PED-BC Pediatric nursing board
certification validating expertise in child
healthcare, development, and disease
management.
Question 1
A 4-year-old child is brought to the emergency department after a fall from a
playground slide. The child is crying and holding the right arm close to the body.
Which pain scale is MOST appropriate for assessing pain in this preschool-age
child?
A. Numeric Rating Scale (0-10)
B. FLACC Scale
C. Wong-Baker FACES Pain Rating Scale
D. Visual Analog Scale
Answer: C. Wong-Baker FACES Pain Rating Scale
Rationale: The Wong-Baker FACES Pain Rating Scale is developmentally
appropriate for children ages 3-7 years. It uses six faces ranging from happy to
sad/crying, allowing the child to point to the face that best describes their pain. The
Numeric Rating Scale and Visual Analog Scale require abstract thinking and are
more appropriate for children ≥8 years. The FLACC Scale is a behavioral pain
assessment tool used for infants and children who cannot self-report pain.
Question 2
A 6-month-old infant is admitted with bronchiolitis. The nurse notes the infant is
irritable, has a high-pitched cry, and is difficult to console. Which pain assessment
tool is MOST appropriate for this non-verbal infant?
A. FLACC Scale
B. NIPS (Neonatal Infant Pain Scale)
C. Wong-Baker FACES Scale
D. CRIES Scale
,Answer: A. FLACC Scale
Rationale: The FLACC Scale (Face, Legs, Activity, Cry, Consolability) is
validated for assessing pain in infants and children aged 2 months to 7 years who
cannot self-report pain. The NIPS is designed for neonates and infants up to 1 year
of age. The CRIES Scale is specifically for neonates. The Wong-Baker FACES
Scale requires the child to self-report, which is not possible for a 6-month-old.
Question 3
A 10-year-old child with cystic fibrosis is being assessed for fall risk. Which
assessment tool is MOST appropriate for evaluating fall risk in a hospitalized
pediatric patient?
A. Morse Fall Scale
B. Humpty Dumpty Fall Scale
C. Braden Q Scale
D. Pediatric Early Warning Score (PEWS)
Answer: B. Humpty Dumpty Fall Scale
Rationale: The Humpty Dumpty Fall Scale is a pediatric-specific fall risk
assessment tool validated for hospitalized children. It assesses factors such as age,
diagnosis, cognitive impairment, environmental factors, and medication use. The
Morse Fall Scale is designed for adults. The Braden Q Scale assesses pressure
injury risk in children. PEWS assesses clinical deterioration risk.
Question 4
A 2-year-old child is admitted with a new diagnosis of leukemia. The nurse is
assessing the child's developmental milestones. Which milestone would the nurse
EXPECT a typically developing 2-year-old to have achieved?
A. Walks independently and speaks 2-3 word phrases
B. Rides a tricycle and uses scissors
C. Draws a circle and speaks in complete sentences
D. Ties shoelaces and writes own name
Answer: A. Walks independently and speaks 2-3 word phrases
,Rationale: By 24 months (2 years), a typically developing child can walk
independently, run, climb stairs, and speak 2-3 word phrases. Riding a tricycle,
using scissors, and drawing a circle are typical of a 3-4 year old. Speaking in
complete sentences, tying shoelaces, and writing are skills of a 5-6 year old.
Question 5
A 14-year-old adolescent is being screened for depression during a routine well-
child visit. Which screening tool is MOST appropriate for this age group?
A. PHQ-9 (Patient Health Questionnaire-9)
B. Edinburgh Postnatal Depression Scale
C. Ages and Stages Questionnaire (ASQ)
D. Denver Developmental Screening Test
Answer: A. PHQ-9 (Patient Health Questionnaire-9)
Rationale: The PHQ-9 is a validated screening tool for depression in adolescents
and adults. It assesses the frequency of depressive symptoms over the past 2
weeks. The Edinburgh Postnatal Depression Scale is for postpartum depression.
The ASQ and Denver Developmental Screening Test are for developmental
screening in young children.
Question 6
A 3-year-old child is being evaluated for a urinary tract infection. Which method
of urine collection is MOST appropriate for this toilet-trained child?
A. Clean-catch midstream urine specimen
B. Catheterized urine specimen
C. Suprapubic aspiration
D. Bag urine specimen
Answer: A. Clean-catch midstream urine specimen
Rationale: For a toilet-trained child, a clean-catch midstream urine specimen is the
preferred method for urine collection. It is non-invasive and has a lower
contamination rate than bag specimens. Catheterized specimens and suprapubic
aspiration are more invasive and reserved for non-toilet-trained children or when a
clean-catch specimen cannot be obtained.
, Question 7
A 5-year-old child is admitted with asthma exacerbation. The nurse notes that the
child's respiratory rate is 32 breaths/min, heart rate is 130 beats/min, and oxygen
saturation is 92% on room air. Which of the following is the MOST appropriate
intervention?
A. Administer oxygen and notify the healthcare provider
B. Place the child in a supine position
C. Administer oral fluids
D. Obtain a chest X-ray
Answer: A. Administer oxygen and notify the healthcare provider
Rationale: The child has tachycardia (130 beats/min) and mild hypoxemia (SpO₂
92%), indicating respiratory distress. The priority is to administer oxygen and
notify the healthcare provider for further evaluation and treatment. Supine
positioning would worsen respiratory effort. Oral fluids should be withheld until
the child's respiratory status is stable.
Question 8
A newborn is 5 minutes old and has a heart rate of 110 beats/min, respiratory rate
of 40 breaths/min, is crying vigorously, has active movement, and is pink with
some acrocyanosis. The nurse should assign an Apgar score of:
A. 7
B. 8
C. 9
D. 10
Answer: C. 9
Rationale: The Apgar score is based on five components: heart rate (2 points for
>100), respiratory effort (2 points for strong cry), muscle tone (2 points for active
movement), reflex irritability (2 points for vigorous cry), and color (1 point for
pink with acrocyanosis; 2 points for completely pink). Total score: 2+2+2+2+1 =
9. A score of 7-10 is reassuring.
certification validating expertise in child
healthcare, development, and disease
management.
Question 1
A 4-year-old child is brought to the emergency department after a fall from a
playground slide. The child is crying and holding the right arm close to the body.
Which pain scale is MOST appropriate for assessing pain in this preschool-age
child?
A. Numeric Rating Scale (0-10)
B. FLACC Scale
C. Wong-Baker FACES Pain Rating Scale
D. Visual Analog Scale
Answer: C. Wong-Baker FACES Pain Rating Scale
Rationale: The Wong-Baker FACES Pain Rating Scale is developmentally
appropriate for children ages 3-7 years. It uses six faces ranging from happy to
sad/crying, allowing the child to point to the face that best describes their pain. The
Numeric Rating Scale and Visual Analog Scale require abstract thinking and are
more appropriate for children ≥8 years. The FLACC Scale is a behavioral pain
assessment tool used for infants and children who cannot self-report pain.
Question 2
A 6-month-old infant is admitted with bronchiolitis. The nurse notes the infant is
irritable, has a high-pitched cry, and is difficult to console. Which pain assessment
tool is MOST appropriate for this non-verbal infant?
A. FLACC Scale
B. NIPS (Neonatal Infant Pain Scale)
C. Wong-Baker FACES Scale
D. CRIES Scale
,Answer: A. FLACC Scale
Rationale: The FLACC Scale (Face, Legs, Activity, Cry, Consolability) is
validated for assessing pain in infants and children aged 2 months to 7 years who
cannot self-report pain. The NIPS is designed for neonates and infants up to 1 year
of age. The CRIES Scale is specifically for neonates. The Wong-Baker FACES
Scale requires the child to self-report, which is not possible for a 6-month-old.
Question 3
A 10-year-old child with cystic fibrosis is being assessed for fall risk. Which
assessment tool is MOST appropriate for evaluating fall risk in a hospitalized
pediatric patient?
A. Morse Fall Scale
B. Humpty Dumpty Fall Scale
C. Braden Q Scale
D. Pediatric Early Warning Score (PEWS)
Answer: B. Humpty Dumpty Fall Scale
Rationale: The Humpty Dumpty Fall Scale is a pediatric-specific fall risk
assessment tool validated for hospitalized children. It assesses factors such as age,
diagnosis, cognitive impairment, environmental factors, and medication use. The
Morse Fall Scale is designed for adults. The Braden Q Scale assesses pressure
injury risk in children. PEWS assesses clinical deterioration risk.
Question 4
A 2-year-old child is admitted with a new diagnosis of leukemia. The nurse is
assessing the child's developmental milestones. Which milestone would the nurse
EXPECT a typically developing 2-year-old to have achieved?
A. Walks independently and speaks 2-3 word phrases
B. Rides a tricycle and uses scissors
C. Draws a circle and speaks in complete sentences
D. Ties shoelaces and writes own name
Answer: A. Walks independently and speaks 2-3 word phrases
,Rationale: By 24 months (2 years), a typically developing child can walk
independently, run, climb stairs, and speak 2-3 word phrases. Riding a tricycle,
using scissors, and drawing a circle are typical of a 3-4 year old. Speaking in
complete sentences, tying shoelaces, and writing are skills of a 5-6 year old.
Question 5
A 14-year-old adolescent is being screened for depression during a routine well-
child visit. Which screening tool is MOST appropriate for this age group?
A. PHQ-9 (Patient Health Questionnaire-9)
B. Edinburgh Postnatal Depression Scale
C. Ages and Stages Questionnaire (ASQ)
D. Denver Developmental Screening Test
Answer: A. PHQ-9 (Patient Health Questionnaire-9)
Rationale: The PHQ-9 is a validated screening tool for depression in adolescents
and adults. It assesses the frequency of depressive symptoms over the past 2
weeks. The Edinburgh Postnatal Depression Scale is for postpartum depression.
The ASQ and Denver Developmental Screening Test are for developmental
screening in young children.
Question 6
A 3-year-old child is being evaluated for a urinary tract infection. Which method
of urine collection is MOST appropriate for this toilet-trained child?
A. Clean-catch midstream urine specimen
B. Catheterized urine specimen
C. Suprapubic aspiration
D. Bag urine specimen
Answer: A. Clean-catch midstream urine specimen
Rationale: For a toilet-trained child, a clean-catch midstream urine specimen is the
preferred method for urine collection. It is non-invasive and has a lower
contamination rate than bag specimens. Catheterized specimens and suprapubic
aspiration are more invasive and reserved for non-toilet-trained children or when a
clean-catch specimen cannot be obtained.
, Question 7
A 5-year-old child is admitted with asthma exacerbation. The nurse notes that the
child's respiratory rate is 32 breaths/min, heart rate is 130 beats/min, and oxygen
saturation is 92% on room air. Which of the following is the MOST appropriate
intervention?
A. Administer oxygen and notify the healthcare provider
B. Place the child in a supine position
C. Administer oral fluids
D. Obtain a chest X-ray
Answer: A. Administer oxygen and notify the healthcare provider
Rationale: The child has tachycardia (130 beats/min) and mild hypoxemia (SpO₂
92%), indicating respiratory distress. The priority is to administer oxygen and
notify the healthcare provider for further evaluation and treatment. Supine
positioning would worsen respiratory effort. Oral fluids should be withheld until
the child's respiratory status is stable.
Question 8
A newborn is 5 minutes old and has a heart rate of 110 beats/min, respiratory rate
of 40 breaths/min, is crying vigorously, has active movement, and is pink with
some acrocyanosis. The nurse should assign an Apgar score of:
A. 7
B. 8
C. 9
D. 10
Answer: C. 9
Rationale: The Apgar score is based on five components: heart rate (2 points for
>100), respiratory effort (2 points for strong cry), muscle tone (2 points for active
movement), reflex irritability (2 points for vigorous cry), and color (1 point for
pink with acrocyanosis; 2 points for completely pink). Total score: 2+2+2+2+1 =
9. A score of 7-10 is reassuring.
