Pediatric Nurse Practitioner Exam Preparation
PEDIATRIC NURSE PRACTITIONER EXAM PREPARATION FOR
2025/2026 COMPLETE QUESTIONS AND CORRECT ANSWERS
|ALREADY GRADED A+||BRAND NEW!!
A 5-year-old child has sudden onset of nonblanching purpuric lesions scattered
over the body and petechiae scattered over the neck and shoulders. The mother
reports that the child has been healthy, except for a cold a few weeks ago. The
child is not taking any medications. Physical examination reveals a healthy, afebrile
child with no other significant findings. The laboratory data show a hemoglobin
level of 12.5 g/dL, white blood cell count of 6500/mm3, and platelet count of
20,000/mm3. Based on this information, what should the PNP do next?
A) Reassure the parents that these findings are consistent with acute idiopathic
thrombocytopenia purpura (ITP), and advise a hematology consultation for
confirmation
B) Refer the child immediately to the pediatric hematology/oncology department
of the nearest tertiary care center
C) Report the family to the local protective services department as soon as
possible because of the
a
A 4-year-old child is scheduled for a tonsillectomy and adenoidectomy. The
preoperative laboratory tests indicate a prolonged active partial thromboplastin
time (aPTT). The PNP should suggest that they:
A) Continue with the surgery, and monitor the child closely for bleeding
complications
B) Cancel the surgery, and recheck the aPTT in 1 week
C) Cancel the surgery, and refer the child to a hematologist
D) Obtain a family history, and determine whether there are other relatives with a
bleeding disorder
c
1|Page
, Pediatric Nurse Practitioner Exam Preparation
A 14-year-old adolescent, who appears to be in acute distress and is anxious, is
brought to the clinic with symptoms of high fever, chills, malaise, pharyngitis,
vomiting, peripheral cyanosis, tachypnea, tachycardia, low blood pressure, and
erythroderma. The PNP recognizes this as toxic shock syndrome and:
A) Orders a CBC and blood culture immediately
B) Orders a CBC and blood culture, and sends the adolescent to an emergency
room for a lumbar puncture
C) Sends the adolescent to the emergency room by ambulance immediately
without providing any treatment in the clinic
D) Collaborates with the clinic physician to determine appropriate antibiotic use in
this patient
c
The PNP is assessing a neonate in the nursery. The cremasteric reflex is absent,
and the right testicle cannot be palpated in the scrotum. The PNP should:
A) Order a sonogram
B) Consult with the physician
C) Wait for the next well visit to see if the situation has changed
D) Order an MRI
b
A 9-year-old child is brought to the clinic for the evaluation and treatment of a
rash. While examining the child, the PNP detects a speech dysfluency. The most
appropriate plan of treatment should include:
A) Treating the rash and scheduling a well-child visit to address the speech
problem
B) Treating the rash and making a referral for speech, language, and hearing
evaluation with a speech pathologist
C) Treating the rash and making no referral because it is too late for speech
therapy to be beneficial
D) Using a clinical screening tool to determine whether a language disorder exists
b
2|Page
, Pediatric Nurse Practitioner Exam Preparation
A 13-year-old adolescent complains of having difficulty walking and the arms
feeling weak. The adolescent had a cold 2 weeks ago. On examination, the PNP is
not able to elicit deep tendon reflexes. The PNP knows that the most appropriate
course of action is to:
A) Refer the adolescent to an orthopedic surgeon
B) Schedule a follow-up visit in 1 week
C) Refer the adolescent to a neurologist
D) Refer the adolescent to an emergency room
d
A 1-year-old child is brought to the clinic with a temperature of 102°F and left
flank pain. The urine dipstick test indicates nitrates and leukocyte esterase. The
presenting signs and symptoms suggest left pyelonephritis. Based on the data, the
most appropriate action for the PNP is to:
A) Refer the child to a urologist for diagnosis and treatment
B) Consult with a physician
C) Provide symptomatic treatment for 24 hours, and repeat the urine dipstick test
D) Send urine for culture and sensitivity testing
b
A neonate is diagnosed with trisomy 21 based on karyotyping. What type of
follow-up will the infant need?
A) Echocardiography; thyroid function tests at birth, 3 months, and yearly
thereafter; a CBC; and an audiology consult
B) An ophthalmologic evaluation, neck x-ray films by age 3 years, and referral to
early intervention and parent education
C) Karyotyping, echocardiography, audiologic and ophthalmologic evaluation, and
referral to early intervention and parent education
D) Karyotyping; echocardiography; renal ultrasonography; thyroid function tests at
birth, age 3 months, and yearly thereafter; and referral to early intervention and
parent education
a
3|Page
, Pediatric Nurse Practitioner Exam Preparation
The parents of a 9-year-old with primary enuresis request information regarding
treatment options. When discussing alternative treatments for enuresis, the PNP
offers pertinent information to help the child and parents make an appropriate
decision about which treatment would be best. The family should be told:
A) The alarm is the safest therapy, but the relapse rate is about 10%
B) Pharmacologic therapy has the lowest relapse rate
C) Motivational therapy should be used after pharmacologic treatment
D) Treatment should begin with bladder awareness training
d
A parent asks for suggestions in helping a 6-year-old child who wets the bed. What
intervention would the PNP recommend for this child diagnosed with primary
nocturnal enuresis?
A) Use a "wet night" calendar to mark the dates of wetting accidents
B) Allow the child to take care of changing wet clothes and linens
C) Criticize the child when a wetting accident has occurred
D) Praise any progress made by the child
d
A 10-year-old child is examined because of recurrent UTIs. A urologic workup is
performed. No abnormalities are found. To help prevent future UTIs, the PNP
should suggest which of the following interventions?
A) Taking a 30-minute bath daily
B) Avoiding showering
C) Using a voiding schedule to expand the bladder
D) Practicing good perineal hygiene
d
A PNP responsible for neonatal discharge rounds at the hospital examines a male
infant and notes that the urethral opening appears displaced ventrally along the
glans. A closer assessment reveals an undiagnosed mild hypospadias. What should
the parents be told?
A) Hypospadias occurs in approximately 1 in 500 neonates
4|Page
PEDIATRIC NURSE PRACTITIONER EXAM PREPARATION FOR
2025/2026 COMPLETE QUESTIONS AND CORRECT ANSWERS
|ALREADY GRADED A+||BRAND NEW!!
A 5-year-old child has sudden onset of nonblanching purpuric lesions scattered
over the body and petechiae scattered over the neck and shoulders. The mother
reports that the child has been healthy, except for a cold a few weeks ago. The
child is not taking any medications. Physical examination reveals a healthy, afebrile
child with no other significant findings. The laboratory data show a hemoglobin
level of 12.5 g/dL, white blood cell count of 6500/mm3, and platelet count of
20,000/mm3. Based on this information, what should the PNP do next?
A) Reassure the parents that these findings are consistent with acute idiopathic
thrombocytopenia purpura (ITP), and advise a hematology consultation for
confirmation
B) Refer the child immediately to the pediatric hematology/oncology department
of the nearest tertiary care center
C) Report the family to the local protective services department as soon as
possible because of the
a
A 4-year-old child is scheduled for a tonsillectomy and adenoidectomy. The
preoperative laboratory tests indicate a prolonged active partial thromboplastin
time (aPTT). The PNP should suggest that they:
A) Continue with the surgery, and monitor the child closely for bleeding
complications
B) Cancel the surgery, and recheck the aPTT in 1 week
C) Cancel the surgery, and refer the child to a hematologist
D) Obtain a family history, and determine whether there are other relatives with a
bleeding disorder
c
1|Page
, Pediatric Nurse Practitioner Exam Preparation
A 14-year-old adolescent, who appears to be in acute distress and is anxious, is
brought to the clinic with symptoms of high fever, chills, malaise, pharyngitis,
vomiting, peripheral cyanosis, tachypnea, tachycardia, low blood pressure, and
erythroderma. The PNP recognizes this as toxic shock syndrome and:
A) Orders a CBC and blood culture immediately
B) Orders a CBC and blood culture, and sends the adolescent to an emergency
room for a lumbar puncture
C) Sends the adolescent to the emergency room by ambulance immediately
without providing any treatment in the clinic
D) Collaborates with the clinic physician to determine appropriate antibiotic use in
this patient
c
The PNP is assessing a neonate in the nursery. The cremasteric reflex is absent,
and the right testicle cannot be palpated in the scrotum. The PNP should:
A) Order a sonogram
B) Consult with the physician
C) Wait for the next well visit to see if the situation has changed
D) Order an MRI
b
A 9-year-old child is brought to the clinic for the evaluation and treatment of a
rash. While examining the child, the PNP detects a speech dysfluency. The most
appropriate plan of treatment should include:
A) Treating the rash and scheduling a well-child visit to address the speech
problem
B) Treating the rash and making a referral for speech, language, and hearing
evaluation with a speech pathologist
C) Treating the rash and making no referral because it is too late for speech
therapy to be beneficial
D) Using a clinical screening tool to determine whether a language disorder exists
b
2|Page
, Pediatric Nurse Practitioner Exam Preparation
A 13-year-old adolescent complains of having difficulty walking and the arms
feeling weak. The adolescent had a cold 2 weeks ago. On examination, the PNP is
not able to elicit deep tendon reflexes. The PNP knows that the most appropriate
course of action is to:
A) Refer the adolescent to an orthopedic surgeon
B) Schedule a follow-up visit in 1 week
C) Refer the adolescent to a neurologist
D) Refer the adolescent to an emergency room
d
A 1-year-old child is brought to the clinic with a temperature of 102°F and left
flank pain. The urine dipstick test indicates nitrates and leukocyte esterase. The
presenting signs and symptoms suggest left pyelonephritis. Based on the data, the
most appropriate action for the PNP is to:
A) Refer the child to a urologist for diagnosis and treatment
B) Consult with a physician
C) Provide symptomatic treatment for 24 hours, and repeat the urine dipstick test
D) Send urine for culture and sensitivity testing
b
A neonate is diagnosed with trisomy 21 based on karyotyping. What type of
follow-up will the infant need?
A) Echocardiography; thyroid function tests at birth, 3 months, and yearly
thereafter; a CBC; and an audiology consult
B) An ophthalmologic evaluation, neck x-ray films by age 3 years, and referral to
early intervention and parent education
C) Karyotyping, echocardiography, audiologic and ophthalmologic evaluation, and
referral to early intervention and parent education
D) Karyotyping; echocardiography; renal ultrasonography; thyroid function tests at
birth, age 3 months, and yearly thereafter; and referral to early intervention and
parent education
a
3|Page
, Pediatric Nurse Practitioner Exam Preparation
The parents of a 9-year-old with primary enuresis request information regarding
treatment options. When discussing alternative treatments for enuresis, the PNP
offers pertinent information to help the child and parents make an appropriate
decision about which treatment would be best. The family should be told:
A) The alarm is the safest therapy, but the relapse rate is about 10%
B) Pharmacologic therapy has the lowest relapse rate
C) Motivational therapy should be used after pharmacologic treatment
D) Treatment should begin with bladder awareness training
d
A parent asks for suggestions in helping a 6-year-old child who wets the bed. What
intervention would the PNP recommend for this child diagnosed with primary
nocturnal enuresis?
A) Use a "wet night" calendar to mark the dates of wetting accidents
B) Allow the child to take care of changing wet clothes and linens
C) Criticize the child when a wetting accident has occurred
D) Praise any progress made by the child
d
A 10-year-old child is examined because of recurrent UTIs. A urologic workup is
performed. No abnormalities are found. To help prevent future UTIs, the PNP
should suggest which of the following interventions?
A) Taking a 30-minute bath daily
B) Avoiding showering
C) Using a voiding schedule to expand the bladder
D) Practicing good perineal hygiene
d
A PNP responsible for neonatal discharge rounds at the hospital examines a male
infant and notes that the urethral opening appears displaced ventrally along the
glans. A closer assessment reveals an undiagnosed mild hypospadias. What should
the parents be told?
A) Hypospadias occurs in approximately 1 in 500 neonates
4|Page
