Free Certified Pediatric Nurse Practitioner – Acute Care (CPNP-AC) Certification Exam Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Certified Pediatric Nurse Practitioner – Acute Care (CPNP-AC) Certification Exam practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A 12-year-old and two family members present with headache and nausea after an overnight power outage. None has a fever. Which household exposure should the acute care PNP specifically investigate for a possible shared carbon monoxide source?

   1. A. Use of an electric space heater in a bedroom
   2. B. Use of a gasoline generator inside the garage
   3. C. Use of a humidifier beside the sleeping area
   4. D. Use of an electric blanket throughout the night

   Answer: B

   Explanation: CDC states, "With a focused history, exposure to a CO source may become apparent." It identifies gasoline-powered generators in enclosed spaces as CO sources. The clustered afebrile illness warrants asking about the generator; the electric devices listed do not burn fuel.

   Reference: CDC Clinical Guidance for Carbon Monoxide Poisoning Following Disasters and Severe Weather — How to Recognize CO Poisoning; generator warning

2. 2After swimming in floodwater abroad, a 17-year-old develops fever, severe calf pain, conjunctival suffusion, jaundice, and oliguria. Which infection should lead the differential diagnosis?

   1. A. Leptospirosis
   2. B. Giardiasis
   3. C. Typhoid fever
   4. D. Cryptosporidiosis

   Answer: A

   Explanation: CDC describes leptospirosis with "myalgia, characteristically involving the calves and lower back; conjunctival suffusion" and severe renal and hepatic involvement. This combined exposure and multisystem pattern favors leptospirosis.

   Reference: CDC Yellow Book: Leptospirosis — Clinical presentation

3. 3A 9-year-old with a severe asthma exacerbation is receiving repeated inhaled albuterol. Which inhaled medication is recommended as an additional bronchodilator during initial emergency treatment?

   1. A. Fluticasone
   2. B. Ipratropium
   3. C. Salmeterol
   4. D. Cromolyn

   Answer: B

   Explanation: NHLBI recommends SABA "with the addition of inhaled ipratropium bromide in severe exacerbations." Ipratropium adds antimuscarinic bronchodilation; the alternatives do not provide this recommended acute adjunct.

   Reference: NHLBI Asthma Care Quick Reference — Page 4, Managing Exacerbations, Urgent or Emergency Care

4. 4A PNP appraises a pediatric randomized trial. Every randomized child is analyzed in the originally assigned group, including children who never started treatment or switched treatments. Which analysis principle is being followed?

   1. A. Per-protocol analysis
   2. B. As-treated analysis
   3. C. Intention-to-treat analysis
   4. D. Safety-population analysis

   Answer: C

   Explanation: NHLBI states, "Intention-to-treat (ITT) means everybody who was randomized is analyzed according to the original group to which they are assigned." Retaining the randomized grouping identifies intention-to-treat analysis.

   Reference: NHLBI Study Quality Assessment Tools — Guidance for Controlled Intervention Studies, Question 14

5. 5During follow-up of a 9-year-old with asthma, the PNP asks the caregiver to recall symptom frequency and activity limitation to assess current impairment. Which recall interval does the NHLBI quick reference specify for this assessment?

   1. A. The preceding 2–4 weeks
   2. B. The preceding 3 months
   3. C. The preceding 12 months
   4. D. The preceding 1–2 years

   Answer: A

   Explanation: NHLBI specifies, "Assess impairment by patient’s or caregiver’s recall of events during the previous 2–4 weeks; assess risk over the last year." The question asks about current impairment, rather than the longer risk interval or spirometry interval.

   Reference: NHLBI Asthma Care Quick Reference — Page 5, Initial Visit: Classifying Asthma Severity, table note

6. 6An adolescent returning from a tropical region has fever, retro-orbital pain, myalgias, and petechiae. As the fever resolves, abdominal pain and clinical plasma leakage develop. Which infection best explains this course?

   1. A. Rubella
   2. B. Dengue
   3. C. Chikungunya
   4. D. Zika virus disease

   Answer: B

   Explanation: CDC states, "The critical phase of dengue begins at defervescence" and describes plasma leakage during that phase. The evolution of this febrile illness into leakage at defervescence strongly favors dengue.

   Reference: CDC Clinical Features of Dengue — Clinical presentation, Critical phase

7. 7A 12-year-old has a severe asthma exacerbation that remains poorly responsive to intensive inhaled bronchodilators, oxygen, and systemic corticosteroids. Which intravenous adjunct should the PNP consider?

   1. A. Calcium gluconate
   2. B. Sodium bicarbonate
   3. C. Magnesium sulfate
   4. D. Potassium chloride

   Answer: C

   Explanation: NHLBI recommends considering "intravenous magnesium sulfate" for severe exacerbations unresponsive to initial treatment. The other electrolyte therapies do not provide this asthma rescue intervention.

   Reference: NHLBI Asthma Care Quick Reference — Page 4, Urgent or Emergency Care

8. 8A PNP reviews pediatric treatment evidence. One report uses statistical techniques to combine effect estimates from several studies into a single pooled estimate. Which method is described?

   1. A. Meta-analysis
   2. B. Case-control study
   3. C. Prospective cohort study
   4. D. Qualitative systematic review

   Answer: A

   Explanation: NHLBI describes a meta-analysis as using "statistical techniques to combine the results of the different studies into a single pooled estimate of effect". A qualitative systematic review does not statistically pool the results.

   Reference: NHLBI Study Quality Assessment Tools — Guidance for Systematic Reviews and Meta-Analyses, introductory paragraphs

9. 9A 16-year-old with acute diplopia, dysphagia, and descending weakness is being evaluated for foodborne botulism. Which dietary history specifically addresses a well-described exposure to botulinum toxin?

   1. A. Consumption of unpasteurized milk products
   2. B. Consumption of undercooked chicken meat
   3. C. Consumption of homemade canned vegetables
   4. D. Consumption of raw shellfish from seawater

   Answer: C

   Explanation: CDC identifies foodborne botulism risk as "consumption of home-canned food". The other exposures are relevant to other foodborne infections, but home canning specifically addresses the suspected preformed botulinum toxin exposure. An absent exposure history would not exclude botulism.

   Reference: CDC Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021 — Exposure Risk Factors and Botulism Diagnosis, Background

10. 10A school-aged child has recurrent brief lapses of awareness with staring and no loss of postural tone. The events are classified as generalized seizures. Which seizure type best fits?

    1. A. Tonic
    2. B. Atonic
    3. C. Absence
    4. D. Clonic

    Answer: C

    Explanation: NINDS states, "Absence seizures may cause the person to appear to be staring into space". Among generalized types, this nonmotor staring pattern favors absence rather than stiffening, loss of tone, or repeated jerking.

    Reference: NINDS Epilepsy and Seizures — Generalized seizures