A mother brings her 9-month-old to the clinic and reports that the infant screams whenever she leaves the room and cries when a new babysitter arrives. The infant sits without support, babbles "mamama," and transfers toys hand to hand. Which response by the nurse is BEST?

"This is expected separation anxiety; short, consistent goodbyes will help your baby learn you return."

"This behavior suggests an insecure attachment, so a referral to a specialist is needed."

"Slip out quietly while your baby is distracted so the goodbye is less upsetting."

"This should have resolved by 6 months, so it is a sign that needs autism screening."

At a sports physical, an asymptomatic 14-year-old has a blood pressure of 134/84 mm Hg. A repeat auscultated reading with a correctly sized cuff later in the visit is 132/84 mm Hg. Which action is MOST appropriate?

Recognize the reading is in the stage 1 hypertension range and arrange a repeat check within 1 to 2 weeks.

Document a normal reading for an athletic adolescent and plan no specific follow-up.

Record the reading as elevated blood pressure and plan to recheck in 1 year.

Send the teen to the emergency department for treatment of hypertensive emergency.

A nurse is assessing the development of a 9-month-old born at term at a well visit. The parent has no specific concerns. Which finding should the nurse report for further evaluation?

The infant cannot sit without support

The infant says 'dada' but not to a specific person

The infant cries when the parent leaves the room

The infant is not yet walking independently

Parents of a 5-year-old ask to stay in the room while their child has a lumbar puncture. The child is clinging to the mother and crying. Which response by the nurse BEST reflects family-centered care?

"You are welcome to stay. I will explain what you will see and you can sit near her head and talk to her."

"It is usually easier on parents to wait outside, and we will come get you as soon as it is over."

"You can stay only if she settles down first, because crying makes the procedure harder to do."

"One of you can stand just outside the curtain so she can hear your voice during the procedure."

A 12-year-old with type 1 diabetes has influenza and is eating very little. Blood glucose is 280 mg/dL and urine ketones are moderate. Which instruction should the nurse give the family?

Continue giving insulin, check glucose and ketones every 2 to 3 hours, push fluids, and call the diabetes team

Hold all insulin until the child is able to eat normal meals again

Give only the long-acting insulin and check glucose again tomorrow morning

Encourage sugar-containing soda only and recheck glucose at bedtime

A 15-year-old is hospitalized for 10 days after spinal fusion surgery. She is worried about how her back will look and asks when her friends can visit. Which nursing intervention BEST supports her developmental needs?

Arrange visits or video calls with friends and provide privacy during care.

Encourage her parents to stay at the bedside at all times so she is never alone.

Place her in a shared room with a younger child so she has company during the day.

Limit phone and social media use throughout the stay to promote healing and rest.

During a 6-month well visit, the nurse notes that the corneal light reflex is centered in one pupil but displaced from center in the other. On the cover-uncover test, the uncovered eye shifts to fixate. Which action is MOST appropriate?

Refer the infant to a pediatric eye specialist for evaluation of strabismus.

Reassure the parents that eye misalignment is normal until 12 months.

Teach the parents to patch the stronger eye for a few hours each day.

Recheck the eyes with visual acuity testing when the child turns 3.

A 4-year-old admitted with dehydration is scheduled for an IV insertion in 10 minutes. The child is sitting on the bed with a parent and asks what is going to happen. How should the nurse prepare the child for the procedure?

Use simple words just before the procedure and let the child practice on a doll with the equipment

Avoid mentioning the IV so the child does not become upset

Explain the procedure in detail several days ahead so the child has time to adjust

Show the child an anatomical diagram of the veins in the arm

The parent of a 4-year-old being discharged with a prescription for oral amoxicillin for community-acquired pneumonia receives medication teaching. Which statement indicates a need for further teaching?

"Once her fever has been gone for a full day, I can stop giving the medicine."

"I'll use the oral syringe from the pharmacy to measure each dose."

"I'll call if she starts breathing faster or seems to be working harder to breathe."

"I'll keep giving the medicine until the bottle is finished, even if she feels better."

A 10-year-old with type 1 diabetes is doing well academically but needs blood glucose checks, snacks during class, and access to water and the restroom. Which school plan BEST meets this child's needs?

A Section 504 plan that provides health-related accommodations in the general classroom

An Individualized Education Program with specialized instruction in a resource room

A referral for homebound instruction until glucose levels become stable

An informal agreement between the parent and teacher with no written plan

CPN Certified Pediatric Nurse Exam

Free CPN Certified Pediatric Nurse Practice Questions

10 sample questions for the CPN Certified Pediatric Nurse Exam, with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.

Sections covered on the exam: Health Promotion, Assessment, Planning and Management, Professional Responsibilities.

Question 1 · Health Promotion
A mother brings her 9-month-old to the clinic and reports that the infant screams whenever she leaves the room and cries when a new babysitter arrives. The infant sits without support, babbles "mamama," and transfers toys hand to hand. Which response by the nurse is BEST?
- A."This behavior suggests an insecure attachment, so a referral to a specialist is needed."
- B."Slip out quietly while your baby is distracted so the goodbye is less upsetting."
- C."This is expected separation anxiety; short, consistent goodbyes will help your baby learn you return."
- D."This should have resolved by 6 months, so it is a sign that needs autism screening."
Show answer and explanation
Answer: C. "This is expected separation anxiety; short, consistent goodbyes will help your baby learn you return."
Separation and stranger anxiety normally emerge around 8 to 9 months as object permanence develops, and the other milestones described are on track. Brief, predictable goodbyes build trust. Sneaking away undermines trust and tends to worsen distress, and the behavior is neither a sign of poor attachment nor overdue to resolve.
Question 2 · Health Promotion
At a sports physical, an asymptomatic 14-year-old has a blood pressure of 134/84 mm Hg. A repeat auscultated reading with a correctly sized cuff later in the visit is 132/84 mm Hg. Which action is MOST appropriate?
- A.Document a normal reading for an athletic adolescent and plan no specific follow-up.
- B.Recognize the reading is in the stage 1 hypertension range and arrange a repeat check within 1 to 2 weeks.
- C.Record the reading as elevated blood pressure and plan to recheck in 1 year.
- D.Send the teen to the emergency department for treatment of hypertensive emergency.
Show answer and explanation
Answer: B. Recognize the reading is in the stage 1 hypertension range and arrange a repeat check within 1 to 2 weeks.
For adolescents 13 and older, a reading of 130-139/80-89 mm Hg is in the stage 1 range, and an asymptomatic teen should have lifestyle counseling and a repeat measurement within 1 to 2 weeks to confirm. Elevated blood pressure is 120-129/less than 80, and emergency care is for symptomatic or much higher readings.
Question 3 · Assessment
A nurse is assessing the development of a 9-month-old born at term at a well visit. The parent has no specific concerns. Which finding should the nurse report for further evaluation?
- A.The infant says 'dada' but not to a specific person
- B.The infant cries when the parent leaves the room
- C.The infant is not yet walking independently
- D.The infant cannot sit without support
Show answer and explanation
Answer: D. The infant cannot sit without support
Most infants sit without support by about 9 months, so inability to do so is a gross motor red flag. Independent walking is expected between about 9 and 15 months, stranger and separation anxiety are typical at this age, and nonspecific 'mama' or 'dada' babbling is expected before specific words appear around 12 months.
Question 4 · Planning and Management
Parents of a 5-year-old ask to stay in the room while their child has a lumbar puncture. The child is clinging to the mother and crying. Which response by the nurse BEST reflects family-centered care?
- A."It is usually easier on parents to wait outside, and we will come get you as soon as it is over."
- B."You are welcome to stay. I will explain what you will see and you can sit near her head and talk to her."
- C."You can stay only if she settles down first, because crying makes the procedure harder to do."
- D."One of you can stand just outside the curtain so she can hear your voice during the procedure."
Show answer and explanation
Answer: B. "You are welcome to stay. I will explain what you will see and you can sit near her head and talk to her."
Family-centered care supports parental presence during procedures when parents wish it, along with preparation and a meaningful role such as comforting the child at the head of the bed. Sending parents out or setting conditions on their presence undermines the partnership with the family. Keeping a parent outside the curtain withholds the comfort of touch and visual contact the child needs.
Question 5 · Planning and Management
A 12-year-old with type 1 diabetes has influenza and is eating very little. Blood glucose is 280 mg/dL and urine ketones are moderate. Which instruction should the nurse give the family?
- A.Continue giving insulin, check glucose and ketones every 2 to 3 hours, push fluids, and call the diabetes team
- B.Hold all insulin until the child is able to eat normal meals again
- C.Give only the long-acting insulin and check glucose again tomorrow morning
- D.Encourage sugar-containing soda only and recheck glucose at bedtime
Show answer and explanation
Answer: A. Continue giving insulin, check glucose and ketones every 2 to 3 hours, push fluids, and call the diabetes team
Illness raises stress hormones and increases insulin needs, so insulin must never be stopped; omitting it can lead to diabetic ketoacidosis. Sick-day rules include frequent glucose and ketone checks, plenty of fluids, and contacting the diabetes team when moderate or large ketones are present, since extra rapid-acting insulin is often needed. Rechecking only once a day misses rising ketones.
Question 6 · Health Promotion
A 15-year-old is hospitalized for 10 days after spinal fusion surgery. She is worried about how her back will look and asks when her friends can visit. Which nursing intervention BEST supports her developmental needs?
- A.Encourage her parents to stay at the bedside at all times so she is never alone.
- B.Place her in a shared room with a younger child so she has company during the day.
- C.Arrange visits or video calls with friends and provide privacy during care.
- D.Limit phone and social media use throughout the stay to promote healing and rest.
Show answer and explanation
Answer: C. Arrange visits or video calls with friends and provide privacy during care.
Adolescents are working on identity versus role confusion, and peer relationships, privacy, and body image are central concerns. Supporting peer contact and protecting privacy meet these needs. Constant parental presence, rooming with young children, and cutting off peer contact all work against adolescent development.
Question 7 · Health Promotion
During a 6-month well visit, the nurse notes that the corneal light reflex is centered in one pupil but displaced from center in the other. On the cover-uncover test, the uncovered eye shifts to fixate. Which action is MOST appropriate?
- A.Reassure the parents that eye misalignment is normal until 12 months.
- B.Refer the infant to a pediatric eye specialist for evaluation of strabismus.
- C.Teach the parents to patch the stronger eye for a few hours each day.
- D.Recheck the eyes with visual acuity testing when the child turns 3.
Show answer and explanation
Answer: B. Refer the infant to a pediatric eye specialist for evaluation of strabismus.
Intermittent misalignment can be normal in the first few months, but persistent asymmetry after about 4 to 6 months suggests strabismus, which can cause amblyopia if not treated early. Patching is a treatment that must be prescribed after diagnosis, and waiting until age 3 risks permanent vision loss.
Question 8 · Assessment
A 4-year-old admitted with dehydration is scheduled for an IV insertion in 10 minutes. The child is sitting on the bed with a parent and asks what is going to happen. How should the nurse prepare the child for the procedure?
- A.Avoid mentioning the IV so the child does not become upset
- B.Explain the procedure in detail several days ahead so the child has time to adjust
- C.Show the child an anatomical diagram of the veins in the arm
- D.Use simple words just before the procedure and let the child practice on a doll with the equipment
Show answer and explanation
Answer: D. Use simple words just before the procedure and let the child practice on a doll with the equipment
Preschoolers have a limited sense of time and use magical thinking, so preparation should occur shortly before the procedure, in simple, concrete terms, with hands-on play using dolls or real equipment. Preparing days ahead increases anxiety at this age, diagrams are too abstract, and not telling the child undermines trust.
Question 9 · Planning and Management
The parent of a 4-year-old being discharged with a prescription for oral amoxicillin for community-acquired pneumonia receives medication teaching. Which statement indicates a need for further teaching?
- A."I'll use the oral syringe from the pharmacy to measure each dose."
- B."I'll call if she starts breathing faster or seems to be working harder to breathe."
- C."Once her fever has been gone for a full day, I can stop giving the medicine."
- D."I'll keep giving the medicine until the bottle is finished, even if she feels better."
Show answer and explanation
Answer: C. "Once her fever has been gone for a full day, I can stop giving the medicine."
Antibiotics should be continued for the full prescribed course even after the fever resolves, because stopping early can lead to relapse and resistance. Using an oral syringe for accurate measurement, watching for signs of increased work of breathing, and finishing the full course are all correct statements.
Question 10 · Planning and Management
A 10-year-old with type 1 diabetes is doing well academically but needs blood glucose checks, snacks during class, and access to water and the restroom. Which school plan BEST meets this child's needs?
- A.A Section 504 plan that provides health-related accommodations in the general classroom
- B.An Individualized Education Program with specialized instruction in a resource room
- C.A referral for homebound instruction until glucose levels become stable
- D.An informal agreement between the parent and teacher with no written plan
Show answer and explanation
Answer: A. A Section 504 plan that provides health-related accommodations in the general classroom
A Section 504 plan provides accommodations for a disability that affects a major life activity, such as diabetes care tasks during school, without requiring special education services. An Individualized Education Program is for a child whose disability requires specially designed instruction, which this child does not need. Homebound instruction is unnecessary, and an informal agreement does not protect the child's rights.

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