PNP-PC ACTUAL EXAM 2026/2027 | PNCB-Certified Content |
Verified Rationales | Primary Care | Pass Guaranteed - A+
Graded
DOMAIN 1: HEALTH PROMOTION & DISEASE PREVENTION (40 Questions) –
23%
Q1: A PNP-PC is conducting a 2-week well-child visit for a breastfed infant. The mother
asks about vitamin supplementation. Which recommendation is consistent with current
AAP guidelines?
A. No supplementation needed if infant is feeding well
B. Vitamin D 400 IU daily beginning in first few days of life [CORRECT]
C. Vitamin K supplementation until 6 months
D. Iron supplementation beginning at 2 weeks
Correct Answer: B
,Rationale: The AAP recommends vitamin D supplementation 400 IU daily for all
breastfed infants beginning in the first few days of life, continued until infant consumes
1 liter (32 oz) of vitamin D-fortified formula or milk daily. Breast milk is low in vitamin D;
deficiency causes rickets. Vitamin K is given as single injection at birth (not ongoing);
iron supplementation begins at 4 months for breastfed infants.
● Option A is incorrect because adequate feeding does not provide sufficient
vitamin D from breast milk; supplementation mandatory.
● Option C is incorrect because vitamin K is single dose at birth for bleeding
prevention; not continued.
● Option D is incorrect because iron supplementation begins at 4 months (1
mg/kg/day) for breastfed infants, not 2 weeks.
Clinical Pearl: Formula-fed infants receiving 32 oz/day of vitamin D-fortified formula do
not require additional supplementation.
Q2: [SATA] A PNP-PC is reviewing immunization records for a 6-month-old infant. Which
vaccines should have been administered according to the 2026 CDC schedule? (Select
all that apply.)
A. Hepatitis B #1 [CORRECT]
B. DTaP #2 [CORRECT]
C. IPV #2 [CORRECT]
D. MMR #1
,Correct Answer: A, B, C
Rationale: By 6 months, infant should have received: Hepatitis B #1 (birth-2 months), #2
(1-2 months); DTaP #1 (2 months), #2 (4 months); IPV #1 (2 months), #2 (4 months);
Hib #1, #2; PCV13 #1, #2; Rotavirus #1, #2; and influenza (annual, 2 doses first season
if not previously vaccinated). MMR is given at 12-15 months, not 6 months (except for
travel or outbreak situations).
● Option D is incorrect because MMR #1 is given at 12-15 months, not 6 months.
Catch-Up Scheduling: If doses missed, give next doses as soon as possible without
restarting series; minimum intervals must be observed.
Q3: A PNP-PC is evaluating growth of a 9-month-old infant. Birth weight was 7 lb 8 oz
(3.4 kg). Current weight is 16 lb (7.3 kg). Which interpretation is correct?
A. Failure to thrive requiring immediate intervention
B. Appropriate weight gain following growth curve [CORRECT]
C. Obesity risk requiring dietary intervention
D. Protein-calorie malnutrition
Correct Answer: B
, Rationale: Expected weight gain: birth weight doubles by 5-6 months, triples by 12
months. This infant (3.4 kg birth weight) should weigh approximately 6.8 kg at 6 months
and 10.2 kg at 12 months. Current weight 7.3 kg at 9 months is appropriate, following
expected growth trajectory. Plot on WHO growth chart for confirmation.
● Option A is incorrect because weight is appropriate for age; no evidence of
growth faltering.
● Option C is incorrect because 7.3 kg at 9 months is not obese; approximately
50th percentile for age.
● Option D is incorrect because no evidence of malnutrition; weight appropriate.
Growth Velocity: Infants gain 5-7 oz (140-200 g) per week in first 3 months, then
gradually decelerate; monthly weight checks important in first year.
Q4: A PNP-PC is conducting a 4-year well-child visit. Which developmental screening
tool is most appropriate for autism spectrum disorder surveillance?
A. Denver II
B. Ages and Stages Questionnaire (ASQ-3)
C. Modified Checklist for Autism in Toddlers (M-CHAT-R/F) [CORRECT]
D. Vanderbilt Assessment Scale
Correct Answer: C
Verified Rationales | Primary Care | Pass Guaranteed - A+
Graded
DOMAIN 1: HEALTH PROMOTION & DISEASE PREVENTION (40 Questions) –
23%
Q1: A PNP-PC is conducting a 2-week well-child visit for a breastfed infant. The mother
asks about vitamin supplementation. Which recommendation is consistent with current
AAP guidelines?
A. No supplementation needed if infant is feeding well
B. Vitamin D 400 IU daily beginning in first few days of life [CORRECT]
C. Vitamin K supplementation until 6 months
D. Iron supplementation beginning at 2 weeks
Correct Answer: B
,Rationale: The AAP recommends vitamin D supplementation 400 IU daily for all
breastfed infants beginning in the first few days of life, continued until infant consumes
1 liter (32 oz) of vitamin D-fortified formula or milk daily. Breast milk is low in vitamin D;
deficiency causes rickets. Vitamin K is given as single injection at birth (not ongoing);
iron supplementation begins at 4 months for breastfed infants.
● Option A is incorrect because adequate feeding does not provide sufficient
vitamin D from breast milk; supplementation mandatory.
● Option C is incorrect because vitamin K is single dose at birth for bleeding
prevention; not continued.
● Option D is incorrect because iron supplementation begins at 4 months (1
mg/kg/day) for breastfed infants, not 2 weeks.
Clinical Pearl: Formula-fed infants receiving 32 oz/day of vitamin D-fortified formula do
not require additional supplementation.
Q2: [SATA] A PNP-PC is reviewing immunization records for a 6-month-old infant. Which
vaccines should have been administered according to the 2026 CDC schedule? (Select
all that apply.)
A. Hepatitis B #1 [CORRECT]
B. DTaP #2 [CORRECT]
C. IPV #2 [CORRECT]
D. MMR #1
,Correct Answer: A, B, C
Rationale: By 6 months, infant should have received: Hepatitis B #1 (birth-2 months), #2
(1-2 months); DTaP #1 (2 months), #2 (4 months); IPV #1 (2 months), #2 (4 months);
Hib #1, #2; PCV13 #1, #2; Rotavirus #1, #2; and influenza (annual, 2 doses first season
if not previously vaccinated). MMR is given at 12-15 months, not 6 months (except for
travel or outbreak situations).
● Option D is incorrect because MMR #1 is given at 12-15 months, not 6 months.
Catch-Up Scheduling: If doses missed, give next doses as soon as possible without
restarting series; minimum intervals must be observed.
Q3: A PNP-PC is evaluating growth of a 9-month-old infant. Birth weight was 7 lb 8 oz
(3.4 kg). Current weight is 16 lb (7.3 kg). Which interpretation is correct?
A. Failure to thrive requiring immediate intervention
B. Appropriate weight gain following growth curve [CORRECT]
C. Obesity risk requiring dietary intervention
D. Protein-calorie malnutrition
Correct Answer: B
, Rationale: Expected weight gain: birth weight doubles by 5-6 months, triples by 12
months. This infant (3.4 kg birth weight) should weigh approximately 6.8 kg at 6 months
and 10.2 kg at 12 months. Current weight 7.3 kg at 9 months is appropriate, following
expected growth trajectory. Plot on WHO growth chart for confirmation.
● Option A is incorrect because weight is appropriate for age; no evidence of
growth faltering.
● Option C is incorrect because 7.3 kg at 9 months is not obese; approximately
50th percentile for age.
● Option D is incorrect because no evidence of malnutrition; weight appropriate.
Growth Velocity: Infants gain 5-7 oz (140-200 g) per week in first 3 months, then
gradually decelerate; monthly weight checks important in first year.
Q4: A PNP-PC is conducting a 4-year well-child visit. Which developmental screening
tool is most appropriate for autism spectrum disorder surveillance?
A. Denver II
B. Ages and Stages Questionnaire (ASQ-3)
C. Modified Checklist for Autism in Toddlers (M-CHAT-R/F) [CORRECT]
D. Vanderbilt Assessment Scale
Correct Answer: C
