PNCB Examination 2026 Questions and
Answers
You are seeing a 4-week old infant whose mother states that the child's right eye is
wet all the time and sometime there is thick mucus on the lashes. There has been
no fever and the baby is feeding well. Eye exam reveals a normal red reflex
bilaterally with no evidence of purulent drainage, conjunctival erythema, or
cloudiness over the cornea. You suspect:
a) adenovirus conjunctivits
b) nasolacrimal stenosis
c) chlamydial conjunctivitis
d) congenital cataract - Correct answer-b) nasolacrimal duct stenosis
A 9-month-old infant who was born at 32-weeks reaches for a block with only the
left hand. The right arm remains still at the side of her body. The PNP would:
a) record these findings as normal for a premature infant
b) refer the infant for further evaluation
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,c) refer the child for a muscle biopsy
d) record that the child will likely be left-handed - Correct answer-b) refer the
infant for further evaluation
During a 2-month-old well child visit you note that the red reflex in one eye seems
paler than in the other. What is the most appropriate follow-up step for this
observation?
a) assess and document a normal corneal light reflex in that eye
b) preform the cover/uncover test
c) re-evaluate the red re-screening test in 2 weeks
d) refer the infant to a pediatric ophthalmologist immediately - Correct answer-d)
refer the infant to a pediatric ophthalmologist immediately
Primary dentition erupts between:
a) 6-11 years
b) 6-30 months
c) 1-5 years
d) 12-24 months - Correct answer-b) 6-30 months
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,The parent of a 4-year-old points to a picture and says "That's your sister!". The
child responds by saying "No! It's my baby!". This is an example of which type of
thinking in preschool-age children?
a) animism
b) artificialism
c) egocentrism
d) realism - Correct answer-d) realism
The primary care PNP performs a developmental assessment on a 32-month-old
child. The child's parent reports that about 70% of the child's speech is intelligible.
The pediatric nurse practitioner observes that the child has difficulty pronouncing
"t" "d" "k" and "g". Which action is correct?
a) evaluate the child's cognitive abilities
b) obtain a hearing evaluation
c) reassure the parent that this is normal
d) refer the child to a speech therapist - Correct answer-c) reassure the parent that
this is normal
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, The primary care PNP is offering anticipatory guidance to the parents of a 12-
month-old child. The parents are bilingual in Spanish and English and have many
Spanish-speaking relatives nearby. They are resisting exposing the child to Spanish
out of concern that the child will not learn English well. What will the PNP tell the
parents?
a) children who learn two languages simultaneously often confuse them in
conversation
b) children with multi-language proficiency do not understand that others cannot
do this
c) learning two languages at an early age prevents children from development a
dominant language
d) most bilingual children are able to shift from one language to another when
appropriate - Correct answer-d) most bilingual children are able to shift from one
language to another when appropriate
The parents of a 3-year-old child are concerns that the child has begun refusing
usual foods and wants to eat mashed potatoes and chicken strips at every meal and
snack. The child's rate of weight has slowed, but the child remains at the same
percentile for weight on a growth chart. What will the PNP tell the parents to do>
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Answers
You are seeing a 4-week old infant whose mother states that the child's right eye is
wet all the time and sometime there is thick mucus on the lashes. There has been
no fever and the baby is feeding well. Eye exam reveals a normal red reflex
bilaterally with no evidence of purulent drainage, conjunctival erythema, or
cloudiness over the cornea. You suspect:
a) adenovirus conjunctivits
b) nasolacrimal stenosis
c) chlamydial conjunctivitis
d) congenital cataract - Correct answer-b) nasolacrimal duct stenosis
A 9-month-old infant who was born at 32-weeks reaches for a block with only the
left hand. The right arm remains still at the side of her body. The PNP would:
a) record these findings as normal for a premature infant
b) refer the infant for further evaluation
©C0PYRIGHT 2025, ALL RIGHTS RESERVED 1
,c) refer the child for a muscle biopsy
d) record that the child will likely be left-handed - Correct answer-b) refer the
infant for further evaluation
During a 2-month-old well child visit you note that the red reflex in one eye seems
paler than in the other. What is the most appropriate follow-up step for this
observation?
a) assess and document a normal corneal light reflex in that eye
b) preform the cover/uncover test
c) re-evaluate the red re-screening test in 2 weeks
d) refer the infant to a pediatric ophthalmologist immediately - Correct answer-d)
refer the infant to a pediatric ophthalmologist immediately
Primary dentition erupts between:
a) 6-11 years
b) 6-30 months
c) 1-5 years
d) 12-24 months - Correct answer-b) 6-30 months
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,The parent of a 4-year-old points to a picture and says "That's your sister!". The
child responds by saying "No! It's my baby!". This is an example of which type of
thinking in preschool-age children?
a) animism
b) artificialism
c) egocentrism
d) realism - Correct answer-d) realism
The primary care PNP performs a developmental assessment on a 32-month-old
child. The child's parent reports that about 70% of the child's speech is intelligible.
The pediatric nurse practitioner observes that the child has difficulty pronouncing
"t" "d" "k" and "g". Which action is correct?
a) evaluate the child's cognitive abilities
b) obtain a hearing evaluation
c) reassure the parent that this is normal
d) refer the child to a speech therapist - Correct answer-c) reassure the parent that
this is normal
©C0PYRIGHT 2025, ALL RIGHTS RESERVED 3
, The primary care PNP is offering anticipatory guidance to the parents of a 12-
month-old child. The parents are bilingual in Spanish and English and have many
Spanish-speaking relatives nearby. They are resisting exposing the child to Spanish
out of concern that the child will not learn English well. What will the PNP tell the
parents?
a) children who learn two languages simultaneously often confuse them in
conversation
b) children with multi-language proficiency do not understand that others cannot
do this
c) learning two languages at an early age prevents children from development a
dominant language
d) most bilingual children are able to shift from one language to another when
appropriate - Correct answer-d) most bilingual children are able to shift from one
language to another when appropriate
The parents of a 3-year-old child are concerns that the child has begun refusing
usual foods and wants to eat mashed potatoes and chicken strips at every meal and
snack. The child's rate of weight has slowed, but the child remains at the same
percentile for weight on a growth chart. What will the PNP tell the parents to do>
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