CPNP-PC CERTIFIED PEDIATRIC
PRIMARY CARE NURSE
PRACTITIONER BOARD EXAM
CPNP-PC CERTIFIED PEDIATRIC
PRIMARY CARE NURSE PRACTITIONER
BOARD EXAM PREP 2025/2026
COMPLETE 450 QUESTIONS AND
CORRECT ANSWERS WITH
RATIONALES |ALREADY GRADED
A+||BRAND NEW!!!
Older adolescents with congenital heart defects should be transitioned to adult congenital heart
specialists in order to
A. provide subacute bacterial endocarditis (SBE) prophylaxis.
B. reduce the risk of long-term complications.
C. prepare for the next procedure.
D. refill medications.
The correct answer is B - reduce the risk of long-term complications.
Many children with congenital heart disease (CHD) undergo palliative, not corrective, procedures
when young. As these children grow, they continue to require close follow-up to note when subtle
changes occur and when potential future procedures or surgeries are needed. Studies have shown
that as these older adolescents transitioned to adult CHD specialists, only a small percentage
received the follow-up care they needed. Sometimes several years passed from the time of
recommended transition until they were seen by an adult CHD specialist, usually prompted by new or
increased symptoms.
Not all patients with congenital heart disease require SBE prophylaxis or medications. If these
patients are on medications, the prescribing health care provider should follow them serially to
assess how they are doing, and if any new signs or symptoms have developed. Pregnancy is also not
recommended for women with severe congenital heart lesions and appropriate counseling and birth
control options need to
be discussed.
Which of the following is the MOST appropriate advice for caregivers regarding a child's exposure to
virtual violence?
A+ TEST BANK 1
, CPNP-PC CERTIFIED PEDIATRIC
PRIMARY CARE NURSE
PRACTITIONER BOARD EXAM
A. provide supervision by co-playing or co-viewing first-person shooter games
B. limit exposure to virtual violence to cartoon violence for children under the age of 6
C. implement a "media diet" due to the proven link between virtual violence and real-world
aggression
D. allow exposure to media violence in a controlled virtual reality environment as an outlet to safely
release aggression
The correct answer is C - implement a "media diet" due to the proven link between virtual violence
and real-world aggression
Exposure to violence in media, referred to as virtual violence, places children and adolescents at risk
for negative health effects. Counseling on media consumption is an important way that pediatric
health care providers can reduce the risk of youth violence. Although it is recommended that
caregivers co-view programming or co-play games, first-person shooter games are not
recommended for children of any age. Additionally, because children under the age of 6 can have
difficulty separating fantasy from reality, this group should not be exposed to any type of virtual
violence, including cartoon violence. A common misconception is that children can safely release
aggression in a virtual reality environment. However, it has been shown that experiencing virtual
violence in this way can increase aggression in children and adolescents. Caregivers should be guided
in developing a healthy "media diet" with a focus on time constraints as well as content choice. The
link between virtual violence and real-world aggression has been scientifically proven.
The benefit of fluoride is achieved through which of the following mechanisms?
A. bactericidal effect on Streptococcus mutans
B. remineralization of carious lesions
C. prevention of plaque adherence
D. destruction of milk sugars
The correct answer is B - remineralization of carious lesions
It is important for health care providers to screen for dental caries and to identify risk factors for
development of decay. Caries occur from the overgrowth of the bacteria Streptococcus mutans,
Streptococcus sobrinus, and lactobacillus species, which are part of normal human flora. These
bacteria adhere well to the tooth surface. Topical fluoride is effective in assisting in the prevention of
caries by inhibiting demineralization and aiding in the remineralization of carious lesions. While
fluoride does not prevent plaque adherence, it can alter the enamel of teeth making it more resistant
to the destructive effects of the bacteria found in the mouth. Milk sugars are a common cause of
caries providing a medium for the bacteria to flourish.
The parents of a 5 year old are frustrated by their child's need to select her own clothing, despite
weather and safety. Which is the BEST example of a parent statement to the child that will promote
self-esteem?
A. "Go ahead and wear the sandals, but you will be cold."
A+ TEST BANK 2
, CPNP-PC CERTIFIED PEDIATRIC
PRIMARY CARE NURSE
PRACTITIONER BOARD EXAM
B. "Wear the sandals, but take your shoes and socks in case you change your mind."
C. "You must wear shoes and socks, but you can choose between the red or black ones."
D. "It is too cold to wear sandals, and we cannot leave until you decide to put on shoes and socks."
The correct answer is C - "You must wear shoes and socks, but you can choose between the red or
black ones."
Children need to have limits identified and consequences clearly stated. The goal of discipline is to
ultimately teach the child, not to punish them. Children at age 4 and 5 are at Erikson's developmental
stage of "initiative vs. guilt," and Piaget's "intuition" or preoperational thinking. In order to facilitate
the development of and foster self-esteem, the parent needs to provide guidance, but allow the
child some choices. Limit setting paired with providing options for the child, like the choice of which
shoes to wear, while maintaining that the child cannot wear sandals, supports developmental
theories and fosters a child's self-esteem. There may be times when allowing the child full autonomy
in dressing is acceptable, but safety and health concerns must be considered first by the parents.
Three siblings ages 7-15 years present for new patient visits having recently moved cross country. The
MOST effective guidance related to injury prevention includes
A. incorporating knowledge of risks specific to the community.
B. asking about previous injuries each child has sustained.
C. covering as many age specific areas as possible.
D. directing counselling specifically to each child.
The correct answer is A - incorporating knowledge of risks specific to the community.
Anticipatory guidance for safety and injury prevention is an integral part for the care of children and
should be directed towards the caregivers as they have the capability to modify the child's
environment to promote safety. Safety counseling includes general preventative measures such as
the use of car seats and safety belts as well as developmentally appropriate safety considerations.
Studies have demonstrated that anticipatory guidance surrounding injury prevention are effective.
However, to be retentive, teaching must be limited to a number of topics and not a fully exhaustive
list.
The effectiveness of safety counseling can be improved if a health care provider knows the risks
specific to the local population, especially for new families unfamiliar with potential risks. For
example, recreational activities such as all-terrain vehicles, snowmobiles, and/or personal watercraft
are specific to geographic locations and safety prevention should be tailored to meet these topics.
Health care providers should adapt their age specific safety anticipatory guidance to meet the needs
of the child and family on the basis of risks in the local community as well as the expressed needs of
the patient and families.
A caregiver expresses concern for her 12 month old's lack of interest in playing with other children,
especially due to a family history of autism spectrum disorder. Which of the following is the MOST
appropriate response?
A+ TEST BANK 3
, CPNP-PC CERTIFIED PEDIATRIC
PRIMARY CARE NURSE
PRACTITIONER BOARD EXAM
A. evaluate for social interactions such as peek-a-boo and pat-a-cake
B. offer reassurance that interactive play begins at age 3
C. attempt to engage the child in imitating behaviors
D. refer for a developmental evaluation
The correct answer is B - offer reassurance that interactive play begins at age 3
Play is an essential component in assessing development. Because there is a slight increased risk of
autism spectrum disorder in familial studies, the caregiver is appropriately concerned for the child's
risk. Peek-a-boo and pat-a-cake are developmentally appropriate engaging behaviors at this age;
however, this does not address the concerns of the caregiver. Imitating behaviors begin between
ages 2-3 years, so the child is too young to be evaluated for this type of play. Despite family concerns,
a developmental evaluation is not needed as the child's lack of interactive play does not warrant a
referral at 12 months of age. By educating about age-appropriate types of play, the specific concerns
are being addressed.
A child presents with a two-day history of perianal erythema, itching, pain, and a fever reaching 100.5
F (38 C). Which of the following is the MOST important history question?
A. "Was a fever-reducer given?"
B. "Have you changed bath soaps recently?"
C. "Has the child had a sore throat recently?"
D. "Does anyone in the house have a similar rash?"
The correct answer is C - "Has the child had a sore throat recently?"
The child in this scenario is likely presenting with a perianal streptococcal infection. Common
symptoms include erythema, pain, local itching, and blood streaked stools. While presentation with
fever can occur, many cases do not involve systemic symptoms. The infection is usually a result of
autoinoculation from a recent group A streptococcal infection. On physical exam the perianal area is
erythematous with distinct margins that can extend up to 2 cm from the anus. While the history
questions posed in the options are appropriately asked, the most important is whether there is
history of a recent sore throat which would cause the streptococcal autoinoculation. Rapid strep test
of a perianal swab assists in confirming the diagnosis. Treatment for perianal infection is the same as
for streptococcal pharyngitis with penicillin V or amoxicillin being the most appropriate antibiotics.
Perianal pruritis is also seen with pinworm infections. However, these children typically present with
irritability, hyperactivity and insomnia. They are not painful and do not present with systemic
symptoms. On exam during nighttime, long, white threadlike worms can be seen at the anus.
A mother is concerned about a lump identified under the nipple of her 10-year-old daughter's breast.
The child recently completed leukemia treatment. On examination the right nipple is elevated with
palpable non-tender, soft tissue. The MOST appropriate next step is to
A. reassure that this is normal breast development for the child's age.
B. obtain bloodwork to assess hormone levels and blood counts.
A+ TEST BANK 4
PRIMARY CARE NURSE
PRACTITIONER BOARD EXAM
CPNP-PC CERTIFIED PEDIATRIC
PRIMARY CARE NURSE PRACTITIONER
BOARD EXAM PREP 2025/2026
COMPLETE 450 QUESTIONS AND
CORRECT ANSWERS WITH
RATIONALES |ALREADY GRADED
A+||BRAND NEW!!!
Older adolescents with congenital heart defects should be transitioned to adult congenital heart
specialists in order to
A. provide subacute bacterial endocarditis (SBE) prophylaxis.
B. reduce the risk of long-term complications.
C. prepare for the next procedure.
D. refill medications.
The correct answer is B - reduce the risk of long-term complications.
Many children with congenital heart disease (CHD) undergo palliative, not corrective, procedures
when young. As these children grow, they continue to require close follow-up to note when subtle
changes occur and when potential future procedures or surgeries are needed. Studies have shown
that as these older adolescents transitioned to adult CHD specialists, only a small percentage
received the follow-up care they needed. Sometimes several years passed from the time of
recommended transition until they were seen by an adult CHD specialist, usually prompted by new or
increased symptoms.
Not all patients with congenital heart disease require SBE prophylaxis or medications. If these
patients are on medications, the prescribing health care provider should follow them serially to
assess how they are doing, and if any new signs or symptoms have developed. Pregnancy is also not
recommended for women with severe congenital heart lesions and appropriate counseling and birth
control options need to
be discussed.
Which of the following is the MOST appropriate advice for caregivers regarding a child's exposure to
virtual violence?
A+ TEST BANK 1
, CPNP-PC CERTIFIED PEDIATRIC
PRIMARY CARE NURSE
PRACTITIONER BOARD EXAM
A. provide supervision by co-playing or co-viewing first-person shooter games
B. limit exposure to virtual violence to cartoon violence for children under the age of 6
C. implement a "media diet" due to the proven link between virtual violence and real-world
aggression
D. allow exposure to media violence in a controlled virtual reality environment as an outlet to safely
release aggression
The correct answer is C - implement a "media diet" due to the proven link between virtual violence
and real-world aggression
Exposure to violence in media, referred to as virtual violence, places children and adolescents at risk
for negative health effects. Counseling on media consumption is an important way that pediatric
health care providers can reduce the risk of youth violence. Although it is recommended that
caregivers co-view programming or co-play games, first-person shooter games are not
recommended for children of any age. Additionally, because children under the age of 6 can have
difficulty separating fantasy from reality, this group should not be exposed to any type of virtual
violence, including cartoon violence. A common misconception is that children can safely release
aggression in a virtual reality environment. However, it has been shown that experiencing virtual
violence in this way can increase aggression in children and adolescents. Caregivers should be guided
in developing a healthy "media diet" with a focus on time constraints as well as content choice. The
link between virtual violence and real-world aggression has been scientifically proven.
The benefit of fluoride is achieved through which of the following mechanisms?
A. bactericidal effect on Streptococcus mutans
B. remineralization of carious lesions
C. prevention of plaque adherence
D. destruction of milk sugars
The correct answer is B - remineralization of carious lesions
It is important for health care providers to screen for dental caries and to identify risk factors for
development of decay. Caries occur from the overgrowth of the bacteria Streptococcus mutans,
Streptococcus sobrinus, and lactobacillus species, which are part of normal human flora. These
bacteria adhere well to the tooth surface. Topical fluoride is effective in assisting in the prevention of
caries by inhibiting demineralization and aiding in the remineralization of carious lesions. While
fluoride does not prevent plaque adherence, it can alter the enamel of teeth making it more resistant
to the destructive effects of the bacteria found in the mouth. Milk sugars are a common cause of
caries providing a medium for the bacteria to flourish.
The parents of a 5 year old are frustrated by their child's need to select her own clothing, despite
weather and safety. Which is the BEST example of a parent statement to the child that will promote
self-esteem?
A. "Go ahead and wear the sandals, but you will be cold."
A+ TEST BANK 2
, CPNP-PC CERTIFIED PEDIATRIC
PRIMARY CARE NURSE
PRACTITIONER BOARD EXAM
B. "Wear the sandals, but take your shoes and socks in case you change your mind."
C. "You must wear shoes and socks, but you can choose between the red or black ones."
D. "It is too cold to wear sandals, and we cannot leave until you decide to put on shoes and socks."
The correct answer is C - "You must wear shoes and socks, but you can choose between the red or
black ones."
Children need to have limits identified and consequences clearly stated. The goal of discipline is to
ultimately teach the child, not to punish them. Children at age 4 and 5 are at Erikson's developmental
stage of "initiative vs. guilt," and Piaget's "intuition" or preoperational thinking. In order to facilitate
the development of and foster self-esteem, the parent needs to provide guidance, but allow the
child some choices. Limit setting paired with providing options for the child, like the choice of which
shoes to wear, while maintaining that the child cannot wear sandals, supports developmental
theories and fosters a child's self-esteem. There may be times when allowing the child full autonomy
in dressing is acceptable, but safety and health concerns must be considered first by the parents.
Three siblings ages 7-15 years present for new patient visits having recently moved cross country. The
MOST effective guidance related to injury prevention includes
A. incorporating knowledge of risks specific to the community.
B. asking about previous injuries each child has sustained.
C. covering as many age specific areas as possible.
D. directing counselling specifically to each child.
The correct answer is A - incorporating knowledge of risks specific to the community.
Anticipatory guidance for safety and injury prevention is an integral part for the care of children and
should be directed towards the caregivers as they have the capability to modify the child's
environment to promote safety. Safety counseling includes general preventative measures such as
the use of car seats and safety belts as well as developmentally appropriate safety considerations.
Studies have demonstrated that anticipatory guidance surrounding injury prevention are effective.
However, to be retentive, teaching must be limited to a number of topics and not a fully exhaustive
list.
The effectiveness of safety counseling can be improved if a health care provider knows the risks
specific to the local population, especially for new families unfamiliar with potential risks. For
example, recreational activities such as all-terrain vehicles, snowmobiles, and/or personal watercraft
are specific to geographic locations and safety prevention should be tailored to meet these topics.
Health care providers should adapt their age specific safety anticipatory guidance to meet the needs
of the child and family on the basis of risks in the local community as well as the expressed needs of
the patient and families.
A caregiver expresses concern for her 12 month old's lack of interest in playing with other children,
especially due to a family history of autism spectrum disorder. Which of the following is the MOST
appropriate response?
A+ TEST BANK 3
, CPNP-PC CERTIFIED PEDIATRIC
PRIMARY CARE NURSE
PRACTITIONER BOARD EXAM
A. evaluate for social interactions such as peek-a-boo and pat-a-cake
B. offer reassurance that interactive play begins at age 3
C. attempt to engage the child in imitating behaviors
D. refer for a developmental evaluation
The correct answer is B - offer reassurance that interactive play begins at age 3
Play is an essential component in assessing development. Because there is a slight increased risk of
autism spectrum disorder in familial studies, the caregiver is appropriately concerned for the child's
risk. Peek-a-boo and pat-a-cake are developmentally appropriate engaging behaviors at this age;
however, this does not address the concerns of the caregiver. Imitating behaviors begin between
ages 2-3 years, so the child is too young to be evaluated for this type of play. Despite family concerns,
a developmental evaluation is not needed as the child's lack of interactive play does not warrant a
referral at 12 months of age. By educating about age-appropriate types of play, the specific concerns
are being addressed.
A child presents with a two-day history of perianal erythema, itching, pain, and a fever reaching 100.5
F (38 C). Which of the following is the MOST important history question?
A. "Was a fever-reducer given?"
B. "Have you changed bath soaps recently?"
C. "Has the child had a sore throat recently?"
D. "Does anyone in the house have a similar rash?"
The correct answer is C - "Has the child had a sore throat recently?"
The child in this scenario is likely presenting with a perianal streptococcal infection. Common
symptoms include erythema, pain, local itching, and blood streaked stools. While presentation with
fever can occur, many cases do not involve systemic symptoms. The infection is usually a result of
autoinoculation from a recent group A streptococcal infection. On physical exam the perianal area is
erythematous with distinct margins that can extend up to 2 cm from the anus. While the history
questions posed in the options are appropriately asked, the most important is whether there is
history of a recent sore throat which would cause the streptococcal autoinoculation. Rapid strep test
of a perianal swab assists in confirming the diagnosis. Treatment for perianal infection is the same as
for streptococcal pharyngitis with penicillin V or amoxicillin being the most appropriate antibiotics.
Perianal pruritis is also seen with pinworm infections. However, these children typically present with
irritability, hyperactivity and insomnia. They are not painful and do not present with systemic
symptoms. On exam during nighttime, long, white threadlike worms can be seen at the anus.
A mother is concerned about a lump identified under the nipple of her 10-year-old daughter's breast.
The child recently completed leukemia treatment. On examination the right nipple is elevated with
palpable non-tender, soft tissue. The MOST appropriate next step is to
A. reassure that this is normal breast development for the child's age.
B. obtain bloodwork to assess hormone levels and blood counts.
A+ TEST BANK 4
