PEDIATRIC NP EXAM PRACTICE QUESTIONS
EXAMS WITH CORRECT SOLUTIONS
2026/2027/UPDATED /GRADED A+
1. A healthy 12yo female is at the clinic for a well checkup. On physical
examination, a marked elevation of the right scapula and right thoracic
hump and spinal curve abnormally are noted. Spinal films indicate 20
degree curve. The PNP should:
a. refer the patient to an orthopedist
b. monitor the patient every 3 mo until menarche
c. refer the patient for physical therapy
d. recommend bedrest and back brace - ANSWER-a
2. The mother of a newborn brings the baby to the clinic because she is afraid
something is wrong with her baby ("his head is so big"). The PNP responds
that:
a. "this is normal. The head of a newborn is proportionately large to the
rest of the body"
b. "Yes, this does appear abnormal. I will make an appointment for the
baby to be seen by a neurologist."
c. "your head appears large so it is probably genetic." - ANSWER-a
3. What is the % of risk an autosomal dominant gene is being passed on to
each offspring?
a. 25
b. 50
c. 100
d. none - ANSWER-b
,4. A 13yo female is at the clinic for a routine check up. What presenting
symptoms might alert the PNP to the presence of a possible genetic
disorder?
a. <10% on growth chart, Tanner I, and learning difficulties
b. Precocious puberty, developmental delays, gifted piano player
c. Lactose intolerance, frequent ear infections, speech delays
d. Peanut allergy, right-sided weakness, and exhibits bullying behavior -
ANSWER-a
5. The parents of a son with hemophilia are considering another pregnancy.
The mother has been identified as a carrier of the hemophilia gene. What
chance does each female offspring have of having hemophilia.
a. 100%
b. 50%
c. 25%
d. none - ANSWER-d
6. An adolescent is being seen at a community health center because of
recurrent respiratory tract infections. The complete blood cell count (CBC)
with differential shows a white blood cell count of 20,500 with 35% blast
cells. The next step in managing the adolescent's care is to:
A) Repeat the CBC with differential in 1 week
B) Refer to a specialist in pediatric hematology
C) Perform bone marrow aspiration
D) Hospitalize the adolescent immediately - ANSWER-b
7. A 9-month-old infant was diagnosed with sickle cell disease shortly after
birth. The mother telephones the PNP to report that the infant has a fever
of 103.2°F. The best response to the mother is:
A) "Take the infant to the emergency room immediately."
B) "Administer a dose of ibuprofen, and call back in 6 hours if
the fever continues."
, C) "Give extra fluids and acetaminophen, and call back
tomorrow if the fever continues."
D) "Give extra fluids and acetaminophen, and bring the infant to
the clinic tomorrow morning." - ANSWER-a
8. A 5-year-old child has sudden onset of nonblanching purpuric lesions
scattered over the body and petechiae scattered over the neck and
shoulders. The mother reports that the child has been healthy, except for a
cold a few weeks ago. The child is not taking any medications. Physical
examination reveals a healthy, afebrile child with no other significant
findings. The laboratory data show a hemoglobin level of 12.5 g/dL, white
blood cell count of 6500/mm3, and platelet count of 20,000/mm3. Based on
this information, what should the PNP do next?
A) Reassure the parents that these findings are consistent with
acute idiopathic thrombocytopenia purpura (ITP), and advise
a hematology consultation for confirmation
B) Refer the child immediately to the pediatric
hematology/oncology department of the nearest tertiary care
center
C) Report the family to the local protective services department
as soon as possible because of the - ANSWER-a
9. A 4-year-old child is scheduled for a tonsillectomy and adenoidectomy. The
preoperative laboratory tests indicate a prolonged active partial
thromboplastin time (aPTT). The PNP should suggest that they:
A) Continue with the surgery, and monitor the child closely for
bleeding complications
B) Cancel the surgery, and recheck the aPTT in 1 week
C) Cancel the surgery, and refer the child to a hematologist
D) Obtain a family history, and determine whether there are
other relatives with a bleeding disorder - ANSWER-c
, 10. A 13-year-old adolescent complains of having difficulty walking and the
arms feeling weak. The adolescent had a cold 2 weeks ago. On examination,
the PNP is not able to elicit deep tendon reflexes. The PNP knows that the
most appropriate course of action is to:
A) Refer the adolescent to an orthopedic surgeon
B) Schedule a follow-up visit in 1 week
C) Refer the adolescent to a neurologist
D) Refer the adolescent to an emergency room - ANSWER-d
11. A 1-year-old child is brought to the clinic with a temperature of 102°F and
left flank pain. The urine dipstick test indicates nitrates and leukocyte
esterase. The presenting signs and symptoms suggest left pyelonephritis.
Based on the data, the most appropriate action for the PNP is to:
A) Refer the child to a urologist for diagnosis and treatment
B) Consult with a physician
C) Provide symptomatic treatment for 24 hours, and repeat the
urine dipstick test
D) Send urine for culture and sensitivity testing - ANSWER-b
12. A 10-year-old child is examined because of recurrent UTIs. A urologic
workup is performed. No abnormalities are found. To help prevent future
UTIs, the PNP should suggest which of the following interventions?
A) Taking a 30-minute bath daily
B) Avoiding showering
C) Using a voiding schedule to expand the bladder
D) Practicing good perineal hygiene - ANSWER-d
13. A PNP responsible for neonatal discharge rounds at the hospital examines a
male infant and notes that the urethral opening appears displaced ventrally
along the glans. A closer assessment reveals an undiagnosed mild
hypospadias. What should the parents be told?
A) Hypospadias occurs in approximately 1 in 500 neonates
EXAMS WITH CORRECT SOLUTIONS
2026/2027/UPDATED /GRADED A+
1. A healthy 12yo female is at the clinic for a well checkup. On physical
examination, a marked elevation of the right scapula and right thoracic
hump and spinal curve abnormally are noted. Spinal films indicate 20
degree curve. The PNP should:
a. refer the patient to an orthopedist
b. monitor the patient every 3 mo until menarche
c. refer the patient for physical therapy
d. recommend bedrest and back brace - ANSWER-a
2. The mother of a newborn brings the baby to the clinic because she is afraid
something is wrong with her baby ("his head is so big"). The PNP responds
that:
a. "this is normal. The head of a newborn is proportionately large to the
rest of the body"
b. "Yes, this does appear abnormal. I will make an appointment for the
baby to be seen by a neurologist."
c. "your head appears large so it is probably genetic." - ANSWER-a
3. What is the % of risk an autosomal dominant gene is being passed on to
each offspring?
a. 25
b. 50
c. 100
d. none - ANSWER-b
,4. A 13yo female is at the clinic for a routine check up. What presenting
symptoms might alert the PNP to the presence of a possible genetic
disorder?
a. <10% on growth chart, Tanner I, and learning difficulties
b. Precocious puberty, developmental delays, gifted piano player
c. Lactose intolerance, frequent ear infections, speech delays
d. Peanut allergy, right-sided weakness, and exhibits bullying behavior -
ANSWER-a
5. The parents of a son with hemophilia are considering another pregnancy.
The mother has been identified as a carrier of the hemophilia gene. What
chance does each female offspring have of having hemophilia.
a. 100%
b. 50%
c. 25%
d. none - ANSWER-d
6. An adolescent is being seen at a community health center because of
recurrent respiratory tract infections. The complete blood cell count (CBC)
with differential shows a white blood cell count of 20,500 with 35% blast
cells. The next step in managing the adolescent's care is to:
A) Repeat the CBC with differential in 1 week
B) Refer to a specialist in pediatric hematology
C) Perform bone marrow aspiration
D) Hospitalize the adolescent immediately - ANSWER-b
7. A 9-month-old infant was diagnosed with sickle cell disease shortly after
birth. The mother telephones the PNP to report that the infant has a fever
of 103.2°F. The best response to the mother is:
A) "Take the infant to the emergency room immediately."
B) "Administer a dose of ibuprofen, and call back in 6 hours if
the fever continues."
, C) "Give extra fluids and acetaminophen, and call back
tomorrow if the fever continues."
D) "Give extra fluids and acetaminophen, and bring the infant to
the clinic tomorrow morning." - ANSWER-a
8. A 5-year-old child has sudden onset of nonblanching purpuric lesions
scattered over the body and petechiae scattered over the neck and
shoulders. The mother reports that the child has been healthy, except for a
cold a few weeks ago. The child is not taking any medications. Physical
examination reveals a healthy, afebrile child with no other significant
findings. The laboratory data show a hemoglobin level of 12.5 g/dL, white
blood cell count of 6500/mm3, and platelet count of 20,000/mm3. Based on
this information, what should the PNP do next?
A) Reassure the parents that these findings are consistent with
acute idiopathic thrombocytopenia purpura (ITP), and advise
a hematology consultation for confirmation
B) Refer the child immediately to the pediatric
hematology/oncology department of the nearest tertiary care
center
C) Report the family to the local protective services department
as soon as possible because of the - ANSWER-a
9. A 4-year-old child is scheduled for a tonsillectomy and adenoidectomy. The
preoperative laboratory tests indicate a prolonged active partial
thromboplastin time (aPTT). The PNP should suggest that they:
A) Continue with the surgery, and monitor the child closely for
bleeding complications
B) Cancel the surgery, and recheck the aPTT in 1 week
C) Cancel the surgery, and refer the child to a hematologist
D) Obtain a family history, and determine whether there are
other relatives with a bleeding disorder - ANSWER-c
, 10. A 13-year-old adolescent complains of having difficulty walking and the
arms feeling weak. The adolescent had a cold 2 weeks ago. On examination,
the PNP is not able to elicit deep tendon reflexes. The PNP knows that the
most appropriate course of action is to:
A) Refer the adolescent to an orthopedic surgeon
B) Schedule a follow-up visit in 1 week
C) Refer the adolescent to a neurologist
D) Refer the adolescent to an emergency room - ANSWER-d
11. A 1-year-old child is brought to the clinic with a temperature of 102°F and
left flank pain. The urine dipstick test indicates nitrates and leukocyte
esterase. The presenting signs and symptoms suggest left pyelonephritis.
Based on the data, the most appropriate action for the PNP is to:
A) Refer the child to a urologist for diagnosis and treatment
B) Consult with a physician
C) Provide symptomatic treatment for 24 hours, and repeat the
urine dipstick test
D) Send urine for culture and sensitivity testing - ANSWER-b
12. A 10-year-old child is examined because of recurrent UTIs. A urologic
workup is performed. No abnormalities are found. To help prevent future
UTIs, the PNP should suggest which of the following interventions?
A) Taking a 30-minute bath daily
B) Avoiding showering
C) Using a voiding schedule to expand the bladder
D) Practicing good perineal hygiene - ANSWER-d
13. A PNP responsible for neonatal discharge rounds at the hospital examines a
male infant and notes that the urethral opening appears displaced ventrally
along the glans. A closer assessment reveals an undiagnosed mild
hypospadias. What should the parents be told?
A) Hypospadias occurs in approximately 1 in 500 neonates
