NR 328 Pediatric Nursing Exam Practice 2026/2027 Chamberlain
College
1. A nurse is assessing a 4-year-old child’s growth and development. According
to Erikson, which developmental task should the child be working on?
A. Initiative vs. Guilt
B. Industry vs. Inferiority
C. Autonomy vs. Shame and Doubt
D. Trust vs. Mistrust
Answer: A
Rationale: Preschool-age 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 interaction.
2. Which clinical manifestation is a hallmark sign of pyloric stenosis in an infant?
A. Currant jelly-like stools
B. Projectile vomiting after feedings
C. Abdominal distention and ribbon-like stools
D. Bile-stained emesis
Answer: B
Rationale: Hypertrophic pyloric stenosis typically presents with non-bile-stained
projectile vomiting shortly after feeding in infants between 2 and 8 weeks of age.
,3. A 10-month-old infant is brought to the clinic. The nurse notes the child
cannot sit steadily without support. How should the nurse interpret this
finding?
A. The infant is showing a delay in gross motor skills.
B. The infant is showing a slight delay in fine motor skills.
C. This is a normal finding for this age.
D. The infant needs an immediate neurological referral.
Answer: A
Rationale: Infants typically sit steadily without support by 8 months. Failure to do so by 10
months indicates a delay in gross motor development.
4. What is the priority nursing intervention for a child experiencing a cyanotic
‘Tet spell’ (hypercyanotic episode)?
A. Administer high-flow oxygen via mask.
B. Prepare for immediate intubation.
C. Place the child in a knee-chest position.
D. Administer intravenous morphine.
Answer: C
Rationale: Placing the child in a knee-chest position increases systemic vascular
resistance, which helps reduce the right-to-left shunt and improves oxygenation.
5. Which dietary instruction should the nurse provide to the parents of a child
with Celiac disease?
A. Avoid all dairy products.
B. Limit intake of simple sugars.
C. Increase intake of wheat and rye fibers.
D. Follow a strict gluten-free diet.
Answer: D
, Rationale: Celiac disease is a permanent intolerance to gluten (found in wheat, barley, rye,
and oats), requiring a lifelong gluten-free diet.
6. A nurse is caring for a child with nephrotic syndrome. Which of the following
is a classic clinical manifestation of this condition?
A. Gross hematuria and hypertension
B. Low serum cholesterol and high albumin
C. Polyuria and weight loss
D. Massive proteinuria and edema
Answer: D
Rationale: Nephrotic syndrome is characterized by massive proteinuria,
hypoalbuminemia, hyperlipidemia, and generalized edema.
7. When administering Digoxin to an infant, the nurse should withhold the dose
and notify the provider if the apical heart rate is below:
A. 60 beats per minute
B. 90 beats per minute
C. 100 beats per minute
D. 110 beats per minute
Answer: B
Rationale: In infants, Digoxin is generally withheld if the pulse is less than 90-110 bpm; in
older children, it is withheld if less than 70 bpm.
8. A 2-year-old is admitted with suspected intussusception. Which finding
during the assessment supports this diagnosis?
A. Hyperactive bowel sounds in all quadrants
B. A sausage-shaped mass in the upper right quadrant
C. Pain that radiates to the right shoulder
D. Constant, dull abdominal pain
Answer: B
College
1. A nurse is assessing a 4-year-old child’s growth and development. According
to Erikson, which developmental task should the child be working on?
A. Initiative vs. Guilt
B. Industry vs. Inferiority
C. Autonomy vs. Shame and Doubt
D. Trust vs. Mistrust
Answer: A
Rationale: Preschool-age 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 interaction.
2. Which clinical manifestation is a hallmark sign of pyloric stenosis in an infant?
A. Currant jelly-like stools
B. Projectile vomiting after feedings
C. Abdominal distention and ribbon-like stools
D. Bile-stained emesis
Answer: B
Rationale: Hypertrophic pyloric stenosis typically presents with non-bile-stained
projectile vomiting shortly after feeding in infants between 2 and 8 weeks of age.
,3. A 10-month-old infant is brought to the clinic. The nurse notes the child
cannot sit steadily without support. How should the nurse interpret this
finding?
A. The infant is showing a delay in gross motor skills.
B. The infant is showing a slight delay in fine motor skills.
C. This is a normal finding for this age.
D. The infant needs an immediate neurological referral.
Answer: A
Rationale: Infants typically sit steadily without support by 8 months. Failure to do so by 10
months indicates a delay in gross motor development.
4. What is the priority nursing intervention for a child experiencing a cyanotic
‘Tet spell’ (hypercyanotic episode)?
A. Administer high-flow oxygen via mask.
B. Prepare for immediate intubation.
C. Place the child in a knee-chest position.
D. Administer intravenous morphine.
Answer: C
Rationale: Placing the child in a knee-chest position increases systemic vascular
resistance, which helps reduce the right-to-left shunt and improves oxygenation.
5. Which dietary instruction should the nurse provide to the parents of a child
with Celiac disease?
A. Avoid all dairy products.
B. Limit intake of simple sugars.
C. Increase intake of wheat and rye fibers.
D. Follow a strict gluten-free diet.
Answer: D
, Rationale: Celiac disease is a permanent intolerance to gluten (found in wheat, barley, rye,
and oats), requiring a lifelong gluten-free diet.
6. A nurse is caring for a child with nephrotic syndrome. Which of the following
is a classic clinical manifestation of this condition?
A. Gross hematuria and hypertension
B. Low serum cholesterol and high albumin
C. Polyuria and weight loss
D. Massive proteinuria and edema
Answer: D
Rationale: Nephrotic syndrome is characterized by massive proteinuria,
hypoalbuminemia, hyperlipidemia, and generalized edema.
7. When administering Digoxin to an infant, the nurse should withhold the dose
and notify the provider if the apical heart rate is below:
A. 60 beats per minute
B. 90 beats per minute
C. 100 beats per minute
D. 110 beats per minute
Answer: B
Rationale: In infants, Digoxin is generally withheld if the pulse is less than 90-110 bpm; in
older children, it is withheld if less than 70 bpm.
8. A 2-year-old is admitted with suspected intussusception. Which finding
during the assessment supports this diagnosis?
A. Hyperactive bowel sounds in all quadrants
B. A sausage-shaped mass in the upper right quadrant
C. Pain that radiates to the right shoulder
D. Constant, dull abdominal pain
Answer: B
