100+ Free BCPPS Practice Questions

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Question 1

Score: 0/0

Which enzyme is the dominant CYP450 isoenzyme expressed in the fetal and early neonatal liver that subsequently declines as CYP3A4 matures?

CYP2D6

CYP3A7

CYP2C9

CYP1A2

to track

2026 Statistics

Key Facts: BCPPS Exam

175

Total Questions

100 Part 1 + 75 Part 2

4h 23m

Testing Time

Two-part format

66%

Pass Rate

BPS first-time

$600

Application Fee

BPS 2026

7 years

Certification Valid

Recertification cycle

3 yrs

Practice Pathway

or PGY1+PGY2

The BCPPS exam has a pass rate near 66% for first-time candidates. It is a 175-item computer-based BPS examination (100 items in Part 1 and 75 in Part 2) totaling ~4 hours 23 minutes of testing. Scoring is scaled on the BPS 75 scale. Eligibility requires an active pharmacist license plus one of: 3 years of pediatric pharmacy practice experience, PGY1 + PGY2 pediatric residency, or PGY1 residency plus 1 year of pediatric practice. The 2026 application fee is $600 ($300 retake) and certification is valid 7 years.

Sample BCPPS Practice Questions

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

1Which enzyme is the dominant CYP450 isoenzyme expressed in the fetal and early neonatal liver that subsequently declines as CYP3A4 matures?

A.CYP2D6

B.CYP3A7

C.CYP2C9

D.CYP1A2

Explanation: CYP3A7 is the principal fetal/neonatal CYP3A isoform. Its activity declines within the first weeks to months of life as CYP3A4 expression rises, contributing to the age-dependent clearance of many substrates (e.g., midazolam, fentanyl).

2Immature UGT-mediated glucuronidation in neonates is MOST classically associated with toxicity from which antibiotic?

A.Vancomycin

B.Gentamicin

C.Chloramphenicol

D.Ceftriaxone

Explanation: Chloramphenicol is conjugated by UGT2B7 glucuronidation. Neonates have immature UGT activity, causing accumulation and the classic 'gray baby syndrome' (cyanosis, cardiovascular collapse, abdominal distension).

3A 3-month-old term infant weighs 6 kg. Using 80 mg/kg/day of amoxicillin for acute otitis media, what is the appropriate total daily dose?

A.240 mg/day

B.360 mg/day

C.480 mg/day

D.960 mg/day

Explanation: 80 mg/kg/day x 6 kg = 480 mg/day, typically divided twice daily (240 mg BID). Guidelines recommend 80-90 mg/kg/day for acute otitis media to overcome intermediate-resistance pneumococci.

4Which intramuscular injection site is preferred for a healthy 4-month-old infant receiving routine vaccines?

A.Deltoid

B.Vastus lateralis

C.Dorsogluteal

D.Ventrogluteal

Explanation: The vastus lateralis (anterolateral thigh) is recommended for IM injections in infants <12 months. The deltoid is used starting at ~12-18 months of age when muscle mass is adequate.

5Which commercially available suspending vehicle is commonly used for extemporaneous pediatric oral suspensions to provide both suspension and sweetening?

A.Simple syrup alone

B.Ora-Plus and Ora-Sweet (1:1)

C.Sterile water for irrigation

D.Polyethylene glycol 400

Explanation: A 1:1 mix of Ora-Plus (suspending vehicle) and Ora-Sweet (flavored/sweetened vehicle) is a widely used combination for pediatric extemporaneous suspensions to provide uniform suspension and palatability.

6A premature infant has apnea of prematurity. What is the drug of choice?

A.Theophylline

B.Caffeine citrate

C.Albuterol

D.Doxapram

Explanation: Caffeine citrate is the agent of choice for apnea of prematurity. It has a wide therapeutic window, long half-life allowing once-daily dosing, and improved outcomes (reduced BPD, cerebral palsy) shown in the CAP trial.

7Empiric therapy for early-onset neonatal sepsis most commonly includes which regimen?

A.Vancomycin + cefepime

B.Ampicillin + gentamicin

C.Ceftriaxone monotherapy

D.Piperacillin-tazobactam monotherapy

Explanation: Early-onset sepsis (<72 hours) pathogens are Group B Streptococcus, E. coli, and Listeria. Ampicillin + gentamicin is the standard empiric regimen covering these organisms synergistically.

8What is the preferred first-line inhaled medication for acute asthma exacerbation in children?

A.Ipratropium

B.Short-acting beta-2 agonist (albuterol)

C.Inhaled corticosteroid

D.Salmeterol

Explanation: Short-acting beta-2 agonists (SABAs) like albuterol are first-line bronchodilators for acute asthma exacerbation due to rapid onset and direct smooth-muscle relaxation.

9Which medication is first-line for croup (laryngotracheobronchitis) in a 2-year-old?

A.Dexamethasone

B.Amoxicillin

C.Albuterol

D.Acetaminophen

Explanation: A single dose of dexamethasone (typically 0.6 mg/kg PO/IV/IM, max 16 mg) is first-line treatment for croup, reducing inflammation and severity. Racemic epinephrine is added for moderate-severe cases.

10Per the 2026 CDC ACIP schedule, the first dose of hepatitis B vaccine should be administered at what age?

A.Birth (within 24 hours)

B.1 month

C.2 months

D.6 months

Explanation: HepB vaccine dose #1 is given within 24 hours of birth for all medically stable infants ≥2 kg, per ACIP, to prevent perinatal hepatitis B transmission. Infants of HBsAg-positive mothers also receive HBIG within 12 hours.

About the BCPPS Exam

The BCPPS certification recognizes pharmacists with advanced knowledge of pediatric pharmacotherapy from neonates through adolescents. The 175-item BPS exam is delivered in two parts at Pearson VUE and is aligned to the BPS Pediatric Pharmacy content outline covering pharmacokinetics, pharmacotherapy across disease states, compounding, medication safety, and professional practice.

Questions

175 scored questions

Time Limit

4 hours 23 minutes (split — Part 1 and Part 2)

Passing Score

Scaled (BPS 75 scale)

Exam Fee

$600 (Board of Pharmacy Specialties (BPS))

BCPPS Exam Content Outline

~15%

Pediatric-Specific Drug Knowledge

Developmental pharmacokinetics (CYP maturation, glucuronidation, neonatal clearance), weight/BSA dosing, extemporaneous compounding (USP <795>/<797>/<800>), drug administration routes in children, and age-appropriate formulations.

~65%

Pediatric Disease States & Pharmacotherapy

Neonatology (sepsis, PDA, apnea of prematurity, surfactant), infectious diseases (AOM, pneumonia, meningitis, RSV prophylaxis), respiratory (asthma, CF, bronchiolitis), cardiology, endocrine (T1DM, DKA), neurology (seizures, ADHD), heme/onc (SCD, ALL, ITP), GI, renal, pain/sedation, vaccines (ACIP), and adolescent medicine.

~20%

Professional Practice, Medication Safety & EBM

Pediatric medication error prevention, high-alert drugs, weight-based dosing safety, evidence-based medicine and literature appraisal in pediatrics, pharmacoeconomics, quality improvement, advocacy, and collaborative practice.

How to Pass the BCPPS Exam

What You Need to Know

Passing score: Scaled (BPS 75 scale)
Exam length: 175 questions
Time limit: 4 hours 23 minutes (split — Part 1 and Part 2)
Exam fee: $600

Keys to Passing

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

BCPPS Study Tips from Top Performers

1Master developmental pharmacokinetics — memorize CYP maturation timelines (CYP3A7 to CYP3A4 switch, CYP2D6, CYP2C9/2C19) and UGT glucuronidation gaps explaining chloramphenicol and morphine neonatal toxicity

2Drill weight-based dosing and maximum-dose caps cold — amoxicillin 80-90 mg/kg/day for AOM, ceftriaxone max 2 g/day, acetaminophen 15 mg/kg q4-6h (max 75 mg/kg/day)

3Know the 2026 ACIP pediatric schedule including PCV15/PCV20, RSV (nirsevimab/Beyfortus vs palivizumab), HPV, and meningococcal ACWY and B

4Study neonatal sepsis pathogens (GBS, E. coli, Listeria) and empiric regimens (ampicillin + gentamicin for EOS; vancomycin + gentamicin or cefepime for LOS)

5Review USP <795>, <797>, and <800> beyond-use dates and suspending vehicles (Ora-Plus/Ora-Sweet) for pediatric extemporaneous compounding

Frequently Asked Questions

What is the BCPPS pass rate?

The BCPPS first-time pass rate is approximately 66% based on recent BPS continuous-testing results. Scores are reported on the BPS scaled-score system and the cut score is set by the BPS Specialty Council through standard setting.

How many questions are on the BCPPS exam and how long is it?

The BCPPS exam contains 175 multiple-choice questions delivered in two parts. Part 1 is 100 items in 2 hours 30 minutes and Part 2 is 75 items in 1 hour 53 minutes, with an optional 30-minute break between parts. Total testing time is approximately 4 hours 23 minutes.

What are the BCPPS eligibility requirements?

Candidates must hold an active pharmacist license and meet one of these pathways: (1) three (3) years of pediatric pharmacy practice experience, (2) completion of a PGY1 pharmacy residency plus one (1) year of pediatric practice, or (3) completion of an ASHP-accredited PGY1 pharmacy residency plus a PGY2 pediatric pharmacy residency. All practice experience must be post-licensure.

How much does the BCPPS exam cost in 2026?

The 2026 BCPPS initial application fee is $600 USD. The retake application fee is $300 USD for candidates who failed the exam within the previous year. The 2026 application window runs February 8 – August 17.

How long is BCPPS certification valid?

BCPPS certification is valid for 7 years. Recertification can be achieved either by passing a recertification examination or by completing 100 hours of BPS-approved continuing pharmacy education (e.g., through PPA, ASHP, or ACCP).

What topics are highest yield for BCPPS preparation?

High-yield areas include: neonatal pharmacokinetics and dosing (CYP3A7, glucuronidation, renal clearance maturation), weight-based and BSA dosing, pediatric infectious disease (high-dose amoxicillin for AOM, RSV monoclonals), pediatric asthma/CF (including CFTR modulators), neonatal sepsis (amp + gent), seizures, ADHD, T1DM technology (pumps/CGM/closed-loop), SCD (hydroxyurea/crizanlizumab), ACIP vaccine schedule, and medication-safety in weight-based dosing.