Pediatric Nursing Practice Exam - NR 328 2026 |Chamberlain College
1. A 4-year-old child is admitted to the hospital with a diagnosis of epiglottitis.
Which of the following nursing interventions is most critical?
A. Obtain a throat culture immediately
B. Avoid any attempt to visualize the throat
C. Place the child in a supine position
D. Encourage the child to lie flat and drink fluids
Answer: B
Rationale: In a child with suspected epiglottitis, visualizing the throat with a tongue
depressor or obtaining a throat culture can trigger a laryngospasm and cause immediate
airway obstruction.
2. An infant is diagnosed with pyloric stenosis. What is the classic clinical
manifestation the nurse would expect to observe?
A. Currant jelly-like stools
B. Abdominal distention and bile-stained emesis
C. Steatorrhea and foul-smelling stools
D. Projectile vomiting after feeding
Answer: D
Rationale: Projectile vomiting is a hallmark sign of hypertrophic pyloric stenosis due to
the narrowing of the pyloric sphincter, preventing stomach contents from entering the
duodenum.
,3. A school-age child with Cystic Fibrosis is receiving pancreatic enzymes. The
nurse should teach the parents to administer these enzymes:
A. With every meal and every snack
B. Once daily in the morning before breakfast
C. Every evening at bedtime
D. Only if the child has a bowel movement
Answer: A
Rationale: Pancreatic enzymes are necessary to digest fats, proteins, and carbohydrates;
they must be taken with all meals and snacks to ensure adequate nutrient absorption.
4. Which of the following is a priority intervention for a child hospitalized with a
Vaso-occlusive Sickle Cell Crisis?
A. Aggressive pain management and hydration
B. Restriction of oral and IV fluids
C. Encouraging vigorous physical exercise
D. Administration of cold compresses to painful joints
Answer: A
Rationale: Management of sickle cell crisis focuses on hydration to reduce blood viscosity
and aggressive pain control to manage the extreme discomfort caused by ischemia.
5. A nurse is assessing a child with Tetralogy of Fallot who suddenly becomes
cyanotic and dyspneic. Which action should the nurse take first?
A. Administer a dose of Digoxin
B. Place the child in a knee-chest position
C. Prepare for immediate endotracheal intubation
D. Perform a chest percussion treatment
Answer: B
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. A 2-year-old is suspected of having Hirschsprung disease. Which stool
characteristic supports this diagnosis?
A. Ribbon-like, foul-smelling stools
B. Loose, watery stools with mucus
C. Large, bulky, greasy stools
D. Black, tarry stools
Answer: A
Rationale: In Hirschsprung disease, the lack of ganglionic cells in the colon leads to an
obstruction; as stool passes the narrow segment, it becomes ribbon-like.
7. When teaching parents about the care of a child with a Pavlik harness for Hip
Dysplasia, which instruction should the nurse include?
A. The harness should be worn 24 hours a day
B. Apply lotions or powders under the straps to prevent irritation
C. Remove the harness for diaper changes only
D. Adjust the straps every 2 hours at home
Answer: A
Rationale: The Pavlik harness is typically worn 24 hours a day to maintain the hip in
flexion and abduction; parents should not adjust the straps themselves.
8. Which laboratory finding would the nurse expect in a child with Nephrotic
Syndrome?
A. Low serum cholesterol
B. Hypoalbuminemia
C. Reduced urine specific gravity
D. Elevated serum protein
Answer: B
Rationale: Nephrotic syndrome is characterized by massive proteinuria, which leads to
low levels of albumin in the blood (hypoalbuminemia).
1. A 4-year-old child is admitted to the hospital with a diagnosis of epiglottitis.
Which of the following nursing interventions is most critical?
A. Obtain a throat culture immediately
B. Avoid any attempt to visualize the throat
C. Place the child in a supine position
D. Encourage the child to lie flat and drink fluids
Answer: B
Rationale: In a child with suspected epiglottitis, visualizing the throat with a tongue
depressor or obtaining a throat culture can trigger a laryngospasm and cause immediate
airway obstruction.
2. An infant is diagnosed with pyloric stenosis. What is the classic clinical
manifestation the nurse would expect to observe?
A. Currant jelly-like stools
B. Abdominal distention and bile-stained emesis
C. Steatorrhea and foul-smelling stools
D. Projectile vomiting after feeding
Answer: D
Rationale: Projectile vomiting is a hallmark sign of hypertrophic pyloric stenosis due to
the narrowing of the pyloric sphincter, preventing stomach contents from entering the
duodenum.
,3. A school-age child with Cystic Fibrosis is receiving pancreatic enzymes. The
nurse should teach the parents to administer these enzymes:
A. With every meal and every snack
B. Once daily in the morning before breakfast
C. Every evening at bedtime
D. Only if the child has a bowel movement
Answer: A
Rationale: Pancreatic enzymes are necessary to digest fats, proteins, and carbohydrates;
they must be taken with all meals and snacks to ensure adequate nutrient absorption.
4. Which of the following is a priority intervention for a child hospitalized with a
Vaso-occlusive Sickle Cell Crisis?
A. Aggressive pain management and hydration
B. Restriction of oral and IV fluids
C. Encouraging vigorous physical exercise
D. Administration of cold compresses to painful joints
Answer: A
Rationale: Management of sickle cell crisis focuses on hydration to reduce blood viscosity
and aggressive pain control to manage the extreme discomfort caused by ischemia.
5. A nurse is assessing a child with Tetralogy of Fallot who suddenly becomes
cyanotic and dyspneic. Which action should the nurse take first?
A. Administer a dose of Digoxin
B. Place the child in a knee-chest position
C. Prepare for immediate endotracheal intubation
D. Perform a chest percussion treatment
Answer: B
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. A 2-year-old is suspected of having Hirschsprung disease. Which stool
characteristic supports this diagnosis?
A. Ribbon-like, foul-smelling stools
B. Loose, watery stools with mucus
C. Large, bulky, greasy stools
D. Black, tarry stools
Answer: A
Rationale: In Hirschsprung disease, the lack of ganglionic cells in the colon leads to an
obstruction; as stool passes the narrow segment, it becomes ribbon-like.
7. When teaching parents about the care of a child with a Pavlik harness for Hip
Dysplasia, which instruction should the nurse include?
A. The harness should be worn 24 hours a day
B. Apply lotions or powders under the straps to prevent irritation
C. Remove the harness for diaper changes only
D. Adjust the straps every 2 hours at home
Answer: A
Rationale: The Pavlik harness is typically worn 24 hours a day to maintain the hip in
flexion and abduction; parents should not adjust the straps themselves.
8. Which laboratory finding would the nurse expect in a child with Nephrotic
Syndrome?
A. Low serum cholesterol
B. Hypoalbuminemia
C. Reduced urine specific gravity
D. Elevated serum protein
Answer: B
Rationale: Nephrotic syndrome is characterized by massive proteinuria, which leads to
low levels of albumin in the blood (hypoalbuminemia).
