CPN Competency Certification Study Guide Exam Questions
with Certified for Accuracy Answers 2026/2027
Which of the following congenital hernias is more commonly seen in African-American
children?
A. Umbilical hernia.
B. Inguinal hernia.
C. Hiatal hernia.
D. Femoral hernia. - correct answer A: Umbilical hernias are more common in African-
American children. They usually resolve with growth of the child by age 4 and do not
require surgical correction
A 13-year-old female has the development of breast buds and sparse long, downy pubic
hair. What Tanner stage does this development suggest?
A. Tanner 1.
B. Tanner 2.
C. Tanner 3.
D. Tanner 4. - correct answer B: Breast buds and sparse downy pubic hair are
characteristics of Tanner stage 2. Tanner's 5 stages assess maturity of both males and
females based on direct observation of breasts and genitals. Females are evaluated on
breast development, onset of menses, and pubic hair distribution. Males are evaluation
on penis and testes development and pubic hair distribution
Apocrine sweat glands develop during onset of puberty. In which part of the body are
these glands most commonly located?
A. Scalp.
B. Feet.
C. Hands.
D. Axilla - correct answer D: Apocrine sweat glands develop with the increase in
hormones during the onset of puberty and are located primarily in the axilla and pubic
area, opening into hair follicles. These sweat glands cause body odor.
,A 16-year-old male has hearing loss at the 4000-Hertz range on audiogram. What is the
most common cause for such a hearing deficit?
A. Cerumen in the ear canal.
B. Prolonged exposure to noises over 100 decibels.
C. Medulla oblongata tumor.
D. Ruptured tympanic membrane. - correct answer B: Prolonged exposure to loud
noises (music, power tools, firearms) can lead to high frequency hearing loss at the
4000-Hertz level, making it hard for the child to hear high-pitched voices and certain
sounds, such as consonants. Digital hearing aids may be programmed to compensate
for high frequency hearing loss
Which of the following would NOT be considered a pediatric patient at high risk for
dehydration?
A. 4-year-old male with 30% body surface area burn.
B. 7-year-old female with diabetic ketoacidosis
C. 12-year-old male with hyperventilation due to anxiety
D. 8-year-old male with cellulitis in the right arm. - correct answer D: Cellulitis, a
bacterial skin infection, is not associated with dehydration. Burns, diabetic ketoacidosis,
and hyperventilation may all contribute to dehydration in children.
A 15-year-old female is evaluated for an intentional overdose of aspirin. The excessive
ingestion of this medication puts the patient at risk for what acid-base disorder?
A. Metabolic acidosis.
B. Metabolic alkalosis.
C. Respiratory acidosis.
D. Respiratory alkalosis. - correct answer A: The ingestion of aspirin (salicylic acid)
puts the patient at risk for a metabolic acidosis due to the acidic medication. Symptoms
include drowsiness, confusion, headache, decreased blood pressure, flushed skin,
nausea, vomiting, diarrhea and tachypnea.
Symptoms consistent with a diagnosis of dehydration in children would include all of the
following EXCEPT:
,A. Thirst.
B. Bradycardia.
C. Dry mucous membranes.
D. Depressed fontanelles. - correct answer B: Tachycardia, not bradycardia, is a
common sign of dehydration in pediatric patients. Children with dehydration typically are
thirsty and have dry mucous membranes, reduced skin turgor, and depressed
fontanelles (in infants).
A 6-year-old female with dehydration due to vomiting is evaluated with a complete blood
count (CBC). What lab finding is expected?
A. Decreased mean corpuscular (cell) volume (MCV).
B. Increased MCV.
C. Increased hematocrit.
D. Normal red cell distribution width (RDW). - correct answer C: Due to volume loss,
the hematocrit will be elevated as red blood cells become more concentrated in the
blood. The MCV test shows the average size of the red blood cells and helps to
determine the type of anemia while RDW shows the variations in cell size, important for
some types of anemia (such as pernicious anemia).
What is the leading cause of death in children in developing countries?
A. Accidental trauma.
B. TB.
C. AIDS.
D. Infectious diarrhea. - correct answer D: Infectious diarrhea remains the leading
cause of death in developing countries. Outbreaks of diarrhea are common in areas
with poor sanitation that allows food and water to become contaminated with bacteria,
such as E. coli or Shigella.
What is the most common cause of viral (non-bacterial) diarrhea in pediatric patients?
A. Rotavirus.
B. Parainfluenza.
C. Influenza.
, D. Parvovirus B19. - correct answer A: Rotavirus is the most common cause for viral
diarrhea in children and may be accompanied by nausea and vomiting that lead to
severe dehydration. Parainfluenza, influenza, and parvovirus B19 cause mainly upper
respiratory illnesses.
After a camping trip a 14-year-old male develops diarrhea, flatulence, steatorrhea, and
abdominal cramping. The other campers who drank water from a stream also have
similar symptoms. What is the most likely causative organism?
A. Coli.
B. Giardia Lamblia.
C. Rotavirus.
D. Shigella. - correct answer B: Giardia Lamblia is a parasite that is commonly spread
via the drinking of contaminated water, especially streams that are contaminated with
animal feces. A broad spectrum of gastrointestinal symptoms can occur.
A 2-year-old female is undergoing an evaluation for celiac disease (sprue). Which of the
following is NOT a risk factor for this disease?
A. First degree relative with the disease.
B. Recent travel to Mexico.
C. Congenital trisomy 21.
D. History of type 1 diabetes mellitus - correct answer B: Celiac disease is not
infectious and not related to travel. Celiac disease (sprue) is
sensitivity to gluten products and is more commonly seen in children with relatives with
the disease, those with trisomy 21, or those with type 1 diabetes.
A 6-year-old male grabbed a pot of boiling water off of a stove and has a burn on the
dorsum of the forearm. The burn area is red with edema and thin-walled blisters. What
classification of burn is this?
A. First-degree burn.
B. Second-degree burn.
C. Third-degree burn. - correct answer B: A burn area that is red with blistering is
consistent with a seconD:degree burn. A firstdegree burn would have erythema but no
with Certified for Accuracy Answers 2026/2027
Which of the following congenital hernias is more commonly seen in African-American
children?
A. Umbilical hernia.
B. Inguinal hernia.
C. Hiatal hernia.
D. Femoral hernia. - correct answer A: Umbilical hernias are more common in African-
American children. They usually resolve with growth of the child by age 4 and do not
require surgical correction
A 13-year-old female has the development of breast buds and sparse long, downy pubic
hair. What Tanner stage does this development suggest?
A. Tanner 1.
B. Tanner 2.
C. Tanner 3.
D. Tanner 4. - correct answer B: Breast buds and sparse downy pubic hair are
characteristics of Tanner stage 2. Tanner's 5 stages assess maturity of both males and
females based on direct observation of breasts and genitals. Females are evaluated on
breast development, onset of menses, and pubic hair distribution. Males are evaluation
on penis and testes development and pubic hair distribution
Apocrine sweat glands develop during onset of puberty. In which part of the body are
these glands most commonly located?
A. Scalp.
B. Feet.
C. Hands.
D. Axilla - correct answer D: Apocrine sweat glands develop with the increase in
hormones during the onset of puberty and are located primarily in the axilla and pubic
area, opening into hair follicles. These sweat glands cause body odor.
,A 16-year-old male has hearing loss at the 4000-Hertz range on audiogram. What is the
most common cause for such a hearing deficit?
A. Cerumen in the ear canal.
B. Prolonged exposure to noises over 100 decibels.
C. Medulla oblongata tumor.
D. Ruptured tympanic membrane. - correct answer B: Prolonged exposure to loud
noises (music, power tools, firearms) can lead to high frequency hearing loss at the
4000-Hertz level, making it hard for the child to hear high-pitched voices and certain
sounds, such as consonants. Digital hearing aids may be programmed to compensate
for high frequency hearing loss
Which of the following would NOT be considered a pediatric patient at high risk for
dehydration?
A. 4-year-old male with 30% body surface area burn.
B. 7-year-old female with diabetic ketoacidosis
C. 12-year-old male with hyperventilation due to anxiety
D. 8-year-old male with cellulitis in the right arm. - correct answer D: Cellulitis, a
bacterial skin infection, is not associated with dehydration. Burns, diabetic ketoacidosis,
and hyperventilation may all contribute to dehydration in children.
A 15-year-old female is evaluated for an intentional overdose of aspirin. The excessive
ingestion of this medication puts the patient at risk for what acid-base disorder?
A. Metabolic acidosis.
B. Metabolic alkalosis.
C. Respiratory acidosis.
D. Respiratory alkalosis. - correct answer A: The ingestion of aspirin (salicylic acid)
puts the patient at risk for a metabolic acidosis due to the acidic medication. Symptoms
include drowsiness, confusion, headache, decreased blood pressure, flushed skin,
nausea, vomiting, diarrhea and tachypnea.
Symptoms consistent with a diagnosis of dehydration in children would include all of the
following EXCEPT:
,A. Thirst.
B. Bradycardia.
C. Dry mucous membranes.
D. Depressed fontanelles. - correct answer B: Tachycardia, not bradycardia, is a
common sign of dehydration in pediatric patients. Children with dehydration typically are
thirsty and have dry mucous membranes, reduced skin turgor, and depressed
fontanelles (in infants).
A 6-year-old female with dehydration due to vomiting is evaluated with a complete blood
count (CBC). What lab finding is expected?
A. Decreased mean corpuscular (cell) volume (MCV).
B. Increased MCV.
C. Increased hematocrit.
D. Normal red cell distribution width (RDW). - correct answer C: Due to volume loss,
the hematocrit will be elevated as red blood cells become more concentrated in the
blood. The MCV test shows the average size of the red blood cells and helps to
determine the type of anemia while RDW shows the variations in cell size, important for
some types of anemia (such as pernicious anemia).
What is the leading cause of death in children in developing countries?
A. Accidental trauma.
B. TB.
C. AIDS.
D. Infectious diarrhea. - correct answer D: Infectious diarrhea remains the leading
cause of death in developing countries. Outbreaks of diarrhea are common in areas
with poor sanitation that allows food and water to become contaminated with bacteria,
such as E. coli or Shigella.
What is the most common cause of viral (non-bacterial) diarrhea in pediatric patients?
A. Rotavirus.
B. Parainfluenza.
C. Influenza.
, D. Parvovirus B19. - correct answer A: Rotavirus is the most common cause for viral
diarrhea in children and may be accompanied by nausea and vomiting that lead to
severe dehydration. Parainfluenza, influenza, and parvovirus B19 cause mainly upper
respiratory illnesses.
After a camping trip a 14-year-old male develops diarrhea, flatulence, steatorrhea, and
abdominal cramping. The other campers who drank water from a stream also have
similar symptoms. What is the most likely causative organism?
A. Coli.
B. Giardia Lamblia.
C. Rotavirus.
D. Shigella. - correct answer B: Giardia Lamblia is a parasite that is commonly spread
via the drinking of contaminated water, especially streams that are contaminated with
animal feces. A broad spectrum of gastrointestinal symptoms can occur.
A 2-year-old female is undergoing an evaluation for celiac disease (sprue). Which of the
following is NOT a risk factor for this disease?
A. First degree relative with the disease.
B. Recent travel to Mexico.
C. Congenital trisomy 21.
D. History of type 1 diabetes mellitus - correct answer B: Celiac disease is not
infectious and not related to travel. Celiac disease (sprue) is
sensitivity to gluten products and is more commonly seen in children with relatives with
the disease, those with trisomy 21, or those with type 1 diabetes.
A 6-year-old male grabbed a pot of boiling water off of a stove and has a burn on the
dorsum of the forearm. The burn area is red with edema and thin-walled blisters. What
classification of burn is this?
A. First-degree burn.
B. Second-degree burn.
C. Third-degree burn. - correct answer B: A burn area that is red with blistering is
consistent with a seconD:degree burn. A firstdegree burn would have erythema but no
