PNP PNCB EXAM 2025-2026 QUESTIONS
AND DETAILED CORRECT ANSWER | A+
GRADE VERIFIED ANSWERS
A 12-month-old infant exhibits poor weight gain after
previously normal growth patterns. There is no history of
vomiting, diarrhea, or irregular bowel movements, and the
physical exam is normal. What is the next step in
evaluating these findings?
a) complete blood count and electrolytes
b) feeding and stooling history and 3-day diet history
c) stool cultures for ova and parasites
d) swallow study with videofluoroscopy Correct Answer b)
feeding and stooling history and 3-day diet history
A toddler is seen in the clinic after a 2-day history of
intermittent vomiting and diarrhea. An assessment reveals
an irritable child with dry mucous membranes, 3 second
capillary refill, 2 second recoil of skin, mild tachycardia and
tachypnea, and cool hands and feet. The child has had
two wet diapers in the past 24 hours. What will the primary
care PNP recommend?
a) anti-diarrheal medication and clear fluids for 24 hours
b) bolus of IV normal saline in the clinic until improvement
c) hospital admission for iV rehydration and oral fluids
d) oral rehydration solution with follow-up in 24 hours
Correct Answer d) oral rehydration solution with follow-up
in 24 hours
,A 2-month-old infant cries up to 4 hours each day and
according to the parents, is inconsolable during crying
episodes with fists and legs noted to be tense and stiff.
The infant is breastfeeding frequently but is often fussy
during feedings. The physical exam is normal and the
infant is gaining weight normally. what will the primary
care PNP recommend?
a) a complete work-up, including laboratory and radiologic
tests
b) eliminating certain foods from the mother's diet
c) empiric treatment with a proton pump inhibitor
medications
d) stopping breastfeeding and beginning a hydrolyzed
formula Correct Answer b) eliminating certain foods from
the mother's diet
The parents of a 3-month-old reports that the infant arches
and gages while feeding and spits up undigested formula
frequently. The infant's weight gain has dropped to the 5th
percentile from the 12th percentile. What is the best
course of treatment for this infant?
a) begin a trial of extensively hydrolyzed protein formula
for 2-4 weeks
b) initiative an empiric trial of acid suppression with a
proton pump inhibitor
c) perform a esophageal pH monitoring to determine the
degree of reflux
d) reassure the parent that these symptoms will likely
resolve by 12-24 months Correct Answer a) begin a trial of
extensively hydrolyzed protein formula for 2-4 weeks
,An adolescent is diagnosed with functional abdominal pain
(FAP). The child's symptoms worsen during stressful
events, especially with school anxiety. what will be an
important part of treatment for this child?
a) informing the parents that the pain is most likely not real
b) instituting a lactose-free diet along with lactobacillus
supplements
c) teaching about the brain-gut interaction causing
symptoms
d) using histamine2-blockers to help alleviate symptoms
Correct Answer c) teaching about the brain-gut interaction
causing symptoms
The most common congenital heart defect in children is:
a) tricuspid atresia
b) ventricular septal defect
c) aortic stenosis
d) pulmonary atresia Correct Answer b) ventricular septal
defect
An otherwise healthy child with an acyanotic heart defect
may have:
a) low oxygen saturations
b) right to left shunting
c) left to right shunting
d) clubbing of the digits Correct Answer c) left to right
shunting
The mother of a 4-month-old infant reports that he turned
"blue" and seemed to have fast, laboured breathing
seemed to improve. On physical examination, the mucous
, membranes of the lips and mouth appear mildly cyanotic.
A systolic murmur is heard best at the left sternal border.
Vital signs are normal with normal peripheral pulses.
There is no hepatosplenomegaly. A likely diagnosis is:
a) congestive heart failure
b) apnea
c) coarctation of the aorta
d) cyanotic spell related to tetralogy of fallot Correct
Answer d) cyanotic spell related to tetralogy of fallot
Which of the following is true regarding innocent
murmurs?
a) the murmur is holosystolic
b) prompt referral to a cardiologist is indicated
c) the precordial thrill is present
d) the murmur is low intensity, grade 1-3 Correct Answer
d) the murmur is low intensity, grade 1-3
A most concerning cardiac finding in a newborn or infant
assessment is:
a) a blood pressure of 70/40
b) decreased femoral pulses
c) a regular heart rate of 100 while sleeping
d) a soft, grade 3/6 systolic murmur Correct Answer b)
decreased femoral pulses
A 12-year-old girl seen at a routine visit has a blood
pressure of 140/90. She denies any symptoms. The initial
management would include:
a) intravenous pyelogram
b) return for two repeat blood pressure measurements
AND DETAILED CORRECT ANSWER | A+
GRADE VERIFIED ANSWERS
A 12-month-old infant exhibits poor weight gain after
previously normal growth patterns. There is no history of
vomiting, diarrhea, or irregular bowel movements, and the
physical exam is normal. What is the next step in
evaluating these findings?
a) complete blood count and electrolytes
b) feeding and stooling history and 3-day diet history
c) stool cultures for ova and parasites
d) swallow study with videofluoroscopy Correct Answer b)
feeding and stooling history and 3-day diet history
A toddler is seen in the clinic after a 2-day history of
intermittent vomiting and diarrhea. An assessment reveals
an irritable child with dry mucous membranes, 3 second
capillary refill, 2 second recoil of skin, mild tachycardia and
tachypnea, and cool hands and feet. The child has had
two wet diapers in the past 24 hours. What will the primary
care PNP recommend?
a) anti-diarrheal medication and clear fluids for 24 hours
b) bolus of IV normal saline in the clinic until improvement
c) hospital admission for iV rehydration and oral fluids
d) oral rehydration solution with follow-up in 24 hours
Correct Answer d) oral rehydration solution with follow-up
in 24 hours
,A 2-month-old infant cries up to 4 hours each day and
according to the parents, is inconsolable during crying
episodes with fists and legs noted to be tense and stiff.
The infant is breastfeeding frequently but is often fussy
during feedings. The physical exam is normal and the
infant is gaining weight normally. what will the primary
care PNP recommend?
a) a complete work-up, including laboratory and radiologic
tests
b) eliminating certain foods from the mother's diet
c) empiric treatment with a proton pump inhibitor
medications
d) stopping breastfeeding and beginning a hydrolyzed
formula Correct Answer b) eliminating certain foods from
the mother's diet
The parents of a 3-month-old reports that the infant arches
and gages while feeding and spits up undigested formula
frequently. The infant's weight gain has dropped to the 5th
percentile from the 12th percentile. What is the best
course of treatment for this infant?
a) begin a trial of extensively hydrolyzed protein formula
for 2-4 weeks
b) initiative an empiric trial of acid suppression with a
proton pump inhibitor
c) perform a esophageal pH monitoring to determine the
degree of reflux
d) reassure the parent that these symptoms will likely
resolve by 12-24 months Correct Answer a) begin a trial of
extensively hydrolyzed protein formula for 2-4 weeks
,An adolescent is diagnosed with functional abdominal pain
(FAP). The child's symptoms worsen during stressful
events, especially with school anxiety. what will be an
important part of treatment for this child?
a) informing the parents that the pain is most likely not real
b) instituting a lactose-free diet along with lactobacillus
supplements
c) teaching about the brain-gut interaction causing
symptoms
d) using histamine2-blockers to help alleviate symptoms
Correct Answer c) teaching about the brain-gut interaction
causing symptoms
The most common congenital heart defect in children is:
a) tricuspid atresia
b) ventricular septal defect
c) aortic stenosis
d) pulmonary atresia Correct Answer b) ventricular septal
defect
An otherwise healthy child with an acyanotic heart defect
may have:
a) low oxygen saturations
b) right to left shunting
c) left to right shunting
d) clubbing of the digits Correct Answer c) left to right
shunting
The mother of a 4-month-old infant reports that he turned
"blue" and seemed to have fast, laboured breathing
seemed to improve. On physical examination, the mucous
, membranes of the lips and mouth appear mildly cyanotic.
A systolic murmur is heard best at the left sternal border.
Vital signs are normal with normal peripheral pulses.
There is no hepatosplenomegaly. A likely diagnosis is:
a) congestive heart failure
b) apnea
c) coarctation of the aorta
d) cyanotic spell related to tetralogy of fallot Correct
Answer d) cyanotic spell related to tetralogy of fallot
Which of the following is true regarding innocent
murmurs?
a) the murmur is holosystolic
b) prompt referral to a cardiologist is indicated
c) the precordial thrill is present
d) the murmur is low intensity, grade 1-3 Correct Answer
d) the murmur is low intensity, grade 1-3
A most concerning cardiac finding in a newborn or infant
assessment is:
a) a blood pressure of 70/40
b) decreased femoral pulses
c) a regular heart rate of 100 while sleeping
d) a soft, grade 3/6 systolic murmur Correct Answer b)
decreased femoral pulses
A 12-year-old girl seen at a routine visit has a blood
pressure of 140/90. She denies any symptoms. The initial
management would include:
a) intravenous pyelogram
b) return for two repeat blood pressure measurements
