1
Pediatric Nursing Test Bank 2025–2026 | Davis Advantage
3rd Edition by Kathryn Rudd | 200 NCLEX-Style Questions
with Answers & Detailed Rationales
1.
A 2-year-old child is brought to the clinic with a high fever of 39.2°C (102.5°F) for the past two
days. The parent reports that the child is irritable and has been refusing solid food but drinking
fluids. Upon assessment, the nurse notes clear nasal drainage and red throat. The parent asks,
“Can I give my child aspirin to bring down the fever quickly?” The nurse recalls that the child
recently had viral pharyngitis. What is the most appropriate response by the nurse?
A. Aspirin is ineffective for fever in toddlers.
B. Aspirin may cause Reye’s syndrome in children.
C. Acetaminophen is more flavorful for children.
D. Toddlers cannot absorb aspirin well.
Correct Answer:
B. Aspirin may cause Reye’s syndrome in children.
Rationale:
Aspirin is contraindicated in children with viral illnesses due to the risk of Reye’s syndrome,
which can lead to liver and brain swelling. Educating parents on safe fever-reducing alternatives
like acetaminophen or ibuprofen is crucial. Though aspirin is effective in adults, it poses
serious health threats in pediatrics, especially during illnesses like varicella or influenza. Options
A, C, and D are inaccurate: the issue is not efficacy, flavor, or absorption — it's safety. Nurses
play a key role in preventing medication errors in home care settings.
Citation:
Rudd, K. L., & Kocisko, D. A. (2022). Davis Advantage for Pediatric Nursing (3rd ed., pp. 18–
19). F.A. Davis.
2.
,2
A nurse is assessing a 6-month-old infant during a well-baby visit. The infant's mother expresses
concern that her baby has not started crawling yet. The nurse observes that the infant can roll
from back to front and reach for toys, but does not sit independently. Based on normal
developmental milestones, how should the nurse respond?
A. Recommend a neurological consult.
B. Suggest physical therapy referral.
C. Reassure the mother that this is normal development.
D. Advise starting solid food to encourage strength.
Correct Answer:
C. Reassure the mother that this is normal development.
Rationale:
At 6 months, it is normal for infants to roll over, reach, and start to sit with support — crawling
is typically expected between 6–10 months. The child’s current milestones fall within expected
parameters. Advising therapy or consultation is premature unless other delays are noted. Solid
foods will not accelerate motor development. Nurses should use these moments to provide
reassurance and anticipatory guidance for what to expect in the coming months.
Citation:
Rudd, K. L., & Kocisko, D. A. (2022). Davis Advantage for Pediatric Nursing (3rd ed., pp. 60–
62). F.A. Davis.
3.
During a routine pediatric check-up, a nurse evaluates the language development of a 3-year-old
child. The child is able to say their name, count to five, and speak in short three-word sentences.
The parent mentions that the child becomes frustrated when not understood. What should the
nurse do next?
A. Explain that the child's speech is developmentally appropriate.
B. Refer the child for a speech-language evaluation.
C. Recommend daily structured speech lessons.
D. Test for hearing loss immediately.
Correct Answer:
A. Explain that the child's speech is developmentally appropriate.
Rationale:
By age 3, a child should be speaking in 3- to 4-word sentences, know their name, and count
small quantities. Frustration with communication is common at this stage and doesn’t necessarily
indicate a disorder. Unless regression or major delays are present, the nurse should reassure the
parent and monitor over time. Hearing loss or therapy referrals are only warranted if the child
fails to progress or shows other red flags.
,3
Citation:
Rudd, K. L., & Kocisko, D. A. (2022). Davis Advantage for Pediatric Nursing (3rd ed., pp. 77–
78). F.A. Davis.
4.
A 4-year-old child is brought to the emergency department after ingesting an unknown quantity
of acetaminophen tablets. The mother reports finding the child with an open bottle 30 minutes
ago. The child is awake, has stable vitals, and no symptoms. What is the nurse’s priority action?
A. Give the child activated charcoal.
B. Monitor the child for 24 hours.
C. Notify the healthcare provider and prepare for N-acetylcysteine.
D. Induce vomiting with ipecac syrup.
Correct Answer:
C. Notify the healthcare provider and prepare for N-acetylcysteine.
Rationale:
Acetaminophen toxicity can cause hepatic injury, and treatment must be initiated early, even in
asymptomatic stages. The antidote N-acetylcysteine (NAC) is most effective when
administered within 8 hours of ingestion. Activated charcoal may be used in some cases, but the
provider must be consulted first. Ipecac is no longer recommended due to risk and lack of
efficacy. Immediate intervention helps prevent liver damage, which may not present until 24–72
hours post-ingestion.
Citation:
Rudd, K. L., & Kocisko, D. A. (2022). Davis Advantage for Pediatric Nursing (3rd ed., pp. 146–
148). F.A. Davis.
5.
A nurse is evaluating a 9-month-old during a well-child check. The infant can sit without
support, pull up to stand, and babble but does not say any words. The parent expresses concern
about the child’s language development. The nurse also observes that the infant turns toward
sounds and reacts when the parent enters the room. Based on normal developmental milestones,
how should the nurse respond?
A. Refer the child to a speech-language pathologist.
B. Recommend hearing screening immediately.
C. Reassure the parent and continue routine monitoring.
D. Begin daily language therapy at home.
Correct Answer:
C. Reassure the parent and continue routine monitoring.
, 4
Rationale:
At 9 months, infants typically babble, respond to sound, and show recognition of familiar
voices or faces, but do not need to speak actual words yet. Saying the first words usually
occurs around 12 months. Since the infant shows hearing responsiveness and social
engagement, there are no red flags for speech delay at this point. Referrals and interventions
would be premature. The nurse should provide reassurance and give anticipatory guidance about
upcoming developmental milestones.
Citation:
Rudd, K. L., & Kocisko, D. A. (2022). Davis Advantage for Pediatric Nursing (3rd ed., pp. 66–
68). F.A. Davis.
6.
A 5-year-old child is brought to the clinic for a preschool physical. The parent expresses concern
that the child has begun lying and occasionally blames younger siblings for accidents. The nurse
evaluates the child’s cognitive development. What is the most developmentally appropriate
interpretation of this behavior?
A. The child is showing early signs of conduct disorder.
B. The behavior indicates sibling rivalry and requires counseling.
C. The child is experiencing delayed moral development.
D. The child is displaying typical imagination and guilt avoidance.
Correct Answer:
D. The child is displaying typical imagination and guilt avoidance.
Rationale:
At age 4–5, imaginative play and boundary-testing behaviors are typical. Children may lie or
shift blame to avoid punishment or discomfort from guilt. This behavior reflects a normal stage
of moral development where children learn about consequences. Unless the behavior is
persistent and harmful, it does not indicate conduct disorder or moral delay. The nurse should
educate parents about healthy discipline strategies and reassurance about the child’s
developmental stage.
Citation:
Rudd, K. L., & Kocisko, D. A. (2022). Davis Advantage for Pediatric Nursing (3rd ed., pp. 85–
86). F.A. Davis.
7.
A 7-month-old infant is hospitalized for bronchiolitis and requires oxygen therapy. The infant is
irritable and has nasal flaring and intercostal retractions. The nurse places the child in a high
Pediatric Nursing Test Bank 2025–2026 | Davis Advantage
3rd Edition by Kathryn Rudd | 200 NCLEX-Style Questions
with Answers & Detailed Rationales
1.
A 2-year-old child is brought to the clinic with a high fever of 39.2°C (102.5°F) for the past two
days. The parent reports that the child is irritable and has been refusing solid food but drinking
fluids. Upon assessment, the nurse notes clear nasal drainage and red throat. The parent asks,
“Can I give my child aspirin to bring down the fever quickly?” The nurse recalls that the child
recently had viral pharyngitis. What is the most appropriate response by the nurse?
A. Aspirin is ineffective for fever in toddlers.
B. Aspirin may cause Reye’s syndrome in children.
C. Acetaminophen is more flavorful for children.
D. Toddlers cannot absorb aspirin well.
Correct Answer:
B. Aspirin may cause Reye’s syndrome in children.
Rationale:
Aspirin is contraindicated in children with viral illnesses due to the risk of Reye’s syndrome,
which can lead to liver and brain swelling. Educating parents on safe fever-reducing alternatives
like acetaminophen or ibuprofen is crucial. Though aspirin is effective in adults, it poses
serious health threats in pediatrics, especially during illnesses like varicella or influenza. Options
A, C, and D are inaccurate: the issue is not efficacy, flavor, or absorption — it's safety. Nurses
play a key role in preventing medication errors in home care settings.
Citation:
Rudd, K. L., & Kocisko, D. A. (2022). Davis Advantage for Pediatric Nursing (3rd ed., pp. 18–
19). F.A. Davis.
2.
,2
A nurse is assessing a 6-month-old infant during a well-baby visit. The infant's mother expresses
concern that her baby has not started crawling yet. The nurse observes that the infant can roll
from back to front and reach for toys, but does not sit independently. Based on normal
developmental milestones, how should the nurse respond?
A. Recommend a neurological consult.
B. Suggest physical therapy referral.
C. Reassure the mother that this is normal development.
D. Advise starting solid food to encourage strength.
Correct Answer:
C. Reassure the mother that this is normal development.
Rationale:
At 6 months, it is normal for infants to roll over, reach, and start to sit with support — crawling
is typically expected between 6–10 months. The child’s current milestones fall within expected
parameters. Advising therapy or consultation is premature unless other delays are noted. Solid
foods will not accelerate motor development. Nurses should use these moments to provide
reassurance and anticipatory guidance for what to expect in the coming months.
Citation:
Rudd, K. L., & Kocisko, D. A. (2022). Davis Advantage for Pediatric Nursing (3rd ed., pp. 60–
62). F.A. Davis.
3.
During a routine pediatric check-up, a nurse evaluates the language development of a 3-year-old
child. The child is able to say their name, count to five, and speak in short three-word sentences.
The parent mentions that the child becomes frustrated when not understood. What should the
nurse do next?
A. Explain that the child's speech is developmentally appropriate.
B. Refer the child for a speech-language evaluation.
C. Recommend daily structured speech lessons.
D. Test for hearing loss immediately.
Correct Answer:
A. Explain that the child's speech is developmentally appropriate.
Rationale:
By age 3, a child should be speaking in 3- to 4-word sentences, know their name, and count
small quantities. Frustration with communication is common at this stage and doesn’t necessarily
indicate a disorder. Unless regression or major delays are present, the nurse should reassure the
parent and monitor over time. Hearing loss or therapy referrals are only warranted if the child
fails to progress or shows other red flags.
,3
Citation:
Rudd, K. L., & Kocisko, D. A. (2022). Davis Advantage for Pediatric Nursing (3rd ed., pp. 77–
78). F.A. Davis.
4.
A 4-year-old child is brought to the emergency department after ingesting an unknown quantity
of acetaminophen tablets. The mother reports finding the child with an open bottle 30 minutes
ago. The child is awake, has stable vitals, and no symptoms. What is the nurse’s priority action?
A. Give the child activated charcoal.
B. Monitor the child for 24 hours.
C. Notify the healthcare provider and prepare for N-acetylcysteine.
D. Induce vomiting with ipecac syrup.
Correct Answer:
C. Notify the healthcare provider and prepare for N-acetylcysteine.
Rationale:
Acetaminophen toxicity can cause hepatic injury, and treatment must be initiated early, even in
asymptomatic stages. The antidote N-acetylcysteine (NAC) is most effective when
administered within 8 hours of ingestion. Activated charcoal may be used in some cases, but the
provider must be consulted first. Ipecac is no longer recommended due to risk and lack of
efficacy. Immediate intervention helps prevent liver damage, which may not present until 24–72
hours post-ingestion.
Citation:
Rudd, K. L., & Kocisko, D. A. (2022). Davis Advantage for Pediatric Nursing (3rd ed., pp. 146–
148). F.A. Davis.
5.
A nurse is evaluating a 9-month-old during a well-child check. The infant can sit without
support, pull up to stand, and babble but does not say any words. The parent expresses concern
about the child’s language development. The nurse also observes that the infant turns toward
sounds and reacts when the parent enters the room. Based on normal developmental milestones,
how should the nurse respond?
A. Refer the child to a speech-language pathologist.
B. Recommend hearing screening immediately.
C. Reassure the parent and continue routine monitoring.
D. Begin daily language therapy at home.
Correct Answer:
C. Reassure the parent and continue routine monitoring.
, 4
Rationale:
At 9 months, infants typically babble, respond to sound, and show recognition of familiar
voices or faces, but do not need to speak actual words yet. Saying the first words usually
occurs around 12 months. Since the infant shows hearing responsiveness and social
engagement, there are no red flags for speech delay at this point. Referrals and interventions
would be premature. The nurse should provide reassurance and give anticipatory guidance about
upcoming developmental milestones.
Citation:
Rudd, K. L., & Kocisko, D. A. (2022). Davis Advantage for Pediatric Nursing (3rd ed., pp. 66–
68). F.A. Davis.
6.
A 5-year-old child is brought to the clinic for a preschool physical. The parent expresses concern
that the child has begun lying and occasionally blames younger siblings for accidents. The nurse
evaluates the child’s cognitive development. What is the most developmentally appropriate
interpretation of this behavior?
A. The child is showing early signs of conduct disorder.
B. The behavior indicates sibling rivalry and requires counseling.
C. The child is experiencing delayed moral development.
D. The child is displaying typical imagination and guilt avoidance.
Correct Answer:
D. The child is displaying typical imagination and guilt avoidance.
Rationale:
At age 4–5, imaginative play and boundary-testing behaviors are typical. Children may lie or
shift blame to avoid punishment or discomfort from guilt. This behavior reflects a normal stage
of moral development where children learn about consequences. Unless the behavior is
persistent and harmful, it does not indicate conduct disorder or moral delay. The nurse should
educate parents about healthy discipline strategies and reassurance about the child’s
developmental stage.
Citation:
Rudd, K. L., & Kocisko, D. A. (2022). Davis Advantage for Pediatric Nursing (3rd ed., pp. 85–
86). F.A. Davis.
7.
A 7-month-old infant is hospitalized for bronchiolitis and requires oxygen therapy. The infant is
irritable and has nasal flaring and intercostal retractions. The nurse places the child in a high
