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NNP Certification Exam (CPNR) | Actual Verified Q&A | 2025 Updated A+ Neonatal Practice Review

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This CPNR NNP Certification Exam Prep (2025 Updated Edition) contains verified actual exam-style questions and accurate answers, graded A+. It supports neonatal clinicians preparing for certification by reinforcing clinical judgment, neonatal physiology, diagnostics, and management.

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Uploaded on
December 24, 2025
Number of pages
32
Written in
2025/2026
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CPNR 2019 NNP Certification Exam Actual Questions &
Answers (2025 Updated Edition) | Verified Q&A | Graded
A+ | Complete Test Prep


Limited horizontal nystagmus resolves by:

a. 1-2 months of age

b. 2-3 months of age

c. 3-4 months of age - ✔✔c. 3-4 months of age



Infants with bronchopulmonary dysplasia have increased energy needs, often as much as:

a. 10-20%

b. 20-40%

c. 40-60% - ✔✔b. 20-40%



What are the protein requirements for term infants?

a. 2 g/kg/day

b. 3 g/kg/day

c. 4 g/kg/day - ✔✔b. 3 g/kg/day



Preterm may require 3.5-4 g/kg/day. Minimum is 2 g/kg/day



A normal blood finding in the term neonate on day one of life is:

a. a hematocrit of 65%

b. a hemoglobin level of 18 g/dL

c. erythrocyte count of 3 million - ✔✔b. a hemoglobin level of 18 g/dL



The principle action of volume expanders during resuscitation is to:

a. address myocardial decompensation

b. facilitate peripheral vasoconstriction

,c. maintain cardiac output and blood pressure - ✔✔c. maintain cardiac output and blood pressure



A two day old neonate has an abdominal mass. The most likely cause is:

a. adrenal hemorrhage

b. polycystic kidney

c. volvulus - ✔✔b. polycystic kidney



Renal is the most frequent cause of abdominal masses in newborns.



There is an increased risk of hypochloremia in neonates who:

a. are asphyxiated at birth

b. had prolonged diarrhea

c. have been over-treated with diuretics - ✔✔c. have been over-treated with diuretics



A decision to provide morphine to a dying infant is framed by the principle of:

a. autonomy

b. nonmaleficence

c. justice - ✔✔b. nonmaleficence



justice = equal opportunity to all

autonomy = allowed to take direction in accordance to own/best self interest



The first sign of hypothermia in a critically ill neonate is a drop in which temperature?

a. axillary

b. rectal

c. skin - ✔✔c. skin



A preterm infant is born with cutaneous pinkish-gray granulomas. This finding is characteristic of
infection with:

,a. candida albicans

b. listeria monocytogenes

c. toxoplasma gondii - ✔✔b. listeria monocytogenes



Rib fractures are noted on routine chest x-ray on a 3 month old premature infant. The most likely cause
of this finding is:

a. congenital hypoparathyroidism

b. inadequate calcium and phosphorus intake

c. vitamin D deficiency due to malabsorption - ✔✔b. inadequate calcium and phosphorus intake



The drug of choice when treating opioid withdrawal is:

a. diazepam

b. oral morphine

c. pheobarbital - ✔✔b. oral morphine



A neonate with acute renal failure requires short acting narcotic analgesic. The best drug to use in this
situation is:

a. fentanyl

b. morphine

c. sufentanil - ✔✔a. fentanyl



A term neonate who was born to an HBsAg positive mother is being discharged three months after birth
following surgery for a cardiac condition. The mother asks when the next Hep b immunization should be
given. The NP should advise that it be given at:

a. four months

b. six months

c. twelve months - ✔✔b. six months



A term, small for gestational age neonate at 4 hours of life is tachypneic, plethoric, lethargic, and has a
blood sugar of 53 mg/dL and a central hematrocrit of 70%. The most likely diagnosis is:

, a. hyperviscosity

b. hypocalcemia

c. hypoglycemia - ✔✔a. hyperviscosity



A factor that would result in increased insensible water loss in neonates is:

a. hypothermia

b. phototherapy

c. postmaturity - ✔✔b. phototherapy



A neonate has a flat reddish birthmark with sharply delineated edges on the nape of the neck. When
pressure is applied to the birthmark, there is minimal blanching. This finding is consistent with:

a. infantile hemangioma

b. nevus simplex

c. port wine stain - ✔✔c. port wine stain



nevus simplex does blanch.



A neonate is born to a mother with a positive TB test but no signs of active disease. Management of this
neonate should include:

a. initiate medication therapy on mother and infant

b. no special evaluation or therapy

c. separate mother and neonate until status can be confirmed - ✔✔b. no special evaluation or therapy



The standard of care for neonatal nursing is judged according to the standard of care:

a. locally

b. nationally

c. regionally - ✔✔b. nationally



Which of the following is a contraindication to breastfeeding?

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