PEDIATRIC NURSE PRACTITIONER {PNP} ACTUAL
EXAM 2025-2026 300 QUESTINS WITH DETAIED
ANSWERS AREADY GRADED A+
H.O. is a 5 yo Vietnamese child who has fallen off of his growth curve. The best intervention would
be to:
a. Suggest high-calorie breakfast drinks as supplements
b. incorporate traditional foods into a management plan that will provide increased calories and
nutrients
c. educate the family on the need for increased calories and nutrients
d. refer the family to growth clinic for evaluation - CORRECT ANSWER-B
While taking the history of 6-month old E.M. you learn that she is not sleeping through the night and
will not fall back to sleep without the parents rocking or feeding her. This is an example of:
a. somnambulism
b. pavor nocturnus
c. learned behavior
d. delayed sleep phase - CORRECT ANSWER-C
Which of the following scenarios is suggestive of a child who may not be ready to enter first grade?
An inability to:
a. recognize six colors and remember one's phone number
b. accurately use pronouns
c. empathize with others
d. count to five and draw a person with three parts - CORRECT ANSWER-d
T.T. is a 9 week old preterm infant whose birth wt was 2.3 kg. Mom was HBs Ag Neg. He is seen
today for the first time since discharge from the nursery. He has received no prior immunizations.
The appropriate immunizations to give at this time would be:
a. Dtap, Hib, IPV, rotavirus, HepB 1, pneumo
b. Dtap, Hib, OPV, rotavirus, HepB 1
c. Dtap, Hib, rotavirus, IPV, pneumo
,d. Dtap, Hib, IPV, pneumo - CORRECT ANSWER-a
While examining 10 yo RMs teeth you note that the upper incisors slightly overlap the lower incisors.
The second and lower first molars are absent. Your assessment is:
a. malocclusion
b. delayed mandibular dentition
c. normal dentition
d. hyperdontia - CORRECT ANSWER-b
The mother of 5yo DW is concerned that her son often cheats when playing board games with his
older sister. What is the most appropriate response to DWs behavior?
a. encourage the parent to use 5 minute time-outs when cheating occurs
b. explain that DW is developmentally unable to comprehend rigid rules
c. make sure that DW understands the rules before starting to play the game
d. explain to DW that cheating is like lying and is not acceptable behavior - CORRECT ANSWER-b
While conducting the Denver II developmental screening test, the mother of an 18 mos old child
reports to you that the toddler doesn't imitate activities. You decide to assess the child's
development further by giving him tasks from which sector?
a. personal-social
b. fine motor-adaptive
c. language
d. gross motor - CORRECT ANSWER-a
You have ordered routine blood screening for a 2yo girl who because of dietary habits, is at risk for
iron deficiency anemia. Which of the following findings is not associated with iron deficiency
anemia?
a. hypochromic RBC
b. microcytic RBC
c. low reticulocyte count
d. low free erythrocyte protoporphyrin (FEP) level - CORRECT ANSWER-d
,During a prenatal visit, you review the mother's record for routine prenatal screening results. While
education the mother, you explain that the screening of maternal serum for alpha-fetoprotein
(MSAFP) between the 15th - 21st weeks of pregnancy is done primarily to screen for:
a. phenylketonuria
b. galactosemia
c. cystic fibrosis
d. neural tube defects - CORRECT ANSWER-d
A tenderness is detected over the tibial tuberosity of a 10 year old boy during a routine exam at a
school based clinic. The PNP knows this may be a sign of:
a. osgood-schlatter dz
b. blount's dz
c. plantar fasciitis
d. effusion in the joint space - CORRECT ANSWER-a
The parents of a 1 wk old infant are concerned about the unusual shape of their child's head. In the
physical exam of the infant, which of the following signs would not support a diagnosis of
craniosynostosis?
a. palpation of a ridge along a given suture line
b. unusual skull configuration
c. a palpable lesion at the occipital region
d. abnormal head cirumference - CORRECT ANSWER-c
In the emergency room, you encounter a toddler whose injuries are not consistent with the history
that is given. Which of the following would be the best step a provider could take in order to foster
communication with abusive parents?
a. realize that abusive parents have essentially different goals for their children than other caregivers
do
b. understand that parental hostility and resistance are potent symptoms of fear and inadequacy
c. consider referring the parents to substance abuse program
d. be cautious when sharing the results of medical findings - CORRECT ANSWER-b
You are preparing a drug prevention program for middle school students. Your educational approach
is based on the knowledge that the most common substance abuse in adolescence is:
, a. marijuana
b. cocaine
c. heroin
d. alcohol - CORRECT ANSWER-d
During a check up of a 15 mos old girl, you note that the child has dropped significantly in percentile
for weight over the past few months. In evaluating a child with failure to thrive, the most important
part of you assessment involves:
a. the history
b. the physical exam
c. laboratory studies
d. observation of family interactions - CORRECT ANSWER-a
A 7yo child in your caseload has recently been placed on methylphenidate for behavioral concerns
associated with ADHD. Which of the following side effects are not associated with this drugs?
a. decreased appetite
b. weight loss
c. irritability
d. decreased heart rate - CORRECT ANSWER-d
The parents of an 8yo child are concerned that their son does not want to attend school. Which of
the following historical findings aren't usually associated with the diagnosis of school phobia?
a. sporadic school absence
b. chronic medical illness
c. vague physical symptoms
d. depression and anxiety - CORRECT ANSWER-b
A 17yo girl is referred to your clinic by the school nurse to be assessed for an eating disorder. Which
of the following dynamics is not characteristic of anorexia nervosa?
a. excessive eating followed by purging
b. a pervasive sense of helplessness and ineffectiveness
c. wt loss that gives the patient a sense of mastery and control
d. low body temp, pulse, and bp - CORRECT ANSWER-a
EXAM 2025-2026 300 QUESTINS WITH DETAIED
ANSWERS AREADY GRADED A+
H.O. is a 5 yo Vietnamese child who has fallen off of his growth curve. The best intervention would
be to:
a. Suggest high-calorie breakfast drinks as supplements
b. incorporate traditional foods into a management plan that will provide increased calories and
nutrients
c. educate the family on the need for increased calories and nutrients
d. refer the family to growth clinic for evaluation - CORRECT ANSWER-B
While taking the history of 6-month old E.M. you learn that she is not sleeping through the night and
will not fall back to sleep without the parents rocking or feeding her. This is an example of:
a. somnambulism
b. pavor nocturnus
c. learned behavior
d. delayed sleep phase - CORRECT ANSWER-C
Which of the following scenarios is suggestive of a child who may not be ready to enter first grade?
An inability to:
a. recognize six colors and remember one's phone number
b. accurately use pronouns
c. empathize with others
d. count to five and draw a person with three parts - CORRECT ANSWER-d
T.T. is a 9 week old preterm infant whose birth wt was 2.3 kg. Mom was HBs Ag Neg. He is seen
today for the first time since discharge from the nursery. He has received no prior immunizations.
The appropriate immunizations to give at this time would be:
a. Dtap, Hib, IPV, rotavirus, HepB 1, pneumo
b. Dtap, Hib, OPV, rotavirus, HepB 1
c. Dtap, Hib, rotavirus, IPV, pneumo
,d. Dtap, Hib, IPV, pneumo - CORRECT ANSWER-a
While examining 10 yo RMs teeth you note that the upper incisors slightly overlap the lower incisors.
The second and lower first molars are absent. Your assessment is:
a. malocclusion
b. delayed mandibular dentition
c. normal dentition
d. hyperdontia - CORRECT ANSWER-b
The mother of 5yo DW is concerned that her son often cheats when playing board games with his
older sister. What is the most appropriate response to DWs behavior?
a. encourage the parent to use 5 minute time-outs when cheating occurs
b. explain that DW is developmentally unable to comprehend rigid rules
c. make sure that DW understands the rules before starting to play the game
d. explain to DW that cheating is like lying and is not acceptable behavior - CORRECT ANSWER-b
While conducting the Denver II developmental screening test, the mother of an 18 mos old child
reports to you that the toddler doesn't imitate activities. You decide to assess the child's
development further by giving him tasks from which sector?
a. personal-social
b. fine motor-adaptive
c. language
d. gross motor - CORRECT ANSWER-a
You have ordered routine blood screening for a 2yo girl who because of dietary habits, is at risk for
iron deficiency anemia. Which of the following findings is not associated with iron deficiency
anemia?
a. hypochromic RBC
b. microcytic RBC
c. low reticulocyte count
d. low free erythrocyte protoporphyrin (FEP) level - CORRECT ANSWER-d
,During a prenatal visit, you review the mother's record for routine prenatal screening results. While
education the mother, you explain that the screening of maternal serum for alpha-fetoprotein
(MSAFP) between the 15th - 21st weeks of pregnancy is done primarily to screen for:
a. phenylketonuria
b. galactosemia
c. cystic fibrosis
d. neural tube defects - CORRECT ANSWER-d
A tenderness is detected over the tibial tuberosity of a 10 year old boy during a routine exam at a
school based clinic. The PNP knows this may be a sign of:
a. osgood-schlatter dz
b. blount's dz
c. plantar fasciitis
d. effusion in the joint space - CORRECT ANSWER-a
The parents of a 1 wk old infant are concerned about the unusual shape of their child's head. In the
physical exam of the infant, which of the following signs would not support a diagnosis of
craniosynostosis?
a. palpation of a ridge along a given suture line
b. unusual skull configuration
c. a palpable lesion at the occipital region
d. abnormal head cirumference - CORRECT ANSWER-c
In the emergency room, you encounter a toddler whose injuries are not consistent with the history
that is given. Which of the following would be the best step a provider could take in order to foster
communication with abusive parents?
a. realize that abusive parents have essentially different goals for their children than other caregivers
do
b. understand that parental hostility and resistance are potent symptoms of fear and inadequacy
c. consider referring the parents to substance abuse program
d. be cautious when sharing the results of medical findings - CORRECT ANSWER-b
You are preparing a drug prevention program for middle school students. Your educational approach
is based on the knowledge that the most common substance abuse in adolescence is:
, a. marijuana
b. cocaine
c. heroin
d. alcohol - CORRECT ANSWER-d
During a check up of a 15 mos old girl, you note that the child has dropped significantly in percentile
for weight over the past few months. In evaluating a child with failure to thrive, the most important
part of you assessment involves:
a. the history
b. the physical exam
c. laboratory studies
d. observation of family interactions - CORRECT ANSWER-a
A 7yo child in your caseload has recently been placed on methylphenidate for behavioral concerns
associated with ADHD. Which of the following side effects are not associated with this drugs?
a. decreased appetite
b. weight loss
c. irritability
d. decreased heart rate - CORRECT ANSWER-d
The parents of an 8yo child are concerned that their son does not want to attend school. Which of
the following historical findings aren't usually associated with the diagnosis of school phobia?
a. sporadic school absence
b. chronic medical illness
c. vague physical symptoms
d. depression and anxiety - CORRECT ANSWER-b
A 17yo girl is referred to your clinic by the school nurse to be assessed for an eating disorder. Which
of the following dynamics is not characteristic of anorexia nervosa?
a. excessive eating followed by purging
b. a pervasive sense of helplessness and ineffectiveness
c. wt loss that gives the patient a sense of mastery and control
d. low body temp, pulse, and bp - CORRECT ANSWER-a
