NACE Care of the Child Exam Questions &
Answers with RATIONALES | Latest 2026
Verified Study Guide
NACE Care of the Child Exam Questions & Answers with EXPERT RATIONALE |
Latest 2026 Verified Study Guide
• This study guide contains 150 carefully crafted multiple-choice questions covering
all core topics in the NACE Care of the Child exam, each with five answer options
(A–E), a highlighted correct answer, and a detailed EXPERT RATIONALE to reinforce
understanding.
• For best results, attempt each question independently before checking the correct
answer, then read the EXPERT RATIONALE carefully to strengthen your clinical
reasoning and retention.
1. A nurse is assessing a 2-year-old child. Which of the following findings is
considered a normal developmental milestone for this age?
A. Speaks in complete sentences of 6–8 words
B. Rides a bicycle without training wheels
C. Reads simple words
D. Ties shoelaces independently
E. Uses approximately 50 words and speaks in two-word phrases
Correct Answer: E. Uses approximately 50 words and speaks in two-word
phrases
EXPERT RATIONALE: By age 2, a child is expected to have a vocabulary of about
50 words and combine two words together (e.g., "more milk"). Complete sentences
develop around ages 4–5, and complex motor skills like riding a bike or tying laces
develop much later.
,2. A nurse is caring for a newborn. Which reflex should be present at birth and
disappear by 4–6 months?
A. Babinski reflex
B. Parachute reflex
C. Landau reflex
D. Moro reflex
E. Stepping reflex disappears at 12 months
Correct Answer: D. Moro reflex
EXPERT RATIONALE: The Moro (startle) reflex is present at birth and normally
disappears by 4–6 months. It involves the infant extending arms and legs in
response to a sudden stimulus. Persistence beyond 6 months may indicate
neurological dysfunction.
3. Which immunization is recommended at birth before hospital discharge?
A. MMR vaccine
B. Varicella vaccine
C. Pneumococcal vaccine
D. DTaP vaccine
E. Hepatitis B vaccine
Correct Answer: E. Hepatitis B vaccine
EXPERT RATIONALE: The first dose of Hepatitis B vaccine is recommended at
birth, ideally within 24 hours. This protects against perinatal transmission of
Hepatitis B, which can lead to chronic liver disease.
4. A child is brought to the clinic with a fever of 39.5°C. Which nursing
intervention is the priority?
,A. Apply ice packs to the groin and axilla
B. Administer aspirin as ordered
C. Administer antipyretics as ordered and ensure adequate hydration
D. Place the child in a cool bath immediately
E. Restrict all fluids to prevent further fever
Correct Answer: C. Administer antipyretics as ordered and ensure adequate
hydration
EXPERT RATIONALE: The priority is to reduce fever safely using antipyretics
(acetaminophen or ibuprofen) and maintain hydration. Ice packs can cause
vasoconstriction and shivering. Aspirin is contraindicated in children due to risk of
Reye's syndrome. Cold baths are not recommended.
5. A nurse is educating parents about car seat safety for a 6-month-old infant.
What is the correct instruction?
A. Forward-facing car seat in the front passenger seat
B. Forward-facing car seat in the back seat
C. Rear-facing car seat in the back seat
D. Booster seat in the back seat
E. Rear-facing car seat in the front passenger seat
Correct Answer: C. Rear-facing car seat in the back seat
EXPERT RATIONALE: Infants should be placed in a rear-facing car seat in the
back seat until age 2 or until they exceed the car seat's height/weight limit. Rear-
facing provides the best protection for the head, neck, and spine in a crash.
6. A nurse is assessing a child with suspected epiglottitis. Which action should
the nurse take first?
, A. Obtain a throat culture immediately
B. Prepare for intubation equipment
C. Place the child flat in bed
D. Do not inspect the throat and notify the physician immediately
E. Administer oral antibiotics
Correct Answer: D. Do not inspect the throat and notify the physician
immediately
EXPERT RATIONALE: Inspecting the throat in epiglottitis can trigger complete
airway obstruction. The child should be kept calm and upright (tripod position).
Notify the physician immediately and prepare for emergency airway management.
7. Which of the following is the most appropriate sleeping position for a
healthy newborn?
A. Prone (on the stomach)
B. On the side
C. Supine (on the back)
D. Semi-reclined at 45 degrees
E. Alternating prone and supine
Correct Answer: C. Supine (on the back)
EXPERT RATIONALE: The American Academy of Pediatrics (AAP) recommends
placing all healthy infants on their backs to sleep to reduce the risk of Sudden
Infant Death Syndrome (SIDS). Prone sleeping significantly increases SIDS risk.
8. A 4-year-old is admitted with croup. Which assessment finding indicates the
child's condition is worsening?
A. Occasional barking cough
Answers with RATIONALES | Latest 2026
Verified Study Guide
NACE Care of the Child Exam Questions & Answers with EXPERT RATIONALE |
Latest 2026 Verified Study Guide
• This study guide contains 150 carefully crafted multiple-choice questions covering
all core topics in the NACE Care of the Child exam, each with five answer options
(A–E), a highlighted correct answer, and a detailed EXPERT RATIONALE to reinforce
understanding.
• For best results, attempt each question independently before checking the correct
answer, then read the EXPERT RATIONALE carefully to strengthen your clinical
reasoning and retention.
1. A nurse is assessing a 2-year-old child. Which of the following findings is
considered a normal developmental milestone for this age?
A. Speaks in complete sentences of 6–8 words
B. Rides a bicycle without training wheels
C. Reads simple words
D. Ties shoelaces independently
E. Uses approximately 50 words and speaks in two-word phrases
Correct Answer: E. Uses approximately 50 words and speaks in two-word
phrases
EXPERT RATIONALE: By age 2, a child is expected to have a vocabulary of about
50 words and combine two words together (e.g., "more milk"). Complete sentences
develop around ages 4–5, and complex motor skills like riding a bike or tying laces
develop much later.
,2. A nurse is caring for a newborn. Which reflex should be present at birth and
disappear by 4–6 months?
A. Babinski reflex
B. Parachute reflex
C. Landau reflex
D. Moro reflex
E. Stepping reflex disappears at 12 months
Correct Answer: D. Moro reflex
EXPERT RATIONALE: The Moro (startle) reflex is present at birth and normally
disappears by 4–6 months. It involves the infant extending arms and legs in
response to a sudden stimulus. Persistence beyond 6 months may indicate
neurological dysfunction.
3. Which immunization is recommended at birth before hospital discharge?
A. MMR vaccine
B. Varicella vaccine
C. Pneumococcal vaccine
D. DTaP vaccine
E. Hepatitis B vaccine
Correct Answer: E. Hepatitis B vaccine
EXPERT RATIONALE: The first dose of Hepatitis B vaccine is recommended at
birth, ideally within 24 hours. This protects against perinatal transmission of
Hepatitis B, which can lead to chronic liver disease.
4. A child is brought to the clinic with a fever of 39.5°C. Which nursing
intervention is the priority?
,A. Apply ice packs to the groin and axilla
B. Administer aspirin as ordered
C. Administer antipyretics as ordered and ensure adequate hydration
D. Place the child in a cool bath immediately
E. Restrict all fluids to prevent further fever
Correct Answer: C. Administer antipyretics as ordered and ensure adequate
hydration
EXPERT RATIONALE: The priority is to reduce fever safely using antipyretics
(acetaminophen or ibuprofen) and maintain hydration. Ice packs can cause
vasoconstriction and shivering. Aspirin is contraindicated in children due to risk of
Reye's syndrome. Cold baths are not recommended.
5. A nurse is educating parents about car seat safety for a 6-month-old infant.
What is the correct instruction?
A. Forward-facing car seat in the front passenger seat
B. Forward-facing car seat in the back seat
C. Rear-facing car seat in the back seat
D. Booster seat in the back seat
E. Rear-facing car seat in the front passenger seat
Correct Answer: C. Rear-facing car seat in the back seat
EXPERT RATIONALE: Infants should be placed in a rear-facing car seat in the
back seat until age 2 or until they exceed the car seat's height/weight limit. Rear-
facing provides the best protection for the head, neck, and spine in a crash.
6. A nurse is assessing a child with suspected epiglottitis. Which action should
the nurse take first?
, A. Obtain a throat culture immediately
B. Prepare for intubation equipment
C. Place the child flat in bed
D. Do not inspect the throat and notify the physician immediately
E. Administer oral antibiotics
Correct Answer: D. Do not inspect the throat and notify the physician
immediately
EXPERT RATIONALE: Inspecting the throat in epiglottitis can trigger complete
airway obstruction. The child should be kept calm and upright (tripod position).
Notify the physician immediately and prepare for emergency airway management.
7. Which of the following is the most appropriate sleeping position for a
healthy newborn?
A. Prone (on the stomach)
B. On the side
C. Supine (on the back)
D. Semi-reclined at 45 degrees
E. Alternating prone and supine
Correct Answer: C. Supine (on the back)
EXPERT RATIONALE: The American Academy of Pediatrics (AAP) recommends
placing all healthy infants on their backs to sleep to reduce the risk of Sudden
Infant Death Syndrome (SIDS). Prone sleeping significantly increases SIDS risk.
8. A 4-year-old is admitted with croup. Which assessment finding indicates the
child's condition is worsening?
A. Occasional barking cough
