APEA Pediatric Primary Care 3

Question 1

A 10-year-old presents with fever, sore throat, tonsillar exudates, and tender anterior cervical lymphadenopathy but no cough. What is the most appropriate initial management?

Accepted Answer

Perform rapid strep antigen test or throat culture

Answer

Clinical features consistent with streptococcal pharyngitis (Centor/McIsaac criteria) should be confirmed with a rapid antigen test or culture before initiating antibiotics to avoid overtreatment.

Question 2

According to the American Academy of Pediatrics, when should a child's first dental visit occur?

Accepted Answer

When the first tooth erupts or by the first birthday

Answer

The AAP recommends that a child's first dental visit occur when the first tooth erupts or by 12 months of age to establish a dental home and assess for early childhood caries risk.

Question 3

A 6-year-old boy has primary nocturnal enuresis with no daytime symptoms. What is the most appropriate initial management?

Accepted Answer

Behavioral therapy including bladder training and motivational strategies

Answer

Behavioral interventions, including scheduled voids, bladder training, positive reinforcement, and moisture alarms, are the first-line treatment for primary nocturnal enuresis; pharmacotherapy is reserved for refractory cases.

Question 4

Which finding on the newborn physical examination requires the most urgent further evaluation?

Accepted Answer

Unequal femoral pulses bilaterally

Answer

Unequal or diminished femoral pulses may indicate coarctation of the aorta, a critical congenital heart defect requiring immediate echocardiographic evaluation and cardiology consultation.

Question 5

A 2-week-old neonate presents with a rectal temperature of 38.2°C (100.8°F). What is the most appropriate management?

Accepted Answer

Full sepsis evaluation and empirical antibiotic therapy

Answer

Any fever in a neonate younger than 28 days mandates a full septic workup including CBC, blood culture, urinalysis, urine culture, and lumbar puncture, with empirical antibiotics pending results.

APEA - Advanced Practice Education Associates Practice Test

APEA - Advanced Practice Education Associates Practice Test

APEA Pediatric Primary Care 3