North Carolina Certified Pediatric Nurse (CPN) | 3
Complete Mock Tests | Guaranteed Pass Pack 2027/2028
Abstract
This comprehensive 200-question examination is specifically designed for candidates
preparing for the Certified Pediatric Nurse (CPN) certification examination offered by the
Pediatric Nursing Certification Board (PNCB). The CPN credential is the premier
certification for registered nurses who provide care for infants, children, adolescents, and
young adults, with more than 56,000 nursing professionals actively holding this credential .
The examination content is structured according to the official PNCB CPN test blueprint,
which is based on the most recent Job Task Analysis research . The exam distribution
includes: Assessment (30%), Health Promotion (17%), Management (48%), and Professional
Role (5%) . The exam consists of 175 multiple-choice questions (150 scored and 25 pretest
questions) with a 3-hour time limit .
This resource incorporates specific North Carolina nursing regulations, including the
state's participation in the Nurse Licensure Compact and continuing education
requirements for APRNs (50 contact hours annually) . Each question includes detailed
rationales explaining why the correct answer is right and why distractors are incorrect,
with references to current clinical guidelines and evidence-based pediatric nursing practice
. This resource serves as both a self-assessment tool and a comprehensive review for
candidates seeking certification in the 2027-2028 cycle.
Mock Test 1: Assessment & Health Promotion
Questions 1-60
1. A 6-month-old infant is brought to the clinic for a well-child visit. Which developmental
milestone should the nurse expect the infant to have achieved?
A) Sitting without support
B) Transferring objects from one hand to the other
C) Rolling from back to abdomen
D) Pincer grasp
Correct Answer: C
Rationale: Rolling from back to abdomen is a gross motor milestone typically achieved by 5-
6 months of age . The sequence of infant motor development follows a cephalocaudal
pattern. Why the others are incorrect: A) Sitting without support is a 7-8 month milestone.
B) Transferring objects hand-to-hand is a 7-month milestone. D) Pincer grasp is a 9-10
month milestone.
,Reference: Bright Futures: Guidelines for Health Supervision of Infants, Children, and
Adolescents
2. A 4-year-old child is hospitalized for asthma exacerbation. According to Erikson's theory
of psychosocial development, which intervention best supports the child's developmental
stage?
A) Encourage the child to complete art projects independently
B) Allow the child to choose which color bandage to apply
C) Provide a detailed medical explanation of the treatment
D) Allow the child to remain in bed to conserve energy
Correct Answer: B
Rationale: The preschool-age child (3-6 years) is in Erikson's initiative vs. guilt stage.
Allowing choices supports a sense of initiative and autonomy during hospitalization . Why
the others are incorrect: A) Art projects are appropriate but choice-making is more specific
to this stage. C) Detailed explanations exceed the cognitive abilities of a preschooler. D)
Restricting activity without opportunity for choice may foster guilt.
Reference: Wong's Nursing Care of Infants and Children
3. A school-age child is brought to the clinic with a fever, sore throat, and difficulty
swallowing. Examination reveals a red throat with tonsillar exudate and petechiae on the
soft palate. Which laboratory finding would be most consistent with a diagnosis of acute
post-streptococcal glomerulonephritis (APSGN)?
A) Elevated serum albumin and decreased blood urea nitrogen
B) Elevated antistreptolysin O (ASO) titer and hematuria
C) Markedly decreased serum creatinine and leukopenia
D) Profuse glucosuria and ketonuria
Correct Answer: B
Rationale: APSGN is an immune-complex disease following a group A beta-hemolytic
streptococcal infection. Key diagnostic findings include a positive ASO titer indicating
previous infection, along with gross or microscopic hematuria due to glomerular damage .
Why the others are incorrect: A) Albumin is typically decreased in nephrotic syndrome, not
APSGN. C) Creatinine is typically elevated, not decreased, and leukopenia is not
characteristic. D) Glucosuria and ketonuria indicate diabetes, not renal disease.
Reference: PNCB CPN Content Outline, Assessment Domain
,4. A 14-year-old adolescent expresses a desire to receive the HPV vaccine during a clinic
visit, but the accompanying parent explicitly refuses consent. Which action must the nurse
take in accordance with North Carolina minor consent laws?
A) Administer the vaccine because the minor is over 12 years old and can consent to
immunizations independently
B) Defer the vaccination and educate both the parent and adolescent about the benefits of
the vaccine to seek alignment
C) File an immediate report with the Department of Social Services for medical neglect
D) Administer the vaccine after obtaining authorization from the clinic's medical director
Correct Answer: B
Rationale: In North Carolina, minors can consent independently to the prevention,
diagnosis, and treatment of venereal diseases and other reportable diseases under certain
conditions, but routine immunizations like the HPV vaccine generally still require parental
or legal guardian consent. The nurse must defer and provide education . Why the others are
incorrect: A) North Carolina law does not permit minors over 12 to consent to routine
immunizations independently. C) Parental refusal of vaccination does not constitute
medical neglect in North Carolina. D) Medical director authorization does not override
parental consent requirements.
Reference: North Carolina Board of Nursing; North Carolina Minor Consent Laws
5. A 5-year-old child with a history of tetralogy of Fallot becomes severely agitated during a
blood draw, turns deeply cyanotic, and begins hyperventilating. Which position should the
nurse place the child in immediately?
A) High-Fowler's position with legs extended
B) Knee-chest position
C) Prone position with head turned to the side
D) Trendelenburg position
Correct Answer: B
Rationale: This describes a hypercyanotic "tet spell." Placing the child in a knee-chest
position increases systemic vascular resistance, which decreases the right-to-left shunt
across the ventricular septal defect, redirecting more blood flow into the pulmonary artery
to improve oxygenation . Why the others are incorrect: A) High-Fowler's with legs extended
decreases SVR and worsens the shunt. C) Prone position does not provide the hemodynamic
benefit of knee-chest. D) Trendelenburg does not specifically address right-to-left shunting.
Reference: Wong's Nursing Care of Infants and Children
6. An 8-month-old infant is assessed for developmental progress. Which primitive reflex, if
still present, indicates a potential delay in neurological development?
, A) Babinski reflex
B) Plantar grasp reflex
C) Moro reflex
D) Parachute reflex
Correct Answer: C
Rationale: The Moro reflex normally disappears by 4 to 6 months of age. Persistence beyond
6 months strongly suggests neurological dysfunction . Why the others are incorrect: A) The
Babinski reflex can persist normally up to 12-24 months. B) The plantar grasp reflex
disappears around 9-12 months. D) The parachute reflex is a protective response that
appears around 7-9 months and persists.
Reference: Wong's Nursing Care of Infants and Children
7. A 12-year-old child with type 1 diabetes mellitus presents with a blood glucose level of
450 mg/dL, arterial pH of 7.15, and positive serum ketones. The nurse initiates an
intravenous infusion of regular insulin. What is the primary therapeutic goal of insulin
administration in this situation?
A) Rapidly lower the blood glucose level to less than 100 mg/dL within the first 2 hours
B) Clear serum ketones and reverse the underlying metabolic acidosis
C) Shift potassium out of the cells and into the extracellular fluid space
D) Prevent hypoglycemia during the acute phase of treatment
Correct Answer: B
Rationale: The child is in diabetic ketoacidosis. The primary therapeutic goal of insulin
administration is to clear serum ketones and reverse the underlying metabolic acidosis.
Insulin stops ketone production and allows cells to utilize glucose . Why the others are
incorrect: A) Rapid glucose lowering can cause cerebral edema; glucose should be reduced
gradually (50-100 mg/dL/hour). C) Insulin shifts potassium INTO cells, not out, which is
why potassium must be monitored. D) While preventing hypoglycemia is important, it is
not the primary therapeutic goal.
Reference: PNCB CPN Content Outline, Management Domain
8. A nurse is providing anticipatory guidance to the parents of a 2-month-old infant. Which
statement should be included regarding infant sleep safety?
A) Place the infant on the stomach to prevent aspiration
B) Use a soft blanket and pillow for comfort
C) Place the infant supine on a firm sleep surface without loose bedding
D) Use a sleep positioner to maintain head position
Correct Answer: C
Complete Mock Tests | Guaranteed Pass Pack 2027/2028
Abstract
This comprehensive 200-question examination is specifically designed for candidates
preparing for the Certified Pediatric Nurse (CPN) certification examination offered by the
Pediatric Nursing Certification Board (PNCB). The CPN credential is the premier
certification for registered nurses who provide care for infants, children, adolescents, and
young adults, with more than 56,000 nursing professionals actively holding this credential .
The examination content is structured according to the official PNCB CPN test blueprint,
which is based on the most recent Job Task Analysis research . The exam distribution
includes: Assessment (30%), Health Promotion (17%), Management (48%), and Professional
Role (5%) . The exam consists of 175 multiple-choice questions (150 scored and 25 pretest
questions) with a 3-hour time limit .
This resource incorporates specific North Carolina nursing regulations, including the
state's participation in the Nurse Licensure Compact and continuing education
requirements for APRNs (50 contact hours annually) . Each question includes detailed
rationales explaining why the correct answer is right and why distractors are incorrect,
with references to current clinical guidelines and evidence-based pediatric nursing practice
. This resource serves as both a self-assessment tool and a comprehensive review for
candidates seeking certification in the 2027-2028 cycle.
Mock Test 1: Assessment & Health Promotion
Questions 1-60
1. A 6-month-old infant is brought to the clinic for a well-child visit. Which developmental
milestone should the nurse expect the infant to have achieved?
A) Sitting without support
B) Transferring objects from one hand to the other
C) Rolling from back to abdomen
D) Pincer grasp
Correct Answer: C
Rationale: Rolling from back to abdomen is a gross motor milestone typically achieved by 5-
6 months of age . The sequence of infant motor development follows a cephalocaudal
pattern. Why the others are incorrect: A) Sitting without support is a 7-8 month milestone.
B) Transferring objects hand-to-hand is a 7-month milestone. D) Pincer grasp is a 9-10
month milestone.
,Reference: Bright Futures: Guidelines for Health Supervision of Infants, Children, and
Adolescents
2. A 4-year-old child is hospitalized for asthma exacerbation. According to Erikson's theory
of psychosocial development, which intervention best supports the child's developmental
stage?
A) Encourage the child to complete art projects independently
B) Allow the child to choose which color bandage to apply
C) Provide a detailed medical explanation of the treatment
D) Allow the child to remain in bed to conserve energy
Correct Answer: B
Rationale: The preschool-age child (3-6 years) is in Erikson's initiative vs. guilt stage.
Allowing choices supports a sense of initiative and autonomy during hospitalization . Why
the others are incorrect: A) Art projects are appropriate but choice-making is more specific
to this stage. C) Detailed explanations exceed the cognitive abilities of a preschooler. D)
Restricting activity without opportunity for choice may foster guilt.
Reference: Wong's Nursing Care of Infants and Children
3. A school-age child is brought to the clinic with a fever, sore throat, and difficulty
swallowing. Examination reveals a red throat with tonsillar exudate and petechiae on the
soft palate. Which laboratory finding would be most consistent with a diagnosis of acute
post-streptococcal glomerulonephritis (APSGN)?
A) Elevated serum albumin and decreased blood urea nitrogen
B) Elevated antistreptolysin O (ASO) titer and hematuria
C) Markedly decreased serum creatinine and leukopenia
D) Profuse glucosuria and ketonuria
Correct Answer: B
Rationale: APSGN is an immune-complex disease following a group A beta-hemolytic
streptococcal infection. Key diagnostic findings include a positive ASO titer indicating
previous infection, along with gross or microscopic hematuria due to glomerular damage .
Why the others are incorrect: A) Albumin is typically decreased in nephrotic syndrome, not
APSGN. C) Creatinine is typically elevated, not decreased, and leukopenia is not
characteristic. D) Glucosuria and ketonuria indicate diabetes, not renal disease.
Reference: PNCB CPN Content Outline, Assessment Domain
,4. A 14-year-old adolescent expresses a desire to receive the HPV vaccine during a clinic
visit, but the accompanying parent explicitly refuses consent. Which action must the nurse
take in accordance with North Carolina minor consent laws?
A) Administer the vaccine because the minor is over 12 years old and can consent to
immunizations independently
B) Defer the vaccination and educate both the parent and adolescent about the benefits of
the vaccine to seek alignment
C) File an immediate report with the Department of Social Services for medical neglect
D) Administer the vaccine after obtaining authorization from the clinic's medical director
Correct Answer: B
Rationale: In North Carolina, minors can consent independently to the prevention,
diagnosis, and treatment of venereal diseases and other reportable diseases under certain
conditions, but routine immunizations like the HPV vaccine generally still require parental
or legal guardian consent. The nurse must defer and provide education . Why the others are
incorrect: A) North Carolina law does not permit minors over 12 to consent to routine
immunizations independently. C) Parental refusal of vaccination does not constitute
medical neglect in North Carolina. D) Medical director authorization does not override
parental consent requirements.
Reference: North Carolina Board of Nursing; North Carolina Minor Consent Laws
5. A 5-year-old child with a history of tetralogy of Fallot becomes severely agitated during a
blood draw, turns deeply cyanotic, and begins hyperventilating. Which position should the
nurse place the child in immediately?
A) High-Fowler's position with legs extended
B) Knee-chest position
C) Prone position with head turned to the side
D) Trendelenburg position
Correct Answer: B
Rationale: This describes a hypercyanotic "tet spell." Placing the child in a knee-chest
position increases systemic vascular resistance, which decreases the right-to-left shunt
across the ventricular septal defect, redirecting more blood flow into the pulmonary artery
to improve oxygenation . Why the others are incorrect: A) High-Fowler's with legs extended
decreases SVR and worsens the shunt. C) Prone position does not provide the hemodynamic
benefit of knee-chest. D) Trendelenburg does not specifically address right-to-left shunting.
Reference: Wong's Nursing Care of Infants and Children
6. An 8-month-old infant is assessed for developmental progress. Which primitive reflex, if
still present, indicates a potential delay in neurological development?
, A) Babinski reflex
B) Plantar grasp reflex
C) Moro reflex
D) Parachute reflex
Correct Answer: C
Rationale: The Moro reflex normally disappears by 4 to 6 months of age. Persistence beyond
6 months strongly suggests neurological dysfunction . Why the others are incorrect: A) The
Babinski reflex can persist normally up to 12-24 months. B) The plantar grasp reflex
disappears around 9-12 months. D) The parachute reflex is a protective response that
appears around 7-9 months and persists.
Reference: Wong's Nursing Care of Infants and Children
7. A 12-year-old child with type 1 diabetes mellitus presents with a blood glucose level of
450 mg/dL, arterial pH of 7.15, and positive serum ketones. The nurse initiates an
intravenous infusion of regular insulin. What is the primary therapeutic goal of insulin
administration in this situation?
A) Rapidly lower the blood glucose level to less than 100 mg/dL within the first 2 hours
B) Clear serum ketones and reverse the underlying metabolic acidosis
C) Shift potassium out of the cells and into the extracellular fluid space
D) Prevent hypoglycemia during the acute phase of treatment
Correct Answer: B
Rationale: The child is in diabetic ketoacidosis. The primary therapeutic goal of insulin
administration is to clear serum ketones and reverse the underlying metabolic acidosis.
Insulin stops ketone production and allows cells to utilize glucose . Why the others are
incorrect: A) Rapid glucose lowering can cause cerebral edema; glucose should be reduced
gradually (50-100 mg/dL/hour). C) Insulin shifts potassium INTO cells, not out, which is
why potassium must be monitored. D) While preventing hypoglycemia is important, it is
not the primary therapeutic goal.
Reference: PNCB CPN Content Outline, Management Domain
8. A nurse is providing anticipatory guidance to the parents of a 2-month-old infant. Which
statement should be included regarding infant sleep safety?
A) Place the infant on the stomach to prevent aspiration
B) Use a soft blanket and pillow for comfort
C) Place the infant supine on a firm sleep surface without loose bedding
D) Use a sleep positioner to maintain head position
Correct Answer: C
