BARKLEY PEDIATRIC NURSE PRACTITIONER–
PRIMARY CARE (PNP-PC) REVIEW EXAM
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF]
Core Domains
• Growth and Development Across the Lifespan
• Health Promotion and Well-Child Care
• Immunizations and Infectious Diseases
• Assessment and Diagnosis of Common Pediatric Conditions
• Management of Acute and Chronic Illnesses
• Pharmacology and Prescribing in Pediatrics
• Mental, Emotional, and Behavioral Health
• Cardiovascular and Respiratory Disorders
• Gastrointestinal and Genitourinary Disorders
• Professional Issues, Ethics, and Practice Management
Introduction
This comprehensive Barkley Pediatric Nurse Practitioner–Primary
Care (PNP-PC) Review Examination is designed to evaluate
clinical knowledge, diagnostic reasoning, and evidence-based
management skills essential for PNP-PC certification success. The
assessment covers growth and development, health promotion,
disease prevention, assessment, diagnosis, and management of
,acute and chronic conditions across the pediatric lifespan.
Through a rigorous combination of multiple-choice questions and
clinical scenarios, this exam emphasizes the application of
current guidelines, differential diagnosis, pharmacologic
management, and family-centered care. Each question includes a
detailed rationale to reinforce clinical reasoning and enhance
exam readiness. This resource serves as an essential tool for PNP-
PC candidates preparing for PNCB certification examinations.
SECTION ONE: QUESTIONS 1–100
Question 1
A 9-month-old infant is brought to the clinic for a well-child
visit. The mother reports the baby can sit alone, transfers
objects from hand to hand, and has begun to pull to stand.
Which gross motor milestone is expected at this age?
A. Rolls from back to abdomen
B. Crawls on hands and knees
C. Walks independently
D. Sits without support
B
RATIONALE: Pulling to stand typically occurs at 9-10
months; many 9-month-olds are crawling or beginning to
crawl. Rolling back to abdomen is a 6-month skill; sitting
without support occurs by 8 months; walking independently is
a 12-15 month skill.
Question 2
A 4-year-old child is brought to the clinic for a preschool
,physical. The child can hop on one foot, draw a person with
three parts, and speak in sentences of 5 words. Which
language milestone is expected at this age?
A. 10-word vocabulary
B. Tells stories and uses past tense
C. Says "mama" and "dada" specifically
D. Uses two-word sentences
B
RATIONALE: At 4 years, children can tell stories, use past
tense, and have a vocabulary of approximately 1500 words.
They can speak in complete sentences. The other options are
milestones for younger children (12-24 months).
Question 3
A 2-month-old infant is being evaluated. The PNP notes a
positive Moro reflex and palmar grasp. The mother asks when
these reflexes should disappear. The PNP responds:
A. 1 month
B. 3-6 months
C. 9-12 months
D. 18 months
B
RATIONALE: The Moro reflex disappears by 4-6 months; the
palmar grasp by 5-6 months. Persistence beyond 6 months may
indicate neurological dysfunction.
Question 4
A healthy 12-month-old has doubled his birth weight and
, grown 10 inches in length. According to normal growth
patterns, the PNP should expect the child to triple birth weight
by what age?
A. 6 months
B. 12 months
C. 18 months
D. 24 months
B
RATIONALE: Infants typically double birth weight by 4-6
months and triple it by 12 months. Length increases by 50% by
12 months.
Question 5
The mother of a 15-month-old is concerned because her child
"walks but looks bowlegged." The PNP explains that
physiologic bowing of the legs:
A. Is abnormal and requires orthopedic referral
B. Typically resolves by 3 years without treatment
C. Indicates vitamin D deficiency
D. Is caused by early walking
B
RATIONALE: Physiologic genu varum (bowlegs) is common
in toddlers and usually resolves by 2-3 years as the child
grows. It is not a sign of rickets unless other signs or risk
factors are present.
Question 6
At what age does an infant usually develop stranger anxiety?
PRIMARY CARE (PNP-PC) REVIEW EXAM
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF]
Core Domains
• Growth and Development Across the Lifespan
• Health Promotion and Well-Child Care
• Immunizations and Infectious Diseases
• Assessment and Diagnosis of Common Pediatric Conditions
• Management of Acute and Chronic Illnesses
• Pharmacology and Prescribing in Pediatrics
• Mental, Emotional, and Behavioral Health
• Cardiovascular and Respiratory Disorders
• Gastrointestinal and Genitourinary Disorders
• Professional Issues, Ethics, and Practice Management
Introduction
This comprehensive Barkley Pediatric Nurse Practitioner–Primary
Care (PNP-PC) Review Examination is designed to evaluate
clinical knowledge, diagnostic reasoning, and evidence-based
management skills essential for PNP-PC certification success. The
assessment covers growth and development, health promotion,
disease prevention, assessment, diagnosis, and management of
,acute and chronic conditions across the pediatric lifespan.
Through a rigorous combination of multiple-choice questions and
clinical scenarios, this exam emphasizes the application of
current guidelines, differential diagnosis, pharmacologic
management, and family-centered care. Each question includes a
detailed rationale to reinforce clinical reasoning and enhance
exam readiness. This resource serves as an essential tool for PNP-
PC candidates preparing for PNCB certification examinations.
SECTION ONE: QUESTIONS 1–100
Question 1
A 9-month-old infant is brought to the clinic for a well-child
visit. The mother reports the baby can sit alone, transfers
objects from hand to hand, and has begun to pull to stand.
Which gross motor milestone is expected at this age?
A. Rolls from back to abdomen
B. Crawls on hands and knees
C. Walks independently
D. Sits without support
B
RATIONALE: Pulling to stand typically occurs at 9-10
months; many 9-month-olds are crawling or beginning to
crawl. Rolling back to abdomen is a 6-month skill; sitting
without support occurs by 8 months; walking independently is
a 12-15 month skill.
Question 2
A 4-year-old child is brought to the clinic for a preschool
,physical. The child can hop on one foot, draw a person with
three parts, and speak in sentences of 5 words. Which
language milestone is expected at this age?
A. 10-word vocabulary
B. Tells stories and uses past tense
C. Says "mama" and "dada" specifically
D. Uses two-word sentences
B
RATIONALE: At 4 years, children can tell stories, use past
tense, and have a vocabulary of approximately 1500 words.
They can speak in complete sentences. The other options are
milestones for younger children (12-24 months).
Question 3
A 2-month-old infant is being evaluated. The PNP notes a
positive Moro reflex and palmar grasp. The mother asks when
these reflexes should disappear. The PNP responds:
A. 1 month
B. 3-6 months
C. 9-12 months
D. 18 months
B
RATIONALE: The Moro reflex disappears by 4-6 months; the
palmar grasp by 5-6 months. Persistence beyond 6 months may
indicate neurological dysfunction.
Question 4
A healthy 12-month-old has doubled his birth weight and
, grown 10 inches in length. According to normal growth
patterns, the PNP should expect the child to triple birth weight
by what age?
A. 6 months
B. 12 months
C. 18 months
D. 24 months
B
RATIONALE: Infants typically double birth weight by 4-6
months and triple it by 12 months. Length increases by 50% by
12 months.
Question 5
The mother of a 15-month-old is concerned because her child
"walks but looks bowlegged." The PNP explains that
physiologic bowing of the legs:
A. Is abnormal and requires orthopedic referral
B. Typically resolves by 3 years without treatment
C. Indicates vitamin D deficiency
D. Is caused by early walking
B
RATIONALE: Physiologic genu varum (bowlegs) is common
in toddlers and usually resolves by 2-3 years as the child
grows. It is not a sign of rickets unless other signs or risk
factors are present.
Question 6
At what age does an infant usually develop stranger anxiety?
