CPN PRACTICE EXAMINATION 2026
QUESTIONS WITH ANSWERS GRADED A+
◍ Which of the following characteristics is NOT part of the Apgar scoring
method for assessmentof newborns?
A. Heart rate.
B. Respiratory effort.
C. Skin color.
D. Eye tracking.
Answer: D: Eye tracking is not a component as the child is not able to focus
well enough to track atbirth. Heart rate, color, muscle tone, reflex
irritability, and respiratory effort are the components ofthe Apgar scoring
system.
◍ Depressed or inverted T-waves on ECG analysis can occur with many
different clinicalsituations in pediatric patients. Which of the following is
NOT a common reason for depressedor inverted T-waves?
A. Hypokalemia.
B. Myocarditis.
C. Digitalis toxicity.
D. Hyperthyroidism..
Answer: B: Hyperthyroidism commonly causes an increase in T-wave
amplitude, not a decrease.Myocarditis, hypokalemia, and digitalis toxicity
are common reasons for inverted or decreased Twaves.
◍ Type 1 Diabetes Intervention.
Answer: -Monitor blood glucose frequently (before meals and snacks)
(before and mid way through starting new physical activities)
-Carbohydrate, fat, and protein counting-Admin Insulin-Promote regular
exercise and healthy weight-Pre meal BS goal is 80-130
,◍ 3 months (Infant - Social/Emotional).
Answer: Social smile
◍ 7-9 months (Infant - Social/Emotional).
Answer: Enjoys peekaboo and likes to look in the Mirror
◍ Toddler 12-18 months(Physical motor) *KNOW THIS.
Answer: Anterior fontanelle closes
◍ 6 months (Infant - Language/Cognition).
Answer: Continuous babbling Babbles in response to sound as in
conversation
◍ A 2-year-old female is undergoing an evaluation for celiac disease (sprue).
Which of thefollowing is NOT a risk factor for this disease?
A. First degree relative with the disease.
B. Recent travel to Mexico.
C. Congenital trisomy 21.
D. History of type 1 diabetes mellitus.
Answer: B: Celiac disease is not infectious and not related to travel. Celiac
disease (sprue) issensitivity to gluten products and is more commonly seen
in children with relatives with thedisease, those with trisomy 21, or those
with type 1 diabetes.
◍ Tumor Lysis Syndrome.
Answer: -Metabolic disorder occuring within 72 hours following starting
chemo-ELEVATED URIC ACID, POTASSIUM, and electrolyte
managementNO FLUIDS WITH POTASSIUM-Dysrhythmias, renal
impairment/failure (b/c of increased uric acid), lethargy, muscle spasms,
cramps, seizures, N/V-IV fluids, Diuretic, daily weight, strict I&Os
◍ Preschooler(Death and Dying).
Answer: Death is received as a temporary departure
◍ Acute anemia.
Answer: -Muscle weakness, fatigue, pallor, headache, lightheartedness,
increased HR -Treatment is based etiology (Blood transfusion is generally
, required <7-8)-Iron Supplement is generally used with a Hgb >7-8 The
increased breakdown of red blood cells seen in some anemias can lead to
PRURITUS/ITCHING due to the process of unconjugated bilirubin
◍ A 13-year-old female has the development of breast buds and sparse long,
downy pubic hair.What Tanner stage does this development suggest?
A. Tanner 1.
B. Tanner 2.
C. Tanner 3.
D. Tanner 4..
Answer: B: Breast buds and sparse downy pubic hair are characteristics of
Tanner stage 2. Tanner's5 stages assess maturity of both males and females
based on direct observation of breasts andgenitals. Females are evaluated on
breast development, onset of menses, and pubic hairdistribution. Males are
evaluation on penis and testes development and pubic hair distribution
◍ Toddlers(Death and Dying).
Answer: Fear is related to separation from parents
◍ TonsillitisKNOW THIS.
Answer: -Acute and chronic inflammation of the tonsils -Causes:Strep
infection-Complications: Obstruction (d/t hypertrophy) and Peritonsillar
abscess -S&S: Red, swollen tonsils with exudate, lymph gland tenderness,
fever, and foul smelling breath-Pre-op: Antibiotics, antipyretics, analgesics,
throat lozenges, and warm salt water-Post-op: Side lying to promote
drainage, ice collar for comfort, analgesics, clear cool fluids, check for
hemorrhage (1ST 24HRS OR 7DAYS WHEN THE SCABS FALL OFF)
FREQUENT SWALLOWING, RESTLESSNESS, FAST THREADY
PULSE, VOMITING BRIGHT RED BLOOD
◍ A 15-year-old female is diagnosed with a newly-acquired infectious disease.
Which of thefollowing is NOT a mandatory reportable disease to the health
department?
A. T
B. B. Varicella.
, C. Syphilis.
D. Rabies..
Answer: B: Varicella (chickenpox) is not a reportable disease, and most
children are vaccinated forvaricella; however, the CDC requires reporting of
TB, syphilis, and rabies as these are public healthconcerns.
◍ Menigitis.
Answer: -inflammation of the meninges of the brain and spinal
cord-Bacterial and Viral (aseptic meningitis)-Infant S&S: high pitched cry,
bulging fontanel, irritability-Children S&S: headache, stiff neck, vomiting,
nuchal rigidity-Diagnosis: LUMBAR PUNCTURE (LOW GLUCOSE IN
CSF + BACETERAL MENINGITIS; bacteria eats glucose) increased
protein in CSF increased pressure when CSF is obtained-Tx: ABX therapy
and DROPLET CONTACTS (aseptic meningitis is symptom support)
◍ Cerebral Palsy (CP).
Answer: -A non progressive neuromuscular disorder that affect movement
and posture -S&S: abnormal muscle coordination and tone, vision, hearing,
& speech disturbances, seizures, INTELLECTUAL DISABILITY SEEN IN
LESS THAT <1/2 OF KIDS WITH CP-Tx: speech, PT, OT, equipment for
walking, and AGE APPROPRIATE COGNITIVE ACTIVITIES AND
INCENTIVES FOR MOTOR DEVELOPMENT*high top shoes for kids
with spastic CP *helmet for kids with ataxia CP
◍ Hirshsprung's Disease.
Answer: -Absence of ganglionic cells (cells that move things through),
peristalsis is absent resulting in the large intestine's inability to move
food-S&S: Abd distention!!!, constipation-"ribbon like stools" ( (liquid
stool, going around obstruction) foul smelling -Diagnosis: Rectal Biopsy
-Temporary ostomy and then repair -enema (to evacuate bowel), bowel
irrigation with golytely (NG tube) , low residue diet, high calorie and
protein - low fiber
◍ Typical symptoms of anemia in a pediatric patient would include all of the
following EXCEPT:
QUESTIONS WITH ANSWERS GRADED A+
◍ Which of the following characteristics is NOT part of the Apgar scoring
method for assessmentof newborns?
A. Heart rate.
B. Respiratory effort.
C. Skin color.
D. Eye tracking.
Answer: D: Eye tracking is not a component as the child is not able to focus
well enough to track atbirth. Heart rate, color, muscle tone, reflex
irritability, and respiratory effort are the components ofthe Apgar scoring
system.
◍ Depressed or inverted T-waves on ECG analysis can occur with many
different clinicalsituations in pediatric patients. Which of the following is
NOT a common reason for depressedor inverted T-waves?
A. Hypokalemia.
B. Myocarditis.
C. Digitalis toxicity.
D. Hyperthyroidism..
Answer: B: Hyperthyroidism commonly causes an increase in T-wave
amplitude, not a decrease.Myocarditis, hypokalemia, and digitalis toxicity
are common reasons for inverted or decreased Twaves.
◍ Type 1 Diabetes Intervention.
Answer: -Monitor blood glucose frequently (before meals and snacks)
(before and mid way through starting new physical activities)
-Carbohydrate, fat, and protein counting-Admin Insulin-Promote regular
exercise and healthy weight-Pre meal BS goal is 80-130
,◍ 3 months (Infant - Social/Emotional).
Answer: Social smile
◍ 7-9 months (Infant - Social/Emotional).
Answer: Enjoys peekaboo and likes to look in the Mirror
◍ Toddler 12-18 months(Physical motor) *KNOW THIS.
Answer: Anterior fontanelle closes
◍ 6 months (Infant - Language/Cognition).
Answer: Continuous babbling Babbles in response to sound as in
conversation
◍ A 2-year-old female is undergoing an evaluation for celiac disease (sprue).
Which of thefollowing is NOT a risk factor for this disease?
A. First degree relative with the disease.
B. Recent travel to Mexico.
C. Congenital trisomy 21.
D. History of type 1 diabetes mellitus.
Answer: B: Celiac disease is not infectious and not related to travel. Celiac
disease (sprue) issensitivity to gluten products and is more commonly seen
in children with relatives with thedisease, those with trisomy 21, or those
with type 1 diabetes.
◍ Tumor Lysis Syndrome.
Answer: -Metabolic disorder occuring within 72 hours following starting
chemo-ELEVATED URIC ACID, POTASSIUM, and electrolyte
managementNO FLUIDS WITH POTASSIUM-Dysrhythmias, renal
impairment/failure (b/c of increased uric acid), lethargy, muscle spasms,
cramps, seizures, N/V-IV fluids, Diuretic, daily weight, strict I&Os
◍ Preschooler(Death and Dying).
Answer: Death is received as a temporary departure
◍ Acute anemia.
Answer: -Muscle weakness, fatigue, pallor, headache, lightheartedness,
increased HR -Treatment is based etiology (Blood transfusion is generally
, required <7-8)-Iron Supplement is generally used with a Hgb >7-8 The
increased breakdown of red blood cells seen in some anemias can lead to
PRURITUS/ITCHING due to the process of unconjugated bilirubin
◍ A 13-year-old female has the development of breast buds and sparse long,
downy pubic hair.What Tanner stage does this development suggest?
A. Tanner 1.
B. Tanner 2.
C. Tanner 3.
D. Tanner 4..
Answer: B: Breast buds and sparse downy pubic hair are characteristics of
Tanner stage 2. Tanner's5 stages assess maturity of both males and females
based on direct observation of breasts andgenitals. Females are evaluated on
breast development, onset of menses, and pubic hairdistribution. Males are
evaluation on penis and testes development and pubic hair distribution
◍ Toddlers(Death and Dying).
Answer: Fear is related to separation from parents
◍ TonsillitisKNOW THIS.
Answer: -Acute and chronic inflammation of the tonsils -Causes:Strep
infection-Complications: Obstruction (d/t hypertrophy) and Peritonsillar
abscess -S&S: Red, swollen tonsils with exudate, lymph gland tenderness,
fever, and foul smelling breath-Pre-op: Antibiotics, antipyretics, analgesics,
throat lozenges, and warm salt water-Post-op: Side lying to promote
drainage, ice collar for comfort, analgesics, clear cool fluids, check for
hemorrhage (1ST 24HRS OR 7DAYS WHEN THE SCABS FALL OFF)
FREQUENT SWALLOWING, RESTLESSNESS, FAST THREADY
PULSE, VOMITING BRIGHT RED BLOOD
◍ A 15-year-old female is diagnosed with a newly-acquired infectious disease.
Which of thefollowing is NOT a mandatory reportable disease to the health
department?
A. T
B. B. Varicella.
, C. Syphilis.
D. Rabies..
Answer: B: Varicella (chickenpox) is not a reportable disease, and most
children are vaccinated forvaricella; however, the CDC requires reporting of
TB, syphilis, and rabies as these are public healthconcerns.
◍ Menigitis.
Answer: -inflammation of the meninges of the brain and spinal
cord-Bacterial and Viral (aseptic meningitis)-Infant S&S: high pitched cry,
bulging fontanel, irritability-Children S&S: headache, stiff neck, vomiting,
nuchal rigidity-Diagnosis: LUMBAR PUNCTURE (LOW GLUCOSE IN
CSF + BACETERAL MENINGITIS; bacteria eats glucose) increased
protein in CSF increased pressure when CSF is obtained-Tx: ABX therapy
and DROPLET CONTACTS (aseptic meningitis is symptom support)
◍ Cerebral Palsy (CP).
Answer: -A non progressive neuromuscular disorder that affect movement
and posture -S&S: abnormal muscle coordination and tone, vision, hearing,
& speech disturbances, seizures, INTELLECTUAL DISABILITY SEEN IN
LESS THAT <1/2 OF KIDS WITH CP-Tx: speech, PT, OT, equipment for
walking, and AGE APPROPRIATE COGNITIVE ACTIVITIES AND
INCENTIVES FOR MOTOR DEVELOPMENT*high top shoes for kids
with spastic CP *helmet for kids with ataxia CP
◍ Hirshsprung's Disease.
Answer: -Absence of ganglionic cells (cells that move things through),
peristalsis is absent resulting in the large intestine's inability to move
food-S&S: Abd distention!!!, constipation-"ribbon like stools" ( (liquid
stool, going around obstruction) foul smelling -Diagnosis: Rectal Biopsy
-Temporary ostomy and then repair -enema (to evacuate bowel), bowel
irrigation with golytely (NG tube) , low residue diet, high calorie and
protein - low fiber
◍ Typical symptoms of anemia in a pediatric patient would include all of the
following EXCEPT:
