itle:** **Pediatric Nursing Mastery: NCLEX-RN
**T
Questions for Infant, Child, and Adolescent Care**
---
### Question 1 of 88
A nurse is caring for a 4-year-old child who is admitted with dehydration. Which of the following 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 most reliable for acute fluid changes. BP is a late sign. Skin turgor
less reliable in well-nourished children.
💫ANSWER✔️✔️: C) Daily weight
---
### Question 2 of 88
A nurse is assessing a 6-month-old infant during a well-child visit. Which finding 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. Social smile (2-3 mo), rolling over,
babbling are expected at 6 months.
💫ANSWER✔️✔️: A) Head lag when pulled to sit
---
### Question 3 of 88
**Select-All-That-Apply (SATA):** A nurse is providing discharge teaching to the parents of a child with a
new diagnosis of asthma. Which 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 ibuprofen if the child has aspirin-sensitive asthma.
E) Keep a rescue inhaler available at all times.
💫RATIONALE✔️✔️: Daily peak flow (A), pre-exercise albuterol (B), avoid NSAIDs in aspirin-sensitive
asthma (D), rescue inhaler (E) correct. Green zone (80-100%) is safe; red zone (<50%) is emergency (C
wrong).
💫ANSWER✔️✔️: A, B, D, E
---
### Question 4 of 88
,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 action 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 indicates bleeding. First assess vital signs
and throat (B). Ice chips and pain meds not first steps.
💫ANSWER✔️✔️: B) Assess the child’s vital signs and throat for bleeding.
---
### Question 5 of 88
A nurse is assessing a 10-year-old child with suspected acute rheumatic fever. Which finding is a major
Jones criterion?
A) Fever
B) Elevated C-reactive protein (CRP)
C) Carditis
D) Arthralgia
💫RATIONALE✔️✔️: Major Jones criteria: carditis (C), polyarthritis, chorea, erythema marginatum,
subcutaneous nodules. Fever and arthralgia are minor criteria.
💫ANSWER✔️✔️: C) Carditis
---
, ### Question 6 of 88
A nurse is providing education to the parents of a child with cystic fibrosis (CF) about pancreatic enzyme
replacement therapy. Which statement by the parent indicates understanding?
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✔️✔️: Capsules can be opened and mixed with acidic soft food like applesauce (B). Enzymes
with every meal/snack, not PRN or with antibiotics. Milk interferes.
💫ANSWER✔️✔️: B) "I will open the capsule and sprinkle the beads on applesauce."
---
### Question 7 of 88
**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 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
E) Seizures
💫RATIONALE✔️✔️: NAS causes CNS irritability: hypertonia/tremors (A), excessive crying (B), poor feeding
(C), seizures (E). Hyperthermia, not hypothermia (D).
**T
Questions for Infant, Child, and Adolescent Care**
---
### Question 1 of 88
A nurse is caring for a 4-year-old child who is admitted with dehydration. Which of the following 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 most reliable for acute fluid changes. BP is a late sign. Skin turgor
less reliable in well-nourished children.
💫ANSWER✔️✔️: C) Daily weight
---
### Question 2 of 88
A nurse is assessing a 6-month-old infant during a well-child visit. Which finding 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. Social smile (2-3 mo), rolling over,
babbling are expected at 6 months.
💫ANSWER✔️✔️: A) Head lag when pulled to sit
---
### Question 3 of 88
**Select-All-That-Apply (SATA):** A nurse is providing discharge teaching to the parents of a child with a
new diagnosis of asthma. Which 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 ibuprofen if the child has aspirin-sensitive asthma.
E) Keep a rescue inhaler available at all times.
💫RATIONALE✔️✔️: Daily peak flow (A), pre-exercise albuterol (B), avoid NSAIDs in aspirin-sensitive
asthma (D), rescue inhaler (E) correct. Green zone (80-100%) is safe; red zone (<50%) is emergency (C
wrong).
💫ANSWER✔️✔️: A, B, D, E
---
### Question 4 of 88
,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 action 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 indicates bleeding. First assess vital signs
and throat (B). Ice chips and pain meds not first steps.
💫ANSWER✔️✔️: B) Assess the child’s vital signs and throat for bleeding.
---
### Question 5 of 88
A nurse is assessing a 10-year-old child with suspected acute rheumatic fever. Which finding is a major
Jones criterion?
A) Fever
B) Elevated C-reactive protein (CRP)
C) Carditis
D) Arthralgia
💫RATIONALE✔️✔️: Major Jones criteria: carditis (C), polyarthritis, chorea, erythema marginatum,
subcutaneous nodules. Fever and arthralgia are minor criteria.
💫ANSWER✔️✔️: C) Carditis
---
, ### Question 6 of 88
A nurse is providing education to the parents of a child with cystic fibrosis (CF) about pancreatic enzyme
replacement therapy. Which statement by the parent indicates understanding?
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✔️✔️: Capsules can be opened and mixed with acidic soft food like applesauce (B). Enzymes
with every meal/snack, not PRN or with antibiotics. Milk interferes.
💫ANSWER✔️✔️: B) "I will open the capsule and sprinkle the beads on applesauce."
---
### Question 7 of 88
**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 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
E) Seizures
💫RATIONALE✔️✔️: NAS causes CNS irritability: hypertonia/tremors (A), excessive crying (B), poor feeding
(C), seizures (E). Hyperthermia, not hypothermia (D).
