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Physician Assistant Certification

NCCPA Pediatrics CAQ Examination Practice Test

Pediatric practice requires age-sensitive assessment of infants, children, and adolescents, with attention to growth, development, symptom patterns, and caregiver observations. Questions in this practice bank sample decisions involving acute illness, chronic conditions, preventive care, and urgent presentations, including fever in young infants, asthma control, diabetes-related hypoglycemia, and suspected foreign-body aspiration.

Exam overview

Exam providerNational Commission on Certification of Physician Assistants
Exam codeNot listed
CategoryPhysician Assistant Certification

About the NCCPA Pediatrics CAQ Examination Exam

Clinical reasoning in pediatrics includes distinguishing a well-appearing child from one who needs immediate stabilization, selecting age-appropriate diagnostic evaluation, and identifying findings that change the urgency of care. Cases may require interpreting vital signs and examination findings, recognizing patterns such as Kawasaki disease or obstructive sleep apnea, and choosing safe next steps for airway concerns. Other decisions involve adjusting asthma controller therapy, treating allergic rhinitis, evaluating recurrent abdominal pain without alarm features, and responding to low glucose when a child can take oral treatment. Pediatric management also depends on developmental stage, immunization history, growth, medication use, and the reliability of caregiver-reported symptoms. Practice with these scenarios emphasizes prioritization, risk recognition, and matching intervention to the child’s presentation.

Sample Practice Questions

Review a selection from this exam's published US Practice Tests practice bank.

Question 1

A 10-year-old with type 1 diabetes is alert and has a point-of-care glucose of 62 mg/dL. The child can swallow safely and has no seizure or altered consciousness. What is the immediate treatment?

  1. AGive a rapid-acting source of oral carbohydrate and recheck glucose shortly afterward
  2. BGive a large dose of long-acting insulin
  3. CRestrict food and fluids for one hour
  4. DGive glucagon by injection as the first choice despite safe swallowing
Show answerCorrect answer: A

A conscious child who can swallow should receive a rapid-acting oral carbohydrate for hypoglycemia, followed by a glucose recheck after about 15 minutes and repeat treatment if still low. Glucagon is generally used when oral treatment is unsafe or the child cannot take carbohydrate by mouth.

Question 2

A 6-year-old with a body mass index above the 99th percentile snores loudly most nights, has witnessed pauses in breathing during sleep, and struggles to stay awake in class. What is the most appropriate next step?

  1. AEvaluate for obstructive sleep apnea, generally with overnight polysomnography
  2. BReassure the family that snoring is normal in children and needs no assessment
  3. CPrescribe a sedating antihistamine at bedtime
  4. DOrder an electroencephalogram as the initial test for all nighttime symptoms
Show answerCorrect answer: A

Habitual loud snoring, witnessed apneas, daytime impairment, and obesity raise concern for obstructive sleep apnea. Overnight polysomnography is the standard diagnostic study when available. Sedatives can worsen airway obstruction, and an electroencephalogram does not evaluate sleep-related airway obstruction.

Question 3

A 7-year-old with asthma has persistent symptoms despite correct inhaler technique and regular use of a low-dose inhaled corticosteroid. Which controller adjustment is generally appropriate?

  1. AStop the inhaled corticosteroid and use a short-acting bronchodilator only
  2. BConsider stepping up to a medium-dose inhaled corticosteroid after reassessing adherence, exposures, and diagnosis
  3. CBegin daily oral antibiotics
  4. DUse an oral corticosteroid every day as the preferred long-term controller
Show answerCorrect answer: B

Before stepping up asthma therapy, reassess the diagnosis, inhaler technique, adherence, and modifiable exposures. For persistent symptoms despite appropriate low-dose inhaled corticosteroid therapy, increasing controller intensity, such as to a medium dose, is a common step-up approach guided by age and current recommendations.

Question 4

A 6-week-old infant has a temperature of 38.2°C (100.8°F) measured rectally and appears well. What is the most appropriate next step?

  1. AGive acetaminophen and arrange routine follow-up tomorrow
  2. BPromptly evaluate for serious bacterial infection, including age-appropriate urine, blood, and cerebrospinal fluid testing
  3. CObtain a chest radiograph and discharge if it is normal
  4. DObserve at home because the infant appears well
Show answerCorrect answer: B

A rectal temperature of 38.0°C or higher in an infant younger than 3 months warrants prompt medical evaluation. Depending on age and clinical circumstances, this includes assessment for invasive bacterial infection; a well appearance does not rule it out.

Question 5

A 2-month-old infant has a rectal temperature of 38.1°C (100.6°F) at home but is afebrile and well appearing in clinic. The infant was born at term and has no significant medical history. What is the most appropriate approach?

  1. AReassure the family because the infant is afebrile now
  2. BArrange urgent evaluation for a febrile young infant, including age-appropriate testing and management
  3. CGive an antipyretic and observe at home for 24 hours
  4. DObtain only a respiratory viral test and defer further evaluation
Show answerCorrect answer: B

A documented rectal temperature of 38.0°C or higher in an infant younger than 3 months warrants prompt medical evaluation even if the infant appears well or is afebrile later. The evaluation and disposition depend on age, appearance, test results, and current guidance.

Question 6

A 12-year-old has had persistent nasal congestion, sneezing, and itchy, watery eyes during the spring for several years. Examination shows pale, edematous nasal turbinates. Which treatment is generally the most effective single medication for persistent allergic rhinitis?

  1. AA daily intranasal corticosteroid
  2. BAn oral antibiotic course
  3. CA topical nasal decongestant used continuously for several weeks
  4. DA cough suppressant
Show answerCorrect answer: A

Intranasal corticosteroids are generally the most effective single therapy for persistent allergic rhinitis, including nasal congestion. Proper technique and regular use improve benefit; prolonged topical decongestant use can cause rebound congestion.

Question 7

A 9-month-old who has not received routine immunizations presents with a hoarse voice, drooling, and difficulty swallowing. The infant is sitting upright and appears anxious. What is the safest initial approach?

  1. AKeep the child calm and arrange emergency airway-capable evaluation without examining the throat
  2. BUse a tongue depressor to inspect the pharynx immediately
  3. CLay the child flat and obtain a throat swab before treatment
  4. DSend the child home with oral fluids and arrange routine follow-up
Show answerCorrect answer: A

Drooling, dysphagia, and a hoarse voice in an under-immunized infant raise concern for epiglottitis or another impending airway emergency. Agitating the child or manipulating the pharynx can precipitate airway obstruction; maintain a calm, upright position and obtain emergency airway-capable care.

How to use this practice test

The free practice set draws up to 20 random questions from the 50-question bank. Work through each case by identifying the key age-specific finding and choosing the safest next action. Results appear after the session, so you can note which clinical decisions need further review.

Preparation tips

  • For febrile infants, compare age, rectal temperature, appearance, and history before deciding on evaluation and disposition.
  • Review pediatric asthma step-up decisions, including how persistent symptoms and inhaler technique affect controller adjustments.
  • Practice distinguishing urgent airway presentations, such as drooling with dysphagia or unilateral wheezing after choking, from routine outpatient complaints.
  • For pediatric diabetes scenarios, connect glucose level and mental status with the appropriate immediate treatment route.
  • Revisit childhood pattern recognition for Kawasaki disease, allergic rhinitis, obstructive sleep apnea, and functional abdominal pain, including findings that warrant escalation.
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