10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
The CPNP-AC exam has 175 questions and runs 3 hours.
These 10 free CPNP-AC questions are organized by exam domain, so you can see how each part of the Certified Pediatric Nurse Practitioner - Acute Care blueprint is tested. Reveal the answer and explanation under each question.
Domain 1: Assessment 34% of exam
Question 1
An 11-year-old receiving continuous nebulized albuterol for a severe asthma exacerbation initially has a respiratory rate of 42/min, loud wheezing, and a PaCO2 of 27 mm Hg. Forty-five minutes later, the respiratory rate is 24/min, wheezing is barely audible, and PaCO2 is 46 mm Hg. Air entry is markedly reduced, and the child is becoming drowsy. SpO2 remains 97% on supplemental oxygen. Which interpretation best accounts for the change?
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Correct answer: C - Respiratory muscle fatigue with impending ventilatory failure
Question 2
Three episodes of sudden crying, pallor, and drawing the knees toward the abdomen bring an 18-month-old to the emergency department. Each episode lasts several minutes; between episodes, the child appears comfortable but unusually tired. Two loose stools occurred earlier in the day. The abdomen is soft between episodes, with no palpable mass, and there has been no bloody stool. Perfusion is normal. The most informative initial imaging study is:
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Correct answer: D - Abdominal ultrasonography
Question 3
In the recovery area after inguinal hernia repair, a 2-year-old cannot provide a reliable self-report of pain. The child keeps the jaw clenched and frowns throughout the assessment. The legs are tense and restless but are neither kicking nor drawn up. The child squirms and shifts position without arching or becoming rigid, sobs continuously, and remains distressed despite a parent's attempts to comfort. What FLACC score and interpretation should be documented?
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Correct answer: B - 8/10, indicating severe pain behaviors
Question 4
Generalized convulsions in a 9-year-old with epilepsy stop after benzodiazepine treatment and an IV levetiracetam load. Seventy-five minutes later, the child still does not follow commands or interact with the parent. Oxygenation, ventilation, glucose, sodium, and calcium are normal. There is no fever, trauma, meningismus, or new focal deficit. Before attributing the persistent depressed consciousness to a prolonged postictal state, which evaluation has priority?
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Correct answer: C - Continuous bedside EEG monitoring
Domain 2: Diagnosis 24% of exam
Question 5
On the second hospital day for a vaso-occlusive pain episode, a 12-year-old with HbSS develops a temperature of 38.7 °C, cough, and pleuritic chest pain. Respiratory rate is 32/min and SpO2 is 89% on room air. The child is awake and conversant. Chest radiography shows a new right lower-lobe segmental airspace opacity without volume loss. Which diagnosis unifies the new findings?
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Correct answer: A - Acute chest syndrome
Question 6
A term infant who fed well during the first several days of life is brought in at 8 days of age for poor feeding and rapid breathing. Brachial pulses are strong, but femoral pulses are barely palpable. Blood pressure measured with appropriately sized cuffs is 88/52 mm Hg in the right arm and 48/30 mm Hg in a leg. The feet are cool with delayed capillary refill. These findings most strongly localize the problem to:
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Correct answer: D - Critical coarctation of the aorta
Domain 3: Management 37% of exam
Question 7
An 8-year-old weighing 26 kg develops abrupt palpitations. The monitor shows a regular rhythm at 224/min with a QRS duration of 0.06 seconds and no clearly visible P waves. The child is alert, blood pressure is 108/66 mm Hg, and peripheral perfusion is normal. Vagal maneuvers have not changed the rhythm, and a patent IV is available. Select the next intervention.
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Correct answer: A - Adenosine 2.6 mg by rapid IV push, immediately followed by a saline flush
Question 8
Induction chemotherapy for acute myeloid leukemia has left a 15-year-old with an absolute neutrophil count of 180 cells/microliter. A temperature of 38.8 °C prompts blood cultures from the central catheter and a peripheral vein. Blood pressure, perfusion, and mental status are normal. There is no focal infection, catheter-site inflammation, or history of resistant-organism colonization. Local susceptibility data support cefepime activity against likely gram-negative pathogens. Which initial IV antibiotic regimen is appropriate?
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Correct answer: B - Cefepime alone
Question 9
After gentle nasal suction, a 6-month-old admitted with a first episode of bronchiolitis remains unable to take more than 40% of usual feeds. Wet diapers have decreased. Respiratory rate is 48/min with mild subcostal retractions, SpO2 is consistently 94-96% on room air, and there has been no apnea. The infant has normal perfusion and no vomiting or abdominal distention. What should be added to the supportive care plan?
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Correct answer: B - Nasogastric hydration while continuing tolerated oral feeds
Question 10
One hour into treatment for diabetic ketoacidosis, a 13-year-old has improved perfusion after isotonic IV fluids and has passed urine. Glucose is 428 mg/dL, venous pH is 7.14, and bicarbonate is 8 mEq/L. A repeat, nonhemolyzed potassium result is 2.7 mEq/L. Insulin has not yet been given. Which treatment sequence addresses the immediate electrolyte risk?
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Correct answer: B - Replace potassium before starting the insulin infusion