NRSG 421 PEDIATRICS FINAL EXAM 2025 ACTUAL EXAM
COMPLETE ACCURATE EXAM QUESTIONS WITH DETAILED
VERIFIED ANSWERS (100% CORRECT ANSWERS
The nurse is assessing a 6-month-old infant during a well-child visit. Which
developmental milestone would the nurse expect to observe?
A) Walks independently.
B) Sits without support.
C) Says "dada" and "mama" specifically.
D) Feeds self with a spoon.
E) Stands holding onto furniture.
Correct Answer: B) Sits without support.
Rationale: Most infants can sit without support by 6-8 months of
age. Walking independently typically occurs around 12 months,
specific words around 9-12 months, and spoon feeding much later.
Question 2
A 4-year-old child is admitted to the hospital with pneumonia. Which nursing
intervention is most appropriate to help the child cope with hospitalization?
A) Limit parental visits to prevent overstimulation.
B) Provide complex explanations of medical procedures.
C) Encourage play with medical equipment and offer choices when possible.
D) Administer sedatives frequently to ensure rest.
E) Avoid discussing the child's illness with them.
Correct Answer: C) Encourage play with medical equipment and
offer choices when possible.
Rationale: For preschoolers, encouraging therapeutic play (e.g.,
with dolls or medical equipment) helps them process fears and
understand procedures. Offering choices provides a sense of
control. Limiting parents and complex explanations are not age-
appropriate.
Question 3
The nurse is calculating a medication dosage for a 2-year-old child weighing
12 kg. The order is for medication X 10 mg/kg/dose. The medication is
,available as 100 mg/5 mL. How many mL should the nurse administer per
dose?
A) 0.6 mL
B) 1.2 mL
C) 2.4 mL
D) 6 mL
E) 12 mL
Correct Answer: D) 6 mL
Rationale: First, calculate the total dose: 10 mg/kg * 12 kg = 120
mg. Next, calculate the volume: (120 mg / 100 mg) * 5 mL = 1.2 * 5
mL = 6 mL.
Question 4
A 9-month-old infant is diagnosed with bronchiolitis. Which clinical
manifestation would the nurse expect to find?
A) High-pitched stridor on inspiration.
B) Barking cough with inspiratory stridor.
C) Wheezing, crackles, tachypnea, and nasal flaring.
D) Sudden onset of high fever and muffled voice.
E) Slow, deep respirations.
Correct Answer: C) Wheezing, crackles, tachypnea, and nasal
flaring.
Rationale: Bronchiolitis, often caused by RSV, is characterized by
inflammation of the bronchioles, leading to wheezing, crackles, and
increased work of breathing (tachypnea, nasal flaring). Stridor is
more indicative of upper airway obstruction (e.g., croup or
epiglottitis).
Question 5
The nurse is teaching parents of a 6-month-old about introducing solid foods.
Which food should be introduced first?
A) Whole cow's milk.
,B) Pureed meats.
C) Infant rice cereal.
D) Peanut butter.
E) Citrus fruits.
Correct Answer: C) Infant rice cereal.
Rationale: Iron-fortified infant rice cereal (or other single-grain
cereals) is typically the first solid food recommended due to its iron
content and low allergenic potential. Whole cow's milk is not
recommended before 12 months, and allergenic foods like peanut
butter are introduced later after basic solids are established.
Question 6
A 3-year-old child is scheduled for a tonsillectomy. Which finding, if observed
post-operatively, should the nurse report immediately?
A) Frequent swallowing.
B) Sore throat.
C) Low-grade fever.
D) Refusal to eat.
E) Complaining of ear pain.
Correct Answer: A) Frequent swallowing.
Rationale: Frequent swallowing after a tonsillectomy can indicate
post-operative bleeding, which is a serious complication and
requires immediate assessment.
Question 7
The nurse is assessing a 7-year-old child who has a history of asthma. The
child is experiencing an acute asthma exacerbation. Which medication is the
most appropriate first-line treatment for acute bronchospasm?
A) Inhaled fluticasone.
B) Oral prednisone.
C) Albuterol (short-acting beta-2 agonist).
D) Salmeterol (long-acting beta-2 agonist).
, E) Montelukast.
Correct Answer: C) Albuterol (short-acting beta-2 agonist).
Rationale: Short-acting beta-2 agonists (SABAs) like albuterol are
bronchodilators that provide rapid relief of acute bronchospasm and
are the first-line treatment for asthma exacerbations.
Question 8
A 15-year-old adolescent with Type 1 Diabetes Mellitus (T1DM) is learning
about self-management. Which statement indicates a need for further
teaching?
A) "I should check my blood sugar before meals and at bedtime."
B) "I can skip my insulin if I don't feel like eating much."
C) "Exercise can help lower my blood sugar, so I might need less insulin."
D) "I need to carry a source of fast-acting sugar with me."
E) "It's important to monitor my HbA1c every 3-6 months."
Correct Answer: B) "I can skip my insulin if I don't feel like eating
much."
Rationale: Skipping insulin doses, even with reduced food intake,
can lead to hyperglycemia and potentially diabetic ketoacidosis,
particularly with basal insulin needs. Insulin management must be
carefully balanced with food and activity.
Question 9
The nurse is preparing to administer an immunization to a 9-month-old
infant. Which site is most appropriate for intramuscular (IM) injections in
infants?
A) Deltoid muscle.
B) Dorsogluteal muscle.
C) Ventrogluteal muscle.
D) Vastus lateralis muscle.
E) Rectus femoris muscle.
Correct Answer: D) Vastus lateralis muscle.
COMPLETE ACCURATE EXAM QUESTIONS WITH DETAILED
VERIFIED ANSWERS (100% CORRECT ANSWERS
The nurse is assessing a 6-month-old infant during a well-child visit. Which
developmental milestone would the nurse expect to observe?
A) Walks independently.
B) Sits without support.
C) Says "dada" and "mama" specifically.
D) Feeds self with a spoon.
E) Stands holding onto furniture.
Correct Answer: B) Sits without support.
Rationale: Most infants can sit without support by 6-8 months of
age. Walking independently typically occurs around 12 months,
specific words around 9-12 months, and spoon feeding much later.
Question 2
A 4-year-old child is admitted to the hospital with pneumonia. Which nursing
intervention is most appropriate to help the child cope with hospitalization?
A) Limit parental visits to prevent overstimulation.
B) Provide complex explanations of medical procedures.
C) Encourage play with medical equipment and offer choices when possible.
D) Administer sedatives frequently to ensure rest.
E) Avoid discussing the child's illness with them.
Correct Answer: C) Encourage play with medical equipment and
offer choices when possible.
Rationale: For preschoolers, encouraging therapeutic play (e.g.,
with dolls or medical equipment) helps them process fears and
understand procedures. Offering choices provides a sense of
control. Limiting parents and complex explanations are not age-
appropriate.
Question 3
The nurse is calculating a medication dosage for a 2-year-old child weighing
12 kg. The order is for medication X 10 mg/kg/dose. The medication is
,available as 100 mg/5 mL. How many mL should the nurse administer per
dose?
A) 0.6 mL
B) 1.2 mL
C) 2.4 mL
D) 6 mL
E) 12 mL
Correct Answer: D) 6 mL
Rationale: First, calculate the total dose: 10 mg/kg * 12 kg = 120
mg. Next, calculate the volume: (120 mg / 100 mg) * 5 mL = 1.2 * 5
mL = 6 mL.
Question 4
A 9-month-old infant is diagnosed with bronchiolitis. Which clinical
manifestation would the nurse expect to find?
A) High-pitched stridor on inspiration.
B) Barking cough with inspiratory stridor.
C) Wheezing, crackles, tachypnea, and nasal flaring.
D) Sudden onset of high fever and muffled voice.
E) Slow, deep respirations.
Correct Answer: C) Wheezing, crackles, tachypnea, and nasal
flaring.
Rationale: Bronchiolitis, often caused by RSV, is characterized by
inflammation of the bronchioles, leading to wheezing, crackles, and
increased work of breathing (tachypnea, nasal flaring). Stridor is
more indicative of upper airway obstruction (e.g., croup or
epiglottitis).
Question 5
The nurse is teaching parents of a 6-month-old about introducing solid foods.
Which food should be introduced first?
A) Whole cow's milk.
,B) Pureed meats.
C) Infant rice cereal.
D) Peanut butter.
E) Citrus fruits.
Correct Answer: C) Infant rice cereal.
Rationale: Iron-fortified infant rice cereal (or other single-grain
cereals) is typically the first solid food recommended due to its iron
content and low allergenic potential. Whole cow's milk is not
recommended before 12 months, and allergenic foods like peanut
butter are introduced later after basic solids are established.
Question 6
A 3-year-old child is scheduled for a tonsillectomy. Which finding, if observed
post-operatively, should the nurse report immediately?
A) Frequent swallowing.
B) Sore throat.
C) Low-grade fever.
D) Refusal to eat.
E) Complaining of ear pain.
Correct Answer: A) Frequent swallowing.
Rationale: Frequent swallowing after a tonsillectomy can indicate
post-operative bleeding, which is a serious complication and
requires immediate assessment.
Question 7
The nurse is assessing a 7-year-old child who has a history of asthma. The
child is experiencing an acute asthma exacerbation. Which medication is the
most appropriate first-line treatment for acute bronchospasm?
A) Inhaled fluticasone.
B) Oral prednisone.
C) Albuterol (short-acting beta-2 agonist).
D) Salmeterol (long-acting beta-2 agonist).
, E) Montelukast.
Correct Answer: C) Albuterol (short-acting beta-2 agonist).
Rationale: Short-acting beta-2 agonists (SABAs) like albuterol are
bronchodilators that provide rapid relief of acute bronchospasm and
are the first-line treatment for asthma exacerbations.
Question 8
A 15-year-old adolescent with Type 1 Diabetes Mellitus (T1DM) is learning
about self-management. Which statement indicates a need for further
teaching?
A) "I should check my blood sugar before meals and at bedtime."
B) "I can skip my insulin if I don't feel like eating much."
C) "Exercise can help lower my blood sugar, so I might need less insulin."
D) "I need to carry a source of fast-acting sugar with me."
E) "It's important to monitor my HbA1c every 3-6 months."
Correct Answer: B) "I can skip my insulin if I don't feel like eating
much."
Rationale: Skipping insulin doses, even with reduced food intake,
can lead to hyperglycemia and potentially diabetic ketoacidosis,
particularly with basal insulin needs. Insulin management must be
carefully balanced with food and activity.
Question 9
The nurse is preparing to administer an immunization to a 9-month-old
infant. Which site is most appropriate for intramuscular (IM) injections in
infants?
A) Deltoid muscle.
B) Dorsogluteal muscle.
C) Ventrogluteal muscle.
D) Vastus lateralis muscle.
E) Rectus femoris muscle.
Correct Answer: D) Vastus lateralis muscle.
