NR328
FINAL EXAM
PEDIATRIC NURSING
100% Exam-Style Questions
Pediatric Nursing | NCLEX-Style | Exam-Focused
✔ 100% exam-style and NCLEX-style questions
✔ Cumulative coverage of Exam 1, Exam 2, and Exam 3 content
✔ Growth & development across all pediatric age groups
✔ Acute and chronic pediatric conditions (all major body systems)
✔ Emergency, priority, and safety-based nursing decisions
✔ Medication administration and pediatric dosage principles
✔ Fluid, electrolyte, and infection control concepts
✔ Family-centered care, ethics, and legal considerations
✔ High-level clinical judgment and prioritization
✔ Correct and verified answers included
“This final exam resource is designed to reflect the true scope, depth, and challenge of the NR328 Pediatric
Nursing Final Exam. Every question emphasizes critical thinking, clinical judgment, and safe pediatric care,
helping you integrate knowledge across all course concepts. Use this guide to strengthen your confidence,
refine your decision-making, and approach the final exam with clarity and readiness.”
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 nurse is assessing a 12-month-old infant during a well-child visit. Which
developmental milestone should the nurse expect the infant to have achieved?
A) Building a tower of three blocks
B) Using a pincer grasp to pick up a small object – Correct answer✅✅
C) Walking independently up stairs
D) Speaking in two-word phrases
_____2. A nurse is providing discharge teaching to the parents of a toddler who has undergone
surgical repair of a ventricular septal defect. Which statement by a parent indicates a need for
further instruction?
A) We will give our child the prescribed pain medication every four hours as needed.
B) We will allow our child to play quietly with toys on the floor.
C) We will avoid large crowds and people who are ill for the next few weeks. – Correct
answer✅✅
D) We will keep the incision clean and dry until it is completely healed.
_____3. A 4-year-old child is admitted to the pediatric unit with a diagnosis of acute
lymphoblastic leukemia. The child appears pale and anemic. Which nursing intervention is most
appropriate to address the child's anemia?
A) Encourage foods rich in complex carbohydrates
B) Plan for frequent rest periods throughout the day – Correct answer✅✅
C) Restrict fluids to prevent fluid overload
D) Implement strict contact isolation precautions
_____4. A nurse is caring for an 8-month-old infant with hydrocephalus who recently had a
ventriculoperitoneal shunt placed. Which finding requires immediate notification of the
healthcare provider?
A) The anterior fontanel is soft and flat when the infant is upright
B) The infant is irritable and the anterior fontanel is tense and bulging – Correct
answer✅✅
C) The infant exhibits a high-pitched cry when being undressed
D) The dressing over the shunt tract has a small amount of serosanguineous drainage
_____5. A nurse is assessing a 3-year-old child with suspected intussusception. Which clinical
manifestation is most commonly associated with this condition?
A) Ribbon-like stools
B) Projectile vomiting without nausea
C) Intermittent colicky abdominal pain with drawing up of the knees – Correct
answer✅✅
D) Massive hematemesis
_____6. A nurse is teaching the parents of a 2-year-old toddler about appropriate discipline.
Which statement by the nurse is most consistent with current developmental guidance?
A) Time-out sessions should last for 10 minutes to ensure the child understands the
consequence.
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) Praise the child for desired behaviors and use redirection for undesired behaviors. –
Correct answer✅✅
C) Spanking is an effective last resort when other methods have failed.
D) Explain in detail why the behavior is wrong so the child can logically process the
situation.
_____7. A 10-year-old child is newly diagnosed with type 1 diabetes mellitus. The nurse is
teaching the child and parents about insulin administration. Which statement by the parents
demonstrates an accurate understanding of the teaching?
A) We will inject the insulin into the muscle of the thigh for the fastest absorption.
B) We should rotate injection sites to prevent lipohypertrophy. – Correct answer✅✅
C) We will store all of our open insulin pens in the freezer to keep them fresh.
D) We only need to monitor blood glucose levels when our child feels symptomatic.
_____8. A nurse is caring for a 6-year-old child with nephrotic syndrome. Which nursing
intervention is most critical for this child?
A) Encouraging a high-protein, high-sodium diet to replace losses
B) Measuring abdominal girth and weighing the child daily – Correct answer✅✅
C) Restricting all fluids to prevent severe hypertension
D) Placing the child in semi-Fowler's position to reduce peripheral edema
_____9. A 5-year-old child is brought to the emergency department after ingesting an unknown
amount of a household cleaner. The child is alert and oriented. Which action should the nurse
take first?
A) Administer activated charcoal immediately
B) Induce vomiting using syrup of ipecac
C) Assess the child's airway, breathing, and circulation – Correct answer✅✅
D) Perform a gastric lavage to remove the substance
_____10. A nurse is preparing to administer a prescribed medication to a 15-month-old toddler.
Which approach is most appropriate for the nurse to use?
A) Tell the toddler the medicine will taste good even if it does not
B) Offer the toddler a choice between taking the medicine orally or as an injection
C) Use a firm tone of voice and hold the toddler down securely
D) Administer the medication using a syringe directed toward the inner cheek – Correct
answer✅✅
_____11. A nurse is assessing a newborn infant for signs of developmental dysplasia of the hip.
Which finding would the nurse identify as a positive Ortolani sign?
A) An audible click felt when the femoral head is abducted and lifted
B) A palpable "clunk" when the adducted hip is gently pushed posteriorly
C) Unequal gluteal skin folds and a shortened affected limb
D) Limited range of motion in the affected hip during passive flexion – Correct
answer✅✅
_____12. A child with cystic fibrosis is receiving pancreatic enzyme replacement therapy. Which
instruction should the nurse include in the teaching plan for the parents?
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.
, A) Administer the enzymes on an empty stomach to enhance absorption.
B) Decrease the enzyme dosage if the child experiences steatorrhea.
C) Give the enzyme supplements with all meals and snacks containing fat. – Correct
answer✅✅
D) Mix the enzymes in hot cereal to mask the taste for the toddler.
_____13. A nurse is caring for a 7-year-old child who is undergoing chemotherapy and
experiencing severe mucositis. Which intervention should the nurse implement to promote oral
comfort and nutrition?
A) Provide lemon-glycerin swabs to clean the oral mucosa
B) Encourage the child to eat spicy foods to stimulate saliva production
C) Offer soft, bland, and lukewarm or cool foods – Correct answer✅✅
D) Instruct the child to use a firm-bristled toothbrush to remove plaque
_____14. A 4-year-old child is admitted to the hospital with a diagnosis of Kawasaki disease.
Which clinical manifestation is most characteristic of this illness during the acute phase?
A) Desquamation of the hands and feet
B) Strawberry tongue and bilateral conjunctival injection without exudate – Correct
answer✅✅
C) Joint pain and swelling in the large joints
D) A maculopapular rash that peels in large sheets
_____15. A nurse is providing preoperative teaching to the parents of a 14-month-old toddler
scheduled for a cleft palate repair. Which statement by the nurse is most accurate regarding
postoperative care?
A) Your child will be placed in arm restraints to prevent injury to the surgical site. –
Correct answer✅✅
B) You may use a straw to give your child fluids to prevent spillage on the incision.
C) It is safe to give your child hard foods like cookies once the numbness wears off.
D) We will place your child in a prone position to facilitate drainage.
_____16. A nurse is assessing a 9-month-old infant for signs of iron deficiency anemia. Which
finding is most consistent with this diagnosis?
A) Polycythemia and a ruddy complexion
B) Pallor, lethargy, and a preference for non-nutritive substances – Correct answer✅✅
C) Generalized edema and distended abdomen
D) Yellowish tint to the skin and sclera
_____17. A nurse is caring for a 12-year-old adolescent who is diagnosed with scoliosis and fitted
for a Milwaukee brace. Which statement by the adolescent indicates a need for further
emotional support?
A) I will wear a tight undershirt under the brace to prevent skin breakdown.
B) I can take the brace off for an hour a day to shower and do my back exercises.
C) I am never going to wear this to school because everyone will stare at me. – Correct
answer✅✅
D) I understand I need to wear this brace for most of the day to stop my curve from getting
worse.
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.
FINAL EXAM
PEDIATRIC NURSING
100% Exam-Style Questions
Pediatric Nursing | NCLEX-Style | Exam-Focused
✔ 100% exam-style and NCLEX-style questions
✔ Cumulative coverage of Exam 1, Exam 2, and Exam 3 content
✔ Growth & development across all pediatric age groups
✔ Acute and chronic pediatric conditions (all major body systems)
✔ Emergency, priority, and safety-based nursing decisions
✔ Medication administration and pediatric dosage principles
✔ Fluid, electrolyte, and infection control concepts
✔ Family-centered care, ethics, and legal considerations
✔ High-level clinical judgment and prioritization
✔ Correct and verified answers included
“This final exam resource is designed to reflect the true scope, depth, and challenge of the NR328 Pediatric
Nursing Final Exam. Every question emphasizes critical thinking, clinical judgment, and safe pediatric care,
helping you integrate knowledge across all course concepts. Use this guide to strengthen your confidence,
refine your decision-making, and approach the final exam with clarity and readiness.”
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 nurse is assessing a 12-month-old infant during a well-child visit. Which
developmental milestone should the nurse expect the infant to have achieved?
A) Building a tower of three blocks
B) Using a pincer grasp to pick up a small object – Correct answer✅✅
C) Walking independently up stairs
D) Speaking in two-word phrases
_____2. A nurse is providing discharge teaching to the parents of a toddler who has undergone
surgical repair of a ventricular septal defect. Which statement by a parent indicates a need for
further instruction?
A) We will give our child the prescribed pain medication every four hours as needed.
B) We will allow our child to play quietly with toys on the floor.
C) We will avoid large crowds and people who are ill for the next few weeks. – Correct
answer✅✅
D) We will keep the incision clean and dry until it is completely healed.
_____3. A 4-year-old child is admitted to the pediatric unit with a diagnosis of acute
lymphoblastic leukemia. The child appears pale and anemic. Which nursing intervention is most
appropriate to address the child's anemia?
A) Encourage foods rich in complex carbohydrates
B) Plan for frequent rest periods throughout the day – Correct answer✅✅
C) Restrict fluids to prevent fluid overload
D) Implement strict contact isolation precautions
_____4. A nurse is caring for an 8-month-old infant with hydrocephalus who recently had a
ventriculoperitoneal shunt placed. Which finding requires immediate notification of the
healthcare provider?
A) The anterior fontanel is soft and flat when the infant is upright
B) The infant is irritable and the anterior fontanel is tense and bulging – Correct
answer✅✅
C) The infant exhibits a high-pitched cry when being undressed
D) The dressing over the shunt tract has a small amount of serosanguineous drainage
_____5. A nurse is assessing a 3-year-old child with suspected intussusception. Which clinical
manifestation is most commonly associated with this condition?
A) Ribbon-like stools
B) Projectile vomiting without nausea
C) Intermittent colicky abdominal pain with drawing up of the knees – Correct
answer✅✅
D) Massive hematemesis
_____6. A nurse is teaching the parents of a 2-year-old toddler about appropriate discipline.
Which statement by the nurse is most consistent with current developmental guidance?
A) Time-out sessions should last for 10 minutes to ensure the child understands the
consequence.
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) Praise the child for desired behaviors and use redirection for undesired behaviors. –
Correct answer✅✅
C) Spanking is an effective last resort when other methods have failed.
D) Explain in detail why the behavior is wrong so the child can logically process the
situation.
_____7. A 10-year-old child is newly diagnosed with type 1 diabetes mellitus. The nurse is
teaching the child and parents about insulin administration. Which statement by the parents
demonstrates an accurate understanding of the teaching?
A) We will inject the insulin into the muscle of the thigh for the fastest absorption.
B) We should rotate injection sites to prevent lipohypertrophy. – Correct answer✅✅
C) We will store all of our open insulin pens in the freezer to keep them fresh.
D) We only need to monitor blood glucose levels when our child feels symptomatic.
_____8. A nurse is caring for a 6-year-old child with nephrotic syndrome. Which nursing
intervention is most critical for this child?
A) Encouraging a high-protein, high-sodium diet to replace losses
B) Measuring abdominal girth and weighing the child daily – Correct answer✅✅
C) Restricting all fluids to prevent severe hypertension
D) Placing the child in semi-Fowler's position to reduce peripheral edema
_____9. A 5-year-old child is brought to the emergency department after ingesting an unknown
amount of a household cleaner. The child is alert and oriented. Which action should the nurse
take first?
A) Administer activated charcoal immediately
B) Induce vomiting using syrup of ipecac
C) Assess the child's airway, breathing, and circulation – Correct answer✅✅
D) Perform a gastric lavage to remove the substance
_____10. A nurse is preparing to administer a prescribed medication to a 15-month-old toddler.
Which approach is most appropriate for the nurse to use?
A) Tell the toddler the medicine will taste good even if it does not
B) Offer the toddler a choice between taking the medicine orally or as an injection
C) Use a firm tone of voice and hold the toddler down securely
D) Administer the medication using a syringe directed toward the inner cheek – Correct
answer✅✅
_____11. A nurse is assessing a newborn infant for signs of developmental dysplasia of the hip.
Which finding would the nurse identify as a positive Ortolani sign?
A) An audible click felt when the femoral head is abducted and lifted
B) A palpable "clunk" when the adducted hip is gently pushed posteriorly
C) Unequal gluteal skin folds and a shortened affected limb
D) Limited range of motion in the affected hip during passive flexion – Correct
answer✅✅
_____12. A child with cystic fibrosis is receiving pancreatic enzyme replacement therapy. Which
instruction should the nurse include in the teaching plan for the parents?
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.
, A) Administer the enzymes on an empty stomach to enhance absorption.
B) Decrease the enzyme dosage if the child experiences steatorrhea.
C) Give the enzyme supplements with all meals and snacks containing fat. – Correct
answer✅✅
D) Mix the enzymes in hot cereal to mask the taste for the toddler.
_____13. A nurse is caring for a 7-year-old child who is undergoing chemotherapy and
experiencing severe mucositis. Which intervention should the nurse implement to promote oral
comfort and nutrition?
A) Provide lemon-glycerin swabs to clean the oral mucosa
B) Encourage the child to eat spicy foods to stimulate saliva production
C) Offer soft, bland, and lukewarm or cool foods – Correct answer✅✅
D) Instruct the child to use a firm-bristled toothbrush to remove plaque
_____14. A 4-year-old child is admitted to the hospital with a diagnosis of Kawasaki disease.
Which clinical manifestation is most characteristic of this illness during the acute phase?
A) Desquamation of the hands and feet
B) Strawberry tongue and bilateral conjunctival injection without exudate – Correct
answer✅✅
C) Joint pain and swelling in the large joints
D) A maculopapular rash that peels in large sheets
_____15. A nurse is providing preoperative teaching to the parents of a 14-month-old toddler
scheduled for a cleft palate repair. Which statement by the nurse is most accurate regarding
postoperative care?
A) Your child will be placed in arm restraints to prevent injury to the surgical site. –
Correct answer✅✅
B) You may use a straw to give your child fluids to prevent spillage on the incision.
C) It is safe to give your child hard foods like cookies once the numbness wears off.
D) We will place your child in a prone position to facilitate drainage.
_____16. A nurse is assessing a 9-month-old infant for signs of iron deficiency anemia. Which
finding is most consistent with this diagnosis?
A) Polycythemia and a ruddy complexion
B) Pallor, lethargy, and a preference for non-nutritive substances – Correct answer✅✅
C) Generalized edema and distended abdomen
D) Yellowish tint to the skin and sclera
_____17. A nurse is caring for a 12-year-old adolescent who is diagnosed with scoliosis and fitted
for a Milwaukee brace. Which statement by the adolescent indicates a need for further
emotional support?
A) I will wear a tight undershirt under the brace to prevent skin breakdown.
B) I can take the brace off for an hour a day to shower and do my back exercises.
C) I am never going to wear this to school because everyone will stare at me. – Correct
answer✅✅
D) I understand I need to wear this brace for most of the day to stop my curve from getting
worse.
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.
