PEDIATRIC NURSE PRACTITIONER
(PNP) PRACTICE EXAMINATION
QUESTIONS WITH CORRECT
ANSWERS PLUS RATIONALES
2026/2027 EDITION WITH INSTANT
PDF DOWNLOAD
1. A 2-month-old infant is brought to the clinic for a routine health
visit. Which finding requires the most immediate evaluation?
A. Mild cradle cap
B. Brief startle response to loud noise
C. Respiratory rate of 68 breaths/minute with nasal flaring
D. Moro reflex present bilaterally
Correct Answer: C. Respiratory rate of 68 breaths/minute with
nasal flaring
Rationale: Tachypnea accompanied by nasal flaring indicates
increased work of breathing and may signal respiratory distress. In
a young infant, significant respiratory abnormalities require
prompt assessment because infants can deteriorate rapidly.
Cradle cap and normal primitive reflexes are expected findings at
this age.
2. Which developmental milestone is generally expected in a
healthy 6-month-old infant?
,A. Walking independently
B. Sitting briefly without support
C. Using two-word phrases
D. Copying a circle
Correct Answer: B. Sitting briefly without support
Rationale: By approximately 6 months, many infants can sit briefly
without support and demonstrate improved head and trunk
control. Independent walking and two-word phrases occur much
later, while copying geometric shapes is a preschool-level skill.
3. A 15-month-old child is evaluated during a well-child visit.
Which developmental skill is most appropriate for this age?
A. Hopping on one foot
B. Using several two-word sentences
C. Walking independently
D. Drawing a person with three body parts
Correct Answer: C. Walking independently
Rationale: Independent walking is commonly achieved around
12–15 months. Hopping, complex language, and drawing
recognizable figures develop later. Developmental surveillance
should consider the child's overall progression rather than a
single milestone.
4. A 3-year-old child has fever, drooling, muffled speech, and is
sitting forward with the neck extended. What is the priority
action?
,A. Inspect the throat with a tongue depressor
B. Obtain a throat culture
C. Maintain the child's position and arrange emergency airway
management
D. Encourage oral fluids
Correct Answer: C. Maintain the child's position and arrange
emergency airway management
Rationale: Drooling, muffled voice, fever, and a tripod-like posture
can indicate acute upper-airway obstruction. Attempting to
visualize the pharynx with a tongue depressor may worsen
obstruction. The priority is to minimize agitation and secure
appropriate emergency airway support.
5. Which vaccine is routinely recommended for infants beginning
at approximately 2 months of age?
A. Human papillomavirus vaccine
B. Rotavirus vaccine
C. Zoster vaccine
D. Pneumococcal polysaccharide vaccine
Correct Answer: B. Rotavirus vaccine
Rationale: Rotavirus vaccination begins during early infancy and is
administered according to a specific age-dependent schedule.
HPV and zoster vaccines are intended for older populations, while
the pneumococcal conjugate vaccine—not the polysaccharide
formulation—is routinely used in young children.
, 6. A 4-year-old child has a barking cough and inspiratory stridor
that occurs at rest. Which treatment is most appropriate?
A. Oral antibiotics only
B. Nebulized hypertonic saline only
C. Corticosteroid therapy with nebulized epinephrine for
significant stridor at rest
D. Cough suppressant therapy
Correct Answer: C. Corticosteroid therapy with nebulized
epinephrine for significant stridor at rest
Rationale: Croup with stridor at rest represents more significant
upper-airway narrowing. Corticosteroids reduce airway
inflammation, while nebulized epinephrine provides rapid
temporary reduction in airway edema. The child should also be
observed for recurrence of symptoms.
7. A 7-year-old child presents with polyuria, polydipsia, weight
loss, abdominal pain, and vomiting. Which laboratory
abnormality is most concerning for diabetic ketoacidosis?
A. Mildly elevated serum sodium
B. Metabolic acidosis with elevated anion gap
C. Low-normal hemoglobin
D. Elevated HDL cholesterol
Correct Answer: B. Metabolic acidosis with elevated anion gap
Rationale: Diabetic ketoacidosis is characterized by
hyperglycemia, ketosis, and metabolic acidosis, typically with an
elevated anion gap. Vomiting, abdominal pain, dehydration, and
altered mental status may accompany the condition. DKA
requires urgent medical management.
(PNP) PRACTICE EXAMINATION
QUESTIONS WITH CORRECT
ANSWERS PLUS RATIONALES
2026/2027 EDITION WITH INSTANT
PDF DOWNLOAD
1. A 2-month-old infant is brought to the clinic for a routine health
visit. Which finding requires the most immediate evaluation?
A. Mild cradle cap
B. Brief startle response to loud noise
C. Respiratory rate of 68 breaths/minute with nasal flaring
D. Moro reflex present bilaterally
Correct Answer: C. Respiratory rate of 68 breaths/minute with
nasal flaring
Rationale: Tachypnea accompanied by nasal flaring indicates
increased work of breathing and may signal respiratory distress. In
a young infant, significant respiratory abnormalities require
prompt assessment because infants can deteriorate rapidly.
Cradle cap and normal primitive reflexes are expected findings at
this age.
2. Which developmental milestone is generally expected in a
healthy 6-month-old infant?
,A. Walking independently
B. Sitting briefly without support
C. Using two-word phrases
D. Copying a circle
Correct Answer: B. Sitting briefly without support
Rationale: By approximately 6 months, many infants can sit briefly
without support and demonstrate improved head and trunk
control. Independent walking and two-word phrases occur much
later, while copying geometric shapes is a preschool-level skill.
3. A 15-month-old child is evaluated during a well-child visit.
Which developmental skill is most appropriate for this age?
A. Hopping on one foot
B. Using several two-word sentences
C. Walking independently
D. Drawing a person with three body parts
Correct Answer: C. Walking independently
Rationale: Independent walking is commonly achieved around
12–15 months. Hopping, complex language, and drawing
recognizable figures develop later. Developmental surveillance
should consider the child's overall progression rather than a
single milestone.
4. A 3-year-old child has fever, drooling, muffled speech, and is
sitting forward with the neck extended. What is the priority
action?
,A. Inspect the throat with a tongue depressor
B. Obtain a throat culture
C. Maintain the child's position and arrange emergency airway
management
D. Encourage oral fluids
Correct Answer: C. Maintain the child's position and arrange
emergency airway management
Rationale: Drooling, muffled voice, fever, and a tripod-like posture
can indicate acute upper-airway obstruction. Attempting to
visualize the pharynx with a tongue depressor may worsen
obstruction. The priority is to minimize agitation and secure
appropriate emergency airway support.
5. Which vaccine is routinely recommended for infants beginning
at approximately 2 months of age?
A. Human papillomavirus vaccine
B. Rotavirus vaccine
C. Zoster vaccine
D. Pneumococcal polysaccharide vaccine
Correct Answer: B. Rotavirus vaccine
Rationale: Rotavirus vaccination begins during early infancy and is
administered according to a specific age-dependent schedule.
HPV and zoster vaccines are intended for older populations, while
the pneumococcal conjugate vaccine—not the polysaccharide
formulation—is routinely used in young children.
, 6. A 4-year-old child has a barking cough and inspiratory stridor
that occurs at rest. Which treatment is most appropriate?
A. Oral antibiotics only
B. Nebulized hypertonic saline only
C. Corticosteroid therapy with nebulized epinephrine for
significant stridor at rest
D. Cough suppressant therapy
Correct Answer: C. Corticosteroid therapy with nebulized
epinephrine for significant stridor at rest
Rationale: Croup with stridor at rest represents more significant
upper-airway narrowing. Corticosteroids reduce airway
inflammation, while nebulized epinephrine provides rapid
temporary reduction in airway edema. The child should also be
observed for recurrence of symptoms.
7. A 7-year-old child presents with polyuria, polydipsia, weight
loss, abdominal pain, and vomiting. Which laboratory
abnormality is most concerning for diabetic ketoacidosis?
A. Mildly elevated serum sodium
B. Metabolic acidosis with elevated anion gap
C. Low-normal hemoglobin
D. Elevated HDL cholesterol
Correct Answer: B. Metabolic acidosis with elevated anion gap
Rationale: Diabetic ketoacidosis is characterized by
hyperglycemia, ketosis, and metabolic acidosis, typically with an
elevated anion gap. Vomiting, abdominal pain, dehydration, and
altered mental status may accompany the condition. DKA
requires urgent medical management.
