NR328 Week 4 Pediatric Nursing Exam
W4 NR328 Exam | 70 Questions with Answers & Rationale
Pediatric Nursing | Exam Preparation Review
Question 1
i a
uv
A nurse is performing a well-child assessment on a 12-month-old infant. Which developmental
St
milestone should the nurse expect the infant to have achieved?
x-
A. Speaking in 2–3 word sentences
fe
ht
B. Walking independently without support
rig
✓ C. Pulling to stand and cruising along furniture
:B
D. Riding a tricycle
m
ro
■ Correct Answer: C
yF
Rationale: By 12 months, most infants can pull themselves to a standing position and cruise (walk
nl
while holding onto furniture). Independent walking typically occurs between 12–15 months.
yO
Two-to-three word sentences develop around 24 months. Riding a tricycle is a 3-year milestone.
Cruising is the expected gross motor milestone at 12 months.
Bu
, Question 2
i a
uv
St
x-
fe
ht
rig
:B
m
A client with asthma does peak flow meter readings before and after an albuterol nebulizer treatment.
ro
The peak flow meter on the left indicates the reading prior to treatment, and the meter on the right
yF
indicates the reading following treatment. What conclusion can be drawn from these readings?
nl
yO
A. The peak flow reading is improved indicating no further treatment is needed.
Bu
B. The peak flow reading did not improve as a result of the treatment; a different medication is needed.
C. The peak flow reading did not improve as a result of the treatment; another albuterol treatment is
needed.
✓ D. The peak flow reading is improved but the client still requires further treatment.
■ Correct Answer: D
Rationale: The right meter shows a higher peak flow reading than the left, confirming the albuterol
produced bronchodilation. However, the reading has not reached the green zone (80–100% of
personal best), meaning significant bronchoconstriction persists. Further treatment — additional
bronchodilators or corticosteroids — is still required. Option A is incorrect because the reading is not
yet in the safe zone.
, Question 3
i a
uv
St
x-
fe
ht
rig
:B
m
A child comes to urgent care with their caregiver due to a sore throat for two days. The caregiver
ro
explains that the child was diagnosed with streptococcal disease three months ago and asks how
yF
they could already have it again. What follow-up question should the nurse ask?
nl
yO
A. "Did you switch out their toothbrush and orthodontics after 24 hours?"
Bu
B. "Do you have a surgeon in mind to perform their tonsillectomy?"
C. "Are you open to having an immunization for them this visit?"
✓ D. "Why didn't you make sure to complete all of the antibiotics?"
■ Correct Answer: D
Rationale: Recurrent streptococcal pharyngitis is most commonly caused by incomplete antibiotic
therapy. When a full antibiotic course is not completed, some bacteria survive and can recolonize,
leading to a repeat infection. The nurse's priority follow-up is to assess whether the previous antibiotic
course was completed. This addresses the most likely cause of the recurrence and opens therapeutic
teaching.
, Question 4
i a
uv
St
x-
fe
ht
rig
:B
m
An emergency department nurse is caring for a 4-year-old client with acute laryngotracheobronchitis.
ro
Which clinical sign associated with this condition is most concerning to the nurse?
yF
nl
A. Hoarseness
yO
B. Low-grade fever
Bu
✓ C. Nasal flaring
D. Barky, brassy cough
■ Correct Answer: C
Rationale: Nasal flaring is a sign of increased work of breathing and respiratory distress — the most
alarming finding in croup (laryngotracheobronchitis). It indicates the child is struggling to maintain
adequate ventilation and oxygenation, signaling potential respiratory failure. Hoarseness and barky
cough are classic but expected croup symptoms. Low-grade fever is anticipated with viral infection.
Nasal flaring demands immediate intervention.
W4 NR328 Exam | 70 Questions with Answers & Rationale
Pediatric Nursing | Exam Preparation Review
Question 1
i a
uv
A nurse is performing a well-child assessment on a 12-month-old infant. Which developmental
St
milestone should the nurse expect the infant to have achieved?
x-
A. Speaking in 2–3 word sentences
fe
ht
B. Walking independently without support
rig
✓ C. Pulling to stand and cruising along furniture
:B
D. Riding a tricycle
m
ro
■ Correct Answer: C
yF
Rationale: By 12 months, most infants can pull themselves to a standing position and cruise (walk
nl
while holding onto furniture). Independent walking typically occurs between 12–15 months.
yO
Two-to-three word sentences develop around 24 months. Riding a tricycle is a 3-year milestone.
Cruising is the expected gross motor milestone at 12 months.
Bu
, Question 2
i a
uv
St
x-
fe
ht
rig
:B
m
A client with asthma does peak flow meter readings before and after an albuterol nebulizer treatment.
ro
The peak flow meter on the left indicates the reading prior to treatment, and the meter on the right
yF
indicates the reading following treatment. What conclusion can be drawn from these readings?
nl
yO
A. The peak flow reading is improved indicating no further treatment is needed.
Bu
B. The peak flow reading did not improve as a result of the treatment; a different medication is needed.
C. The peak flow reading did not improve as a result of the treatment; another albuterol treatment is
needed.
✓ D. The peak flow reading is improved but the client still requires further treatment.
■ Correct Answer: D
Rationale: The right meter shows a higher peak flow reading than the left, confirming the albuterol
produced bronchodilation. However, the reading has not reached the green zone (80–100% of
personal best), meaning significant bronchoconstriction persists. Further treatment — additional
bronchodilators or corticosteroids — is still required. Option A is incorrect because the reading is not
yet in the safe zone.
, Question 3
i a
uv
St
x-
fe
ht
rig
:B
m
A child comes to urgent care with their caregiver due to a sore throat for two days. The caregiver
ro
explains that the child was diagnosed with streptococcal disease three months ago and asks how
yF
they could already have it again. What follow-up question should the nurse ask?
nl
yO
A. "Did you switch out their toothbrush and orthodontics after 24 hours?"
Bu
B. "Do you have a surgeon in mind to perform their tonsillectomy?"
C. "Are you open to having an immunization for them this visit?"
✓ D. "Why didn't you make sure to complete all of the antibiotics?"
■ Correct Answer: D
Rationale: Recurrent streptococcal pharyngitis is most commonly caused by incomplete antibiotic
therapy. When a full antibiotic course is not completed, some bacteria survive and can recolonize,
leading to a repeat infection. The nurse's priority follow-up is to assess whether the previous antibiotic
course was completed. This addresses the most likely cause of the recurrence and opens therapeutic
teaching.
, Question 4
i a
uv
St
x-
fe
ht
rig
:B
m
An emergency department nurse is caring for a 4-year-old client with acute laryngotracheobronchitis.
ro
Which clinical sign associated with this condition is most concerning to the nurse?
yF
nl
A. Hoarseness
yO
B. Low-grade fever
Bu
✓ C. Nasal flaring
D. Barky, brassy cough
■ Correct Answer: C
Rationale: Nasal flaring is a sign of increased work of breathing and respiratory distress — the most
alarming finding in croup (laryngotracheobronchitis). It indicates the child is struggling to maintain
adequate ventilation and oxygenation, signaling potential respiratory failure. Hoarseness and barky
cough are classic but expected croup symptoms. Low-grade fever is anticipated with viral infection.
Nasal flaring demands immediate intervention.
