Barkley CPNP-AC Exam Practice Questions 2026/2027:
Complete 250-Q Test Bank with Verified Answers &
Detailed Rationales | PNCB Acute Care Pediatric NP
Certification Review | 100% Pass Guarantee
SECTION 1: PROFESSIONAL ISSUES & ETHICAL PRACTICE (Questions 1–30)
Question 1
A PICU is experiencing an increase in central line infections, so the ACPNPs decide to
complete a quality improvement project to try to decrease the infection rate. The
PRIMARY reason this endeavor is important is to:
A) Address and support patient safety and quality of care
B) Decrease costs associated with longer lengths of stay for children with infection
C) Identify a new method for central line placement
D) Collect data to document incidence of central line infection compared to national
benchmarks
Correct Answer: A) Address and support patient safety and quality of care
Rationale: Central line-associated bloodstream infections (CLABSI) are the most common
healthcare-associated infection in neonates and children and increase morbidity and
mortality . A quality improvement project includes identifying a problem and uses a
method such as PDSA (Plan, Do, Study, Act) to evaluate the problem and identify solutions
to improve the process of care .
Question 2
An 8-year-old has just been diagnosed with leukemia. The parents do not want him to
know the diagnosis until he is in the hospital for treatment. What is the best approach?
A) Agree with parents, and wait until he is beginning to start treatment
B) Discuss the importance of allowing the child to know his illness now and be involved
in any decision-making
C) Prepare child by playing a game with him to demonstrate what will happen in the
hospital, without disclosing the diagnosis
,D) There is no reason for him to know the diagnosis as long as he is aware of treatment
as it occurs
Correct Answer: B) Discuss the importance of allowing the child to know his illness
now and be involved in any decision-making
Rationale: A school-aged child diagnosed with a life-threatening illness should be allowed
to participate in decision-making with full awareness of his illness. In the case of
participation in a study medication or protocol, the child would also be asked to provide
assent while the parents consent, so transparency is important .
Question 3
A nurse practitioner is asked to witness a blood consent for a child to receive a unit of
packed cells. The provider explaining the procedure leaves out important information
regarding the possibility of contracting an illness from the blood product. The parent
signs the consent, and the NP is asked to sign as witness. What is the best response?
A) Refuse to sign the consent in front of the parent
B) Ask to speak to the other provider in private and discuss the missing information
C) Sign the consent since the parent did not have questions
D) Tell the parents that the other provider left out important information
Correct Answer: B) Ask to speak to the other provider in private and discuss the
missing information
Rationale: Informed consent requires the provider to offer all information about the
procedure, including potential complications. Obtaining consent and/or signing as a
witness requires that the patient/family receives all appropriate information . The NP
should address this privately with the provider.
Question 4
A PNP is preparing to work in a pediatric intensive care unit. She has completed an
acute care program, passed the acute care boards, and secured the position.
Documentation of the educational program, license, and certification reflects which part
of the hospital credentialing process?
,A) Privileging
B) Credentialing
C) Onboarding
D) License verification
Correct Answer: B) Credentialing
Rationale: The process of verifying and documenting the education, certification, and
licensing of a provider is called credentialing. Privileging refers to the set of patient care
skills the provider will be able to utilize based on previous training and validation .
Question 5
An adolescent with a history of severe depression and anxiety, managed with
medication and therapy, has been admitted with pneumonia. She is hesitant to cough
and becomes angry when the respiratory therapist wants to engage her in treatments.
What is the best management?
A) Continue home medications, explain carefully what is being done and why
B) Continue home medications and tell her that she needs to complete treatments as
scheduled
C) Add albuterol to her treatment regimen which will help with coughing
D) Allow her to say no now and she can choose the time for the therapist to return
Correct Answer: A) Continue home medications, explain carefully what is being
done and why
Rationale: A patient being treated with medication for mental health should continue this
therapy as prescribed, as some medications have risks associated with stopping abruptly. A
teen should also have expectations that she will participate in therapy that will improve
her health status. Continuing her depression medications and explaining treatment is most
important .
Question 6
A PNP is completing a literature search for a quality improvement project and is unable
to find a systematic review or randomized controlled trial for this topic. The next level of
evidence to search for includes:
, A) Case studies
B) Expert opinion
C) Quasi-experimental study
D) Cohort study
Correct Answer: D) Cohort study
Rationale: The evidence pyramid illustrates best levels of information to guide practice
change. Systematic reviews and meta-analyses are the highest level, followed by
randomized controlled trials. Cohort studies fall in the middle of the pyramid, followed by
quasi-experimental studies, case studies, and expert opinion .
Question 7
An acute care PNP moves to another state where the job market is limited and finds a
position in an outpatient dermatology office. In considering this job offer, what is most
important?
A) Based on the APRN consensus model, she can work in any pediatric setting as long as
she will be trained on the job
B) She must check with the state board of nursing to find out whether they have
independent practice and if so, she can take the position
C) The APRN consensus model requires that education match certification and practice,
so dermatology would not match acute care practice
D) If the dermatology practice is affiliated with a hospital, it may be considered an acute
care position and a viable position for the ACPNP
Correct Answer: C) The APRN consensus model requires that education match
certification and practice, so dermatology would not match acute care practice
Rationale: The APRN Consensus Model (LACE: Licensure, Accreditation, Certification,
Education) outlines recommendations for uniformity of practice expectations in the
regulation of APRN roles. Despite independent practice clauses, the consensus model
dictates which population an APRN can care for and what certification is acceptable for
that population-based role. Dermatology is a specialty, not acute or critical care in nature .
Complete 250-Q Test Bank with Verified Answers &
Detailed Rationales | PNCB Acute Care Pediatric NP
Certification Review | 100% Pass Guarantee
SECTION 1: PROFESSIONAL ISSUES & ETHICAL PRACTICE (Questions 1–30)
Question 1
A PICU is experiencing an increase in central line infections, so the ACPNPs decide to
complete a quality improvement project to try to decrease the infection rate. The
PRIMARY reason this endeavor is important is to:
A) Address and support patient safety and quality of care
B) Decrease costs associated with longer lengths of stay for children with infection
C) Identify a new method for central line placement
D) Collect data to document incidence of central line infection compared to national
benchmarks
Correct Answer: A) Address and support patient safety and quality of care
Rationale: Central line-associated bloodstream infections (CLABSI) are the most common
healthcare-associated infection in neonates and children and increase morbidity and
mortality . A quality improvement project includes identifying a problem and uses a
method such as PDSA (Plan, Do, Study, Act) to evaluate the problem and identify solutions
to improve the process of care .
Question 2
An 8-year-old has just been diagnosed with leukemia. The parents do not want him to
know the diagnosis until he is in the hospital for treatment. What is the best approach?
A) Agree with parents, and wait until he is beginning to start treatment
B) Discuss the importance of allowing the child to know his illness now and be involved
in any decision-making
C) Prepare child by playing a game with him to demonstrate what will happen in the
hospital, without disclosing the diagnosis
,D) There is no reason for him to know the diagnosis as long as he is aware of treatment
as it occurs
Correct Answer: B) Discuss the importance of allowing the child to know his illness
now and be involved in any decision-making
Rationale: A school-aged child diagnosed with a life-threatening illness should be allowed
to participate in decision-making with full awareness of his illness. In the case of
participation in a study medication or protocol, the child would also be asked to provide
assent while the parents consent, so transparency is important .
Question 3
A nurse practitioner is asked to witness a blood consent for a child to receive a unit of
packed cells. The provider explaining the procedure leaves out important information
regarding the possibility of contracting an illness from the blood product. The parent
signs the consent, and the NP is asked to sign as witness. What is the best response?
A) Refuse to sign the consent in front of the parent
B) Ask to speak to the other provider in private and discuss the missing information
C) Sign the consent since the parent did not have questions
D) Tell the parents that the other provider left out important information
Correct Answer: B) Ask to speak to the other provider in private and discuss the
missing information
Rationale: Informed consent requires the provider to offer all information about the
procedure, including potential complications. Obtaining consent and/or signing as a
witness requires that the patient/family receives all appropriate information . The NP
should address this privately with the provider.
Question 4
A PNP is preparing to work in a pediatric intensive care unit. She has completed an
acute care program, passed the acute care boards, and secured the position.
Documentation of the educational program, license, and certification reflects which part
of the hospital credentialing process?
,A) Privileging
B) Credentialing
C) Onboarding
D) License verification
Correct Answer: B) Credentialing
Rationale: The process of verifying and documenting the education, certification, and
licensing of a provider is called credentialing. Privileging refers to the set of patient care
skills the provider will be able to utilize based on previous training and validation .
Question 5
An adolescent with a history of severe depression and anxiety, managed with
medication and therapy, has been admitted with pneumonia. She is hesitant to cough
and becomes angry when the respiratory therapist wants to engage her in treatments.
What is the best management?
A) Continue home medications, explain carefully what is being done and why
B) Continue home medications and tell her that she needs to complete treatments as
scheduled
C) Add albuterol to her treatment regimen which will help with coughing
D) Allow her to say no now and she can choose the time for the therapist to return
Correct Answer: A) Continue home medications, explain carefully what is being
done and why
Rationale: A patient being treated with medication for mental health should continue this
therapy as prescribed, as some medications have risks associated with stopping abruptly. A
teen should also have expectations that she will participate in therapy that will improve
her health status. Continuing her depression medications and explaining treatment is most
important .
Question 6
A PNP is completing a literature search for a quality improvement project and is unable
to find a systematic review or randomized controlled trial for this topic. The next level of
evidence to search for includes:
, A) Case studies
B) Expert opinion
C) Quasi-experimental study
D) Cohort study
Correct Answer: D) Cohort study
Rationale: The evidence pyramid illustrates best levels of information to guide practice
change. Systematic reviews and meta-analyses are the highest level, followed by
randomized controlled trials. Cohort studies fall in the middle of the pyramid, followed by
quasi-experimental studies, case studies, and expert opinion .
Question 7
An acute care PNP moves to another state where the job market is limited and finds a
position in an outpatient dermatology office. In considering this job offer, what is most
important?
A) Based on the APRN consensus model, she can work in any pediatric setting as long as
she will be trained on the job
B) She must check with the state board of nursing to find out whether they have
independent practice and if so, she can take the position
C) The APRN consensus model requires that education match certification and practice,
so dermatology would not match acute care practice
D) If the dermatology practice is affiliated with a hospital, it may be considered an acute
care position and a viable position for the ACPNP
Correct Answer: C) The APRN consensus model requires that education match
certification and practice, so dermatology would not match acute care practice
Rationale: The APRN Consensus Model (LACE: Licensure, Accreditation, Certification,
Education) outlines recommendations for uniformity of practice expectations in the
regulation of APRN roles. Despite independent practice clauses, the consensus model
dictates which population an APRN can care for and what certification is acceptable for
that population-based role. Dermatology is a specialty, not acute or critical care in nature .
