PedsCE PNP-PC Exam LATEST 2026 REAL
EXAM (COMPLETE EXAM) QUESTIONS
AND CORRECT ANSWERS|AGRADE
In reacting to parental divorce, a child between the ages of 9 and 12 differs from a
younger
child in his or her:
a. Acceptance of the family's dissolution
b. Conscious, intense anger
c. Positive reaction to the departure of a parent
d. Tendency toward emotional decompensation - Correct Answerb. Conscious,
intense anger
Rationale: Divorce is stressful and depending on the age of the child then you can
expect different reactions. Children 2- 5 years of age will often have regression,
sleep disturbances, irritability and aggression. Children 6-8 years of age will often
express open grieving and feelings of being rejected. They may also experience
fussiness, regression, sadness, fear
and exhibit immature behaviors. Children 9-12 show fear and intense anger at one
or both parents.th The child who is 13 + years of age is worried about their own
future, may act out or have depression symptoms. (Burns 6 edition, chapter 17)
A 15-year-old male patient reports a three-day history of sore throat, fever,
malaise. Physical examination reveals pharyngitis, anterior cervical adenopathy,
and an oral temperature of 101.6F (38.7C). Which diagnostic test does a pediatric
primary care nurse practitioner order next?
Page 1 of 114
,a. Antistreptolysin O titer
b. Cytomegalovirus titer
c. Monospot and complete blood count
d. Rapid streptococcal antigen test - Correct Answerd. Rapid streptococcal antigen
test
Rationale: Classic symptoms of strep pharyngitis include rapid onset of fever, sore
throat, anterior cervical adenopathy, abdominal pain/nausea/vomiting, and
headache. The most effective way to test for this disease process safely and
quickly is the rapid streptococcal antigen test. The monospot tests for EBV and
usually is a more insidious onset without severe symptoms. Cytomegalovirus
usually affects the GI tract primarily. Antstrepotolysin O titer detects antibodies to
strep antigens and don't rise until 1-3 weeks after infection. (Burns)
10. During a well-child visit, a mother expresses concern that her three-year-old
has recently started to stutter when excited. The pediatric primary care nurse
practitioner informs the mother that stuttering in a preschool-aged child:
a. Is a normal characteristic of language development
b. Is a sign of abnormal speech pattern development
c. Occurs because the child does not know what to say
d. Signals the presence of stress in the child's environment - Correct Answera. Is a
normal characteristic of language development
Rationale: 3-4 year old children have normal hesistancy in speech or stuttering.
They will repeat words especially when stating a full sentence or when excited. It
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,should not include syllable repetition. This usually resolves by 5 years of age and
should not cause undue stress to the child. (Burns)
A 14-year-old female patient has nonpustular, closed and open comedones. The
patient has administered over-the-counter medications without effect. The
pediatric primary care nurse practitioner's next action is to:
a. Prescribe oral minocyclyine (Minocin)
b. Prescribe topical tretinoin (Retin-A)
c. Recommend an antibacterial facial soap
d. Refer the patient to a dermatologist - Correct Answerb. Prescribe topical
tretinoin (Retin-A)
Rationale: Because over the counter treatment of mild to moderate acne was
ineffective, topical tretinoin (Retin-A) is recommended as the next line of
treatment. Patients with mild to moderate comedonal and/or inflammatory acne
usually respond well to a combination of topical retinoids, benzoyl peroxide, and
antibiotics. Moderate to severe papulopustular acne warrants the use of oral
antibiotics in combination with topical agents. (Zitelli and Davis' Atlas of Pediatric
Physical Diagnosis, Chapter 8)
While evaluating a three-day old infant, a pediatric primary care nurse practitioner
turns the infant on the side to examine the back and notes a sharp line of
demarcation dividing the upper and lower parts of the body. The dependent half
is bright red and the superior half is pale. The etiology of this phenomenon is:
a. An elevated central hematocrit level, typically > 65%
b. An immature autonomic regulatory system, generally referred to as the
"harlequin" sign
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, c. Decreased blood flow to the superior half, usually caused by coarctation of the
aorta d. Vasoconstriction of peripheral blood vessels, usually caused by sepsis -
Correct Answerb. An immature autonomic regulatory system, generally referred to
as the "harlequin" sign
Rationale: The classic appearance of a harlequin sign is the is a division of the
body skin color from forehead to pubis into red and pale halves. Etiology is
unknown but thought be immature autonomic response. It is a benign finding and
is self resolving. The high HCT would result in redden appearance overall.
Coarctation would be associated with poor
pulses and blood pressure differences as well as pale mottle appearance overall
(coarctation usually occurs between the take off of the right subclavian and the
remainder of the body. Sepsis results in a mottled appearance with poor cap refill
and cool extremities. (Burns)
Which symptom requires immediate medical attention in a female adolescent
who has recently started to use oral contraceptives
a. Increasing emotional lability
b. Spotting between periods
c. Worsening headaches
d. Increasing breast tenderness - Correct Answerd. Worsening headaches
Rationale: Worsening headaches in a female adolescent who has recently started
to take oral contraceptives is worrisome. Individuals with a history of headaches
taking pills that contain estrogen are at an increased risk of stroke. Increasing
breast tenderness and emotional lability, in addition to spotting between cycles,
are common side effects in many who recently have begun taking oral
contraceptives. ( WHO, Medical eligibility for contraceptive use, 2015)
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EXAM (COMPLETE EXAM) QUESTIONS
AND CORRECT ANSWERS|AGRADE
In reacting to parental divorce, a child between the ages of 9 and 12 differs from a
younger
child in his or her:
a. Acceptance of the family's dissolution
b. Conscious, intense anger
c. Positive reaction to the departure of a parent
d. Tendency toward emotional decompensation - Correct Answerb. Conscious,
intense anger
Rationale: Divorce is stressful and depending on the age of the child then you can
expect different reactions. Children 2- 5 years of age will often have regression,
sleep disturbances, irritability and aggression. Children 6-8 years of age will often
express open grieving and feelings of being rejected. They may also experience
fussiness, regression, sadness, fear
and exhibit immature behaviors. Children 9-12 show fear and intense anger at one
or both parents.th The child who is 13 + years of age is worried about their own
future, may act out or have depression symptoms. (Burns 6 edition, chapter 17)
A 15-year-old male patient reports a three-day history of sore throat, fever,
malaise. Physical examination reveals pharyngitis, anterior cervical adenopathy,
and an oral temperature of 101.6F (38.7C). Which diagnostic test does a pediatric
primary care nurse practitioner order next?
Page 1 of 114
,a. Antistreptolysin O titer
b. Cytomegalovirus titer
c. Monospot and complete blood count
d. Rapid streptococcal antigen test - Correct Answerd. Rapid streptococcal antigen
test
Rationale: Classic symptoms of strep pharyngitis include rapid onset of fever, sore
throat, anterior cervical adenopathy, abdominal pain/nausea/vomiting, and
headache. The most effective way to test for this disease process safely and
quickly is the rapid streptococcal antigen test. The monospot tests for EBV and
usually is a more insidious onset without severe symptoms. Cytomegalovirus
usually affects the GI tract primarily. Antstrepotolysin O titer detects antibodies to
strep antigens and don't rise until 1-3 weeks after infection. (Burns)
10. During a well-child visit, a mother expresses concern that her three-year-old
has recently started to stutter when excited. The pediatric primary care nurse
practitioner informs the mother that stuttering in a preschool-aged child:
a. Is a normal characteristic of language development
b. Is a sign of abnormal speech pattern development
c. Occurs because the child does not know what to say
d. Signals the presence of stress in the child's environment - Correct Answera. Is a
normal characteristic of language development
Rationale: 3-4 year old children have normal hesistancy in speech or stuttering.
They will repeat words especially when stating a full sentence or when excited. It
Page 2 of 114
,should not include syllable repetition. This usually resolves by 5 years of age and
should not cause undue stress to the child. (Burns)
A 14-year-old female patient has nonpustular, closed and open comedones. The
patient has administered over-the-counter medications without effect. The
pediatric primary care nurse practitioner's next action is to:
a. Prescribe oral minocyclyine (Minocin)
b. Prescribe topical tretinoin (Retin-A)
c. Recommend an antibacterial facial soap
d. Refer the patient to a dermatologist - Correct Answerb. Prescribe topical
tretinoin (Retin-A)
Rationale: Because over the counter treatment of mild to moderate acne was
ineffective, topical tretinoin (Retin-A) is recommended as the next line of
treatment. Patients with mild to moderate comedonal and/or inflammatory acne
usually respond well to a combination of topical retinoids, benzoyl peroxide, and
antibiotics. Moderate to severe papulopustular acne warrants the use of oral
antibiotics in combination with topical agents. (Zitelli and Davis' Atlas of Pediatric
Physical Diagnosis, Chapter 8)
While evaluating a three-day old infant, a pediatric primary care nurse practitioner
turns the infant on the side to examine the back and notes a sharp line of
demarcation dividing the upper and lower parts of the body. The dependent half
is bright red and the superior half is pale. The etiology of this phenomenon is:
a. An elevated central hematocrit level, typically > 65%
b. An immature autonomic regulatory system, generally referred to as the
"harlequin" sign
Page 3 of 114
, c. Decreased blood flow to the superior half, usually caused by coarctation of the
aorta d. Vasoconstriction of peripheral blood vessels, usually caused by sepsis -
Correct Answerb. An immature autonomic regulatory system, generally referred to
as the "harlequin" sign
Rationale: The classic appearance of a harlequin sign is the is a division of the
body skin color from forehead to pubis into red and pale halves. Etiology is
unknown but thought be immature autonomic response. It is a benign finding and
is self resolving. The high HCT would result in redden appearance overall.
Coarctation would be associated with poor
pulses and blood pressure differences as well as pale mottle appearance overall
(coarctation usually occurs between the take off of the right subclavian and the
remainder of the body. Sepsis results in a mottled appearance with poor cap refill
and cool extremities. (Burns)
Which symptom requires immediate medical attention in a female adolescent
who has recently started to use oral contraceptives
a. Increasing emotional lability
b. Spotting between periods
c. Worsening headaches
d. Increasing breast tenderness - Correct Answerd. Worsening headaches
Rationale: Worsening headaches in a female adolescent who has recently started
to take oral contraceptives is worrisome. Individuals with a history of headaches
taking pills that contain estrogen are at an increased risk of stroke. Increasing
breast tenderness and emotional lability, in addition to spotting between cycles,
are common side effects in many who recently have begun taking oral
contraceptives. ( WHO, Medical eligibility for contraceptive use, 2015)
Page 4 of 114
