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Free CNA Pediatric Nursing Certification Exam Practice Questions

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Sample Practice Questions

Try these 10 sample questions from the CNA Pediatric Nursing Certification Exam practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

  1. 1A developmentally mature, competent youth asks that an aunt join care discussions instead of the youth's parents. Who should determine the family's involvement in this situation?

    1. A.The parents, using their preferred family roles
    2. B.The youth, using their own definition of familyCorrect answer: B
    3. C.The aunt, using her understanding of the family
    4. D.The nurse, using the unit's usual family structure

    Explanation: CNA states, "the family’s involvement in health care is determined by the child, provided that he or she is developmentally mature and competent to do so." The stated maturity and competence allow the youth to determine involvement; kinship or unit custom does not transfer this choice.

    Reference: CNA Pediatric Nursing Blueprint — p. 2, Assumptions—Child and Family

  2. 2A parent becomes quiet while describing a child's recent intensive-care admission. The nurse wants to understand the experience before providing teaching. Which opening best supports a therapeutic relationship?

    1. A.What part of that experience has been hardest for your family?Correct answer: A
    2. B.Which medicines did your child receive during that admission?
    3. C.How many days did your child spend in the intensive-care unit?
    4. D.Which follow-up appointments did the discharge team arrange?

    Explanation: "I listened to Khalid’s story highlighting positively that he recognized that Ahmed was having difficulties breathing" The standards describe listening to a parent's story and recognizing the parent's effective response. Inviting the parent's experience establishes the therapeutic relationship before focusing on clinical details.

    Reference: Canadian Paediatric Nursing Standards — printed p. 8, Standard I, Amed's Story

  3. 3During a child's admission history, the parent provides a complete prescription list but mentions using a traditional remedy at home. Which follow-up best completes the medication history?

    1. A.Ask which other non-prescription products the child currently usesCorrect answer: A
    2. B.Ask which pharmacy prints the labels on the prescription containers
    3. C.Ask which clinician last renewed the child's prescription medicines
    4. D.Ask which storage location the family uses for prescription medicines

    Explanation: ISMP Canada advises, "Prompt questions about non-prescription categories". The remedy prompts a broader product history; pharmacy, renewal, and storage details do not identify omitted substances.

    Reference: ISMP Canada—Medication Reconciliation in Home Care — Appendix, Top 10 Practical Tips, tip 2

  4. 4A child repeatedly goes without prescribed medicine because the family cannot afford the dispensing costs. Which health determinant is most directly demonstrated?

    1. A.Education and literacy
    2. B.Physical environment
    3. C.Income and social statusCorrect answer: C
    4. D.Gender and culture

    Explanation: CNA includes "income and social status" among social determinants of health. The stated obstacle is affordability. Education, environment, and gender/culture are other real social determinants, but none is identified as the cause of this particular access barrier.

    Reference: CNA Pediatric Nursing Blueprint — p. 12, competency 5.1

  5. 5A child with known asthma requires a rapid inhaled bronchodilator during an acute exacerbation. Which medication is the usual bronchodilator of choice?

    1. A.Montelukast
    2. B.SalbutamolCorrect answer: B
    3. C.Budesonide
    4. D.Ipratropium

    Explanation: CPS states, "Salbutamol (albuterol) is the bronchodilator of choice". Ipratropium is an adjunct in more severe attacks; budesonide and montelukast do not replace the rapid first-line bronchodilator.

    Reference: CPS—Managing an Acute Asthma Exacerbation — Medical management—Short-acting beta2-agonists

  6. 6A child requires long-term ventilatory support that limits independent daily activities. In the framework for children with medical complexity, which domain is illustrated most directly by this information?

    1. A.Frequent health-care use
    2. B.High caregiver needs
    3. C.Functional limitation and technology dependenceCorrect answer: C
    4. D.Chronic condition and fragility

    Explanation: The blueprint identifies "functional limitation/technology dependant" as a domain of medical complexity. Dependence on ventilation with activity limitations describes that domain; it does not by itself quantify visits, caregiver workload, or fragility.

    Reference: CNA Pediatric Nursing Blueprint — Competency 8.1

  7. 7A nurse explains the chromosomal basis of Down syndrome to a family. Which finding is characteristic of trisomy 21?

    1. A.An extra copy of chromosome 13
    2. B.An extra copy of chromosome 18
    3. C.A deletion involving chromosome 22
    4. D.An extra copy of chromosome 21Correct answer: D

    Explanation: The Public Health Agency of Canada describes Down syndrome as "resulting in an extra copy of chromosome 21." Trisomy 13 and trisomy 18 are other chromosomal conditions; a chromosome 22 deletion is also a different genetic abnormality.

    Reference: Public Health Agency of Canada: Congenital anomalies technical appendix — Selected congenital anomalies—Down syndrome (Q90)

  8. 8A child receiving potentially curative cancer treatment has troublesome symptoms and family distress. How should the nurse explain the relationship between palliative care and the cancer treatment?

    1. A.Palliative care requires completion of the planned curative treatment
    2. B.Palliative measures can be introduced alongside the potentially curative treatmentCorrect answer: B
    3. C.Palliative care requires a change to a comfort-only treatment goal
    4. D.Palliative care requires a decision to discontinue the chemotherapy

    Explanation: The CPS explains that "palliative measures are sometimes introduced alongside potentially curative treatments." Symptom and family support need not wait for treatment completion, a comfort-only decision, or chemotherapy withdrawal.

    Reference: Canadian Paediatric Society: Goals of care conversations and advance care planning for paediatric patients living with serious illness — The role of palliative care

  9. 9A hospitalized child has had several painful procedures. To individualize the next pain-management plan, which history question is most directly useful?

    1. A.Which approaches have helped your child manage pain during previous procedures?Correct answer: A
    2. B.Which previous procedures required your child to fast beforehand?
    3. C.Which previous procedures required your child to have an intravenous line?
    4. D.Which previous procedures required your child to remain still?

    Explanation: The pain guideline includes "Parental report of previously successful pain management strategies". Asking about prior effective approaches directly informs the next pain plan. The other questions gather valid clinical history but do not establish what previously helped the child cope with pain.

    Reference: Royal Children's Hospital: Acute pain management — Assessment

  10. 10During a child's transfer handover, the receiving nurse repeats a critical observation and the sending nurse confirms that it is correct. Which communication strategy is being used?

    1. A.SBAR
    2. B.Check-backCorrect answer: B
    3. C.I-PASS
    4. D.Call-out

    Explanation: AHRQ defines a check-back as "a closed-loop communication strategy used to verify and validate exchanged information." Repetition by the receiver and confirmation by the sender complete that loop. SBAR and I-PASS organize information, whereas a call-out announces it without necessarily completing verification.

    Reference: AHRQ TeamSTEPPS: Check-Back (or Repeat-Back) — Tool: Check-Back—Definition

Exam Review

About CNA Pediatric Nursing Certification Exam

CNA Pediatric Nursing Certification Exam · CA

Key exam facts

Provider
Canadian Nurses Association (CNA) certification program. Meazure Learning develops and maintains the exams and provides testing/statistical services; ProctorU delivers remote proctoring and Meazure Learning administers in-person test centres.
Format
Computer-based multiple-choice knowledge examination, remotely proctored at home through ProctorU or at a Meazure Learning test centre in select Canadian cities. Blueprint: 30–50% independent and 50–70% case-based questions; case sets contain approximately four questions. The four-option practice bank does not reproduce official case-set presentation.
Exam questions
Total questions: 160–165.
Time limit
Four hours (240 minutes) to answer the exam questions, according to CNA CBT exam tips. This is answering time, not a total appointment/check-in duration.
Passing score
Criterion-referenced: the specialty exam committee sets the pass mark using a modified Angoff method, with statistical validation by testing consultants. CNA explicitly states that the pass mark is not published; results are reported as pass or unsuccessful.
Exam fee
Dollar amounts as published on CNA's Canadian fee schedule ($; the page does not expressly state an ISO currency code): initial application $588 for CNA members/$780 for non-members, including a $130 non-refundable administrative fee. Additional appointment fee paid to the administrator: $85 online through ProctorU or $110 in person through Meazure Learning. Applicable provincial GST/HST is additional. Reduced rewrite application fee $378 member/$500 non-member for the next two calendar years after an unsuccessful result. Fees are set annually.

Topics covered

The authority publishes percentage ranges for each content area. The practice percentages below use the midpoint of each range, normalized to 100%; they are not exact percentages published by the authority. Practice question counts may differ slightly because of rounding.

  • Professional Practice, Leadership and Advocacy — Official range: 5–7% (Practice allocation: 6.09%)

    • Practise according to Canadian Paediatric Nursing Standards, CNA code of ethics and ethical principles applying to children
    • Identify relevant legislation, social and organizational policies affecting child and family health and well-being
    • Reflect on personal values, beliefs and biases
    • Advocate for unique needs of children and families and the broader pediatric population
    • Use a strengths-based approach to build child and family self-advocacy and system navigation capacity
    • Provide culturally-safe care
    • Recognize specific populations' unique needs
    • Promote a safe, healthy and inclusive workplace
    • Interprofessional collaboration
    • Quality improvement initiatives
    • Continuing education

  • Child and Family Centered Care — Official range: 5–7% (Practice allocation: 6.09%)

    • Establish a therapeutic relationship with the child and family
    • Partner respectfully, non-judgmentally and culturally safely in care decisions and plans
    • Collect child and family information while maintaining privacy and confidentiality
    • Understand family structure, developmental stage and functionality
    • Incorporate child and family strengths and resources
    • Identify need for and use trained interpreters
    • Recognize alterations in well-being affecting participation in care
    • Advocate for appropriate resources
    • Provide honest, factual, timely information and support

  • Growth and Development — Official range: 5–7% (Practice allocation: 6.09%)

    • Typical development and variations in childhood
    • Safety risks associated with developmental level
    • Strategies addressing developmental responses to illness and health-care encounters
    • Anticipatory guidance and coaching related to developmental stages and levels

  • Pediatric Nursing Process — Official range: 10–15% (Practice allocation: 12.69%)

    • Comprehensive child and family health history
    • Comprehensive physical and psychosocial/mental health assessment
    • Assessment variations by developmental stage and pediatric anatomy and physiology
    • Normal and abnormal physical, laboratory and investigative findings
    • Actual or potential assessment alterations and their significance
    • Culture-specific meanings, descriptions, causes, acceptance and treatment of symptoms
    • Implement interventions and care according to assessment findings
    • Safe pediatric medication administration principles
    • Evaluate nursing intervention effectiveness

  • Promotion of Well-Being and Prevention of Illness/Injury — Official range: 5–7% (Practice allocation: 6.09%)

    • Social determinants of health and their impact on child health
    • Practice environment safety and risk assessment
    • Relevant screening tools for actual and potential individual and family risks
    • Health and well-being promotion at individual, family and community levels

  • Common Pediatric Illnesses and Conditions — Official range: 20–25% (Practice allocation: 22.84%)

    • Basic pathophysiology, manifestations, interventions, management, treatment response, family education and documentation
    • Asthma and upper/lower respiratory infections
    • Autism spectrum disorder and ADHD
    • Child maltreatment and domestic violence
    • Diaper dermatitis, pressure injuries, minor burns, rashes
    • Failure to thrive, malnutrition
    • Fluid and electrolyte imbalances
    • Gastroesophageal reflux disease, constipation and infectious gastroenteritis
    • Juvenile idiopathic arthritis, inflammatory bowel disease
    • Newborn jaundice
    • Obesity
    • Seizures
    • Sexually transmitted infection
    • Trauma (e.g., concussions, fractures)
    • Type 1 and 2 diabetes
    • Urinary tract infection

  • Common Pediatric Emergencies — Official range: 5–7% (Practice allocation: 6.09%)

    • Basic emergency pathophysiology, manifestations, interventions, management, treatment response, family education and documentation
    • Airway obstruction
    • Altered level of consciousness
    • Cardio-pulmonary arrest
    • Diabetic ketoacidosis
    • Meningitis
    • Mental health crisis
    • Shock
    • Toxic ingestion
    • Trauma

  • Children with Medical Complexity — Official range: 5–7% (Practice allocation: 6.09%)

    • Definition of children with medical complexity
    • Basic pathophysiology of identified medically complex conditions
    • Unique and ongoing family needs
    • Potential variation from typical pediatric baseline parameters
    • Interventions based on identified and potential risks
    • Family-guided care plan development and maintenance
    • Support family competency in caring for medically complex children
    • Clinical judgment recognizing family expertise

  • Genetic and Congenital Conditions — Official range: 1–3% (Practice allocation: 2.03%)

    • Basic pathophysiology of common genetic and congenital conditions
    • Evidence-informed interventions for genetic and congenital conditions
    • Family support, collaboration, advocacy and referral

  • Palliative Care — Official range: 5–7% (Practice allocation: 6.09%)

    • Palliative care alone or combined with disease-reducing or curative therapies
    • Child and family needs, hopes, beliefs, fears, expectations and strengths
    • Sensitivity to values, beliefs, practices, development and preparedness for dying
    • Goals of care and advance care planning discussions
    • Symptom management, respite, end of life and grief support resources
    • Dialogue to understand nature and meaning of a MAID request

  • Mental Health and Substance Use — Official range: 5–10% (Practice allocation: 7.61%)

    • Routine pediatric mental health assessment
    • Strategies supporting safety for self and others
    • Partner to create a safety plan
    • Trauma-informed care and harm reduction
    • Common pediatric mental health conditions and presentations
    • Routine substance-use screening and opportunities for intervention
    • Individualized referral to evidence-informed treatment and resources

  • Pain — Official range: 5–7% (Practice allocation: 6.09%)

    • Interpret pain-related data
    • Child health history relevant to pain
    • Developmentally appropriate pain assessment tools
    • Physical pain assessment
    • Pain types and behavioural, cognitive and physiological responses
    • Consequences of ineffective pain management
    • Interventions preventing and alleviating pain
    • Non-pharmacological pain strategies
    • Safe appropriate pharmacological pain agents based on assessment
    • Effectiveness and sequelae of pharmacological and non-pharmacological agents
    • Child and family teaching about pain medications

  • Transitions in Care — Official range: 5–7% (Practice allocation: 6.09%)

    • Effective communication at care transitions
    • Assess child and family readiness for safe transitions
    • Partner in transition and discharge needs discussions
    • Health education and information to optimize transitions
    • Coordinate resources supporting transitions
    • Share information for care coordination
    • Safe effective transition and discharge processes

How to prepare

Work through the topics, read the explanation after each answer, and revisit the areas where you miss questions. Use the official outline and reference materials below to guide your study.

These independent practice questions are not actual exam items and do not guarantee a passing result.

Frequently asked questions

What is the exam format?

Computer-based multiple-choice knowledge examination, remotely proctored at home through ProctorU or at a Meazure Learning test centre in select Canadian cities. Blueprint: 30–50% independent and 50–70% case-based questions; case sets contain approximately four questions. The four-option practice bank does not reproduce official case-set presentation.

How many questions are on the exam?

Total questions: 160–165.

How long is the exam?

Four hours (240 minutes) to answer the exam questions, according to CNA CBT exam tips. This is answering time, not a total appointment/check-in duration.

What is the passing score?

Criterion-referenced: the specialty exam committee sets the pass mark using a modified Angoff method, with statistical validation by testing consultants. CNA explicitly states that the pass mark is not published; results are reported as pass or unsuccessful.

How much does the exam cost?

Dollar amounts as published on CNA's Canadian fee schedule ($; the page does not expressly state an ISO currency code): initial application $588 for CNA members/$780 for non-members, including a $130 non-refundable administrative fee. Additional appointment fee paid to the administrator: $85 online through ProctorU or $110 in person through Meazure Learning. Applicable provincial GST/HST is additional. Reduced rewrite application fee $378 member/$500 non-member for the next two calendar years after an unsuccessful result. Fees are set annually.

Official sources and references

Confirm current exam arrangements with the exam provider.