PNP-PC Board Certification Practice Exam
2026/2027: PNCB CPNP-PC Format with
Verified Questions & Rationales – Graded A+
DOMAIN 1: HEALTH MAINTENANCE AND PROMOTION (Questions 1-23)
Subdomain: Growth and Development (Questions 1-8)
Q1: A 2-month-old infant is brought for a well-child visit. The parent asks what
developmental milestones to expect. Which finding would be NORMAL for this age?
A. Rolling from back to front
B. Social smile in response to parent
C. Sitting without support for several seconds
D. Reaching for and grasping a rattle
Correct Answer: B
Rationale: Social smile typically emerges by 2 months of age and is an important
social-emotional milestone per CDC guidelines. Rolling from back to front (A) typically
occurs around 4-6 months. Sitting without support (C) occurs around 6-8 months.
Reaching and grasping (D) develops around 3-4 months. The 2-month visit is also when
the first set of immunizations (DTaP, Hib, IPV, PCV, RV) are due.
PNCB Domain: Health Maintenance and Promotion – Growth and Development
,Age Group: Infant (0-12 months) | Cognitive Level: Level 1 – Recall | Difficulty: Moderate
Q2: A 12-month-old child is seen for a well-child visit. Which gross motor milestone
should the nurse practitioner expect to assess?
A. Walking independently
B. Running
C. Jumping with both feet
D. Walking up stairs with assistance
Correct Answer: A
Rationale: Independent walking typically occurs between 9-15 months, with most
children walking by 12 months. Running (B) develops around 18-24 months. Jumping
with both feet (C) develops around 2-3 years. Walking up stairs with assistance (D)
develops around 15-18 months. If a 12-month-old is not yet walking but pulling to stand
and cruising, this is within the expected range and warrants continued monitoring.
PNCB Domain: Health Maintenance and Promotion – Growth and Development
Age Group: Infant (0-12 months) | Cognitive Level: Level 1 – Recall | Difficulty: Moderate
Q3: A 4-year-old child is brought for a well-child visit. Which fine motor skill should the
nurse practitioner expect the child to demonstrate?
A. Copying a square
B. Tying shoelaces
C. Cutting with scissors along a line
,D. Drawing a person with 6 body parts
Correct Answer: A
Rationale: Copying a square is a typical fine motor milestone for a 4-year-old. Tying
shoelaces (B) develops around 5-6 years. Cutting with scissors along a line (C) develops
around 3-4 years but is more consistently achieved by 4-5 years. Drawing a person with
3-4 body parts is expected at 4 years; 6 parts is more typical at 5 years. By age 4,
children also typically hop on one foot, use 4-5 word sentences, and can name some
colors.
PNCB Domain: Health Maintenance and Promotion – Growth and Development
Age Group: Preschooler (1-5 years) | Cognitive Level: Level 1 – Recall | Difficulty:
Moderate
Q4 (NGN-Style): A 9-month-old infant is brought for a well-child visit. The parent reports
the infant cannot sit without support, does not roll in either direction, and does not bear
weight on legs when held in a standing position. The infant reaches for toys but uses a
raking grasp rather than pincer grasp. The parent denies any illness, and the infant
appears well on exam.
Question: Based on these findings, what is the PRIORITY action?
A. Reassure the parent that all infants develop at their own pace
B. Schedule a follow-up visit in 2 months to reassess milestones
C. Administer the Ages and Stages Questionnaire (ASQ) and consider early intervention
referral
D. Order an MRI of the brain to rule out structural abnormalities
, Correct Answer: C
Rationale: The infant is missing several key 9-month milestones: sitting without support
(should be present by 9 months), rolling (should be present by 6 months), and bearing
weight (should be present by 6-7 months). This pattern of gross motor delay warrants
formal developmental screening and possible early intervention referral. Reassurance
(A) without screening is inappropriate given the delays. Waiting 2 months (B) delays
intervention. MRI (D) is premature without initial developmental assessment and
possible pediatric neurology referral.
PNCB Domain: Health Maintenance and Promotion – Growth and Development
Age Group: Infant (0-12 months) | Cognitive Level: Level 3 – Analysis/Synthesis |
Difficulty: Difficult
Q5: A 6-month-old is able to sit with support, rolls both directions, and transfers objects
between hands. The parent asks when to expect the child to sit independently. Which
response is MOST accurate?
A. "Most infants sit independently by 4 months"
B. "Sitting without support typically develops between 6-8 months"
C. "Your baby should sit independently by 10 months"
D. "Independent sitting is not expected until 12 months"
Correct Answer: B
Rationale: Independent sitting without support typically develops between 6-8 months of
age. By 4 months (A), infants can sit with support but not independently. Waiting until
10 months (C) or 12 months (D) is beyond the typical window and may indicate delay if
2026/2027: PNCB CPNP-PC Format with
Verified Questions & Rationales – Graded A+
DOMAIN 1: HEALTH MAINTENANCE AND PROMOTION (Questions 1-23)
Subdomain: Growth and Development (Questions 1-8)
Q1: A 2-month-old infant is brought for a well-child visit. The parent asks what
developmental milestones to expect. Which finding would be NORMAL for this age?
A. Rolling from back to front
B. Social smile in response to parent
C. Sitting without support for several seconds
D. Reaching for and grasping a rattle
Correct Answer: B
Rationale: Social smile typically emerges by 2 months of age and is an important
social-emotional milestone per CDC guidelines. Rolling from back to front (A) typically
occurs around 4-6 months. Sitting without support (C) occurs around 6-8 months.
Reaching and grasping (D) develops around 3-4 months. The 2-month visit is also when
the first set of immunizations (DTaP, Hib, IPV, PCV, RV) are due.
PNCB Domain: Health Maintenance and Promotion – Growth and Development
,Age Group: Infant (0-12 months) | Cognitive Level: Level 1 – Recall | Difficulty: Moderate
Q2: A 12-month-old child is seen for a well-child visit. Which gross motor milestone
should the nurse practitioner expect to assess?
A. Walking independently
B. Running
C. Jumping with both feet
D. Walking up stairs with assistance
Correct Answer: A
Rationale: Independent walking typically occurs between 9-15 months, with most
children walking by 12 months. Running (B) develops around 18-24 months. Jumping
with both feet (C) develops around 2-3 years. Walking up stairs with assistance (D)
develops around 15-18 months. If a 12-month-old is not yet walking but pulling to stand
and cruising, this is within the expected range and warrants continued monitoring.
PNCB Domain: Health Maintenance and Promotion – Growth and Development
Age Group: Infant (0-12 months) | Cognitive Level: Level 1 – Recall | Difficulty: Moderate
Q3: A 4-year-old child is brought for a well-child visit. Which fine motor skill should the
nurse practitioner expect the child to demonstrate?
A. Copying a square
B. Tying shoelaces
C. Cutting with scissors along a line
,D. Drawing a person with 6 body parts
Correct Answer: A
Rationale: Copying a square is a typical fine motor milestone for a 4-year-old. Tying
shoelaces (B) develops around 5-6 years. Cutting with scissors along a line (C) develops
around 3-4 years but is more consistently achieved by 4-5 years. Drawing a person with
3-4 body parts is expected at 4 years; 6 parts is more typical at 5 years. By age 4,
children also typically hop on one foot, use 4-5 word sentences, and can name some
colors.
PNCB Domain: Health Maintenance and Promotion – Growth and Development
Age Group: Preschooler (1-5 years) | Cognitive Level: Level 1 – Recall | Difficulty:
Moderate
Q4 (NGN-Style): A 9-month-old infant is brought for a well-child visit. The parent reports
the infant cannot sit without support, does not roll in either direction, and does not bear
weight on legs when held in a standing position. The infant reaches for toys but uses a
raking grasp rather than pincer grasp. The parent denies any illness, and the infant
appears well on exam.
Question: Based on these findings, what is the PRIORITY action?
A. Reassure the parent that all infants develop at their own pace
B. Schedule a follow-up visit in 2 months to reassess milestones
C. Administer the Ages and Stages Questionnaire (ASQ) and consider early intervention
referral
D. Order an MRI of the brain to rule out structural abnormalities
, Correct Answer: C
Rationale: The infant is missing several key 9-month milestones: sitting without support
(should be present by 9 months), rolling (should be present by 6 months), and bearing
weight (should be present by 6-7 months). This pattern of gross motor delay warrants
formal developmental screening and possible early intervention referral. Reassurance
(A) without screening is inappropriate given the delays. Waiting 2 months (B) delays
intervention. MRI (D) is premature without initial developmental assessment and
possible pediatric neurology referral.
PNCB Domain: Health Maintenance and Promotion – Growth and Development
Age Group: Infant (0-12 months) | Cognitive Level: Level 3 – Analysis/Synthesis |
Difficulty: Difficult
Q5: A 6-month-old is able to sit with support, rolls both directions, and transfers objects
between hands. The parent asks when to expect the child to sit independently. Which
response is MOST accurate?
A. "Most infants sit independently by 4 months"
B. "Sitting without support typically develops between 6-8 months"
C. "Your baby should sit independently by 10 months"
D. "Independent sitting is not expected until 12 months"
Correct Answer: B
Rationale: Independent sitting without support typically develops between 6-8 months of
age. By 4 months (A), infants can sit with support but not independently. Waiting until
10 months (C) or 12 months (D) is beyond the typical window and may indicate delay if
