PEDIATRIC NURSING CASE STUDY-
BASED COMPLETE QUESTIONS PRACTICE
WITH 100% VERIFIED ANSWERS
PEDIATRIC NURSING STUDY GUIDE
1. A 4-year-old child presents with a barking cough, stridor, and
moderate subcostal retractions. The parents report the symptoms
started suddenly at night. What is the priority nursing intervention?
A) Administer racemic epinephrine nebulizer
B) Obtain a throat culture for bacteria
C) Prepare for endotracheal intubation
D) Place the child in a croup tent with cool mist
Correct Answer: A
Rationale: This presentation is classic for moderate to severe croup
(laryngotracheobronchitis). Racemic epinephrine reduces mucosal
edema; cool mist is supportive but not the priority for moderate distress.
2. A 2-month-old infant with RSV bronchiolitis has nasal flaring,
grunting, and an oxygen saturation of 88% on room air. Which action
should the nurse take first?
A) Apply a nasal cannula at 2 L/min
B) Suction the nares with a bulb syringe
C) Notify the provider for possible high-flow nasal cannula
,D) Place the infant in a prone position
Correct Answer: B
Rationale: Nasal obstruction worsens work of breathing in infants;
suctioning clears the airway and may improve saturations before
oxygen is applied.
3. A school-age child with cystic fibrosis has a chronic cough and thick
sputum. Which intervention best promotes airway clearance?
A) Daily oral corticosteroids
B) Chest physiotherapy with postural drainage twice daily
C) Restrict fluids to decrease secretions
D) Use of a cool-mist humidifier only
Correct Answer: B
Rationale: Chest physiotherapy (percussion and postural drainage) helps
mobilize thick secretions, a cornerstone of CF management.
4. A 3-year-old presents with fever, dysphagia, drooling, and a muffled
voice. The child is sitting upright and leaning forward. What is the
nurse’s priority action?
A) Inspect the throat with a tongue depressor
B) Prepare for immediate intubation in the OR
C) Keep the child calm and do not agitate
D) Start IV antibiotics immediately
Correct Answer: C
Rationale: Symptoms suggest epiglottitis; agitation or throat inspection
can cause complete airway obstruction. Keep child calm, prepare for
controlled airway intervention.
,5. A 6-month-old infant is diagnosed with acute otitis media. Which
nursing instruction is most important regarding antibiotics?
A) Stop antibiotics when fever resolves
B) Complete the full course as prescribed
C) Mix antibiotics with formula to improve taste
D) Give antibiotics only at night to reduce side effects
Correct Answer: B
Rationale: Incomplete antibiotic courses promote resistance; full course
is essential even if symptoms improve.
6. A 10-year-old with asthma has a peak expiratory flow rate of 55% of
personal best. The nurse auscultates diminished breath sounds and no
wheezing. What is the best interpretation?
A) The child is improving and can return to play
B) Severe bronchospasm with poor air movement
C) A normal finding for a child with asthma
D) The inhaler technique needs re-education
Correct Answer: B
Rationale: Diminished breath sounds with low peak flow and no
wheezing (“silent chest”) indicates severe obstruction and potential
respiratory failure.
7. A toddler with a fever of 104°F (40°C) has a generalized tonic-clonic
seizure lasting 3 minutes. After the seizure, the child is sleepy but
arousable. What is the priority nursing action?
A) Administer rectal diazepam immediately
, B) Place the child in a cool bath
C) Assess temperature and give antipyretics
D) Prepare for lumbar puncture
Correct Answer: C
Rationale: This is a simple febrile seizure; postictal sleep is normal.
Priority is treating fever and monitoring; no acute anticonvulsant
needed unless seizure recurs.
8. A 5-year-old is admitted with pertussis. Which isolation precaution is
most appropriate?
A) Standard precautions only
B) Contact precautions
C) Droplet precautions
D) Airborne precautions
Correct Answer: C
Rationale: Pertussis (Bordetella pertussis) is transmitted via respiratory
droplets; droplet precautions continue until 5 days of appropriate
antibiotics.
9. An infant with congenital heart disease and RSV bronchiolitis has a
respiratory rate of 70, heart rate 190, and liver 3 cm below costal
margin. What complication should the nurse suspect?
A) Pneumothorax
B) Heart failure
C) Sepsis
D) Metabolic acidosis
Correct Answer: B
BASED COMPLETE QUESTIONS PRACTICE
WITH 100% VERIFIED ANSWERS
PEDIATRIC NURSING STUDY GUIDE
1. A 4-year-old child presents with a barking cough, stridor, and
moderate subcostal retractions. The parents report the symptoms
started suddenly at night. What is the priority nursing intervention?
A) Administer racemic epinephrine nebulizer
B) Obtain a throat culture for bacteria
C) Prepare for endotracheal intubation
D) Place the child in a croup tent with cool mist
Correct Answer: A
Rationale: This presentation is classic for moderate to severe croup
(laryngotracheobronchitis). Racemic epinephrine reduces mucosal
edema; cool mist is supportive but not the priority for moderate distress.
2. A 2-month-old infant with RSV bronchiolitis has nasal flaring,
grunting, and an oxygen saturation of 88% on room air. Which action
should the nurse take first?
A) Apply a nasal cannula at 2 L/min
B) Suction the nares with a bulb syringe
C) Notify the provider for possible high-flow nasal cannula
,D) Place the infant in a prone position
Correct Answer: B
Rationale: Nasal obstruction worsens work of breathing in infants;
suctioning clears the airway and may improve saturations before
oxygen is applied.
3. A school-age child with cystic fibrosis has a chronic cough and thick
sputum. Which intervention best promotes airway clearance?
A) Daily oral corticosteroids
B) Chest physiotherapy with postural drainage twice daily
C) Restrict fluids to decrease secretions
D) Use of a cool-mist humidifier only
Correct Answer: B
Rationale: Chest physiotherapy (percussion and postural drainage) helps
mobilize thick secretions, a cornerstone of CF management.
4. A 3-year-old presents with fever, dysphagia, drooling, and a muffled
voice. The child is sitting upright and leaning forward. What is the
nurse’s priority action?
A) Inspect the throat with a tongue depressor
B) Prepare for immediate intubation in the OR
C) Keep the child calm and do not agitate
D) Start IV antibiotics immediately
Correct Answer: C
Rationale: Symptoms suggest epiglottitis; agitation or throat inspection
can cause complete airway obstruction. Keep child calm, prepare for
controlled airway intervention.
,5. A 6-month-old infant is diagnosed with acute otitis media. Which
nursing instruction is most important regarding antibiotics?
A) Stop antibiotics when fever resolves
B) Complete the full course as prescribed
C) Mix antibiotics with formula to improve taste
D) Give antibiotics only at night to reduce side effects
Correct Answer: B
Rationale: Incomplete antibiotic courses promote resistance; full course
is essential even if symptoms improve.
6. A 10-year-old with asthma has a peak expiratory flow rate of 55% of
personal best. The nurse auscultates diminished breath sounds and no
wheezing. What is the best interpretation?
A) The child is improving and can return to play
B) Severe bronchospasm with poor air movement
C) A normal finding for a child with asthma
D) The inhaler technique needs re-education
Correct Answer: B
Rationale: Diminished breath sounds with low peak flow and no
wheezing (“silent chest”) indicates severe obstruction and potential
respiratory failure.
7. A toddler with a fever of 104°F (40°C) has a generalized tonic-clonic
seizure lasting 3 minutes. After the seizure, the child is sleepy but
arousable. What is the priority nursing action?
A) Administer rectal diazepam immediately
, B) Place the child in a cool bath
C) Assess temperature and give antipyretics
D) Prepare for lumbar puncture
Correct Answer: C
Rationale: This is a simple febrile seizure; postictal sleep is normal.
Priority is treating fever and monitoring; no acute anticonvulsant
needed unless seizure recurs.
8. A 5-year-old is admitted with pertussis. Which isolation precaution is
most appropriate?
A) Standard precautions only
B) Contact precautions
C) Droplet precautions
D) Airborne precautions
Correct Answer: C
Rationale: Pertussis (Bordetella pertussis) is transmitted via respiratory
droplets; droplet precautions continue until 5 days of appropriate
antibiotics.
9. An infant with congenital heart disease and RSV bronchiolitis has a
respiratory rate of 70, heart rate 190, and liver 3 cm below costal
margin. What complication should the nurse suspect?
A) Pneumothorax
B) Heart failure
C) Sepsis
D) Metabolic acidosis
Correct Answer: B
