CPNP-AC Sample Questions & Answers
Free Certified Pediatric Nurse Practitioner - Acute Care (CPNP-AC) practice questions with worked answers and explanations. See how the ExamJungle simulator prepares you — then jump into the full test.
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- Question 1IntermediateSelect 2
Assessment · Evaluate health risks relevant to patients and caregivers (for example, physiologic, psychosocial, environmental)
An 8-year-old child with severe static encephalopathy who is non-verbal and non-ambulatory is admitted to the pediatric unit with an acute displaced spiral femur fracture and severe protein-calorie malnutrition. Which TWO clinical and psychosocial findings represent critical health risk indicators that mandate priority reporting and immediate multidisciplinary child protection evaluation? (Select TWO)
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Correct answers: C, E
Discrepancy between history and developmental abilities is a hallmark indicator of physical abuse requiring immediate child protection referral.
Non-ambulatory children with unexplained fractures and injuries inconsistent with developmental capacity have high specificity for maltreatment, requiring prompt reporting.
- Question 2Beginner
Assessment · Complete a physical examination, including age- and situation-specific screening, to identify: emergent and life-threatening conditions
A 3-year-old unimmunized child presents to the emergency department with acute onset of high fever, toxic appearance, muffled 'hot potato' voice, inspiratory stridor at rest, and is sitting in a tripod position with neck extension and spontaneous drooling. Which physical examination maneuver is strictly CONTRAINDICATED due to the immediate risk of precipitating catastrophic airway occlusion?
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Correct answer: D
In suspected acute epiglottitis, invasive pharyngeal examination with a tongue blade can trigger acute laryngospasm and catastrophic, complete airway obstruction.
- Question 3Intermediate
Assessment · Complete a physical examination, including age- and situation-specific screening, to identify: acute, complex, critical, and chronic conditions
A 7-year-old child hospitalized with severe pneumonia develops altered responsiveness and progressive tachycardia. On physical examination, the CPNP-AC notes bounding peripheral pulses, brisk capillary refill of less than 1 second ('flash refill'), a widened pulse pressure (blood pressure 94/36 mmHg), and warm, hyperemic extremities. Which underlying hemodynamic state is demonstrated by these clinical findings?
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Correct answer: D
Warm distributive shock presents with low systemic vascular resistance, bounding pulses, flash capillary refill, and widened pulse pressure from peripheral vasodilation.
- Question 4Advanced
Assessment · Complete a physical examination, including age- and situation-specific screening, to identify: emergent and life-threatening conditions
An 11-year-old child admitted to the pediatric intensive care unit following a severe traumatic brain injury demonstrates acute neurological deterioration. Over a 30-minute interval, the child's heart rate drops from 94 bpm to 48 bpm, blood pressure shifts from 104/62 mmHg to 152/50 mmHg, and respiratory patterns become irregular and shallow. Which clinical syndrome is demonstrated, and what critical anatomical risk is impending?
flowchart TD ICP[Rising Intracranial Pressure] --> Hypoperfusion[Decreased Cerebral Perfusion Pressure] Hypoperfusion --> Sympathetic[Sympathetic Surge: Severe Hypertension] Sympathetic --> Baroreceptors[Baroreceptor Reflex: Bradycardia] Baroreceptors --> Brainstem[Brainstem Compression: Irregular Respirations] Brainstem --> Herniation([Impending Transtentorial Herniation])Show answer & explanation
Correct answer: D
Cushing triad (hypertension with widened pulse pressure, bradycardia, irregular breathing) signals life-threatening intracranial hypertension and brainstem herniation.
- Question 5Intermediate
Assessment · Identify and order diagnostic studies (for example, blood and body fluids, EKG, imaging)
A 5-month-old infant presents with abrupt-onset poor feeding, pallor, and diaphoresis. Continuous cardiac telemetry reveals a narrow-complex, regular tachycardia with a sustained heart rate of 285 bpm and non-discernible P waves. Which diagnostic study is MOST essential to order immediately to determine the electrophysiologic mechanism of this arrhythmia while establishing vascular access?
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Correct answer: B
A 12-lead ECG is the gold standard diagnostic tool to confirm supraventricular tachycardia (SVT), differentiate ventricular tachycardia, and evaluate for pre-excitation.
- Question 6Intermediate
Assessment · Identify and order diagnostic studies (for example, blood and body fluids, EKG, imaging)
In an acutely ill pediatric patient presenting with suspected septic shock and cellular hypoperfusion, a point-of-care serum lactate concentration exceeding _____ mmol/L is widely recognized as an objective diagnostic threshold signaling severe tissue dysoxia, anaerobic metabolism, and heightened mortality risk.
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Correct answer: C
Serum lactate >4.0 mmol/L in pediatric sepsis reflects profound tissue hypoperfusion, anaerobic glycolysis, and organ dysfunction, guiding intensive resuscitation.
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