1. A 6-month-old infant presents with a three-day history of cough and runny nose. On examination, the infant has mild intercostal retractions. Which of the following is the most appropriate initial management? A. Prescribe antibiotics B. Initiate bronchodilators C. Provide supportive care and monitor D. Order chest X-ray Answer: C. Provide supportive care and monitor Rationale: The symptoms suggest a mild viral respiratory infection. Supportive care, including hydration and fever management, is appropriate. Antibiotics are not indicated without evidence of bacterial infection, bronchodilators are not effective for upper respiratory infections, and a chest X-ray is not indicated for mild symptoms without distress. 2. A 3-year-old child is brought to the clinic with a history of recurrent otitis media. Which of the following factors is most likely contributing to the child's condition? A. Frequent swimming B. Exposure to secondhand smoke C. Use of pacifier D. All of the above Answer: D. All of the above Rationale: All listed options are risk factors for recurrent otitis media. Frequent swimming can lead to water retention in the ear canal, exposure to secondhand smoke can impair immune function and increase infection risk, and pacifier use has been associated with higher rates of otitis media. 3. During a well-child visit, you note that a 10-year-old child has a BMI in the 95th percentile for age and sex. What is the next best step in management? A. Refer to a nutritionist B. Start an intensive exercise program C. Begin pharmacotherapy for weight loss D. Counsel on diet and physical activity; plan follow-up Answer: D. Counsel on diet and physical activity; plan follow-up Rationale: The child is classified as obese based on BMI. The initial