PedsCE PNP-PC Exam Practice Questions with Correct Answers and
Rationales A+ Grade 2026/2027 | Complete Pediatric Nurse Practitioner
Study Guide
The most likely cause of bilateral purulent conjunctivitis in a 1-day old infant is
a. Gonorrheal opthalmia
b. Chlamydia infection
c. Symphilitic opthalmia
d. Adenovirus infection - (ANSWER)a. Gonorrheal ophthalmia
Rationale: Gonorrehea usually appears in the first 3-5 days of life. Chlamydia is between days 5-14. The
other 2 are less common in neonates. Most common causes of conjunctivitis in newborn includes,
Chlamydia, Gonorrhea, HSV, and chemical induced conjunctivitis. (Burns)
Which of the following circumstances is most suggestive of excessive stress in a family with a chronically
ill child?
a. The father takes a second job to meet financial responsibilities
b. The mother provides the majority of the care for the child
c. The parents stop participation in a support group
d. A sibling exhibits decline in school performance - (ANSWER)c. The parents stop participation in a
support group
Rationale: Chronic illness takes a significant stress on the family. It can result in changes in roles as well
as the sibling feeling unloved or left out in some way. Can also result in depression/anxiety of parents
and other family members. Positive social networks are a positive influence on parents and the PNP
should be concerned if the family is withdrawing from supportive social networks. This could indicate
depression or extreme stress on the family unit. (Burns)
An otherwise healthy 2-year old boy is brought to the emergency room with a four-week history of
wheezing and persistent cough. Prior to the start of these symptoms, the parent recalls a coughing event
which resolved spontaneously. Of the following the most likely diagnosis is:
,PedsCE PNP-PC Exam Practice Questions with Correct Answers and
Rationales A+ Grade 2026/2027 | Complete Pediatric Nurse Practitioner
Study Guide
a. Viral pneumonia
b. Acute laryngotracheobronchitis
c. Bronchiolitis
d. Foreign body aspiration - (ANSWER)d. Foreign body aspiration
Rationale: An initial choking, gagging, or coughing episode following by spontaneous resolution is often
present in history finding of a child with foreign body aspiration. The episode is typically followed by
respiratory symptoms such as stridor, wheezing, and prolonged cough in the absence of illness. Acute
layngotracheobronchitis, bronchitis, and viral pneumonia are also associated with coughing and
wheezing but also involve other symptoms such as fever, rhinorrhea, fatigue and usually resolve within
10-14 days. (Nelson Textbook of Pediatrics 20th edition, Chapter 327)
The sexual development of a 14-year old girl is notably delayed. She is very short, slightly obese, and
complains of constipation and fatigue. Her skin is sallow and coarse in texture, and her hair is brittle.
Which of the following tests should be obtained?
a. Serum leutinizing hormone and chromosome analysis
b. Serum thyroxine and thryroid-stimulating hormone
c. Chromosome analysis and serum thyroxine
d. Serum leutinizing hormone and thyroid stimulating hormone - (ANSWER)b. Serum thyroxine and
thryroid-stimulating hormone
Rationale: Classic symptoms of growth failure, goiter, delayed or arrested puberty, delayed dentition,
weight gain, fatigue, dry skin, hyperlipidemia, decline in school performance, menorrhagia, and fatigue.
It would be most appropriate to test for hypothyroidism first in this patient. If these are normal then you
may want to consider the other tests for reasons for her growth delay etc. (Burns)
Which of the following children requires a language referral for further evaluation?
, PedsCE PNP-PC Exam Practice Questions with Correct Answers and
Rationales A+ Grade 2026/2027 | Complete Pediatric Nurse Practitioner
Study Guide
a. 1-year-old with a 5-word vocabulary
b. 2-year-old who cannot put two words together
c. 2-year-old with a 30-word vocabulary
d. 3-year-old who is understandable to parents - (ANSWER)b. 2-year-old who cannot put two words
together
Rationale: A 1 year old can have ~5 words with normal development, a 2 year old should have 20+
words, and by the age of 3 the child should be fully understandable by parents and 90% intelligible by
strangers. A 2 year old should be able to put 2 word sentences together so if this milestone is not
present then the patient needs further evaluation to assess for language delays. (Burns, Bright Futures)
A pediatric primary care nurse practitioner observes multiple oval macules, both hyperpigmented and
hypopigmented, on a child's upper trunk. A fine scale surrounds the borders of the lesions. The diagnosis
is:
a. Atopic dermatitis
b. Keratosis pilaris
c. Pityriasis rosea
d. Tinea versicolor - (ANSWER)d. Tinea versicolor
Rationale: Tinea versicolor is a common dermatosis characterized by multiple small, oval, scaly patches
measuring 1 to 3 cm in diameter, usually located in a raindrop pattern on the upper chest, back, and
proximal portions of the upper extremities. In children, atopic dermatitis lesions are typically dry,
papular, and intensely pruritic. Circumscribed scaly patches are distributed on the wrists, ankles, and
antecubital and popliteal fossae. Keratosis Pilaris is typically distributed on the posterior upper portion of
the arms and lesions are dry and papular. With Pityriasis rosea, a prodrome of malaise, headache, and
mild constitutional symptoms occasionally precedes the rash but is not crucial for diagnosis. The typical
eruption begins with the appearance of one or multiple "herald patches" which are large, isolated, oval
lesions, usually pink in color and slightly scaly; they may occur anywhere on the body. From 5 to 10 days
later, other smaller oval lesions appear on the body, frequently concentrated over the trunk but also
Rationales A+ Grade 2026/2027 | Complete Pediatric Nurse Practitioner
Study Guide
The most likely cause of bilateral purulent conjunctivitis in a 1-day old infant is
a. Gonorrheal opthalmia
b. Chlamydia infection
c. Symphilitic opthalmia
d. Adenovirus infection - (ANSWER)a. Gonorrheal ophthalmia
Rationale: Gonorrehea usually appears in the first 3-5 days of life. Chlamydia is between days 5-14. The
other 2 are less common in neonates. Most common causes of conjunctivitis in newborn includes,
Chlamydia, Gonorrhea, HSV, and chemical induced conjunctivitis. (Burns)
Which of the following circumstances is most suggestive of excessive stress in a family with a chronically
ill child?
a. The father takes a second job to meet financial responsibilities
b. The mother provides the majority of the care for the child
c. The parents stop participation in a support group
d. A sibling exhibits decline in school performance - (ANSWER)c. The parents stop participation in a
support group
Rationale: Chronic illness takes a significant stress on the family. It can result in changes in roles as well
as the sibling feeling unloved or left out in some way. Can also result in depression/anxiety of parents
and other family members. Positive social networks are a positive influence on parents and the PNP
should be concerned if the family is withdrawing from supportive social networks. This could indicate
depression or extreme stress on the family unit. (Burns)
An otherwise healthy 2-year old boy is brought to the emergency room with a four-week history of
wheezing and persistent cough. Prior to the start of these symptoms, the parent recalls a coughing event
which resolved spontaneously. Of the following the most likely diagnosis is:
,PedsCE PNP-PC Exam Practice Questions with Correct Answers and
Rationales A+ Grade 2026/2027 | Complete Pediatric Nurse Practitioner
Study Guide
a. Viral pneumonia
b. Acute laryngotracheobronchitis
c. Bronchiolitis
d. Foreign body aspiration - (ANSWER)d. Foreign body aspiration
Rationale: An initial choking, gagging, or coughing episode following by spontaneous resolution is often
present in history finding of a child with foreign body aspiration. The episode is typically followed by
respiratory symptoms such as stridor, wheezing, and prolonged cough in the absence of illness. Acute
layngotracheobronchitis, bronchitis, and viral pneumonia are also associated with coughing and
wheezing but also involve other symptoms such as fever, rhinorrhea, fatigue and usually resolve within
10-14 days. (Nelson Textbook of Pediatrics 20th edition, Chapter 327)
The sexual development of a 14-year old girl is notably delayed. She is very short, slightly obese, and
complains of constipation and fatigue. Her skin is sallow and coarse in texture, and her hair is brittle.
Which of the following tests should be obtained?
a. Serum leutinizing hormone and chromosome analysis
b. Serum thyroxine and thryroid-stimulating hormone
c. Chromosome analysis and serum thyroxine
d. Serum leutinizing hormone and thyroid stimulating hormone - (ANSWER)b. Serum thyroxine and
thryroid-stimulating hormone
Rationale: Classic symptoms of growth failure, goiter, delayed or arrested puberty, delayed dentition,
weight gain, fatigue, dry skin, hyperlipidemia, decline in school performance, menorrhagia, and fatigue.
It would be most appropriate to test for hypothyroidism first in this patient. If these are normal then you
may want to consider the other tests for reasons for her growth delay etc. (Burns)
Which of the following children requires a language referral for further evaluation?
, PedsCE PNP-PC Exam Practice Questions with Correct Answers and
Rationales A+ Grade 2026/2027 | Complete Pediatric Nurse Practitioner
Study Guide
a. 1-year-old with a 5-word vocabulary
b. 2-year-old who cannot put two words together
c. 2-year-old with a 30-word vocabulary
d. 3-year-old who is understandable to parents - (ANSWER)b. 2-year-old who cannot put two words
together
Rationale: A 1 year old can have ~5 words with normal development, a 2 year old should have 20+
words, and by the age of 3 the child should be fully understandable by parents and 90% intelligible by
strangers. A 2 year old should be able to put 2 word sentences together so if this milestone is not
present then the patient needs further evaluation to assess for language delays. (Burns, Bright Futures)
A pediatric primary care nurse practitioner observes multiple oval macules, both hyperpigmented and
hypopigmented, on a child's upper trunk. A fine scale surrounds the borders of the lesions. The diagnosis
is:
a. Atopic dermatitis
b. Keratosis pilaris
c. Pityriasis rosea
d. Tinea versicolor - (ANSWER)d. Tinea versicolor
Rationale: Tinea versicolor is a common dermatosis characterized by multiple small, oval, scaly patches
measuring 1 to 3 cm in diameter, usually located in a raindrop pattern on the upper chest, back, and
proximal portions of the upper extremities. In children, atopic dermatitis lesions are typically dry,
papular, and intensely pruritic. Circumscribed scaly patches are distributed on the wrists, ankles, and
antecubital and popliteal fossae. Keratosis Pilaris is typically distributed on the posterior upper portion of
the arms and lesions are dry and papular. With Pityriasis rosea, a prodrome of malaise, headache, and
mild constitutional symptoms occasionally precedes the rash but is not crucial for diagnosis. The typical
eruption begins with the appearance of one or multiple "herald patches" which are large, isolated, oval
lesions, usually pink in color and slightly scaly; they may occur anywhere on the body. From 5 to 10 days
later, other smaller oval lesions appear on the body, frequently concentrated over the trunk but also
