NR328
EXAM II
PEDIATRIC NURSING
100% Exam-Style Questions
Pediatric Nursing | NCLEX-Style | Exam-Focused
✔ 100% exam-style multiple-choice questions
✔ NCLEX-style clinical judgment questions
✔ Select-All-That-Apply (SATA) questions
✔ Pediatric acute and chronic illness scenarios
✔ Renal disorders (nephrotic syndrome, glomerulonephritis)
✔ Hematologic conditions (sickle cell disease, leukemia, iron disorders)
✔ Respiratory conditions (croup, bronchiolitis, asthma, epiglottitis)
✔ Gastrointestinal disorders (intussusception, pyloric stenosis, Hirschsprung disease)
✔ Infectious and inflammatory diseases (Kawasaki disease, meningitis)
✔ Endocrine and metabolic conditions (type 1 diabetes, hypothyroidism)
✔ Postoperative pediatric nursing care
✔ Emergency and priority nursing interventions
✔ Medication administration and safety principles
✔ Growth and developmental assessment integration
✔ Clear identification of correct answers
✔ Exam-level difficulty aligned with NR328 Exam 2
✔ No filler, no repetition, no outdated content
This study guide is an independent educational resource and is not affiliated with or endorsed by any academic institution. It is intended for exam preparation
purposes only.
1
© 2026. All rights reserved. Unauthorized distribution is prohibited.
, _____1. A 4-year-old child is brought to the pediatric clinic by a parent who reports that the
child has been experiencing intermittent episodes of periorbital edema, fatigue, and foamy urine
over the past two weeks. Blood pressure is 100/65 mm Hg, and the child appears mildly
edematous around the eyes and ankles. Urinalysis reveals 4+ proteinuria and the serum albumin
level is 1.8 g/dL. Which of the following is the most likely diagnosis?
A) Acute poststreptococcal glomerulonephritis
B) Nephrotic syndrome – Correct answer✅✅
C) Urinary tract infection
D) Henoch-Schönlein purpura
_____2. A 6-month-old infant is admitted to the pediatric unit with severe dehydration
secondary to acute gastroenteritis. The infant weighs 7 kg, and the physician orders fluid
resuscitation with isotonic saline. Which of the following is the most appropriate initial fluid
bolus?
A) 70 mL over 10 minutes
B) 140 mL over 20 minutes – Correct answer✅✅
C) 210 mL over 30 minutes
D) 350 mL over 60 minutes
_____3. The nurse is caring for a 10-year-old child newly diagnosed with type 1 diabetes
mellitus. The child's blood glucose at bedtime is 248 mg/dL, and the parent asks whether the
child should receive insulin at this time. Which of the following is the most appropriate nursing
response?
A) Hold the insulin and recheck the blood glucose in the morning
B) Administer the prescribed sliding-scale rapid-acting insulin as ordered – Correct
answer✅✅
C) Give the child a carbohydrate-containing snack to prevent hypoglycemia during the
night
D) Administer half the usual dose of long-acting insulin to avoid overnight hypoglycemia
_____4. A 3-year-old child with a history of iron deficiency anemia is seen in the clinic for a
follow-up visit after three months of oral iron supplementation. The parents report that the
child's appetite has improved and the child seems more active. Which of the following
laboratory findings would best indicate that the iron therapy has been effective?
A) Hemoglobin of 11.5 g/dL and reticulocyte count of 2.5% – Correct answer✅✅
B) Hemoglobin of 10.2 g/dL and ferritin level of 8 ng/mL
C) Hemoglobin of 12.8 g/dL and total iron-binding capacity of 480 mcg/dL
D) Hemoglobin of 11.0 g/dL and mean corpuscular volume of 72 fL
_____5. A nurse is providing discharge teaching to the parents of a 2-year-old child who has
undergone surgical repair of a ventricular septal defect. Which of the following statements by a
parent indicates that further teaching is needed?
A) We will give the acetaminophen as prescribed for pain management
This study guide is an independent educational resource and is not affiliated with or endorsed by any academic institution. It is intended for exam preparation
purposes only.
2
© 2026. All rights reserved. Unauthorized distribution is prohibited.
, B) We will avoid large crowds and people who are ill for the next few weeks – Correct
answer✅✅
C) We will keep the incision clean and dry and report any signs of redness or drainage
D) We will encourage our child to participate in quiet play activities and limit strenuous
activity
_____6. The nurse is assessing a 5-year-old child with suspected acute lymphoblastic leukemia.
Which of the following clinical manifestations would the nurse most likely observe?
A) Polycythemia, splenomegaly, and hypertension
B) Pallor, petechiae, and hepatosplenomegaly – Correct answer✅✅
C) Bradycardia, cyanosis, and clubbing of fingers
D) Hyperactivity, tachypnea, and bounding peripheral pulses
_____7. A 12-year-old child with sickle cell disease presents to the emergency department with
severe pain in the lower extremities, fever of 38.9 degrees Celsius, and tachycardia. Which of the
following interventions should the nurse anticipate as the priority?
A) Administering oral ibuprofen and applying warm compresses to the affected areas
B) Initiating intravenous hydration with normal saline and administering parenteral opioid
analgesics – Correct answer✅✅
C) Administering oxygen at 4 L per nasal cannula and obtaining a chest radiograph
D) Preparing the child for an immediate exchange transfusion
_____8. A nurse is caring for an 8-month-old infant with bronchiolitis caused by respiratory
syncytial virus. Which of the following nursing interventions is most appropriate for this child?
A) Administering prescribed bronchodilators via nebulizer before each feeding
B) Maintaining the infant in a supine position to facilitate drainage of secretions
C) Providing frequent small feedings and monitoring for signs of aspiration – Correct
answer✅✅
D) Suctioning the nasopharynx every 30 minutes to maintain airway patency
_____9. The nurse is assessing a newborn infant with suspected congenital hypothyroidism.
Which of the following findings would most strongly support this diagnosis?
A) Hypertonia, hyperreflexia, and tachycardia
B) Prolonged jaundice, macroglossia, and poor feeding – Correct answer✅✅
C) Microcephaly, prominent occiput, and downward-slanting palpebral fissures
D) Low-set ears, webbed neck, and widely spaced nipples
_____10. A 7-year-old child is being evaluated for suspected juvenile idiopathic arthritis. Which
of the following findings would the nurse expect to assess?
A) Asymmetric joint involvement with morning stiffness lasting less than 15 minutes
B) Symmetric joint swelling, warmth, and morning stiffness lasting more than one hour –
Correct answer✅✅
This study guide is an independent educational resource and is not affiliated with or endorsed by any academic institution. It is intended for exam preparation
purposes only.
3
© 2026. All rights reserved. Unauthorized distribution is prohibited.
, C) Migratory polyarthritis with fever and a history of a recent streptococcal infection
D) Hemarthrosis and prolonged bleeding time following minor joint trauma
_____11. The nurse is providing preoperative teaching to the parents of a 14-month-old child
scheduled for a hypospadias repair. Which of the following postoperative instructions is most
important for the nurse to include?
A) The child should be placed in a supine position with the hips elevated for 48 hours after
surgery
B) Double diapering should be avoided because it increases the risk of infection at the
surgical site – Correct answer✅✅
C) The child may return to daycare two days after discharge provided there is no fever
D) Tub baths are permitted beginning on the third postoperative day to promote healing
_____12. A nurse is assessing a 4-year-old child with suspected Kawasaki disease. Which of the
following clinical manifestations is required to establish the diagnosis?
A) Desquamation of the hands and feet beginning within the first 48 hours of fever
B) Cervical lymphadenopathy exceeding 1.5 cm in diameter, usually unilateral – Correct
answer✅✅
C) Conjunctival injection with exudate and photophobia
D) Polymorphous rash predominantly on the trunk and extremities with pruritus
_____13. A 9-month-old infant is brought to the emergency department with signs of increased
intracranial pressure, including a bulging anterior fontanel, vomiting, and irritability. The nurse
should anticipate that the physician will order which of the following as the initial diagnostic
test?
A) Computed tomography scan of the head – Correct answer✅✅
B) Lumbar puncture for cerebrospinal fluid analysis
C) Magnetic resonance imaging of the brain with contrast
D) Skull radiographs in the anteroposterior and lateral views
_____14. The nurse is caring for a 6-year-old child who has just returned from the postanesthesia
care unit after an appendectomy for a ruptured appendix. Which of the following nursing
interventions is the priority at this time?
A) Encouraging the child to deep breathe and cough every two hours while awake
B) Assessing the child's level of consciousness, airway patency, and vital signs – Correct
answer✅✅
C) Administering intravenous antibiotics within the first hour of arrival on the unit
D) Offering clear fluids and advancing the diet as tolerated
_____15. A nurse is teaching the parents of a 3-year-old child with cystic fibrosis about pancreatic
enzyme replacement therapy. Which of the following statements by a parent indicates an
understanding of the teaching?
This study guide is an independent educational resource and is not affiliated with or endorsed by any academic institution. It is intended for exam preparation
purposes only.
4
© 2026. All rights reserved. Unauthorized distribution is prohibited.
EXAM II
PEDIATRIC NURSING
100% Exam-Style Questions
Pediatric Nursing | NCLEX-Style | Exam-Focused
✔ 100% exam-style multiple-choice questions
✔ NCLEX-style clinical judgment questions
✔ Select-All-That-Apply (SATA) questions
✔ Pediatric acute and chronic illness scenarios
✔ Renal disorders (nephrotic syndrome, glomerulonephritis)
✔ Hematologic conditions (sickle cell disease, leukemia, iron disorders)
✔ Respiratory conditions (croup, bronchiolitis, asthma, epiglottitis)
✔ Gastrointestinal disorders (intussusception, pyloric stenosis, Hirschsprung disease)
✔ Infectious and inflammatory diseases (Kawasaki disease, meningitis)
✔ Endocrine and metabolic conditions (type 1 diabetes, hypothyroidism)
✔ Postoperative pediatric nursing care
✔ Emergency and priority nursing interventions
✔ Medication administration and safety principles
✔ Growth and developmental assessment integration
✔ Clear identification of correct answers
✔ Exam-level difficulty aligned with NR328 Exam 2
✔ No filler, no repetition, no outdated content
This study guide is an independent educational resource and is not affiliated with or endorsed by any academic institution. It is intended for exam preparation
purposes only.
1
© 2026. All rights reserved. Unauthorized distribution is prohibited.
, _____1. A 4-year-old child is brought to the pediatric clinic by a parent who reports that the
child has been experiencing intermittent episodes of periorbital edema, fatigue, and foamy urine
over the past two weeks. Blood pressure is 100/65 mm Hg, and the child appears mildly
edematous around the eyes and ankles. Urinalysis reveals 4+ proteinuria and the serum albumin
level is 1.8 g/dL. Which of the following is the most likely diagnosis?
A) Acute poststreptococcal glomerulonephritis
B) Nephrotic syndrome – Correct answer✅✅
C) Urinary tract infection
D) Henoch-Schönlein purpura
_____2. A 6-month-old infant is admitted to the pediatric unit with severe dehydration
secondary to acute gastroenteritis. The infant weighs 7 kg, and the physician orders fluid
resuscitation with isotonic saline. Which of the following is the most appropriate initial fluid
bolus?
A) 70 mL over 10 minutes
B) 140 mL over 20 minutes – Correct answer✅✅
C) 210 mL over 30 minutes
D) 350 mL over 60 minutes
_____3. The nurse is caring for a 10-year-old child newly diagnosed with type 1 diabetes
mellitus. The child's blood glucose at bedtime is 248 mg/dL, and the parent asks whether the
child should receive insulin at this time. Which of the following is the most appropriate nursing
response?
A) Hold the insulin and recheck the blood glucose in the morning
B) Administer the prescribed sliding-scale rapid-acting insulin as ordered – Correct
answer✅✅
C) Give the child a carbohydrate-containing snack to prevent hypoglycemia during the
night
D) Administer half the usual dose of long-acting insulin to avoid overnight hypoglycemia
_____4. A 3-year-old child with a history of iron deficiency anemia is seen in the clinic for a
follow-up visit after three months of oral iron supplementation. The parents report that the
child's appetite has improved and the child seems more active. Which of the following
laboratory findings would best indicate that the iron therapy has been effective?
A) Hemoglobin of 11.5 g/dL and reticulocyte count of 2.5% – Correct answer✅✅
B) Hemoglobin of 10.2 g/dL and ferritin level of 8 ng/mL
C) Hemoglobin of 12.8 g/dL and total iron-binding capacity of 480 mcg/dL
D) Hemoglobin of 11.0 g/dL and mean corpuscular volume of 72 fL
_____5. A nurse is providing discharge teaching to the parents of a 2-year-old child who has
undergone surgical repair of a ventricular septal defect. Which of the following statements by a
parent indicates that further teaching is needed?
A) We will give the acetaminophen as prescribed for pain management
This study guide is an independent educational resource and is not affiliated with or endorsed by any academic institution. It is intended for exam preparation
purposes only.
2
© 2026. All rights reserved. Unauthorized distribution is prohibited.
, B) We will avoid large crowds and people who are ill for the next few weeks – Correct
answer✅✅
C) We will keep the incision clean and dry and report any signs of redness or drainage
D) We will encourage our child to participate in quiet play activities and limit strenuous
activity
_____6. The nurse is assessing a 5-year-old child with suspected acute lymphoblastic leukemia.
Which of the following clinical manifestations would the nurse most likely observe?
A) Polycythemia, splenomegaly, and hypertension
B) Pallor, petechiae, and hepatosplenomegaly – Correct answer✅✅
C) Bradycardia, cyanosis, and clubbing of fingers
D) Hyperactivity, tachypnea, and bounding peripheral pulses
_____7. A 12-year-old child with sickle cell disease presents to the emergency department with
severe pain in the lower extremities, fever of 38.9 degrees Celsius, and tachycardia. Which of the
following interventions should the nurse anticipate as the priority?
A) Administering oral ibuprofen and applying warm compresses to the affected areas
B) Initiating intravenous hydration with normal saline and administering parenteral opioid
analgesics – Correct answer✅✅
C) Administering oxygen at 4 L per nasal cannula and obtaining a chest radiograph
D) Preparing the child for an immediate exchange transfusion
_____8. A nurse is caring for an 8-month-old infant with bronchiolitis caused by respiratory
syncytial virus. Which of the following nursing interventions is most appropriate for this child?
A) Administering prescribed bronchodilators via nebulizer before each feeding
B) Maintaining the infant in a supine position to facilitate drainage of secretions
C) Providing frequent small feedings and monitoring for signs of aspiration – Correct
answer✅✅
D) Suctioning the nasopharynx every 30 minutes to maintain airway patency
_____9. The nurse is assessing a newborn infant with suspected congenital hypothyroidism.
Which of the following findings would most strongly support this diagnosis?
A) Hypertonia, hyperreflexia, and tachycardia
B) Prolonged jaundice, macroglossia, and poor feeding – Correct answer✅✅
C) Microcephaly, prominent occiput, and downward-slanting palpebral fissures
D) Low-set ears, webbed neck, and widely spaced nipples
_____10. A 7-year-old child is being evaluated for suspected juvenile idiopathic arthritis. Which
of the following findings would the nurse expect to assess?
A) Asymmetric joint involvement with morning stiffness lasting less than 15 minutes
B) Symmetric joint swelling, warmth, and morning stiffness lasting more than one hour –
Correct answer✅✅
This study guide is an independent educational resource and is not affiliated with or endorsed by any academic institution. It is intended for exam preparation
purposes only.
3
© 2026. All rights reserved. Unauthorized distribution is prohibited.
, C) Migratory polyarthritis with fever and a history of a recent streptococcal infection
D) Hemarthrosis and prolonged bleeding time following minor joint trauma
_____11. The nurse is providing preoperative teaching to the parents of a 14-month-old child
scheduled for a hypospadias repair. Which of the following postoperative instructions is most
important for the nurse to include?
A) The child should be placed in a supine position with the hips elevated for 48 hours after
surgery
B) Double diapering should be avoided because it increases the risk of infection at the
surgical site – Correct answer✅✅
C) The child may return to daycare two days after discharge provided there is no fever
D) Tub baths are permitted beginning on the third postoperative day to promote healing
_____12. A nurse is assessing a 4-year-old child with suspected Kawasaki disease. Which of the
following clinical manifestations is required to establish the diagnosis?
A) Desquamation of the hands and feet beginning within the first 48 hours of fever
B) Cervical lymphadenopathy exceeding 1.5 cm in diameter, usually unilateral – Correct
answer✅✅
C) Conjunctival injection with exudate and photophobia
D) Polymorphous rash predominantly on the trunk and extremities with pruritus
_____13. A 9-month-old infant is brought to the emergency department with signs of increased
intracranial pressure, including a bulging anterior fontanel, vomiting, and irritability. The nurse
should anticipate that the physician will order which of the following as the initial diagnostic
test?
A) Computed tomography scan of the head – Correct answer✅✅
B) Lumbar puncture for cerebrospinal fluid analysis
C) Magnetic resonance imaging of the brain with contrast
D) Skull radiographs in the anteroposterior and lateral views
_____14. The nurse is caring for a 6-year-old child who has just returned from the postanesthesia
care unit after an appendectomy for a ruptured appendix. Which of the following nursing
interventions is the priority at this time?
A) Encouraging the child to deep breathe and cough every two hours while awake
B) Assessing the child's level of consciousness, airway patency, and vital signs – Correct
answer✅✅
C) Administering intravenous antibiotics within the first hour of arrival on the unit
D) Offering clear fluids and advancing the diet as tolerated
_____15. A nurse is teaching the parents of a 3-year-old child with cystic fibrosis about pancreatic
enzyme replacement therapy. Which of the following statements by a parent indicates an
understanding of the teaching?
This study guide is an independent educational resource and is not affiliated with or endorsed by any academic institution. It is intended for exam preparation
purposes only.
4
© 2026. All rights reserved. Unauthorized distribution is prohibited.
