CPNP-PC/AC CERTIFICATION PRACTICE
QUESTIONS WITH CORRECT ANSWERS
AND RATIONALES 2026/2027
Domain 1: Health Promotion & Maintenance (Questions 1-75)
1. A 2-week-old infant is brought in for a routine well-child visit. The mother
reports that the infant cries for 3 hours each evening and seems
inconsolable. Which of the following is the most appropriate anticipatory
guidance?
A. Recommend starting rice cereal in the bottle to help the infant sleep
longer
B. Educate the mother about normal crying patterns and strategies for
soothing a fussy infant
C. Prescribe simethicone drops for suspected colic
D. Refer the infant to a pediatric gastroenterologist
Correct Answer: B
Rationale: Crying peaks around 6-8 weeks of age, and infants may cry 2-3
hours daily. Anticipatory guidance about normal crying patterns, the "Period
of PURPLE Crying," and safe soothing techniques is essential. Rice cereal
in bottles is not recommended before 4-6 months due to choking risk and
,developmental readiness. Simethicone has limited evidence for colic.
Referral is premature without failed interventions .
---
2. A 4-year-old presents with a barking cough and inspiratory stridor that
worsens at night. The child is afebrile and well-appearing. What is the most
likely diagnosis?
A. Epiglottitis
B. Croup
C. Foreign body aspiration
D. Bacterial tracheitis
Correct Answer: B
Rationale: Croup (laryngotracheobronchitis) is characterized by a barking
cough, inspiratory stridor, and worsening at night, typically in children 6
months to 3 years. Epiglottitis presents with drooling, tripod positioning, and
toxicity. Foreign body aspiration typically has sudden onset with no viral
prodrome. Bacterial tracheitis presents with high fever and toxicity .
---
3. A 15-year-old female presents with secondary amenorrhea for 8 months
and a BMI of 15. The most likely cause is:
,A. Polycystic ovary syndrome
B. Anorexia nervosa
C. Thyroid disorder
D. Ovarian tumor
Correct Answer: B
Rationale: Low BMI with secondary amenorrhea strongly suggests
hypothalamic suppression from anorexia nervosa. PCOS is associated with
normal or elevated BMI. Thyroid disorders may cause amenorrhea but are
less likely with this presentation. Ovarian tumors are rare causes of
amenorrhea .
---
4. In anticipatory guidance for a 12-month-old, the PNP should emphasize:
A. Potty training readiness
B. Rear-facing car seat until at least age 2
C. Swimming lessons
D. Brushing teeth twice daily with fluoridated toothpaste
Correct Answer: B
, Rationale: Safety guidance should emphasize rear-facing car seats until
age 2 or until height/weight limits are met. Potty training is typically not
initiated until 18-24 months. Swimming lessons are not recommended for
children under 4 years. While dental hygiene is important, brushing with
fluoridated toothpaste is emphasized at the 12-month visit, but car seat
safety is the priority .
---
5. A 7-year-old with persistent asthma has an FEV1 of 55% predicted. This
severity classification is:
A. Intermittent
B. Mild persistent
C. Moderate persistent
D. Severe persistent
Correct Answer: C
Rationale: FEV1 60-80% predicted indicates moderate persistent asthma;
<60% indicates severe persistent. Intermittent asthma has FEV1 >80%.
Mild persistent asthma has FEV1 >80% with symptoms >2 days/week .
---
6. A child presents with fever, drooling, and tripod positioning. The priority
action is:
QUESTIONS WITH CORRECT ANSWERS
AND RATIONALES 2026/2027
Domain 1: Health Promotion & Maintenance (Questions 1-75)
1. A 2-week-old infant is brought in for a routine well-child visit. The mother
reports that the infant cries for 3 hours each evening and seems
inconsolable. Which of the following is the most appropriate anticipatory
guidance?
A. Recommend starting rice cereal in the bottle to help the infant sleep
longer
B. Educate the mother about normal crying patterns and strategies for
soothing a fussy infant
C. Prescribe simethicone drops for suspected colic
D. Refer the infant to a pediatric gastroenterologist
Correct Answer: B
Rationale: Crying peaks around 6-8 weeks of age, and infants may cry 2-3
hours daily. Anticipatory guidance about normal crying patterns, the "Period
of PURPLE Crying," and safe soothing techniques is essential. Rice cereal
in bottles is not recommended before 4-6 months due to choking risk and
,developmental readiness. Simethicone has limited evidence for colic.
Referral is premature without failed interventions .
---
2. A 4-year-old presents with a barking cough and inspiratory stridor that
worsens at night. The child is afebrile and well-appearing. What is the most
likely diagnosis?
A. Epiglottitis
B. Croup
C. Foreign body aspiration
D. Bacterial tracheitis
Correct Answer: B
Rationale: Croup (laryngotracheobronchitis) is characterized by a barking
cough, inspiratory stridor, and worsening at night, typically in children 6
months to 3 years. Epiglottitis presents with drooling, tripod positioning, and
toxicity. Foreign body aspiration typically has sudden onset with no viral
prodrome. Bacterial tracheitis presents with high fever and toxicity .
---
3. A 15-year-old female presents with secondary amenorrhea for 8 months
and a BMI of 15. The most likely cause is:
,A. Polycystic ovary syndrome
B. Anorexia nervosa
C. Thyroid disorder
D. Ovarian tumor
Correct Answer: B
Rationale: Low BMI with secondary amenorrhea strongly suggests
hypothalamic suppression from anorexia nervosa. PCOS is associated with
normal or elevated BMI. Thyroid disorders may cause amenorrhea but are
less likely with this presentation. Ovarian tumors are rare causes of
amenorrhea .
---
4. In anticipatory guidance for a 12-month-old, the PNP should emphasize:
A. Potty training readiness
B. Rear-facing car seat until at least age 2
C. Swimming lessons
D. Brushing teeth twice daily with fluoridated toothpaste
Correct Answer: B
, Rationale: Safety guidance should emphasize rear-facing car seats until
age 2 or until height/weight limits are met. Potty training is typically not
initiated until 18-24 months. Swimming lessons are not recommended for
children under 4 years. While dental hygiene is important, brushing with
fluoridated toothpaste is emphasized at the 12-month visit, but car seat
safety is the priority .
---
5. A 7-year-old with persistent asthma has an FEV1 of 55% predicted. This
severity classification is:
A. Intermittent
B. Mild persistent
C. Moderate persistent
D. Severe persistent
Correct Answer: C
Rationale: FEV1 60-80% predicted indicates moderate persistent asthma;
<60% indicates severe persistent. Intermittent asthma has FEV1 >80%.
Mild persistent asthma has FEV1 >80% with symptoms >2 days/week .
---
6. A child presents with fever, drooling, and tripod positioning. The priority
action is:
