100+ Free ABP General Pediatrics Practice Questions

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~80-91% first-time historically (89% in 2024) Pass Rate

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Question 1

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A 2-month-old infant presents for a well-child visit. According to the CDC/AAP immunization schedule, which vaccines are routinely recommended at this visit?

Tdap, HPV, and meningococcal ACWY

MMR, varicella, hepatitis A, and DTaP

DTaP, Hib, IPV, PCV15/20, rotavirus, and hepatitis B (second or third dose)

Influenza only

to track

2026 Statistics

Key Facts: ABP General Pediatrics Exam

330

Approximate MCQ Items

4 sections, 330-350 total per ABP

7 hrs

Total Testing Time

1-day exam at Pearson VUE

12%

Preventive Pediatrics Weight

Largest domain on 2024 blueprint

180

Passing Scaled Score

Out of 0-300 scale, criterion-referenced

89%

2024 Pass Rate

First-time takers, ABP historical data

3 yr

Residency Required

ACGME-accredited pediatrics

The ABP General Pediatrics exam is a 1-day, ~330-question computer-based test (7 hours) from the American Board of Pediatrics administered October 13-15, 2026. The 2024 blueprint weights Preventive Pediatrics/Well-Child Care 12%, Infectious Diseases 7%, Mental and Behavioral Health 6%, EENT 6%, Cardiology 5%, Pulmonology 5%, GI 5%, Adolescent Care 5%, Emergency/Critical Care 4%, Neurology 4%, Skin 4%, Orthopedics 4%, Fetal/Neonatal 4%, and remaining domains 2-3% each. The pass score is a scaled 180 (of 300). Pass rate was 89% in 2024. Eligibility requires 3 years of ACGME pediatrics residency.

Sample ABP General Pediatrics Practice Questions

Try these sample questions to test your ABP General Pediatrics exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 2-month-old infant presents for a well-child visit. According to the CDC/AAP immunization schedule, which vaccines are routinely recommended at this visit?

A.Tdap, HPV, and meningococcal ACWY

B.MMR, varicella, hepatitis A, and DTaP

C.DTaP, Hib, IPV, PCV15/20, rotavirus, and hepatitis B (second or third dose)

D.Influenza only

Explanation: At the 2-month visit, the routine AAP/CDC schedule includes DTaP, Hib, IPV, PCV15 or PCV20, rotavirus (oral), and either a second or third hepatitis B dose depending on the brand used. MMR and varicella are given at 12-15 months. HPV and Tdap are adolescent vaccines. Influenza is given ≥6 months of age.

2A 4-month-old exclusively breastfed infant is seen for a well-child visit. Which supplement is routinely recommended?

A.Fluoride 0.25 mg daily

B.Iron 1 mg/kg/day

C.Vitamin D 400 IU daily

D.Vitamin K 1 mg intramuscular

Explanation: The AAP recommends 400 IU/day of vitamin D beginning within the first few days of life for all exclusively and partially breastfed infants to prevent rickets. Iron supplementation (1 mg/kg/day) is recommended starting at 4 months for exclusively breastfed term infants. Fluoride is added only after 6 months if the water supply is not fluoridated. Vitamin K is given once as a single IM dose at birth.

3A 9-month-old infant can sit without support, pulls to stand, has a pincer grasp, says 'mama' and 'dada' non-specifically, and waves bye-bye. Development is:

A.Delayed in language

B.Delayed in gross motor

C.Delayed in fine motor

D.Appropriate for age

Explanation: At 9 months, typical milestones include sitting without support (by 6-8 mo), pulling to stand (8-10 mo), fine pincer grasp (9-12 mo), nonspecific 'mama/dada' (8-10 mo), and social gestures like waving (9-12 mo). This child is appropriate for age. Specific 'mama/dada' is typically achieved by 12 months.

4Per AAP guidelines, at which well-child visit should autism-specific screening (e.g., M-CHAT-R/F) first be formally administered?

A.Only if parental concern is raised

B.6 months

C.36 months

D.18 months (and again at 24 months)

Explanation: The AAP recommends universal autism-specific screening at both the 18-month and 24-month well-child visits using validated tools such as the M-CHAT-R/F. General developmental surveillance occurs at every visit, and general developmental screening (e.g., ASQ-3) is recommended at 9, 18, and 30 months.

5A 15-month-old has a weight below the 3rd percentile and has crossed two major percentile lines downward over the past 6 months. Length and head circumference are appropriate. The MOST likely cause is:

A.Genetic short stature

B.Inadequate caloric intake

C.Growth hormone deficiency

D.Hypothyroidism

Explanation: In failure to thrive (FTT), weight drops first, followed by length, and then head circumference. Isolated weight failure with preserved length and head circumference almost always indicates inadequate caloric intake (nonorganic FTT most commonly; may be organic from malabsorption or increased losses). Endocrine causes typically present with short stature (length affected first) and normal or increased weight.

6A 5-year-old has BMI at the 98th percentile. According to current AAP guidelines for childhood obesity, which initial step is MOST appropriate?

A.Start metformin

B.Intensive health behavior and lifestyle treatment (IHBLT) with ≥26 hours of face-to-face family-based counseling over 3-12 months

C.Refer for bariatric surgery evaluation

D.Observation only until age 10

Explanation: The 2023 AAP Clinical Practice Guideline for childhood obesity recommends that for children ≥6 years with obesity, the first-line treatment is Intensive Health Behavior and Lifestyle Treatment (IHBLT) delivering ≥26 hours of face-to-face, family-based, multicomponent behavioral treatment. Pharmacotherapy (e.g., semaglutide, metformin) may be considered ≥12 years with obesity as an adjunct. Bariatric surgery evaluation is for ≥13 years with severe obesity.

7A 2-week-old exclusively breastfed term newborn has regained birth weight and is feeding 8-12 times daily. The mother asks about safe sleep. You should counsel:

A.Side sleeping is equally safe

B.Supine sleep on a firm flat surface in the parents' room (not bed) with no loose bedding, bumpers, or soft toys, for at least the first 6 months

C.Prone sleep on a soft mattress reduces reflux risk

D.Bed-sharing is recommended through 1 year

Explanation: The AAP 2022 safe sleep policy recommends supine sleep on a firm, flat, noninclined sleep surface (certified crib, bassinet, or play yard) in the parents' room (room-sharing, NOT bed-sharing) for at least the first 6 months and ideally 1 year. Avoid soft bedding, bumpers, weighted sleep sacks, and inclined sleepers. This reduces SIDS/SUID risk.

8According to current AAP/CDC guidance, universal lipid screening is recommended:

A.Every year from age 2

B.Once between ages 9-11 years and again between 17-21 years

C.Only for children with family history of hyperlipidemia

D.Not recommended in pediatrics

Explanation: Per the NHLBI/AAP guidelines, universal (non-fasting) lipid screening is recommended once between 9-11 years (before puberty lowers LDL) and again between 17-21 years. Earlier selective screening (starting age 2) is done for children with positive family history of premature CVD, dyslipidemia, obesity, diabetes, hypertension, or smoking.

9A 12-month-old has a hemoglobin of 10.2 g/dL. Per AAP, universal hemoglobin screening is recommended at what age?

A.24 months

B.6 months

C.12 months

D.4 years

Explanation: The AAP recommends universal anemia screening (hemoglobin) at 12 months of age, with risk assessment for iron deficiency. Infants at high risk (preterm, low birth weight, exclusive breastfeeding without iron supplementation after 4 months, early cow's milk introduction) should have earlier/more frequent screening.

10Per AAP 2021 lead screening guidance, which children require universal blood lead level testing?

A.Only children with pica

B.All children at 12 and 24 months who are Medicaid-eligible or who have CDC/state-specific risk factors; universal testing is recommended in high-prevalence areas

C.All children at birth

D.Universal testing is not recommended

Explanation: Universal blood lead level testing is required for Medicaid-eligible children at 12 and 24 months, and for those with high-risk factors (older housing, sibling with elevated lead, living near industrial sources). In 2021, the CDC lowered the blood lead reference value to 3.5 µg/dL. Selective risk-based screening is used elsewhere based on state/local risk.

About the ABP General Pediatrics Exam

The ABP General Pediatrics Initial Certifying Examination validates foundational knowledge for safe, independent practice as a general pediatrician. The 2024 Content Outline (effective October 15, 2024) organizes knowledge into 24 domains — led by Preventive Pediatrics/Well-Child Care (12%), Infectious Diseases (7%), Mental and Behavioral Health (6%), and EENT (6%). The exam consists of approximately 330-350 single-best-answer multiple-choice items administered over one day (7 hours) at Pearson VUE. Eligibility requires successful completion of 3 years of ACGME-accredited pediatrics residency. The 2026 administration is October 13, 14, or 15.

Questions

330 scored questions

Time Limit

1-day CBT, 7 hours across 4 sections with optional breaks

Passing Score

Scaled score of 180 (0-300 range); criterion-referenced

Exam Fee

$2,242 regular registration (2026 cycle) (American Board of Pediatrics (ABP) / Pearson VUE)

ABP General Pediatrics Exam Content Outline

12%

Preventive Pediatrics / Well-Child Care

Normal growth/development (CDC 2022 revised milestones), AAP Bright Futures screenings, AAP/CDC immunization schedule, lead (12/24 mo), anemia (12 mo), lipid (9-11, 17-21), autism M-CHAT-R/F (18/24 mo), safe sleep 2022, car seat rear-facing 2018, obesity IHBLT per 2023 AAP CPG.

Infectious Diseases

Kawasaki IVIG/coronary aneurysms, neonatal meningitis (Listeria — ampicillin), measles/Koplik spots, sickle cell fever (ceftriaxone), LTBI short-course (3HP, 4R), congenital infections, CDC 2021 STI guidelines.

Mental and Behavioral Health

ADHD AAP 2019 (stimulants first-line, Vanderbilt ≥2 settings), ASD (M-CHAT-R/F, ADOS-2, EI), pediatric MDD (fluoxetine + CBT, TADS), suicide screening (ASQ, Columbia), lethal means restriction, substance use (CRAFFT).

Eye, Ear, Nose, and Throat

AOM AAP 2013 (high-dose amoxicillin), tubes for recurrent AOM or OME, retropharyngeal abscess, conjunctivitis-otitis syndrome (H. flu — augmentin), GAS pharyngitis (penicillin for ARF prevention), OSA/adenotonsillectomy.

Cardiology

Cyanotic CHD (d-TGA 'egg on string,' ToF, TAPVR, tricuspid atresia — PGE1), acyanotic CHD (VSD, ASD fixed split S2, PDA, coarctation BP differential), HCM (sudden cardiac death in athletes), rhythm disorders.

Pulmonology

Asthma GINA 2023/NAEPP 2020 — SMART/ICS-formoterol; bronchiolitis AAP supportive (nirsevimab prevention); cystic fibrosis (sweat chloride ≥60, CFTR modulators/Trikafta); foreign body aspiration; TB.

Gastroenterology

Pyloric stenosis (olive, HCMA), intussusception (US target, air enema), malrotation/volvulus (bilious vomiting = surgical emergency), IBD (Crohn skip lesions vs UC continuous), celiac disease (tTG-IgA).

Adolescent Care

Tanner staging, HEEADSSS, LARC first-line contraception (AAP/ACOG), confidentiality, CDC 2021 STI (doxycycline for chlamydia), eating disorders, Graves, college vaccines (MenACWY/MenB, HPV, Tdap).

Emergency and Critical Care

DKA (isotonic, insulin 0.05-0.1 U/kg/hr, cerebral edema), anaphylaxis (IM epinephrine 0.01 mg/kg), iron/deferoxamine, beta-blocker/glucagon, bacterial tracheitis/epiglottitis airway.

Neurology

Infantile spasms (West — ACTH; vigabatrin for TSC), febrile seizures (simple vs complex), DMD (X-linked, Gowers, elevated CK, new gene therapies), epilepsy syndromes, cerebral palsy.

Skin / Dermatology

Atopic dermatitis (emollients + TCS, dupilumab, JAK inhibitors), impetigo (topical mupirocin), port-wine stain / Sturge-Weber (GNAQ), infantile hemangioma (propranolol), MRSA (I&D).

Orthopedics and Sports Medicine

DDH (Ortolani/Barlow, US 4-6 wk, Pavlik), Legg-Calvé-Perthes, SCFE in obese adolescents (in situ pinning), transient synovitis vs septic (Kocher), Osgood-Schlatter, scoliosis, pre-participation (HCM).

Fetal and Neonatal Care

2022 AAP hyperbilirubinemia (neurotoxicity risk factors, phototherapy), HIE/therapeutic hypothermia (33.5°C × 72h), TTN vs RDS vs meconium aspiration, neonatal sepsis, congenital hypothyroidism (levothyroxine 10-15 mcg/kg).

Psychosocial Issues

Family structures (divorce, foster, adoption), ACEs/trauma-informed care, cyberbullying, social determinants of health, equity/racism in medicine.

Child Abuse and Neglect

Sentinel injuries (TEN-4-FACES-P bruising in <4 mo), abusive head trauma (bilateral subdural + multilayered retinal hemorrhages), posterior rib fractures, skeletal survey, mandatory reporting.

Hematology-Oncology

ALL (flow, ETV6-RUNX1 favorable), neuroblastoma (MYCN poor), Wilms, sickle cell (hydroxyurea ≥9 mo, TCD screening), ITP (post-viral), IDA.

Allergy and Immunology

Anaphylaxis (IM epi first-line), SCID (TREC NBS, IL2RG X-linked), Wiskott-Aldrich (eczema + small platelets), CGD, IgA deficiency, food allergies.

Endocrinology

Congenital hypothyroidism, CAH salt-wasting (21-OHase), Graves (methimazole, not PTU), central precocious puberty (GnRH agonist), T1DM/T2DM, short stature.

Nephrology, Fluids and Electrolytes

PSGN (low C3, post-strep), minimal change NS (prednisone), HSP/IgA vasculitis, HUS (E. coli O157:H7), isotonic maintenance fluids (AAP 2018), DKA.

Genitourinary System

UTI (AAP 2011: US after 1st febrile, VCUG after 2nd), VUR grading, hydrocele/inguinal hernia, testicular torsion (<6 hr surgical window), cryptorchidism.

Genetics, Dysmorphology, and Metabolic Disorders

Trisomies (21, 18, 13), Turner (45,X), Klinefelter (47,XXY), Fragile X, urea cycle (OTC, hyperammonemia with respiratory alkalosis), MSUD, PKU, galactosemia, mitochondrial.

Rheumatology

JIA (oligoarticular ANA+ q3mo slit-lamp), acute rheumatic fever (Jones), SLE, Kawasaki, Ehlers-Danlos vascular (COL3A1), dermatomyositis.

Ethics

Confidentiality for adolescents, parental refusal (override when high-benefit/high-harm), mature minor, assent vs consent, end-of-life, equity.

Patient Safety, Quality Improvement, and Research Methods

PDSA cycles, SMART aims, outcome/process/balancing measures, just culture, disclosure of errors, RCA, stats (sens/spec, NPV/PPV, NNT).

How to Pass the ABP General Pediatrics Exam

What You Need to Know

Passing score: Scaled score of 180 (0-300 range); criterion-referenced
Exam length: 330 questions
Time limit: 1-day CBT, 7 hours across 4 sections with optional breaks
Exam fee: $2,242 regular registration (2026 cycle)

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ABP General Pediatrics Study Tips from Top Performers

1AAP Bright Futures visits and the CDC/AAP immunization schedule are the backbone of Domain 1 (12% of exam). Memorize 2-month, 4-month, 6-month, 12-month vaccine combinations, and universal screenings (hemoglobin at 12 mo, lead at 12 and 24 mo, M-CHAT-R/F at 18 and 24 mo, ASQ-3 at 9/18/30 mo, lipid 9-11 and 17-21 yr).

2For neonatal jaundice, master the 2022 AAP hyperbilirubinemia guideline — phototherapy and exchange thresholds are stratified by gestational age AND presence of hyperbilirubinemia neurotoxicity risk factors (isoimmune hemolysis, G6PD deficiency, sepsis, significant bruising, albumin <3.0). The old 2004 Bhutani nomogram is outdated.

3DKA management in children (high-yield): IV isotonic fluid bolus (10-20 mL/kg 0.9% saline) first, then insulin 0.05-0.1 U/kg/hr 1-2 hours AFTER fluids started. NEVER give insulin bolus (worsens cerebral edema). Cerebral edema is the leading cause of DKA-related pediatric death — watch for headache, altered mentation, bradycardia, hypertension. Treat with mannitol or hypertonic saline immediately.

4Asthma step therapy per GINA 2023 / NAEPP 2020 updates: SMART therapy (single maintenance and reliever with ICS-formoterol) is first-line for ages ≥12. LABA monotherapy is CONTRAINDICATED (FDA black box for mortality). Montelukast has a boxed warning for neuropsychiatric events (depression, suicidal thoughts).

5Adolescent confidentiality: in most US states, minors can independently consent to contraception, STI testing/treatment, mental health care, substance use treatment, and pregnancy-related care. Assess capacity, document the assent discussion, encourage parent involvement when safe, but do NOT breach confidentiality except when required for safety (suicide/homicide risk, abuse).

Frequently Asked Questions

What is the ABP General Pediatrics Initial Certifying Examination?

The ABP General Pediatrics Initial Certifying Examination is administered by the American Board of Pediatrics to validate that a candidate possesses the knowledge required for independent practice as a general pediatrician. It is a 1-day, computer-based, ~330-question single-best-answer multiple-choice exam delivered at Pearson VUE. Passing is required for initial board certification. The 2024 Content Outline (24 domains) is effective October 15, 2024 and governs the 2026 exam.

Who is eligible to take the ABP General Pediatrics Exam?

Candidates must have successfully completed 3 years of ACGME-accredited pediatrics residency training (or an acceptable equivalent), hold a valid unrestricted medical license, and have the program director's attestation that the candidate has met all ABP requirements. Candidates have a 7-year initial eligibility window from residency completion to pass the exam.

What is the format of the ABP General Pediatrics Exam?

The computer-based exam is administered at Pearson VUE Professional Testing Centers over a single 7-hour testing day. It consists of four sections with optional scheduled breaks between sections, totaling approximately 330-350 single-best-answer multiple-choice items. Each item is followed by four or five answer options.

How much does the 2026 ABP General Pediatrics Exam cost?

For 2026, the regular registration fee is approximately $2,242 (the ABP publishes updated fees annually). Late registration adds a fee. Cancellation and retake policies are set by the ABP. MOC enrollment requires annual fees after certification.

When is the 2026 exam administered?

The 2026 ABP General Pediatrics Initial Certifying Examination is offered October 13, 14, or 15, 2026 at Pearson VUE testing centers. Candidates schedule one of these three days. Registration typically opens in the spring (February-April) and closes before the summer deadline; late registration window follows.

How is the exam scored?

The ABP uses a scaled scoring system ranging from 0 to 300, with a passing score of 180. The scaled score adjusts for minor differences in exam difficulty across years. The pass score is criterion-referenced (set by content-expert panels), not norm-referenced. Results are typically posted to the ABP candidate portal approximately 10-12 weeks after the exam.

What are the highest-yield topics for ABP General Pediatrics?

Preventive Pediatrics/Well-Child Care (12%) is by far the highest-weighted domain — master AAP Bright Futures screenings, the AAP/CDC immunization schedule, the 2022 hyperbilirubinemia guideline, safe sleep, obesity management (2023 AAP CPG), and developmental milestones. Next highest: Infectious Diseases (7%), Mental and Behavioral Health (6%), EENT (6%). Focus on Kawasaki disease, IVIG timing, neonatal meningitis coverage (Listeria), asthma step therapy (GINA 2023 SMART), DKA fluid/insulin protocols, anaphylaxis (IM epinephrine), ADHD AAP 2019 stimulants, ASD screening (M-CHAT-R/F), and AOM first-line (high-dose amoxicillin).

How should I study for the ABP General Pediatrics exam?

Start in the PL-2 year. Use the 2024 ABP Content Outline as the blueprint. Integrate comprehensive resources (PREP Self-Assessment, MedStudy, AAP PREP Online) with high-volume question banks (BoardVitals, Rosh, OpenExamPrep). Lead with Preventive Pediatrics and the largest organ-system domains (ID, Mental/Behavioral, Cardio, Pulm, GI). Take at least 2-3 timed, full-length (330-question) mock exams in the 3 months before the exam. Review the AAP Red Book for infectious diseases. Review recent AAP guidelines (2022 hyperbilirubinemia, 2023 obesity, 2019 ADHD, 2018 fluids, 2014/2022 bronchiolitis/RSV) as these generate new questions.