I85PREP
⌘ K
CMCP Pediatría study materials
CMCP Pediatría study resources

CMCP Pediatría practice questions

One question at a time. Build your CMCP Pediatría understanding.

First 50 of 200 questions. Each one lists the choices, the correct answer, and an explanation. The checker at the top of this page saves progress in this browser when it is available.

Continue in the practice tool above to load more questions, 50 at a time.

Question 1Pediatría general y crecimiento y desarrollo

A term newborn is examined at 24 hours of life. Which finding is the most reliable indicator of gestational maturity at birth?

  1. Anterior fontanelle size
  2. Presence of the grasp reflex Correct answer.
  3. Crown-heel length
  4. Vernix caseosa distribution

Explanation

Newborn maturational assessment (Ballard-type scoring) relies on neuromuscular and physical criteria, and reflexes such as grasp mature in a predictable sequence with gestation. Vernix, fontanelle size and body length vary too widely to be reliable maturity markers.

Question 2Pediatría general y crecimiento y desarrollo

At what age does a typically developing infant usually achieve independent sitting without support?

  1. 11 to 12 months
  2. 6 to 8 months Correct answer.
  3. 4 to 5 months
  4. 2 to 3 months

Explanation

Independent sitting is a gross motor milestone normally attained between about 6 and 8 months. Earlier sitting requires support, and by 11 to 12 months most infants are pulling to stand or cruising.

Question 3Pediatría general y crecimiento y desarrollo

A 9-month-old has a weight-for-length above the 97th percentile and a length at the 50th percentile. Which statement best describes the most appropriate initial approach?

  1. Reassure the family because infant adiposity always resolves spontaneously
  2. Restrict dietary fat to less than 10 percent of energy
  3. Assess feeding practices, activity and growth trajectory before laboratory testing Correct answer.
  4. Order endocrine testing for hypothyroidism immediately

Explanation

Infant overweight is common and usually related to feeding and activity patterns; the first step is a careful history of intake, feeding cues and serial growth rather than laboratory testing. Endocrine causes are rare and fat restriction is inappropriate in infancy because fat is essential for brain development.

Question 4Pediatría general y crecimiento y desarrollo

Which primitive reflex normally disappears by about 4 to 6 months of age?

  1. Babinski sign
  2. Pupillary light reflex
  3. Moro reflex Correct answer.
  4. Gag reflex

Explanation

The Moro reflex is a primitive reflex that normally integrates by around 4 to 6 months. Persistence beyond this window suggests a central nervous system abnormality.

Question 5Pediatría general y crecimiento y desarrollo

A 4-year-old is brought for a routine visit. Which developmental task is most characteristic of this age?

  1. Hopping on one foot and drawing a person with three parts Correct answer.
  2. Tying shoelaces independently
  3. Using scissors to cut a straight line
  4. Naming four colors and copying a square

Explanation

At around 4 years children typically hop on one foot and draw a person with several body parts, reflecting gains in gross motor control and representational drawing. Cutting a straight line and naming four colors are usually achieved nearer 4 to 5 years, and shoelace tying comes later.

Question 6Pediatría general y crecimiento y desarrollo

Which of the following best defines the growth velocity concern that warrants evaluation in a school-aged child?

  1. Height below the 10th percentile on a single measurement
  2. A documented fall across two or more major height percentile lines over time Correct answer.
  3. A height prediction below mid-parental height
  4. Weight below the 5th percentile at one visit

Explanation

Serial measurements matter more than a single point; crossing downward across two or more percentile channels indicates abnormal velocity and requires evaluation. A single value below a percentile line can be normal constitutionally.

Question 7Pediatría general y crecimiento y desarrollo

Which immunization is routinely recommended at birth in most national schedules?

  1. Human papillomavirus
  2. Varicella
  3. Hepatitis B Correct answer.
  4. Measles-mumps-rubella

Explanation

Hepatitis B vaccine is given at birth in most schedules to prevent perinatal transmission. MMR, varicella and HPV are scheduled later in childhood or adolescence.

Question 8Pediatría general y crecimiento y desarrollo

A 12-month-old has not yet begun to babble or point. What is the most appropriate next step?

  1. Reassure the parents and recheck at 18 months
  2. Recommend only increased screen time for language stimulation
  3. Refer for audiological and developmental evaluation Correct answer.
  4. Prescribe iron supplementation empirically

Explanation

Absence of babbling and pointing by 12 months is a language and social communication red flag requiring prompt hearing and developmental assessment. Watchful waiting delays intervention during a critical period.

Question 9Pediatría general y crecimiento y desarrollo

Which anthropometric measure is the most sensitive index of acute nutritional status in a young child?

  1. Height-for-age
  2. Weight-for-height Correct answer.
  3. Head circumference-for-age
  4. Mid-upper arm circumference

Explanation

Weight-for-height reflects recent energy balance and falls quickly in acute malnutrition, whereas height-for-age reflects chronic or long-standing deprivation.

Question 10Pediatría general y crecimiento y desarrollo

A 10-year-old boy has a bone age of 8 years and a height below the 3rd percentile, with a normal growth hormone stimulation test. Which condition most likely explains these findings?

  1. Constitutional delay of growth and puberty Correct answer.
  2. Familial short stature
  3. Growth hormone deficiency
  4. Turner syndrome

Explanation

Constitutional delay shows delayed bone age relative to chronological age, normal growth hormone testing and often a family history of late puberty. Familial short stature typically has a bone age matching chronological age.

Question 11Pediatría general y crecimiento y desarrollo

Which of the following is the most appropriate screening tool for developmental surveillance at a 18-month well-child visit?

  1. Serum lead level in all children
  2. Routine cranial ultrasound
  3. Routine electroencephalography
  4. A standardized parent-completed developmental screening questionnaire Correct answer.

Explanation

Standardized parent-report screening tools such as the Ages and Stages Questionnaire improve detection of developmental delay compared with informal observation. Imaging and EEG are not routine screening tools in asymptomatic children.

Question 12Pediatría general y crecimiento y desarrollo

A 7-year-old is noted to have a body mass index at the 90th percentile. Which classification is most consistent with this value?

  1. Normal weight
  2. Severe obesity
  3. Overweight Correct answer.
  4. Obesity

Explanation

For children aged 2 years and older, a BMI between the 85th and 94th percentile is classified as overweight, while obesity begins at the 95th percentile.

Question 13Pediatría general y crecimiento y desarrollo

A mother reports that her 6-month-old cannot hold her head steady when pulled to sit. Which developmental domain is most directly affected?

  1. Fine motor
  2. Gross motor Correct answer.
  3. Expressive language
  4. Social-emotional

Explanation

Head control during a pull-to-sit maneuver is a gross motor milestone reflecting axial tone and strength. Fine motor concerns would involve reaching and grasping.

Question 14Pediatría general y crecimiento y desarrollo

Which statement about the use of growth charts in preterm infants is most accurate?

  1. Chronological age is always used for plotting growth
  2. Standard term charts should be used from birth without adjustment
  3. Preterm infants should be plotted only by weight, not length
  4. Corrected age should be used for growth and development assessment until about 2 years Correct answer.

Explanation

For preterm infants, corrected age (chronological age minus weeks of prematurity) is used for growth and developmental assessment until roughly 2 years. This avoids overdiagnosing delay or growth failure.

Question 15Pediatría general y crecimiento y desarrollo

Which of the following is a recognized feature of normal puberty in girls?

  1. Menarche as the first sign
  2. Growth spurt preceding thelarche
  3. Thelarche as the first sign, typically around 8 to 13 years Correct answer.
  4. Adrenarche preceding thelarche by several years

Explanation

In girls, breast budding (thelarche) is typically the first sign of puberty, occurring between about 8 and 13 years. Menarche occurs later, and the pubertal growth spurt follows thelarche.

Question 16Pediatría general y crecimiento y desarrollo

A 5-year-old boy has a head circumference above the 97th percentile with a normal neurological exam and a family history of large heads. Which is the most appropriate next step?

  1. Immediate cranial imaging
  2. Referral for shunt placement
  3. Reassurance and follow-up of head circumference trajectory Correct answer.
  4. Genetic testing for neurofibromatosis

Explanation

Macrocephaly with a normal exam and a family history of large heads often reflects benign familial macrocephaly. Serial measurement of head circumference trajectory is appropriate before imaging.

Question 17Pediatría general y crecimiento y desarrollo

Which of the following is the best example of a fine motor milestone typically achieved by 12 months?

  1. Using a spoon without spilling
  2. Copying a circle
  3. Building a tower of three cubes
  4. Pincer grasp using thumb and index finger Correct answer.

Explanation

The pincer grasp develops around 9 to 12 months and reflects fine motor maturation. Building a tower of three cubes and copying a circle occur in the second and third years.

Question 18Pediatría general y crecimiento y desarrollo

A 2-year-old is brought for a visit. Which behavior most appropriately reflects expected social-emotional development at this age?

  1. Sharing toys consistently
  2. Comforting a distressed peer spontaneously
  3. Parallel play alongside other children Correct answer.
  4. Cooperative play with shared rules

Explanation

Toddlers typically engage in parallel play, playing beside rather than with peers. Cooperative play, consistent sharing and spontaneous empathy develop later in the preschool and school years.

Question 19Pediatría general y crecimiento y desarrollo

Which of the following best describes the expected pattern of growth in height during the first year of life?

  1. Length doubles over the first year
  2. Length remains stable until 6 months
  3. Length increases by about 50 percent over the first year Correct answer.
  4. Length increases by about 10 percent over the first year

Explanation

Infant length increases by roughly 50 percent in the first year, while weight typically triples by 12 months. Stating that length doubles confuses it with the weight pattern.

Question 20Pediatría general y crecimiento y desarrollo

A 3-year-old is noted to have a vocabulary of about 50 words and uses two-word phrases. How should this be interpreted?

  1. Consistent with advanced language
  2. Indicative of hearing loss only
  3. Normal for age
  4. Concerning for expressive language delay Correct answer.

Explanation

By 2 years most children use at least 50 words and combine words; by 3 years vocabulary and sentence length should be substantially greater. A 50-word vocabulary with two-word phrases at 3 years suggests expressive language delay requiring evaluation.

Question 21Pediatría general y crecimiento y desarrollo

Which of the following is the most appropriate method to assess linear growth in a child who cannot stand?

  1. Recumbent length with a measuring board Correct answer.
  2. Self-reported height
  3. Standing height with a stadiometer
  4. Arm span alone

Explanation

Children who cannot stand reliably should have recumbent length measured with a proper board. Standing height is used once the child can stand independently and reliably.

Question 22Pediatría general y crecimiento y desarrollo

A 14-year-old girl has not yet had menarche and has no breast development. Which finding is most concerning?

  1. Absence of breast development at 14 years Correct answer.
  2. Thelarche at 10 years
  3. Menarche at 15 years
  4. Growth spurt at 12 years

Explanation

Absence of breast development by 13 to 14 years suggests delayed puberty and warrants evaluation. Menarche by 15 years and thelarche at 10 years fall within normal ranges.

Question 23Pediatría general y crecimiento y desarrollo

Which of the following statements about the Apgar score is most accurate?

  1. It should be recorded at 1 and 5 minutes after birth Correct answer.
  2. It replaces the need for newborn physical examination
  3. It predicts long-term neurological outcome
  4. It is used to guide immediate resuscitation

Explanation

The Apgar score is assigned at 1 and 5 minutes (and repeated if needed) to describe newborn condition. It guides but does not dictate resuscitation and does not predict long-term outcome.

Question 24Pediatría general y crecimiento y desarrollo

A 6-year-old has a body mass index at the 97th percentile and a fasting glucose of 105 mg/dL. Which next step is most appropriate?

  1. Start insulin therapy immediately
  2. Reassure because pediatric obesity is benign
  3. Repeat fasting glucose and consider further metabolic screening Correct answer.
  4. Restrict all carbohydrates indefinitely

Explanation

A fasting glucose of 105 mg/dL in an obese child falls in the impaired fasting glucose range and warrants confirmation and further metabolic evaluation. Immediate insulin therapy is not indicated at this level.

Question 25Neonatología

A term newborn is placed skin-to-skin with the mother immediately after birth. Which physiologic benefit is best supported for this practice in a stable newborn?

  1. Accelerated closure of the ductus arteriosus
  2. Faster umbilical cord separation
  3. Immediate rise in serum bilirubin clearance
  4. Improved thermoregulation and breastfeeding initiation Correct answer.

Explanation

Skin-to-skin contact after birth supports thermoregulation, stabilizes cardiorespiratory transition, and promotes early breastfeeding initiation. It does not pharmacologically close the ductus arteriosus or affect cord separation timing.

Question 26Neonatología

Which finding on routine newborn examination most strongly suggests developmental dysplasia of the hip in a 2-week-old infant?

  1. Symmetric gluteal creases
  2. Bilateral symmetric Moro reflex
  3. Ortolani-positive hip with a palpable clunk Correct answer.
  4. Physiologic genu varum

Explanation

An Ortolani maneuver that produces a palpable clunk indicates a dislocatable hip and warrants imaging and orthopedic referral. Asymmetric creases can be a clue but symmetric creases do not exclude dysplasia.

Question 27Neonatología

A newborn at 36 hours of life has a total bilirubin of 15 mg/dL and is otherwise well, feeding, and term. Which factor most increases the risk of significant hyperbilirubinemia requiring treatment?

  1. ABO incompatibility with a positive direct antiglobulin test Correct answer.
  2. Birth weight of 3.4 kg
  3. Cephalohematoma that is resolving
  4. Exclusive breastfeeding with adequate output

Explanation

Hemolytic disease such as ABO incompatibility with a positive direct antiglobulin test accelerates bilirubin production and raises the risk of severe hyperbilirubinemia. Adequate feeding, normal weight, and resolving cephalohematoma are lower-risk features.

Question 28Neonatología

Which intervention is the first step in the management of a newborn with suspected neonatal sepsis?

  1. Start antiviral therapy for all cases
  2. Obtain blood culture and start empiric antibiotics promptly Correct answer.
  3. Give intravenous immunoglobulin routinely
  4. Wait for culture results before treating

Explanation

When sepsis is suspected, blood cultures should be obtained and empiric antibiotics started without delay, because early treatment improves outcomes. Waiting for culture results risks progression of infection.

Question 29Neonatología

A preterm infant at 30 weeks gestation is being managed in the delivery room. Which practice best reduces the risk of intraventricular hemorrhage?

  1. Rapid volume expansion with boluses
  2. Delayed cord clamping and avoidance of rapid fluid shifts Correct answer.
  3. Immediate high-pressure ventilation
  4. Routine sodium bicarbonate administration

Explanation

Prevention of intraventricular hemorrhage focuses on stabilizing cerebral blood flow, including delayed cord clamping and avoiding abrupt changes in blood pressure or volume. Rapid boluses and high-pressure ventilation can destabilize cerebral perfusion.

Question 30Neonatología

Which is the recommended initial management for a newborn with a low blood glucose level and clinical symptoms?

  1. Start oral feeds only
  2. Observe for one hour before intervention
  3. Give intravenous glucose promptly Correct answer.
  4. Give intramuscular glucagon

Explanation

Symptomatic neonatal hypoglycemia requires prompt intravenous glucose to correct the level and prevent neurologic injury. Observation or oral feeds alone is inadequate when symptoms are present.

Question 31Neonatología

Which finding is most consistent with respiratory distress syndrome in a preterm infant?

  1. Bilateral coarse crackles with fever
  2. Gradual onset of symptoms after 48 hours
  3. Asymmetric breath sounds with absent cry
  4. Grunting, retractions, and tachypnea with onset soon after birth Correct answer.

Explanation

Respiratory distress syndrome from surfactant deficiency presents soon after birth with grunting, retractions, and tachypnea. Later onset or febrile presentations suggest other causes such as pneumonia or sepsis.

Question 32Neonatología

A term infant is noted to have a single umbilical artery at birth. Which associated condition should be screened for?

  1. Renal and urinary tract anomalies Correct answer.
  2. Congenital heart disease
  3. Cleft palate
  4. Developmental dysplasia of the hip

Explanation

A single umbilical artery is associated with renal and urinary tract anomalies, so renal ultrasonography is often recommended. Cardiac and other anomalies are less specifically linked.

Question 33Neonatología

Which is the most appropriate initial step in evaluating a newborn with ambiguous genitalia?

  1. Assign male sex pending evaluation
  2. Start testosterone therapy
  3. Delay all testing until one year of age
  4. Obtain karyotype and electrolyte assessment urgently Correct answer.

Explanation

Ambiguous genitalia require urgent evaluation for possible congenital adrenal hyperplasia, including karyotype and electrolytes to detect salt-wasting crisis. Sex assignment should be deferred until the evaluation is complete.

Question 34Neonatología

Which immunization is typically given at birth in many national schedules?

  1. Hepatitis B vaccine Correct answer.
  2. Human papillomavirus vaccine
  3. Measles-mumps-rubella vaccine
  4. Varicella vaccine

Explanation

Hepatitis B vaccine is commonly administered at birth as part of routine immunization schedules. MMR, varicella, and HPV vaccines are given later in childhood.

Question 35Neonatología

A newborn presents with bilious vomiting on the first day of life. Which diagnosis must be excluded urgently?

  1. Transient tachypnea of the newborn
  2. Gastroesophageal reflux
  3. Malrotation with midgut volvulus Correct answer.
  4. Physiologic jaundice

Explanation

Bilious vomiting in a neonate is a surgical emergency until malrotation with midgut volvulus is excluded, because delay risks bowel necrosis. Reflux does not typically produce bilious emesis.

Question 36Neonatología

Which is the recommended position for placing a newborn to sleep to reduce the risk of sudden infant death syndrome?

  1. Supine position Correct answer.
  2. Side-lying position
  3. Elevated head position
  4. Prone position

Explanation

Placing infants supine for sleep is the recommended practice to reduce the risk of sudden infant death syndrome. Prone and side-lying positions are associated with increased risk.

Question 37Neonatología

A newborn at 24 hours of life has a temperature of 38.0°C. Which is the most appropriate next step?

  1. Apply a cooling blanket
  2. Perform a full sepsis evaluation and start empiric antibiotics Correct answer.
  3. Reassure and recheck in 24 hours
  4. Give antipyretics and discharge

Explanation

Fever in a neonate is a red flag for serious bacterial infection and warrants a full sepsis evaluation with empiric antibiotics. Observation or antipyretics alone are unsafe.

Question 38Neonatología

Which finding is most consistent with neonatal abstinence syndrome?

  1. Excessive weight gain and sleepiness
  2. Hypertonia, irritability, and poor feeding Correct answer.
  3. Hypotonia, lethargy, and apnea
  4. Bradycardia with hypothermia

Explanation

Neonatal abstinence syndrome typically presents with central nervous system hyperirritability, hypertonia, and feeding difficulties. Hypotonia and lethargy are less typical.

Question 39Neonatología

A premature infant at 28 weeks is at increased risk for which nutritional deficiency?

  1. Calcium excess
  2. Vitamin C deficiency
  3. Iron deficiency due to low stores Correct answer.
  4. Excess vitamin D

Explanation

Preterm infants have low iron stores and rapid growth, placing them at risk for iron deficiency, so supplementation is often needed. Other vitamin and mineral deficiencies are less directly related to prematurity in this context.

Question 40Neonatología

Which maneuver is used to assess for hip instability in a newborn?

  1. Barlow maneuver Correct answer.
  2. Stepping reflex
  3. Palmar grasp
  4. Moro maneuver

Explanation

The Barlow maneuver tests whether the femoral head can be dislocated posteriorly from the acetabulum. The Moro, palmar grasp, and stepping reflex are neurologic assessments.

Question 41Neonatología

Which is the most appropriate initial management for a newborn with meconium-stained amniotic fluid who is vigorous and breathing?

  1. Start antibiotics
  2. Provide warmth, dry, and stimulate while monitoring Correct answer.
  3. Routine intubation and suctioning
  4. Immediate chest compressions

Explanation

A vigorous newborn with meconium-stained fluid should receive routine initial steps of warmth, drying, and stimulation with close monitoring. Routine intubation and suctioning are not indicated for vigorous infants.

Question 42Neonatología

Which is the best indicator of adequate breastfeeding in a 1-week-old exclusively breastfed infant?

  1. Eight or more wet diapers per day and appropriate weight gain Correct answer.
  2. Maternal breast fullness alone
  3. Sleeping through the night
  4. Frequent crying after feeds

Explanation

Adequate output (six to eight or more wet diapers daily) and appropriate weight gain indicate sufficient intake. Sleeping patterns and maternal symptoms are less reliable indicators.

Question 43Neonatología

Which is the recommended initial action for a newborn with suspected choanal atresia who is in respiratory distress?

  1. Start antibiotics
  2. Place a nasal airway or oral airway and evaluate Correct answer.
  3. Perform chest physiotherapy
  4. Give nebulized epinephrine

Explanation

Newborns are obligate nasal breathers, so choanal atresia can cause significant distress; establishing an oral or nasal airway is the priority. Other therapies do not address the obstruction.

Question 44Neonatología

Which is the normal range for heart rate in a healthy term newborn at rest?

  1. 40 to 60 beats per minute
  2. 60 to 100 beats per minute
  3. 100 to 160 beats per minute Correct answer.
  4. 160 to 220 beats per minute

Explanation

A normal resting heart rate in a term newborn is approximately 100 to 160 beats per minute. Rates outside this range may indicate distress or arrhythmia.

Question 45Nutrición y gastroenterología pediátrica

¿Cuál es la recomendación general sobre la introducción de alimentos complementarios en un lactante sano alimentado con leche materna?

  1. Iniciar a los 4 meses con cereales
  2. Iniciar al año de vida
  3. Iniciar a los 2 meses con papillas
  4. Iniciar alrededor de los 6 meses manteniendo la lactancia Correct answer.

Explanation

La leche materna cubre las necesidades nutricionales hasta aproximadamente los 6 meses, momento en que se recomienda iniciar la alimentación complementaria sin suspender la lactancia. Introducirla antes o después de forma innecesaria aumenta riesgos de intolerancia o déficits.

Question 46Nutrición y gastroenterología pediátrica

Un lactante de 5 meses presenta regurgitaciones frecuentes, sin pérdida de peso ni signos de alarma. ¿Cuál es la medida inicial más adecuada?

  1. Funduplicatura quirúrgica
  2. Fórmula espesada y medidas posturales Correct answer.
  3. Suspender todas las tomas nocturnas
  4. Procinéticos de forma rutinaria

Explanation

El reflujo gastroesofágico fisiológico del lactante se maneja con medidas conservadoras: espesantes, fraccionamiento de tomas y posición adecuada tras comer. Los fármacos y la cirugía se reservan para casos complicados.

Question 47Nutrición y gastroenterología pediátrica

¿Cuál es el signo clínico más característico de la deshidratación moderada en un lactante con gastroenteritis aguda?

  1. Pliegue cutáneo que se mantiene elevado Correct answer.
  2. Hiperactividad marcada
  3. Diuresis abundante
  4. Fontanela abombada

Explanation

El signo del pliegue cutáneo persistente refleja pérdida de turgencia por depleción de líquidos. Se acompaña de otros signos como mucosas secas, taquicardia y oliguria.

Question 48Nutrición y gastroenterología pediátrica

¿Qué tipo de leche se recomienda de forma general en un lactante menor de un año sin antecedentes de alergia?

  1. Leche desnatada
  2. Leche entera de vaca
  3. Fórmula adaptada o leche materna Correct answer.
  4. Leche de soja

Explanation

Antes del año se recomienda leche materna o fórmula adaptada, que aportan el perfil de nutrientes adecuado. La leche de vaca entera no debe ser el alimento lácteo principal antes de los 12 meses.

Question 49Nutrición y gastroenterología pediátrica

¿Cuál es la causa más frecuente de diarrea aguda en la infancia?

  1. Sobrecrecimiento bacteriano
  2. Intolerancia a la lactosa
  3. Infección viral Correct answer.
  4. Enfermedad celíaca

Explanation

La mayoría de las diarreas agudas infantiles son de origen viral, especialmente por rotavirus y norovirus. El manejo fundamental es la rehidratación oral.

Question 50Nutrición y gastroenterología pediátrica

Un niño de 2 años con gastroenteritis presenta deshidratación leve y tolera la vía oral. ¿Cuál es la pauta inicial de rehidratación oral más adecuada?

  1. Zumos de fruta para reponer energía
  2. Bebidas isotónicas deportivas
  3. Agua sola en grandes volúmenes
  4. Suero de rehidratación oral en pequeñas cantidades frecuentes Correct answer.

Explanation

La solución de rehidratación oral con composición adecuada de sodio y glucosa, administrada en tomas pequeñas y frecuentes, es el tratamiento de elección en la deshidratación leve. El agua sola o los líquidos hipertónicos pueden empeorar el balance.