Certification Exam Latest Update Questions Answers

Pediatric Nursing Certification Board (PNCB) Acute Care Certification Exam (Latest Update 2025 / 2026) Questions & Answers | Grade A | 100% Correct (Verified Answers)

Question:

An adolescent presents after a recent viral illness with numbness and a feeling of heaviness and weakness in bilateral lower extremities. The MOST likely

diagnosis is:

• acute flaccid myelitis
• Guillain-Barré syndrome
• myasthenia gravis
• tick paralysis

Answer:

• Guillain-Barré syndrome

GBS is an acute inflammatory demyelinating polyradiculoneuropathy. It typically presents post infectious illness with the typical timing of presentation about 10 days following the infection. The classic symptoms are 1 / 4

areflexia, flaccidity, and symmetrical ascending weakness. Progression can vary in nature from rapid onset with progression to slower development over weeks. Typical symptoms start with numbness or paresthesia in the hands and feet, with a sensation of heaviness in the legs. The weakness is ascending and involves the arms, trunk, and bulbar muscles, and is often symmetric.The manifestation of AFM typically occurs within 7 days of a respiratory or febrile illness, and the resultant limb weakness may be to one or all four limbs. While AFM can be challenging to differentiate from GBS, weakness is more commonly asymmetrical and is most often seen in young children.Myasthenia gravis is an autoimmune condition where antibodies block the acetylcholine receptors at the neuromuscular junction.Tick paralysis produces an acute lower motor pattern of weakness, clinically similar to Guillain-Barré syndrome, but without the prodrome of an infectious illness.

Question:

A child is resuscitated on location after a presumed submersion injury. Upon arrival the child is alert and fully conscious, and airway, perfusion, and respiratory effort are normal. Management includes supplemental oxygen, blood gas measurements, along with

• chest radiograph and IV antibiotics.
• IV diuretics and admission to general pediatric floor.
• IV steroids and admission to PICU.
• observation for at least 6 hours and discharge home if stable.

Answer:

• observation for at least 6 hours and discharge home if stable. 2 / 4

Even those who have spontaneous ventilation and minimal or no neurologic dysfunction after resuscitation should be given supplemental oxygen to minimize the risk of progressive hypoxemia and acidosis with subsequent myocardial and cerebral damage.Physical examination has limited sensitivity for detecting hypoxemia. If oxygenation is confirmed as normal by pulse oximetry or blood gas determination while breathing room air, the likelihood of aspiration is minimal.Observation for a minimum of 6 hours with continued or repeat pulse oximetry or repeat blood gas determination should be sufficient to assess the possibility of late deterioration in gas exchange. When significant problems occur in gas exchange they typically present within 4 to 6 hours of submersion. Children who are observed for at least 6 hours and remain alert and fully conscious, may be discharged from the emergency department. The risk of pulmonary infection is always present, but retrospective studies have demonstrated no benefit from prophylactic antibiotics. Antibiotics should thus be reserved for strongly-suspected or proven bacterial infection. There is no demonstrated value in the use of steroids in this scenario.

Question:

A previously healthy adolescent presents with a sudden onset of severe right hip and knee pain. Physical examination findings include limited internal rotation of the right hip and inability to bear weight. What is the MOST appropriate diagnostic study?

• nuclear medicine bone scan of pelvis, right femur, and knee
• magnetic resonance imaging (MRI) of right hip, femur, and knee
• radiographs of pelvis in anterior-posterior and lateral views 3 / 4

• ultrasound of right hip

Answer:

• radiographs of pelvis in anterior-posterior and lateral views

The differential diagnosis of hip pain in children and adolescents includes fractures, Legg-Calvé-Perthes disease, slipped capital femoral epiphysis (SCFE), septic arthritis, and toxic synovitis. In the adolescent age group, sudden onset of pain without history of trauma or fever is most representative of slipped capital femoral epiphysis.

Question:

An adolescent female with a body-mass index of 30 has complaints of severe headaches that have occurred when going to the bathroom followed by brief

loss of vision and hearing own heartbeat. The MOST likely diagnosis is:

• cluster headache
• neuroblastoma
• pseudotumor cerebri
• tension headache

Answer:

• pseudotumor cerebri

Pseudotumor cerebri is a disorder characterized by increased intracranial pressure. It is associated with certain medical conditions and typically affects adolescent females, with a higher frequency in adolescents who are overweight. The symptoms of pseudotumor cerebri include nonspecific

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