in children? a) Amoxicillin b) Azithromycin c) Ceftriaxone d) Vancomycin e) Metronidazole - a) Amoxicillin 8 What is the primary method of preventing pneumonia in children? a) Routine antibiotic prophylaxis b) Regular chest Xrays c) Vaccination d) Use of bronchodilators e) Isolation from other children - c) Vaccination 9 What clinical feature is commonly observed in severe pneumonia cases in children? a) Mild respiratory distress b) Cyanosis c) Normal respiratory rate d) No fever e) Decreased appetite - b) Cyanosis 10 Which of the following is a potential complication of pneumonia in children? a) Otitis media b) Conjunctivitis c) Empyema d) Dermatitis e) Gastroenteritis - c) Empyema 11 What laboratory finding is indicative of bacterial pneumonia? a) Elevated lymphocyte count b) Leukocytosis with neutrophilia c) Normal white blood cell count d) Decreased platelet count e) Hypoglycemia - b) Leukocytosis with neutrophilia 12 Which type of pneumonia is commonly associated with staphylococcal infection? a) Lobar pneumonia b) Bronchopneumonia c) Interstitial pneumonia d) Aspiration pneumonia e) Atypical pneumonia - b) Bronchopneumonia 13 What is the recommended antibiotic therapy for staphylococcal pneumonia in children? a) Amoxicillin b) Ceftriaxone c) Vancomycin d) Metronidazole e) Ciprofloxacin - c) Vancomycin 14 What is a key clinical sign of pneumococcal pneumonia in children? a) Hyperinflation of the lungs b) Pleuritic chest pain c) Stridor d) Nasal flaring e) Rhonchi - b) Pleuritic chest pain 15 Which complication is not typically associated with pneumonia in children? a) Pleural effusion b) Lung abscess c) Meningitis d) Acute rheumatic fever e) Pneumatoceles - d) Acute rheumatic fever 1 What is the most common chronic disease in childhood? a) Diabetes b) Asthma c) Epilepsy d) Rheumatic fever e) Congenital heart disease - b) Asthma 2 Which factor is not a known risk factor for developing asthma in children? a) Positive family history of asthma b) Exposure to tobacco smoke c) High socioeconomic status d) Respiratory infections like RSV e) Atopic dermatitis - c) High socioeconomic status 3 What is the primary characteristic of asthma? a) Chronic productive cough b) Fixed airway obstruction c) Inflammatory disorder of the respiratory mucosa d) Frequent lung infections e) Hyperinflated lungs - c) Inflammatory disorder of the respiratory mucosa 4 Which environmental factor is not typically associated with asthma exacerbations? a) Cold air b) Tobacco smoke c) Animal dander d) High humidity e) Exercise - d) High humidity 5 What is the main physiological change in the airways of asthmatic children? a) Loss of airway smooth muscle b) Decrease in goblet cell number c) Airway remodeling d) Increased airflow e) Decreased mucus production - c) Airway remodeling 6 Which of the following is a common trigger for asthma symptoms in children? a) High-fat diet b) Sunlight exposure c) Pollen exposure d) High altitude e) Sedentary lifestyle - c) Pollen exposure 7 What is a common symptom of asthma in children that often occurs at night or early morning? a) Productive cough b) Cyanosis c) Wheezing d) Stridor e) Chest pain - c) Wheezing 8 Which cytokine is not typically associated with asthma pathophysiology? a) IL-2 b) IL-4 c) IL-5 d) IL-13 e) IFNgamma - e) IFN-gamma 9 Which test is most commonly used to diagnose and monitor asthma in children over 5 years old? a) Chest X-ray b) Spirometry c) Blood gas analysis d) Skin prick test e) Sputum culture - b) Spirometry 10 What is the primary function of inhaled glucocorticosteroids in asthma management? a) Bronchodilation b) Anti-inflammatory c) Antihistamine d) Decongestant e) Mucolytic - b) Antiinflammatory 11 Which medication is considered a "reliever" in asthma treatment? a) Inhaled glucocorticosteroids b) Long-acting betaagonists c) Leukotriene modifiers d) Short-acting beta-agonists e) Systemic corticosteroids - d) Short-acting beta-agonists 12 What is a potential side effect of long-term use of inhaled corticosteroids in children? a) Weight loss b) Growth retardation c) Increased appetite d) Hypertension e) Hyperglycemia - b) Growth retardation 13 What is the Asthma Predictive Index (API) used for? a) To diagnose asthma in adults b) To predict children with wheezing who will develop asthma later in life c) To measure lung function in children with asthma d) To determine the severity of asthma attacks e) To guide emergency treatment of asthma - b) To predict children with wheezing who will develop asthma later in life 14 What is the typical pattern of symptoms in exercise-induced asthma? a) Symptoms improve during exercise b) Symptoms only occur at rest c) Symptoms worsen immediately after exercise d) Symptoms occur randomly e) Symptoms occur during sleep - c) Symptoms worsen immediately after exercise 15 Which of the following is not a recommended treatment during an acute asthma attack? a) Inhaled short-acting beta-agonists b) Oral glucocorticosteroids c) Oxygen therapy d) Sedatives e) Theophylline - d) Sedatives 1 What is the most common presenting feature of congenital heart disease in children? a) Cyanosis b) Heart murmur c) Tachycardia d) Bradycardia e) Edema - b) Heart murmur 2 Which congenital heart defect is characterized by a left-to-right shunt? a) Tetralogy of Fallot b) Transposition of the great vessels c) Atrial septal defect d) Tricuspid atresia e) Total anomalous pulmonary venous return - c) Atrial septal defect 3 What maternal condition is a known risk factor for congenital heart disease? a) Hypertension b) Diabetes mellitus c) Hyperthyroidism d) Hypothyroidism e) Preeclampsia - b) Diabetes mellitus 4 Which syndrome is associated with a high incidence of congenital heart defects, such as ventricular septal defect and atrioventricular canal defect? a) Down syndrome (Trisomy 21) b) Turner syndrome c) Klinefelter syndrome d) Marfan syndrome e) Patau syndrome (Trisomy 13) - a) Down syndrome (Trisomy 21) 5 What is the characteristic heart defect associated with Turner syndrome? a) Atrial septal defect b) Ventricular septal defect c) Patent ductus arteriosus d) Coarctation of the aorta e) Pulmonary stenosis - d) Coarctation of the aorta 6 Which congenital heart defect is characterized by a continuous "machinery" murmur? a) Atrial septal defect b) Ventricular septal defect c) Patent ductus arteriosus d) Tetralogy of Fallot e) Transposition of the great vessels - c) Patent ductus arteriosus 7 What is the typical radiological finding in a child with a large ventricular septal defect? a) Cardiomegaly b) Hyperinflation of the lungs c) Pleural effusion d) Ground-glass opacities e) Honeycomb pattern - a) Cardiomegaly