**Title:** **Pediatric Proficiency: NCLEX-RN
Questions for Infant, Child, and Adolescent Care**
---
### Question 1 of 87
A nurse is caring for a 4-year-old child admitted with dehydration. Which 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 87
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 87
**Select-All-That-Apply (SATA):** A nurse is providing discharge teaching to parents of a child with new
asthma. Which instructions should the nurse include? (Select all that apply.)
A) Use a peak flow meter daily.
B) Administer albuterol before exercise.
C) Call 911 if peak flow is in the green zone.
D) Avoid ibuprofen if 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%) safe; red zone (<50%) emergency.
💫ANSWER✔️✔️: A, B, D, E
---
### Question 4 of 87
,A nurse is caring for a 2-year-old child post-tonsillectomy. The child swallows frequently and is restless.
Which action should the nurse take first?
A) Offer ice chips.
B) Assess vital signs and throat for bleeding.
C) Administer acetaminophen.
D) Place child supine.
💫RATIONALE✔️✔️: Frequent swallowing indicates bleeding. First assess vital signs and throat (B). Ice
chips and pain meds not first steps.
💫ANSWER✔️✔️: B) Assess vital signs and throat for bleeding.
---
### Question 5 of 87
A nurse is assessing a 10-year-old with suspected acute rheumatic fever. Which finding is a major Jones
criterion?
A) Fever
B) Elevated CRP
C) Carditis
D) Arthralgia
💫RATIONALE✔️✔️: Major Jones criteria: carditis (C), polyarthritis, chorea, erythema marginatum,
subcutaneous nodules. Fever and arthralgia are minor.
💫ANSWER✔️✔️: C) Carditis
---
, ### Question 6 of 87
A nurse is teaching parents of a child with CF about pancreatic enzymes. Which statement indicates
understanding?
A) "I will give enzymes only when my child has diarrhea."
B) "I will open the capsule and sprinkle beads on applesauce."
C) "I will stop enzymes if my child is on antibiotics."
D) "I will give enzymes at bedtime with milk."
💫RATIONALE✔️✔️: Capsules can be opened and mixed with acidic soft food like applesauce (B). Enzymes
with every meal/snack. Milk interferes.
💫ANSWER✔️✔️: B) "I will open the capsule and sprinkle beads on applesauce."
---
### Question 7 of 87
**Select-All-That-Apply (SATA):** A nurse is assessing a newborn for neonatal abstinence syndrome
(NAS). Which findings should the nurse expect? (Select all that apply.)
A) Hypertonia and tremors
B) Excessive crying
C) Poor feeding
D) Hypothermia
E) Seizures
💫RATIONALE✔️✔️: NAS causes hypertonia/tremors (A), excessive crying (B), poor feeding (C), seizures
(E). Hyperthermia, not hypothermia (D).
💫ANSWER✔️✔️: A, B, C, E
Questions for Infant, Child, and Adolescent Care**
---
### Question 1 of 87
A nurse is caring for a 4-year-old child admitted with dehydration. Which 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 87
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 87
**Select-All-That-Apply (SATA):** A nurse is providing discharge teaching to parents of a child with new
asthma. Which instructions should the nurse include? (Select all that apply.)
A) Use a peak flow meter daily.
B) Administer albuterol before exercise.
C) Call 911 if peak flow is in the green zone.
D) Avoid ibuprofen if 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%) safe; red zone (<50%) emergency.
💫ANSWER✔️✔️: A, B, D, E
---
### Question 4 of 87
,A nurse is caring for a 2-year-old child post-tonsillectomy. The child swallows frequently and is restless.
Which action should the nurse take first?
A) Offer ice chips.
B) Assess vital signs and throat for bleeding.
C) Administer acetaminophen.
D) Place child supine.
💫RATIONALE✔️✔️: Frequent swallowing indicates bleeding. First assess vital signs and throat (B). Ice
chips and pain meds not first steps.
💫ANSWER✔️✔️: B) Assess vital signs and throat for bleeding.
---
### Question 5 of 87
A nurse is assessing a 10-year-old with suspected acute rheumatic fever. Which finding is a major Jones
criterion?
A) Fever
B) Elevated CRP
C) Carditis
D) Arthralgia
💫RATIONALE✔️✔️: Major Jones criteria: carditis (C), polyarthritis, chorea, erythema marginatum,
subcutaneous nodules. Fever and arthralgia are minor.
💫ANSWER✔️✔️: C) Carditis
---
, ### Question 6 of 87
A nurse is teaching parents of a child with CF about pancreatic enzymes. Which statement indicates
understanding?
A) "I will give enzymes only when my child has diarrhea."
B) "I will open the capsule and sprinkle beads on applesauce."
C) "I will stop enzymes if my child is on antibiotics."
D) "I will give enzymes at bedtime with milk."
💫RATIONALE✔️✔️: Capsules can be opened and mixed with acidic soft food like applesauce (B). Enzymes
with every meal/snack. Milk interferes.
💫ANSWER✔️✔️: B) "I will open the capsule and sprinkle beads on applesauce."
---
### Question 7 of 87
**Select-All-That-Apply (SATA):** A nurse is assessing a newborn for neonatal abstinence syndrome
(NAS). Which findings should the nurse expect? (Select all that apply.)
A) Hypertonia and tremors
B) Excessive crying
C) Poor feeding
D) Hypothermia
E) Seizures
💫RATIONALE✔️✔️: NAS causes hypertonia/tremors (A), excessive crying (B), poor feeding (C), seizures
(E). Hyperthermia, not hypothermia (D).
💫ANSWER✔️✔️: A, B, C, E
