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100+ Free Pediatrics Board Practice Questions
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Sample Pediatrics Board Practice Questions
Try these sample questions to test your Pediatrics Board exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.
1A 2-day-old male infant born at 31 weeks gestation experiences recurrent episodes of apnea lasting 22 seconds, associated with cyanosis and a drop in heart rate to 80 bpm. Sepsis workup is normal, and physical exam is otherwise unremarkable. What is the most appropriate first-line pharmacologic treatment?
A.Caffeine citrate
B.Theophylline
C.Albuterol nebulization
D.Phenobarbital
Explanation: Caffeine citrate is the first-line therapy for apnea of prematurity. It acts as a central respiratory stimulant, has a wide therapeutic index, a long half-life, and does not require routine blood level monitoring.
2A male infant born at 29 weeks gestation develops grunting, nasal flaring, and chest retractions immediately after birth. A chest radiograph shows diffuse reticulogranular 'ground-glass' patterns and air bronchograms. Which of the following prenatal interventions is most effective in preventing this condition?
A.Maternal administration of betamethasone 24-48 hours before delivery
B.Maternal administration of magnesium sulfate immediately before delivery
C.Prophylactic administration of indomethacin to the neonate within 2 hours of life
D.Maternal administration of progesterone during the second trimester
Explanation: Maternal betamethasone (antenatal corticosteroids) accelerates fetal lung maturation by inducing surfactant production, significantly reducing the incidence of Respiratory Distress Syndrome (RDS) in preterm infants.
3A full-term male infant born via elective Cesarean section without labor presents with tachypnea (RR 82 bpm) and mild intercostal retractions at 1 hour of life. Chest radiograph shows prominent perihilar vascular markings and fluid lines in the interlobar fissures. What is the primary pathophysiologic mechanism of this condition?
A.Delayed clearance of fetal lung fluid via lymphatic and pulmonary circulation
B.Deficiency of alveolar surfactant leading to microatelectasis
C.Meconium obstruction of small airways leading to air trapping
D.Bacterial colonization of the lower respiratory tract
Explanation: Transient Tachypnea of the Newborn (TTN) is caused by delayed resorption of fetal lung fluid, which normally occurs during active labor via catecholamine-driven activation of epithelial sodium channels (ENaC). Elective C-section without labor increases this risk.
4According to the 2022 AAP Hyperbilirubinemia Guidelines, which of the following is considered a major hyperbilirubinemia neurotoxicity risk factor that lowers the threshold for phototherapy and exchange transfusion?
A.Glucose-6-phosphate dehydrogenase (G6PD) deficiency
B.Gestational age of 38 weeks
C.Exclusive breastfeeding with weight loss of 5%
D.Cephalohematoma
Explanation: G6PD deficiency is a recognized neurotoxicity risk factor because it can cause rapid, unpredictable hemolysis, raising the risk of bilirubin-induced neurologic dysfunction (BIND) and kernicterus.
5A 12-hour-old term neonate develops lethargy, temperature instability (temp 35.9 C), and poor feeding. The maternal history is positive for Group B Streptococcus (GBS) colonization with inadequate intrapartum antibiotic prophylaxis. What is the most appropriate empiric antimicrobial regimen?
A.Ampicillin and Gentamicin
B.Ceftriaxone and Vancomycin
C.Cefotaxime and Clindamycin
D.Piperacillin-Tazobactam and Gentamicin
Explanation: The standard empiric therapy for early-onset neonatal sepsis (EOS) is Ampicillin (covering GBS, Listeria monocytogenes) and Gentamicin (covering Gram-negative rods like E. coli).
6A term female infant is born via emergency Cesarean section for abruption placentae. Apgar scores are 2, 4, and 5 at 1, 5, and 10 minutes respectively. Cord pH is 6.9, and base deficit is 18 mmol/L. The infant is lethargic with hypotonia and absent reflexes. Which of the following is correct regarding therapeutic hypothermia for this neonate?
A.It should be initiated within 6 hours of birth and maintain a core temperature of 33.5 C for 72 hours
B.It should be initiated within 12 hours of birth and maintain a core temperature of 35.0 C for 48 hours
C.It is contraindicated in patients with a base deficit greater than 15 mmol/L
D.It should be initiated only after the first 24 hours of life to assess long-term deficits
Explanation: Therapeutic hypothermia (whole-body or selective head cooling) is indicated for moderate-to-severe hypoxic-ischemic encephalopathy (HIE). It must be started within 6 hours of birth, cooling the core temperature to 33.5 C for 72 hours to reduce brain injury.
7A preterm infant born at 27 weeks gestation on post-op day 14 of life develops abdominal distension, feeding intolerance, and bloody stools. An abdominal radiograph demonstrates subserosal gas bubbles within the bowel wall (pneumatosis intestinalis). According to Bell's Staging Criteria, which stage does this represent?
A.Stage II (Proven Necrotizing Enterocolitis)
B.Stage I (Suspected Necrotizing Enterocolitis)
C.Stage IIIa (Advanced Bowel Dysfunction, Intact Bowel)
D.Stage IIIb (Advanced Bowel Dysfunction, Perforated Bowel)
Explanation: Pneumatosis intestinalis is the hallmark radiographic finding of Bell's Stage II (Proven NEC). Stage I is suspected NEC (normal or non-specific radiographs), Stage IIIa is advanced NEC with intact bowel (with ascites), and Stage IIIb features pneumoperitoneum (perforated bowel).
8A term female neonate is born via Cesarean section following prolonged rupture of membranes. Shortly after birth, she develops severe respiratory distress, hypoxemia, and labile oxygen saturations. Echocardiography shows right-to-left shunting through the patent ductus arteriosus (PDA) and patent foramen ovale (PFO). What is the key diagnostic finding that supports Persistent Pulmonary Hypertension of the Newborn (PPHN)?
A.A pre-ductal and post-ductal oxygen saturation gradient of >10%
B.An increase in arterial oxygen tension (PaO2) of >100 mmHg during a 100% hyperoxia test
C.A pulmonary-to-systemic pressure ratio of <0.5
D.Left ventricular hypertrophy on chest radiograph
Explanation: A significant gradient (>10%) between pre-ductal (right hand) and post-ductal (either foot) oxygen saturation reflects right-to-left shunting across a patent ductus arteriosus due to high pulmonary vascular resistance, which is diagnostic of PPHN.
9An infant is born at 26 weeks gestation weighing 850 grams. According to standard screening guidelines, when should the first screening head ultrasound (HUS) be performed to detect Intraventricular Hemorrhage (IVH)?
A.At 7 to 10 days of life
B.Within the first 24 hours of life
C.At 4 weeks of life
D.Only if the infant develops a sudden drop in hematocrit
Explanation: Screening HUS is recommended for all infants born at <30 weeks gestation. The first scan is typically performed between 7 and 10 days of life, which captures the vast majority of clinically significant hemorrhages (most occur within the first 3-5 days).
10A term infant is born with a prenatal diagnosis of left-sided Congenital Diaphragmatic Hernia (CDH). In the delivery room, the infant exhibits severe respiratory distress, cyanosis, and a scaphoid abdomen. What is the most critical immediate step in resuscitation?
A.Immediate endotracheal intubation and placement of an orogastric tube
B.Initiation of positive pressure ventilation via bag-mask
C.Administration of bolus surfactant
D.Immediate umbilical vein catheterization and administration of epinephrine
Explanation: Immediate endotracheal intubation prevents air from entering the gastrointestinal tract, which would compress the hypoplastic lungs. An orogastric tube is placed to decompress the stomach and bowel. Bag-mask ventilation is contraindicated.
About the Pediatrics Board Exam
This practice exam covers neonatology, pediatric infectious diseases, emergency/critical care, systemic pediatric disorders, and adolescent preventive pediatrics.
Assessment
100 multiple-choice questions
Time Limit
3 hours
Passing Score
60%
Exam Fee
Free (Saudi Commission for Health Specialties (SCFHS))
Pediatrics Board Exam Content Outline
20%
Neonatology & Developmental
Prematurity, respiratory distress syndrome, developmental milestones, and growth tracking.
20%
Pediatric Infectious Diseases
Common childhood viral/bacterial infections, immunization schedules, and fever of unknown origin.
20%
Pediatric Emergency & Critical Care
Shock, status epilepticus, poisoning, asthma exacerbations, and pediatric ICU management.
20%
Systemic Pediatric Disorders
Pediatric cardiology, nephrology, endocrinology, and gastroenterology.
20%
Adolescent & Preventive Pediatrics
Adolescent medicine, counseling, and pediatric health checkups.
How to Pass the Pediatrics Board Exam
What You Need to Know
- Passing score: 60%
- Assessment: 100 multiple-choice questions
- Time limit: 3 hours
- Exam fee: Free
Keys to Passing
- Complete 500+ practice questions
- Score 80%+ consistently before scheduling
- Focus on highest-weighted sections
- Use our AI tutor for tough concepts
Frequently Asked Questions
What is the format of the Pediatrics Board exam?
The exam consists of 100 multiple-choice questions covering all five content domains.
What is the passing score for the Pediatrics Board exam?
Candidates must score at least 60% to pass the exam.