Page 1 of 213
LATEST 2025/2026 CPNP-PC REAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS (WELL
EXPLAINED RATIONALES) GRADED A+/2025/2026
CPNP-PC (GUARANTEED SUCCESS)
A 6-month-old infant can roll both ways, sit briefly without support, and brings
hands to midline. However, the mother notes no babbling or vocalizations. What is
the next best step?
A. Reassure the mother
B. Refer to ENT
C. Schedule hearing evaluation and refer to early intervention
D. Begin sign language Correct Answer: C. Schedule hearing evaluation and
refer to early intervention
Why: Lack of babbling at 6 months is a red flag for hearing impairment or
developmental delay. Early Intervention and audiologic evaluation are indicated.
A is incorrect: Silence is not normal at this age.
B is partially correct, but ENT referral is premature unless audiology confirms an
issue.
D is incorrect: Sign language can support communication but is not a substitute for
proper evaluation.
A 30-month-old is seen for a well visit. She follows 2-step commands, stacks six
blocks, and uses 2-3 word phrases. Her mother is concerned she can't ride a
tricycle. What is the most appropriate response?
A. Refer for gross motor assessment
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B. Reassure this is age-appropriate
C. Recommend physical therapy
D. Recommend a preschool gym program Correct Answer: B. Reassure this is
age-appropriate
Why: Riding a tricycle is expected closer to 3 years of age. This child meets
multiple 30-month milestones (stacking blocks, following commands, 2-3 word
phrases).
A/C/D are incorrect: No gross motor delay exists. Referrals or programs are
unnecessary and may create undue concern.
A 5-year-old is new to your practice. His parents are concerned because he still
wets the bed, avoids eye contact, and prefers to play alone. What screening is most
appropriate?
A. ASQ
B. M-CHAT
C. Vanderbilt
D. Ages & Stages SE Correct Answer: D. Ages & Stages SE
Why: The Ages & Stages: Social-Emotional is appropriate for assessing concerns
like social withdrawal, eye contact, and behavior. These are key indicators of
possible ASD or emotional challenges.
A is incorrect: ASQ-3 is more general, not focused on emotional/social domains.
B is incorrect: M-CHAT is validated for use under age 3.
C is incorrect: Vanderbilt is for ADHD, not autism or social delay.
, Page 3 of 213
A mother of a 3-year-old says her son speaks in sentences, runs, and climbs well
but is not potty trained. He has no other delays. What is your next step?
A. Refer for developmental testing
B. Reassure the parent
C. Refer to urology
D. Begin behavior therapy Correct Answer: B. Reassure the parent
Why: Many children are not toilet trained at 3 years. As long as other
developmental milestones are on track, this is within normal range.
A/C/D are incorrect: Without other delays or medical issues (e.g., UTI, neuro
dysfunction), no referral or therapy is needed yet.
A 15-month-old child walks independently, points to desired objects, and uses 3
words. What is the best screening tool to assess for autism?
A. ASQ-3
B. Denver II
C. M-CHAT-R/F
D. PEDS Correct Answer: C. M-CHAT-R/F
Why: The Modified Checklist for Autism in Toddlers (Revised with Follow-Up) is
validated for screening children 16-30 months old for autism spectrum disorder.
A is incorrect: ASQ-3 covers broad development, not autism-specific concerns.
**B is outdated and less specific for ASD screening.
D is incorrect: PEDS is a parent concern-based tool, less specific for ASD.
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A 2-month-old holds her head up briefly when prone but does not smile socially.
Parents are concerned. What is your recommendation?
A. Immediate early intervention referral
B. Reassure and reassess at 4 months
C. Order neuroimaging
D. Refer to neurology Correct Answer: B. Reassure and reassess at 4 months
Why: Social smiling typically emerges around 6-8 weeks, but a 2-month-old
without it isn't necessarily abnormal. Reassessment at the next visit is appropriate.
A/C/D are incorrect: Without other abnormal findings, these steps are premature
and potentially anxiety-inducing.
A 12-month-old waves bye-bye, stands with support, but does not pincer grasp.
What is the next best action?
A. Monitor and reassess at 15 months
B. Refer for occupational therapy
C. Recommend fine motor exercises at home
D. Begin vitamin D supplementation Correct Answer: A. Monitor and reassess at
15 months
Why: The pincer grasp usually develops between 9-12 months. Since this child is
only 12 months and meeting other milestones, monitoring is appropriate.
B/C are incorrect: There's no clear motor delay yet.
D is irrelevant: Vitamin D is for bone health, not fine motor skill.
A 9-month-old is brought in for a well-child visit. The caregiver reports the baby
can sit without support, babble with consonants, and reach for toys. On
LATEST 2025/2026 CPNP-PC REAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS (WELL
EXPLAINED RATIONALES) GRADED A+/2025/2026
CPNP-PC (GUARANTEED SUCCESS)
A 6-month-old infant can roll both ways, sit briefly without support, and brings
hands to midline. However, the mother notes no babbling or vocalizations. What is
the next best step?
A. Reassure the mother
B. Refer to ENT
C. Schedule hearing evaluation and refer to early intervention
D. Begin sign language Correct Answer: C. Schedule hearing evaluation and
refer to early intervention
Why: Lack of babbling at 6 months is a red flag for hearing impairment or
developmental delay. Early Intervention and audiologic evaluation are indicated.
A is incorrect: Silence is not normal at this age.
B is partially correct, but ENT referral is premature unless audiology confirms an
issue.
D is incorrect: Sign language can support communication but is not a substitute for
proper evaluation.
A 30-month-old is seen for a well visit. She follows 2-step commands, stacks six
blocks, and uses 2-3 word phrases. Her mother is concerned she can't ride a
tricycle. What is the most appropriate response?
A. Refer for gross motor assessment
, Page 2 of 213
B. Reassure this is age-appropriate
C. Recommend physical therapy
D. Recommend a preschool gym program Correct Answer: B. Reassure this is
age-appropriate
Why: Riding a tricycle is expected closer to 3 years of age. This child meets
multiple 30-month milestones (stacking blocks, following commands, 2-3 word
phrases).
A/C/D are incorrect: No gross motor delay exists. Referrals or programs are
unnecessary and may create undue concern.
A 5-year-old is new to your practice. His parents are concerned because he still
wets the bed, avoids eye contact, and prefers to play alone. What screening is most
appropriate?
A. ASQ
B. M-CHAT
C. Vanderbilt
D. Ages & Stages SE Correct Answer: D. Ages & Stages SE
Why: The Ages & Stages: Social-Emotional is appropriate for assessing concerns
like social withdrawal, eye contact, and behavior. These are key indicators of
possible ASD or emotional challenges.
A is incorrect: ASQ-3 is more general, not focused on emotional/social domains.
B is incorrect: M-CHAT is validated for use under age 3.
C is incorrect: Vanderbilt is for ADHD, not autism or social delay.
, Page 3 of 213
A mother of a 3-year-old says her son speaks in sentences, runs, and climbs well
but is not potty trained. He has no other delays. What is your next step?
A. Refer for developmental testing
B. Reassure the parent
C. Refer to urology
D. Begin behavior therapy Correct Answer: B. Reassure the parent
Why: Many children are not toilet trained at 3 years. As long as other
developmental milestones are on track, this is within normal range.
A/C/D are incorrect: Without other delays or medical issues (e.g., UTI, neuro
dysfunction), no referral or therapy is needed yet.
A 15-month-old child walks independently, points to desired objects, and uses 3
words. What is the best screening tool to assess for autism?
A. ASQ-3
B. Denver II
C. M-CHAT-R/F
D. PEDS Correct Answer: C. M-CHAT-R/F
Why: The Modified Checklist for Autism in Toddlers (Revised with Follow-Up) is
validated for screening children 16-30 months old for autism spectrum disorder.
A is incorrect: ASQ-3 covers broad development, not autism-specific concerns.
**B is outdated and less specific for ASD screening.
D is incorrect: PEDS is a parent concern-based tool, less specific for ASD.
, Page 4 of 213
A 2-month-old holds her head up briefly when prone but does not smile socially.
Parents are concerned. What is your recommendation?
A. Immediate early intervention referral
B. Reassure and reassess at 4 months
C. Order neuroimaging
D. Refer to neurology Correct Answer: B. Reassure and reassess at 4 months
Why: Social smiling typically emerges around 6-8 weeks, but a 2-month-old
without it isn't necessarily abnormal. Reassessment at the next visit is appropriate.
A/C/D are incorrect: Without other abnormal findings, these steps are premature
and potentially anxiety-inducing.
A 12-month-old waves bye-bye, stands with support, but does not pincer grasp.
What is the next best action?
A. Monitor and reassess at 15 months
B. Refer for occupational therapy
C. Recommend fine motor exercises at home
D. Begin vitamin D supplementation Correct Answer: A. Monitor and reassess at
15 months
Why: The pincer grasp usually develops between 9-12 months. Since this child is
only 12 months and meeting other milestones, monitoring is appropriate.
B/C are incorrect: There's no clear motor delay yet.
D is irrelevant: Vitamin D is for bone health, not fine motor skill.
A 9-month-old is brought in for a well-child visit. The caregiver reports the baby
can sit without support, babble with consonants, and reach for toys. On
