Free Certified Pediatric Nurse Practitioner – Primary Care (CPNP-PC) Certification Exam Practice Questions

Sample Practice Questions

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

1. 1At a newborn visit, a parent plans exclusive breastfeeding. What daily vitamin D supplement dose should the PNP recommend beginning shortly after birth?

   1. A. 200 IU each day
   2. B. 400 IU each day
   3. C. 600 IU each day
   4. D. 800 IU each day

   Answer: B

   Explanation: CDC states, "Babies who are fed only breast milk or who receive both breast milk and infant formula need to have a supplement with 400 IU of vitamin D every day beginning shortly after birth." Exclusive breastfeeding meets this condition; the recommended supplement is 400 IU daily.

   Reference: Vitamin D — Infant and Toddler Nutrition — Making sure children get enough — Breast milk

2. 2A PNP assesses growth in a healthy term-born 8-month-old infant in the United States. Which reference should be used for routine infant growth plotting?

   1. A. WHO Child Growth Standards
   2. B. CDC extended BMI-for-age charts
   3. C. CDC BMI-for-age charts for ages 2–20
   4. D. Fenton preterm infant growth charts

   Answer: A

   Explanation: CDC specifies, "To assess growth for children younger than 2 years using WHO Child Growth Standards:" WHO standards are appropriate for this term infant. The BMI charts address older children, and the Fenton charts address preterm growth.

   Reference: Using WHO Growth Standard Charts — Assessing growth

3. 3A caregiver asks why aspirin should be avoided for a child with fever and influenza-like symptoms. Which serious complication explains this counseling?

   1. A. Hemolytic uremic syndrome
   2. B. Reye syndrome
   3. C. Guillain–Barré syndrome
   4. D. Kawasaki disease

   Answer: B

   Explanation: NIDCD states, "Because aspirin is considered a major preventable risk factor for Reye’s syndrome." This association supports avoiding aspirin for this febrile viral illness unless specifically directed by the child's clinician.

   Reference: Ear Infections in Children — How is an acute middle ear infection treated?

4. 4A PNP reviews a cohort study in which 20 of 100 exposed children and 10 of 200 unexposed children develop an outcome. What is the exposed-to-unexposed risk ratio?

   1. A. 0.25
   2. B. 2.00
   3. C. 4.00
   4. D. 4.75

   Answer: C

   Explanation: CDC states, "The RR, the preferred measure for cohort studies, is calculated as the attack rate (risk) among the exposed group divided by the attack rate (risk) among the unexposed group." The ratio is (20/100)/(10/200) = 4. Inverting gives 0.25, comparing case counts gives 2, and calculating an odds ratio gives 4.75.

   Reference: Analyzing and Interpreting Data — The CDC Field Epidemiology Manual — Measures of Association — Risk Ratio (Relative Risk)

5. 5A healthy 9-month-old drinks iron-fortified infant formula. The family asks when whole cow's milk may first replace formula as the child's usual milk beverage. What age should the PNP recommend?

   1. A. At 9 months of age
   2. B. At 10 months of age
   3. C. At 12 months of age
   4. D. At 18 months of age

   Answer: C

   Explanation: CDC states, "You can introduce your child to whole cow's milk at 12 months old (but not before)." The earliest recommended transition for this healthy infant is 12 months; earlier ages are premature, and 18 months is not the first recommended age.

   Reference: Cow's Milk and Milk Alternatives — When to introduce cow's milk to your child

6. 6A child weighs 28.8 kg and is 1.20 m tall. What BMI should the PNP calculate before determining the sex-specific BMI-for-age percentile?

   1. A. 24 kg/m²
   2. B. 41.47 kg/m²
   3. C. 0.05 kg/m²
   4. D. 20 kg/m²

   Answer: D

   Explanation: CDC defines BMI using "body weight (in kilograms) divided by the square of their height (in meters)". Calculate 28.8 ÷ 1.20² = 20. Dividing by height once gives 24; multiplying by height squared gives 41.47; inverting the BMI ratio gives 0.05.

   Reference: Child and Teen BMI Categories — BMI categories for children and teens

7. 7A caregiver asks which routine topical product helps hold water in the skin after bathing a child with atopic dermatitis. Which product should the PNP identify?

   1. A. Topical calcineurin inhibitor
   2. B. Topical antibiotic
   3. C. Emollient moisturizer
   4. D. Topical corticosteroid

   Answer: C

   Explanation: NIAMS states, "Keeping the skin hydrated by applying moisturizers immediately after bathing to hold the water in your skin is important when treating atopic dermatitis." Moisturizers retain water; the other topical classes have anti-inflammatory or antimicrobial roles rather than this routine hydration purpose.

   Reference: Atopic Dermatitis: Diagnosis, Treatment, and Steps to Take — Treatment of Atopic Dermatitis — Skin care

8. 8An intervention study reports a risk ratio of 1.1 with a two-sided 95% confidence interval of 0.8–1.4. Which interpretation should guide the PNP's appraisal?

   1. A. The interval remains compatible with no association.
   2. B. The interval establishes a statistically significant increase.
   3. C. The interval establishes a statistically significant decrease.
   4. D. The interval remains compatible with a twofold increase.

   Answer: A

   Explanation: CDC explains that "a CI that includes 1.0 is compatible with the null hypothesis." This interval includes 1, so it remains compatible with no association; it supports neither a statistically significant increase nor decrease. A twofold risk ratio of 2 lies outside the reported interval.

   Reference: Analyzing and Interpreting Data — The CDC Field Epidemiology Manual — Interpreting the Confidence Interval — Relation to the null hypothesis

9. 9The parent of a healthy 2-year-old wants to offer 100% fruit juice despite counseling that whole fruit is preferable. What maximum daily juice volume should the PNP recommend?

   1. A. 2 fluid ounces daily
   2. B. 4 fluid ounces daily
   3. C. 6 fluid ounces daily
   4. D. 8 fluid ounces daily

   Answer: B

   Explanation: CDC states, "The American Academy of Pediatrics recommends no more than 4 ounces of 100% fruit juice a day for children ages 1 through 3 years." This 2-year-old falls in that age group. Four ounces is the upper limit, not a required intake; 2 ounces is below the limit but is not the maximum.

   Reference: Foods and Drinks to Avoid or Limit — Juice before 12 months

10. 10A 10-year-old's BMI-for-age is at the 90th percentile for sex and age. Which CDC weight category applies?

    1. A. Healthy weight
    2. B. Overweight
    3. C. Obesity
    4. D. Underweight

    Answer: B

    Explanation: CDC defines overweight as "85th percentile to less than the 95th percentile". The 90th percentile is within that interval, above healthy weight and below the obesity threshold.

    Reference: Child and Teen BMI Categories — BMI categories for children and teens 2 through 19 — Overweight