PNP-PC Certification Exam Latest QUESTION AND
ANSWER (HIGHLY RECOMMENDED) FULLY SOLVED
Stranger anxiety develops - ANSWER: 6-7 mos
Separation anxiety develops - ANSWER: 8-9 mos
Conditions that increase pulse/HR - ANSWER: Temperature (1 deg F = 10 bpm),
anxiety, stress, exercise, severe anemia, hyperthyroidism, hypoxia, heart disease
When to start measuring BP at well child checks - ANSWER: 3 yo
Head circumference versus chest circumference - ANSWER: Head approx 2 cm > than
chest during 1st year of life; usually equal at 1 yo; then during childhood chest is
usually 5-7 cm larger than head
Posterior fontanel closes - ANSWER: By 2 mos
Anterior fontanel closes - ANSWER: By 18 mos
Large anterior fontanel associated with - ANSWER: Chronically increased ICP, SDH,
rickets, hypothyroidism, OI
Late closure of anterior fontanel associated with - ANSWER: Increased ICP,
hypothyroidism, rickets, syphilis, downs, OI
Microcephaly - ANSWER: >2 SD below mean for age, sex, gestation
Intrauterine infections (herpes, rubella, syphilis, Zika), genetic defects, drug and
alcohol usage during preg
Macrocephaly - ANSWER: >2 SD above mean for age, sex, gestation
Hydrocephalus, masses, inc ICP, skeletal dysplasia's, familial
Caput succedaneum - ANSWER: Edema of scalp that crosses suture lines; usually
resolves in 2-3 days; usually d/t birth trauma
Cephalohematoma - ANSWER: Subperiosteal blood collection that does not cross
suture lines; often d/t birth trauma; doesn't appear until several hours after birth
and may inc over 24 hrs; resolves over weeks to mos; may worsen hyperbili; may
also have underlying skull fracture
Head control - ANSWER: Hold erect & midline at 4 mos; no head lag should be
present at 6 mos- could be sing of NMD or CP
Turner's Syndrome - ANSWER: 99% of the time in females
, Webbed neck, widespread nipples, abnormal ears, micrognathia, lymphedema of
hands/feet, cardiac disease
Binocular vision (fixate on one visual fields w both eyes simultaneously) in infants
develops - ANSWER: By 3-4 mos
Intermittent strabismus - ANSWER: may be normal 0-6 mos
Turning in or outward of eyes without cover/uncover
Esophoria - ANSWER: Eye deviates inward & returns to midline when uncovered
Exophoria - ANSWER: Eye deviates outward & returns to midline when uncovered
Vision progression - ANSWER: 20/20 not possible <6 yo
20/30 at 5 yo (2+3=5)
Tonsillar hypertrophy - ANSWER: Normal immune response in pediatrics; largest in
size at 8-9 yo & then should dec in size after puberty
S1 - ANSWER: Closure of AVV's
S2 - ANSWER: Closure of semilunar valves
S3 - ANSWER: May be normal in children "Kentucky"
S4 - ANSWER: Almost never normal "Tennessee"
Innocent murmurs - ANSWER: Soft, systolic, never more than Grade III; low pitched,
musical, vibratory, short in duration; loudest at LLSB or 2nd or 3rd, loudness varies
with position changes
Pulmonary ejection murmur - ANSWER: Pulmonic area, early to mid systole
Stills/vibratory murmur - ANSWER: Musical/vibratory, heard best at LLSB
Heard best during times of anxiety/stress
Louder when supine
Venous hum - ANSWER: Best heard above/below clavicles, 2nd or 3rd ICS, disappears
when child lies down or turns neck
Pectus carinatum - ANSWER: Protuberant sternum
Pectus excavatum - ANSWER: Depressed sternum
Klinefelters (XXY) - ANSWER: Gynecomastia, small penis/tested, scoliosis, Dec
testosterone lvls, height > 6 feet, aspermia
ANSWER (HIGHLY RECOMMENDED) FULLY SOLVED
Stranger anxiety develops - ANSWER: 6-7 mos
Separation anxiety develops - ANSWER: 8-9 mos
Conditions that increase pulse/HR - ANSWER: Temperature (1 deg F = 10 bpm),
anxiety, stress, exercise, severe anemia, hyperthyroidism, hypoxia, heart disease
When to start measuring BP at well child checks - ANSWER: 3 yo
Head circumference versus chest circumference - ANSWER: Head approx 2 cm > than
chest during 1st year of life; usually equal at 1 yo; then during childhood chest is
usually 5-7 cm larger than head
Posterior fontanel closes - ANSWER: By 2 mos
Anterior fontanel closes - ANSWER: By 18 mos
Large anterior fontanel associated with - ANSWER: Chronically increased ICP, SDH,
rickets, hypothyroidism, OI
Late closure of anterior fontanel associated with - ANSWER: Increased ICP,
hypothyroidism, rickets, syphilis, downs, OI
Microcephaly - ANSWER: >2 SD below mean for age, sex, gestation
Intrauterine infections (herpes, rubella, syphilis, Zika), genetic defects, drug and
alcohol usage during preg
Macrocephaly - ANSWER: >2 SD above mean for age, sex, gestation
Hydrocephalus, masses, inc ICP, skeletal dysplasia's, familial
Caput succedaneum - ANSWER: Edema of scalp that crosses suture lines; usually
resolves in 2-3 days; usually d/t birth trauma
Cephalohematoma - ANSWER: Subperiosteal blood collection that does not cross
suture lines; often d/t birth trauma; doesn't appear until several hours after birth
and may inc over 24 hrs; resolves over weeks to mos; may worsen hyperbili; may
also have underlying skull fracture
Head control - ANSWER: Hold erect & midline at 4 mos; no head lag should be
present at 6 mos- could be sing of NMD or CP
Turner's Syndrome - ANSWER: 99% of the time in females
, Webbed neck, widespread nipples, abnormal ears, micrognathia, lymphedema of
hands/feet, cardiac disease
Binocular vision (fixate on one visual fields w both eyes simultaneously) in infants
develops - ANSWER: By 3-4 mos
Intermittent strabismus - ANSWER: may be normal 0-6 mos
Turning in or outward of eyes without cover/uncover
Esophoria - ANSWER: Eye deviates inward & returns to midline when uncovered
Exophoria - ANSWER: Eye deviates outward & returns to midline when uncovered
Vision progression - ANSWER: 20/20 not possible <6 yo
20/30 at 5 yo (2+3=5)
Tonsillar hypertrophy - ANSWER: Normal immune response in pediatrics; largest in
size at 8-9 yo & then should dec in size after puberty
S1 - ANSWER: Closure of AVV's
S2 - ANSWER: Closure of semilunar valves
S3 - ANSWER: May be normal in children "Kentucky"
S4 - ANSWER: Almost never normal "Tennessee"
Innocent murmurs - ANSWER: Soft, systolic, never more than Grade III; low pitched,
musical, vibratory, short in duration; loudest at LLSB or 2nd or 3rd, loudness varies
with position changes
Pulmonary ejection murmur - ANSWER: Pulmonic area, early to mid systole
Stills/vibratory murmur - ANSWER: Musical/vibratory, heard best at LLSB
Heard best during times of anxiety/stress
Louder when supine
Venous hum - ANSWER: Best heard above/below clavicles, 2nd or 3rd ICS, disappears
when child lies down or turns neck
Pectus carinatum - ANSWER: Protuberant sternum
Pectus excavatum - ANSWER: Depressed sternum
Klinefelters (XXY) - ANSWER: Gynecomastia, small penis/tested, scoliosis, Dec
testosterone lvls, height > 6 feet, aspermia
