ANCC PNP Certification ACTUAL EXAM
ALL QUESTIONS AND ANSWERS
ALREADY GRADED A+. 100% VERIFIED
SOLUTIONS | UPDATED PER LATEST
GUIDELINES | GRADED A+
.
DOMAIN 1: HEALTH PROMOTION, GROWTH & DEVELOPMENT
Question 1
A 2-month-old infant presents for a well-child examination. Which developmental milestone
should the PNP expect the infant to have achieved?
• A. Rolling over from front to back
• B. Following objects with eyes past midline
• C. Sitting without support
• D. Transferring objects from hand to hand
Answer: B. Following objects with eyes past midline
Rationale: By 2 months of age, infants typically demonstrate visual tracking past midline, social
smile, and cooing sounds. Rolling over typically occurs at 4-6 months. Sitting without support
occurs at 6-8 months. Transferring objects between hands occurs at 6-7 months. This illustrates
the cephalocaudal and proximodistal progression of gross motor development.
,Question 2
A 12-month-old child is at the 5th percentile for weight and 50th percentile for length. Which
finding is most concerning?
• A. The child is not yet walking independently
• B. The child has not tripled their birth weight
• C. The child only says "mama" and "dada"
• D. The child does not use a pincer grasp
Answer: B. The child has not tripled their birth weight
Rationale: By 12 months, infants should have tripled their birth weight. Failure to do so
warrants evaluation for failure to thrive or underlying medical conditions. Walking
independently can occur up to 15 months. Saying "mama" and "dada" is appropriate at 12
months. Pincer grasp typically develops by 9-10 months but may be delayed.
Question 3
A 4-year-old child presents for a well-child visit. According to Erikson's stages of psychosocial
development, this child is in which stage?
• A. Trust vs. Mistrust
• B. Autonomy vs. Shame and Doubt
• C. Initiative vs. Guilt
• D. Industry vs. Inferiority
Answer: C. Initiative vs. Guilt
Rationale: According to Erikson, children ages 3-6 years are in the Initiative vs. Guilt stage,
where they begin to assert power and control over their environment through play and social
interaction. Trust vs. Mistrust is infancy (0-1 year). Autonomy vs. Shame and Doubt is
toddlerhood (1-3 years). Industry vs. Inferiority is school-age (6-12 years).
Question 4
Which immunization should be administered at the 4-month well-child visit?
• A. MMR
, • B. Varicella
• C. DTaP, IPV, Hib, PCV13, RV
• D. Tdap
Answer: C. DTaP, IPV, Hib, PCV13, RV
Rationale: At 4 months, the infant receives the second dose of DTaP, IPV, Hib, PCV13, and RV
(rotavirus). MMR and varicella are first given at 12-15 months. Tdap is given at 11-12 years. The
immunization schedule is critical for preventing vaccine-preventable diseases in the pediatric
population.
Question 5
A 16-year-old adolescent presents for a sports physical. Which screening is recommended for all
adolescents at this age?
• A. Depression screening (PHQ-9)
• B. HIV screening
• C. Lipid panel
• D. All of the above
Answer: D. All of the above
Rationale: The USPSTF recommends screening adolescents for depression (PHQ-9) and HIV. A
lipid panel is recommended for adolescents with risk factors and is part of routine screening
guidelines. The PNP should also screen for substance use, eating disorders, and risk-taking
behaviors during the adolescent visit.
Question 6
A 3-week-old newborn presents with jaundice. The PNP notes that the jaundice is present in the
palms and soles. This indicates:
• A. Physiologic jaundice
• B. Pathologic jaundice requiring evaluation
• C. Breastfeeding jaundice
• D. Gilbert's syndrome
, Answer: B. Pathologic jaundice requiring evaluation
Rationale: Jaundice extending to the palms and soles indicates significant hyperbilirubinemia
(typically >15-18 mg/dL) and requires urgent evaluation for pathologic causes such as hemolytic
disease, biliary atresia, or sepsis. Physiologic jaundice typically appears after 24 hours of life and
resolves by 2 weeks. Breastfeeding jaundice peaks at 4-7 days.
Question 7
A 9-month-old infant is not yet sitting independently. What is the most appropriate next step?
• A. Reassure the parents that this is within normal limits
• B. Refer for developmental evaluation
• C. Recommend physical therapy
• D. Order a brain MRI
Answer: B. Refer for developmental evaluation
Rationale: By 9 months, infants should be sitting without support. Failure to achieve this
milestone warrants developmental evaluation to assess for global developmental delay or
neuromuscular conditions. Early intervention is critical for optimal outcomes.
Question 8
A 2-year-old child has a BMI >95th percentile. Which intervention is most appropriate?
• A. Recommend a restrictive diet
• B. Encourage family-based lifestyle changes including increased physical activity and
healthy eating
• C. Refer to a pediatric endocrinologist
• D. Prescribe weight-loss medication
Answer: B. Encourage family-based lifestyle changes including increased physical activity and
healthy eating
Rationale: The PNP should address obesity using a family-centered, non-stigmatizing approach
focused on healthy lifestyle changes. Restrictive diets are inappropriate for young children and
may lead to disordered eating. Medication is not first-line for obesity in this age group.
ALL QUESTIONS AND ANSWERS
ALREADY GRADED A+. 100% VERIFIED
SOLUTIONS | UPDATED PER LATEST
GUIDELINES | GRADED A+
.
DOMAIN 1: HEALTH PROMOTION, GROWTH & DEVELOPMENT
Question 1
A 2-month-old infant presents for a well-child examination. Which developmental milestone
should the PNP expect the infant to have achieved?
• A. Rolling over from front to back
• B. Following objects with eyes past midline
• C. Sitting without support
• D. Transferring objects from hand to hand
Answer: B. Following objects with eyes past midline
Rationale: By 2 months of age, infants typically demonstrate visual tracking past midline, social
smile, and cooing sounds. Rolling over typically occurs at 4-6 months. Sitting without support
occurs at 6-8 months. Transferring objects between hands occurs at 6-7 months. This illustrates
the cephalocaudal and proximodistal progression of gross motor development.
,Question 2
A 12-month-old child is at the 5th percentile for weight and 50th percentile for length. Which
finding is most concerning?
• A. The child is not yet walking independently
• B. The child has not tripled their birth weight
• C. The child only says "mama" and "dada"
• D. The child does not use a pincer grasp
Answer: B. The child has not tripled their birth weight
Rationale: By 12 months, infants should have tripled their birth weight. Failure to do so
warrants evaluation for failure to thrive or underlying medical conditions. Walking
independently can occur up to 15 months. Saying "mama" and "dada" is appropriate at 12
months. Pincer grasp typically develops by 9-10 months but may be delayed.
Question 3
A 4-year-old child presents for a well-child visit. According to Erikson's stages of psychosocial
development, this child is in which stage?
• A. Trust vs. Mistrust
• B. Autonomy vs. Shame and Doubt
• C. Initiative vs. Guilt
• D. Industry vs. Inferiority
Answer: C. Initiative vs. Guilt
Rationale: According to Erikson, children ages 3-6 years are in the Initiative vs. Guilt stage,
where they begin to assert power and control over their environment through play and social
interaction. Trust vs. Mistrust is infancy (0-1 year). Autonomy vs. Shame and Doubt is
toddlerhood (1-3 years). Industry vs. Inferiority is school-age (6-12 years).
Question 4
Which immunization should be administered at the 4-month well-child visit?
• A. MMR
, • B. Varicella
• C. DTaP, IPV, Hib, PCV13, RV
• D. Tdap
Answer: C. DTaP, IPV, Hib, PCV13, RV
Rationale: At 4 months, the infant receives the second dose of DTaP, IPV, Hib, PCV13, and RV
(rotavirus). MMR and varicella are first given at 12-15 months. Tdap is given at 11-12 years. The
immunization schedule is critical for preventing vaccine-preventable diseases in the pediatric
population.
Question 5
A 16-year-old adolescent presents for a sports physical. Which screening is recommended for all
adolescents at this age?
• A. Depression screening (PHQ-9)
• B. HIV screening
• C. Lipid panel
• D. All of the above
Answer: D. All of the above
Rationale: The USPSTF recommends screening adolescents for depression (PHQ-9) and HIV. A
lipid panel is recommended for adolescents with risk factors and is part of routine screening
guidelines. The PNP should also screen for substance use, eating disorders, and risk-taking
behaviors during the adolescent visit.
Question 6
A 3-week-old newborn presents with jaundice. The PNP notes that the jaundice is present in the
palms and soles. This indicates:
• A. Physiologic jaundice
• B. Pathologic jaundice requiring evaluation
• C. Breastfeeding jaundice
• D. Gilbert's syndrome
, Answer: B. Pathologic jaundice requiring evaluation
Rationale: Jaundice extending to the palms and soles indicates significant hyperbilirubinemia
(typically >15-18 mg/dL) and requires urgent evaluation for pathologic causes such as hemolytic
disease, biliary atresia, or sepsis. Physiologic jaundice typically appears after 24 hours of life and
resolves by 2 weeks. Breastfeeding jaundice peaks at 4-7 days.
Question 7
A 9-month-old infant is not yet sitting independently. What is the most appropriate next step?
• A. Reassure the parents that this is within normal limits
• B. Refer for developmental evaluation
• C. Recommend physical therapy
• D. Order a brain MRI
Answer: B. Refer for developmental evaluation
Rationale: By 9 months, infants should be sitting without support. Failure to achieve this
milestone warrants developmental evaluation to assess for global developmental delay or
neuromuscular conditions. Early intervention is critical for optimal outcomes.
Question 8
A 2-year-old child has a BMI >95th percentile. Which intervention is most appropriate?
• A. Recommend a restrictive diet
• B. Encourage family-based lifestyle changes including increased physical activity and
healthy eating
• C. Refer to a pediatric endocrinologist
• D. Prescribe weight-loss medication
Answer: B. Encourage family-based lifestyle changes including increased physical activity and
healthy eating
Rationale: The PNP should address obesity using a family-centered, non-stigmatizing approach
focused on healthy lifestyle changes. Restrictive diets are inappropriate for young children and
may lead to disordered eating. Medication is not first-line for obesity in this age group.
