Pediatric Nurse Practitioner
Exam Practice Comprehensive
Questions (Frequently Tested)
with Verified Answers Graded
A+
The PNP is examining a neonate with a heart murmur. The S2 sound is loudest at the apex. The
respiratory rate is 65 breaths per minute, and the heart rate is 180 beats per minute. Which of
the following would be an appropriate action by the PNP?
A) Reevaluate the neonate in 24 hours
B) Increase the number of oral feedings
C) Order cardiac catheterization
D) Refer the neonate to a cardiologist - Answer: d
On examination of a 3-month-old infant the PNP is unable to elicit a red reflex in the right eye.
Previous examinations failed to note the presence or absence of a red reflex. The PNP's
response is to:
A) Reassure the parents that this is not a problem because the infant has dark eyes
B) Note this finding in the infant's chart and check again in a few months
C) Refer the infant to an ophthalmologist to rule out retinal trauma
D) Immediately refer the infant to a pediatric ophthalmologist to rule out a congenital cataract
or retinoblastoma - Answer: d
,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
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
A 14-year-old adolescent, who appears to be in acute distress and is anxious, is brought to the
clinic with symptoms of high fever, chills, malaise, pharyngitis, vomiting, peripheral cyanosis,
tachypnea, tachycardia, low blood pressure, and erythroderma. The PNP recognizes this as toxic
shock syndrome and:
A) Orders a CBC and blood culture immediately
B) Orders a CBC and blood culture, and sends the adolescent to an emergency room for a
lumbar puncture
,C) Sends the adolescent to the emergency room by ambulance immediately without providing
any treatment in the clinic
D) Collaborates with the clinic physician to determine appropriate antibiotic use in this patient -
Answer: c
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
A neonate is diagnosed with trisomy 21 based on karyotyping. What type of follow-up will the
infant need?
A) Echocardiography; thyroid function tests at birth, 3 months, and yearly thereafter; a CBC; and
an audiology consult
B) An ophthalmologic evaluation, neck x-ray films by age 3 years, and referral to early
intervention and parent education
C) Karyotyping, echocardiography, audiologic and ophthalmologic evaluation, and referral to
early intervention and parent education
D) Karyotyping; echocardiography; renal ultrasonography; thyroid function tests at birth, age 3
months, and yearly thereafter; and referral to early intervention and parent education - Answer:
a
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
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
B) The infant should be evaluated for other anomalies of the upper urinary tract
C) The infant should be assessed for undescended testes and inguinal hernia
D) Routine circumcision should be performed by 6 weeks of age - Answer: c
A 15-year-old adolescent has pallor and fatigue. The CBC results are consistent with iron-
deficiency anemia. What would be appropriate information to give this adolescent?
A) Antacids increase the absorption of iron
B) Dairy foods are good sources of dietary iron
C) Juices fortified with vitamin C inhibit the absorption of nonheme iron
D) Tannin-containing products, such as tea, inhibit the absorption of nonheme iron - Answer: d
When discussing the cause of impetigo with the parents of a child just diagnosed, the PNP tells
them it is caused by:
A) Klebsiella species or group A beta-hemolytic streptococci (GABHS)
B) Proteus species or anaerobes
C) Staphylococcus aureus or GABHS
D) Escherichia coli or candidal organisms - Answer: c
The PNP examines a 4-year-old child who is home-schooled and immunization-delayed. The
child has pain when chewing; a fever; and enlarged, tender salivary nodes. The PNP diagnoses
mumps and informs the mother that mumps is contagious for:
Exam Practice Comprehensive
Questions (Frequently Tested)
with Verified Answers Graded
A+
The PNP is examining a neonate with a heart murmur. The S2 sound is loudest at the apex. The
respiratory rate is 65 breaths per minute, and the heart rate is 180 beats per minute. Which of
the following would be an appropriate action by the PNP?
A) Reevaluate the neonate in 24 hours
B) Increase the number of oral feedings
C) Order cardiac catheterization
D) Refer the neonate to a cardiologist - Answer: d
On examination of a 3-month-old infant the PNP is unable to elicit a red reflex in the right eye.
Previous examinations failed to note the presence or absence of a red reflex. The PNP's
response is to:
A) Reassure the parents that this is not a problem because the infant has dark eyes
B) Note this finding in the infant's chart and check again in a few months
C) Refer the infant to an ophthalmologist to rule out retinal trauma
D) Immediately refer the infant to a pediatric ophthalmologist to rule out a congenital cataract
or retinoblastoma - Answer: d
,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
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
A 14-year-old adolescent, who appears to be in acute distress and is anxious, is brought to the
clinic with symptoms of high fever, chills, malaise, pharyngitis, vomiting, peripheral cyanosis,
tachypnea, tachycardia, low blood pressure, and erythroderma. The PNP recognizes this as toxic
shock syndrome and:
A) Orders a CBC and blood culture immediately
B) Orders a CBC and blood culture, and sends the adolescent to an emergency room for a
lumbar puncture
,C) Sends the adolescent to the emergency room by ambulance immediately without providing
any treatment in the clinic
D) Collaborates with the clinic physician to determine appropriate antibiotic use in this patient -
Answer: c
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
A neonate is diagnosed with trisomy 21 based on karyotyping. What type of follow-up will the
infant need?
A) Echocardiography; thyroid function tests at birth, 3 months, and yearly thereafter; a CBC; and
an audiology consult
B) An ophthalmologic evaluation, neck x-ray films by age 3 years, and referral to early
intervention and parent education
C) Karyotyping, echocardiography, audiologic and ophthalmologic evaluation, and referral to
early intervention and parent education
D) Karyotyping; echocardiography; renal ultrasonography; thyroid function tests at birth, age 3
months, and yearly thereafter; and referral to early intervention and parent education - Answer:
a
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
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
B) The infant should be evaluated for other anomalies of the upper urinary tract
C) The infant should be assessed for undescended testes and inguinal hernia
D) Routine circumcision should be performed by 6 weeks of age - Answer: c
A 15-year-old adolescent has pallor and fatigue. The CBC results are consistent with iron-
deficiency anemia. What would be appropriate information to give this adolescent?
A) Antacids increase the absorption of iron
B) Dairy foods are good sources of dietary iron
C) Juices fortified with vitamin C inhibit the absorption of nonheme iron
D) Tannin-containing products, such as tea, inhibit the absorption of nonheme iron - Answer: d
When discussing the cause of impetigo with the parents of a child just diagnosed, the PNP tells
them it is caused by:
A) Klebsiella species or group A beta-hemolytic streptococci (GABHS)
B) Proteus species or anaerobes
C) Staphylococcus aureus or GABHS
D) Escherichia coli or candidal organisms - Answer: c
The PNP examines a 4-year-old child who is home-schooled and immunization-delayed. The
child has pain when chewing; a fever; and enlarged, tender salivary nodes. The PNP diagnoses
mumps and informs the mother that mumps is contagious for:
