Pediatric Nurse Practitioner PNP Exam Questions and Answers, Exams of Nursing

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Pediatric Nurse Practitioner PNP EXAM

2024.2025 VERIFIED EXAM WITH SOLUTION

(SCORE A) GUARANTEED PASS

A pediatric nurse practitioner is considering leaving primary care for a position in a mental health clinic which includes screening and managing medications for patients of all ages. Before making such a change in employment it is MOST important to consult the A. staff at the certification board. B. staff at the malpractice insurance carrier. C. professional organization's scope and standards of practice. D. state board of nursing's rules and regulations. D. state board of nursing's rules and regulations. The parents of a 2-year-old are concerned that their child is having temper tantrums in public settings. Which is the BEST response? A. Modifying expectations when in a public place is acceptable to promote calming. B. The temper tantrum is an indication that the child is tired and needs a nap.

C. Address any safety concerns while ignoring the child's display of behavior. D. Respond to the tantrum with firm expectations for public behavior. C. Address any safety concerns while ignoring the child's display of behavior. Which of the following has been identified as a potential cause of bowel perforation if ingested? A. jewelry beads B. latex balloons C. multiple magnets D. marbles C. multiple magnets A 10 month old has had apparent abdominal pain for the past 4 hours. During episodes of pain, the infant screams inconsolably and draws his legs towards the abdomen, has vomited twice, but has had no diarrhea. Between episodes the infant is calm and quiet. The MOST likely diagnosis is: A. appendicitis B. acute gastroenteritis C. intussusception

D. Meckel's diverticulum C. intussusception A 10-month-old male is irritable and has lower extremity weakness on physical exam. Which of the following infant characteristics would prompt screening for rickets? A. African American ethnicity B. living below 40 degrees latitude C. recent relocation from Texas to Wisconsin D. breastfed supplemented with 18 oz (532 mL) formula per day A. African American ethnicity In addition to use of the supine position, which of the following is a sudden infant death syndrome risk reduction strategy to teach parents? A. use a humidifier in the room to avoid overheating B. allow co-sleeping to monitor infant sleep position C. give the infant a pacifier at bed and nap time D. use a device to maintain supine sleep position C. give the infant a pacifier at bed and nap time

The MOST common symptom of hepatitis A in a 14 month old is: A. ascites B. dark urine C. fever D. jaundice C. fever Which of the following PRIMARY interventions assists in the prevention of adolescent depression? A. screen for co-morbid conditions B. discuss changes associated with adolescence C. recommend help from professionals rather than friends D. reassure that short-term depression and mood swings can be normal B. discuss changes associated with adolescence An adolescent presents with a complaint of chest pain. Which associated symptom MOST likely indicates that the underlying problem is of a non-cardiac origin?

A. pain with palpation B. nausea C. palpitations D. syncope A. pain with palpation An infant born at 35 weeks has which of the following risks? A. excessive wakefulness B. poor sucking strength C. hyperglycemia D. colic B. poor sucking strength A 12-month-old with no recent medication history presents with fever, malaise, bullous impetigo, and diffuse erythroderma in flexural and periorificial areas. Mucous membranes are not affected, but crusting and fissuring are evident around the eyes, mouth, and nose. When the skin is gently rubbed, the epidermis in the area is denuded. These findings are characteristic of: A. Kawasaki disease B. staphylococcal scalded skin syndrome C. Stevens-Johnson syndrome

D. toxic epidermal necrolysis B. staphylococcal scalded skin syndrome During the winter, a school-age child with a history of asthma presents with a one-day history of rhinorrhea, sore throat, dry hacking cough, a few episodes of vomiting and general malaise. Vital signs are as follows (see table): Which is the most appropriate INITIAL diagnostic test? A. complete blood count B. rapid influenza test C. rapid respiratory syncytial virus antigen D. rapid strep test B. rapid influenza test The child at highest risk for having an elevated blood lead level is a: A. 3 month old exclusively breastfed infant B. 6 month old who lives in a home built after 1970 C. 2 year old with iron deficiency anemia D. 2 year old who is a picky eater C. 2 year old with iron deficiency anemia

Nutritional assessment of an adolescent on a strict vegan diet should include regular growth monitoring, dietary analysis, and laboratory assessment of: A. iron, vitamin B12, and zinc B. calcium, vitamin B6, and zinc C. iron, potassium, and vitamin B D. calcium, potassium, and vitamin B A. iron, vitamin B12, and zinc For acute bacterial sinusitis, the optimal duration of antimicrobial therapy is: A. 7 days total treatment B. 14 days total treatment C. 7 days after symptoms have resolved D. 10 days after symptoms have resolved C. 7 days after symptoms have resolved The caregivers of an 18 month old are both overweight. Appropriate guidance to address their child maintaining a healthy weight should include A. limiting carbohydrate intake. B. offering vitamin supplementation.

C. responding to child's cues for hunger and satiety. D. returning for weight and BMI measurements every 6 months. C. responding to child's cues for hunger and satiety. When counseling parents whose children have had food-induced anaphylaxis, which teaching point is the MOST important? A. Exercise can be a co-factor in food induced anaphylaxis. B. Timely administration of epinephrine is the standard of care. C. Children with severe food-induced allergic reactions have a higher risk for asthma. D. The severity of previous reactions cannot predict the severity of future reactions. B. Timely administration of epinephrine is the standard of care. Which of the following lab abnormalities is MOST suggestive of iron-deficiency anemia? A. low hemoglobin B. low mean corpuscular volume C. low serum ferritin D. low serum iron C. low serum ferritin

An adolescent with primary hypertension has left ventricular hypertrophy identified on echocardiogram. The appropriate therapeutic goal for the blood pressure is a reduction A. of diastolic value by 10 mmHg. B. of systolic value by 10 mmHg. C. to less than the 90th percentile for gender, age, and height. D. to at least the 95th percentile for gender, age, and height C. to less than the 90th percentile for gender, age, and height. Which of the following is MOST appropriately included in guidance provided to caregivers about reducing their adolescent's risk of dating violence? A. encourage abstinence from sexual intercourse B. monitor for school problems and depression C. review text messages and emails D. talk about healthy relationships D. talk about healthy relationships

A term infant born by C-section, with birthweight of 5 lb 5 oz (2.4 kg), develops a respiratory rate of 68 bpm with clear breath sounds at 2 hours of life. The MOST likely diagnosis is: A. congenitally acquired pneumonia B. pneumothorax incident to delivery C. respiratory distress syndrome D. transient tachypnea of the newborn D. transient tachypnea of the newborn First-line therapy for a 5 year old with acute otitis media and concurrent purulent conjunctivitis is: A. amoxicillin 90 mg/kg/day B. azithromycin 10 mg/kg/day on day 1, then 5 mg/kg/day on days 2- 5 C. amoxicillin/clavulanate (Augmentin) with 90 mg/kg/day of amoxicillin component D. cephalexin (Keflex) 50mg/kg/day C. amoxicillin/clavulanate (Augmentin) with 90 mg/kg/day of amoxicillin component A 1 week old has a papular rash, with clustered lesions, which was first noticed by the caregiver three days ago. A few areas appear to be pustular. The infant is otherwise healthy. What is the MOST likely diagnosis?

A. erythema toxicum B. milia C. neonatal acne D. neonatal pustular melanosis A. erythema toxicum A 5 year old complains of a painful left eye after being accidentally scratched by a sibling two hours ago. Fluorescein exam shows a small central corneal abrasion. The MOST appropriate management during the first 24 hours is A. frequent application of topical anesthetics. B. frequent application of topical antibiotic. C. occlusive patching of the injured eye. D. monitoring with return office visit. B. frequent application of topical antibiotic. Alternating doses of ibuprofen and acetaminophen for the treatment of fevers A. increases the risk of dosage errors and toxicity. B. allows for lower total dosage of both drugs. C. results in more rapid resolution of the fever than using either drug alone. D. is appropriate only for children over the age of six months.

A. increases the risk of dosage errors and toxicity. During a visit for an acute illness, which element of a child's history can only be completed by the health care provider? A. history of present illness B. past medical history C. review of systems D. diagnosis A. history of present illness A 6 year old with viral induced asthma presents with 3 days of low grade fever, rhinorrhea, and cough. In addition to wheezing, which of the following findings are MOST likely noted on physical examination? A. tachypnea and crackles to bases B. tachypnea and intercostal retractions C. intercostal retractions and crackles to bases D. productive cough and prolonged inspiration B. tachypnea and intercostal retractions

Counseling regarding meningococcal disease for a prospective college freshman who plans to live in a dormitory should include that the A. meningococcal vaccine confers lifelong immunity. B. meningococcal vaccine is mandatory for all college students. C. risk for meningococcal disease is just as high for commuting students. D. risk for meningococcal disease is increased for freshmen dormitory residents. D. risk for meningococcal disease is increased for freshmen dormitory residents. When providing anticipatory guidance to parents whose infant has colic, which information is MOST appropriate to include? A. fever is often an accompanying symptom of colic B. infants with colic are hypersensitive to stimuli C. teething can stimulate a colicky response D. symptoms increase at 3 - 4 months of age B. infants with colic are hypersensitive to stimuli Adolescents who receive education about condoms should also have information about the A. usage of petroleum jelly for lubrication. B. brands least likely to break during intercourse.

C. technique for safe removal focusing on rerolling condom. D. use of long-acting reversible contraception as dual-protection. D. use of long-acting reversible contraception as dual-protection. Recommendations for the use of supplemental iron in otherwise healthy infants and children includes that A. preterm infants fed human milk should receive supplementation at 2 months of age. B. exclusively breastfed infants should begin supplementation at 4 months of age. C. exclusively breastfed infants should begin supplementation at 6 months of age. D. toddlers should receive supplementation with liquid or chewable iron products. B. exclusively breastfed infants should begin supplementation at 4 months of age. A nurse practitioner is purchasing a "claims-based malpractice insurance policy" for the first time. This will cover A. a claim made during the period the policy is active depending on state laws and age of claimant. B. any event that occurs during the policy period regardless of when the claim is made. C. an extension of the original malpractice policy if new employment occurs. D. a claim made prior to the inception date of the policy.

A. a claim made during the period the policy is active depending on state laws and age of claimant. During a sports physical, an otherwise healthy 18-year-old female who is a competitive athlete gives a history of mild abdominal pain and nausea, last menstrual period 3 months ago, and weight loss of 30 pounds in the past year. Exam findings are included in the table below. Which of the following is the MOST likely diagnosis? A. anorexia nervosa B. celiac disease C. inflammatory bowel disease D. new onset diabetes A. anorexia nervosa Education for caregivers about safe use of an infant car safety seat includes that the A. harness straps should be above the shoulders with the seat rear-facing. B. seat should shift a little more than 1 inch from side to side. C. infant can be swaddled prior to placing in the seat. D. retainer clip should be at armpit level. D. retainer clip should be at armpit level.

A mildly ill 4 year old, with a recent positive rapid strep test, returns with abdominal pain and erythematous nonblanching lesions on the legs. What is the MOST likely diagnosis? A. erythema multiforme B. Henoch-Schönlein purpura (HSP) C. immune thrombocytopenia purpura D. scarlet fever B. Henoch-Schönlein purpura (HSP) A 10 year old presents with a 6 month history of headaches occurring twice per month described as frontal, pounding, lasting for most of the day, and accompanied by nausea and light sensitivity. Which is the BEST initial treatment? A. amitriptyline (Elavil) B. ibuprofen (Advil) C. promethazine (Phenergan) D. sumatriptan (Imitrex) B. ibuprofen (Advil) When obtaining a comprehensive health history for a new adolescent patient, which is the BEST approach for the psychosocial assessment?

A. refrain from asking sexuality related questions unless the caregiver has concerns B. ask the caregiver to complete an anxiety screening questionnaire C. begin the psychosocial screening with personal questions D. complete the history without the caregiver present D. complete the history without the caregiver present An adolescent has a 4-week history of a paroxysmal cough and occasional post- tussive emesis. Physical exam is essentially unremarkable except for signs of an upper respiratory infection. The MOST likely causative organism is: A. Bordetella pertussis B. Haemophilus influenzae C. Mycoplasma pneumoniae D. Streptococcus pneumoniae A. Bordetella pertussis An infant with a history of prematurity presents with a full anterior fontanelle, and slightly separated sagittal suture. Head circumference has increased from 50th to the 90th percentile on the growth chart. Which of the following is the MOST likely diagnosis? A. craniosynostosis B. hydrocephalus

C. intraventricular hemorrhage D. plagiocephaly B. hydrocephalus Completion of a urine drug screening for an adolescent at the request of a parent is considered A. a risk to the patient-practitioner relationship. B. unreliable because of the long half-life of most drugs of abuse. C. an acceptable measure to assist with patient referral for therapy. D. a reliable method of determining recent use of a substance such as marijuana. A. a risk to the patient-practitioner relationship. Caregivers report that their child awakens crying and agitated during the last half of the nighttime sleep cycle, followed by appearing fully awake and readily comforted. This child is experiencing: A. nightmares B. sleep starts C. sleep tremors D. somniloquy A. nightmares

Which laboratory assessment is the BEST indicator of vitamin D deficiency? A. 1,25(OH)2-D (calcitriol) B. 25(OH)-D (cholecalciferol) C. PTH (parathyroid hormone) D. serum calcium B. 25(OH)-D (cholecalciferol) A child weighing 45 kg has a positive rapid strep test and is started on amoxicillin. Two days later the mother calls and reports the child has developed an itchy, raised rash over his trunk, but no other symptoms. Which of the following is the BEST management strategy? A. change to clindamycin 300 mg every 8 hours for 10 days B. change to minocycline 75 mg twice daily for 10 days with meals C. acknowledge penicillin allergy and add an antihistamine to the current regimen D. continue the amoxicillin as the rash is a response to a toxin from the strep bacteria A. change to clindamycin 300 mg every 8 hours for 10 days

Which of the following screening criteria would BEST predict dyslipidemia in a child? A. child with blood pressure above 85th percentile for age B. child with body mass index at 90th percentile for age C. parent with high blood pressure at 55 years D. grandparent surviving heart attack at 65 years B. child with body mass index at 90th percentile for age Screening for depression among adolescents should occur: A. annually during patient interview B. at every visit using a formal self-reported screening tool C. annually using a parent-completed Pediatric Symptom Checklist D. more often when there are frequent somatic complaints D. more often when there are frequent somatic complaints Which of the following is the MOST appropriate advice for the proper fitting and use of bike or sports helmets? A. replace helmet every 2 years B. avoid using secondhand helmets C. position helmet high on forehead

D. fit helmet to allow some movement side to side B. avoid using secondhand helmets A previously healthy child's leg wound is cultured in the office with results revealing methicillin-resistant Staphylococcus aureus (MRSA). With a known allergy to sulfa, the BEST choice for treatment is: A. clindamycin (Cleocin) B. rifampin (Rifadin) C. trimethoprim-sulfamethoxazole (Bactrim) D. vancomycin (Vancocin) A. clindamycin (Cleocin) For a 21 month old with persistent fever following 48 hours of antibiotics for a first febrile urinary tract infection, which of the following is the MOST appropriate diagnostic test? A. repeat urinalysis B. renal ultrasound C. voiding cystourethrogram D. dimercaptosuccinic acid scan B. renal ultrasound

When prescribing a selective serotonin reuptake inhibitor to treat a child with an anxiety disorder, it is MOST important to A. obtain a complete blood count prior to beginning the medication. B. disclose side effects including the increased risk of suicidal ideation. C. determine the initial dosage based on the severity of the symptoms. D. disclose that this class of medications is not FDA approved for treating anxiety. B. disclose side effects including the increased risk of suicidal ideation. The purpose of administering acidophilus (Lactobacillus) while taking antibiotics is to A. decrease pH in the gastrointestinal tract. B. decrease diarrhea by adding additional fiber. C. enhance the absorption of the antibiotic in the colon. D. treat diarrheal illnesses caused by Clostridium difficile. A. decrease pH in the gastrointestinal tract. A 16 year old presents with a three-hour history of acute pain and swelling of the scrotum, severe enough to make examination difficult. What should be the FIRST course of action? A. Doppler study of the scrotum

B. transillumination of the scrotum C. refer to the emergency department D. obtain history of sexually transmitted infections C. refer to the emergency department When assessing social language and self-help domains for a healthy 18 month old, which of the following findings would be a concern? A. frequently brings objects to caregiver B. points to pictures while being read a book C. assists with dressing and undressing by raising arms D. has no interest when caregiver begins a new activity D. has no interest when caregiver begins a new activity A newborn fails the initial hearing screen by otoacoustic emissions. Which method of testing provides the MOST accurate reassessment? A. auditory brainstem response B. behavioral observation audiometry C. repeat otoacoustic emissions D. visual reinforced audiometry A. auditory brainstem response

A child with no symptoms of hyperkalemia has a potassium level of 5.8 mEq/L reported on a basic metabolic panel. Which is the MOST appropriate next step? A. obtain a capillary specimen B. decrease potassium in the diet C. obtain a free flowing venous specimen D. discontinue any use of nonsteroidal anti-inflammatory drugs C. obtain a free flowing venous specimen An adolescent complains of shortness of breath, coughing, throat tightness, and audible laryngeal wheezing with stridor during soccer games. Spirometric lung function testing reveals "truncated" and inconsistent inspiratory and expiratory flow-volume loops. Referral should be made to a/an: A. occupational therapist B. physical therapist C. psychologist D. speech therapist D. speech therapist

An adolescent presents with an infected pierced naval, revealing moderate swelling, erythema, and exudate. The piercing, kept open with a gold ring, is one month old, and has been maintained with antibacterial soap and water cleansing. The adolescent reports swimming in a lake one week ago. Which of the following is the MOST appropriate? A. remove jewelry from naval B. initiate oral antibiotics C. apply topical barrier cream D. cleanse with hydrogen peroxide B. initiate oral antibiotics In a 2 month old with visible rib fractures on radiograph, the NEXT most critical evaluation to obtain is a: A. long bone series B. coagulation profile C. CT scan of the head D. retinal ophthalmologic exam C. CT scan of the head Which laboratory testing is recommended annually for an adolescent with Turner syndrome? A. CBC, serum glucose, celiac panel