Certified Pediatric Nurse Practitioner (CPNP) Exam Review

The Certified Pediatric Nurse Practitioner certification is available to those Nurse Practitioners who practice in acute or primary care. The Certified Pediatric Nurse Practitioner specializes in assessing, diagnosing, and treating pediatric patients with acute or chronic pediatric diseases as well as seeing children for well-child visits and other common concerns.

In order to take the Certified Pediatric Nurse Practitioner certification exam, the applicant must have a Master's Degree from an accredited Nurse Practitioner program with specialization in Acute Care or Primary Care along with an active Registered Nurse license.

The Certified Pediatric Nurse Practitioner exam is offered throughout the year at various testing centers throughout the United States. The exam fee is $385 for both Acute Care and Primary Care Nurse Practitioners.

The exam is 175 questions (150 are scored, 25 are pre-test) with 3 hours to complete the exam. Questions focus on the Nurse Practitioner's assessment, diagnosis, and treatment of the pediatric patient. Questions specific to disease states are included, along with physiologic affects of pediatric illness. There are also questions pertaining to educating the patient and family regarding illness in a child.

Recertification of the Certified Pediatric Nurse Practitioner certified requires various continuing education, and self-assessment activities. This varies for the Acute Care and Primary Care Nurse Practitioner. The guidelines that must be met for recertification can be found on the Pediatric Nursing Certification Board website.

Nursing Certification Central

Free Pediatric Nurse Practitioner Practice Test

1. Which of the following patients should be referred for further developmental evaluation?

a. Term 12-month-old child not walking independently whose older sibling walked at 10 months
b. Premature 7-month-old child born at 28 weeks gestation not sitting independently
c. Term 12-month-old infant not using single words
d. Term 6-month-old infant with poor head control

2. An infant with gastroesophageal reflux is being discharged from the hospital with a nasogastric tube for feeding. Which of the following would be most effective for teaching the patient's family how to care for the nasogastric tube at home?

a. Arrange for nasogastric tube teaching after discharge with a home health care nurse
b. Have the family observe a nurse placing the feeding tube before discharge
c. Teach the primary caregiver how to care for the feeding tube before discharge and tell him/her to teach the rest of the patient's home caregivers
d. Have the family observe, help with in-hospital feeding tube care, and then demonstrate independent skills with the feeding tube prior to hospital discharge

3. Which of the following is accurate about the emancipated minor?

a. The adolescent patient who disagrees with a parent/guardian about medical treatment can be treated as an emancipated minor
b. All 50 states have identical legal statutes with regard to the emancipated minor.
c. The emancipated minor may not legally consent to medical care involving reproductive health issues
d. The emancipated minor may legally consent to all types of medical care

4. Which of the following is most accurate regarding pain assessment in the pediatric patient?

a. Behavioral pain assessment measures are useful for measuring pain in infants or children with impaired communication skills
b. Most pediatric patients can use self-report pain scales (e.g., FACES, 0-10 scales) by 2 years of age
c. Premature neonates are neurologically less capable of feeling pain
d. Parents are an unreliable source of pain assessment in the cognitively impaired pediatric patient

5. An important assumption underlying the "family systems theory" is:

a. Problems in the family can be traced back to individual family members
b. Family dysfunction is best addressed by emphasizing past (rather than current) family dynamics.
c. The family is a closed system which does not interact with its environment
d. Changes in one part of the family affect all other parts of the family system

Pediatric Nurse Practitioner Answers and Explanations

1. D: The pediatric nurse practitioner should be familiar with ranges of normal development and so-called "red flags" which necessitate further developmental screening. Until 24 months of age, the premature infant's development should be assessed with a corrected age based on the degree of prematurity (e.g., a 7 month-old child born at 28 weeks should have met developmental milestones of a term 4-month-old). Language red flags include no babbling by 12 months and no single words by 16 months. Gross motor red flags include lack of head control by 4 months, inability to sit by 9 months, and not pulling to stand by 12 months.

2. D: The use of new medical devices (e.g., apnea monitor, feeding tube, and tracheostomy) in the home requires thorough and individualized family education. Assessing the family's resources, wishes, and capabilities is a crucial first step in assessing the needs of each patient/family. It is also important to identify resources in the community that may be helpful. The most successful family teaching includes a variety of methods for imparting information (e.g., verbal, written, demonstration) with consideration of any barriers to comprehension, such as language barriers or inability to read. It is important to evaluate effectiveness of the patient/family education once completed.

3. D: State laws vary with regard to the emancipated minor. Most states have a minimum age requirement (generally 14-16 years) and require the minor to be financially independent and living separately from his/her parents. In some states, joining the military, getting married, or becoming pregnant lead to essentially automatic emancipated minor status. Emancipated minors may consent for all medical care. The emancipated minor differs from what is referred to as the "mature minor exemption," which allows a minor to seek medical care without parental consent if he/she demonstrates to the court sufficient maturity and cognitive ability to make an independent judgment about medical treatment.

4. A: Behavioral pain assessment measures (such as facial expression, body movement, and crying) are especially useful in the infant patient or older patient with limited communication skills. Physiologic pain assessment measures (e.g., heart rate, sweating) are not specific for pain response, but can be helpful when combined with behavioral pain-response assessments. Most pediatric patients can use one of the many available self-report measures by age 4-5 years. In the patient with impaired cognition or communication skills, parents (or other primary caregivers) are a valuable resource for assessment of pain. Premature infants experience pain, but their responses may be blunted relative to the term infant.

5. D: Understanding how a pediatric patient's family structure and functioning affects the health of an individual patient is an important part of pediatric assessment. Family systems theory is based on the idea that interactions and changes in one member of the family system and environment affect the rest of the family, which in turn affects other family members. Problems in the family are viewed primarily as originating from the interaction of the family members, rather than an individual. Family systems theory places emphasis on current problems and interactions, rather than past dynamics.

CPNP Review

Certified Pediatric Nurse Practitioner Acute Care

Certified Pediatric Nurse Practitioner Primary Care

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Last Updated: 04/18/2018


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