PNCB CPN EXAM CERTIFICATION
TEST 2026 FULL QUESTIONS AND
ANSWERS GRADED A+
◉ Otoscope: how to straighten canal . Answer: ≥ 3 y/o: Up & back
< 3 y/o: Down & out
◉ Phenylketonuria (PKU): definition, SSx, c/b . Answer: Autosomal
recessive disorder (two carrier parents affected one child):
inability to break down amino acid phenylalanine
SSx: Musty urine odor
c/b: untreated, can lead to albinism (b/c phenylalanine can't convert
to melanin), neurologic changes (nonadherence to diet of low-
protein)
◉ Congenital Adrenal Hyperplasia: definition; SSx (x4) . Answer:
enzyme deficiency for synthesis of cortisol
SSx:
,- ambiguous genitalia
- lethargy, poor feeding/FTT
- metabolic acidosis = hyperK, hypoNa, hypoglycemia
- hypotension, hypothermia
◉ Anterior and Posterior Fontanels closures . Answer: P: 1-3mos; A:
18-24mos
◉ Erickson's 8 Stages of Psychosocial Development . Answer: 1)
INFANT: trust vs mistrust
2) TODDLER: autonomy vs shame and doubt
3) PRESCHOOL: initiative vs.guilt
4) GRADE SCHOOL: industry vs. inferiority
5) TEENAGER: identity vs role confusion.
6) YOUNG ADULT: intimacy vs isolation
7) MIDDLE AGE: generativity vs. stagnation
8) OLDER ADULT: integrity vs. despair
◉ MMR vaccine contraindication . Answer: severely compromised
◉ % of understandable language: 1-4yrs . Answer: 1 yo: 1-word
sentences, 25%
2 yo: 2-word sentences, 50%
,3 yo: 3-word sentences, 75%
4 yo: 5-6+ word sentences, 100%
◉ Laryngotracheobronchitis (Croup): common age/gender, causative
virusus, SSx (x2), Dx, Tx . Answer: 6mos- 3yrs, males>females
Parainfluenza 1&2, RSV
SSx: seal/barky cough, stridor
Dx: steeple sign
Tx: steroids (dexamethasone 0.6 mg/kg IV/IM)
◉ pneumonia: common organisms, school-age, SSx (x2), Dx, Tx .
Answer: community acquired: strep pneumoniae
school-age: atypical viral mycoplasma pneumoniae (low fever)
SSx: rales/crackles, focal diminished breath sounds
Dx: focal infiltrates on XR
, Tx: high-dose Amoxicillin or Ceftriaxone; Azithromycin (atypical
mycoplasma p.)
◉ Pertussis (whooping cough): pathophys, SSx (x2), Dx, Tx . Answer:
bacteria attaches to cilia in resp tract
→ produces toxins
→ causes inflammation and loss of surfactant
SSx:
- paroxysmal (violent/painful/uncontrollable) cough
- post-tussive emesis
Dx: pertussis PCR + Cx
Tx:
- Azithryomycin (infants)
- Bactrim (older)
- no longer: Erythromycin & Clarithromycin d/t high risk of IHPS
(infantile hypertrophic pyloric stenosis)
◉ Tracheitis & Epiglottitis similarities: organism, lateral neck XR, SSx
(x3), Tx (x2) . Answer: HFlu
Dx: present with thumb print sign on lateral neck XR
TEST 2026 FULL QUESTIONS AND
ANSWERS GRADED A+
◉ Otoscope: how to straighten canal . Answer: ≥ 3 y/o: Up & back
< 3 y/o: Down & out
◉ Phenylketonuria (PKU): definition, SSx, c/b . Answer: Autosomal
recessive disorder (two carrier parents affected one child):
inability to break down amino acid phenylalanine
SSx: Musty urine odor
c/b: untreated, can lead to albinism (b/c phenylalanine can't convert
to melanin), neurologic changes (nonadherence to diet of low-
protein)
◉ Congenital Adrenal Hyperplasia: definition; SSx (x4) . Answer:
enzyme deficiency for synthesis of cortisol
SSx:
,- ambiguous genitalia
- lethargy, poor feeding/FTT
- metabolic acidosis = hyperK, hypoNa, hypoglycemia
- hypotension, hypothermia
◉ Anterior and Posterior Fontanels closures . Answer: P: 1-3mos; A:
18-24mos
◉ Erickson's 8 Stages of Psychosocial Development . Answer: 1)
INFANT: trust vs mistrust
2) TODDLER: autonomy vs shame and doubt
3) PRESCHOOL: initiative vs.guilt
4) GRADE SCHOOL: industry vs. inferiority
5) TEENAGER: identity vs role confusion.
6) YOUNG ADULT: intimacy vs isolation
7) MIDDLE AGE: generativity vs. stagnation
8) OLDER ADULT: integrity vs. despair
◉ MMR vaccine contraindication . Answer: severely compromised
◉ % of understandable language: 1-4yrs . Answer: 1 yo: 1-word
sentences, 25%
2 yo: 2-word sentences, 50%
,3 yo: 3-word sentences, 75%
4 yo: 5-6+ word sentences, 100%
◉ Laryngotracheobronchitis (Croup): common age/gender, causative
virusus, SSx (x2), Dx, Tx . Answer: 6mos- 3yrs, males>females
Parainfluenza 1&2, RSV
SSx: seal/barky cough, stridor
Dx: steeple sign
Tx: steroids (dexamethasone 0.6 mg/kg IV/IM)
◉ pneumonia: common organisms, school-age, SSx (x2), Dx, Tx .
Answer: community acquired: strep pneumoniae
school-age: atypical viral mycoplasma pneumoniae (low fever)
SSx: rales/crackles, focal diminished breath sounds
Dx: focal infiltrates on XR
, Tx: high-dose Amoxicillin or Ceftriaxone; Azithromycin (atypical
mycoplasma p.)
◉ Pertussis (whooping cough): pathophys, SSx (x2), Dx, Tx . Answer:
bacteria attaches to cilia in resp tract
→ produces toxins
→ causes inflammation and loss of surfactant
SSx:
- paroxysmal (violent/painful/uncontrollable) cough
- post-tussive emesis
Dx: pertussis PCR + Cx
Tx:
- Azithryomycin (infants)
- Bactrim (older)
- no longer: Erythromycin & Clarithromycin d/t high risk of IHPS
(infantile hypertrophic pyloric stenosis)
◉ Tracheitis & Epiglottitis similarities: organism, lateral neck XR, SSx
(x3), Tx (x2) . Answer: HFlu
Dx: present with thumb print sign on lateral neck XR
