NR 328 Pediatric Nursing Final Exam Practice Questions 2026
|Chamberlain College
1. According to Erikson’s stages of psychosocial development, which stage
applies to a 4-year-old child?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Trust vs. Mistrust
D. Industry vs. Inferiority
Answer: B
Rationale: Preschool-aged children (3 to 6 years) are in the stage of Initiative vs. Guilt,
where they begin to assert power and control through play and social interactions.
2. A nurse is assessing a 2-month-old infant. Which of the following findings
should the nurse report to the provider?
A. Closure of the posterior fontanel
B. Asymmetrical gluteal folds
C. The absence of a social smile
D. A head circumference that is 2 cm larger than the chest circumference
Answer: B
Rationale: Asymmetrical gluteal folds are a clinical manifestation of developmental
dysplasia of the hip (DDH) and require further evaluation.
,3. Which pain scale is most appropriate for a 4-year-old child who is post-
operative?
A. FLACC scale
B. Numerical Rating Scale (0-10)
C. Wong-Baker FACES scale
D. CRIES scale
Answer: C
Rationale: The Wong-Baker FACES scale is appropriate for children as young as 3 years
old as they can point to the face that best represents their pain.
4. A child is admitted with suspected epiglottitis. Which nursing action is the
highest priority?
A. Obtaining a throat culture
B. Monitoring oxygen saturation and airway patency
C. Initiating intravenous access
D. Assessing the child’s temperature rectally
Answer: B
Rationale: Epiglottitis is a medical emergency due to the risk of sudden airway
obstruction; maintaining a patent airway is the priority.
5. What is the primary dietary recommendation for a child diagnosed with
Celiac disease?
A. Low sodium diet
B. High protein diet
C. Gluten-free diet
D. Lactose-free diet
Answer: C
Rationale: Celiac disease is an immune reaction to eating gluten, a protein found in wheat,
barley, and rye.
, 6. A nurse is caring for a child with Tetralogy of Fallot who experiences a ‘tet
spell.’ Which position should the nurse place the child in?
A. Knee-chest position
B. Supine with legs elevated
C. High-Fowler’s position
D. Side-lying position
Answer: A
Rationale: The knee-chest position increases systemic vascular resistance, which helps
reduce the right-to-left shunt and improves oxygenation.
7. Which of the following is a classic sign of pyloric stenosis in an infant?
A. Currant jelly-like stools
B. Bile-stained emesis
C. Ribbon-like stools
D. Projectile vomiting
Answer: D
Rationale: Projectile vomiting after feeding is the hallmark sign of hypertrophic pyloric
stenosis due to the gastric outlet obstruction.
8. When administering digoxin to a pediatric patient, the nurse should withhold
the dose if the apical pulse is below what rate for an infant?
A. 110 bpm
B. 70 bpm
C. 90 bpm
D. 60 bpm
Answer: C
Rationale: Digoxin is typically withheld in infants if the heart rate is less than 90-110 bpm
to avoid bradycardia and toxicity.
|Chamberlain College
1. According to Erikson’s stages of psychosocial development, which stage
applies to a 4-year-old child?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Trust vs. Mistrust
D. Industry vs. Inferiority
Answer: B
Rationale: Preschool-aged children (3 to 6 years) are in the stage of Initiative vs. Guilt,
where they begin to assert power and control through play and social interactions.
2. A nurse is assessing a 2-month-old infant. Which of the following findings
should the nurse report to the provider?
A. Closure of the posterior fontanel
B. Asymmetrical gluteal folds
C. The absence of a social smile
D. A head circumference that is 2 cm larger than the chest circumference
Answer: B
Rationale: Asymmetrical gluteal folds are a clinical manifestation of developmental
dysplasia of the hip (DDH) and require further evaluation.
,3. Which pain scale is most appropriate for a 4-year-old child who is post-
operative?
A. FLACC scale
B. Numerical Rating Scale (0-10)
C. Wong-Baker FACES scale
D. CRIES scale
Answer: C
Rationale: The Wong-Baker FACES scale is appropriate for children as young as 3 years
old as they can point to the face that best represents their pain.
4. A child is admitted with suspected epiglottitis. Which nursing action is the
highest priority?
A. Obtaining a throat culture
B. Monitoring oxygen saturation and airway patency
C. Initiating intravenous access
D. Assessing the child’s temperature rectally
Answer: B
Rationale: Epiglottitis is a medical emergency due to the risk of sudden airway
obstruction; maintaining a patent airway is the priority.
5. What is the primary dietary recommendation for a child diagnosed with
Celiac disease?
A. Low sodium diet
B. High protein diet
C. Gluten-free diet
D. Lactose-free diet
Answer: C
Rationale: Celiac disease is an immune reaction to eating gluten, a protein found in wheat,
barley, and rye.
, 6. A nurse is caring for a child with Tetralogy of Fallot who experiences a ‘tet
spell.’ Which position should the nurse place the child in?
A. Knee-chest position
B. Supine with legs elevated
C. High-Fowler’s position
D. Side-lying position
Answer: A
Rationale: The knee-chest position increases systemic vascular resistance, which helps
reduce the right-to-left shunt and improves oxygenation.
7. Which of the following is a classic sign of pyloric stenosis in an infant?
A. Currant jelly-like stools
B. Bile-stained emesis
C. Ribbon-like stools
D. Projectile vomiting
Answer: D
Rationale: Projectile vomiting after feeding is the hallmark sign of hypertrophic pyloric
stenosis due to the gastric outlet obstruction.
8. When administering digoxin to a pediatric patient, the nurse should withhold
the dose if the apical pulse is below what rate for an infant?
A. 110 bpm
B. 70 bpm
C. 90 bpm
D. 60 bpm
Answer: C
Rationale: Digoxin is typically withheld in infants if the heart rate is less than 90-110 bpm
to avoid bradycardia and toxicity.
