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Latest MCQs 2026 Updated Certified Pediatric Nurse Practitioner - Primary Care exam Questions

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CPNP-PC exam Format | CPNP-PC Course Contents | CPNP-PC Course Outline | CPNP-PC exam Syllabus | CPNP-PC exam Objectives

Exam Code: CPNP-PC

Exam Name: Certified Pediatric Nurse Practitioner - Primary Care

Number of Questions: 175 multiple-choice items (150 scored questions + 25 unscored pretest questions; pretest items are indistinguishable and dispersed throughout the exam).

Time Allotted: 3 hours (180 minutes).

Passing Score: Determined using the Modified Angoff method by subject matter experts; results are reported as pass/fail. A scaled score of 400 (on a 200-800 scale) is typically the minimum passing threshold across PNCB exams- though exact cut scores vary by form to ensure equivalence.

Pass Rate: Approximately 75-80% (varies annually; official rates are published by PNCB but not always in real-time).

Exam Format: Computer-based at PSI testing centers; non-adaptive (linear format); includes a tutorial for navigation.



Health Maintenance and Promotion 30% (45 ITEMS)



- Provide anticipatory guidance to support growth and development from birth to young adulthood in collaboration with patients/caregivers

- Provide immunization counseling according to current national guidelines- including discussion of:

- Indications and contraindications

- Adverse effects

- Vaccine hesitancy

- Risks of non-adherence

- Advise about age-appropriate injury prevention and safety (e.g.- environmental exposure- violence- sports and recreation- vehicle safety- disaster preparedness)

- Educate about illness prevention and early warning signs of pediatric illness and emergencies

- Educate about age-appropriate social- behavioral- and mental health syllabus (e.g.- social media use- substance use- grief- trauma- sexual health)



Assessment and Diagnosis 35% (52 ITEMS)

- Growth and Development

- Evaluate and interpret growth parameters

- Perform developmental surveillance

- History and Physical Exam

- Obtain history of present illness and perform review of systems

- Obtain appropriate health and social histories (e.g.- comprehensive- interval) based on type of visit

- Perform appropriate physical examination (e.g.- complete- focused)

- Diagnostic Testing

- Order and interpret point of care testing

- Order and interpret diagnostic laboratory tests

- Order and interpret diagnostic imaging tests

- Screening and Assessment

- Select- utilize- and interpret developmental- behavioral- and mental health screening and exam tools

- Select- utilize- and interpret social determinants of health screening and exam tools

- Select- utilize- and interpret disease-specific screening and exam tools

- Clinical Decision Making and Diagnosis

- Integrate health history- physical examination findings- and results of applicable screening and diagnostic testing

- Incorporate information obtained from other sources (e.g.- consultants- other health care professionals)

- Develop and prioritize differential diagnoses

- Establish a diagnosis based on evaluation of patient data



Management 30% (45 ITEMS)

- Child and Caregiver Counseling and Education

- Provide condition-specific counseling and education- including treatment options

- Educate about benefits and potential adverse reactions of pharmacological interventions

- Discuss non-pharmacological interventions

- Counsel regarding the threshold for seeking follow-up care

- Review the risks of non-adherence to recommended treatment

- Therapeutic Interventions

- Prescribe pharmacologic agents

- Recommend the use of over-the-counter pharmacologic agents

- Order or recommend non-pharmacologic treatments

- Discuss complementary and integrative treatment modalities as appropriate

- Develop realistic health care goals using shared decision-making

- Facilitate improved health outcomes using brief cognitive interventions and therapeutic communication techniques

- Procedures

- Perform procedures as indicated

- Initiate interventions in response to life-threatening situations

- Collaboration and Referral

- Advocate on behalf of patients and families to Boost health outcomes

- Collaborate with other health professionals to meet patient care needs

- Refer to specialists as indicated for evaluation- counseling- and/or treatment

- Refer children- adolescents or caregivers to community resources as indicated

- Contact child protective services to report suspected maltreatment or neglect

- Coordination of Care

- Facilitate patient and family-centered care for children of all ages with acute and chronic conditions

- Coordinate care for pediatric patients and families with special healthcare needs

- Provide guidance about and/or coordinate transition to adult care

- Evaluation and Follow-up

- Evaluate the plan of care and modify based on patient response or outcomes

- Establish a plan for follow-up care



Leadership- Ethics- and Practice Management 5% (8 ITEMS)

- Leadership and Evidence-based Practice

- Serve as a clinical resource for other health care professionals

- Critically evaluate and synthesize research and apply findings to clinical practice

- Identify the need for and participate in research and/or quality monitoring to Boost clinical outcomes

- Develop- implement- and/or modify clinical practice guidelines

- Advocate at the local- state- and federal levels in support of professional practice and/or issues that impact patient care

- Legal and Ethical Issues

- Practice in accordance with regulatory guidelines (e.g.- HIPAA- scope of practice- informed consent)

- Integrate cultural awareness and inclusiveness into all aspects of professional practice

- Exemplify ethical practices and encourage similar conduct in peers

- Prepare and maintain materials for licensure- credentialing- and privileging

- Identify and respond to adverse and sentinel events to promote a culture of patient safety

- Practice Management

- Document patient encounters in a manner which supports applicable diagnostic and procedure codes

- Utilize appropriate billing and coding to facilitate reimbursement

- Increase access to care (e.g.- provide access to interpreters- Boost access for clients with various disabilities- facilitate transportation- extend appointment hours- telehealth)



- Developmental- Behavioral- & Mental Health

- Dermatology

- Allergy/Immunology

- Otolaryngology

- Gastroenterology

- Infectious Diseases

- Pulmonology

- Musculoskeletal/Orthopedic

- Nutrition

- Sexual and Reproductive Health

- Cardiology

- Neurology

- Pain

- Endocrinology

- Urology/Nephrology

- Child Maltreatment

- Ophthalmology

- Environmental Health/Toxicology

- Hematology/Oncology

- Genetics

- Rheumatology

- Cerumen removal

- Collect skin and body fluid specimens

- Fluorescein staining

- Fluoride application

- Incision and drainage

- Reduction of nursemaids elbow

- Removal of foreign body

- Removal of sutures and staples

- Umbilical cord cauterization

- Wart removal

- Adverse Childhood Events (ACE) Questionnaire

- Ages & Stages Questionnaire

- Ages & Stages Questionnaire: Social-Emotional

- Ask Suicide-Screening Questions

- CRAFFT Alcohol and Substance Screening Tool

- Edinburgh Postnatal Depression Scale (EPDS)

- Generalized Anxiety Disorder 7-item scale (GAD-7)

- Modified Checklist for Autism in Toddlers- Revised- with Follow-Up (M-CHAT-R/F)™

- NICHQ Vanderbilt Assessment Scales [any version]

- Patient Health Questionnaire (PHQ) [any version]

- Pediatric Symptom Checklist (PSC)

- Screen for Child Anxiety Related Emotional Disorders

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