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A set of pediatric nursing questions and answers designed to help students prepare for their pediatric nursing exams. It includes 70 multiple-choice questions with structured rationales, incorporating next generation nclex (ngn)-style questions and case scenarios. The questions cover a range of topics relevant to pediatric nursing, such as corrosive ingestion, picc line care, poison control, play activities for hospitalized children, growth and development, postoperative teaching, oxygen saturation monitoring, medication effectiveness, seizure precautions, priority assessment, dietary needs, cast care, lung sounds, and ecg changes. Each question is followed by a detailed rationale explaining the correct answer, making it a valuable resource for nursing students.
Typology: Exams
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Question: Which of the following statements by the nurse best demonstrates an understanding of corrosive ingestion?
A. “If there are no burns on the lips or mouth, it means the esophagus must also be uninjured.” B. “We will neutralize the bleach immediately by giving an acid beverage.” C. “Injury caused by a corrosive liquid can cover a larger surface area than a corrosive solid.” D. “We should administer activated charcoal immediately.”
Answer: C. “Injury caused by a corrosive liquid can cover a larger surface area than a corrosive solid.”
Rationale: Corrosive liquids tend to spread broadly over mucosal surfaces, causing more extensive tissue damage. Absence of oral burns does not rule out possible esophageal or gastric injury, and immediate neutralization with an acid can exacerbate injuries.
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Question:
Poison control centers provide step-by-step guidance based on the specific substance ingested. Immediate calls allow for the most appropriate and up-to-date interventions.
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Question: Which play activity is most appropriate?
A. Cutting shapes from colored paper B. Drawing stick figures with crayons C. Riding a tricycle down the hall D. Building towers of blocks
Answer: D. Building towers of blocks
Rationale: Block-building is developmentally suitable for a 2-year-old, fosters fine motor coordination, and allows “destructive” play (knocking blocks down)—an outlet for stress.
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Question: A. “He has all of his primary (baby) teeth.” B. “He can’t hop on one foot yet.”
C. “His birth weight is tripled.” D. “He is able to say his first and last name.”
Answer: C. “His birth weight is tripled.”
Rationale: By 30 months (2½ years), most toddlers should have quadrupled their birth weight. Tripling is typically expected by 12 months of age.
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Question: Which of the following instructions should the nurse include?
A. “You can give your infant a tub bath once you are home.” B. “Apply hydrocortisone cream on the penis daily.” C. “Clamp the stent twice daily to keep it patent.” D. “Allow the stent to drain into the diaper.”
Answer: D. “Allow the stent to drain into the diaper.”
Rationale: The stent must remain open and unobstructed to ensure urine drains freely and to protect the surgical site. Clamping or tub baths may increase risk of infection or dislodgement.
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Edema is a hallmark of nephrotic syndrome; a positive therapeutic response to steroids includes reduced swelling.
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Question: Which nursing intervention should be included in the plan of care?
A. Place a padded tongue blade at the bedside. B. Allow the child to play action video games on a tablet. C. Let the child take tub baths independently. D. Ensure oxygen delivery equipment is functioning in the room.
Answer: D. Ensure oxygen delivery equipment is functioning in the room.
Rationale: During a seizure that impacts breathing or involves significant muscle spasms, oxygen may be necessary. Tongue blades are no longer recommended due to risk of injury.
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Question: Which child should the nurse assess first?
A. A toddler with a concussion who just had a forceful vomiting episode B. An adolescent with infective endocarditis reporting a mild headache C. An adolescent who was placed in halo traction an hour ago, rating pain 6/
D. A school-age child who has acute glomerulonephritis with tea-colored urine
Answer: A. A toddler with a concussion who just had a forceful vomiting episode
Rationale: Forceful vomiting following a head injury may indicate rising intracranial pressure. This is an urgent assessment priority.
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Question: Which statement by the nurse is most appropriate?
A. “Offer frequent, high-protein meals and snacks throughout the day.” B. “Aim for a diet very low in fat, around 10% of total calories.” C. “Limit daily calorie intake to about 1,200.” D. “Give a multivitamin once weekly.”
Answer: A. “Offer frequent, high-protein meals and snacks throughout the day.”
Rationale: Children with cystic fibrosis often have malabsorption and increased metabolic needs. High-protein, high-calorie intake supports growth and weight maintenance.
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Question: Which finding should the parents report to the provider immediately?
Question: Which newly written prescription should the nurse question?
A. Furosemide (Lasix) B. Captopril (Capoten) C. Regular insulin (IV) D. Potassium chloride (KCl)
Answer: D. Potassium chloride
Rationale: Peaked T waves and wide QRS can signal hyperkalemia, so administering additional potassium would put the child at high risk for worsening cardiac dysrhythmias.
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Question: Which statement should the nurse include?
A. “Your child should be able to balance so that the balls of their feet touch the ground while seated.” B. “Ride bikes at least 2 feet to the side of other riders.” C. “Wear dark clothing with a reflective strip if riding at night.” D. “Always ride facing oncoming traffic.”
Answer: A. “Your child should be able to balance so that the balls of their feet touch the ground while seated.”
Rationale: Proper seat height helps maintain safe balance and control of the bicycle. Children should ride with traffic (not facing traffic) and avoid night rides when possible.
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Question: Which action should the nurse take?
A. Obtain a throat culture swab immediately. B. Monitor the child’s oxygen saturation continuously. C. Use a warm mist humidifier at the bedside. D. Place the child flat on their back.
Answer: B. Monitor the child’s oxygen saturation continuously.
Rationale: Epiglottitis is a medical emergency that can compromise the airway. Continuous pulse oximetry and readiness for advanced airway management are critical. Throat swabs can provoke more airway swelling.
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Question:
Children with varicella are infectious until lesions have all crusted over. This typically occurs about 6 days after onset of the rash.
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Question: Which teaching point is correct?
A. “Use the salmeterol (long-acting beta2 agonist) inhaler every 4 hours during acute wheezing.” B. “Monitor your child’s weight weekly on inhaled corticosteroids.” C. “Pulmonary function tests are usually done about every 12–24 months to gauge therapy response.” D. “When checking peak flow, record the midpoint of three readings.”
Answer: C. “Pulmonary function tests are usually done about every 12–24 months to gauge therapy response.”
Rationale: Pulmonary function tests (PFTs) are conducted periodically (usually annually or biennially) to monitor asthma control and any changes in lung function.
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Question: Which findings are expected? (Select all that apply.)
A. Steatorrhea
B. Vomiting C. Lethargy D. Constipation E. Weight gain
Answer(s): B (Vomiting) and C (Lethargy)
Rationale: Intussusception commonly presents with episodes of pain, vomiting, lethargy, and a “currant jelly” stool. Weight gain and steatorrhea are inconsistent with this acute intestinal obstruction.
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Question: Which finding may reflect a concerning complication?
A. Erythrocyte sedimentation rate (ESR) of 18 mm/hr B. WBC of 6,200/mm³ C. C-reactive protein (CRP) of 1.4 mg/L D. RBC of 4.7 million/mm³
Answer: A. ESR of 18 mm/hr
Rationale: An elevated ESR can signal ongoing inflammation or infection, important considerations after surgery. Normal reference ranges vary by facility, but an ESR at 18 mm/hr in a child may be high.
D. “Explore the parents’ current feelings and wishes regarding organ donation.”
Answer: D. “Explore the parents’ current feelings and wishes regarding organ donation.”
Rationale: The family’s understanding, feelings, and emotional readiness are paramount before proceeding with more information or consents.
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Question: How can the nurse best minimize the infant’s pain?
A. Use a manual spring-loaded lancet for the heel. B. Apply an ice pack to the heel before the puncture. C. Encourage the mother to breastfeed during the procedure. D. Apply topical lidocaine before performing the heel stick.
Answer: C. Encourage the mother to breastfeed during the procedure.
Rationale: Breastfeeding can help reduce procedural pain through oral sucrose effect, comfort, and the release of natural endorphins during feeding.
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Question: Which finding indicates the treatment worked?
A. Alleviation of nausea and vomiting B. Onset of loose stool within 15 minutes C. Serum potassium of 4.1 mEq/L D. Blood pressure of 86/52 mm Hg
Answer: C. Serum potassium of 4.1 mEq/L
Rationale: Kayexalate helps lower potassium; a level within normal range (~3.5 to 5.0 mEq/L) proves effectiveness.
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Question: Which factor is the priority consideration?
A. Anticipated length of stay B. Required treatment schedule C. Disease process and risk of contagion D. The child’s self-care ability
Answer: C. Disease process and risk of contagion
Rationale:
Calculation Steps:
Answer: 2 mL
Rationale: Double-check calculations for accuracy. Ibuprofen dosing must be precise to avoid toxicity in infants.
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Question: Which finding should be reported to the provider?
A. Emergence of a central incisor tooth B. Persistent strabismus C. An open anterior fontanel D. Presence of external ear wax
Answer: B. Persistent strabismus
Rationale: By 6 months, intermittent strabismus may still occur briefly; however, consistent or prominent strabismus requires further evaluation for possible ophthalmic or muscular issues.
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Question: Which action should the school nurse do first?
A. Assess the child’s head for injury B. Look for any oral bleeding C. Count respirations and assess airway D. Check for unilateral weakness in the extremities
Answer: C. Count respirations and assess airway
Rationale: Following seizure activity, airway and breathing stability are essential. Checking for injuries is also important but follows ensuring the airway is intact.
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Question: Which activity should the nurse offer?
A. An adventure book to read B. Frequent visits from peers in a group C. A large-piece puzzle with multiple participants D. Puppets for imaginative play
Answer: A. An adventure book to read
