NR 328 Pediatric Nursing Final Exam Practice 2026 |Chamberlain
College
1. A 2-year-old child is admitted to the hospital with a diagnosis of epiglottitis.
Which of the following nursing actions is the priority?
A. Obtain a throat culture immediately
B. Place the child in a supine position
C. Administer an oral sedative to keep the child calm
D. Prepare intubation equipment at the bedside
Answer: D
Rationale: Epiglottitis is a medical emergency that can lead to sudden airway obstruction.
Intubation equipment should be readily available. Throat cultures and visual inspection of
the throat are contraindicated as they can trigger laryngospasm.
2. When assessing a 4-year-old child, the nurse notes the child uses short
sentences and is in the ‘Preoperational’ stage of development. This finding
aligns with whose theory?
A. Erikson
B. Kohlberg
C. Piaget
D. Freud
Answer: C
Rationale: Jean Piaget’s theory of cognitive development identifies the Preoperational
stage as occurring between ages 2 and 7 years.
,3. A school-age child with cystic fibrosis is being discharged. What should the
nurse include in the teaching regarding pancreatic enzyme replacement?
A. Administer enzymes once daily in the morning
B. Give enzymes with all meals and snacks
C. Dissolve the enzymes in a glass of warm milk
D. Avoid giving enzymes if the child is having fatty stools
Answer: B
Rationale: Pancreatic enzymes must be taken with every meal and snack to facilitate the
absorption of fat-soluble vitamins and nutrients in children with cystic fibrosis.
4. A nurse is caring for an infant who has undergone a surgical repair for a cleft
lip. Which position is most appropriate postoperatively?
A. Prone
B. Knee-chest
C. Trendelenburg
D. Supine or side-lying
Answer: D
Rationale: The infant should be placed on their back (supine) or side-lying on the side
opposite the repair to prevent the suture line from rubbing against the sheets.
5. The nurse is assessing a child with Tetralogy of Fallot who suddenly becomes
cyanotic and dyspneic. Which action should the nurse take first?
A. Place the child in the knee-chest position
B. Administer 100% oxygen via mask
C. Prepare to administer morphine sulfate
D. Call the rapid response team
Answer: A
Rationale: The knee-chest position increases systemic vascular resistance, which helps
reduce the right-to-left shunt and improves oxygenation during a ‘tet spell’.
, 6. What is the most common clinical manifestation of pyloric stenosis in an
infant?
A. Currant jelly stools
B. Steatorrhea
C. Projectile vomiting
D. Ribbon-like stools
Answer: C
Rationale: Hypertrophic pyloric stenosis typically presents with non-bilious projectile
vomiting after feedings, usually appearing between 3 to 5 weeks of age.
7. A nurse is teaching parents about SIDS prevention. Which statement by the
parents indicates an understanding of the teaching?
A. I will place my baby on their back to sleep
B. I will use a soft mattress with plenty of blankets
C. I will put my baby to sleep on their stomach
D. I will keep the room very warm so the baby doesn’t get cold
Answer: A
Rationale: The ‘Back to Sleep’ campaign recommends placing infants in the supine position
to reduce the risk of Sudden Infant Death Syndrome (SIDS).
8. A child is admitted with a suspected diagnosis of Wilms tumor. Which of the
following is a critical nursing precaution?
A. Do not palpate the abdomen
B. Maintain the child on strict bed rest
C. Palpate the abdomen every 4 hours for changes
D. Prepare the child for a lumbar puncture
Answer: A
Rationale: Palpation of the abdomen in a child with Wilms tumor should be avoided to
prevent accidental rupture of the tumor capsule and seeding of cancer cells.
College
1. A 2-year-old child is admitted to the hospital with a diagnosis of epiglottitis.
Which of the following nursing actions is the priority?
A. Obtain a throat culture immediately
B. Place the child in a supine position
C. Administer an oral sedative to keep the child calm
D. Prepare intubation equipment at the bedside
Answer: D
Rationale: Epiglottitis is a medical emergency that can lead to sudden airway obstruction.
Intubation equipment should be readily available. Throat cultures and visual inspection of
the throat are contraindicated as they can trigger laryngospasm.
2. When assessing a 4-year-old child, the nurse notes the child uses short
sentences and is in the ‘Preoperational’ stage of development. This finding
aligns with whose theory?
A. Erikson
B. Kohlberg
C. Piaget
D. Freud
Answer: C
Rationale: Jean Piaget’s theory of cognitive development identifies the Preoperational
stage as occurring between ages 2 and 7 years.
,3. A school-age child with cystic fibrosis is being discharged. What should the
nurse include in the teaching regarding pancreatic enzyme replacement?
A. Administer enzymes once daily in the morning
B. Give enzymes with all meals and snacks
C. Dissolve the enzymes in a glass of warm milk
D. Avoid giving enzymes if the child is having fatty stools
Answer: B
Rationale: Pancreatic enzymes must be taken with every meal and snack to facilitate the
absorption of fat-soluble vitamins and nutrients in children with cystic fibrosis.
4. A nurse is caring for an infant who has undergone a surgical repair for a cleft
lip. Which position is most appropriate postoperatively?
A. Prone
B. Knee-chest
C. Trendelenburg
D. Supine or side-lying
Answer: D
Rationale: The infant should be placed on their back (supine) or side-lying on the side
opposite the repair to prevent the suture line from rubbing against the sheets.
5. The nurse is assessing a child with Tetralogy of Fallot who suddenly becomes
cyanotic and dyspneic. Which action should the nurse take first?
A. Place the child in the knee-chest position
B. Administer 100% oxygen via mask
C. Prepare to administer morphine sulfate
D. Call the rapid response team
Answer: A
Rationale: The knee-chest position increases systemic vascular resistance, which helps
reduce the right-to-left shunt and improves oxygenation during a ‘tet spell’.
, 6. What is the most common clinical manifestation of pyloric stenosis in an
infant?
A. Currant jelly stools
B. Steatorrhea
C. Projectile vomiting
D. Ribbon-like stools
Answer: C
Rationale: Hypertrophic pyloric stenosis typically presents with non-bilious projectile
vomiting after feedings, usually appearing between 3 to 5 weeks of age.
7. A nurse is teaching parents about SIDS prevention. Which statement by the
parents indicates an understanding of the teaching?
A. I will place my baby on their back to sleep
B. I will use a soft mattress with plenty of blankets
C. I will put my baby to sleep on their stomach
D. I will keep the room very warm so the baby doesn’t get cold
Answer: A
Rationale: The ‘Back to Sleep’ campaign recommends placing infants in the supine position
to reduce the risk of Sudden Infant Death Syndrome (SIDS).
8. A child is admitted with a suspected diagnosis of Wilms tumor. Which of the
following is a critical nursing precaution?
A. Do not palpate the abdomen
B. Maintain the child on strict bed rest
C. Palpate the abdomen every 4 hours for changes
D. Prepare the child for a lumbar puncture
Answer: A
Rationale: Palpation of the abdomen in a child with Wilms tumor should be avoided to
prevent accidental rupture of the tumor capsule and seeding of cancer cells.
