PNCB CPN LATEST 2026 PRACTICE EXAM QUESTIONS AND
SOLUTIONS RATED A+
✔✔DM: Sick days - ✔✔Increase BS and insulin needs
check BS more often
✔✔DM treatment - ✔✔1st line is diet and exercise
metformin only drug approve for peds
✔✔Osteomyelitis - ✔✔most common organism is staphylococcus bacteria
✔✔Structural Scoliosis - ✔✔S-shaped curvature of the spine
✔✔Normal Hemoglobin - ✔✔11.5-14.5
✔✔Cardiac murmur - ✔✔common in chronic anemia due to chronic increase in HR
✔✔Iron deficiency Anemia - ✔✔treat with iron supplementation
give with dropper, brush teeth afterwards
best between meals with citrus
stools should be tarry green black when levels are normal (few days to week)
✔✔Sickle Cell Anemia: Fever - ✔✔caused by splenic failure (low ability to fight
infection)
first sign of bacteremia
✔✔sickle cell child with fever - ✔✔straight to ED
give penicillin, does work of spleen when spleen doesn't work
✔✔ITP - ✔✔Bleeding precautions
bruising when plt<50
petechi when plt <20
avoid: ibuprofen and injections
bleeding precautions
✔✔Uveitis - ✔✔Inflammation of eyes, associated with cataracts
✔✔MMR and Varicella Vaccines - ✔✔live vaccines, give unless child is severely
immunocompromised. Specifically recommended for children with HIV
✔✔Brain tumor - ✔✔most common symptom: Headache upon awakening
✔✔Hodgkin's lymphoma - ✔✔night sweats
, ✔✔Wilms' Tumor (Nephroblastoma) - ✔✔DO NOT palpate abdomen (may disseminate
cancer cells to other sites)
✔✔Tumor Lysis Syndrome - ✔✔Serious metabolic disorder occurring within 72 hours
following administration of chemotherapy resulting in elevated uric acid, potassium, and
phosphorus and decreased calcium
✔✔Mild Dehydration - ✔✔Normal tears and urine
cracked lips or thirst
normal HR and Cap refill
✔✔Moderate Dehydration - ✔✔decreased tear and urine output
increased HR
irritability or decreased activity
✔✔Hypotonic Dehydration - ✔✔Na <130
causes: water intoxication, watering down formula
✔✔Mild to moderate dehydration treatment - ✔✔ORT (pedialyte)
Use syringe or cup, give 2-5mL every 2-3 minutes or 5-10mL every 5 minutes
age appropriate diet (NOT Brat diet)
if the gut works, use it!
✔✔Severe dehydration - ✔✔bolus isotonic solution
maintanence hypertonic solution (D5NS)
✔✔Rotavirus - ✔✔most common cause of diarrhea and vomiting
✔✔Diarrhea - ✔✔metabolic ASSidosis
✔✔Vomiting - ✔✔Metabolic ALKalosis
✔✔Cleft Lip & Palate - ✔✔Specially designed nipples for feeding
✔✔Cleft Lip repair - ✔✔1-4 months
✔✔Cleft Palate repair - ✔✔when weaned from bottle/breast (6-12 months)
✔✔Cleft Lip post-op - ✔✔keep hands away from mouth (swaddle)
✔✔Cleft Palate post-op - ✔✔elbow restraints in hospital and home until 1st post-op appt
✔✔Esophageal Atresia/Tracheoesophageal Fistula - ✔✔do not feed orally, prepare for
g-tube, keep suction equipment at bedside
SOLUTIONS RATED A+
✔✔DM: Sick days - ✔✔Increase BS and insulin needs
check BS more often
✔✔DM treatment - ✔✔1st line is diet and exercise
metformin only drug approve for peds
✔✔Osteomyelitis - ✔✔most common organism is staphylococcus bacteria
✔✔Structural Scoliosis - ✔✔S-shaped curvature of the spine
✔✔Normal Hemoglobin - ✔✔11.5-14.5
✔✔Cardiac murmur - ✔✔common in chronic anemia due to chronic increase in HR
✔✔Iron deficiency Anemia - ✔✔treat with iron supplementation
give with dropper, brush teeth afterwards
best between meals with citrus
stools should be tarry green black when levels are normal (few days to week)
✔✔Sickle Cell Anemia: Fever - ✔✔caused by splenic failure (low ability to fight
infection)
first sign of bacteremia
✔✔sickle cell child with fever - ✔✔straight to ED
give penicillin, does work of spleen when spleen doesn't work
✔✔ITP - ✔✔Bleeding precautions
bruising when plt<50
petechi when plt <20
avoid: ibuprofen and injections
bleeding precautions
✔✔Uveitis - ✔✔Inflammation of eyes, associated with cataracts
✔✔MMR and Varicella Vaccines - ✔✔live vaccines, give unless child is severely
immunocompromised. Specifically recommended for children with HIV
✔✔Brain tumor - ✔✔most common symptom: Headache upon awakening
✔✔Hodgkin's lymphoma - ✔✔night sweats
, ✔✔Wilms' Tumor (Nephroblastoma) - ✔✔DO NOT palpate abdomen (may disseminate
cancer cells to other sites)
✔✔Tumor Lysis Syndrome - ✔✔Serious metabolic disorder occurring within 72 hours
following administration of chemotherapy resulting in elevated uric acid, potassium, and
phosphorus and decreased calcium
✔✔Mild Dehydration - ✔✔Normal tears and urine
cracked lips or thirst
normal HR and Cap refill
✔✔Moderate Dehydration - ✔✔decreased tear and urine output
increased HR
irritability or decreased activity
✔✔Hypotonic Dehydration - ✔✔Na <130
causes: water intoxication, watering down formula
✔✔Mild to moderate dehydration treatment - ✔✔ORT (pedialyte)
Use syringe or cup, give 2-5mL every 2-3 minutes or 5-10mL every 5 minutes
age appropriate diet (NOT Brat diet)
if the gut works, use it!
✔✔Severe dehydration - ✔✔bolus isotonic solution
maintanence hypertonic solution (D5NS)
✔✔Rotavirus - ✔✔most common cause of diarrhea and vomiting
✔✔Diarrhea - ✔✔metabolic ASSidosis
✔✔Vomiting - ✔✔Metabolic ALKalosis
✔✔Cleft Lip & Palate - ✔✔Specially designed nipples for feeding
✔✔Cleft Lip repair - ✔✔1-4 months
✔✔Cleft Palate repair - ✔✔when weaned from bottle/breast (6-12 months)
✔✔Cleft Lip post-op - ✔✔keep hands away from mouth (swaddle)
✔✔Cleft Palate post-op - ✔✔elbow restraints in hospital and home until 1st post-op appt
✔✔Esophageal Atresia/Tracheoesophageal Fistula - ✔✔do not feed orally, prepare for
g-tube, keep suction equipment at bedside
