Pediatric NP Exam Practice Questions
and Answers
The mother of a newborn brings the baby to the clinic because she is afraid something
is wrong with her baby ("his head is so big"). The PNP responds that:
a. "this is normal. The head of a newborn is proportionately large to the rest of the body"
b. "Yes, this does appear abnormal. I will make an appointment for the baby to be seen
by a neurologist."
d. "your head appears large so it is probably genetic." - ANSWER-a
A healthy 12yo female is at the clinic for a well checkup. On physical examination, a
marked elevation of the right scapula and right thoracic hump and spinal curve
abnormally are noted. Spinal films indicate 20 degree curve. The PNP should:
a. refer the patient to an orthopedist
b. monitor the patient every 3 mo until menarche
c. refer the patient for physical therapy
d. recommend bedrest and back brace - ANSWER-a
What is the % of risk an autosomal dominant gene is being passed on to each
offspring?
a. 25
b. 50
c. 100
d. none - ANSWER-b
A 13yo female is at the clinic for a routine check up. What presenting symptoms might
alert the PNP to the presence of a possible genetic disorder?
a. <10% on growth chart, Tanner I, and learning difficulties
b. Precocious puberty, developmental delays, gifted piano player
c. Lactose intolerance, frequent ear infections, speech delays
d. Peanut allergy, right-sided weakness, and exhibits bullying behavior - ANSWER-a
The parents of a son with hemophilia are considering another pregnancy. The mother
has been identified as a carrier of the hemophilia gene. What chance does each female
offspring have of having hemophilia.
a. 100%
b. 50%
c. 25%
d. none - ANSWER-d
,An adolescent is being seen at a community health center because of recurrent
respiratory tract infections. The complete blood cell count (CBC) with differential shows
a white blood cell count of 20,500 with 35% blast cells. The next step in managing the
adolescent's care is to:
A) Repeat the CBC with differential in 1 week
B) Refer to a specialist in pediatric hematology
C) Perform bone marrow aspiration
D) Hospitalize the adolescent immediately - ANSWER-b
A 9-month-old infant was diagnosed with sickle cell disease shortly after birth. The
mother telephones the PNP to report that the infant has a fever of 103.2°F. The best
response to the mother is:
A) "Take the infant to the emergency room immediately."
B) "Administer a dose of ibuprofen, and call back in 6 hours if the fever continues."
C) "Give extra fluids and acetaminophen, and call back tomorrow if the fever continues."
D) "Give extra fluids and acetaminophen, and bring the infant to the clinic tomorrow
morning." - ANSWER-a
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 - ANSWER-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 - ANSWER-c
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 - ANSWER-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 - ANSWER-b
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 - ANSWER-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
B) The infant should be evaluated for other anomalies of the upper urinary tract
C) The infant should be assessed for undescended testes and inguinal hernia
D) Routine circumcision should be performed by 6 weeks of age - ANSWER-c
A 2-month-old infant is brought to clinic with a stuffy, runny nose of 3 days' duration.
The infant is afebrile and has no cough or respiratory difficulty but is not nursing or
sleeping well. The tympanic membranes are within normal limits. What advice would the
PNP give?
A) Administer amoxicillin suspension 125 mg/5 mL, 1 tsp three times a day for 10 days
B) Elevate the head of the bed, administer saline nose drops, and use a room humidifier
C) Investigate allergic overload in the home; administer amoxicillin and Neosynephrine
nose drops
D) Change the infant's formula to a soy-based formula - ANSWER-b
A 2-year-old child is brought to the clinic with a 2-day history of a harsh, predominantly
nocturnal cough, fever of 100°F, and clear rhinorrhea. The child is diagnosed with
croup. Which of the following would the PNP tell the parent?
A) "The cold symptoms should be gone in 3 days."
B) "If the child is unable to swallow and begins to drool, call the office."
C) "A high fever is normal for the first 2 days of a cold."
, D) "An antibiotic needs to be prescribed." - ANSWER-b
A mother calls the office and asks what she can do to decrease the discomfort her 9-
year-old child is experiencing with an upper respiratory tract infection. The mother
should be instructed to:
A) Administer pseudoephedrine and normal saline nose drops
B) Administer normal saline nose drops and benzonatate
C) Place a cool-mist humidifier in the child's room, and administer benzonatate
D) Administer dextromethorphan and normal saline nose drops - ANSWER-a
The mother of a 10-week-old calls the office because the infant is passing hard stools.
What suggestions would the PNP offer a mother?
A) "Do nothing. Time will take care of the problem."
B) "Hold the infant upright so gravity can help the stool pass."
C) "Give a little extra water with added pasteurized apple or prune juice."
D) "Add honey to a 4-oz bottle of water." - ANSWER-c
The PNP returns a phone call to the mother of a 2-week-old infant. The infant is
breastfed exclusively and at the 1-week checkup weighed 4 oz more than at birth. The
infant has not had a bowel movement in 4 days but has had more than eight wet
diapers each day, is nursing vigorously, and has no signs or symptoms of illness.
Appropriate counseling for this mother should include:
A) Because there has been no bowel movement in 4 days, a glycerin suppository
should be administered
B) Rectal stimulation should be performed every hour until a bowel movement is
produced
C) No treatment is necessary; the mother should be reassured only
D) The infant should be evaluated in the gastroenterology clinic - ANSWER-c
While examining a 3-year-old child for a well-child visit, labial adhesions are noted. The
PNP discusses with the mother:
A) Concern of sexual abuse
B) Proper hygiene
C) Causes of UTI
D) Surgical treatment of the adhesions - ANSWER-b
In providing anticipatory guidance to the parents of a 5-year-old child with diabetes, the
PNP should teach them to recognize the symptoms of sweating, hunger, drowsiness,
and confusion. These are all symptoms of:
A) Diabetic ketoacidosis
B) The dawn phenomenon
C) Hypoglycemia
D) The Somogyi phenomenon - ANSWER-c
A PNP has been asked by the emergency room physician to evaluate a child for
costochondritis. The PNP would expect to find:
and Answers
The mother of a newborn brings the baby to the clinic because she is afraid something
is wrong with her baby ("his head is so big"). The PNP responds that:
a. "this is normal. The head of a newborn is proportionately large to the rest of the body"
b. "Yes, this does appear abnormal. I will make an appointment for the baby to be seen
by a neurologist."
d. "your head appears large so it is probably genetic." - ANSWER-a
A healthy 12yo female is at the clinic for a well checkup. On physical examination, a
marked elevation of the right scapula and right thoracic hump and spinal curve
abnormally are noted. Spinal films indicate 20 degree curve. The PNP should:
a. refer the patient to an orthopedist
b. monitor the patient every 3 mo until menarche
c. refer the patient for physical therapy
d. recommend bedrest and back brace - ANSWER-a
What is the % of risk an autosomal dominant gene is being passed on to each
offspring?
a. 25
b. 50
c. 100
d. none - ANSWER-b
A 13yo female is at the clinic for a routine check up. What presenting symptoms might
alert the PNP to the presence of a possible genetic disorder?
a. <10% on growth chart, Tanner I, and learning difficulties
b. Precocious puberty, developmental delays, gifted piano player
c. Lactose intolerance, frequent ear infections, speech delays
d. Peanut allergy, right-sided weakness, and exhibits bullying behavior - ANSWER-a
The parents of a son with hemophilia are considering another pregnancy. The mother
has been identified as a carrier of the hemophilia gene. What chance does each female
offspring have of having hemophilia.
a. 100%
b. 50%
c. 25%
d. none - ANSWER-d
,An adolescent is being seen at a community health center because of recurrent
respiratory tract infections. The complete blood cell count (CBC) with differential shows
a white blood cell count of 20,500 with 35% blast cells. The next step in managing the
adolescent's care is to:
A) Repeat the CBC with differential in 1 week
B) Refer to a specialist in pediatric hematology
C) Perform bone marrow aspiration
D) Hospitalize the adolescent immediately - ANSWER-b
A 9-month-old infant was diagnosed with sickle cell disease shortly after birth. The
mother telephones the PNP to report that the infant has a fever of 103.2°F. The best
response to the mother is:
A) "Take the infant to the emergency room immediately."
B) "Administer a dose of ibuprofen, and call back in 6 hours if the fever continues."
C) "Give extra fluids and acetaminophen, and call back tomorrow if the fever continues."
D) "Give extra fluids and acetaminophen, and bring the infant to the clinic tomorrow
morning." - ANSWER-a
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 - ANSWER-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 - ANSWER-c
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 - ANSWER-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 - ANSWER-b
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 - ANSWER-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
B) The infant should be evaluated for other anomalies of the upper urinary tract
C) The infant should be assessed for undescended testes and inguinal hernia
D) Routine circumcision should be performed by 6 weeks of age - ANSWER-c
A 2-month-old infant is brought to clinic with a stuffy, runny nose of 3 days' duration.
The infant is afebrile and has no cough or respiratory difficulty but is not nursing or
sleeping well. The tympanic membranes are within normal limits. What advice would the
PNP give?
A) Administer amoxicillin suspension 125 mg/5 mL, 1 tsp three times a day for 10 days
B) Elevate the head of the bed, administer saline nose drops, and use a room humidifier
C) Investigate allergic overload in the home; administer amoxicillin and Neosynephrine
nose drops
D) Change the infant's formula to a soy-based formula - ANSWER-b
A 2-year-old child is brought to the clinic with a 2-day history of a harsh, predominantly
nocturnal cough, fever of 100°F, and clear rhinorrhea. The child is diagnosed with
croup. Which of the following would the PNP tell the parent?
A) "The cold symptoms should be gone in 3 days."
B) "If the child is unable to swallow and begins to drool, call the office."
C) "A high fever is normal for the first 2 days of a cold."
, D) "An antibiotic needs to be prescribed." - ANSWER-b
A mother calls the office and asks what she can do to decrease the discomfort her 9-
year-old child is experiencing with an upper respiratory tract infection. The mother
should be instructed to:
A) Administer pseudoephedrine and normal saline nose drops
B) Administer normal saline nose drops and benzonatate
C) Place a cool-mist humidifier in the child's room, and administer benzonatate
D) Administer dextromethorphan and normal saline nose drops - ANSWER-a
The mother of a 10-week-old calls the office because the infant is passing hard stools.
What suggestions would the PNP offer a mother?
A) "Do nothing. Time will take care of the problem."
B) "Hold the infant upright so gravity can help the stool pass."
C) "Give a little extra water with added pasteurized apple or prune juice."
D) "Add honey to a 4-oz bottle of water." - ANSWER-c
The PNP returns a phone call to the mother of a 2-week-old infant. The infant is
breastfed exclusively and at the 1-week checkup weighed 4 oz more than at birth. The
infant has not had a bowel movement in 4 days but has had more than eight wet
diapers each day, is nursing vigorously, and has no signs or symptoms of illness.
Appropriate counseling for this mother should include:
A) Because there has been no bowel movement in 4 days, a glycerin suppository
should be administered
B) Rectal stimulation should be performed every hour until a bowel movement is
produced
C) No treatment is necessary; the mother should be reassured only
D) The infant should be evaluated in the gastroenterology clinic - ANSWER-c
While examining a 3-year-old child for a well-child visit, labial adhesions are noted. The
PNP discusses with the mother:
A) Concern of sexual abuse
B) Proper hygiene
C) Causes of UTI
D) Surgical treatment of the adhesions - ANSWER-b
In providing anticipatory guidance to the parents of a 5-year-old child with diabetes, the
PNP should teach them to recognize the symptoms of sweating, hunger, drowsiness,
and confusion. These are all symptoms of:
A) Diabetic ketoacidosis
B) The dawn phenomenon
C) Hypoglycemia
D) The Somogyi phenomenon - ANSWER-c
A PNP has been asked by the emergency room physician to evaluate a child for
costochondritis. The PNP would expect to find:
