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When performing a rectal exam, a tender, swollen, bluish ovoid mass is noted at the anal opening. This finding is most likely a(n): Risk factors associated with Hepatitis B include all of the following except: On auscultation of the abdomen, rushes of high-pitched sounds are audible and coincide with abdominal cramps. These findings are most consistent with: Which one of the following symptoms is seen in infants with pyloric stenosis? An enlarged liver with a smooth tender edge may suggest: ...

The groove of the metacarpophalangeal joint can be palpated by having the patient: When auscultating breath sounds in a patient who has left-sided heart failure, the breath sounds are: The ankle-brachial index is a screening test used to assess a person’s risk for: Olecranon bursitis may be caused by all of the following except: In patients who have allergic rhinitis, the nasal mucosa appears: A term used to describe an increase in muscular bulk with diminished strength is: If abdominal ...

The parent of a 2-year-old tells you her daughter recently started having breath-holding spells. She tells you the older sibling “did the same thing” and asks you for help. You advise her that after a breath-holding event: Which of the following represents normal sequencing of development in a toddler? You see a young child who has tripled her birth weight and looks for hidden objects. When given blocks, she places one in each hand. She has a fine pincer grasp. On the floor, she walks aro...

A 7-year-old presents to your office with several linear, curved lines approximately 4 millimeters in length that end in a papule. The lines are near the umbilicus and waist area. He complains about severe itching that is worse at night. You suspect: You see a 10-year-old with warts on the hand. This is best treated with: Which of the following treatments is indicated for tineaversicolor? Jaime presents with lesions on his forearms. He was bit by mosquitos and he “just wouldn’t stop scrat...

A 3-year-old has a history of upper respiratory tract infection 2 weeks ago. She recently started awakening at night. Physical exam reveals a normothermic child. She is smiling, playful, and sitting on the father’s lap. The TMs are gray with scattered bubbles and good motility. What is the best treatment? The mother of a 5-year-old wants to know what to do to decrease the discomfort of her daughter who has a URI. The mother should instruct to: A 7-year-old presents with a complaint of ear pa...

Shelby is a healthy 4-week-old who presents to your office in mid-January with a 3-day history of nasal congestion with occasional cough. She started running a low-grade fever last night (T max 101.5°F). Now she is refusing to nurse and has paroxysmal coughing and noisy/labored breathing. Physical exam reveals an ill-appearing infant with lethargy and tachypnea, intercostal retractions, expiratory wheezes, and occasional rales. She does not attend day care but has a 3-year-old sibling who does ...

Which of the following scenarios is suspicious for the development of neonatal jaundice with potential for kernicterus? Which of the following statements regarding infants with PKU is true? Abdominal pain and vomiting are troublesome in children with type 1 diabetes because these symptoms can occur in which of the following dangerous conditions? A 2-year-old with sickle-cell anemia presents to your office with a fever of 103.4°F, lethargy, and malaise. The mother tells you she stop giving th...

The most accurate way to determine the degree of dehydration in a vomiting child is to assess: A mother brings a 2-year-old to your office with the complaint that she passes 5 to 10 watery stools per day that often contain undigested food. The child appears healthy and has no other GI symptoms. She is acting, eating, and voiding normally. Weight gain is normal and the mother states she often drinks (her favorite drink is Kool-Aid) instead of eating. The best management for this condition is: A...

A 9-year-old who weighs 70 pounds asks why she can’t sit in the front passenger seat of the family car. Your best response is: Which of the following is a priority nurse practitioner role to help children and adolescents to have healthy sexual development? For adolescent girls, peak height velocity should occur by Tanner Stage (SMR): Which of the following statements regarding adolescent substance use is true? Which of the following statements about bullying is true? The mother of a 5-yea...

A 7-month-old male presents with a bulge in the scrotal sac. It is only found in the scrotum and does not seem to bother the child. No difference in size is noted when the child strains or cries. His scrotum’s size is normal in the morning but increases as the day progresses. The scrotal mass is transilluminable and both testes are located in the scrotal sac. You anticipate: A 12-year-old boy awakes with onset of severe, unilateral scrotal pain, nausea, and vomiting. He is afebrile. Inspectio...