Pediatric Nurse Practitioner Exam I|
Complete Questions and Verified
Answers 2025
Question 1
Which institution legally defines the scope of practice for pediatric nurse practitioners?
a. Graduate schools
b. Certification board
c. State legislation
d. NP membership organization
Correct answer: c. State legislation
Explanation: The scope of practice for pediatric nurse practitioners is legally defined by state
legislation, specifically through state nurse practice acts and regulations, which outline the roles,
responsibilities, and limitations of NPs in each state.
Question 2
A healthy 24-month-old can be expected to have achieved which of the following language
milestones?
a. Counts three objects correctly
b. Has a 30–50 word vocabulary
c. States full name
d. Tells a story
Correct answer: b. Has a 30–50 word vocabulary
Explanation: At 24 months, a typically developing child should have a vocabulary of
approximately 30–50 words and begin using two-word phrases. Counting objects, stating their
full name, or telling a story are milestones typically achieved at later ages.
Question 3
,Which symptoms would prompt the ordering of a genetic test for Prader-Willi syndrome?
a. Obesity, daytime hyperactivity, increased libido
b. Large hands/feet, thin saliva
c. Neonatal hypotonia, feeding difficulties
d. Failure to thrive, hyperphagia, clitoromegaly
Correct answer: c. Neonatal hypotonia, feeding difficulties
Explanation: Prader-Willi syndrome is characterized by neonatal hypotonia, poor feeding, and
failure to thrive in infancy, followed later by hyperphagia and obesity. Genetic testing is
warranted when these early symptoms are observed.
Question 4
Emphasis on promoting healthy behavioral changes for the overweight child should include
which of the following?
a. Establishing family goals
b. Maintaining family holiday meal rituals
c. Weighing child daily
d. Using weight loss as a sign of success
Correct answer: a. Establishing family goals
Explanation: Promoting healthy behavioral changes in overweight children involves family-
centered goals to encourage sustainable lifestyle changes, such as improved diet and increased
physical activity, rather than focusing solely on weight loss or maintaining potentially unhealthy
traditions.
Question 5
Which should always be included in the evaluation of a child with a suspected learning disorder?
a. Full history and physical exam
b. Denver II developmental assessment
c. Genetic and chromosomal testing
d. Intelligence quotient measurement
Correct answer: a. Full history and physical exam
,Explanation: A comprehensive history and physical exam are essential to identify potential
medical, environmental, or developmental factors contributing to a suspected learning disorder,
serving as the foundation for further evaluation.
Question 6
What is the MOST important safety question to ask a 17-year-old?
a. Are you aware of ways to avoid accidents?
b. Do you play violent video games more than 2 hours a day?
c. Do you always wear a seat belt when driving or riding in a car?
d. Is there a gun anywhere in your house?
Correct answer: c. Do you always wear a seat belt when driving or riding in a car?
Explanation: Motor vehicle accidents are a leading cause of death among adolescents. Asking
about seat belt use addresses a critical, preventable risk factor for injury.
Question 7
A MOST concerning cardiac finding in the initial newborn assessment is:
a. A soft, grade III/IV systolic murmur
b. A cuff blood pressure of 65/35
c. Decreased femoral pulses
d. A regular heart rate of 95 while sleeping
Correct answer: c. Decreased femoral pulses
Explanation: Decreased femoral pulses in a newborn suggest coarctation of the aorta, a
serious congenital heart defect requiring urgent evaluation, as it can impair lower body
circulation.
Question 8
The American Academy of Pediatrics (AAP) recommends that child ASSENT to participate in
clinical research requires evidence of which of the following?
a. Full understanding of the risk and potential benefits of the treatment
b. Rejection of non-research alternatives
, c. Acceptance of unfamiliar procedures
d. Developmentally appropriate understanding of the nature of his condition
Correct answer: d. Developmentally appropriate understanding of the nature of his condition
Explanation: Child assent for clinical research, per AAP guidelines, requires a
developmentally appropriate understanding of their condition and the study’s purpose, not a full
adult-level comprehension of risks or rejection of alternatives.
Question 9
A 10-year-old obese child whose family history is unknown has a total cholesterol (TC) of 205
when first screened for hyperlipidemia. The MOST appropriate course of action is to:
a. Repeat TC level in 2–4 weeks
b. Repeat TC level after 3 months on a low-fat diet
c. Perform a lipoprotein analysis now
d. Perform a lipoprotein analysis after 3 months on a low-fat diet
Correct answer: c. Perform a lipoprotein analysis now
Explanation: A total cholesterol of 205 mg/dL in a child is elevated (normal <170 mg/dL). A
lipoprotein analysis (lipid panel) is needed to assess LDL, HDL, and triglycerides to guide
management, especially given the unknown family history.
Question 10
Internationally adopted children from ANY country should receive testing for:
a. Tuberculosis, hep B and C, syphilis, HIV
b. Measles, hep A and C, tuberculosis, malaria
c. Syphilis, cytomegalovirus, hep A and C, HIV
d. Measles, hep A and C, cytomegalovirus, malaria
Correct answer: a. Tuberculosis, hep B and C, syphilis, HIV
Explanation: Internationally adopted children are at risk for infectious diseases prevalent in
their countries of origin. Screening for tuberculosis, hepatitis B and C, syphilis, and HIV is
recommended by the AAP to ensure early detection and treatment.
Complete Questions and Verified
Answers 2025
Question 1
Which institution legally defines the scope of practice for pediatric nurse practitioners?
a. Graduate schools
b. Certification board
c. State legislation
d. NP membership organization
Correct answer: c. State legislation
Explanation: The scope of practice for pediatric nurse practitioners is legally defined by state
legislation, specifically through state nurse practice acts and regulations, which outline the roles,
responsibilities, and limitations of NPs in each state.
Question 2
A healthy 24-month-old can be expected to have achieved which of the following language
milestones?
a. Counts three objects correctly
b. Has a 30–50 word vocabulary
c. States full name
d. Tells a story
Correct answer: b. Has a 30–50 word vocabulary
Explanation: At 24 months, a typically developing child should have a vocabulary of
approximately 30–50 words and begin using two-word phrases. Counting objects, stating their
full name, or telling a story are milestones typically achieved at later ages.
Question 3
,Which symptoms would prompt the ordering of a genetic test for Prader-Willi syndrome?
a. Obesity, daytime hyperactivity, increased libido
b. Large hands/feet, thin saliva
c. Neonatal hypotonia, feeding difficulties
d. Failure to thrive, hyperphagia, clitoromegaly
Correct answer: c. Neonatal hypotonia, feeding difficulties
Explanation: Prader-Willi syndrome is characterized by neonatal hypotonia, poor feeding, and
failure to thrive in infancy, followed later by hyperphagia and obesity. Genetic testing is
warranted when these early symptoms are observed.
Question 4
Emphasis on promoting healthy behavioral changes for the overweight child should include
which of the following?
a. Establishing family goals
b. Maintaining family holiday meal rituals
c. Weighing child daily
d. Using weight loss as a sign of success
Correct answer: a. Establishing family goals
Explanation: Promoting healthy behavioral changes in overweight children involves family-
centered goals to encourage sustainable lifestyle changes, such as improved diet and increased
physical activity, rather than focusing solely on weight loss or maintaining potentially unhealthy
traditions.
Question 5
Which should always be included in the evaluation of a child with a suspected learning disorder?
a. Full history and physical exam
b. Denver II developmental assessment
c. Genetic and chromosomal testing
d. Intelligence quotient measurement
Correct answer: a. Full history and physical exam
,Explanation: A comprehensive history and physical exam are essential to identify potential
medical, environmental, or developmental factors contributing to a suspected learning disorder,
serving as the foundation for further evaluation.
Question 6
What is the MOST important safety question to ask a 17-year-old?
a. Are you aware of ways to avoid accidents?
b. Do you play violent video games more than 2 hours a day?
c. Do you always wear a seat belt when driving or riding in a car?
d. Is there a gun anywhere in your house?
Correct answer: c. Do you always wear a seat belt when driving or riding in a car?
Explanation: Motor vehicle accidents are a leading cause of death among adolescents. Asking
about seat belt use addresses a critical, preventable risk factor for injury.
Question 7
A MOST concerning cardiac finding in the initial newborn assessment is:
a. A soft, grade III/IV systolic murmur
b. A cuff blood pressure of 65/35
c. Decreased femoral pulses
d. A regular heart rate of 95 while sleeping
Correct answer: c. Decreased femoral pulses
Explanation: Decreased femoral pulses in a newborn suggest coarctation of the aorta, a
serious congenital heart defect requiring urgent evaluation, as it can impair lower body
circulation.
Question 8
The American Academy of Pediatrics (AAP) recommends that child ASSENT to participate in
clinical research requires evidence of which of the following?
a. Full understanding of the risk and potential benefits of the treatment
b. Rejection of non-research alternatives
, c. Acceptance of unfamiliar procedures
d. Developmentally appropriate understanding of the nature of his condition
Correct answer: d. Developmentally appropriate understanding of the nature of his condition
Explanation: Child assent for clinical research, per AAP guidelines, requires a
developmentally appropriate understanding of their condition and the study’s purpose, not a full
adult-level comprehension of risks or rejection of alternatives.
Question 9
A 10-year-old obese child whose family history is unknown has a total cholesterol (TC) of 205
when first screened for hyperlipidemia. The MOST appropriate course of action is to:
a. Repeat TC level in 2–4 weeks
b. Repeat TC level after 3 months on a low-fat diet
c. Perform a lipoprotein analysis now
d. Perform a lipoprotein analysis after 3 months on a low-fat diet
Correct answer: c. Perform a lipoprotein analysis now
Explanation: A total cholesterol of 205 mg/dL in a child is elevated (normal <170 mg/dL). A
lipoprotein analysis (lipid panel) is needed to assess LDL, HDL, and triglycerides to guide
management, especially given the unknown family history.
Question 10
Internationally adopted children from ANY country should receive testing for:
a. Tuberculosis, hep B and C, syphilis, HIV
b. Measles, hep A and C, tuberculosis, malaria
c. Syphilis, cytomegalovirus, hep A and C, HIV
d. Measles, hep A and C, cytomegalovirus, malaria
Correct answer: a. Tuberculosis, hep B and C, syphilis, HIV
Explanation: Internationally adopted children are at risk for infectious diseases prevalent in
their countries of origin. Screening for tuberculosis, hepatitis B and C, syphilis, and HIV is
recommended by the AAP to ensure early detection and treatment.
