Pediatric FNP Exam Questions Verified Answers
2026/2027 – Questions and Answers | 100%
Verified | Detailed Rationales – Pass Guaranteed –
A+ Graded
1. A 2-month-old infant is brought to the clinic for a well-child visit. The parent
reports the infant has been vomiting after feeds. Which of the following findings
would be most concerning for pyloric stenosis?
• A. Projectile vomiting after feeding
• B. Spitting up small amounts after burping
• C. Vomiting associated with diarrhea
• D. Vomiting only when laid flat
Correct Answer: A. Projectile vomiting after feeding
Rationale: Pyloric stenosis classically presents at 2–8 weeks of age with non-
bilious, projectile vomiting after feeding due to hypertrophy of the pyloric
sphincter. A visible olive-shaped mass in the epigastrium and a hypochloremic,
hypokalemic metabolic alkalosis may also be present. Simple spitting up (B) is
normal reflux. Vomiting with diarrhea (C) suggests gastroenteritis. Positional
vomiting (D) is more consistent with reflux.
2. Which of the following is the most appropriate initial management for a 6-
year-old child with suspected acute otitis media (AOM) who has mild symptoms
and no otorrhea?
• A. Immediate amoxicillin 90 mg/kg/day
• B. Watchful waiting for 48–72 hours
• C. Referral for tympanostomy tubes
, • D. Oral prednisolone
Correct Answer: B. Watchful waiting for 48–72 hours
Rationale: For children ≥6 years with non-severe AOM (mild otalgia, fever
<39°C, no otorrhea), watchful waiting for 48–72 hours is an accepted strategy per
AAP guidelines. Immediate antibiotics (A) are reserved for severe symptoms,
otorrhea, or children <6 months. Tympanostomy tubes (C) are for recurrent AOM
or persistent OME. Steroids (D) are not recommended.
3. A 4-year-old child presents with a “barking” cough, hoarseness, and
inspiratory stridor that worsens at night. What is the most likely diagnosis?
• A. Epiglottitis
• B. Croup (laryngotracheobronchitis)
• C. Bronchiolitis
• D. Asthma
Correct Answer: B. Croup (laryngotracheobronchitis)
Rationale: Croup presents with a barking cough, hoarseness, and inspiratory
stridor, often worse at night, typically in children 6 months–3 years. Epiglottitis (A)
presents with high fever, drooling, and tripod positioning. Bronchiolitis (C) causes
wheezing and crackles in infants. Asthma (D) causes wheezing and shortness of
breath, not barking cough.
4. Which of the following is the recommended treatment for a 3-year-old child
with suspected epiglottitis?
• A. Immediate oral amoxicillin
• B. Racemic epinephrine nebulizer
• C. Emergency airway management and IV antibiotics
, • D. Observation at home
Correct Answer: C. Emergency airway management and IV antibiotics
Rationale: Epiglottitis is a medical emergency due to risk of complete airway
obstruction. Management includes securing the airway (often in the OR) and IV
antibiotics (e.g., ceftriaxone). Oral antibiotics (A) are inappropriate. Racemic
epinephrine (B) is for croup. Observation (D) is dangerous.
5. A 10-year-old child is diagnosed with streptococcal pharyngitis. Which of the
following is the preferred antibiotic?
• A. Amoxicillin
• B. Azithromycin
• C. Ciprofloxacin
• D. Doxycycline
Correct Answer: A. Amoxicillin
Rationale: Penicillin or amoxicillin is first-line for GAS pharyngitis.
Azithromycin (B) is used for penicillin allergy. Ciprofloxacin (C) is not typically used.
Doxycycline (D) is an alternative but not first-line in children.
6. A 5-year-old child presents with a maculopapular rash that started on the face
and spread downward, along with fever, cough, and conjunctivitis. What is the
most likely diagnosis?
• A. Rubella
• B. Measles (rubeola)
• C. Roseola
• D. Fifth disease
, Correct Answer: B. Measles (rubeola)
Rationale: Measles presents with the 3 Cs (cough, coryza, conjunctivitis), high
fever, and a maculopapular rash that starts on the face and spreads downward.
Rubella (A) has a milder rash and posterior auricular lymphadenopathy. Roseola
(C) has high fever followed by a rash. Fifth disease (D) has a “slapped cheek” rash.
7. Which of the following is a classic finding in a child with roseola infantum
(exanthem subitum)?
• A. High fever for 3–5 days followed by a rash
• B. Rash appearing before fever
• C. Koplik spots
• D. Strawberry tongue
Correct Answer: A. High fever for 3–5 days followed by a rash
Rationale: Roseola is caused by HHV-6 and presents with high fever for 3–5
days, which resolves abruptly, followed by a pink maculopapular rash on the
trunk. Koplik spots (C) are seen in measles. Strawberry tongue (D) is seen in
Kawasaki disease or scarlet fever.
8. A 7-year-old child is diagnosed with impetigo. Which of the following is the
most common causative organism?
• A. Staphylococcus aureus
• B. Streptococcus pyogenes
• C. Pseudomonas aeruginosa
• D. Haemophilus influenzae
Correct Answer: A. Staphylococcus aureus
2026/2027 – Questions and Answers | 100%
Verified | Detailed Rationales – Pass Guaranteed –
A+ Graded
1. A 2-month-old infant is brought to the clinic for a well-child visit. The parent
reports the infant has been vomiting after feeds. Which of the following findings
would be most concerning for pyloric stenosis?
• A. Projectile vomiting after feeding
• B. Spitting up small amounts after burping
• C. Vomiting associated with diarrhea
• D. Vomiting only when laid flat
Correct Answer: A. Projectile vomiting after feeding
Rationale: Pyloric stenosis classically presents at 2–8 weeks of age with non-
bilious, projectile vomiting after feeding due to hypertrophy of the pyloric
sphincter. A visible olive-shaped mass in the epigastrium and a hypochloremic,
hypokalemic metabolic alkalosis may also be present. Simple spitting up (B) is
normal reflux. Vomiting with diarrhea (C) suggests gastroenteritis. Positional
vomiting (D) is more consistent with reflux.
2. Which of the following is the most appropriate initial management for a 6-
year-old child with suspected acute otitis media (AOM) who has mild symptoms
and no otorrhea?
• A. Immediate amoxicillin 90 mg/kg/day
• B. Watchful waiting for 48–72 hours
• C. Referral for tympanostomy tubes
, • D. Oral prednisolone
Correct Answer: B. Watchful waiting for 48–72 hours
Rationale: For children ≥6 years with non-severe AOM (mild otalgia, fever
<39°C, no otorrhea), watchful waiting for 48–72 hours is an accepted strategy per
AAP guidelines. Immediate antibiotics (A) are reserved for severe symptoms,
otorrhea, or children <6 months. Tympanostomy tubes (C) are for recurrent AOM
or persistent OME. Steroids (D) are not recommended.
3. A 4-year-old child presents with a “barking” cough, hoarseness, and
inspiratory stridor that worsens at night. What is the most likely diagnosis?
• A. Epiglottitis
• B. Croup (laryngotracheobronchitis)
• C. Bronchiolitis
• D. Asthma
Correct Answer: B. Croup (laryngotracheobronchitis)
Rationale: Croup presents with a barking cough, hoarseness, and inspiratory
stridor, often worse at night, typically in children 6 months–3 years. Epiglottitis (A)
presents with high fever, drooling, and tripod positioning. Bronchiolitis (C) causes
wheezing and crackles in infants. Asthma (D) causes wheezing and shortness of
breath, not barking cough.
4. Which of the following is the recommended treatment for a 3-year-old child
with suspected epiglottitis?
• A. Immediate oral amoxicillin
• B. Racemic epinephrine nebulizer
• C. Emergency airway management and IV antibiotics
, • D. Observation at home
Correct Answer: C. Emergency airway management and IV antibiotics
Rationale: Epiglottitis is a medical emergency due to risk of complete airway
obstruction. Management includes securing the airway (often in the OR) and IV
antibiotics (e.g., ceftriaxone). Oral antibiotics (A) are inappropriate. Racemic
epinephrine (B) is for croup. Observation (D) is dangerous.
5. A 10-year-old child is diagnosed with streptococcal pharyngitis. Which of the
following is the preferred antibiotic?
• A. Amoxicillin
• B. Azithromycin
• C. Ciprofloxacin
• D. Doxycycline
Correct Answer: A. Amoxicillin
Rationale: Penicillin or amoxicillin is first-line for GAS pharyngitis.
Azithromycin (B) is used for penicillin allergy. Ciprofloxacin (C) is not typically used.
Doxycycline (D) is an alternative but not first-line in children.
6. A 5-year-old child presents with a maculopapular rash that started on the face
and spread downward, along with fever, cough, and conjunctivitis. What is the
most likely diagnosis?
• A. Rubella
• B. Measles (rubeola)
• C. Roseola
• D. Fifth disease
, Correct Answer: B. Measles (rubeola)
Rationale: Measles presents with the 3 Cs (cough, coryza, conjunctivitis), high
fever, and a maculopapular rash that starts on the face and spreads downward.
Rubella (A) has a milder rash and posterior auricular lymphadenopathy. Roseola
(C) has high fever followed by a rash. Fifth disease (D) has a “slapped cheek” rash.
7. Which of the following is a classic finding in a child with roseola infantum
(exanthem subitum)?
• A. High fever for 3–5 days followed by a rash
• B. Rash appearing before fever
• C. Koplik spots
• D. Strawberry tongue
Correct Answer: A. High fever for 3–5 days followed by a rash
Rationale: Roseola is caused by HHV-6 and presents with high fever for 3–5
days, which resolves abruptly, followed by a pink maculopapular rash on the
trunk. Koplik spots (C) are seen in measles. Strawberry tongue (D) is seen in
Kawasaki disease or scarlet fever.
8. A 7-year-old child is diagnosed with impetigo. Which of the following is the
most common causative organism?
• A. Staphylococcus aureus
• B. Streptococcus pyogenes
• C. Pseudomonas aeruginosa
• D. Haemophilus influenzae
Correct Answer: A. Staphylococcus aureus
