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Certified Pediatric Nurse Practitioner - Acute Care Practice Test

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

Number of Questions: Approximately 200 multiple-choice questions.
Time Allotted: 3.5 hours.
Content Areas: Based on the above topics, weighted as follows:
Clinical Practice: 60%
Professional Role and Policy: 10%
Systems-Based Practice: 15%
Health Promotion and Disease Prevention: 10%
Special Populations: 5%

- Health History and Physical Examination:
- Comprehensive and focused health histories.
- Developmental assessment
- Denver II
- Ages and Stages Questionnaire
- Physical examination techniques specific to pediatric populations.
- Interpretation of growth charts (e.g., WHO, CDC).

- Diagnostic Reasoning:
- Differential diagnosis development.
- Interpretation of diagnostic tests
- labs
- imaging
- EKG
- PFTs
- Use of clinical guidelines and evidence-based practice.

- Disease Management:
- Acute conditions
- respiratory distress
- sepsis
- dehydration
- Chronic conditions
- asthma
- diabetes
- cystic fibrosis
- Critical care
- shock
- traumatic injury
- cardiac arrest
- Pain management and palliative care.

- Pharmacology:
- Pediatric pharmacokinetics and pharmacodynamics.
- Common medications used in acute care
- antibiotics
- analgesics
- sedatives
- Medication dosing and safety
- weight-based dosing
- renal/hepatic adjustments

- Scope of Practice:
- State and federal regulations governing NP practice.
- Collaborative practice agreements and prescriptive authority.
- Ethical and Legal Issues:
- Informed consent and assent.
- Confidentiality and HIPAA compliance.
- End-of-life care and ethical dilemmas.

- Health Policy and Advocacy:
- Impact of healthcare policies on pediatric acute care.
- Advocacy for patients and families (e.g., access to care, health equity).

- Systems-Based Practice
- Care Coordination:
- Interdisciplinary collaboration
- with physicians
- social workers
- therapists
- Transition of care
- hospital to home
- pediatric to adult care

- Quality Improvement:
- Identifying and addressing gaps in care.
- Implementing evidence-based practice changes.
- Participating in quality improvement initiatives.

- Healthcare Systems:
- Understanding of healthcare financing
- Medicaid
- private insurance
- Utilization of healthcare resources
- telemedicine
- community resources

- Health Promotion and Disease Prevention
- Health Maintenance:
- Immunizations and vaccine schedules.
- Screening for developmental, behavioral, and mental health issues.
- Nutritional counseling and obesity prevention.

- Injury Prevention:
- Education on safety measures (e.g., car seats, helmet use).
- Prevention of accidental injuries (e.g., poisoning, burns).

- Family Education:
- Teaching families about disease management and prevention.
- Supporting families in coping with acute and chronic illnesses.

- Neonates and Infants:
- Management of prematurity, congenital anomalies, and neonatal emergencies.
- Developmental care in the NICU.

- Adolescents:
- Addressing risky behaviors (e.g., substance abuse, sexual health).
- Managing eating disorders and mental health issues.
- Children with Special Healthcare Needs:
- Care coordination for children with complex medical conditions.
- Supporting families of children with disabilities.

- Common Procedures:
- IV insertion, lumbar puncture, wound care, and suturing.
- Airway management (e.g., intubation, tracheostomy care).

- Use of ventilators, ECMO, and other life-support devices.
- Interpretation of monitoring data (e.g., hemodynamic monitoring, capnography).
- Acute Care: Short-term, intensive treatment for severe injuries or illnesses.
- Chronic Condition: A long-term health issue requiring ongoing management.

- Palliative Care: Focused on relieving symptoms and improving quality of life.
- Evidence-Based Practice: Integrating clinical expertise with the best available research.
- Pharmacokinetics: How the body processes medications.

- Health Equity: Ensuring all patients have access to quality care regardless of background.
- Interdisciplinary Team: Collaboration among healthcare professionals from different disciplines.
- Telemedicine: Use of technology to provide remote healthcare services.

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PNCB Certified Pediatric Nurse Practitioner - Acute Care
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Question: 607
A healthcare provider is evaluating the effectiveness of a telemedicine program designed for pediatric patients. Which of the following metrics would best assess the program's impact on patient outcomes?
1. The total number of telemedicine visits conducted
2. The number of healthcare providers participating
amount of time spent on each consultation er: C
nation: The percentage of patients reporting improved health status directly measures the pro on patient outcomes.
ion: 608
nurse practitioner is part of a committee focused on health equity in pediatric care. What is the m ve approach to ensure that health equity initiatives are successfully implemented?
gage community stakeholders in the planning and implementation process us solely on increasing funding for health services
mit the program to urban areas with high needs nitor only quantitative outcomes of the initiatives
er: A
nation: Engaging community stakeholders is crucial for understanding the unique needs of th tion and ensuring that health equity initiatives are culturally relevant and effective.
ion: 609
ear-old child is admitted to the ICU with pneumonia and requires mechanical ventilation. Th
The percentage of patients who report improved health status
3. The Answ
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impact
Quest
A ost
effecti
1. En
2. Foc
3. Li
4. Mo
Answ
Expla e
popula
Quest
A 3-y e
current settings are: tidal volume 8 ml/kg, respiratory rate 20 breaths/min, and PEEP of 5 cm H2O. The latest arterial blood gas shows pH 7.28, PaCO2 60 mmHg, and PaO2 55 mmHg. What is the most appropriate adjustment to Improve the child's ventilation?
1. Increase the respiratory rate to 30 breaths/min
2. Increase the tidal volume to 10 ml/kg
3. Decrease the PEEP to 2 cm H2O
4. Change the mode to CPAP Answer: A
Explanation: Increasing the respiratory rate can help Improve ventilation in a patient with hypercapnia and acidosis, aiming to reduce PaCO2 levels.
Question: 610
A nurse practitioner is working with a multidisciplinary team to develop a care plan for a child with behavioral health issues. Which of the following roles is essential to include in the team to address the child's social needs?
ech-language pathologist cupational therapist diatrician
er: A
nation: A social worker is essential for addressing the child's social needs, such as family dy mmunity resources, which impact overall health and well-being.
ion: 611
ear-old child presents with fever and a rash. The lab results show an elevated white blood cel nd elevated C-reactive protein. What is the most likely diagnosis?
cterial infection al exanthem ergic reaction
toimmune disease er: A
nation: The combination of fever, rash, elevated white blood cell count, and C-reactive protei ts a bacterial infection, which requires prompt evaluation and treatment.
Social worker
Spe
Oc
Pe
Answ
Expla namics
and co
Quest
A 1-y l
count a
1. Ba
2. Vir
3. All
4. Au
Answ
Expla n
sugges
Question: 612
A 15-year-old boy sustains a traumatic injury during a sports event and presents with hypotension, tachycardia, and altered mental status. Which of the following is the most appropriate initial management step?
1. Administer intravenous fluids
2. Begin high-flow oxygen therapy
3. Perform a rapid trauma assessment
4. Prepare for immediate surgical intervention
Answer: C
Explanation: A rapid trauma assessment is crucial to identify the extent of injuries and prioritize interventions, including fluid resuscitation and stabilization.
Question: 613
nsistent meal times and medication administration
xibility in medication schedules based on the child's mood y following the prescribed diet during doctor's visits
oring symptoms unless they worsen significantly er: A
nation: Consistent meal times and medication administration are critical components of mana conditions effectively and can help stabilize the child's health.
ion: 614
atric patient requires a medication that is typically available only in a hospital setting. The care team discusses using telemedicine to facilitate access. What is the most critical factor to er in this scenario?
patient's ability to visit the hospital for medication availability of telehealth services in the area
potential for coordination with the pharmacy for medication delivery patient's preference for in-person visits
er: C
nation: Coordination with the pharmacy for medication delivery is crucial to ensure the patie
A nurse is discussing the management of a child with a chronic condition and the importance of maintaining a routine. Which of the following components should the nurse emphasize as essential for effective disease management?
1. Co
2. Fle
3. Onl
4. Ign Answ
Expla ging
chronic
Quest
A pedi health consid
1. The
2. The
3. The
4. The Answ
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access to necessary medications while utilizing telemedicine.
Question: 615
During a wellness visit, a nurse practitioner notices that a 6-year-old child is significantly underweight for their height, with a BMI in the 5th percentile. The child's mother mentions that they primarily consume sugary beverages and snacks. Which intervention should be prioritized to promote healthy eating habits?
1. Educate the family about the importance of balanced meals and healthy snacks
2. Refer to a pediatric nutritionist for detailed dietary planning
3. Schedule a follow-up visit in one month to monitor weight
4. Suggest switching to low-calorie beverages to reduce sugar intake Answer: A
Explanation: Education about balanced nutrition is crucial for establishing healthy eating habits in children. While referral and follow-up are important, direct education will empower the family to make immediate changes.
nurse is preparing to perform tracheostomy care for a child. Which of the following steps should irst to ensure patient safety during the procedure?
sess the child's airway patency and respiratory status. her all necessary supplies and equipment.
plain the procedure to the child and family.
ction the tracheostomy tube to clear any secretions. er: A
nation: Assessing the child's airway patency and respiratory status is the first step to ensure p efore initiating any procedures, including tracheostomy care.
ion: 617
year-old girl presents with a sudden onset of severe headache, photophobia, and a stiff neck. puncture reveals cloudy cerebrospinal fluid with an elevated white blood cell count. What is ikely diagnosis?
cterial meningitis al meningitis cephalitis
barachnoid hemorrhage
Question: 616
A be
taken f
1. As
2. Gat
3. Ex
4. Su
Answ
Expla atient
safety b
Quest
A 11- A
lumbar the
most l
1. Ba
2. Vir
3. En
4. Su
Answer: A
Explanation: The presence of cloudy cerebrospinal fluid and elevated white blood cell count, along with the clinical presentation, indicates bacterial meningitis.
Question: 618
A 36-week gestational age infant is being evaluated for developmental milestones in the NICU. Which of the following milestones should the nurse expect at this age?
1. Ability to lift head when prone
2. Ability to roll over from back to stomach
3. Ability to sit independently
4. Ability to crawl Answer: A
Explanation: Infants born at 36 weeks gestation can typically lift their heads when placed in a prone position, which is an important developmental milestone.
nurse practitioner is reviewing the impact of social determinants of health on pediatric patients. Which ollowing factors is considered a social determinant that can significantly affect health outco
netic predisposition to diseases mily history of chronic illness
ailability of advanced medical treatments cess to nutritious food
er: D
nation: Access to nutritious food is a key social determinant of health that can significantly nce health outcomes, particularly in pediatric populations, affecting growth and development.
ion: 620
nurse is assessing a child�s airway who is at risk for respiratory compromise. Which of the follo ndicates potential airway obstruction?
of accessory muscles during breathing ar lung sounds on auscultation
rmal respiratory rate for age mmetrical chest expansion
er: A
Question: 619
A
of the f mes?
1. Ge
2. Fa
3. Av
4. Ac
Answ Expla
influe
Quest
A wing
signs i
1. Use
2. Cle
3. No
4. Sy
Answ
Explanation: The use of accessory muscles during breathing is a sign of respiratory distress and potential airway obstruction, indicating the need for immediate intervention.
Question: 621
A 8-year-old child is brought to the clinic with a history of progressive weakness and loss of motor skills. A muscle biopsy shows dystrophic changes. What is the most likely diagnosis?
1. Spinal muscular atrophy
2. Myasthenia gravis
3. Becker muscular dystrophy
4. Duchenne muscular dystrophy Answer: D
Explanation: Dystrophic changes in muscle biopsy are characteristic of Duchenne muscular dystrophy, which typically presents with progressive muscle weakness.
Question: 622
nurse is providing discharge education for parents of a premature infant diagnosed with retinopa turity (ROP). Which of the following statements by the parents indicates a need for further ng?
understand that our baby will need follow-up eye exams." can expect our baby to see normally as they grow." should avoid exposing our baby to bright lights."
need to monitor for signs of visual impairment." er: B
nation: While many infants with ROP may develop normal vision, there is no guarantee, and ave visual impairment; hence, this statement indicates a misunderstanding.
ion: 623
nurse is teaching a family about the management of a child with autism spectrum disorder (ASD of the following strategies should the nurse emphasize to support communication developm
couraging the child to express emotions verbally at all times tricting interaction with peers to minimize stress
owing the child to communicate solely through gestures
ng visual aids and structured routines to enhance understanding
er: D
A thy of
prema teachi
1. "We
2. "We
3. "We
4. "We
Answ
Expla some
may h
Quest
A ).
Which ent?
1. En
2. Res
3. All
4. Usi Answ
Explanation: Using visual aids and structured routines can greatly support communication development in children with ASD by providing clear and consistent cues that enhance understanding.
Question: 624
A 4-year-old child presents with signs of dehydration including dry mucous membranes, a capillary refill time of 4 seconds, and lethargy. Laboratory studies reveal a serum sodium level of 150 mEq/L. What is the most appropriate initial treatment?
1. Provide oral rehydration solutions
2. Administer intravenous normal saline
3. Administer hypotonic saline
4. Start intravenous D5W Answer: B
Explanation: The child is significantly dehydrated with a hypernatremic state, necessitating intravenous normal saline to restore volume and correct electrolyte imbalances.
nurse is preparing to administer ibuprofen to a 6-year-old child weighing 20 kg for fever manag commended dose of ibuprofen is 10 mg/kg every 6-8 hours. What is the maximum single do an administer?
mg mg mg mg
er: B
nation: The maximum single dose for ibuprofen at 10 mg/kg for a 20 kg child is calculated a g/kg = 200 mg; however, the maximum single dose typically administered is limited to 100
practice for safety in children.
ion: 626
nurse is preparing to intubate a 4-year-old child in respiratory distress. Which of the following ments should the nurse perform prior to intubation to determine the appropriate tube size?
asure the child's weight ess the child's height
asure the child's neck circumference the formula (Age + 16) / 4
Question: 625
A ement.
The re se the
nurse c
1. 150
2. 100
3. 200
4. 300
Answ
Expla s 20 kg
� 10 m mg in
Quest
A
assess
1. Me
2. Ass
3. Me
4. Use Answer: D
Explanation: The formula (Age + 16) / 4 provides an estimate for the correct endotracheal tube size in pediatric patients, aiding in appropriate intubation.
Question: 627
A nurse is assessing a child who has recently been diagnosed with celiac disease. Which of the following dietary modifications is essential for this child?
1. Increase intake of gluten-containing grains such as wheat and barley.
2. Introduce dairy products to enhance calcium intake.
3. Eliminate all sources of gluten from the diet.
4. Limit fruits and vegetables due to potential fiber overload. Answer: C
Explanation: Eliminating gluten from the diet is essential for managing celiac disease, as gluten can cause damage to the intestinal lining.
ion: 628
ear-old girl with a history of asthma is prescribed a short-acting beta-agonist (SABA) for acu ing. What is the primary pharmacological action of this medication class?
onchodilation
-inflammatory colytic action ticholinergic
er: A
nation: Short-acting beta-agonists (such as albuterol) primarily act as bronchodilators by rela hial smooth muscle, providing quick relief from acute asthma symptoms.
ion: 629
nurse is reviewing a study on the effectiveness of a new analgesic in pediatric patients. The stud rol group receiving a placebo. What type of evidence-based practice study design is being uti
hort study
ndomized controlled trial e-control study
oss-sectional study
Quest
A 9-y te
wheez
1. Br
2. Anti
3. Mu
4. An
Answ
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bronc
Quest
A y uses
a cont lized?
1. Co
2. Ra
3. Cas
4. Cr
Answer: B
Explanation: A randomized controlled trial (RCT) is designed to compare the effects of an intervention against a placebo, providing high-quality evidence for efficacy.

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Certified Pediatric Nurse Practitioner - Acute Care Practice Test

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