EXAM Actual Exam 2026/2027 – Complete
Questions and Answers with Detailed Rationales –
Pass Guaranteed - A+ Graded
TABLE OF CONTENTS
Section 1 | Health Promotion & Maintenance (Birth to Adolescence) | Q1 – Q17
Section 2 | Pediatric Growth & Development | Q18 – Q34
Section 3 | Acute & Chronic Illness Management | Q35 – Q51
Section 4 | Infectious Diseases & Immunizations | Q52 – Q67
Section 5 | Pediatric Emergencies & Safety | Q68 – Q83
Section 6 | Family-Centered Care & Psychosocial Integrity | Q84 – Q100
Instructions: Choose the single best answer. Pass: 80% in 120 minutes.
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SECTION 1: HEALTH PROMOTION & MAINTENANCE (BIRTH TO ADOLESCENCE) Q1 –
Q17
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Question 1 of 100
A nurse is discharging a 28-hour-old newborn whose mother tested positive for
hepatitis B surface antigen during pregnancy. The mother asks when the infant received
the first hepatitis B dose.
A. The infant should have received the vaccine and HBIG within 12 hours of birth ✓
CORRECT
B. The vaccine is typically delayed until the 2-week well-child checkup
C. The first dose is given at birth only if the mother has active hepatitis C
D. HBIG is unnecessary because the vaccine alone prevents perinatal transmission
,Correct Answer: A
Rationale: Infants born to HBsAg-positive mothers must receive both hepatitis B vaccine
and hepatitis B immune globulin within 12 hours of birth to prevent perinatal infection.
Delaying either dose significantly increases the risk of chronic hepatitis B infection in
the infant. This protocol is one of the most time-sensitive immunization requirements in
newborn care.
Question 2 of 100
During a 4-month-old well-child visit, the mother reports she started adding rice cereal
to the evening bottle to help the infant sleep longer. The infant was born full-term and is
exclusively formula-fed.
A. Encourage this practice since it provides extra calories before bedtime
B. Explain that solids should not be introduced before 4 to 6 months and bottle-feeding
cereal increases aspiration risk ✓ CORRECT
C. Suggest mixing the cereal with breast milk instead of formula for better digestion
D. Recommend increasing the formula volume per feeding rather than adding solids
Correct Answer: B
Rationale: The American Academy of Pediatrics recommends delaying solid foods until
approximately 6 months when the extrusion reflex diminishes and head control is
established. Adding cereal to bottles increases choking and aspiration risk without
improving sleep duration. This is a common misconception among new parents that
requires clear anticipatory guidance.
Question 3 of 100
A pediatric nurse is counseling the parents of a 14-month-old about transitioning from
an infant car seat. The parents plan to turn the child forward-facing on her first birthday
because she meets the minimum weight.
A. Forward-facing is acceptable once the child reaches 20 pounds regardless of age
,B. Rear-facing is only required until the first birthday in most states
C. The child should remain rear-facing until at least age 2 or until reaching the seat's
maximum rear-facing limits ✓ CORRECT
D. A booster seat is the next appropriate step after outgrowing the infant carrier
Correct Answer: C
Rationale: Current safety guidelines recommend children remain rear-facing until at
least 2 years of age or until they reach the highest weight or height allowed by the
convertible car seat manufacturer. Forward-facing too early increases the risk of
cervical spine injury in a crash. Many parents mistakenly believe the first birthday is the
automatic transition point.
Question 4 of 100
A home health nurse visits a family with a 3-month-old and finds the infant sleeping in a
padded crib bumper with a loose blanket and several stuffed animals.
A. These items provide comfort and security for a young infant during sleep
B. The parents should switch to a side-sleeping position to reduce reflux concerns
C. A wedge pillow should be added to elevate the head and prevent choking
D. Remove all soft bedding and toys, and place the infant on the back on a firm mattress
✓ CORRECT
Correct Answer: D
Rationale: Safe sleep guidelines require infants to sleep on their backs on a firm surface
without loose bedding, bumpers, or soft objects that increase suffocation and SIDS risk.
Side sleeping is not recommended because infants can roll prone. This is a high-priority
teaching moment during every home visit with young infants.
Question 5 of 100
, During a kindergarten physical, the school nurse screens a 5-year-old's vision using the
Snellen chart. The child correctly identifies most letters on the 20/30 line but struggles
with the 20/20 line.
A. This result is within normal limits for a preschool-age child and should be rechecked
in 1 year ✓ CORRECT
B. The child requires immediate referral to a pediatric ophthalmologist for glasses
C. The nurse should retest using a picture chart instead of letters for better accuracy
D. A finding of 20/30 indicates amblyopia that requires patching therapy
Correct Answer: A
Rationale: Visual acuity of 20/30 to 20/40 is considered acceptable for children ages 3
to 5 years, with 20/20 expected by school age around 6 to 7 years. Immediate referral
for glasses or patching is unnecessary based on a single 20/30 screening result.
Routine vision screening at well visits catches refractive errors before they affect school
performance.
Question 6 of 100
A mother calls the pediatric clinic frantic because her 18-month-old swallowed an
unknown quantity of her prenatal vitamins. The mother still has syrup of ipecac in the
medicine cabinet from her own childhood.
A. Instruct the mother to administer the ipecac immediately to induce vomiting
B. Tell the mother not to give ipecac and to contact Poison Control immediately for
guidance ✓ CORRECT
C. Advise the mother to give milk to dilute the stomach contents and observe at home
D. Suggest the mother bring the child to the clinic in 2 hours if symptoms develop
Correct Answer: B
Rationale: Syrup of ipecac is no longer recommended for home poisoning management
because induced vomiting can cause aspiration and does not reliably reduce toxin
absorption. Poison Control provides real-time guidance based on the specific iron