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Free CPNP-AC sample questions

Questions from the Certified Pediatric Nurse Practitioner - Acute Care (CPNP-AC) practice bank, with the correct answer and an explanation for each one. No junk, no filler.

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Showing 6 of 12 free sample questions.

Question 1Choose one

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])

Question 2Choose one

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?

Question 3Choose one

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.

Question 4Choose one

A 13-year-old child with an acute exacerbation of cystic fibrosis experiences sudden pleuritic chest pain and dyspnea. The CPNP-AC immediately performs thoracic point-of-care ultrasound (POCUS) at the bedside. Which sonographic finding definitively EXCLUDES a pneumothorax at the specific intercostal acoustic window being examined?

Question 5Choose one

A 2-week-old previously healthy full-term infant presents to the pediatric emergency department with sudden-onset acute bilious (dark spinach-green) emesis, abdominal distension, and progressive lethargy. Which life-threatening diagnosis must be the primary consideration on the differential diagnosis until definitively excluded by emergency upper gastrointestinal imaging?

Question 6Choose one

A 16-year-old adolescent presents to the emergency department following an intentional multi-substance overdose. Physical examination demonstrates marked delirium, severe agitation, core temperature 39.4°C (102.9°F), heart rate 146 bpm, widely dilated pupils (8 mm bilaterally) with sluggish light reflex, completely dry and flushed skin, absent bowel sounds, and acute urinary retention yielding 900 mL on catheterization. Which toxidrome is definitively characterized by this clinical presentation?

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