Board Certified Pediatric Pharmacy Specialist
(BCPPS) Exam Questions And Correct
Answers (Verified Answers) Plus Rationales
2025/2026 Q&A | Instant Download Pdf
1. Which of the following vaccines is contraindicated in a child with a history
of severe anaphylaxis to neomycin?
A. MMR
B. IPV
C. IPV (Inactivated Polio Vaccine)
D. Varicella
Rationale: IPV contains trace amounts of neomycin. MMR and Varicella
vaccines do not have significant neomycin content.
2. A 4-year-old child with asthma presents with mild exacerbation. Which is
the preferred initial therapy?
A. Oral corticosteroid
B. Short-acting beta-agonist inhaler (SABA)
C. Long-acting beta-agonist inhaler (LABA)
D. Leukotriene receptor antagonist
Rationale: SABA is the first-line treatment for acute mild asthma exacerbations
in children.
3. The preferred treatment for Kawasaki disease is:
A. Aspirin alone
B. IV immunoglobulin (IVIG) + Aspirin
C. Corticosteroids
D. Antibiotics
Rationale: IVIG combined with aspirin reduces coronary artery complications in
Kawasaki disease.
,4. Which medication requires therapeutic drug monitoring in neonates?
A. Acetaminophen
B. Gentamicin
C. Ibuprofen
D. Albuterol
Rationale: Gentamicin has a narrow therapeutic index and risk of
nephrotoxicity and ototoxicity in neonates.
5. A 2-year-old with cystic fibrosis requires pancreatic enzyme replacement.
The dose is based on:
A. Age
B. Weight and lipase units per meal
C. Height
D. Serum amylase
Rationale: Dosing of pancreatic enzymes is weight-based and titrated to lipase
units per meal.
6. For febrile neonates (<28 days), the recommended empiric antibiotics are:
A. Vancomycin alone
B. Ampicillin + Gentamicin
C. Ceftriaxone alone
D. Penicillin
Rationale: Ampicillin covers Listeria and enterococci; gentamicin covers Gram-
negative bacteria.
7. Which opioid is preferred for pediatric pain management when IV access is
available?
A. Fentanyl
B. Morphine
, C. Morphine
D. Codeine
Rationale: Morphine is preferred; codeine is contraindicated due to variable
metabolism in children.
8. The most common cause of neonatal jaundice is:
A. Biliary atresia
B. Physiologic immaturity of the liver
C. Hemolysis
D. Hypothyroidism
Rationale: Physiologic jaundice is due to immaturity of bilirubin conjugation in
neonates.
9. In pediatric patients, which antihypertensive class is preferred for first-line
therapy?
A. ACE inhibitors
B. ACE inhibitors
C. Beta-blockers
D. Calcium channel blockers
Rationale: ACE inhibitors are recommended for children, especially with kidney
disease or proteinuria.
10. Which of the following is a key difference between pediatric and adult
pharmacokinetics?
A. Absorption is slower in children
B. Distribution is the same
C. Metabolism and clearance may be higher in children
D. Elimination is slower in all children
Rationale: Children may metabolize some drugs faster due to liver enzyme
maturation.
(BCPPS) Exam Questions And Correct
Answers (Verified Answers) Plus Rationales
2025/2026 Q&A | Instant Download Pdf
1. Which of the following vaccines is contraindicated in a child with a history
of severe anaphylaxis to neomycin?
A. MMR
B. IPV
C. IPV (Inactivated Polio Vaccine)
D. Varicella
Rationale: IPV contains trace amounts of neomycin. MMR and Varicella
vaccines do not have significant neomycin content.
2. A 4-year-old child with asthma presents with mild exacerbation. Which is
the preferred initial therapy?
A. Oral corticosteroid
B. Short-acting beta-agonist inhaler (SABA)
C. Long-acting beta-agonist inhaler (LABA)
D. Leukotriene receptor antagonist
Rationale: SABA is the first-line treatment for acute mild asthma exacerbations
in children.
3. The preferred treatment for Kawasaki disease is:
A. Aspirin alone
B. IV immunoglobulin (IVIG) + Aspirin
C. Corticosteroids
D. Antibiotics
Rationale: IVIG combined with aspirin reduces coronary artery complications in
Kawasaki disease.
,4. Which medication requires therapeutic drug monitoring in neonates?
A. Acetaminophen
B. Gentamicin
C. Ibuprofen
D. Albuterol
Rationale: Gentamicin has a narrow therapeutic index and risk of
nephrotoxicity and ototoxicity in neonates.
5. A 2-year-old with cystic fibrosis requires pancreatic enzyme replacement.
The dose is based on:
A. Age
B. Weight and lipase units per meal
C. Height
D. Serum amylase
Rationale: Dosing of pancreatic enzymes is weight-based and titrated to lipase
units per meal.
6. For febrile neonates (<28 days), the recommended empiric antibiotics are:
A. Vancomycin alone
B. Ampicillin + Gentamicin
C. Ceftriaxone alone
D. Penicillin
Rationale: Ampicillin covers Listeria and enterococci; gentamicin covers Gram-
negative bacteria.
7. Which opioid is preferred for pediatric pain management when IV access is
available?
A. Fentanyl
B. Morphine
, C. Morphine
D. Codeine
Rationale: Morphine is preferred; codeine is contraindicated due to variable
metabolism in children.
8. The most common cause of neonatal jaundice is:
A. Biliary atresia
B. Physiologic immaturity of the liver
C. Hemolysis
D. Hypothyroidism
Rationale: Physiologic jaundice is due to immaturity of bilirubin conjugation in
neonates.
9. In pediatric patients, which antihypertensive class is preferred for first-line
therapy?
A. ACE inhibitors
B. ACE inhibitors
C. Beta-blockers
D. Calcium channel blockers
Rationale: ACE inhibitors are recommended for children, especially with kidney
disease or proteinuria.
10. Which of the following is a key difference between pediatric and adult
pharmacokinetics?
A. Absorption is slower in children
B. Distribution is the same
C. Metabolism and clearance may be higher in children
D. Elimination is slower in all children
Rationale: Children may metabolize some drugs faster due to liver enzyme
maturation.
