Free PA-CP Practice Questions

Question 1

An 18-month-old has been pulling at both ears since yesterday. Temperature is 38.2°C, and the child is drinking normally. Both tympanic membranes are moderately bulging with middle-ear effusions. Thick yellow discharge coats both conjunctivae. There are no medication allergies or antibiotics in the past month. In addition to analgesia, which treatment is preferred?

Accepted Answer

Oral amoxicillin-clavulanate as the initial antibiotic

Answer

Observation for 48-72 hours with a rescue prescription

Answer

Oral amoxicillin as the initial antibiotic

Answer

Oral cefdinir as the initial antibiotic

Question 2

A previously healthy, term 46-day-old infant is evaluated for a rectal temperature of 38.3°C. The infant is alert, feeds well, and has no focal findings. Catheterized urine contains leukocyte esterase and 25 leukocytes per high-power field. Procalcitonin is 0.08 ng/mL, C-reactive protein is 3 mg/L, and the absolute neutrophil count is 2,300/µL. Blood and urine cultures have been collected. The parents prefer home care, have reliable transportation and telephone access, and can return for reassessment tomorrow. Under the AAP pathway for well-appearing febrile infants aged 29-60 days, which plan accommodates that preference?

Accepted Answer

Begin oral antibiotics without routine lumbar puncture; reassess within 24 hours

Answer

Require lumbar puncture and intravenous antibiotics in hospital because of the positive urinalysis

Answer

Withhold antibiotics at home until the urine culture confirms bacterial growth

Answer

Give one intramuscular antibiotic dose, then wait for culture results before arranging follow-up

Question 3

A 5-year-old develops petechiae and several small bruises two weeks after a respiratory illness. Platelet count is 12,000/µL; hemoglobin, leukocyte count, and the remainder of the peripheral smear are normal. There is no mucosal bleeding, hematuria, organomegaly, bone pain, or systemic illness. Pediatric hematology agrees that the presentation is typical of newly diagnosed immune thrombocytopenia and can review the child in 48 hours. The family can reliably follow bleeding precautions. How should this child be managed today?

Accepted Answer

Observe as an outpatient with bleeding precautions and hematology follow-up

Answer

Admit for intravenous immunoglobulin to raise the platelet count promptly

Answer

Start a short prednisone course because the platelet count is below 20,000/µL

Answer

Obtain a bone marrow examination before deciding whether observation is safe

Question 4

Evaluation of a 9-year-old with slowing linear growth and iron-deficiency anemia includes a negative tissue transglutaminase IgA result. Total serum IgA is below the assay’s detection limit. The child continues to eat bread and other gluten-containing foods daily. Celiac disease remains a concern. Which test would best address the limitation of the initial antibody result?

Accepted Answer

IgG tissue transglutaminase antibody testing

Answer

IgA endomysial antibody testing

Answer

HLA-DQ2 and HLA-DQ8 susceptibility genotyping

Answer

Serum wheat-specific IgE antibody testing

Question 5

Within minutes of eating a cookie containing peanuts, an 8-year-old with a known peanut allergy develops wheezing, a hoarse voice, and dizziness. Weight is 26 kg, blood pressure is 72/38 mmHg, and oxygen saturation is 91%. There are no hives. The child remains conscious with a palpable pulse; emergency support is being initiated. Epinephrine 1 mg/mL is available for preparation of a weight-based dose. Which medication order should be carried out first?

Accepted Answer

Epinephrine 0.26 mL of 1 mg/mL intramuscularly in the anterolateral thigh

Answer

Epinephrine 0.026 mL of 1 mg/mL intramuscularly in the anterolateral thigh

Answer

Epinephrine 0.26 mg intravenously as a bolus after dilution to 0.1 mg/mL

Answer

Albuterol 2.5 mg by nebulizer while reassessing the need for epinephrine

Question 6

At a preventive visit, the immunization record of an immunocompetent 16-year-old shows two HPV vaccine doses: one at age 12 years and the other three months later. No additional HPV doses were given. Using the AAP 2026 immunization schedule, what is needed to complete the series?

Accepted Answer

One additional dose now, because the first two were too closely spaced

Answer

No further doses, because the series began before the fifteenth birthday

Answer

Two additional doses, because the patient is now older than 15 years

Answer

A new three-dose series, because the original series was interrupted

Question 7

At an asthma review, a 9-year-old reports cough or wheeze about once a week, no activity limitation, and one nighttime awakening in the past month. FEV1 is 96% of predicted. However, three exacerbations during the past year required oral corticosteroids. The child uses albuterol correctly but has never received a controller. Applying the NAEPP framework for both impairment and future risk, which initial regimen is most appropriate?

Accepted Answer

Daily low-dose inhaled corticosteroid, with albuterol as needed

Answer

Albuterol alone as needed, with oral corticosteroids for subsequent exacerbations

Answer

High-dose inhaled corticosteroid-LABA therapy, with albuterol as needed

Answer

Inhaled corticosteroid courses only during colds, with albuterol as needed

Question 8

A 13-year-old with a BMI at the 97th percentile returns because right knee pain has persisted for three weeks. There was no injury. Knee radiographs and the knee examination are normal, but the child walks with the right foot turned outward. Internal rotation of the right hip is restricted, and flexing that hip causes obligatory external rotation. Which diagnosis best localizes the source of the knee pain?

Accepted Answer

Slipped capital femoral epiphysis

Answer

Legg-Calvé-Perthes disease

Answer

Transient synovitis of the hip

Answer

Oligoarticular juvenile idiopathic arthritis

Question 9

Before an adolescent follow-up visit, a 16-year-old completes the PHQ-9 modified for teens. The total score is 8. On the item asking about thoughts of being better off dead or self-harm, the response is “several days.” The PA has not yet discussed that response with the patient. What does this combination of results require during today’s visit?

Accepted Answer

Assess suicidal thoughts, intent, plan, and access to lethal means directly

Answer

Repeat screening in one month because the total falls in the mild range

Answer

Arrange routine counseling and defer risk assessment to that appointment

Answer

Arrange psychiatric hospitalization based on the questionnaire response alone

Question 10

Routine critical congenital heart disease screening is performed on a well-appearing term newborn at 28 hours of age. On room air, oxygen saturation is 96% in the right hand and 94% in a foot. One hour later, repeat measurements with reliable waveforms are again 96% and 94%. The infant has no murmur or visible cyanosis. Under the AAP’s revised 2025 screening algorithm, how should the second result be handled?

Accepted Answer

Record a failed screen and evaluate the hypoxemia before discharge

Answer

Record a pass because the hand-foot difference is less than 3 percentage points

Answer

Obtain a third set in one hour before deciding whether the screen has failed

Answer

Arrange outpatient echocardiography while allowing the planned discharge today

Free PA-CP Practice Questions

Domain 1: Health Maintenance

Question 1

Domain 2: Infectious Diseases

Question 2

Domain 3: Cardiovascular Disorders

Question 3

Domain 4: Psychiatry and Behavioral Medicine

Question 4

Domain 7: Musculoskeletal Disorders

Question 5

Domain 8: Sports Medicine

Question 6

Domain 11: Hematology/Oncology

Question 7

Domain 12: Endocrine Disorders

Question 8

More PA-CP practice questions

Question 9

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