Pediatric Nursing Exam Practice Questions with Rationales
1. A nurse is assessing a 6-month-old infant. Which finding requires immediate attention?
A. Posterior fontanel closed
B. Respiratory rate of 60 breaths/min with nasal flaring
C. Weight doubled since birth
D. Presence of startle reflex
Answer: B. Respiratory rate of 60 breaths/min with nasal flaring
Rationale:
A respiratory rate of 60 with nasal flaring indicates respiratory distress in an infant and
requires immediate intervention. Closure of the posterior fontanel by 2–3 months is normal.
Doubling birth weight by 6 months is expected. The startle (Moro) reflex is still present at
this age.
2. A child with dehydration is admitted after severe diarrhea. Which assessment finding
indicates severe dehydration?
A. Moist mucous membranes
B. Increased urine output
C. Sunken eyes and delayed capillary refill
D. Bounding pulse
Answer: C. Sunken eyes and delayed capillary refill
Rationale:
Severe dehydration in children commonly presents with sunken eyes, poor skin turgor,
delayed capillary refill, tachycardia, and lethargy. Moist mucous membranes and increased
urine output indicate adequate hydration.
3. Which intervention is the priority for a child experiencing a tonic-clonic seizure?
A. Insert a tongue blade
B. Restrain the child’s arms
C. Place the child on the side
D. Offer water after the seizure begins
Answer: C. Place the child on the side
Rationale:
,The priority during a seizure is maintaining airway patency and preventing aspiration.
Turning the child to the side helps keep the airway clear. Nothing should be inserted into the
mouth, and restraints should not be used.
4. A nurse is teaching parents about immunizations. Which vaccine is usually administered at
birth?
A. Varicella
B. Hepatitis B
C. MMR
D. DTaP
Answer: B. Hepatitis B
Rationale:
The Hepatitis B vaccine is routinely given shortly after birth. Varicella and MMR are
administered after 12 months, while DTaP begins at 2 months.
5. Which statement by the parent of a child with asthma indicates understanding of discharge
teaching?
A. “I will use the rescue inhaler every morning.”
B. “My child should avoid known asthma triggers.”
C. “Antibiotics cure asthma attacks.”
D. “Wheezing is always normal in asthma.”
Answer: B. “My child should avoid known asthma triggers.”
Rationale:
Avoiding triggers such as smoke, dust, pets, and pollen helps prevent asthma exacerbations.
Rescue inhalers are used during acute symptoms, not routinely unless prescribed.
6. A toddler is hospitalized. Which behavior is expected during separation anxiety?
A. Indifference to parents
B. Quiet acceptance
C. Crying and clinging to parents
D. Interest in strangers
Answer: C. Crying and clinging to parents
Rationale:
, Toddlers commonly experience separation anxiety, especially during hospitalization. They
may cry, cling, and resist caregivers when parents leave.
7. Which finding is most concerning in a child with meningitis?
A. Positive Kernig’s sign
B. Fever and irritability
C. Petechial rash with hypotension
D. Headache and photophobia
Answer: C. Petechial rash with hypotension
Rationale:
A petechial rash and hypotension may indicate meningococcal septicemia, a life-threatening
complication requiring immediate treatment.
8. A nurse is caring for a child with Type 1 diabetes mellitus. Which symptom suggests
hypoglycemia?
A. Fruity breath odor
B. Warm flushed skin
C. Tremors and sweating
D. Deep rapid respirations
Answer: C. Tremors and sweating
Rationale:
Hypoglycemia causes shakiness, sweating, irritability, hunger, and confusion. Fruity breath
and Kussmaul respirations are signs of hyperglycemia or diabetic ketoacidosis.
9. Which toy is most appropriate for a hospitalized 2-year-old child?
A. Puzzle with many tiny pieces
B. Video game console
C. Push-pull toy
D. Complex board game
Answer: C. Push-pull toy
Rationale:
Toddlers enjoy active play and simple toys that promote motor development. Toys with tiny
pieces are unsafe due to choking hazards.
10. A child with acute glomerulonephritis is admitted. Which assessment finding is expected?
1. A nurse is assessing a 6-month-old infant. Which finding requires immediate attention?
A. Posterior fontanel closed
B. Respiratory rate of 60 breaths/min with nasal flaring
C. Weight doubled since birth
D. Presence of startle reflex
Answer: B. Respiratory rate of 60 breaths/min with nasal flaring
Rationale:
A respiratory rate of 60 with nasal flaring indicates respiratory distress in an infant and
requires immediate intervention. Closure of the posterior fontanel by 2–3 months is normal.
Doubling birth weight by 6 months is expected. The startle (Moro) reflex is still present at
this age.
2. A child with dehydration is admitted after severe diarrhea. Which assessment finding
indicates severe dehydration?
A. Moist mucous membranes
B. Increased urine output
C. Sunken eyes and delayed capillary refill
D. Bounding pulse
Answer: C. Sunken eyes and delayed capillary refill
Rationale:
Severe dehydration in children commonly presents with sunken eyes, poor skin turgor,
delayed capillary refill, tachycardia, and lethargy. Moist mucous membranes and increased
urine output indicate adequate hydration.
3. Which intervention is the priority for a child experiencing a tonic-clonic seizure?
A. Insert a tongue blade
B. Restrain the child’s arms
C. Place the child on the side
D. Offer water after the seizure begins
Answer: C. Place the child on the side
Rationale:
,The priority during a seizure is maintaining airway patency and preventing aspiration.
Turning the child to the side helps keep the airway clear. Nothing should be inserted into the
mouth, and restraints should not be used.
4. A nurse is teaching parents about immunizations. Which vaccine is usually administered at
birth?
A. Varicella
B. Hepatitis B
C. MMR
D. DTaP
Answer: B. Hepatitis B
Rationale:
The Hepatitis B vaccine is routinely given shortly after birth. Varicella and MMR are
administered after 12 months, while DTaP begins at 2 months.
5. Which statement by the parent of a child with asthma indicates understanding of discharge
teaching?
A. “I will use the rescue inhaler every morning.”
B. “My child should avoid known asthma triggers.”
C. “Antibiotics cure asthma attacks.”
D. “Wheezing is always normal in asthma.”
Answer: B. “My child should avoid known asthma triggers.”
Rationale:
Avoiding triggers such as smoke, dust, pets, and pollen helps prevent asthma exacerbations.
Rescue inhalers are used during acute symptoms, not routinely unless prescribed.
6. A toddler is hospitalized. Which behavior is expected during separation anxiety?
A. Indifference to parents
B. Quiet acceptance
C. Crying and clinging to parents
D. Interest in strangers
Answer: C. Crying and clinging to parents
Rationale:
, Toddlers commonly experience separation anxiety, especially during hospitalization. They
may cry, cling, and resist caregivers when parents leave.
7. Which finding is most concerning in a child with meningitis?
A. Positive Kernig’s sign
B. Fever and irritability
C. Petechial rash with hypotension
D. Headache and photophobia
Answer: C. Petechial rash with hypotension
Rationale:
A petechial rash and hypotension may indicate meningococcal septicemia, a life-threatening
complication requiring immediate treatment.
8. A nurse is caring for a child with Type 1 diabetes mellitus. Which symptom suggests
hypoglycemia?
A. Fruity breath odor
B. Warm flushed skin
C. Tremors and sweating
D. Deep rapid respirations
Answer: C. Tremors and sweating
Rationale:
Hypoglycemia causes shakiness, sweating, irritability, hunger, and confusion. Fruity breath
and Kussmaul respirations are signs of hyperglycemia or diabetic ketoacidosis.
9. Which toy is most appropriate for a hospitalized 2-year-old child?
A. Puzzle with many tiny pieces
B. Video game console
C. Push-pull toy
D. Complex board game
Answer: C. Push-pull toy
Rationale:
Toddlers enjoy active play and simple toys that promote motor development. Toys with tiny
pieces are unsafe due to choking hazards.
10. A child with acute glomerulonephritis is admitted. Which assessment finding is expected?
