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Exam Overview
The CPNP-PC exam is a computer-based test given at PSI test centers across the United States, its territories and Canada. You apply to PNCB first, and once your eligibility is approved you schedule your own appointment with PSI within a 90-day testing window. The exam is offered year-round.
Key Facts About the CPNP-PC Exam
| Feature | Details |
|---|---|
| Certifying body | Pediatric Nursing Certification Board (PNCB) |
| Credential | CPNP-PC (Certified Pediatric Nurse Practitioner - Primary Care) |
| Total questions | 175 |
| Scored questions | 150 (plus 25 unscored pretest questions) |
| Testing time | 3 hours |
| Question format | Multiple choice with three or four options and one correct answer |
| Delivery | PSI test centers only (no remote testing for this exam) |
| Passing score | Scaled score of 400 on a 200 to 800 scale |
| Results | Preliminary pass or fail at the test center; official results by email in about 2 to 3 weeks |
| Exam fee | $407 (includes a $134 nonrefundable registration fee) |
| Retake fee | $288 |
| Testing window | 90 days; one extension available for a fee |
| Certification maintenance | Annual recertification with PNCB |
Fees and policies change from time to time, so confirm them in the current PNCB Candidate Handbook before you apply.
Eligibility
PNCB requires a current, active, unencumbered registered nurse license; graduation from an accredited pediatric primary care NP master's, doctoral or post-master's certificate program, or from a formal dual primary care and acute care PNP program; at least 500 supervised direct patient care clinical hours in pediatric primary care (simulation does not count toward the 500); and three separate graduate courses in advanced physiology and pathophysiology, advanced health assessment and advanced pharmacology. Your school sends your official final transcript directly to PNCB, and you complete PNCB's free Ethics in Testing module before you apply. Graduates of acute-care-only PNP programs and family NPs without documented pediatric primary care NP education are not eligible.
What the Exam Covers
PNCB CPNP-PC Content Outline
| Domain | Scored Questions | Share |
|---|---|---|
| I Health Maintenance and Promotion | 45 | 30% |
| II Assessment and Diagnosis | 52 | 35% |
| III Management | 45 | 30% |
| IV Leadership, Ethics and Practice Management | 8 | 5% |
Health Maintenance and Promotion covers anticipatory guidance from birth to young adulthood, immunization counseling, injury prevention and safety, illness prevention and early warning signs, and education about social, behavioral and mental health topics such as social media, substance use, grief, trauma and sexual health. Assessment and Diagnosis, the largest domain, covers growth and developmental surveillance, the history and physical examination, point-of-care, laboratory and imaging tests, screening tools and clinical decision making. Management covers counseling and education, prescribing and other therapies, office procedures, emergencies, referral and collaboration (including reports to child protective services), care coordination for children with special health care needs, transition to adult care, and follow-up. Leadership, Ethics and Practice Management covers evidence-based practice, quality improvement, advocacy, legal and ethical issues, documentation, billing and coding, and access to care.
Clinical Categories
PNCB also ranks the clinical categories by how many questions each contributes. The list runs from most to fewest questions.
Clinical Categories in Order of Exam Volume
| Rank | Category | Where to Study |
|---|---|---|
| 1 | Developmental, Behavioral and Mental Health | Sections 1 and 3 |
| 2 | Dermatology | Section 4 |
| 3 | Allergy and Immunology | Section 5 |
| 4 | Otolaryngology | Section 6 |
| 5 | Gastroenterology | Section 10 |
| 6 | Infectious Diseases | Section 7 |
| 7 | Pulmonology | Section 8 |
| 8 | Musculoskeletal and Orthopedics | Section 12 |
| 9 | Nutrition | Section 2 |
| 10 | Sexual and Reproductive Health | Section 11 |
| 11 | Cardiology | Section 9 |
| 12 | Neurology | Section 13 |
| 13 | Pain | Section 13 |
| 14 | Endocrinology | Section 14 |
| 15 | Urology and Nephrology | Section 11 |
| 16 | Child Maltreatment | Section 15 |
| 17 | Ophthalmology | Section 6 |
| 18 | Environmental Health and Toxicology | Section 15 |
| 19 | Hematology and Oncology | Section 14 |
| 20 | Genetics | Section 14 |
| 21 | Rheumatology | Section 5 |
The outline also names the office procedures and screening tools you are expected to know. Procedures include cerumen removal, specimen collection, fluorescein staining, fluoride varnish, incision and drainage, nursemaid's elbow reduction, foreign body removal, suture and staple removal, umbilical granuloma cauterization and wart removal. Screening tools include the Ages and Stages Questionnaires, M-CHAT-R/F, the Pediatric Symptom Checklist, NICHQ Vanderbilt scales, the PHQ, GAD-7, SCARED, CRAFFT, the Ask Suicide-Screening Questions, the Edinburgh Postnatal Depression Scale and the ACE questionnaire. Each one is taught in this guide.
How the Exam Is Scored
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. If you do not pass, PNCB sends a report of your performance by content area, which tells you where to focus before you retest.
What Kinds of Questions to Expect
- Cases built around a child and a caregiver that ask for the most likely diagnosis, the best initial test or the first-line treatment
- Growth data, vital signs, screening scores and laboratory results to interpret, often without reference ranges, so you must know normal values by age
- Developmental milestones and the age at which each screening is due
- Anticipatory guidance and immunization counseling questions that ask what the NP should tell the family
- Weight-based dosing, often using generic drug names only
- Findings that require urgent referral, emergency care or a report to child protective services
- Questions on consent, adolescent confidentiality, ethics, quality improvement, billing and basic statistics
- Images and tables, such as skin lesions or growth data
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