PNCB EXAM 200 ACTUAL QUESTIONS AND CORRECT
VERIFIED ANSWERS WITH RATIONALE ALREADY
GRADED A+ LATEST UPDATE 2026-2027
The Pediatric Nursing Certification Board (PNCB) Certified Pediatric Nurse
(CPN) exam is a nationally recognized certification for registered nurses who
demonstrate specialized knowledge and expertise in pediatric nursing.
Content is organized into four domains: Health Promotion (23%), Assessment
(35%), Planning and Management (33%), and Professional Responsibilities
(9%). Candidates must hold an active RN license and have completed at least
1,800 hours of pediatric nursing experience within the previous 24 months.
The exam is offered at PSI testing centers nationwide and via live remote
proctoring, with a passing scaled score of 500 or higher on a 200-800 scale.
1. A 4-year-old child is brought to the pediatric clinic for a well-child visit. The
parent expresses concern because the child stutters when speaking. Which response
by the nurse is most appropriate?
A) Refer the child immediately to a speech therapist for evaluation
B) Tell the parent that stuttering at this age is usually normal and often resolves
spontaneously
C) Ask the parent to correct the child each time stuttering occurs
D) Schedule a hearing test to rule out auditory processing disorder
Correct Answer: B
Rationale: Stuttering or dysfluency is common in children between ages 2 and 5 as
language skills develop rapidly. Most children outgrow this phase without
intervention. The nurse should reassure the parent while providing guidance on
how to respond to the child's stuttering, such as speaking slowly and not
interrupting. Immediate referral is unnecessary unless stuttering persists beyond
age 5 or is accompanied by other signs such as tension or avoidance of speaking.
2. The Pediatric Nursing Certification Board (PNCB) Certified Pediatric Nurse
(CPN) exam consists of 175 multiple-choice questions, of which 150 are scored
and 25 are unscored pretest questions. Candidates are given 3 hours to complete
the exam, which is offered at PSI testing centers or via live remote proctoring. The
,exam content is divided into four domains: Health Promotion (23%), Assessment
(35%), Planning and Management (33%), and Professional Responsibilities (9%).
Correct Answer: This is an informational statement, not a question.
Rationale: This provides an overview of the CPN exam structure and content
distribution.
3. A nurse is performing a developmental assessment on a 4-year-old child. Which
finding would the nurse identify as a typical developmental milestone for this age?
A) Tying shoelaces independently
B) Riding a tricycle
C) Using scissors to cut out a picture
D) Printing their first name
Correct Answer: B
Rationale: By age 4, children typically can ride a tricycle, hop on one foot, and use
scissors to cut along a line. Tying shoelaces and printing first names usually
develop around age 5-6. Using scissors to cut out a picture is more typical at age 5.
4. A 2-month-old infant is brought to the clinic for routine immunizations. The
parent asks about the recommended immunization schedule. Which vaccine should
the nurse administer at this visit?
A) MMR (measles, mumps, rubella)
B) DTaP (diphtheria, tetanus, acellular pertussis)
C) Varicella (chickenpox)
D) Hepatitis A
Correct Answer: B
Rationale: The first dose of DTaP is given at 2 months of age, along with IPV, Hib,
PCV, and RV. MMR and varicella are given at 12-15 months; Hepatitis A is given
at 12 months and again at 18-24 months.
5. A school-age child with asthma is being discharged. The nurse is teaching the
parent about triggers. Which of the following is the most common trigger for an
asthma exacerbation in children?
A) Exercise
B) Respiratory infections (viral)
C) Dust mites
D) Pet dander
Correct Answer: B
Rationale: Viral respiratory infections are the most common triggers for asthma
exacerbations in children, especially in school-age children. Exercise, dust mites,
and pet dander are also triggers but are not as common as viral infections.
,6. A 6-month-old infant is brought to the emergency department with fever and
irritability. The nurse notes a bulging fontanel. Which condition should the nurse
suspect first?
A) Otitis media
B) Meningitis
C) Teething
D) Urinary tract infection
Correct Answer: B
Rationale: A bulging fontanel in an infant, especially with fever and irritability, is a
classic sign of increased intracranial pressure and should raise suspicion for
meningitis or encephalitis. Urgent evaluation is required.
7. A nurse is assessing a child with suspected appendicitis. Which finding is most
consistent with this diagnosis?
A) Pain that is relieved by eating
B) Pain that migrates from the periumbilical area to the right lower quadrant
C) Pain that is worse with flexion of the right hip
D) Diffuse abdominal pain with guarding
Correct Answer: B
Rationale: The classic presentation of appendicitis in children is periumbilical pain
that later migrates to the right lower quadrant (McBurney's point). Pain is
worsened by movement and coughing. Flexion of the hip may relieve pain due to
psoas muscle irritation.
8. A 10-year-old child is prescribed amoxicillin for strep throat. The parent asks
the nurse about potential side effects. Which side effect should the nurse
emphasize as requiring immediate medical attention?
A) Diarrhea
B) Rash
C) Nausea
D) Headache
Correct Answer: B
Rationale: A rash occurring after administration of amoxicillin or any penicillin-
class antibiotic may indicate a hypersensitivity reaction. While diarrhea, nausea,
and headache are possible side effects, a rash can be a sign of an allergic reaction
requiring immediate discontinuation and medical evaluation.
9. A nurse is educating parents about preventing sudden infant death syndrome
(SIDS). Which recommendation is most important?
, A) Place the infant on the back to sleep
B) Use a firm mattress with soft bedding
C) Keep the room temperature above 75°F
D) Allow the infant to sleep with a soft toy for comfort
Correct Answer: A
Rationale: The American Academy of Pediatrics recommends placing infants on
their backs for every sleep to reduce the risk of SIDS. Soft bedding, overheating,
and soft toys increase the risk.
10. A 16-year-old adolescent is brought to the clinic with fatigue, weight loss, and
polyuria. The nurse suspects type 1 diabetes. Which laboratory finding would
confirm this diagnosis?
A) Fasting blood glucose of 95 mg/dL
B) Hemoglobin A1c of 5.2%
C) Random blood glucose of 250 mg/dL
D) Presence of ketones in the urine
Correct Answer: C
Rationale: A random blood glucose of 200 mg/dL or higher, accompanied by
classic symptoms (polyuria, polydipsia, weight loss), confirms diabetes. Fasting
glucose of 95 mg/dL and A1c of 5.2% are normal. Ketones in urine suggest
diabetic ketoacidosis but are not diagnostic alone.
11. A nurse is assessing a 9-month-old infant for developmental milestones. Which
finding would be a cause for concern?
A) Sitting without support
B) Crawling
C) Pincer grasp
D) Not yet walking independently
Correct Answer: D
Rationale: Most infants begin walking independently between 12 and 15 months.
Sitting without support, crawling, and pincer grasp are expected by 9 months.
Absence of walking at 9 months is not concerning.
12. A child is admitted with acute gastroenteritis and is receiving IV fluids. Which
assessment finding indicates that rehydration therapy is effective?
A) Heart rate 150 bpm (baseline 110)
B) Urine output of 1 mL/kg/hour
C) Weight loss of 5% from admission
D) Dry mucous membranes
Correct Answer: B
VERIFIED ANSWERS WITH RATIONALE ALREADY
GRADED A+ LATEST UPDATE 2026-2027
The Pediatric Nursing Certification Board (PNCB) Certified Pediatric Nurse
(CPN) exam is a nationally recognized certification for registered nurses who
demonstrate specialized knowledge and expertise in pediatric nursing.
Content is organized into four domains: Health Promotion (23%), Assessment
(35%), Planning and Management (33%), and Professional Responsibilities
(9%). Candidates must hold an active RN license and have completed at least
1,800 hours of pediatric nursing experience within the previous 24 months.
The exam is offered at PSI testing centers nationwide and via live remote
proctoring, with a passing scaled score of 500 or higher on a 200-800 scale.
1. A 4-year-old child is brought to the pediatric clinic for a well-child visit. The
parent expresses concern because the child stutters when speaking. Which response
by the nurse is most appropriate?
A) Refer the child immediately to a speech therapist for evaluation
B) Tell the parent that stuttering at this age is usually normal and often resolves
spontaneously
C) Ask the parent to correct the child each time stuttering occurs
D) Schedule a hearing test to rule out auditory processing disorder
Correct Answer: B
Rationale: Stuttering or dysfluency is common in children between ages 2 and 5 as
language skills develop rapidly. Most children outgrow this phase without
intervention. The nurse should reassure the parent while providing guidance on
how to respond to the child's stuttering, such as speaking slowly and not
interrupting. Immediate referral is unnecessary unless stuttering persists beyond
age 5 or is accompanied by other signs such as tension or avoidance of speaking.
2. The Pediatric Nursing Certification Board (PNCB) Certified Pediatric Nurse
(CPN) exam consists of 175 multiple-choice questions, of which 150 are scored
and 25 are unscored pretest questions. Candidates are given 3 hours to complete
the exam, which is offered at PSI testing centers or via live remote proctoring. The
,exam content is divided into four domains: Health Promotion (23%), Assessment
(35%), Planning and Management (33%), and Professional Responsibilities (9%).
Correct Answer: This is an informational statement, not a question.
Rationale: This provides an overview of the CPN exam structure and content
distribution.
3. A nurse is performing a developmental assessment on a 4-year-old child. Which
finding would the nurse identify as a typical developmental milestone for this age?
A) Tying shoelaces independently
B) Riding a tricycle
C) Using scissors to cut out a picture
D) Printing their first name
Correct Answer: B
Rationale: By age 4, children typically can ride a tricycle, hop on one foot, and use
scissors to cut along a line. Tying shoelaces and printing first names usually
develop around age 5-6. Using scissors to cut out a picture is more typical at age 5.
4. A 2-month-old infant is brought to the clinic for routine immunizations. The
parent asks about the recommended immunization schedule. Which vaccine should
the nurse administer at this visit?
A) MMR (measles, mumps, rubella)
B) DTaP (diphtheria, tetanus, acellular pertussis)
C) Varicella (chickenpox)
D) Hepatitis A
Correct Answer: B
Rationale: The first dose of DTaP is given at 2 months of age, along with IPV, Hib,
PCV, and RV. MMR and varicella are given at 12-15 months; Hepatitis A is given
at 12 months and again at 18-24 months.
5. A school-age child with asthma is being discharged. The nurse is teaching the
parent about triggers. Which of the following is the most common trigger for an
asthma exacerbation in children?
A) Exercise
B) Respiratory infections (viral)
C) Dust mites
D) Pet dander
Correct Answer: B
Rationale: Viral respiratory infections are the most common triggers for asthma
exacerbations in children, especially in school-age children. Exercise, dust mites,
and pet dander are also triggers but are not as common as viral infections.
,6. A 6-month-old infant is brought to the emergency department with fever and
irritability. The nurse notes a bulging fontanel. Which condition should the nurse
suspect first?
A) Otitis media
B) Meningitis
C) Teething
D) Urinary tract infection
Correct Answer: B
Rationale: A bulging fontanel in an infant, especially with fever and irritability, is a
classic sign of increased intracranial pressure and should raise suspicion for
meningitis or encephalitis. Urgent evaluation is required.
7. A nurse is assessing a child with suspected appendicitis. Which finding is most
consistent with this diagnosis?
A) Pain that is relieved by eating
B) Pain that migrates from the periumbilical area to the right lower quadrant
C) Pain that is worse with flexion of the right hip
D) Diffuse abdominal pain with guarding
Correct Answer: B
Rationale: The classic presentation of appendicitis in children is periumbilical pain
that later migrates to the right lower quadrant (McBurney's point). Pain is
worsened by movement and coughing. Flexion of the hip may relieve pain due to
psoas muscle irritation.
8. A 10-year-old child is prescribed amoxicillin for strep throat. The parent asks
the nurse about potential side effects. Which side effect should the nurse
emphasize as requiring immediate medical attention?
A) Diarrhea
B) Rash
C) Nausea
D) Headache
Correct Answer: B
Rationale: A rash occurring after administration of amoxicillin or any penicillin-
class antibiotic may indicate a hypersensitivity reaction. While diarrhea, nausea,
and headache are possible side effects, a rash can be a sign of an allergic reaction
requiring immediate discontinuation and medical evaluation.
9. A nurse is educating parents about preventing sudden infant death syndrome
(SIDS). Which recommendation is most important?
, A) Place the infant on the back to sleep
B) Use a firm mattress with soft bedding
C) Keep the room temperature above 75°F
D) Allow the infant to sleep with a soft toy for comfort
Correct Answer: A
Rationale: The American Academy of Pediatrics recommends placing infants on
their backs for every sleep to reduce the risk of SIDS. Soft bedding, overheating,
and soft toys increase the risk.
10. A 16-year-old adolescent is brought to the clinic with fatigue, weight loss, and
polyuria. The nurse suspects type 1 diabetes. Which laboratory finding would
confirm this diagnosis?
A) Fasting blood glucose of 95 mg/dL
B) Hemoglobin A1c of 5.2%
C) Random blood glucose of 250 mg/dL
D) Presence of ketones in the urine
Correct Answer: C
Rationale: A random blood glucose of 200 mg/dL or higher, accompanied by
classic symptoms (polyuria, polydipsia, weight loss), confirms diabetes. Fasting
glucose of 95 mg/dL and A1c of 5.2% are normal. Ketones in urine suggest
diabetic ketoacidosis but are not diagnostic alone.
11. A nurse is assessing a 9-month-old infant for developmental milestones. Which
finding would be a cause for concern?
A) Sitting without support
B) Crawling
C) Pincer grasp
D) Not yet walking independently
Correct Answer: D
Rationale: Most infants begin walking independently between 12 and 15 months.
Sitting without support, crawling, and pincer grasp are expected by 9 months.
Absence of walking at 9 months is not concerning.
12. A child is admitted with acute gastroenteritis and is receiving IV fluids. Which
assessment finding indicates that rehydration therapy is effective?
A) Heart rate 150 bpm (baseline 110)
B) Urine output of 1 mL/kg/hour
C) Weight loss of 5% from admission
D) Dry mucous membranes
Correct Answer: B
