NURS250 Pediatric Nursing Updated 2026 | Comprehensive Study Guide,
Practice Exam Questions and Answers, Exam Prep Test Bank, Pediatric
Growth and Development Milestones, Child Health Assessment
Techniques, Common Childhood Disorders and Diseases, Pediatric
Pharmacology and Medication Administration, Family-Centered Nursing
Care, Immunization Schedules and Preventive Health, Pediatric Clinical
Judgment, NCLEX-Style Practice Questions, and Detailed Rationales for
Nursing Exam Success
Question 1: A 4-year-old child presents with a high-pitched, barking cough,
hoarseness, and inspiratory stridor that worsens at night. Which of the following is
the priority nursing intervention?
A. Administer a nebulized bronchodilator
B. Prepare for emergency tracheostomy
C. Place the child in a cool-mist tent and observe for respiratory distress
D. Administer oral antibiotics
CORRECT ANSWER: C. Place the child in a cool-mist tent and observe for
respiratory distress
Rationale: The child is exhibiting classic signs of moderate croup
(laryngotracheobronchitis), which causes subglottic swelling. Cool mist helps reduce
airway edema and ease breathing. Bronchodilators are not the primary treatment,
tracheostomy is reserved for severe cases, and antibiotics are ineffective for viral croup.
Question 2: The mother of an 8-month-old infant asks when she can introduce
cow's milk into the infant's diet. What is the most appropriate response?
A. "You can start now if you dilute it with water."
B. "It is recommended to wait until 12 months of age."
C. "You can introduce it at 9 months in small amounts."
D. "Cow's milk should be avoided until 2 years of age."
CORRECT ANSWER: B. "It is recommended to wait until 12 months of age."
Rationale: The American Academy of Pediatrics recommends delaying introduction of
whole cow's milk until 12 months of age because it lacks adequate iron and essential
fatty acids, and its high renal solute load can stress infant kidneys.
Question 3: A 2-year-old child is brought to the emergency department after
ingesting a small amount of a household cleaner that is alkaline. What is the
priority nursing action?
A. Induce vomiting using syrup of ipecac
B. Administer activated charcoal
,C. Assess the child's airway, breathing, and circulation (ABCs) and do not induce
vomiting
D. Perform gastric lavage immediately
CORRECT ANSWER: C. Assess the child's airway, breathing, and circulation (ABCs)
and do not induce vomiting
Rationale: Alkaline substances cause liquefaction necrosis and can cause severe
burns to the esophagus and airway. Inducing vomiting can re-expose the esophagus
and airway to the corrosive agent and increase risk of aspiration and perforation.
Question 4: A nurse is providing discharge teaching to parents of a child with newly
diagnosed type 1 diabetes. Which statement by the parents indicates a need for
further teaching?
A. "We will give the insulin injection in the same exact spot every day."
B. "We need to test her blood sugar before meals and at bedtime."
C. "We should always have a source of fast-acting sugar available."
D. "We will rotate injection sites to prevent tissue damage."
CORRECT ANSWER: A. "We will give the insulin injection in the same exact spot
every day."
Rationale: Insulin injections should be rotated within the same anatomical region to
prevent lipohypertrophy, which can lead to erratic insulin absorption. Giving it in the
same spot every day increases this risk.
Question 5: A child with suspected acute appendicitis is being assessed. Which
finding is most characteristic of this condition?
A. Diffuse abdominal pain with high fever
B. Pain that migrates from the periumbilical area to the right lower quadrant
C. Pain that is relieved by bending the knees
D. Constipation with bright red blood per rectum
CORRECT ANSWER: B. Pain that migrates from the periumbilical area to the right
lower quadrant
Rationale: This classic pain migration is due to the appendix's visceral innervation
(periumbilical) progressing to parietal peritoneal irritation (right lower quadrant). It is the
hallmark of acute appendicitis. Diffuse pain is more indicative of gastroenteritis.
Question 6: The nurse is caring for a 6-month-old infant with bronchiolitis caused
by respiratory syncytial virus (RSV). Which isolation precaution is most
appropriate?
,A. Standard precautions only
B. Contact and standard precautions
C. Droplet and standard precautions
D. Airborne and standard precautions
CORRECT ANSWER: B. Contact and standard precautions
Rationale: RSV is transmitted via large droplets and direct contact with contaminated
surfaces. Contact precautions (gown and gloves) plus standard precautions are
recommended to prevent the spread of the virus in healthcare settings.
Question 7: A 15-year-old female client is diagnosed with anorexia nervosa. Which
nursing diagnosis should be the priority during the initial phase of treatment?
A. Disturbed body image
B. Imbalanced nutrition: less than body requirements
C. Social isolation
D. Activity intolerance
CORRECT ANSWER: B. Imbalanced nutrition: less than body requirements
Rationale: In the initial phase, the priority is physiological stability. Imbalanced
nutrition leading to malnutrition and electrolyte imbalances poses an immediate threat
to life and must be addressed before psychological issues can be effectively managed.
Question 8: A nurse is assessing a newborn for neonatal abstinence syndrome
(NAS). Which assessment tool is specifically designed for this purpose?
A. APGAR score
B. Ballard score
C. Finnegan Neonatal Abstinence Scoring System
D. Glasgow Coma Scale
CORRECT ANSWER: C. Finnegan Neonatal Abstinence Scoring System
Rationale: The Finnegan Neonatal Abstinence Scoring System is a validated tool used
to assess the severity of withdrawal symptoms in newborns exposed to opioids or other
substances in utero, guiding pharmacologic intervention.
Question 9: A 3-year-old child is hospitalized for a sickle cell crisis. Which
intervention is the highest priority for this child?
A. Initiate contact precautions
B. Administer oral iron supplements
, C. Administer intravenous (IV) fluids and analgesics
D. Prepare the child for a blood transfusion immediately
CORRECT ANSWER: C. Administer intravenous (IV) fluids and analgesics
Rationale: Pain management and hydration are the priorities in a sickle cell crisis. IV
fluids help decrease blood viscosity and promote sickled cell hydration, while
analgesics address severe pain. Iron is contraindicated, and blood transfusions are
reserved for severe anemia.
Question 10: A parent asks the nurse about the appropriate age to introduce solid
foods to their 4-month-old infant. What is the best response?
A. "You should wait until the infant is at least 12 months old."
B. "Most infants are ready between 4 and 6 months."
C. "It is best to start at 3 months to prevent food allergies."
D. "You should wait until the infant has at least 5 teeth."
CORRECT ANSWER: B. "Most infants are ready between 4 and 6 months."
Rationale: The AAP recommends introducing complementary foods around 6 months
of age, but readiness is typically seen between 4 and 6 months based on developmental
milestones like head control and the loss of the extrusion reflex.
Question 11: A nurse is performing a physical assessment on a 9-month-old infant.
Which finding would be considered a normal developmental milestone?
A. Pincer grasp and sitting without support
B. Running and jumping
C. Using a spoon without spilling
D. Building a tower of 4 cubes
CORRECT ANSWER: A. Pincer grasp and sitting without support
Rationale: At 9 months, infants typically have achieved a pincer grasp (using thumb and
forefinger) and can sit without support. Running and jumping are more typical of a 2-3
year old, and building a tower of 4 cubes is a 3-year-old milestone.
Question 12: A child is prescribed amoxicillin for acute otitis media. The parent
reports that the child developed a non-pruritic, maculopapular rash 2 days after
starting the medication. What is the nurse's best response?
A. "This is a life-threatening allergic reaction. Stop the medication and call 911."
B. "The rash is likely a viral exanthem. Continue the antibiotic as prescribed."
Practice Exam Questions and Answers, Exam Prep Test Bank, Pediatric
Growth and Development Milestones, Child Health Assessment
Techniques, Common Childhood Disorders and Diseases, Pediatric
Pharmacology and Medication Administration, Family-Centered Nursing
Care, Immunization Schedules and Preventive Health, Pediatric Clinical
Judgment, NCLEX-Style Practice Questions, and Detailed Rationales for
Nursing Exam Success
Question 1: A 4-year-old child presents with a high-pitched, barking cough,
hoarseness, and inspiratory stridor that worsens at night. Which of the following is
the priority nursing intervention?
A. Administer a nebulized bronchodilator
B. Prepare for emergency tracheostomy
C. Place the child in a cool-mist tent and observe for respiratory distress
D. Administer oral antibiotics
CORRECT ANSWER: C. Place the child in a cool-mist tent and observe for
respiratory distress
Rationale: The child is exhibiting classic signs of moderate croup
(laryngotracheobronchitis), which causes subglottic swelling. Cool mist helps reduce
airway edema and ease breathing. Bronchodilators are not the primary treatment,
tracheostomy is reserved for severe cases, and antibiotics are ineffective for viral croup.
Question 2: The mother of an 8-month-old infant asks when she can introduce
cow's milk into the infant's diet. What is the most appropriate response?
A. "You can start now if you dilute it with water."
B. "It is recommended to wait until 12 months of age."
C. "You can introduce it at 9 months in small amounts."
D. "Cow's milk should be avoided until 2 years of age."
CORRECT ANSWER: B. "It is recommended to wait until 12 months of age."
Rationale: The American Academy of Pediatrics recommends delaying introduction of
whole cow's milk until 12 months of age because it lacks adequate iron and essential
fatty acids, and its high renal solute load can stress infant kidneys.
Question 3: A 2-year-old child is brought to the emergency department after
ingesting a small amount of a household cleaner that is alkaline. What is the
priority nursing action?
A. Induce vomiting using syrup of ipecac
B. Administer activated charcoal
,C. Assess the child's airway, breathing, and circulation (ABCs) and do not induce
vomiting
D. Perform gastric lavage immediately
CORRECT ANSWER: C. Assess the child's airway, breathing, and circulation (ABCs)
and do not induce vomiting
Rationale: Alkaline substances cause liquefaction necrosis and can cause severe
burns to the esophagus and airway. Inducing vomiting can re-expose the esophagus
and airway to the corrosive agent and increase risk of aspiration and perforation.
Question 4: A nurse is providing discharge teaching to parents of a child with newly
diagnosed type 1 diabetes. Which statement by the parents indicates a need for
further teaching?
A. "We will give the insulin injection in the same exact spot every day."
B. "We need to test her blood sugar before meals and at bedtime."
C. "We should always have a source of fast-acting sugar available."
D. "We will rotate injection sites to prevent tissue damage."
CORRECT ANSWER: A. "We will give the insulin injection in the same exact spot
every day."
Rationale: Insulin injections should be rotated within the same anatomical region to
prevent lipohypertrophy, which can lead to erratic insulin absorption. Giving it in the
same spot every day increases this risk.
Question 5: A child with suspected acute appendicitis is being assessed. Which
finding is most characteristic of this condition?
A. Diffuse abdominal pain with high fever
B. Pain that migrates from the periumbilical area to the right lower quadrant
C. Pain that is relieved by bending the knees
D. Constipation with bright red blood per rectum
CORRECT ANSWER: B. Pain that migrates from the periumbilical area to the right
lower quadrant
Rationale: This classic pain migration is due to the appendix's visceral innervation
(periumbilical) progressing to parietal peritoneal irritation (right lower quadrant). It is the
hallmark of acute appendicitis. Diffuse pain is more indicative of gastroenteritis.
Question 6: The nurse is caring for a 6-month-old infant with bronchiolitis caused
by respiratory syncytial virus (RSV). Which isolation precaution is most
appropriate?
,A. Standard precautions only
B. Contact and standard precautions
C. Droplet and standard precautions
D. Airborne and standard precautions
CORRECT ANSWER: B. Contact and standard precautions
Rationale: RSV is transmitted via large droplets and direct contact with contaminated
surfaces. Contact precautions (gown and gloves) plus standard precautions are
recommended to prevent the spread of the virus in healthcare settings.
Question 7: A 15-year-old female client is diagnosed with anorexia nervosa. Which
nursing diagnosis should be the priority during the initial phase of treatment?
A. Disturbed body image
B. Imbalanced nutrition: less than body requirements
C. Social isolation
D. Activity intolerance
CORRECT ANSWER: B. Imbalanced nutrition: less than body requirements
Rationale: In the initial phase, the priority is physiological stability. Imbalanced
nutrition leading to malnutrition and electrolyte imbalances poses an immediate threat
to life and must be addressed before psychological issues can be effectively managed.
Question 8: A nurse is assessing a newborn for neonatal abstinence syndrome
(NAS). Which assessment tool is specifically designed for this purpose?
A. APGAR score
B. Ballard score
C. Finnegan Neonatal Abstinence Scoring System
D. Glasgow Coma Scale
CORRECT ANSWER: C. Finnegan Neonatal Abstinence Scoring System
Rationale: The Finnegan Neonatal Abstinence Scoring System is a validated tool used
to assess the severity of withdrawal symptoms in newborns exposed to opioids or other
substances in utero, guiding pharmacologic intervention.
Question 9: A 3-year-old child is hospitalized for a sickle cell crisis. Which
intervention is the highest priority for this child?
A. Initiate contact precautions
B. Administer oral iron supplements
, C. Administer intravenous (IV) fluids and analgesics
D. Prepare the child for a blood transfusion immediately
CORRECT ANSWER: C. Administer intravenous (IV) fluids and analgesics
Rationale: Pain management and hydration are the priorities in a sickle cell crisis. IV
fluids help decrease blood viscosity and promote sickled cell hydration, while
analgesics address severe pain. Iron is contraindicated, and blood transfusions are
reserved for severe anemia.
Question 10: A parent asks the nurse about the appropriate age to introduce solid
foods to their 4-month-old infant. What is the best response?
A. "You should wait until the infant is at least 12 months old."
B. "Most infants are ready between 4 and 6 months."
C. "It is best to start at 3 months to prevent food allergies."
D. "You should wait until the infant has at least 5 teeth."
CORRECT ANSWER: B. "Most infants are ready between 4 and 6 months."
Rationale: The AAP recommends introducing complementary foods around 6 months
of age, but readiness is typically seen between 4 and 6 months based on developmental
milestones like head control and the loss of the extrusion reflex.
Question 11: A nurse is performing a physical assessment on a 9-month-old infant.
Which finding would be considered a normal developmental milestone?
A. Pincer grasp and sitting without support
B. Running and jumping
C. Using a spoon without spilling
D. Building a tower of 4 cubes
CORRECT ANSWER: A. Pincer grasp and sitting without support
Rationale: At 9 months, infants typically have achieved a pincer grasp (using thumb and
forefinger) and can sit without support. Running and jumping are more typical of a 2-3
year old, and building a tower of 4 cubes is a 3-year-old milestone.
Question 12: A child is prescribed amoxicillin for acute otitis media. The parent
reports that the child developed a non-pruritic, maculopapular rash 2 days after
starting the medication. What is the nurse's best response?
A. "This is a life-threatening allergic reaction. Stop the medication and call 911."
B. "The rash is likely a viral exanthem. Continue the antibiotic as prescribed."
