PEDSCE PNP-PC EXAM PRACTICE QUESTIONS | COMPLETE QUESTIONS WITH 100% RATED
CORRECT ANSWERS | GRADED A+| 2025/2026 LATEST UPDATE
A mother brings her two-month-old infant to a pediatric primary care nurse practitioner's clinic
for a well child examination. The nurse practitioner orders the immunizations and provides an
overview to the mother. The mother states, "I don't want my child to have those shots!" The
nurse practitioner's most appropriate response is to:
a. Provide a strong recommendation for immunization on schedule
b. Inform the mother that state law requires immunization.
c. Negotiate an alternative immunization plan with the mother
d. Recommend that the mother find another provider who shares the mother's philosophy
regarding vaccines. a. Provide a strong recommendation for immunization on schedule
Rationale:The nurse practitioner should assume that all parents will want to vaccinate based on
recommendations. Providing a strong recommendation to vaccinate on schedule and adding
supportive statements is the best response to hesitation or initial refusal. Then listen to and
respond to specific questions and concerns. An alternate immunization plan is not the most
appropriate initial response as NP does not have an understanding of why the mother is
hesitant. Laws vary from state to state and recommending the mother find a different provider
will prevent future chances to discuss immunization. (CDC, Immunizations)
Which is an accurate statement about vegetarian diets during childhood?
a. A child who eats a lactovegetarian diet is unlikely to consume adequate amounts of protein
and vitamins for proper growth and development.
b. Algae is a good source of bioavailable vitamin B12 for a child who eats a vegetarian diet
c. Bioavailable vitamin B12 is present in both animal - and plant-based foods
d. Vitamin B12 and zinc deficiencies place a child at risk for developmental delays d. Vitamin
B12 and zinc deficiencies place a child at risk for developmental delays
,Rationale: B12 and zinc are most commonly found in meat and egg products. Sources of these
nutrients in a vegan diet would include fortified soy milk, fortified soy based meat substitutes,
nutritional yeast, fortified cereals, almonds, brown rice, wheat germ, tofu, pecans, and spinach.
Other deficiencies with vegan or variations of vegetarian diets can include vitamin D, riboflavin,
calcium, and iron. (Burns)
A pediatric primary nurse practitioner evaluates an established patient who has completed
treatment for acute otitis media. The nurse practitioner documents the resolution of the
current illness, a review of previous upper respiratory infections, and the findings of an
otoscopic examination and a brief head-to-toe assessment. Previous documentation includes a
diagnosis of otitis media with effusion and a referral to an otolaryngologist. For which level of
service does the nurse practitioner bill?
a. Comprehensive
b. Detailed
c. Expanded problem-focused
d. Problem-focused d. Problem-focused
Rationale: The practitioner is not providing a comprehensive assessment because she does not
include enough components of the history and physical, expanded problem focused would be a
more extensive Hx with ROS, PE, and medical decision making process. This visit is only focused
on the immediate problem that is now resolved without new diagnosis and limited assessment
so it should be coded as problem focused (Burns; Stewart & Denisco, Chapter 13)
A mother brings her six-year-old daughter to a pediatric primary care nurse practitioner for
evaluation of breast and axillary hair growth. The patient has grown 1 inch during the lastthree
months. The nurse practitioner's action is to:
a. Follow the child's development every six months
b. Inform the mother that this condition is normal
, c. Initiate therapy with ketoconazole (Nizoral)
d. Refer the patient to a pediatric endocrinologist d. Refer the patient to a pediatric
endocrinologist
Rationale: The child has evidence of precocious puberty in a child less than 8 years of age.
Isolated axillary hair or single symptoms can be monitored but when the child has 2 or more
symptoms they should be referred to endocrinology for work up of precocious puberty. The
Ketoconazole is an antifungal medication and will not improve symptoms and this is not a
normal finding. (Burns)
A parent without health insurance brings an infant with bilateral otitis media to a pediatric
primary care nurse practitioner. To optimize treatment adherence, the nurse practitioner
prescribe which oral medication?
a. Amoxicillin (Amoxil) two times daily for 10 days
b. Amoxicillin and clavulanate (Augmentin) twice daily for 10 days
c. Azithromycin (Zithromax) once daily for five days
d. Cefdinir (Omnicef) once daily for 10 days a. Amoxicillin (Amoxil) two times daily for 10
days
Rationale: Amoxicillin is a very inexpensive medication with the lowest cost being around 3-4
dollars compared to Augmentin which can cost 400-900 dollars. Azithromycin and Cefdinir being
40 and 20+ respectively. The lower cost of the medication is a factor. Also, there is more
compliance with 1-2 x a day medications. Finally, Amoxicillin remains first line therapy for AOM
with augmentin as second line therapy and Cefdinir as a third line therapy. Azythromycin is not
recommended for ear infections (Burns, AAP guideline, cost sources from the internet)
The pediatric primary care nurse practitioner treats a two-year-old patient who has acute otitis
media (AOM). The parents report a concern for speech delay. Review of the medical record
reveals two additional AOM diagnoses in the past six months. The patient's plan of care
includes:
CORRECT ANSWERS | GRADED A+| 2025/2026 LATEST UPDATE
A mother brings her two-month-old infant to a pediatric primary care nurse practitioner's clinic
for a well child examination. The nurse practitioner orders the immunizations and provides an
overview to the mother. The mother states, "I don't want my child to have those shots!" The
nurse practitioner's most appropriate response is to:
a. Provide a strong recommendation for immunization on schedule
b. Inform the mother that state law requires immunization.
c. Negotiate an alternative immunization plan with the mother
d. Recommend that the mother find another provider who shares the mother's philosophy
regarding vaccines. a. Provide a strong recommendation for immunization on schedule
Rationale:The nurse practitioner should assume that all parents will want to vaccinate based on
recommendations. Providing a strong recommendation to vaccinate on schedule and adding
supportive statements is the best response to hesitation or initial refusal. Then listen to and
respond to specific questions and concerns. An alternate immunization plan is not the most
appropriate initial response as NP does not have an understanding of why the mother is
hesitant. Laws vary from state to state and recommending the mother find a different provider
will prevent future chances to discuss immunization. (CDC, Immunizations)
Which is an accurate statement about vegetarian diets during childhood?
a. A child who eats a lactovegetarian diet is unlikely to consume adequate amounts of protein
and vitamins for proper growth and development.
b. Algae is a good source of bioavailable vitamin B12 for a child who eats a vegetarian diet
c. Bioavailable vitamin B12 is present in both animal - and plant-based foods
d. Vitamin B12 and zinc deficiencies place a child at risk for developmental delays d. Vitamin
B12 and zinc deficiencies place a child at risk for developmental delays
,Rationale: B12 and zinc are most commonly found in meat and egg products. Sources of these
nutrients in a vegan diet would include fortified soy milk, fortified soy based meat substitutes,
nutritional yeast, fortified cereals, almonds, brown rice, wheat germ, tofu, pecans, and spinach.
Other deficiencies with vegan or variations of vegetarian diets can include vitamin D, riboflavin,
calcium, and iron. (Burns)
A pediatric primary nurse practitioner evaluates an established patient who has completed
treatment for acute otitis media. The nurse practitioner documents the resolution of the
current illness, a review of previous upper respiratory infections, and the findings of an
otoscopic examination and a brief head-to-toe assessment. Previous documentation includes a
diagnosis of otitis media with effusion and a referral to an otolaryngologist. For which level of
service does the nurse practitioner bill?
a. Comprehensive
b. Detailed
c. Expanded problem-focused
d. Problem-focused d. Problem-focused
Rationale: The practitioner is not providing a comprehensive assessment because she does not
include enough components of the history and physical, expanded problem focused would be a
more extensive Hx with ROS, PE, and medical decision making process. This visit is only focused
on the immediate problem that is now resolved without new diagnosis and limited assessment
so it should be coded as problem focused (Burns; Stewart & Denisco, Chapter 13)
A mother brings her six-year-old daughter to a pediatric primary care nurse practitioner for
evaluation of breast and axillary hair growth. The patient has grown 1 inch during the lastthree
months. The nurse practitioner's action is to:
a. Follow the child's development every six months
b. Inform the mother that this condition is normal
, c. Initiate therapy with ketoconazole (Nizoral)
d. Refer the patient to a pediatric endocrinologist d. Refer the patient to a pediatric
endocrinologist
Rationale: The child has evidence of precocious puberty in a child less than 8 years of age.
Isolated axillary hair or single symptoms can be monitored but when the child has 2 or more
symptoms they should be referred to endocrinology for work up of precocious puberty. The
Ketoconazole is an antifungal medication and will not improve symptoms and this is not a
normal finding. (Burns)
A parent without health insurance brings an infant with bilateral otitis media to a pediatric
primary care nurse practitioner. To optimize treatment adherence, the nurse practitioner
prescribe which oral medication?
a. Amoxicillin (Amoxil) two times daily for 10 days
b. Amoxicillin and clavulanate (Augmentin) twice daily for 10 days
c. Azithromycin (Zithromax) once daily for five days
d. Cefdinir (Omnicef) once daily for 10 days a. Amoxicillin (Amoxil) two times daily for 10
days
Rationale: Amoxicillin is a very inexpensive medication with the lowest cost being around 3-4
dollars compared to Augmentin which can cost 400-900 dollars. Azithromycin and Cefdinir being
40 and 20+ respectively. The lower cost of the medication is a factor. Also, there is more
compliance with 1-2 x a day medications. Finally, Amoxicillin remains first line therapy for AOM
with augmentin as second line therapy and Cefdinir as a third line therapy. Azythromycin is not
recommended for ear infections (Burns, AAP guideline, cost sources from the internet)
The pediatric primary care nurse practitioner treats a two-year-old patient who has acute otitis
media (AOM). The parents report a concern for speech delay. Review of the medical record
reveals two additional AOM diagnoses in the past six months. The patient's plan of care
includes:
