PEDIATRIC NURSING CERTIFICATION BOARD {PNCB}Acute Care ACTUAL EXAM 2025-2026 LATEST VERSION WITH 180 QUESTIONS AND CORRECT ANSWERS GRADED WITH EXPERT EXPLANATIONS A+ all you need to pass PNCB exam
A 13-month-old female with a history of developmental delay and hypotonia presents with new
onset seizures, with the following measurements obtained during assessment: weight 18.7 lb (8.5
kg), length 28.3 inches (72 cm) – both in 25 %ile for age , head circumference 14.75 inches (40 cm).
Her head circumference is below the 2 %ile
After achieving control of seizures, which diagnostic testing should be performed FIRST?
A. Brain MRI
B. Head CT
C. Skeletal survey
D. Skull series – CORRECT ANSWER-A. Brain MRI
Imaging by MRI for microcephaly provides more structural information than CT without the radiation
exposure, and identifies abnormalities including lissencephaly, pachygyria, and polymicrogyria. CT is
most useful in evaluating for presence of calcifications, which are associated with congenital viral
infections, Sturge-Weber syndrome, tuberous sclerosis, and intracranial lipoma in newborns, and
with some vascular and neoplastic conditions in older children.
A toddler’s complete blood count (CBC) reveals the following results: WBC 11, RBC 33, Hct 28%, Hgb
9, MCV 60, Plt 200, RDW 18%, Reticulocytes <0.1
Which type of anemia is the MOST likely?
A. Aplastic anemia
B. Diamond-Blackfan anemia
C. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
D. Iron-deficiency anemia – CORRECT ANSWER-D. Iron-deficiency anemia
In a toddler, anemia is defined as a hemoglobin <12.0 g/dl. Types of anemia are classified and
diagnosed by reticulocyte count and size of red blood cells (microcytic, normocytic, and macrocytic).
Iron-deficiency anemia is defined as microcytic anemia with a low reticulocyte count and an elevated
red cell distribution width.
Diamond-Blackfan anemia is a rare congenital form of hypoplastic anemia. It causes constitutional
bone marrow suppression with resultant severe normochromic macrocytic anemia, leukopenia, and
thrombocytopenia.
Aplastic anemia is a life-threatening disease of bone marrow failure with CBC revealing
pancytopenia.
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a hemolytic anemia, characterized by
severe anemia (hemoglobin less than 2.5), leukocytosis, reticulocyte count greater than 30%, and
large red cell distribution width (RDW).
