PNP CERTIFICATION EXAM PREP 2026 UPDATED
PRACTICE QUESTIONS Comprehensive Pediatric
Review Guide with Detailed Rationales, Verified
Answers, Success Workbook
Question 1:
A 2-month-old infant presents for a well-child visit. The mother reports that
the infant is breastfeeding every 2–3 hours and has had 5–6 wet diapers per
day. The infant's weight is at the 25th percentile, length at the 30th percentile,
and head circumference at the 50th percentile. Which of the following is the
most appropriate immunization recommendation at this visit?
A) DTaP, IPV, Hib, PCV13, RV
B) DTaP, IPV, Hib, PCV13, RV, HepB
C) DTaP, IPV, Hib, PCV13, RV, HepA
D) DTaP, IPV, Hib, PCV13, RV, MMR
Correct Answer: B) DTaP, IPV, Hib, PCV13, RV, HepB
Rationale:
At 2 months of age, the CDC recommends the following vaccines: DTaP, IPV,
Hib, PCV13, RV, and HepB (the second dose of HepB is typically given at 1–2
months). Option A is missing HepB. Option C includes HepA, which is not
given until 12 months. Option D includes MMR, which is not given until 12–15
months.
Key Point: The 2-month vaccine schedule includes DTaP, IPV, Hib, PCV13, RV,
and HepB.
Question 2:
A 4-year-old child presents for a well-child visit. The child has received all
recommended vaccines according to the CDC schedule. Which of the following
vaccines is due at this visit?
,A) MMR
B) Varicella
C) DTaP
D) All of the above
Correct Answer: D) All of the above
Rationale:
At 4 years of age, the CDC recommends the following vaccines: DTaP (5th
dose), IPV (4th dose), MMR (2nd dose), and Varicella (2nd dose). All of these
vaccines are due at the 4–6 year visit. Option A, B, and C are all indicated.
Key Point: The 4–6 year visit includes DTaP, IPV, MMR, and Varicella.
Question 3:
A 12-month-old infant presents for a well-child visit. The mother reports that
the infant is drinking whole milk and eating table foods. Which of the
following is the most appropriate developmental screening recommendation
at this visit?
A) M-CHAT (Modified Checklist for Autism in Toddlers)
B) ASQ-3 (Ages and Stages Questionnaire)
C) PEDS (Parents' Evaluation of Developmental Status)
D) All of the above
Correct Answer: D) All of the above
Rationale:
The AAP recommends developmental screening at 9, 18, and 24–30 months
using a validated tool such as the ASQ-3 or PEDS. Autism-specific screening
with the M-CHAT is recommended at 18 and 24 months. At 12 months, both
general developmental and autism-specific screening may be appropriate.
Option A, B, and C are all recommended at various well-child visits.
Key Point: Developmental screening should occur at 9, 18, and 24–30
months; autism screening at 18 and 24 months.
,Question 4:
A 15-year-old adolescent presents for a well-child visit. The adolescent
reports being sexually active with one partner and using condoms
inconsistently. Which of the following is the most appropriate screening
recommendation?
A) Chlamydia and gonorrhea screening
B) HIV screening
C) Syphilis screening
D) All of the above
Correct Answer: D) All of the above
Rationale:
The CDC and USPSTF recommend annual chlamydia and gonorrhea screening
for sexually active women aged <25 years and for sexually active men at
increased risk. HIV screening is recommended for all adolescents aged 15–65
years. Syphilis screening is recommended for those at increased risk. Option
A, B, and C are all indicated for this patient.
Key Point: Sexually active adolescents should be screened for chlamydia,
gonorrhea, HIV, and syphilis as indicated.
Question 5:
A 6-year-old child presents for a well-child visit. The child's BMI is at the 85th
percentile. Which of the following is the most appropriate management?
A) Reassure the parents that this is normal
B) Counsel on healthy eating and physical activity
C) Order laboratory tests for metabolic syndrome
D) Refer to a pediatric endocrinologist
Correct Answer: B) Counsel on healthy eating and physical activity
Rationale:
A BMI ≥85th percentile is classified as overweight. The most appropriate
initial management is counseling on healthy eating and physical activity.
Laboratory testing (Option C) may be considered if there are additional risk
, factors. Referral (Option D) is not necessary at this stage. Option A is
incorrect; the child is overweight and intervention is needed.
Key Point: Overweight children (BMI ≥85th percentile) should receive
counseling on healthy lifestyle changes.
Question 6:
A 2-year-old child presents for a well-child visit. The child is not yet speaking
in two-word phrases. The parents are concerned about speech delay. Which of
the following is the most appropriate next step?
A) Reassure the parents that this is normal and re-evaluate at 3 years
B) Refer to a speech therapist
C) Perform a hearing screening and developmental assessment
D) Recommend a hearing screening only
Correct Answer: C) Perform a hearing screening and developmental
assessment
Rationale:
At 2 years of age, most children can speak in two-word phrases. The first step
in evaluating speech delay is to perform a hearing screening to rule out
hearing loss, followed by a developmental assessment. Option A is incorrect;
this is a concern that warrants evaluation. Option B, referral, may be needed
but should follow assessment. Option D is insufficient.
Key Point: Speech delay evaluation should begin with hearing screening and
developmental assessment.
Question 7:
A 10-year-old child presents for a well-child visit. The child has not received
the HPV vaccine. Which of the following is the most appropriate
recommendation?
A) HPV vaccine 2-dose series starting now
B) HPV vaccine 3-dose series starting now
C) HPV vaccine is not recommended for children under 12
D) HPV vaccine 2-dose series starting at 11 years
PRACTICE QUESTIONS Comprehensive Pediatric
Review Guide with Detailed Rationales, Verified
Answers, Success Workbook
Question 1:
A 2-month-old infant presents for a well-child visit. The mother reports that
the infant is breastfeeding every 2–3 hours and has had 5–6 wet diapers per
day. The infant's weight is at the 25th percentile, length at the 30th percentile,
and head circumference at the 50th percentile. Which of the following is the
most appropriate immunization recommendation at this visit?
A) DTaP, IPV, Hib, PCV13, RV
B) DTaP, IPV, Hib, PCV13, RV, HepB
C) DTaP, IPV, Hib, PCV13, RV, HepA
D) DTaP, IPV, Hib, PCV13, RV, MMR
Correct Answer: B) DTaP, IPV, Hib, PCV13, RV, HepB
Rationale:
At 2 months of age, the CDC recommends the following vaccines: DTaP, IPV,
Hib, PCV13, RV, and HepB (the second dose of HepB is typically given at 1–2
months). Option A is missing HepB. Option C includes HepA, which is not
given until 12 months. Option D includes MMR, which is not given until 12–15
months.
Key Point: The 2-month vaccine schedule includes DTaP, IPV, Hib, PCV13, RV,
and HepB.
Question 2:
A 4-year-old child presents for a well-child visit. The child has received all
recommended vaccines according to the CDC schedule. Which of the following
vaccines is due at this visit?
,A) MMR
B) Varicella
C) DTaP
D) All of the above
Correct Answer: D) All of the above
Rationale:
At 4 years of age, the CDC recommends the following vaccines: DTaP (5th
dose), IPV (4th dose), MMR (2nd dose), and Varicella (2nd dose). All of these
vaccines are due at the 4–6 year visit. Option A, B, and C are all indicated.
Key Point: The 4–6 year visit includes DTaP, IPV, MMR, and Varicella.
Question 3:
A 12-month-old infant presents for a well-child visit. The mother reports that
the infant is drinking whole milk and eating table foods. Which of the
following is the most appropriate developmental screening recommendation
at this visit?
A) M-CHAT (Modified Checklist for Autism in Toddlers)
B) ASQ-3 (Ages and Stages Questionnaire)
C) PEDS (Parents' Evaluation of Developmental Status)
D) All of the above
Correct Answer: D) All of the above
Rationale:
The AAP recommends developmental screening at 9, 18, and 24–30 months
using a validated tool such as the ASQ-3 or PEDS. Autism-specific screening
with the M-CHAT is recommended at 18 and 24 months. At 12 months, both
general developmental and autism-specific screening may be appropriate.
Option A, B, and C are all recommended at various well-child visits.
Key Point: Developmental screening should occur at 9, 18, and 24–30
months; autism screening at 18 and 24 months.
,Question 4:
A 15-year-old adolescent presents for a well-child visit. The adolescent
reports being sexually active with one partner and using condoms
inconsistently. Which of the following is the most appropriate screening
recommendation?
A) Chlamydia and gonorrhea screening
B) HIV screening
C) Syphilis screening
D) All of the above
Correct Answer: D) All of the above
Rationale:
The CDC and USPSTF recommend annual chlamydia and gonorrhea screening
for sexually active women aged <25 years and for sexually active men at
increased risk. HIV screening is recommended for all adolescents aged 15–65
years. Syphilis screening is recommended for those at increased risk. Option
A, B, and C are all indicated for this patient.
Key Point: Sexually active adolescents should be screened for chlamydia,
gonorrhea, HIV, and syphilis as indicated.
Question 5:
A 6-year-old child presents for a well-child visit. The child's BMI is at the 85th
percentile. Which of the following is the most appropriate management?
A) Reassure the parents that this is normal
B) Counsel on healthy eating and physical activity
C) Order laboratory tests for metabolic syndrome
D) Refer to a pediatric endocrinologist
Correct Answer: B) Counsel on healthy eating and physical activity
Rationale:
A BMI ≥85th percentile is classified as overweight. The most appropriate
initial management is counseling on healthy eating and physical activity.
Laboratory testing (Option C) may be considered if there are additional risk
, factors. Referral (Option D) is not necessary at this stage. Option A is
incorrect; the child is overweight and intervention is needed.
Key Point: Overweight children (BMI ≥85th percentile) should receive
counseling on healthy lifestyle changes.
Question 6:
A 2-year-old child presents for a well-child visit. The child is not yet speaking
in two-word phrases. The parents are concerned about speech delay. Which of
the following is the most appropriate next step?
A) Reassure the parents that this is normal and re-evaluate at 3 years
B) Refer to a speech therapist
C) Perform a hearing screening and developmental assessment
D) Recommend a hearing screening only
Correct Answer: C) Perform a hearing screening and developmental
assessment
Rationale:
At 2 years of age, most children can speak in two-word phrases. The first step
in evaluating speech delay is to perform a hearing screening to rule out
hearing loss, followed by a developmental assessment. Option A is incorrect;
this is a concern that warrants evaluation. Option B, referral, may be needed
but should follow assessment. Option D is insufficient.
Key Point: Speech delay evaluation should begin with hearing screening and
developmental assessment.
Question 7:
A 10-year-old child presents for a well-child visit. The child has not received
the HPV vaccine. Which of the following is the most appropriate
recommendation?
A) HPV vaccine 2-dose series starting now
B) HPV vaccine 3-dose series starting now
C) HPV vaccine is not recommended for children under 12
D) HPV vaccine 2-dose series starting at 11 years
