NR 328 CMS Practice Exam PEDIATRIC NURSING EXAM PREP
NR 328 CMS PRACTICE EXAM PEDIATRIC NURSING EXAM
PREP LATEST 2025/2026 ACTUAL EXAM COMPLETE 100
QUESTIONS AND CORRECT ANSWERS GRADED A+
GUARANTEED PASS- ACE YOUR EXAM
The nurse is teaching the family of a child diagnosed with iron-deficiency anemia
about the proper administration of iron supplements. Which points should the
nurse include in the education session? Select all that apply.
a. Stop the medication and call the primary care provider if tarry stools are noted.
b. Administer with milk products to alter the taste if taste is an issue.
c. Administer in two divided doses between meals.
d. Administer with citrus fruits or juices to increase absorption.
e. Use a straw to administer the iron if it is in liquid form.
Answer: C, D, E
Rationale: The family should be instructed to administer the iron supplement in
two divided doses between meals, when free hydrochloric acid is at its greatest
levels to aid in absorption. Using a straw for liquid iron is recommended to avoid
staining the teeth. Citrus fruits or juices also help increase acidity and therefore
absorption of the iron. Milk products bind the iron and interfere with absorption
and should not be used with administration of iron. Tarry stools are an expected
change with iron supplements, and therefore calling the primary care provider is
not necessary
The family of a child hospitalized for care during a sickle cell crisis calls the nurse
into the room because the child is struggling to breathe. Upon assessment, the
1|Page
, NR 328 CMS Practice Exam PEDIATRIC NURSING EXAM PREP
nurse notes a respiratory rate of 30 and that the child is clutching the abdomen
and crying. What does the nurse determine the child may be experiencing?
a. Deficient fluid volume
b. Acute chest syndrome
c. Increasing splenomegaly
d. Cerebrovascular accident
Answer: B
Rationale: In a child experiencing a sickle cell crisis, dyspnea, tachypnea, and
severe abdominal pain can indicate acute chest syndrome, which can be fatal if
not addressed immediately. Deficient fluid volume is characterized by loss of skin
turgor, dry mucous membranes, sunken eyes, dark urine, and rapid breathing or
rapid thready pulse. Severe unrelieved headaches, vomiting, seizures, weakness,
or inability to move a limb or hands and feet can all indicate cerebrovascular
accident. Increasing splenomegaly would be determined by measuring the spleen.
The school nurse is caring for a boy with hemophilia who fell on his arm during
recess. What supportive measures should the nurse use until factor replacement
therapy can be instituted?
a. Applying pressure for at least 1 minute
b. Beginning passive range-of-motion exercise unless the pain is severe
c. Elevating the area above the level of the heart
d. Applying warm, moist compresses
Answer: C
Rationale: The initial response should include elevation of the arm to minimize
bleeding. Cold should be applied to the arm. This will aid in vasoconstriction, which
will in turn minimize blood loss. Pressure is effective in small areas but would not
be as effective for an extremity. Passive range-of-motion exercise is not
2|Page
, NR 328 CMS Practice Exam PEDIATRIC NURSING EXAM PREP
recommended. The child may perform active range-of-motion exercise after the
bleeding episode has resolved
A child with sickle cell anemia is brought to the hospital with pain in the lower
limbs. On examination the child’s skin and tongue are pale and the PaO2 is 98%.
What measure should the nurse take to prevent sickling of red blood cells in this
patient?
a. Give intravenous fluids.
b. Restrict drinking of water.
c. Administer oxygen.
d. Give oral analgesics.
Answer: A
Rationale: Prevention of sickling is an important measure in the management of
sickle cellLinks to an external site. Crisis. Hydration of the body either through oral
or intravenous fluids helps to prevent the sickling phenomenon. The PaO2 of the
patient indicates that oxygen saturation is optimal, and therefore oxygen
administration is not required. Analgesics are given to reduce pain; however they
cannot prevent sickling. Drinking of water should be encouraged.
A child with sickle cell disease is brought to the hospital reporting right knee pain.
On examination, the nurse finds localized swelling and immediately applies a cold
compress to the right knee, massages the knee, and administers ibuprofen for
pain relief. The nurse informs the mother that the child may need a high dose of
an opioid if there is no relief from pain. Which of the measures taken by the nurse
need to be corrected?
a. Giving ibuprofen to the child for pain relief
b. Giving cold compression to the affected area
3|Page
NR 328 CMS PRACTICE EXAM PEDIATRIC NURSING EXAM
PREP LATEST 2025/2026 ACTUAL EXAM COMPLETE 100
QUESTIONS AND CORRECT ANSWERS GRADED A+
GUARANTEED PASS- ACE YOUR EXAM
The nurse is teaching the family of a child diagnosed with iron-deficiency anemia
about the proper administration of iron supplements. Which points should the
nurse include in the education session? Select all that apply.
a. Stop the medication and call the primary care provider if tarry stools are noted.
b. Administer with milk products to alter the taste if taste is an issue.
c. Administer in two divided doses between meals.
d. Administer with citrus fruits or juices to increase absorption.
e. Use a straw to administer the iron if it is in liquid form.
Answer: C, D, E
Rationale: The family should be instructed to administer the iron supplement in
two divided doses between meals, when free hydrochloric acid is at its greatest
levels to aid in absorption. Using a straw for liquid iron is recommended to avoid
staining the teeth. Citrus fruits or juices also help increase acidity and therefore
absorption of the iron. Milk products bind the iron and interfere with absorption
and should not be used with administration of iron. Tarry stools are an expected
change with iron supplements, and therefore calling the primary care provider is
not necessary
The family of a child hospitalized for care during a sickle cell crisis calls the nurse
into the room because the child is struggling to breathe. Upon assessment, the
1|Page
, NR 328 CMS Practice Exam PEDIATRIC NURSING EXAM PREP
nurse notes a respiratory rate of 30 and that the child is clutching the abdomen
and crying. What does the nurse determine the child may be experiencing?
a. Deficient fluid volume
b. Acute chest syndrome
c. Increasing splenomegaly
d. Cerebrovascular accident
Answer: B
Rationale: In a child experiencing a sickle cell crisis, dyspnea, tachypnea, and
severe abdominal pain can indicate acute chest syndrome, which can be fatal if
not addressed immediately. Deficient fluid volume is characterized by loss of skin
turgor, dry mucous membranes, sunken eyes, dark urine, and rapid breathing or
rapid thready pulse. Severe unrelieved headaches, vomiting, seizures, weakness,
or inability to move a limb or hands and feet can all indicate cerebrovascular
accident. Increasing splenomegaly would be determined by measuring the spleen.
The school nurse is caring for a boy with hemophilia who fell on his arm during
recess. What supportive measures should the nurse use until factor replacement
therapy can be instituted?
a. Applying pressure for at least 1 minute
b. Beginning passive range-of-motion exercise unless the pain is severe
c. Elevating the area above the level of the heart
d. Applying warm, moist compresses
Answer: C
Rationale: The initial response should include elevation of the arm to minimize
bleeding. Cold should be applied to the arm. This will aid in vasoconstriction, which
will in turn minimize blood loss. Pressure is effective in small areas but would not
be as effective for an extremity. Passive range-of-motion exercise is not
2|Page
, NR 328 CMS Practice Exam PEDIATRIC NURSING EXAM PREP
recommended. The child may perform active range-of-motion exercise after the
bleeding episode has resolved
A child with sickle cell anemia is brought to the hospital with pain in the lower
limbs. On examination the child’s skin and tongue are pale and the PaO2 is 98%.
What measure should the nurse take to prevent sickling of red blood cells in this
patient?
a. Give intravenous fluids.
b. Restrict drinking of water.
c. Administer oxygen.
d. Give oral analgesics.
Answer: A
Rationale: Prevention of sickling is an important measure in the management of
sickle cellLinks to an external site. Crisis. Hydration of the body either through oral
or intravenous fluids helps to prevent the sickling phenomenon. The PaO2 of the
patient indicates that oxygen saturation is optimal, and therefore oxygen
administration is not required. Analgesics are given to reduce pain; however they
cannot prevent sickling. Drinking of water should be encouraged.
A child with sickle cell disease is brought to the hospital reporting right knee pain.
On examination, the nurse finds localized swelling and immediately applies a cold
compress to the right knee, massages the knee, and administers ibuprofen for
pain relief. The nurse informs the mother that the child may need a high dose of
an opioid if there is no relief from pain. Which of the measures taken by the nurse
need to be corrected?
a. Giving ibuprofen to the child for pain relief
b. Giving cold compression to the affected area
3|Page
