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Exam Code: CPNP-PC
Exam Name: Certified Pediatric Nurse Practitioner - Primary Care
Number of Questions: 175 multiple-choice items (150 scored questions + 25 unscored pretest questions; pretest items are indistinguishable and dispersed throughout the exam).
Time Allotted: 3 hours (180 minutes).
Passing Score: Determined using the Modified Angoff method by subject matter experts; results are reported as pass/fail. A scaled score of 400 (on a 200-800 scale) is typically the minimum passing threshold across PNCB exams- though exact cut scores vary by form to ensure equivalence.
Pass Rate: Approximately 75-80% (varies annually; official rates are published by PNCB but not always in real-time).
Exam Format: Computer-based at PSI testing centers; non-adaptive (linear format); includes a tutorial for navigation.

Health Maintenance and Promotion 30% (45 ITEMS)

- Provide anticipatory guidance to support growth and development from birth to young adulthood in collaboration with patients/caregivers
- Provide immunization counseling according to current national guidelines- including discussion of:
- Indications and contraindications
- Adverse effects
- Vaccine hesitancy
- Risks of non-adherence
- Advise about age-appropriate injury prevention and safety (e.g.- environmental exposure- violence- sports and recreation- vehicle safety- disaster preparedness)
- Educate about illness prevention and early warning signs of pediatric illness and emergencies
- Educate about age-appropriate social- behavioral- and mental health courses (e.g.- social media use- substance use- grief- trauma- sexual health)

Assessment and Diagnosis 35% (52 ITEMS)
- Growth and Development
- Evaluate and interpret growth parameters
- Perform developmental surveillance
- History and Physical Examination
- Obtain history of present illness and perform review of systems
- Obtain appropriate health and social histories (e.g.- comprehensive- interval) based on type of visit
- Perform appropriate physical examination (e.g.- complete- focused)
- Diagnostic Testing
- Order and interpret point of care testing
- Order and interpret diagnostic laboratory tests
- Order and interpret diagnostic imaging tests
- Screening and Assessment
- Select- utilize- and interpret developmental- behavioral- and mental health screening and assessment tools
- Select- utilize- and interpret social determinants of health screening and assessment tools
- Select- utilize- and interpret disease-specific screening and assessment tools
- Clinical Decision Making and Diagnosis
- Integrate health history- physical examination findings- and results of applicable screening and diagnostic testing
- Incorporate information obtained from other sources (e.g.- consultants- other health care professionals)
- Develop and prioritize differential diagnoses
- Establish a diagnosis based on evaluation of patient data

Management 30% (45 ITEMS)
- Child and Caregiver Counseling and Education
- Provide condition-specific counseling and education- including treatment options
- Educate about benefits and potential adverse reactions of pharmacological interventions
- Discuss non-pharmacological interventions
- Counsel regarding the threshold for seeking follow-up care
- Review the risks of non-adherence to recommended treatment
- Therapeutic Interventions
- Prescribe pharmacologic agents
- Recommend the use of over-the-counter pharmacologic agents
- Order or recommend non-pharmacologic treatments
- Discuss complementary and integrative treatment modalities as appropriate
- Develop realistic health care goals using shared decision-making
- Facilitate improved health outcomes using brief cognitive interventions and therapeutic communication techniques
- Procedures
- Perform procedures as indicated
- Initiate interventions in response to life-threatening situations
- Collaboration and Referral
- Advocate on behalf of patients and families to Strengthen health outcomes
- Collaborate with other health professionals to meet patient care needs
- Refer to specialists as indicated for evaluation- counseling- and/or treatment
- Refer children- adolescents or caregivers to community resources as indicated
- Contact child protective services to report suspected maltreatment or neglect
- Coordination of Care
- Facilitate patient and family-centered care for children of all ages with acute and chronic conditions
- Coordinate care for pediatric patients and families with special healthcare needs
- Provide guidance about and/or coordinate transition to adult care
- Evaluation and Follow-up
- Evaluate the plan of care and modify based on patient response or outcomes
- Establish a plan for follow-up care

Leadership- Ethics- and Practice Management 5% (8 ITEMS)
- Leadership and Evidence-based Practice
- Serve as a clinical resource for other health care professionals
- Critically evaluate and synthesize research and apply findings to clinical practice
- Identify the need for and participate in research and/or quality monitoring to Strengthen clinical outcomes
- Develop- implement- and/or modify clinical practice guidelines
- Advocate at the local- state- and federal levels in support of professional practice and/or issues that impact patient care
- Legal and Ethical Issues
- Practice in accordance with regulatory guidelines (e.g.- HIPAA- scope of practice- informed consent)
- Integrate cultural awareness and inclusiveness into all aspects of professional practice
- Exemplify ethical practices and encourage similar conduct in peers
- Prepare and maintain materials for licensure- credentialing- and privileging
- Identify and respond to adverse and sentinel events to promote a culture of patient safety
- Practice Management
- Document patient encounters in a manner which supports applicable diagnostic and procedure codes
- Utilize appropriate billing and coding to facilitate reimbursement
- Increase access to care (e.g.- provide access to interpreters- Strengthen access for clients with various disabilities- facilitate transportation- extend appointment hours- telehealth)

- Developmental- Behavioral- & Mental Health
- Dermatology
- Allergy/Immunology
- Otolaryngology
- Gastroenterology
- Infectious Diseases
- Pulmonology
- Musculoskeletal/Orthopedic
- Nutrition
- Sexual and Reproductive Health
- Cardiology
- Neurology
- Pain
- Endocrinology
- Urology/Nephrology
- Child Maltreatment
- Ophthalmology
- Environmental Health/Toxicology
- Hematology/Oncology
- Genetics
- Rheumatology
- Cerumen removal
- Collect skin and body fluid specimens
- Fluorescein staining
- Fluoride application
- Incision and drainage
- Reduction of nursemaids elbow
- Removal of foreign body
- Removal of sutures and staples
- Umbilical cord cauterization
- Wart removal
- Adverse Childhood Events (ACE) Questionnaire
- Ages & Stages Questionnaire
- Ages & Stages Questionnaire: Social-Emotional
- Ask Suicide-Screening Questions
- CRAFFT Alcohol and Substance Screening Tool
- Edinburgh Postnatal Depression Scale (EPDS)
- Generalized Anxiety Disorder 7-item scale (GAD-7)
- Modified Checklist for Autism in Toddlers- Revised- with Follow-Up (M-CHAT-R/F)™
- NICHQ Vanderbilt Assessment Scales [any version]
- Patient Health Questionnaire (PHQ) [any version]
- Pediatric Symptom Checklist (PSC)
- Screen for Child Anxiety Related Emotional Disorders