APEA Pediatric Primary Care 4

Question 1

A 4-year-old has had fever for 5 days with bilateral nonexudative conjunctivitis, strawberry tongue, cracked lips, and swollen hands and feet. What is the recommended treatment?

Accepted Answer

IV immunoglobulin plus aspirin

Answer

Kawasaki disease is treated with IVIG and aspirin, ideally within 10 days of fever onset, to reduce the risk of coronary artery aneurysms.

Question 2

A 5-week-old boy has projectile nonbilious vomiting after every feed, and an olive-shaped mass is felt in the epigastrium. Which metabolic finding is most expected?

Accepted Answer

Hypochloremic, hypokalemic metabolic alkalosis

Answer

Persistent vomiting of gastric contents in pyloric stenosis causes loss of HCl, leading to hypochloremic, hypokalemic metabolic alkalosis.

Question 3

Which missing milestone would be most concerning in a 9-month-old?

Accepted Answer

Sitting without support

Answer

Most infants sit without support by about 6 months, so not sitting at 9 months is a red flag, while the other skills come later.

Question 4

A 2-year-old with no recent antibiotic use has acute otitis media along with purulent conjunctivitis. What is the most appropriate antibiotic?

Accepted Answer

Amoxicillin-clavulanate

Answer

Otitis-conjunctivitis syndrome suggests beta-lactamase-producing nontypeable H. influenzae, so amoxicillin-clavulanate is preferred.

Question 5

A 6-year-old has bright red cheeks and a lacy, reticular rash on the arms after a mild viral illness. When can the child go back to school?

Accepted Answer

Right away, because the child is no longer contagious once the rash appears

Answer

In erythema infectiosum (parvovirus B19), children are contagious before the rash, so exclusion is not needed once the rash appears.

APEA - Advanced Practice Education Associates Practice Test

APEA - Advanced Practice Education Associates Practice Test

APEA Pediatric Primary Care 4