**Title:** **Pediatric Proficiency: NCLEX-RN Questions
for Infant, Child, and Adolescent Nursing Care**
---
### Question 1 of 82
A nurse is caring for a 4-year-old child who is admitted with dehydration. Which of the following
assessment findings is the most reliable indicator of the child’s hydration status?
A) Blood pressure
B) Skin turgor
C) Daily weight
D) Urine specific gravity
💫RATIONALE✔️✔️: Daily weight (C) is the most sensitive and reliable indicator of fluid status in children
because it reflects acute changes in total body water. Blood pressure is a late sign. Skin turgor can be
less reliable in well-nourished children. Urine specific gravity is helpful but not as precise as weight.
💫ANSWER✔️✔️: C) Daily weight
---
### Question 2 of 82
A nurse is assessing a 6-month-old infant during a well-child visit. Which of the following findings
requires further evaluation?
A) Head lag when pulled to sit
,B) Social smile
C) Ability to roll from back to abdomen
D) Babbling using consonant sounds
💫RATIONALE✔️✔️: Head lag (A) should be absent by 4-6 months of age. Persistent head lag at 6 months
suggests possible neuromuscular or developmental delay. Social smile develops by 2-3 months. Rolling
over and babbling are expected at 6 months.
💫ANSWER✔️✔️: A) Head lag when pulled to sit
---
### Question 3 of 82
**Select-All-That-Apply (SATA):** A nurse is providing discharge teaching to the parents of a child with a
new diagnosis of asthma. Which of the following instructions should the nurse include? (Select all that
apply.)
A) “Use a peak flow meter daily to monitor lung function.”
B) “Administer albuterol before exercise to prevent bronchospasm.”
C) “Call 911 if the child’s peak flow is in the green zone.”
D) “Avoid giving the child ibuprofen if they have aspirin-sensitive asthma.”
E) “Keep a rescue inhaler available at all times.”
💫RATIONALE✔️✔️: Daily peak flow monitoring (A), pre-exercise albuterol (B), avoiding NSAIDs in aspirin-
sensitive asthma (D), and rescue inhaler availability (E) are correct. Green zone (80-100% personal best)
is safe; red zone (<50%) requires emergency care (C is wrong).
💫ANSWER✔️✔️: A, B, D, E
---
### Question 4 of 82
,A nurse is caring for a 2-year-old child who is postoperative following a tonsillectomy. The nurse notes
that the child is swallowing frequently and becomes restless. Which of the following actions should the
nurse take first?
A) Offer the child ice chips to soothe the throat.
B) Assess the child’s vital signs and throat for bleeding.
C) Administer prescribed acetaminophen for pain.
D) Place the child in a supine position to rest.
💫RATIONALE✔️✔️: Frequent swallowing after tonsillectomy is a sign of bleeding (the child is swallowing
blood). The nurse should first assess vital signs and inspect the throat (B) to confirm bleeding. Ice chips
and pain medication are not first steps. Supine position increases aspiration risk.
💫ANSWER✔️✔️: B) Assess the child’s vital signs and throat for bleeding.
---
### Question 5 of 82
A nurse is assessing a 10-year-old child with suspected acute rheumatic fever. Which of the following
findings is a major Jones criterion for this diagnosis?
A) Fever
B) Elevated C-reactive protein (CRP)
C) Carditis
D) Arthralgia
💫RATIONALE✔️✔️: Major Jones criteria for rheumatic fever include carditis (C), polyarthritis, chorea,
erythema marginatum, and subcutaneous nodules. Fever and arthralgia (without arthritis) are minor
criteria. Elevated CRP is a minor criterion.
💫ANSWER✔️✔️: C) Carditis
, ---
### Question 6 of 82
A nurse is providing education to the parents of a child with cystic fibrosis (CF). Which of the following
statements by the parent indicates understanding of pancreatic enzyme replacement therapy?
A) “I will give the enzymes only when my child has diarrhea.”
B) “I will open the capsule and sprinkle the beads on applesauce.”
C) “I will stop enzymes if my child is taking antibiotics.”
D) “I will give the enzymes at bedtime with a glass of milk.”
💫RATIONALE✔️✔️: Pancreatic enzyme capsules can be opened and mixed with acidic soft foods like
applesauce (B) for children who cannot swallow pills. Enzymes must be given with every meal and snack,
not PRN or only with diarrhea. Do not stop with antibiotics. Milk interferes with enzyme activity.
💫ANSWER✔️✔️: B) “I will open the capsule and sprinkle the beads on applesauce.”
---
### Question 7 of 82
**Select-All-That-Apply (SATA):** A nurse is assessing a newborn for signs of neonatal abstinence
syndrome (NAS) secondary to in-utero opioid exposure. Which of the following findings should the nurse
expect? (Select all that apply.)
A) Hypertonia and tremors
B) Excessive crying and irritability
C) Poor feeding and uncoordinated suck
D) Hypothermia
for Infant, Child, and Adolescent Nursing Care**
---
### Question 1 of 82
A nurse is caring for a 4-year-old child who is admitted with dehydration. Which of the following
assessment findings is the most reliable indicator of the child’s hydration status?
A) Blood pressure
B) Skin turgor
C) Daily weight
D) Urine specific gravity
💫RATIONALE✔️✔️: Daily weight (C) is the most sensitive and reliable indicator of fluid status in children
because it reflects acute changes in total body water. Blood pressure is a late sign. Skin turgor can be
less reliable in well-nourished children. Urine specific gravity is helpful but not as precise as weight.
💫ANSWER✔️✔️: C) Daily weight
---
### Question 2 of 82
A nurse is assessing a 6-month-old infant during a well-child visit. Which of the following findings
requires further evaluation?
A) Head lag when pulled to sit
,B) Social smile
C) Ability to roll from back to abdomen
D) Babbling using consonant sounds
💫RATIONALE✔️✔️: Head lag (A) should be absent by 4-6 months of age. Persistent head lag at 6 months
suggests possible neuromuscular or developmental delay. Social smile develops by 2-3 months. Rolling
over and babbling are expected at 6 months.
💫ANSWER✔️✔️: A) Head lag when pulled to sit
---
### Question 3 of 82
**Select-All-That-Apply (SATA):** A nurse is providing discharge teaching to the parents of a child with a
new diagnosis of asthma. Which of the following instructions should the nurse include? (Select all that
apply.)
A) “Use a peak flow meter daily to monitor lung function.”
B) “Administer albuterol before exercise to prevent bronchospasm.”
C) “Call 911 if the child’s peak flow is in the green zone.”
D) “Avoid giving the child ibuprofen if they have aspirin-sensitive asthma.”
E) “Keep a rescue inhaler available at all times.”
💫RATIONALE✔️✔️: Daily peak flow monitoring (A), pre-exercise albuterol (B), avoiding NSAIDs in aspirin-
sensitive asthma (D), and rescue inhaler availability (E) are correct. Green zone (80-100% personal best)
is safe; red zone (<50%) requires emergency care (C is wrong).
💫ANSWER✔️✔️: A, B, D, E
---
### Question 4 of 82
,A nurse is caring for a 2-year-old child who is postoperative following a tonsillectomy. The nurse notes
that the child is swallowing frequently and becomes restless. Which of the following actions should the
nurse take first?
A) Offer the child ice chips to soothe the throat.
B) Assess the child’s vital signs and throat for bleeding.
C) Administer prescribed acetaminophen for pain.
D) Place the child in a supine position to rest.
💫RATIONALE✔️✔️: Frequent swallowing after tonsillectomy is a sign of bleeding (the child is swallowing
blood). The nurse should first assess vital signs and inspect the throat (B) to confirm bleeding. Ice chips
and pain medication are not first steps. Supine position increases aspiration risk.
💫ANSWER✔️✔️: B) Assess the child’s vital signs and throat for bleeding.
---
### Question 5 of 82
A nurse is assessing a 10-year-old child with suspected acute rheumatic fever. Which of the following
findings is a major Jones criterion for this diagnosis?
A) Fever
B) Elevated C-reactive protein (CRP)
C) Carditis
D) Arthralgia
💫RATIONALE✔️✔️: Major Jones criteria for rheumatic fever include carditis (C), polyarthritis, chorea,
erythema marginatum, and subcutaneous nodules. Fever and arthralgia (without arthritis) are minor
criteria. Elevated CRP is a minor criterion.
💫ANSWER✔️✔️: C) Carditis
, ---
### Question 6 of 82
A nurse is providing education to the parents of a child with cystic fibrosis (CF). Which of the following
statements by the parent indicates understanding of pancreatic enzyme replacement therapy?
A) “I will give the enzymes only when my child has diarrhea.”
B) “I will open the capsule and sprinkle the beads on applesauce.”
C) “I will stop enzymes if my child is taking antibiotics.”
D) “I will give the enzymes at bedtime with a glass of milk.”
💫RATIONALE✔️✔️: Pancreatic enzyme capsules can be opened and mixed with acidic soft foods like
applesauce (B) for children who cannot swallow pills. Enzymes must be given with every meal and snack,
not PRN or only with diarrhea. Do not stop with antibiotics. Milk interferes with enzyme activity.
💫ANSWER✔️✔️: B) “I will open the capsule and sprinkle the beads on applesauce.”
---
### Question 7 of 82
**Select-All-That-Apply (SATA):** A nurse is assessing a newborn for signs of neonatal abstinence
syndrome (NAS) secondary to in-utero opioid exposure. Which of the following findings should the nurse
expect? (Select all that apply.)
A) Hypertonia and tremors
B) Excessive crying and irritability
C) Poor feeding and uncoordinated suck
D) Hypothermia
