PNCB Acute Care questions Actual Exam
PNCB ACUTE CARE QUESTIONS ACTUAL EXAM NEWEST
2025/2026 COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES |ALREADY GRADED A+||ALREADY
GRADED A+
A newborn female whose weight and length are between the 2nd and 10th
percentile, respectively, for gestational age has significant pedal edema, a low
hairline, and loose skinfolds at the nape of the neck. Which screening test is MOST
appropriate?
A. ACTH stimulation test
B. Contrast enema
C. Echocardiogram
D. Head ultrasound - ANSWER-C. Echocardiogram
The symptoms are characteristic of Turner syndrome. Many infants who have
Turner syndrome exhibit a low birth weight and decreased length. Cardiac defects
are commonly associated with Turner syndrome, and a comprehensive
cardiovascular evaluation including echocardiography and consultation with a
cardiologist specializing in congenital heart defects should be done. The most
common cardiac defects occurring in females with Turner syndrome include
bicuspid aortic valve, ascending aortic dilatation, coarctation of the aorta, and
partial anomalous pulmonary venous return.
Turner syndrome is not known to be associated with intracranial, adrenal, or
gastrointestinal anomalies.
Following a motor vehicle collision, an adolescent presents with hemoptysis,
tachypnea, and a pulse oximetry (SpO2) reading of 85% on a non-rebreather
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, PNCB Acute Care questions Actual Exam
mask. Chest radiograph reveals right upper and middle lobe consolidations with
subcutaneous emphysema. Following intubation, initial oxygenation index (OI) is
15.
The MOST appropriate ventilator management strategy includes permissive
hypercapnia and:
A. TV of 6-8 ml/kg & PaO2 of 55-80 mmHg
B. TV of 6-8 ml/kg & PaO2 of 70-95 mmHg
C. TV of 9-10 ml/kg & PaO2 of 55-80 mmHg
D. TV of 9-10 ml/kg & PaO2 of 70-95 mmHg - ANSWER-A. TV of 6-8 ml/kg & PaO2
of 55-80 mmHg
Diagnosis is pulmonary contusion AMB hemoptysis, respiratory distress, and
hypoxia, with subcutaneous emphysema and consolidation on CXR .
Management includes targeting low tidal volumes (6-8mL/kg), permissive
hypercapnia, and titration of PEEP and FiO2 to maintain lower oxygenation goals
(PaO2 55-80 mmHg) to prevent oxygen toxicity.
An afebrile school-age child presents with a painful, erythematous, fluctuant
lesion on the arm that measures 1.5 cm in diameter. Appropriate treatment
includes:
A. Topical antibiotic ointment & covering lesion with a dressing
B. Empiric PO antibiotics with office f/u in a week
C. Washing daily with soap and water and keeping dry
D. Incision & drainage with Gram stain of fluid - ANSWER-D. Incision & drainage
with Gram stain of fluid
2|Page
, PNCB Acute Care questions Actual Exam
For purulent skin soft tissue infections, I&D is indicated, specifically in mild cases
lacking systemic symptoms. Sending the drainage for Gram stain and culture is
recommended. The choice to prescribe antibiotics for S. aureus should be limited
to those patients with moderate to severe purulent infections with symptoms of
SIRS, such as fever, tachypnea, tachycardia, or WBC count elevated over 12,000, or
for any patient with a nonpurulent skin infection such as cellulitis, necrotizing
fasciitis, or erysipelas.
Antibiotics should be considered for children with impairment of host defenses,
such as those who are immunocompromised. If antibiotics are prescribed, they
should be prescribed after I&D & f/u should occur in 48 hours to assess efficacy of
treatment.
Following I&D, simply covering the site with a dry dressing is usually the easiest
and most effective treatment. Topical antimicrobials are not recommended for the
treatment of mild skin infections
After an occurrence of nephrolithiasis, which intervention is MOST importantly
included in education provided to the adolescent and family related to long-term
prevention of this condition?
A. Taking a citrate supplement
B. Adhering to a low sodium diet
C. Taking a daily diuretic medication
D. Ensuring at least 2 liters of fluid intake daily - ANSWER-D. Ensuring at least 2
liters of fluid intake daily
Nephrolithiasis (kidney stones), are due to congenital and structural urologic
abnormalities, hypercalciuria, hyperoxaluria/oxalosis, hypocitraturia, or other
metabolic abnormalities.
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, PNCB Acute Care questions Actual Exam
Management is centered around pain control, urine culture with treatment of
concomitant UTI, and hydration. Urologic intervention such as extracorporeal
shock wave lithotripsy or percutaneous nephrolithotomy may be necessary in high
risk cases (e.g., single kidney) or cases of unrelenting pain or urinary obstruction.
Which of the following characterizes "privileging" for a new nurse practitioner
(NP)?
A. The State Board of Nursing grants the ability to practice after the NP meets
state defined criteria for safe practice
B. A hospital grants the NP the ability to practice in the institution after confirming
education, certification & licensure
C. A hospital permits the NP to perform certain procedures after successfully
demonstrating competence as determined by the institution
D. A certification board certifies the NP after successfully passing the certification
exam following validation of education & clinical requirements - ANSWER-C. A
hospital permits the NP to perform certain procedures after successfully
demonstrating competence as determined by the institution
Privileging is the authorization to provide specific services & perform certain
procedures within an institution. It is determined by the institution that hires the
practitioner. Placement of arterial lines is an example of a privileging practice.
An interprofessional team is developing an algorithm to guide the ordering of
diagnostic tests for children seen in their sub-specialty clinic. The team will review
and grade relevant literature and determine studies applicable to their clinical
setting. This approach promotes:
A. Clinical research
4|Page
PNCB ACUTE CARE QUESTIONS ACTUAL EXAM NEWEST
2025/2026 COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES |ALREADY GRADED A+||ALREADY
GRADED A+
A newborn female whose weight and length are between the 2nd and 10th
percentile, respectively, for gestational age has significant pedal edema, a low
hairline, and loose skinfolds at the nape of the neck. Which screening test is MOST
appropriate?
A. ACTH stimulation test
B. Contrast enema
C. Echocardiogram
D. Head ultrasound - ANSWER-C. Echocardiogram
The symptoms are characteristic of Turner syndrome. Many infants who have
Turner syndrome exhibit a low birth weight and decreased length. Cardiac defects
are commonly associated with Turner syndrome, and a comprehensive
cardiovascular evaluation including echocardiography and consultation with a
cardiologist specializing in congenital heart defects should be done. The most
common cardiac defects occurring in females with Turner syndrome include
bicuspid aortic valve, ascending aortic dilatation, coarctation of the aorta, and
partial anomalous pulmonary venous return.
Turner syndrome is not known to be associated with intracranial, adrenal, or
gastrointestinal anomalies.
Following a motor vehicle collision, an adolescent presents with hemoptysis,
tachypnea, and a pulse oximetry (SpO2) reading of 85% on a non-rebreather
1|Page
, PNCB Acute Care questions Actual Exam
mask. Chest radiograph reveals right upper and middle lobe consolidations with
subcutaneous emphysema. Following intubation, initial oxygenation index (OI) is
15.
The MOST appropriate ventilator management strategy includes permissive
hypercapnia and:
A. TV of 6-8 ml/kg & PaO2 of 55-80 mmHg
B. TV of 6-8 ml/kg & PaO2 of 70-95 mmHg
C. TV of 9-10 ml/kg & PaO2 of 55-80 mmHg
D. TV of 9-10 ml/kg & PaO2 of 70-95 mmHg - ANSWER-A. TV of 6-8 ml/kg & PaO2
of 55-80 mmHg
Diagnosis is pulmonary contusion AMB hemoptysis, respiratory distress, and
hypoxia, with subcutaneous emphysema and consolidation on CXR .
Management includes targeting low tidal volumes (6-8mL/kg), permissive
hypercapnia, and titration of PEEP and FiO2 to maintain lower oxygenation goals
(PaO2 55-80 mmHg) to prevent oxygen toxicity.
An afebrile school-age child presents with a painful, erythematous, fluctuant
lesion on the arm that measures 1.5 cm in diameter. Appropriate treatment
includes:
A. Topical antibiotic ointment & covering lesion with a dressing
B. Empiric PO antibiotics with office f/u in a week
C. Washing daily with soap and water and keeping dry
D. Incision & drainage with Gram stain of fluid - ANSWER-D. Incision & drainage
with Gram stain of fluid
2|Page
, PNCB Acute Care questions Actual Exam
For purulent skin soft tissue infections, I&D is indicated, specifically in mild cases
lacking systemic symptoms. Sending the drainage for Gram stain and culture is
recommended. The choice to prescribe antibiotics for S. aureus should be limited
to those patients with moderate to severe purulent infections with symptoms of
SIRS, such as fever, tachypnea, tachycardia, or WBC count elevated over 12,000, or
for any patient with a nonpurulent skin infection such as cellulitis, necrotizing
fasciitis, or erysipelas.
Antibiotics should be considered for children with impairment of host defenses,
such as those who are immunocompromised. If antibiotics are prescribed, they
should be prescribed after I&D & f/u should occur in 48 hours to assess efficacy of
treatment.
Following I&D, simply covering the site with a dry dressing is usually the easiest
and most effective treatment. Topical antimicrobials are not recommended for the
treatment of mild skin infections
After an occurrence of nephrolithiasis, which intervention is MOST importantly
included in education provided to the adolescent and family related to long-term
prevention of this condition?
A. Taking a citrate supplement
B. Adhering to a low sodium diet
C. Taking a daily diuretic medication
D. Ensuring at least 2 liters of fluid intake daily - ANSWER-D. Ensuring at least 2
liters of fluid intake daily
Nephrolithiasis (kidney stones), are due to congenital and structural urologic
abnormalities, hypercalciuria, hyperoxaluria/oxalosis, hypocitraturia, or other
metabolic abnormalities.
3|Page
, PNCB Acute Care questions Actual Exam
Management is centered around pain control, urine culture with treatment of
concomitant UTI, and hydration. Urologic intervention such as extracorporeal
shock wave lithotripsy or percutaneous nephrolithotomy may be necessary in high
risk cases (e.g., single kidney) or cases of unrelenting pain or urinary obstruction.
Which of the following characterizes "privileging" for a new nurse practitioner
(NP)?
A. The State Board of Nursing grants the ability to practice after the NP meets
state defined criteria for safe practice
B. A hospital grants the NP the ability to practice in the institution after confirming
education, certification & licensure
C. A hospital permits the NP to perform certain procedures after successfully
demonstrating competence as determined by the institution
D. A certification board certifies the NP after successfully passing the certification
exam following validation of education & clinical requirements - ANSWER-C. A
hospital permits the NP to perform certain procedures after successfully
demonstrating competence as determined by the institution
Privileging is the authorization to provide specific services & perform certain
procedures within an institution. It is determined by the institution that hires the
practitioner. Placement of arterial lines is an example of a privileging practice.
An interprofessional team is developing an algorithm to guide the ordering of
diagnostic tests for children seen in their sub-specialty clinic. The team will review
and grade relevant literature and determine studies applicable to their clinical
setting. This approach promotes:
A. Clinical research
4|Page
