NUR106 | NUR106 Pediatric Nursing Exam 1
Version 2 Questions with Correct Answers and
Expert Explanation for Each Question
1. When performing a physical assessment on a 2-year-old child, which of the
following techniques should the nurse use first?
A. Auscultate the heart and lungs
B. Check the child’s pupillary response
C. Obtain a rectal temperature
D. Observe the child while they play with a toy
Correct Answer: D
Expert Explanation: Assessment of a toddler should begin with non-invasive
observation to build rapport and decrease anxiety. Observing the child during play
allows the nurse to evaluate developmental milestones and respiratory status
without causing distress. More invasive procedures like auscultation should follow
after the child is comfortable with the nurse’s presence. Rectal temperatures and
other intrusive measures are always performed last to prevent a breakdown in
cooperation. This clinical sequence prioritizes the psychological needs of the
pediatric patient while ensuring accurate data collection.
,2. Which pain assessment tool is most appropriate for a 4-year-old child who is post-
operative?
A. Numeric Rating Scale (0-10)
B. Visual Analog Scale
C. Wong-Baker FACES Scale
D. CRIES Pain Scale
Correct Answer: C
Expert Explanation: The Wong-Baker FACES Scale is designed for children as
young as 3 years old because it uses visual representations of pain. A 4-year-old can
point to a face that represents how they feel even if they cannot quantify pain
numerically. The Numeric Rating Scale is usually reserved for older children and
adolescents who understand abstract concepts of numbers. The CRIES scale is
specifically intended for neonates in a clinical setting. Selecting the age-appropriate
tool ensures that the nurse receives an accurate assessment of the child’s pain level.
3. To assess the ear canal of a 2-year-old child, the nurse should pull the pinna in
which direction?
A. Up and back
B. Straight back
C. Down and back
,D. Down and forward
Correct Answer: C
Expert Explanation: In children under the age of 3, the auditory canal is shorter
and curved differently than in adults. Pulling the pinna down and back straightens
the canal for better visualization of the tympanic membrane. For children older than
3 years and adults, the pinna should be pulled up and back. Using the wrong
technique can lead to an incomplete assessment or discomfort for the child. This
anatomical difference is a critical component of pediatric physical examination
competency.
4. The nurse is educating parents on car seat safety for their newborn. Which
instruction is most accurate?
A. Place the car seat in the front seat if there is no passenger airbag
B. Use a forward-facing seat once the child reaches 1 year of age
C. Secure the harness straps loosely to allow for comfort
D. The car seat should be rear-facing in the back seat until age 2 or height limit
Correct Answer: D
Expert Explanation: Current safety guidelines recommend that infants remain in a
rear-facing car seat in the back seat until at least age 2. This position provides the
best protection for the child’s head, neck, and spine during a collision. Transitioning
, to a forward-facing seat too early increases the risk of serious injury. The harness
should be snug against the child’s body to ensure they are properly restrained.
Nurses play a vital role in injury prevention by reinforcing these evidence-based
safety standards to parents.
5. Which of the following findings during a physical exam of an 8-month-old infant
requires immediate follow-up?
A. A bulging anterior fontanelle while the infant is quiet
B. Closure of the posterior fontanelle
C. Positive Babinski reflex
D. Abdominal breathing
Correct Answer: A
Expert Explanation: A bulging fontanelle in a quiet infant suggests increased
intracranial pressure, which is a medical emergency. The posterior fontanelle
typically closes by 2 to 3 months of age, so its closure is normal at 8 months.
Abdominal breathing is a common finding in infants and is not usually a cause for
concern. A positive Babinski reflex is also considered normal in infants until about 1
to 2 years of age. Identifying abnormal neurological signs is a critical skill in
pediatric nursing assessment.
Version 2 Questions with Correct Answers and
Expert Explanation for Each Question
1. When performing a physical assessment on a 2-year-old child, which of the
following techniques should the nurse use first?
A. Auscultate the heart and lungs
B. Check the child’s pupillary response
C. Obtain a rectal temperature
D. Observe the child while they play with a toy
Correct Answer: D
Expert Explanation: Assessment of a toddler should begin with non-invasive
observation to build rapport and decrease anxiety. Observing the child during play
allows the nurse to evaluate developmental milestones and respiratory status
without causing distress. More invasive procedures like auscultation should follow
after the child is comfortable with the nurse’s presence. Rectal temperatures and
other intrusive measures are always performed last to prevent a breakdown in
cooperation. This clinical sequence prioritizes the psychological needs of the
pediatric patient while ensuring accurate data collection.
,2. Which pain assessment tool is most appropriate for a 4-year-old child who is post-
operative?
A. Numeric Rating Scale (0-10)
B. Visual Analog Scale
C. Wong-Baker FACES Scale
D. CRIES Pain Scale
Correct Answer: C
Expert Explanation: The Wong-Baker FACES Scale is designed for children as
young as 3 years old because it uses visual representations of pain. A 4-year-old can
point to a face that represents how they feel even if they cannot quantify pain
numerically. The Numeric Rating Scale is usually reserved for older children and
adolescents who understand abstract concepts of numbers. The CRIES scale is
specifically intended for neonates in a clinical setting. Selecting the age-appropriate
tool ensures that the nurse receives an accurate assessment of the child’s pain level.
3. To assess the ear canal of a 2-year-old child, the nurse should pull the pinna in
which direction?
A. Up and back
B. Straight back
C. Down and back
,D. Down and forward
Correct Answer: C
Expert Explanation: In children under the age of 3, the auditory canal is shorter
and curved differently than in adults. Pulling the pinna down and back straightens
the canal for better visualization of the tympanic membrane. For children older than
3 years and adults, the pinna should be pulled up and back. Using the wrong
technique can lead to an incomplete assessment or discomfort for the child. This
anatomical difference is a critical component of pediatric physical examination
competency.
4. The nurse is educating parents on car seat safety for their newborn. Which
instruction is most accurate?
A. Place the car seat in the front seat if there is no passenger airbag
B. Use a forward-facing seat once the child reaches 1 year of age
C. Secure the harness straps loosely to allow for comfort
D. The car seat should be rear-facing in the back seat until age 2 or height limit
Correct Answer: D
Expert Explanation: Current safety guidelines recommend that infants remain in a
rear-facing car seat in the back seat until at least age 2. This position provides the
best protection for the child’s head, neck, and spine during a collision. Transitioning
, to a forward-facing seat too early increases the risk of serious injury. The harness
should be snug against the child’s body to ensure they are properly restrained.
Nurses play a vital role in injury prevention by reinforcing these evidence-based
safety standards to parents.
5. Which of the following findings during a physical exam of an 8-month-old infant
requires immediate follow-up?
A. A bulging anterior fontanelle while the infant is quiet
B. Closure of the posterior fontanelle
C. Positive Babinski reflex
D. Abdominal breathing
Correct Answer: A
Expert Explanation: A bulging fontanelle in a quiet infant suggests increased
intracranial pressure, which is a medical emergency. The posterior fontanelle
typically closes by 2 to 3 months of age, so its closure is normal at 8 months.
Abdominal breathing is a common finding in infants and is not usually a cause for
concern. A positive Babinski reflex is also considered normal in infants until about 1
to 2 years of age. Identifying abnormal neurological signs is a critical skill in
pediatric nursing assessment.
