Pediatric Nurse Practitioner Exam II|
Complete Questions and Verified
Answers 2025
Which of the following statements regarding alternating doses of ibuprofen and acetaminophen
for fever is most accurate?
a. alternating drugs increases risk of dosage errors and toxicity
b. alternating allows for lower total dosage of both drugs
c. alternating drugs results in more rapid resolution of the fever than using either drug alone
d. is appropriate only for children over the age of six months
Correct answer: a
Explanation: Alternating ibuprofen and acetaminophen can lead to confusion in dosing
schedules, increasing the risk of accidental overdose and toxicity, such as liver damage from
acetaminophen or renal issues from ibuprofen.
The parents of a 6 year old reports that the child has been allergic to most fruits since early life.
Which history question should be asked FIRST?
a. what were the child's symptoms?
b. how many different fruits is the child allergic to?
c. has the child had any previous testing?
d. how old was the child with the first reaction?
Correct answer: a
Explanation: Identifying specific symptoms (e.g., hives, anaphylaxis) is crucial first to assess
severity and differentiate true allergy from intolerance or other reactions.
The parent a of 2 week old states that even though the infant was fed Enfamil LIPIL with iron in
the hospital, he is now receiving ProSobee LIPIL formula due to concern about allergies in an
older child. What is the BEST response?
,a. the infant should be switched back to the Enfamil because the ProSobee does not contain an
adequate amount of iron
b. the infant should be maintained on Enfamil until there are obvious signs of allergy such as
vomiting and bloody diarrhea
c. both formulas contain equal amounts of nutrients including iron
d. both formulas contain carbohydrates in the form of lactose
Correct answer: c
Explanation: Both Enfamil LIPIL and ProSobee LIPIL are nutritionally equivalent infant
formulas, including iron content; ProSobee is soy-based for potential milk allergies but matches
nutrient profiles.
Which alternative therapy is most likely to be explored by parents of a child with attention deficit
hyperactivity disorder (ADHD)?
a. eliminations of food additives
b. use of multi-vitamin therapy
c. elimination of dietary sugar
d. visual training
Correct answer: a
Explanation: Parents often try eliminating food additives (e.g., dyes, preservatives) as an
alternative therapy for ADHD, based on theories linking them to hyperactivity, though evidence
is limited.
Which criteria is essential for the diagnosis of obsessive-compulsive disorder (OCD) for
children?
a. behaviors occur up to an hour a day
b. behaviors are purposeless
c. presence of repetitive thoughts, images, or processes
d. child recognizes the actions are excessive
Correct answer: c
Explanation: DSM criteria for OCD require obsessions (repetitive thoughts/images) or
compulsions that cause distress, distinguishing it from normal behaviors.
,Of the following, the MOST effective method to prevent childhood gun injuries and death is
a. parents preventing children's access to guns
b. educating children with the Eddie the Eagle program
c. educating children with the STAR Program
d. children's awareness of gun presence in the home.
Correct answer: a
Explanation: Secure storage and preventing access to firearms by children is the most proven
method to reduce unintentional injuries and deaths, per AAP guidelines.
An example of a pleiotropic genetic disorder is:
A) Marfan's syndrome
B) Cri du chat syndrome
C) Vitamin D-resistant rickets
D) Tay-Sachs disease
Correct answer: a
Explanation: Pleiotropy occurs when one gene affects multiple traits; Marfan syndrome
involves connective tissue defects impacting eyes, heart, and skeleton.
A deficiency of which of the following vitamins may cause night blindness, xerophthalmia, or
keratomalacia?
A) Vitamin A
B) Vitamin K
C) Vitamin D
D) Vitamin E
Correct answer: a
Explanation: Vitamin A deficiency impairs retinal function, leading to night blindness and
corneal issues like xerophthalmia and keratomalacia.
, A 6-month-old infant is brought to the office for a well-child visit. The history obtained from the
mother reveals that the infant has had "cold symptoms" for 1 week. The mother reports that the
infant's eating and sleeping habits have not changed and that the infant has not experienced any
other symptoms. Physical examination reveals a temperature of 100.9°F (38.3°C) and right otitis
media. The immunization record reads as follows: Birth-Hep B Age 1 month-Hep B Age 2
months-DTaP, Hib, Prevnar, and IPV What immunizations should the PNP administer today?
A) None (The mother should be instructed to bring the infant back for immunizations in 1
month)
B) Because the infant is febrile, only Hep B
C) Hep B, DTaP, Hib, Prevnar, and IPV
D) Hep B, DTaP, Hib, and OPV
Correct answer: c
Explanation: Mild illness with low-grade fever does not contraindicate routine
immunizations; administer catch-up doses per schedule.
A 6-year-old child in foster care is brought to the clinic by the foster parents. They are concerned
that the child's immunizations may not be current. The child's history indicates no
contraindications to any immunizations. The family has an official immunization record for the
child that lists the following: Age 2 months DTP, OPV, Hib, and Hep B Age 4 months DTP,
OPV, Hib, and Hep B Age 6 months DTP, OPV, and Hib Age 4 years DTP, OPV, Hib, and Hep
B The immunizations recommended for today are as follows:
A) MMR and Var
B) Td and MMR
C) DT, OPV, Hib, and MMR
D) DTaP, IPV, Hib, and MMR
Correct answer: a
Explanation: At 6 years, the child needs MMR (first dose) and varicella if no history, as prior
doses are incomplete for some series but focus on missing vaccines.
The PNP sees a 6-week-old, HIV-exposed neonate in the clinic. The mother received zidovudine
(AZT) starting in the second trimester of pregnancy and intravenous AZT during labor. The
neonate was started on oral AZT after birth. As a prophylaxis for Pneumocystis carinii
pneumonia (PCP) at this 6-week visit, it would be appropriate in conjunction with the HIV
specialist managing the infant to:
Complete Questions and Verified
Answers 2025
Which of the following statements regarding alternating doses of ibuprofen and acetaminophen
for fever is most accurate?
a. alternating drugs increases risk of dosage errors and toxicity
b. alternating allows for lower total dosage of both drugs
c. alternating drugs results in more rapid resolution of the fever than using either drug alone
d. is appropriate only for children over the age of six months
Correct answer: a
Explanation: Alternating ibuprofen and acetaminophen can lead to confusion in dosing
schedules, increasing the risk of accidental overdose and toxicity, such as liver damage from
acetaminophen or renal issues from ibuprofen.
The parents of a 6 year old reports that the child has been allergic to most fruits since early life.
Which history question should be asked FIRST?
a. what were the child's symptoms?
b. how many different fruits is the child allergic to?
c. has the child had any previous testing?
d. how old was the child with the first reaction?
Correct answer: a
Explanation: Identifying specific symptoms (e.g., hives, anaphylaxis) is crucial first to assess
severity and differentiate true allergy from intolerance or other reactions.
The parent a of 2 week old states that even though the infant was fed Enfamil LIPIL with iron in
the hospital, he is now receiving ProSobee LIPIL formula due to concern about allergies in an
older child. What is the BEST response?
,a. the infant should be switched back to the Enfamil because the ProSobee does not contain an
adequate amount of iron
b. the infant should be maintained on Enfamil until there are obvious signs of allergy such as
vomiting and bloody diarrhea
c. both formulas contain equal amounts of nutrients including iron
d. both formulas contain carbohydrates in the form of lactose
Correct answer: c
Explanation: Both Enfamil LIPIL and ProSobee LIPIL are nutritionally equivalent infant
formulas, including iron content; ProSobee is soy-based for potential milk allergies but matches
nutrient profiles.
Which alternative therapy is most likely to be explored by parents of a child with attention deficit
hyperactivity disorder (ADHD)?
a. eliminations of food additives
b. use of multi-vitamin therapy
c. elimination of dietary sugar
d. visual training
Correct answer: a
Explanation: Parents often try eliminating food additives (e.g., dyes, preservatives) as an
alternative therapy for ADHD, based on theories linking them to hyperactivity, though evidence
is limited.
Which criteria is essential for the diagnosis of obsessive-compulsive disorder (OCD) for
children?
a. behaviors occur up to an hour a day
b. behaviors are purposeless
c. presence of repetitive thoughts, images, or processes
d. child recognizes the actions are excessive
Correct answer: c
Explanation: DSM criteria for OCD require obsessions (repetitive thoughts/images) or
compulsions that cause distress, distinguishing it from normal behaviors.
,Of the following, the MOST effective method to prevent childhood gun injuries and death is
a. parents preventing children's access to guns
b. educating children with the Eddie the Eagle program
c. educating children with the STAR Program
d. children's awareness of gun presence in the home.
Correct answer: a
Explanation: Secure storage and preventing access to firearms by children is the most proven
method to reduce unintentional injuries and deaths, per AAP guidelines.
An example of a pleiotropic genetic disorder is:
A) Marfan's syndrome
B) Cri du chat syndrome
C) Vitamin D-resistant rickets
D) Tay-Sachs disease
Correct answer: a
Explanation: Pleiotropy occurs when one gene affects multiple traits; Marfan syndrome
involves connective tissue defects impacting eyes, heart, and skeleton.
A deficiency of which of the following vitamins may cause night blindness, xerophthalmia, or
keratomalacia?
A) Vitamin A
B) Vitamin K
C) Vitamin D
D) Vitamin E
Correct answer: a
Explanation: Vitamin A deficiency impairs retinal function, leading to night blindness and
corneal issues like xerophthalmia and keratomalacia.
, A 6-month-old infant is brought to the office for a well-child visit. The history obtained from the
mother reveals that the infant has had "cold symptoms" for 1 week. The mother reports that the
infant's eating and sleeping habits have not changed and that the infant has not experienced any
other symptoms. Physical examination reveals a temperature of 100.9°F (38.3°C) and right otitis
media. The immunization record reads as follows: Birth-Hep B Age 1 month-Hep B Age 2
months-DTaP, Hib, Prevnar, and IPV What immunizations should the PNP administer today?
A) None (The mother should be instructed to bring the infant back for immunizations in 1
month)
B) Because the infant is febrile, only Hep B
C) Hep B, DTaP, Hib, Prevnar, and IPV
D) Hep B, DTaP, Hib, and OPV
Correct answer: c
Explanation: Mild illness with low-grade fever does not contraindicate routine
immunizations; administer catch-up doses per schedule.
A 6-year-old child in foster care is brought to the clinic by the foster parents. They are concerned
that the child's immunizations may not be current. The child's history indicates no
contraindications to any immunizations. The family has an official immunization record for the
child that lists the following: Age 2 months DTP, OPV, Hib, and Hep B Age 4 months DTP,
OPV, Hib, and Hep B Age 6 months DTP, OPV, and Hib Age 4 years DTP, OPV, Hib, and Hep
B The immunizations recommended for today are as follows:
A) MMR and Var
B) Td and MMR
C) DT, OPV, Hib, and MMR
D) DTaP, IPV, Hib, and MMR
Correct answer: a
Explanation: At 6 years, the child needs MMR (first dose) and varicella if no history, as prior
doses are incomplete for some series but focus on missing vaccines.
The PNP sees a 6-week-old, HIV-exposed neonate in the clinic. The mother received zidovudine
(AZT) starting in the second trimester of pregnancy and intravenous AZT during labor. The
neonate was started on oral AZT after birth. As a prophylaxis for Pneumocystis carinii
pneumonia (PCP) at this 6-week visit, it would be appropriate in conjunction with the HIV
specialist managing the infant to:
