Pediatric Nurse Exam Pediatric Nursing NCLEX 3 — Questions and Answers
Question 1: A 3-month-old is brought to the ER with a bulging fontanelle, high-pitched cry, and fever. The nurse prepares for which PRIORITY intervention?
- Lumbar puncture preparation (Correct answer)
- Administer acetaminophen and discharge
- Place in Trendelenburg position
- Apply a cooling blanket immediately
Correct answer: Lumbar puncture preparation
Signs of bacterial meningitis require immediate lumbar puncture preparation for diagnosis and prompt antibiotic administration.
Question 2: Which immunization is CONTRAINDICATED in an immunocompromised 18-month-old?
- Inactivated influenza vaccine
- MMR vaccine (Correct answer)
- DTaP vaccine
- Pneumococcal conjugate vaccine
Correct answer: MMR vaccine
MMR is a live attenuated vaccine and is contraindicated in immunocompromised children due to risk of vaccine-strain infection.
Question 3: A nurse is calculating maintenance IV fluids for a 25 kg child using the Holliday-Segar method. What is the correct daily fluid requirement?
- 1,250 mL/day
- 1,600 mL/day (Correct answer)
- 1,750 mL/day
- 2,000 mL/day
Correct answer: 1,600 mL/day
Holliday-Segar: 100 mL/kg for first 10 kg + 50 mL/kg for next 10 kg + 20 mL/kg for remaining kg = 1,000 + 500 + 100 = 1,600 mL/day.
Question 4: A 6-year-old with croup presents with a barking cough and stridor at rest. Which treatment is MOST appropriate?
- Inhaled ipratropium
- Nebulized racemic epinephrine (Correct answer)
- IV methylprednisolone bolus
- Chest physiotherapy
Correct answer: Nebulized racemic epinephrine
Nebulized racemic epinephrine rapidly reduces subglottic edema and is indicated for moderate-to-severe croup with stridor at rest.
Question 5: A nurse is assessing a 5-year-old for pain. Which scale is MOST appropriate?
- Numeric Rating Scale (0–10)
- FLACC scale
- Wong-Baker FACES scale (Correct answer)
- CRIES scale
Correct answer: Wong-Baker FACES scale
The Wong-Baker FACES scale is validated for children ages 3–7 who can self-report pain using facial expressions.
Question 6: A 14-year-old newly diagnosed with type 1 diabetes asks why she needs to check ketones when her blood sugar is high. The nurse responds:
- Ketones confirm the type of diabetes you have
- Ketones indicate fat breakdown and risk of diabetic ketoacidosis (Correct answer)
- High ketones mean your insulin is working correctly
- Ketone testing replaces the need for blood glucose checks
Correct answer: Ketones indicate fat breakdown and risk of diabetic ketoacidosis
In insulin deficiency, the body breaks down fat for energy, producing ketones that can accumulate and cause DKA.
Question 7: Which developmental milestone is expected for a typical 12-month-old?
- Walks up stairs independently
- Speaks in 2-word phrases
- Uses a pincer grasp (Correct answer)
- Copies a circle
Correct answer: Uses a pincer grasp
By 12 months, infants develop a mature pincer grasp (thumb and index finger) to pick up small objects.
Pediatric Nurse Exam Pediatric Nursing NCLEX 3
A 3-month-old is brought to the ER with a bulging fontanelle, high-pitched cry, and fever.
The nurse prepares for which PRIORITY intervention?