Pediatric Primary Care Nurse Practitioner Comprehensive
Examination Preparation Study Guide Questions and
Answers 2025 Edition
529 source items
Pediatric Primary Care Nurse Practitioner Study Guide • 1
,Question 1
The primary care pediatric nurse practitioner understands that a major child health
outcome associated with worldwide climate change is :
A. cost of living.
B. education.
C. nutrition.
D. pollution.
Correct Answer: C
Rationale: There is growing evidence that climate change is having a dramatic effect on food
crops that leads to food distribution issues and food insecurity among families.
Question 2
The primary care pediatric nurse practitioner understands that, to achieve the greatest
world-wide reduction in child mortality from pneumonia and diarrhea, which intervention
is most effective?
A. Antibiotics
B. Optimal nutrition
C. Vaccinations
D. Water purification
Correct Answer: C
Rationale: Rotavirus is the most common cause of diarrhea globally and Strep pneumonia is the
leading cause of pneumonia, and together these are the leading infectious causes of childhood
morbidity and mortality globally. Both are vaccine-preventable diseases. Antibiotics to treat
pneumonia, optimal nutrition, and clean water all help to reduce morbidity and mortality, but
vaccination prevents the diseases from occurring.
Question 3
When providing well child care for an infant in the first year of life, the primary care
pediatric nurse practitioner is adhering to the most recent American Academy of Pediatrics
Recommendations for Preventive Pediatric Health Care guidelines by :
A. focusing less on development and more on illness prevention and nutrition.
B. following guidelines established by the Bright Futures publication.
C. scheduling well-baby visits to coincide with key developmental milestones.
D. seeing the infant at ages 2, 4, 6, and 12 months when immunizations are due.
Correct Answer: C
Rationale: In the most recent AAP Recommendations for Preventive Pediatric Health Care, there
is a greater emphasis on behavioral and developmental issues and a recommendation that well
child care be based on child and family development rather than the periodicity of immunization
schedules. This will require a revision of the current recommendations in Bright Futures.
Pediatric Primary Care Nurse Practitioner Study Guide • 2
,Question 4
Which is true about the health status of children in the United States?
A. Globalism has relatively little impact on child health measures in the U.S.
B. Obesity rates among 2- to 5-year-olds have shown a recent significant decrease.
C. The rate of household poverty is lower than in other economically developed nations.
D. Young children who attend preschool or day care have higher food insecurity.
Correct Answer: B
Rationale: Obesity rates are a major concern for child health in the U.S. but recently have
stabilized in the rate of increase and have declined among 2- to 5-year-olds between 2004 and
2013. Globalism has an increasing effect on child health in the U.S. The rate of household poverty
in the U.S. is higher than in other economically developed nations. Young children who attend
preschool or day care have lower food insecurity.
Question 5
Which region globally has the highest infant mortality rate?
A. Indonesia
B. Southern Asia
C. Sub-Saharan Africa
D. Syria
Correct Answer: C
Rationale: Although Sub-Saharan Africa and Southern Asia together account for 81% of the infant
mortality rate globally, Sub-Saharan Africa has the highest infant mortality rate in the world.
Question 6
The parent of a toddler is concerned that the child may have autism. The primary care
pediatric nurse practitioner completes a Modified Checklist for Autism in Toddlers (M-
CHAT) tool, which indicates several areas of concern. What will the nurse practitioner do?
A. Administer a Childhood Autism Rating Scale (CARS) in the clinic.
B. Consult a specialist to determine appropriate early intervention strategies.
C. Refer the child to a behavioral specialist for further evaluation.
D. Tell the parent that this result indicates that the child has autism.
Correct Answer: C
Rationale: The M-CHAT is a screening tool and is useful for detecting behaviors that may indicate
autism. This instrument has been found to have acceptable sensitivity, specificity, and significant
positive predictive value. If these behaviors are detected, the PNP should refer the child to a
specialist for further assessment, using more diagnostic tools. The CARS may be used but requires
specialty training and proper credentials. Until the diagnosis is determined, strategies for
intervention are not discussed. The M-CHAT is a screening tool and is not diagnostic.
Question 7
Pediatric Primary Care Nurse Practitioner Study Guide • 3
, The mother of a newborn tells the primary care pediatric nurse practitioner that she is
worried that her child will develop allergies and asthma. Which tool will the nurse
practitioner use to evaluate this risk?
A. Three-generation pedigree
B. Review of systems
C. Genogram
D. Ecomap
Correct Answer: A
Rationale: The three-generation pedigree is used to map out risks for genetic diseases in families,
as well as conditions with modifiable risk factors. The review of systems is used to evaluate the
history of the child's body systems. The genogram is an approach to developing a family database
to provide a graphic representation of family structure, roles, and problems of recurring
significance in a family. The ecomap is used to identify relationships in the family and community
that are supportive or harmful.
Question 8
The primary care pediatric nurse practitioner is performing a well child check-up on a 20-
month-old child. The child was 4 weeks premature and, according to a parent-completed
developmental questionnaire, has achieved milestones for a 15-month-old infant. Which
action is correct?
A. Perform an in-depth developmental assessment screen at this visit to evaluate this child.
B. Reassure the parent that the child will catch up to normal development by age 2 years.
C. Re-evaluate this child's development and milestone achievements at the 2-year visit.
D. Refer the child to a specialty clinic for evaluation and treatment of developmental delay.
Correct Answer: A
Rationale: This child should be at a 19-month adjusted age for prematurity so, according to the
parent screen, is 4 months behind. The PNP should perform a more in-depth screen to evaluate
this delay. Waiting to see if the child will "catch up" or assuring the parent that this will happen
will cause the delays to become more severe. A referral to a specialty clinic should not be made
solely on the basis of the parent-completed questionnaire but only after further evaluation of
possible delays.
Question 9
When formulating developmental diagnoses for pediatric patients, the primary care
pediatric nurse practitioner may use which resource?
A. DC: 0-3R
B. ICD-10-CM
C. ICSD-3
D. NANDA International
Correct Answer: A
Pediatric Primary Care Nurse Practitioner Study Guide • 4
Examination Preparation Study Guide Questions and
Answers 2025 Edition
529 source items
Pediatric Primary Care Nurse Practitioner Study Guide • 1
,Question 1
The primary care pediatric nurse practitioner understands that a major child health
outcome associated with worldwide climate change is :
A. cost of living.
B. education.
C. nutrition.
D. pollution.
Correct Answer: C
Rationale: There is growing evidence that climate change is having a dramatic effect on food
crops that leads to food distribution issues and food insecurity among families.
Question 2
The primary care pediatric nurse practitioner understands that, to achieve the greatest
world-wide reduction in child mortality from pneumonia and diarrhea, which intervention
is most effective?
A. Antibiotics
B. Optimal nutrition
C. Vaccinations
D. Water purification
Correct Answer: C
Rationale: Rotavirus is the most common cause of diarrhea globally and Strep pneumonia is the
leading cause of pneumonia, and together these are the leading infectious causes of childhood
morbidity and mortality globally. Both are vaccine-preventable diseases. Antibiotics to treat
pneumonia, optimal nutrition, and clean water all help to reduce morbidity and mortality, but
vaccination prevents the diseases from occurring.
Question 3
When providing well child care for an infant in the first year of life, the primary care
pediatric nurse practitioner is adhering to the most recent American Academy of Pediatrics
Recommendations for Preventive Pediatric Health Care guidelines by :
A. focusing less on development and more on illness prevention and nutrition.
B. following guidelines established by the Bright Futures publication.
C. scheduling well-baby visits to coincide with key developmental milestones.
D. seeing the infant at ages 2, 4, 6, and 12 months when immunizations are due.
Correct Answer: C
Rationale: In the most recent AAP Recommendations for Preventive Pediatric Health Care, there
is a greater emphasis on behavioral and developmental issues and a recommendation that well
child care be based on child and family development rather than the periodicity of immunization
schedules. This will require a revision of the current recommendations in Bright Futures.
Pediatric Primary Care Nurse Practitioner Study Guide • 2
,Question 4
Which is true about the health status of children in the United States?
A. Globalism has relatively little impact on child health measures in the U.S.
B. Obesity rates among 2- to 5-year-olds have shown a recent significant decrease.
C. The rate of household poverty is lower than in other economically developed nations.
D. Young children who attend preschool or day care have higher food insecurity.
Correct Answer: B
Rationale: Obesity rates are a major concern for child health in the U.S. but recently have
stabilized in the rate of increase and have declined among 2- to 5-year-olds between 2004 and
2013. Globalism has an increasing effect on child health in the U.S. The rate of household poverty
in the U.S. is higher than in other economically developed nations. Young children who attend
preschool or day care have lower food insecurity.
Question 5
Which region globally has the highest infant mortality rate?
A. Indonesia
B. Southern Asia
C. Sub-Saharan Africa
D. Syria
Correct Answer: C
Rationale: Although Sub-Saharan Africa and Southern Asia together account for 81% of the infant
mortality rate globally, Sub-Saharan Africa has the highest infant mortality rate in the world.
Question 6
The parent of a toddler is concerned that the child may have autism. The primary care
pediatric nurse practitioner completes a Modified Checklist for Autism in Toddlers (M-
CHAT) tool, which indicates several areas of concern. What will the nurse practitioner do?
A. Administer a Childhood Autism Rating Scale (CARS) in the clinic.
B. Consult a specialist to determine appropriate early intervention strategies.
C. Refer the child to a behavioral specialist for further evaluation.
D. Tell the parent that this result indicates that the child has autism.
Correct Answer: C
Rationale: The M-CHAT is a screening tool and is useful for detecting behaviors that may indicate
autism. This instrument has been found to have acceptable sensitivity, specificity, and significant
positive predictive value. If these behaviors are detected, the PNP should refer the child to a
specialist for further assessment, using more diagnostic tools. The CARS may be used but requires
specialty training and proper credentials. Until the diagnosis is determined, strategies for
intervention are not discussed. The M-CHAT is a screening tool and is not diagnostic.
Question 7
Pediatric Primary Care Nurse Practitioner Study Guide • 3
, The mother of a newborn tells the primary care pediatric nurse practitioner that she is
worried that her child will develop allergies and asthma. Which tool will the nurse
practitioner use to evaluate this risk?
A. Three-generation pedigree
B. Review of systems
C. Genogram
D. Ecomap
Correct Answer: A
Rationale: The three-generation pedigree is used to map out risks for genetic diseases in families,
as well as conditions with modifiable risk factors. The review of systems is used to evaluate the
history of the child's body systems. The genogram is an approach to developing a family database
to provide a graphic representation of family structure, roles, and problems of recurring
significance in a family. The ecomap is used to identify relationships in the family and community
that are supportive or harmful.
Question 8
The primary care pediatric nurse practitioner is performing a well child check-up on a 20-
month-old child. The child was 4 weeks premature and, according to a parent-completed
developmental questionnaire, has achieved milestones for a 15-month-old infant. Which
action is correct?
A. Perform an in-depth developmental assessment screen at this visit to evaluate this child.
B. Reassure the parent that the child will catch up to normal development by age 2 years.
C. Re-evaluate this child's development and milestone achievements at the 2-year visit.
D. Refer the child to a specialty clinic for evaluation and treatment of developmental delay.
Correct Answer: A
Rationale: This child should be at a 19-month adjusted age for prematurity so, according to the
parent screen, is 4 months behind. The PNP should perform a more in-depth screen to evaluate
this delay. Waiting to see if the child will "catch up" or assuring the parent that this will happen
will cause the delays to become more severe. A referral to a specialty clinic should not be made
solely on the basis of the parent-completed questionnaire but only after further evaluation of
possible delays.
Question 9
When formulating developmental diagnoses for pediatric patients, the primary care
pediatric nurse practitioner may use which resource?
A. DC: 0-3R
B. ICD-10-CM
C. ICSD-3
D. NANDA International
Correct Answer: A
Pediatric Primary Care Nurse Practitioner Study Guide • 4
