CPNP-PC Practice Questions with
Answers & Rationales: WITH HEALTH
MAINTENANCE AND PROMOTION
COVERED ALREADY GRADED A+
DOMAIN I
1. A 4-year-old child presents for a well-child visit. The mother reports the child can hop on
one foot, draw a person with three parts, and tell a story. Which skill represents a fine motor
developmental milestone appropriate for this age?
A. Hopping on one foot
B. Drawing a person with three parts
C. Telling a story
D. All of the above
Answer: B
Rationale: At age 4, fine motor milestones include copying a cross, drawing a person with 2–4
parts, and using scissors. Hopping (A) is a gross motor milestone. Telling a story (C) is a language
milestone.
2. A 15-month-old child is brought for a well-child exam. The parent is concerned because the
child only says "mama" and "dada" and does not use other words. The child points to desired
objects, follows simple commands, and has normal hearing. What is the most appropriate
response?
A. Refer to audiology for hearing evaluation
B. Refer to speech therapy immediately
1
, C. Reassure the parent that this is normal, and reassess at 18 months
D. Order an MRI of the brain
Answer: C
Rationale: At 15 months, using 3–5 words is expected. However, the child demonstrates other
communication skills (pointing, following commands) and has normal hearing. Reassurance and
reassessment at 18 months is appropriate. A referral for speech therapy (B) may be indicated if
delays persist.
3. According to the CDC immunization schedule, which vaccines are recommended at the 2-
month well-child visit?
A. DTaP, IPV, Hib, PCV13, RV
B. DTaP, IPV, Hib, PCV13, RV, HepB
C. DTaP, IPV, Hib, MMR, Varicella
D. DTaP, IPV, Hib, PCV13, HepA
Answer: A
Rationale: At 2 months, the recommended vaccines are DTaP, IPV, Hib, PCV13, and RV. HepB (B)
is given at birth and again at 6–18 months. MMR and Varicella (C) are given at 12–15 months.
HepA (D) is given at 12–23 months.
4. A 6-month-old infant is exclusively breastfed. Which supplement is recommended for this
infant?
A. Iron
B. Vitamin D
C. Fluoride
D. Both A and B
Answer: D
Rationale: Exclusively breastfed infants should receive vitamin D supplementation (400 IU
daily) starting at birth and iron supplementation (1 mg/kg/day) starting at 4 months of age until
iron-rich complementary foods are introduced. Fluoride (C) supplementation depends on the
fluoride content of the local water supply.
5. A 2-year-old child is at risk for lead poisoning. At what age should routine lead screening
begin?
2
, A. 6 months
B. 12 months
C. 24 months
D. 36 months
Answer: B
Rationale: The CDC and AAP recommend lead screening at 12 and 24 months of age for all
children, or at least once between 12 and 24 months, especially for those at risk.
6. A 10-year-old child with a BMI at the 95th percentile is diagnosed with obesity. Which of
the following is the most appropriate first-line intervention?
A. Prescribe an appetite suppressant
B. Refer for bariatric surgery
C. Provide lifestyle counseling including nutrition and physical activity
D. Order laboratory tests for metabolic syndrome
Answer: C
Rationale: First-line management of childhood obesity includes lifestyle counseling focusing on
nutrition, physical activity, and behavior modification. Pharmacotherapy (A) and bariatric
surgery (B) are reserved for severe cases. Laboratory tests (D) may be indicated but are not the
first intervention.
7. A 16-year-old adolescent is concerned about acne. Which of the following is the most
appropriate first-line topical therapy for mild to moderate acne?
A. Benzoyl peroxide
B. Tretinoin
C. Clindamycin
D. Isotretinoin
Answer: A
Rationale: Benzoyl peroxide is a first-line topical therapy for mild to moderate acne. Tretinoin
(B) is for comedonal acne. Clindamycin (C) is a topical antibiotic. Isotretinoin (D) is for severe,
refractory acne.
8. A parent asks about the appropriate age to introduce peanut-containing foods to an infant.
What is the current recommendation?
3
, A. Avoid peanuts until 3 years of age
B. Introduce peanuts at 4–6 months for high-risk infants
C. Introduce peanuts at 12 months for all infants
D. Avoid peanuts if there is a family history of allergy
Answer: B
Rationale: Current guidelines recommend introducing peanut-containing foods at 4–6
months for infants at high risk of peanut allergy (severe eczema, egg allergy), after evaluation by
a provider. For low-risk infants, peanuts can be introduced with other complementary foods
around 6 months.
9. A 5-year-old child is brought in for a school physical. The child has a history of asthma.
Which of the following immunizations is contraindicated in a child with a true egg allergy?
A. MMR
B. Influenza vaccine
C. DTaP
D. Varicella
Answer: A
Rationale: The MMR vaccine is grown in chick embryo cell culture and contains trace amounts
of egg protein. However, severe allergic reactions are rare, and MMR can be given to children
with egg allergy. The influenza vaccine (B) is also safe for children with egg allergy per current
ACIP guidelines.
10. A 14-year-old adolescent is being screened for depression. Which screening tool is most
appropriate for this age group?
A. PHQ-2
B. PHQ-9
C. GAD-7
D. CAGE questionnaire
Answer: B
Rationale: The PHQ-9 is a validated screening tool for depression in adolescents. The PHQ-2 (A)
is a brief screener. The GAD-7 (C) screens for anxiety. The CAGE (D) screens for alcohol use
disorder.
4
Answers & Rationales: WITH HEALTH
MAINTENANCE AND PROMOTION
COVERED ALREADY GRADED A+
DOMAIN I
1. A 4-year-old child presents for a well-child visit. The mother reports the child can hop on
one foot, draw a person with three parts, and tell a story. Which skill represents a fine motor
developmental milestone appropriate for this age?
A. Hopping on one foot
B. Drawing a person with three parts
C. Telling a story
D. All of the above
Answer: B
Rationale: At age 4, fine motor milestones include copying a cross, drawing a person with 2–4
parts, and using scissors. Hopping (A) is a gross motor milestone. Telling a story (C) is a language
milestone.
2. A 15-month-old child is brought for a well-child exam. The parent is concerned because the
child only says "mama" and "dada" and does not use other words. The child points to desired
objects, follows simple commands, and has normal hearing. What is the most appropriate
response?
A. Refer to audiology for hearing evaluation
B. Refer to speech therapy immediately
1
, C. Reassure the parent that this is normal, and reassess at 18 months
D. Order an MRI of the brain
Answer: C
Rationale: At 15 months, using 3–5 words is expected. However, the child demonstrates other
communication skills (pointing, following commands) and has normal hearing. Reassurance and
reassessment at 18 months is appropriate. A referral for speech therapy (B) may be indicated if
delays persist.
3. According to the CDC immunization schedule, which vaccines are recommended at the 2-
month well-child visit?
A. DTaP, IPV, Hib, PCV13, RV
B. DTaP, IPV, Hib, PCV13, RV, HepB
C. DTaP, IPV, Hib, MMR, Varicella
D. DTaP, IPV, Hib, PCV13, HepA
Answer: A
Rationale: At 2 months, the recommended vaccines are DTaP, IPV, Hib, PCV13, and RV. HepB (B)
is given at birth and again at 6–18 months. MMR and Varicella (C) are given at 12–15 months.
HepA (D) is given at 12–23 months.
4. A 6-month-old infant is exclusively breastfed. Which supplement is recommended for this
infant?
A. Iron
B. Vitamin D
C. Fluoride
D. Both A and B
Answer: D
Rationale: Exclusively breastfed infants should receive vitamin D supplementation (400 IU
daily) starting at birth and iron supplementation (1 mg/kg/day) starting at 4 months of age until
iron-rich complementary foods are introduced. Fluoride (C) supplementation depends on the
fluoride content of the local water supply.
5. A 2-year-old child is at risk for lead poisoning. At what age should routine lead screening
begin?
2
, A. 6 months
B. 12 months
C. 24 months
D. 36 months
Answer: B
Rationale: The CDC and AAP recommend lead screening at 12 and 24 months of age for all
children, or at least once between 12 and 24 months, especially for those at risk.
6. A 10-year-old child with a BMI at the 95th percentile is diagnosed with obesity. Which of
the following is the most appropriate first-line intervention?
A. Prescribe an appetite suppressant
B. Refer for bariatric surgery
C. Provide lifestyle counseling including nutrition and physical activity
D. Order laboratory tests for metabolic syndrome
Answer: C
Rationale: First-line management of childhood obesity includes lifestyle counseling focusing on
nutrition, physical activity, and behavior modification. Pharmacotherapy (A) and bariatric
surgery (B) are reserved for severe cases. Laboratory tests (D) may be indicated but are not the
first intervention.
7. A 16-year-old adolescent is concerned about acne. Which of the following is the most
appropriate first-line topical therapy for mild to moderate acne?
A. Benzoyl peroxide
B. Tretinoin
C. Clindamycin
D. Isotretinoin
Answer: A
Rationale: Benzoyl peroxide is a first-line topical therapy for mild to moderate acne. Tretinoin
(B) is for comedonal acne. Clindamycin (C) is a topical antibiotic. Isotretinoin (D) is for severe,
refractory acne.
8. A parent asks about the appropriate age to introduce peanut-containing foods to an infant.
What is the current recommendation?
3
, A. Avoid peanuts until 3 years of age
B. Introduce peanuts at 4–6 months for high-risk infants
C. Introduce peanuts at 12 months for all infants
D. Avoid peanuts if there is a family history of allergy
Answer: B
Rationale: Current guidelines recommend introducing peanut-containing foods at 4–6
months for infants at high risk of peanut allergy (severe eczema, egg allergy), after evaluation by
a provider. For low-risk infants, peanuts can be introduced with other complementary foods
around 6 months.
9. A 5-year-old child is brought in for a school physical. The child has a history of asthma.
Which of the following immunizations is contraindicated in a child with a true egg allergy?
A. MMR
B. Influenza vaccine
C. DTaP
D. Varicella
Answer: A
Rationale: The MMR vaccine is grown in chick embryo cell culture and contains trace amounts
of egg protein. However, severe allergic reactions are rare, and MMR can be given to children
with egg allergy. The influenza vaccine (B) is also safe for children with egg allergy per current
ACIP guidelines.
10. A 14-year-old adolescent is being screened for depression. Which screening tool is most
appropriate for this age group?
A. PHQ-2
B. PHQ-9
C. GAD-7
D. CAGE questionnaire
Answer: B
Rationale: The PHQ-9 is a validated screening tool for depression in adolescents. The PHQ-2 (A)
is a brief screener. The GAD-7 (C) screens for anxiety. The CAGE (D) screens for alcohol use
disorder.
4
