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PCNB 4 Exam with Correct Answers – Pediatric Certification Prep

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Download the PCNB 4 Exam with verified correct answers. Covers pediatric nursing board review topics, including child health assessment, pharmacology, growth and development, patient safety, and evidence-based care.

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PNCB study set Exam V3 | Questions and Verified
Answers with Rationales| Latest 2025/ 2026 Update
|100% Correct Elaborations (verified Answers)

Caregiver education for an infant with croup includes that urgent medical re-evaluation is needed
if the infant has:
A. audible stridor when calm

B. barky cough in the morning

C. fever of 102˚ F (38.9˚ C) or higher

D. retractions between ribs with crying

A. audible stridor when calm




A preschooler is evaluated for a history of fever and intermittent bone pain and is noted to have
an abdominal mass. Which is the MOST likely diagnosis?
A. neuroblastoma

B. non-Hodgkin's lymphoma

C. osteogenic sarcoma

D. Wilms tumor

A. neuroblastoma



The median age at diagnosis is 22 months, and approximately 90% of cases have been diagnosed
by 5 years of age.



Signs and symptoms reflect the tumor site and extent of disease, but may include fever, failure to
thrive, bone pain, cytopenia, orbital proptosis, masses, bowel obstruction, or spinal cord
compression.



Wilms tumor is an embryonal malignancy of the kidney that can also present with an abdominal
mass. Sarcomas of the extremities are more likely to occur in older children.

, PNCB study set Exam V3 | Questions and Verified
Answers with Rationales| Latest 2025/ 2026 Update
|100% Correct Elaborations (verified Answers)


An adolescent presenting for a pre-college physical describes herself as a sexually active lesbian.
Which is the MOST immediate action?



A. assess for potential psychosocial difficulties



B. ensure human papilloma virus vaccination is up-to-date



C. provide confidential and nonjudgmental care


D. counsel about sexually transmitted infections and contraception



D. counsel about sexually transmitted infections and contraception



Adolescent lesbian and bisexual females are more likely to have been pregnant when compared
to their heterosexual peers



LGB adolescents and young adults are at greater risk for unplanned pregnancy and, it is
important to counsel about accidental pregnancy even with females who have sex with females.
Providing sexual and reproductive health education that includes information about abstinence,
contraception, and sexually transmitted infections (STIs) is necessary for all adolescents and
young adults. Additionally, information about contraception should be offered to all females
regardless of their sexual orientation.


Pre-college visits present an excellent opportunity to ensure that all immunizations are current,
not just the human papilloma virus vaccine. Adolescents and young adults, including those who
know or are unsure about their sexuality, may have psychosocial concerns. Providing care that is

, PNCB study set Exam V3 | Questions and Verified
Answers with Rationales| Latest 2025/ 2026 Update
|100% Correct Elaborations (verified Answers)
confidential, current, factual, and nonjudgmental is required with all patients, regardless of their
sexual orientation.




While some characteristics of an Individualized Education Plan (IEP) and 504 Plan are similar,
the IEP differs in that it uniquely requires

A. a specific medical diagnosis for eligibility.

B. a modification in curriculum to meet the student's needs.

C. an evaluation typically completed through school system resources.

D. a written plan be developed that specifies individualized accommodations.

B. a modification in curriculum to meet the student's needs.


Eligibility for both plans requires a medical diagnosis. For a 504 Plan, this can be any
psychologic or physical disorder which "substantially limits" the individual's learning. These
children can follow the curriculum without modification but may require assistance in the school
setting. This may include conditions such as ADHD, diabetes, or migraines.

In order to be eligible for an IEP, a child has to also have a medical diagnosis, but that diagnosis
must specifically meet criteria as a qualifying disability that seriously affects learning or
behavior and, therefore, requires modification of the school curriculum.

Both a 504 and an IEP require evaluation, although the evaluation for an IEP is more formalized
and is typically completed by a team of professionals. Both an IEP and a 504 plan will include a
written plan. There are no legal requirements for what is included in a 504 plan and there is no
mandated re-evaluation. An IEP has very specific criteria and must describe the specific learning
problems, detail what services will be provided, set annual goals and define how progress will be
measured. Re-evaluation is mandated every 3 years.




When used in treatment of acne vulgaris, topical retinoids act to

, PNCB study set Exam V3 | Questions and Verified
Answers with Rationales| Latest 2025/ 2026 Update
|100% Correct Elaborations (verified Answers)
A. normalize desquamation of the follicular epithelium.



B. minimize development of antibiotic-resistant Cutibacterium acnes (formerly
Propionibacterium acnes).



C. generate free radicals to oxidize proteins in the cell wall of Cutibacterium acnes.



D. work within the cell ribosomes to alter upstream signals affecting inflammatory pathways.



A. normalize desquamation of the follicular epithelium.


The therapeutic objectives in the management of acne vulgaris are to reduce sebum production,
prevent formation of microcomedones, suppress Cutibacterium acnes (formerly
Propionibacterium acnes), and reduce inflammation to prevent scarring.


Topical retinoids, vitamin A derivatives that bind to retinoid receptors in the skin, are a key
component of primary acne management. Topical retinoids normalize desquamation of the
follicular epithelium to prevent new formation of microcomedones, the precursors of both
comedonal and inflammatory lesions. Additionally, retinoids promote clearing of existing
microcomedones and work within the nucleus to alter downstream signals that affect
inflammatory pathways.




A caregiver expresses concern for her 12 month old’s lack of interest in playing with other
children, especially due to a family history of autism spectrum disorder. Which of the following
is the MOST appropriate next step?


A. suggest the caregiver attempt to engage the child in imitating behaviors
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