Certified Pediatric Nurse Practitioner – Primary Care
(CPNP-PC) Comprehensive Study Guide Exam 2025
Exam Description
This Certified Pediatric Nurse Practitioner – Primary Care (CPNP-PC) exam is for graduate
nursing students and certification candidates preparing to provide comprehensive, evidence-
based primary care for infants, children, and adolescents. It evaluates clinical reasoning,
diagnostic decision-making, growth and developmental assessment, health promotion, disease
management, and professional/ethical practice across the pediatric population.
Topics Covered:
1. Growth and developmental milestones
2. Pediatric health supervision and preventive care
3. Common acute pediatric conditions
4. Chronic disease management in children
5. Immunization guidelines and infectious diseases
6. Pediatric pharmacology and dosage calculations
7. Family-centered care and patient education
8. Ethical, legal, and professional issues in pediatric primary care
1|Page
,Certified Pediatric Nurse Practitioner – Primary Care
(CPNP-PC) Comprehensive Study Guide Exam 2025
Certified Pediatric Nurse Practitioner – Primary Care Exam
1. A 2-year-old presents for a well-child visit. Which developmental milestone is expected?
A. Copies a triangle
B. Uses two-word phrases
C. Balances on one foot for 5 seconds
D. Ties shoelaces
Answer: B. Uses two-word phrases
Explanation: At age 2, children typically combine two words (“want cookie”), follow two-step
commands, and show increasing independence.
2. The most reliable indicator of a child’s overall health status is:
A. Weight
B. Height
C. Growth pattern over time
D. Body mass index
Answer: C. Growth pattern over time
Explanation: Consistent growth across percentiles indicates adequate nutrition and health;
abrupt changes may signal disease or malnutrition.
3. The first permanent teeth to erupt are usually:
A. Upper central incisors
B. First molars
C. Lower lateral incisors
D. Canines
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,Certified Pediatric Nurse Practitioner – Primary Care
(CPNP-PC) Comprehensive Study Guide Exam 2025
Answer: B. First molars
Explanation: The first permanent molars (“6-year molars”) erupt around age 6, marking the
transition from primary to mixed dentition.
4. At what age should a child first be screened for autism spectrum disorder (ASD)?
A. 9 months
B. 18 months
C. 3 years
D. 5 years
Answer: B. 18 months
Explanation: The AAP recommends autism screening at 18 and 24 months using tools like the
M-CHAT-R/F for early identification.
5. A 4-year-old presents with bark-like cough and inspiratory stridor. The likely diagnosis
is:
A. Bronchiolitis
B. Croup (laryngotracheobronchitis)
C. Asthma
D. Epiglottitis
Answer: B. Croup (laryngotracheobronchitis)
Explanation: Croup, caused by parainfluenza virus, produces a barking cough and stridor;
treatment includes humidified air and dexamethasone.
6. Which vaccine is contraindicated in a child with a severe egg allergy?
A. MMR
B. Varicella
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, Certified Pediatric Nurse Practitioner – Primary Care
(CPNP-PC) Comprehensive Study Guide Exam 2025
C. Influenza (live, intranasal)
D. Hepatitis A
Answer: C. Influenza (live, intranasal)
Explanation: The live intranasal flu vaccine (LAIV) is contraindicated in severe egg allergy and
immunocompromised patients.
7. The best diagnostic test for iron deficiency anemia in toddlers is:
A. Serum ferritin
B. Serum iron
C. Hematocrit
D. Reticulocyte count
Answer: A. Serum ferritin
Explanation: Ferritin reflects total body iron stores and is the most sensitive early marker of
iron deficiency.
8. A 10-year-old with sore throat has a positive rapid strep test. The first-line treatment is:
A. Azithromycin
B. Amoxicillin
C. Clindamycin
D. Ciprofloxacin
Answer: B. Amoxicillin
Explanation: Penicillin or amoxicillin is the drug of choice for group A streptococcal
pharyngitis to prevent rheumatic fever.
9. Which finding requires urgent evaluation in a 3-month-old?
4|Page
(CPNP-PC) Comprehensive Study Guide Exam 2025
Exam Description
This Certified Pediatric Nurse Practitioner – Primary Care (CPNP-PC) exam is for graduate
nursing students and certification candidates preparing to provide comprehensive, evidence-
based primary care for infants, children, and adolescents. It evaluates clinical reasoning,
diagnostic decision-making, growth and developmental assessment, health promotion, disease
management, and professional/ethical practice across the pediatric population.
Topics Covered:
1. Growth and developmental milestones
2. Pediatric health supervision and preventive care
3. Common acute pediatric conditions
4. Chronic disease management in children
5. Immunization guidelines and infectious diseases
6. Pediatric pharmacology and dosage calculations
7. Family-centered care and patient education
8. Ethical, legal, and professional issues in pediatric primary care
1|Page
,Certified Pediatric Nurse Practitioner – Primary Care
(CPNP-PC) Comprehensive Study Guide Exam 2025
Certified Pediatric Nurse Practitioner – Primary Care Exam
1. A 2-year-old presents for a well-child visit. Which developmental milestone is expected?
A. Copies a triangle
B. Uses two-word phrases
C. Balances on one foot for 5 seconds
D. Ties shoelaces
Answer: B. Uses two-word phrases
Explanation: At age 2, children typically combine two words (“want cookie”), follow two-step
commands, and show increasing independence.
2. The most reliable indicator of a child’s overall health status is:
A. Weight
B. Height
C. Growth pattern over time
D. Body mass index
Answer: C. Growth pattern over time
Explanation: Consistent growth across percentiles indicates adequate nutrition and health;
abrupt changes may signal disease or malnutrition.
3. The first permanent teeth to erupt are usually:
A. Upper central incisors
B. First molars
C. Lower lateral incisors
D. Canines
2|Page
,Certified Pediatric Nurse Practitioner – Primary Care
(CPNP-PC) Comprehensive Study Guide Exam 2025
Answer: B. First molars
Explanation: The first permanent molars (“6-year molars”) erupt around age 6, marking the
transition from primary to mixed dentition.
4. At what age should a child first be screened for autism spectrum disorder (ASD)?
A. 9 months
B. 18 months
C. 3 years
D. 5 years
Answer: B. 18 months
Explanation: The AAP recommends autism screening at 18 and 24 months using tools like the
M-CHAT-R/F for early identification.
5. A 4-year-old presents with bark-like cough and inspiratory stridor. The likely diagnosis
is:
A. Bronchiolitis
B. Croup (laryngotracheobronchitis)
C. Asthma
D. Epiglottitis
Answer: B. Croup (laryngotracheobronchitis)
Explanation: Croup, caused by parainfluenza virus, produces a barking cough and stridor;
treatment includes humidified air and dexamethasone.
6. Which vaccine is contraindicated in a child with a severe egg allergy?
A. MMR
B. Varicella
3|Page
, Certified Pediatric Nurse Practitioner – Primary Care
(CPNP-PC) Comprehensive Study Guide Exam 2025
C. Influenza (live, intranasal)
D. Hepatitis A
Answer: C. Influenza (live, intranasal)
Explanation: The live intranasal flu vaccine (LAIV) is contraindicated in severe egg allergy and
immunocompromised patients.
7. The best diagnostic test for iron deficiency anemia in toddlers is:
A. Serum ferritin
B. Serum iron
C. Hematocrit
D. Reticulocyte count
Answer: A. Serum ferritin
Explanation: Ferritin reflects total body iron stores and is the most sensitive early marker of
iron deficiency.
8. A 10-year-old with sore throat has a positive rapid strep test. The first-line treatment is:
A. Azithromycin
B. Amoxicillin
C. Clindamycin
D. Ciprofloxacin
Answer: B. Amoxicillin
Explanation: Penicillin or amoxicillin is the drug of choice for group A streptococcal
pharyngitis to prevent rheumatic fever.
9. Which finding requires urgent evaluation in a 3-month-old?
4|Page
