FNP PEDS EXAM 1 REAL EXAM QUESTIONS AND CORRECT ANSWERS/NEWEST
UPDATE 2026!!!
Question 1
The mother of a 6-month-old infant is distressed because the infant can say "dada" but not
"mama." She asks the Family Nurse Practitioner (FNP) why this is occurring since she is the
primary caregiver. How should the FNP respond?
A) The infant likely has a stronger emotional bond with the father.
B) At this age, your baby does not understand the meaning of sounds.
C) This indicates a potential expressive language delay.
D) You should stop responding to "dada" to encourage other sounds.
E) Babies usually learn "m" sounds before "d" sounds, so this is unusual.
Correct Answer: B) At this age, your baby does not understand the meaning of sounds.
Rationale: At 6 months of age, infants begin babbling and vocalizing consonant-vowel
combinations such as "da-da" or "ba-ba." However, they do not yet associate these specific
sounds with specific people (referential speech). This usually develops closer to 9–12
months of age. Reassuring the mother that the sound is reflexive rather than intentional
helps alleviate her distress.
Question 2
Which of the following interventions are recommended preventative services for neonates?
(Select all that apply)
1. Rescreening for PKU by 2 weeks of age if the first screen was before 24 hours of life.
2. Screening for developmental dysplasia of the hip (DDH).
3. Screening for sickle hemoglobinopathies.
4. Promotion and support of breastfeeding.
A) 1 and 2 only
B) 2 and 3 only
C) 1, 2, and 4 only
D) 1, 3, and 4 only
E) 1, 2, 3, and 4
Correct Answer: E) 1, 2, 3, and 4
Rationale: All listed interventions are standard of care for neonates. PKU screening
requires the infant to have ingested protein (breast milk or formula) for at least 24
hours for accuracy; therefore, early screens must be repeated. DDH screening
(Barlow/Ortolani) is vital for joint health. Sickle cell screening is part of the
universal newborn metabolic panel. Breastfeeding is the primary recommendation
for nutritional and immunological health.
Question 3
The parent of a 5-month-old infant is worried because the infant becomes fussy but does not
, 2
always seem interested in nursing. The infant's growth parameters (weight, height, head
circumference) are within normal limits. What should the FNP tell the parent?
A) The infant is likely experiencing early-onset lactose intolerance.
B) The infant may be expressing a desire to play or to rest.
C) You should start solid foods immediately to satisfy the infant’s hunger.
D) This is a sign of a nursing strike that requires a lactation consultant.
E) Decrease the time between feedings to ensure the infant isn't overly hungry.
Correct Answer: B) The infant may be expressing a desire to play or to rest.
Rationale: By 5 months, infants become more aware of their environment and social cues.
Fussiness does not always indicate hunger; it can be a sign of overstimulation, boredom, or
tiredness. Since the infant is growing well, the FNP should encourage the parent to look for
alternative cues for play or sleep rather than assuming every cry requires a feeding.
Question 4
An FNP is counseling a couple where one parent has neurofibromatosis (an autosomal dominant
disorder) and the other parent does not. What information should be included regarding the risk
to their future children?
A) Each child has a 25% risk of having the disease.
B) Only male children will be affected.
C) Each child born to this couple will have a 50% risk of having the disease.
D) The disease will skip a generation.
E) 100% of the children will be carriers but asymptomatic.
Correct Answer: C) Each child born to this couple will have a 50% risk of having the
disease.
Rationale: In autosomal dominant inheritance, only one copy of the altered gene is
necessary to cause the disorder. If one parent is affected (genotype Nn) and the other is not
(nn), each pregnancy carries a 50% chance of the child inheriting the dominant allele (N)
and thus the disease.
Question 5
During a well-child exam for an 8-year-old, the FNP learns the child has been having angry
episodes at school. The NP observes the child appear withdrawn and sad. Which action is the
most appropriate first step?
A) Prescribe a low-dose SSRI for childhood depression.
B) Refer the child for an immediate ADHD evaluation.
C) Ask the child and the parent about stressors at home.
) Tell the parent to use stricter discipline for the angry outbursts.
E) Suggest the child be held back a grade to reduce academic pressure.
Correct Answer: C) Ask the child and the parent about stressors at home.
Rationale: Anger and withdrawal in school-age children are often "red flags" for
, 3
underlying emotional distress or depression. Before diagnosing or treating, the clinician
must assess the biopsychosocial environment, including potential trauma, bullying, or
changes in the home life that could be manifesting as behavioral issues.
Question 6
A 3-day-old nursing infant has a newborn metabolic screen positive for galactosemia. What is the
FNP’s priority action?
A) Tell the mother to supplement with formula but continue breastfeeding.
B) Instruct the mother to stop breastfeeding immediately.
C) Recheck the screen in two weeks.
D) Advise the mother to eliminate only dairy from her own diet.
E) Start the infant on a high-protein diet.
Correct Answer: B) Stop breastfeeding immediately.
Rationale: Galactosemia is a rare metabolic disorder where the body cannot process
galactose (a sugar found in lactose). Breast milk is high in lactose. Continued ingestion of
lactose can lead to liver failure, brain damage, and death. Infants must be switched to a
soy-based or elemental formula that is galactose-free.
Question 7
At what age do the anterior fontanels typically close?
A) 1–3 months
B) 4–6 months
C) 9–18 months
D) 24–36 months
E) At birth
Correct Answer: C) 9–18 months
Rationale: The posterior fontanel closes first (by 1–2 months). The larger, diamond-shaped
anterior fontanel remains open to allow for rapid brain growth and typically closes
between 9 and 18 months. Early closure (craniosynostosis) or late closure (rickets,
hypothyroidism) requires further investigation.
Question 8
The FNP understands that which major child health outcome is most dramatically associated
with worldwide climate change?
A) Congenital heart defects
B) Nutrition
C) Scoliosis
D) Autism Spectrum Disorder
E) Type 1 Diabetes
Correct Answer: B) Nutrition
Rationale: Worldwide climate change impacts agriculture, water security, and food
, 4
distribution. This leads to increased rates of malnutrition and food insecurity, which are
primary drivers of global child morbidity and mortality.
Question 9
The parents of a 12-month-old are bilingual in Spanish and English. They are resisting exposing
the child to Spanish because they worry the child will not learn English well. What should the
FNP tell them?
A) They are correct; bilingualism causes significant speech delays.
B) The child should master English first, then learn Spanish at age 5.
C) Most bilingual children are able to shift from one language to another when appropriate.
D) Exposure to two languages will lower the child’s overall IQ.
E) Bilingual children should only speak Spanish at home and English at school.
Correct Answer: C) Most bilingual children are able to shift from one language to another
when appropriate.
Rationale: Research shows that children raised in bilingual environments can successfully
acquire both languages. While they may occasionally "code-switch" or mix terms, they
generally reach language milestones at the same rate as monolingual children and often
have cognitive advantages in executive function.
Question 10
The parent of a 26-month-old child asks when toilet training should begin. How should the FNP
respond?
A) "Most children must be fully trained by age 2."
B) "Tell me about your child's daily habits."
C) "You should wait until the child is at least 4 years old."
D) "Start today by leaving the child in wet diapers to cause discomfort."
E) "Boys train earlier than girls, so you should have started months ago."
Correct Answer: B) Tell me about your child's daily habits.
Rationale: Toilet training readiness is developmental, not strictly chronological. The FNP
should assess for signs of readiness, such as the child being able to stay dry for 2 hours,
following simple commands, expressing an interest in the potty, or being able to pull pants
up and down.
Question 11
To achieve the greatest worldwide reduction in child mortality from pneumonia and diarrhea,
which intervention is most effective?
A) Increased use of broad-spectrum antibiotics
B) Routine imaging for all respiratory symptoms
C) Vaccinations
D) Vitamin C supplementation
E) Universal hand sanitizer stations
UPDATE 2026!!!
Question 1
The mother of a 6-month-old infant is distressed because the infant can say "dada" but not
"mama." She asks the Family Nurse Practitioner (FNP) why this is occurring since she is the
primary caregiver. How should the FNP respond?
A) The infant likely has a stronger emotional bond with the father.
B) At this age, your baby does not understand the meaning of sounds.
C) This indicates a potential expressive language delay.
D) You should stop responding to "dada" to encourage other sounds.
E) Babies usually learn "m" sounds before "d" sounds, so this is unusual.
Correct Answer: B) At this age, your baby does not understand the meaning of sounds.
Rationale: At 6 months of age, infants begin babbling and vocalizing consonant-vowel
combinations such as "da-da" or "ba-ba." However, they do not yet associate these specific
sounds with specific people (referential speech). This usually develops closer to 9–12
months of age. Reassuring the mother that the sound is reflexive rather than intentional
helps alleviate her distress.
Question 2
Which of the following interventions are recommended preventative services for neonates?
(Select all that apply)
1. Rescreening for PKU by 2 weeks of age if the first screen was before 24 hours of life.
2. Screening for developmental dysplasia of the hip (DDH).
3. Screening for sickle hemoglobinopathies.
4. Promotion and support of breastfeeding.
A) 1 and 2 only
B) 2 and 3 only
C) 1, 2, and 4 only
D) 1, 3, and 4 only
E) 1, 2, 3, and 4
Correct Answer: E) 1, 2, 3, and 4
Rationale: All listed interventions are standard of care for neonates. PKU screening
requires the infant to have ingested protein (breast milk or formula) for at least 24
hours for accuracy; therefore, early screens must be repeated. DDH screening
(Barlow/Ortolani) is vital for joint health. Sickle cell screening is part of the
universal newborn metabolic panel. Breastfeeding is the primary recommendation
for nutritional and immunological health.
Question 3
The parent of a 5-month-old infant is worried because the infant becomes fussy but does not
, 2
always seem interested in nursing. The infant's growth parameters (weight, height, head
circumference) are within normal limits. What should the FNP tell the parent?
A) The infant is likely experiencing early-onset lactose intolerance.
B) The infant may be expressing a desire to play or to rest.
C) You should start solid foods immediately to satisfy the infant’s hunger.
D) This is a sign of a nursing strike that requires a lactation consultant.
E) Decrease the time between feedings to ensure the infant isn't overly hungry.
Correct Answer: B) The infant may be expressing a desire to play or to rest.
Rationale: By 5 months, infants become more aware of their environment and social cues.
Fussiness does not always indicate hunger; it can be a sign of overstimulation, boredom, or
tiredness. Since the infant is growing well, the FNP should encourage the parent to look for
alternative cues for play or sleep rather than assuming every cry requires a feeding.
Question 4
An FNP is counseling a couple where one parent has neurofibromatosis (an autosomal dominant
disorder) and the other parent does not. What information should be included regarding the risk
to their future children?
A) Each child has a 25% risk of having the disease.
B) Only male children will be affected.
C) Each child born to this couple will have a 50% risk of having the disease.
D) The disease will skip a generation.
E) 100% of the children will be carriers but asymptomatic.
Correct Answer: C) Each child born to this couple will have a 50% risk of having the
disease.
Rationale: In autosomal dominant inheritance, only one copy of the altered gene is
necessary to cause the disorder. If one parent is affected (genotype Nn) and the other is not
(nn), each pregnancy carries a 50% chance of the child inheriting the dominant allele (N)
and thus the disease.
Question 5
During a well-child exam for an 8-year-old, the FNP learns the child has been having angry
episodes at school. The NP observes the child appear withdrawn and sad. Which action is the
most appropriate first step?
A) Prescribe a low-dose SSRI for childhood depression.
B) Refer the child for an immediate ADHD evaluation.
C) Ask the child and the parent about stressors at home.
) Tell the parent to use stricter discipline for the angry outbursts.
E) Suggest the child be held back a grade to reduce academic pressure.
Correct Answer: C) Ask the child and the parent about stressors at home.
Rationale: Anger and withdrawal in school-age children are often "red flags" for
, 3
underlying emotional distress or depression. Before diagnosing or treating, the clinician
must assess the biopsychosocial environment, including potential trauma, bullying, or
changes in the home life that could be manifesting as behavioral issues.
Question 6
A 3-day-old nursing infant has a newborn metabolic screen positive for galactosemia. What is the
FNP’s priority action?
A) Tell the mother to supplement with formula but continue breastfeeding.
B) Instruct the mother to stop breastfeeding immediately.
C) Recheck the screen in two weeks.
D) Advise the mother to eliminate only dairy from her own diet.
E) Start the infant on a high-protein diet.
Correct Answer: B) Stop breastfeeding immediately.
Rationale: Galactosemia is a rare metabolic disorder where the body cannot process
galactose (a sugar found in lactose). Breast milk is high in lactose. Continued ingestion of
lactose can lead to liver failure, brain damage, and death. Infants must be switched to a
soy-based or elemental formula that is galactose-free.
Question 7
At what age do the anterior fontanels typically close?
A) 1–3 months
B) 4–6 months
C) 9–18 months
D) 24–36 months
E) At birth
Correct Answer: C) 9–18 months
Rationale: The posterior fontanel closes first (by 1–2 months). The larger, diamond-shaped
anterior fontanel remains open to allow for rapid brain growth and typically closes
between 9 and 18 months. Early closure (craniosynostosis) or late closure (rickets,
hypothyroidism) requires further investigation.
Question 8
The FNP understands that which major child health outcome is most dramatically associated
with worldwide climate change?
A) Congenital heart defects
B) Nutrition
C) Scoliosis
D) Autism Spectrum Disorder
E) Type 1 Diabetes
Correct Answer: B) Nutrition
Rationale: Worldwide climate change impacts agriculture, water security, and food
, 4
distribution. This leads to increased rates of malnutrition and food insecurity, which are
primary drivers of global child morbidity and mortality.
Question 9
The parents of a 12-month-old are bilingual in Spanish and English. They are resisting exposing
the child to Spanish because they worry the child will not learn English well. What should the
FNP tell them?
A) They are correct; bilingualism causes significant speech delays.
B) The child should master English first, then learn Spanish at age 5.
C) Most bilingual children are able to shift from one language to another when appropriate.
D) Exposure to two languages will lower the child’s overall IQ.
E) Bilingual children should only speak Spanish at home and English at school.
Correct Answer: C) Most bilingual children are able to shift from one language to another
when appropriate.
Rationale: Research shows that children raised in bilingual environments can successfully
acquire both languages. While they may occasionally "code-switch" or mix terms, they
generally reach language milestones at the same rate as monolingual children and often
have cognitive advantages in executive function.
Question 10
The parent of a 26-month-old child asks when toilet training should begin. How should the FNP
respond?
A) "Most children must be fully trained by age 2."
B) "Tell me about your child's daily habits."
C) "You should wait until the child is at least 4 years old."
D) "Start today by leaving the child in wet diapers to cause discomfort."
E) "Boys train earlier than girls, so you should have started months ago."
Correct Answer: B) Tell me about your child's daily habits.
Rationale: Toilet training readiness is developmental, not strictly chronological. The FNP
should assess for signs of readiness, such as the child being able to stay dry for 2 hours,
following simple commands, expressing an interest in the potty, or being able to pull pants
up and down.
Question 11
To achieve the greatest worldwide reduction in child mortality from pneumonia and diarrhea,
which intervention is most effective?
A) Increased use of broad-spectrum antibiotics
B) Routine imaging for all respiratory symptoms
C) Vaccinations
D) Vitamin C supplementation
E) Universal hand sanitizer stations
