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PNCB CPNP-PC PRIMARY CARE CERTIFICATION
EXAM QUESTIONS WITH ANSWERS AND
RATIONALES – COMPLETE PEDIATRIC NURSE
PRACTITIONER CERTIFICATION DETAILED
GRADED A+ !!
2025/2026 REVIEW
Caregiver education for an infant with croup includes that urgent medical re-evaluation is needed
if the infant has:
A. audible stridor when calm
B. barky cough in the morning
C. fever of 102˚ F (38.9˚ C) or higher
D. retractions between ribs with crying
A. audible stridor when calm
A preschooler is evaluated for a history of fever and intermittent bone pain and is noted to have
an abdominal mass. Which is the MOST likely diagnosis?
A. neuroblastoma
B. non-Hodgkin's lymphoma
C. osteogenic sarcoma
D. Wilms tumor
A. neuroblastoma
The median age at diagnosis is 22 months, and approximately 90% of cases have been
diagnosed by 5 years of age.
Signs and symptoms reflect the tumor site and extent of disease, but may include fever, failure to
thrive, bone pain, cytopenia, orbital proptosis, masses, bowel obstruction, or spinal cord
compression.
Wilms tumor is an embryonal malignancy of the kidney that can also present with an abdominal
mass. Sarcomas of the extremities are more likely to occur in older children.
An adolescent presenting for a pre-college physical describes herself as a sexually active lesbian.
Which is the MOST immediate action?
A. assess for potential psychosocial difficulties
B. ensure human papilloma virus vaccination is up-to-date
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C. provide confidential and nonjudgmental care
D. counsel about sexually transmitted infections and contraception
D. counsel about sexually transmitted infections and contraception
Adolescent lesbian and bisexual females are more likely to have been pregnant when compared
to their heterosexual peers
LGB adolescents and young adults are at greater risk for unplanned pregnancy and, it is
important to counsel about accidental pregnancy even with females who have sex with females.
Providing sexual and reproductive health education that includes information about abstinence,
contraception, and sexually transmitted infections (STIs) is necessary for all adolescents and
young adults. Additionally, information about contraception should be offered to all females
regardless of their sexual orientation.
Pre-college visits present an excellent opportunity to ensure that all immunizations are current,
not just the human papilloma virus vaccine. Adolescents and young adults, including those who
know or are unsure about their sexuality, may have psychosocial concerns. Providing care that is
confidential, current, factual, and nonjudgmental is required with all patients, regardless of their
sexual orientation.
While some characteristics of an Individualized Education Plan (IEP) and 504 Plan are similar,
the IEP differs in that it uniquely requires
A. a specific medical diagnosis for eligibility.
B. a modification in curriculum to meet the student's needs.
C. an evaluation typically completed through school system resources.
D. a written plan be developed that specifies individualized accommodations.
B. a modification in curriculum to meet the student's needs.
Eligibility for both plans requires a medical diagnosis. For a 504 Plan, this can be any
psychologic or physical disorder which "substantially limits" the individual's learning. These
children can follow the curriculum without modification but may require assistance in the school
setting. This may include conditions such as ADHD, diabetes, or migraines.
In order to be eligible for an IEP, a child has to also have a medical diagnosis, but that diagnosis
must specifically meet criteria as a qualifying disability that seriously affects learning or
behavior and, therefore, requires modification of the school curriculum.
Both a 504 and an IEP require evaluation, although the evaluation for an IEP is more formalized
and is typically completed by a team of professionals. Both an IEP and a 504 plan will include a
written plan. There are no legal requirements for what is included in a 504 plan and there is no
mandated re-evaluation. An IEP has very specific criteria and must describe the specific learning
problems, detail what services will be provided, set annual goals and define how progress will be
measured. Re-evaluation is mandated every 3 years.
,3|Page
When used in treatment of acne vulgaris, topical retinoids act to
A. normalize desquamation of the follicular epithelium.
B. minimize development of antibiotic-resistant Cutibacterium
acnes (formerly Propionibacterium acnes).
C. generate free radicals to oxidize proteins in the cell wall of Cutibacterium acnes.
D. work within the cell ribosomes to alter upstream signals affecting inflammatory pathways.
A. normalize desquamation of the follicular epithelium.
The therapeutic objectives in the management of acne vulgaris are to reduce sebum production,
prevent formation of microcomedones, suppress Cutibacterium
acnes (formerly Propionibacterium acnes), and reduce inflammation to prevent scarring.
Topical retinoids, vitamin A derivatives that bind to retinoid receptors in the skin, are a key
component of primary acne management. Topical retinoids normalize desquamation of the
follicular epithelium to prevent new formation of microcomedones, the precursors of both
comedonal and inflammatory lesions. Additionally, retinoids promote clearing of existing
microcomedones and work within the nucleus to alter downstream signals that affect
inflammatory pathways.
A caregiver expresses concern for her 12 month old’s lack of interest in playing with other
children, especially due to a family history of autism spectrum disorder. Which of the following
is the MOST appropriate next step?
A. suggest the caregiver attempt to engage the child in imitating behaviors
B. screen for social interactions such as peek-a-boo and pat-a-cake
C. offer reassurance that interactive play begins at age 3
D. refer for a developmental evaluation
C. offer reassurance that interactive play begins at age 3
A caregiver who is primarily Spanish-speaking reports during a visit that her 24 month old is
bilingual and speaks four words. Which of the following is the BEST initial management?
A. refer to a pediatric speech pathologist with access to translators
B. encourage caregiver to choose one language for communication
C. advise the caregiver to read to the child daily
D. refer to audiology for a hearing evaluation
A. refer to a pediatric speech pathologist with access to translators
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At two years of age a child should be speaking short phrases of two to three words with a
vocabulary of about 50 words, of which 25% are intelligible to strangers. Children from bilingual
homes or who are bilingual tend to develop language more slowly, mixing words and phrases
from the two languages; however, milestones should continue to fall within expected ranges.
Bilingual children with significant delays in vocabulary require the same evaluation as
monolingual children with language delays.
Appropriate instruction for a young adolescent male considering strength training to enhance
muscle mass includes that
A. workouts should focus on 1-2 muscle groups on any exercise day.
B. powerlifting should be delayed until later in reproductive maturation.
C. strength training should occur at least five times a week to be effective.
D. other forms of exercise should be avoided on days that strength training is done.
B. powerlifting should be delayed until later in reproductive maturation.
Powerlifting should be avoided in prepubescent children due to possible injury to long bones and
growth plates as well as the back.
A school-age child is seen for a skin rash that began about 6 weeks ago along with bilateral
limping, and a recent 2-week history of fever. Examination reveals inflammation of knee joints.
Which is the MOST likely diagnosis?
A. Acute rheumatic fever
B. dermatomyositis
C. systemic juvenile idiopathic arthritis
D. systemic lupus erythematosus
C. systemic juvenile idiopathic arthritis
Systemic JIA causes inflammation in one or more joints for 6 weeks’ duration in a child younger
than 16 years of age and is often accompanied by fatigue, inflammation of joints, skin rash, and a
high fever (103° F [39.4° C] or higher) that lasts at least 2 weeks. Pericarditis, pleuritis, anemia,
or enlargement of lymph nodes, liver or the spleen may also occur.
Systemic lupus erythematosus (SLE) is a chronic systemic rheumatic disease. Symptoms include
fatigue, skin rashes, fever, and joint involvement with non-deforming arthritis but with effusion
and tenderness. SLE can involve many organ systems (kidney, skin, blood cells, and nervous
system). A malar rash across the cheeks and bridge of the nose in the shape of a butterfly is seen
in 95% of SLE cases.
PNCB CPNP-PC PRIMARY CARE CERTIFICATION
EXAM QUESTIONS WITH ANSWERS AND
RATIONALES – COMPLETE PEDIATRIC NURSE
PRACTITIONER CERTIFICATION DETAILED
GRADED A+ !!
2025/2026 REVIEW
Caregiver education for an infant with croup includes that urgent medical re-evaluation is needed
if the infant has:
A. audible stridor when calm
B. barky cough in the morning
C. fever of 102˚ F (38.9˚ C) or higher
D. retractions between ribs with crying
A. audible stridor when calm
A preschooler is evaluated for a history of fever and intermittent bone pain and is noted to have
an abdominal mass. Which is the MOST likely diagnosis?
A. neuroblastoma
B. non-Hodgkin's lymphoma
C. osteogenic sarcoma
D. Wilms tumor
A. neuroblastoma
The median age at diagnosis is 22 months, and approximately 90% of cases have been
diagnosed by 5 years of age.
Signs and symptoms reflect the tumor site and extent of disease, but may include fever, failure to
thrive, bone pain, cytopenia, orbital proptosis, masses, bowel obstruction, or spinal cord
compression.
Wilms tumor is an embryonal malignancy of the kidney that can also present with an abdominal
mass. Sarcomas of the extremities are more likely to occur in older children.
An adolescent presenting for a pre-college physical describes herself as a sexually active lesbian.
Which is the MOST immediate action?
A. assess for potential psychosocial difficulties
B. ensure human papilloma virus vaccination is up-to-date
,2|Page
C. provide confidential and nonjudgmental care
D. counsel about sexually transmitted infections and contraception
D. counsel about sexually transmitted infections and contraception
Adolescent lesbian and bisexual females are more likely to have been pregnant when compared
to their heterosexual peers
LGB adolescents and young adults are at greater risk for unplanned pregnancy and, it is
important to counsel about accidental pregnancy even with females who have sex with females.
Providing sexual and reproductive health education that includes information about abstinence,
contraception, and sexually transmitted infections (STIs) is necessary for all adolescents and
young adults. Additionally, information about contraception should be offered to all females
regardless of their sexual orientation.
Pre-college visits present an excellent opportunity to ensure that all immunizations are current,
not just the human papilloma virus vaccine. Adolescents and young adults, including those who
know or are unsure about their sexuality, may have psychosocial concerns. Providing care that is
confidential, current, factual, and nonjudgmental is required with all patients, regardless of their
sexual orientation.
While some characteristics of an Individualized Education Plan (IEP) and 504 Plan are similar,
the IEP differs in that it uniquely requires
A. a specific medical diagnosis for eligibility.
B. a modification in curriculum to meet the student's needs.
C. an evaluation typically completed through school system resources.
D. a written plan be developed that specifies individualized accommodations.
B. a modification in curriculum to meet the student's needs.
Eligibility for both plans requires a medical diagnosis. For a 504 Plan, this can be any
psychologic or physical disorder which "substantially limits" the individual's learning. These
children can follow the curriculum without modification but may require assistance in the school
setting. This may include conditions such as ADHD, diabetes, or migraines.
In order to be eligible for an IEP, a child has to also have a medical diagnosis, but that diagnosis
must specifically meet criteria as a qualifying disability that seriously affects learning or
behavior and, therefore, requires modification of the school curriculum.
Both a 504 and an IEP require evaluation, although the evaluation for an IEP is more formalized
and is typically completed by a team of professionals. Both an IEP and a 504 plan will include a
written plan. There are no legal requirements for what is included in a 504 plan and there is no
mandated re-evaluation. An IEP has very specific criteria and must describe the specific learning
problems, detail what services will be provided, set annual goals and define how progress will be
measured. Re-evaluation is mandated every 3 years.
,3|Page
When used in treatment of acne vulgaris, topical retinoids act to
A. normalize desquamation of the follicular epithelium.
B. minimize development of antibiotic-resistant Cutibacterium
acnes (formerly Propionibacterium acnes).
C. generate free radicals to oxidize proteins in the cell wall of Cutibacterium acnes.
D. work within the cell ribosomes to alter upstream signals affecting inflammatory pathways.
A. normalize desquamation of the follicular epithelium.
The therapeutic objectives in the management of acne vulgaris are to reduce sebum production,
prevent formation of microcomedones, suppress Cutibacterium
acnes (formerly Propionibacterium acnes), and reduce inflammation to prevent scarring.
Topical retinoids, vitamin A derivatives that bind to retinoid receptors in the skin, are a key
component of primary acne management. Topical retinoids normalize desquamation of the
follicular epithelium to prevent new formation of microcomedones, the precursors of both
comedonal and inflammatory lesions. Additionally, retinoids promote clearing of existing
microcomedones and work within the nucleus to alter downstream signals that affect
inflammatory pathways.
A caregiver expresses concern for her 12 month old’s lack of interest in playing with other
children, especially due to a family history of autism spectrum disorder. Which of the following
is the MOST appropriate next step?
A. suggest the caregiver attempt to engage the child in imitating behaviors
B. screen for social interactions such as peek-a-boo and pat-a-cake
C. offer reassurance that interactive play begins at age 3
D. refer for a developmental evaluation
C. offer reassurance that interactive play begins at age 3
A caregiver who is primarily Spanish-speaking reports during a visit that her 24 month old is
bilingual and speaks four words. Which of the following is the BEST initial management?
A. refer to a pediatric speech pathologist with access to translators
B. encourage caregiver to choose one language for communication
C. advise the caregiver to read to the child daily
D. refer to audiology for a hearing evaluation
A. refer to a pediatric speech pathologist with access to translators
, 4|Page
At two years of age a child should be speaking short phrases of two to three words with a
vocabulary of about 50 words, of which 25% are intelligible to strangers. Children from bilingual
homes or who are bilingual tend to develop language more slowly, mixing words and phrases
from the two languages; however, milestones should continue to fall within expected ranges.
Bilingual children with significant delays in vocabulary require the same evaluation as
monolingual children with language delays.
Appropriate instruction for a young adolescent male considering strength training to enhance
muscle mass includes that
A. workouts should focus on 1-2 muscle groups on any exercise day.
B. powerlifting should be delayed until later in reproductive maturation.
C. strength training should occur at least five times a week to be effective.
D. other forms of exercise should be avoided on days that strength training is done.
B. powerlifting should be delayed until later in reproductive maturation.
Powerlifting should be avoided in prepubescent children due to possible injury to long bones and
growth plates as well as the back.
A school-age child is seen for a skin rash that began about 6 weeks ago along with bilateral
limping, and a recent 2-week history of fever. Examination reveals inflammation of knee joints.
Which is the MOST likely diagnosis?
A. Acute rheumatic fever
B. dermatomyositis
C. systemic juvenile idiopathic arthritis
D. systemic lupus erythematosus
C. systemic juvenile idiopathic arthritis
Systemic JIA causes inflammation in one or more joints for 6 weeks’ duration in a child younger
than 16 years of age and is often accompanied by fatigue, inflammation of joints, skin rash, and a
high fever (103° F [39.4° C] or higher) that lasts at least 2 weeks. Pericarditis, pleuritis, anemia,
or enlargement of lymph nodes, liver or the spleen may also occur.
Systemic lupus erythematosus (SLE) is a chronic systemic rheumatic disease. Symptoms include
fatigue, skin rashes, fever, and joint involvement with non-deforming arthritis but with effusion
and tenderness. SLE can involve many organ systems (kidney, skin, blood cells, and nervous
system). A malar rash across the cheeks and bridge of the nose in the shape of a butterfly is seen
in 95% of SLE cases.
