CPNP-AC Peds Nurse Exam Prep practice questions and answers 2026. Tap an option to test yourself — you'll see the correct answer and a plain-English explanation for every question. Free, no login.
Q21A 3-year-old presents with fever, painful joints, salmon-colored rash that appears with fever spikes, and lymphadenopathy. Which diagnosis should be highest on the differential?
✓ Correct answer: D. Systemic Juvenile Idiopathic Arthritis
The combination of fever, arthritis, evanescent salmon-colored rash that coincides with fever spikes, and lymphadenopathy are classic findings of systemic JIA (Still's disease).
Q22A 2-month-old presents with projectile vomiting after feeds, hungry after vomiting, and a palpable olive-shaped mass in the epigastrium. What is the most likely diagnosis?
✓ Correct answer: C. Pyloric Stenosis
The classic triad of projectile vomiting, persistent hunger, and a palpable olive-shaped mass in the epigastrium strongly suggests pyloric stenosis in an infant of typical age.
Q23A 6-year-old presents with sudden onset of left-sided weakness, facial droop, and slurred speech. Recent history includes varicella infection 3 months ago. What is the most likely diagnosis?
✓ Correct answer: B. Acute Stroke
Acute onset of unilateral weakness with facial involvement and speech changes suggests stroke, particularly with recent varicella infection as a risk factor for post-varicella arteriopathy.
Q24A 14-year-old athlete presents with acute knee pain after hearing a 'pop' during a soccer game. Physical exam reveals positive anterior drawer test and effusion. What is the most likely diagnosis?
✓ Correct answer: A. Anterior Cruciate Ligament Tear
The mechanism of injury, audible pop, and positive anterior drawer test are classic findings for an ACL tear, common in adolescent athletes.
Q25A 5-year-old presents with fever, strawberry tongue, cervical lymphadenopathy, and desquamating rash on hands and feet. What is the most likely diagnosis?
✓ Correct answer: D. Kawasaki Disease
These findings represent classic diagnostic criteria for Kawasaki Disease, including fever, strawberry tongue, lymphadenopathy, and characteristic desquamation.
Q26A 12-year-old presents with fever, severe headache, photophobia, and neck stiffness. Recent history includes sinusitis. What diagnosis needs to be ruled out first?
✓ Correct answer: C. Bacterial Meningitis
Given the presentation and recent sinusitis (potential source), bacterial meningitis must be ruled out first due to its life-threatening nature.
Q27A 4-month-old presents with poor feeding, tachypnea, and diaphoresis during feeds. Physical exam reveals a harsh systolic murmur. What is the most likely diagnosis?
✓ Correct answer: B. Ventricular Septal Defect
The combination of feeding difficulties, tachypnea, diaphoresis with feeds, and harsh systolic murmur suggests VSD as the most likely congenital heart defect.
Q28A 16-year-old presents with acute chest pain, shortness of breath, and anxiety following a long car trip. What diagnosis should be considered first?
✓ Correct answer: A. Pulmonary Embolism
The combination of symptoms with recent prolonged immobility (car trip) raises concern for pulmonary embolism, which must be considered first due to its severity.
Q29A 7-year-old presents with fever, right lower quadrant pain, anorexia, and migration of pain from periumbilical area. What is the most likely diagnosis?
✓ Correct answer: D. Acute Appendicitis
The classic presentation of migratory pain from periumbilical to right lower quadrant, along with fever and anorexia, strongly suggests acute appendicitis.
Q30A 3-month-old presents with poor feeding, lethargy, and temperature instability. Labs show hyperammonemia and metabolic acidosis. What diagnosis should be considered?
✓ Correct answer: C. Inborn Error of Metabolism
The combination of poor feeding, lethargy, hyperammonemia, and metabolic acidosis in an infant suggests an inborn error of metabolism.
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