Pediatric Nurse Exam

The CPN exam is a computer-based test. You apply to PNCB first, and once your application is approved you schedule your own appointment within a 90-day testing window, either at a PSI test center or by live remote proctoring from home. The exam is offered year-round.

Key Facts About the CPN Exam

Fees and policies change from time to time, so confirm them in the current PNCB Candidate Handbook before you apply. Many employers take part in PNCB's No Pass, No Pay program, so ask your manager or education department before you pay yourself.

Eligibility for the CPN is based on practice, not on a degree. You need a current, active, unrestricted registered nurse license from the United States, Canada or a US territory, and you must meet one of two practice options:

You attest that you meet one of these options when you apply, and PNCB audits a random sample of applications with supervisor verification. Before you apply you also complete PNCB's free Ethics in Testing module.

PNCB CPN Content Outline

Health Promotion covers tailoring care to genetic, prematurity and environmental risks, anticipatory guidance across childhood (growth and development, injury prevention, nutrition, preventive care, psychosocial stressors, risk reduction, sexual health, resilience and coping), and referral to community resources such as early intervention, behavioral health and social services. Assessment, the largest domain, covers the physical assessment of the child, including history, growth and milestones, pain, nutrition, function, trends that signal decline, substance exposure and withdrawal, safety risks and signs of maltreatment, and the psychosocial assessment of the child and family, including culture, adverse childhood experiences, family dynamics, mental health and suicide risk, risk-taking, human trafficking, coping, adjustment to illness and learning needs. Planning and Management covers acute and chronic physical and behavioral health care, family-centered psychosocial care, procedural preparation and play, education and discharge, trauma-informed care, grief and loss, and palliative and end-of-life care. Professional Responsibilities covers advocacy, ethical and legal issues such as mandatory reporting, confidentiality and refusal of care, professional boundaries, self-care and support for colleagues, prioritizing across an assignment and interdisciplinary collaboration.

PNCB also ranks the clinical conditions by how many questions each contributes. The list runs from most to fewest questions.

Clinical Conditions in Order of Exam Volume

The outline also lists the procedures and interventions you are expected to know: temperature regulation, fluid and electrolyte administration, infection prevention and personal protective equipment, drainage devices, enteral tubes, respiratory devices such as tracheostomies, chest tubes and oxygen delivery, vascular access devices, medication administration, nutrition support, physiologic monitoring, positioning, preventive safety measures such as safe sleep, seizure precautions and fall prevention, skin and wound care, specimen collection and point-of-care testing, and suctioning. Each one is taught in this guide, mostly in Section 3 and in the clinical sections where it applies.

The exam is criterion-referenced: you are measured against a fixed passing standard set by expert panels, not against other candidates. Your raw score on the 150 scored questions is converted to a scaled score from 200 to 800, and a scaled score of 400 passes on every form of the exam. Pretest questions do not count, and you cannot tell which questions they are, so treat every question as scored. There is no penalty for a wrong answer, so answer every question.

• Cases on a pediatric unit, in a clinic or at school that ask which action the nurse should take first
• Priority questions: which child to see first, which finding to report immediately, which intervention comes before the others
• Vital signs, laboratory results, intake and output and pain scores to interpret, usually without reference ranges, so you must know normal values by age
• Developmental questions: how to explain a procedure, which play activity fits, what fear is typical at each age
• Teaching questions, including "which statement by the parent shows a need for further teaching"
• Medication safety and dosage questions, using generic drug names
• Findings that require a report to child protective services, and questions on consent, confidentiality, boundaries and ethics
• Psychosocial questions on coping, grief, culture, trauma-informed care and end-of-life care