PEDIATRIC NURSING SKILLS ASSESSMENT
Summer Series Practice Test Due June/July 2026
1. A 4-year-old child is brought to the emergency department
with a barky cough, stridor, and intercostal retractions. The
child is restless and has an oxygen saturation of 91% on
room air. Which of the following is the priority nursing
intervention?
A. Administer a nebulized bronchodilator
B. Prepare for immediate endotracheal intubation
C. Provide humidified oxygen and have the child sit upright
D. Obtain a throat culture to rule out bacterial infection
Correct Answer: C
Explanation: This presentation is classic for moderate to severe
croup (laryngotracheobronchitis). The priority is to maintain a
patent airway and reduce work of breathing. Humidified
oxygen and positioning the child upright (to ease respiratory
effort) are the immediate, non-invasive interventions.
Nebulized racemic epinephrine is the pharmacological
mainstay, but supportive care with oxygen and positioning
comes first. Intubation is reserved for impending respiratory
failure. A throat culture is not indicated for croup as it is
typically viral.
,2. The nurse is calculating the maintenance fluid rate for a 22-
kg child using the Holliday-Segar method. What is the
correct 24-hour maintenance fluid volume for this child?
A. 1200 mL
B. 1400 mL
C. 1600 mL
D. 2000 mL
Correct Answer: C
Explanation: The Holliday-Segar method calculates
maintenance fluid as 100 mL/kg for the first 10 kg, 50 mL/kg
for the next 10 kg, and 20 mL/kg for each additional kilogram.
For a 22 kg child: (10 kg × 100 mL) + (10 kg × 50 mL) + (2 kg
× 20 mL) = 1000 mL + 500 mL + 40 mL = 1540 mL, which is
approximated to 1600 mL for practical purposes. Options A, B,
and D represent incorrect calculations based on alternative
formulas or arithmetic errors.
3. A 6-month-old infant is scheduled for a well-child visit. The
nurse anticipates administering which vaccines at this visit
according to the standard CDC immunization schedule?
A. DTaP, IPV, PCV13, Rotavirus
B. MMR, Varicella, HepA
C. DTaP, IPV, PCV13, Hib, Rotavirus
D. HepB, DTaP, IPV, PCV13
Correct Answer: C
Explanation: At the 6-month visit, the recommended vaccines
include DTaP (diphtheria, tetanus, pertussis), IPV (inactivated
poliovirus), PCV13 (pneumococcal conjugate), Hib
, (Haemophilus influenzae type b), and Rotavirus. MMR and
Varicella are given at 12-15 months. HepB is given at birth, 1-
2 months, and 6-18 months (often at the 6-month visit, but
not always). However, the standard core set at 6 months
includes DTaP, IPV, PCV13, Hib, and Rotavirus. Option C is the
most comprehensive and correct answer.
4. The nurse is assessing a 2-year-old child with suspected iron
deficiency anemia. Which clinical manifestation is most
consistent with this condition?
A. Hyperactivity and impulsivity
B. Pallor and conjunctival pallor
C. Jaundice and dark urine
D. Short stature and delayed dentition
Correct Answer: B
Explanation: Iron deficiency anemia in a toddler typically
presents with pallor (of the skin and conjunctiva), fatigue, and
irritability. Hyperactivity is not characteristic. Jaundice and
dark urine are signs of hemolytic anemias (e.g., sickle cell
crisis) or liver issues. Short stature and delayed dentition are
more associated with chronic malnutrition or endocrine
disorders, not specifically iron deficiency anemia.
5. A 10-year-old child with type 1 diabetes mellitus is brought
to the school nurse with confusion, diaphoresis, and
tachycardia. The child ate lunch one hour ago but did not
, finish the meal. Which immediate action should the school
nurse take?
A. Administer a glucagon injection
B. Give 15 grams of fast-acting carbohydrate (e.g., glucose
tablets)
C. Check blood glucose and then give insulin if it is high
D. Send the child to the emergency department immediately
Correct Answer: B
Explanation: The child is displaying classic signs of
hypoglycemia (confusion, diaphoresis, tachycardia). The
immediate treatment for a conscious child experiencing
hypoglycemia is to provide 15 grams of fast-acting
carbohydrate. The rule of 15 is standard. Glucagon is for
unconscious children or those who cannot swallow. Insulin
would worsen the hypoglycemia. Sending to the ED is
unnecessary before trying the simple intervention.
6. The nurse is performing a developmental screening using the
Denver II on a 9-month-old infant. Which milestone would
the nurse expect this infant to have achieved?
A. Walks alone
B. Uses a pincer grasp
C. Builds a tower of two blocks
D. Follows a one-step command
Correct Answer: B
Explanation: At 9 months, a typical infant can use a pincer
grasp (thumb and forefinger), sit without support, and begin to
crawl. Walking alone is expected around 12-15 months.
Summer Series Practice Test Due June/July 2026
1. A 4-year-old child is brought to the emergency department
with a barky cough, stridor, and intercostal retractions. The
child is restless and has an oxygen saturation of 91% on
room air. Which of the following is the priority nursing
intervention?
A. Administer a nebulized bronchodilator
B. Prepare for immediate endotracheal intubation
C. Provide humidified oxygen and have the child sit upright
D. Obtain a throat culture to rule out bacterial infection
Correct Answer: C
Explanation: This presentation is classic for moderate to severe
croup (laryngotracheobronchitis). The priority is to maintain a
patent airway and reduce work of breathing. Humidified
oxygen and positioning the child upright (to ease respiratory
effort) are the immediate, non-invasive interventions.
Nebulized racemic epinephrine is the pharmacological
mainstay, but supportive care with oxygen and positioning
comes first. Intubation is reserved for impending respiratory
failure. A throat culture is not indicated for croup as it is
typically viral.
,2. The nurse is calculating the maintenance fluid rate for a 22-
kg child using the Holliday-Segar method. What is the
correct 24-hour maintenance fluid volume for this child?
A. 1200 mL
B. 1400 mL
C. 1600 mL
D. 2000 mL
Correct Answer: C
Explanation: The Holliday-Segar method calculates
maintenance fluid as 100 mL/kg for the first 10 kg, 50 mL/kg
for the next 10 kg, and 20 mL/kg for each additional kilogram.
For a 22 kg child: (10 kg × 100 mL) + (10 kg × 50 mL) + (2 kg
× 20 mL) = 1000 mL + 500 mL + 40 mL = 1540 mL, which is
approximated to 1600 mL for practical purposes. Options A, B,
and D represent incorrect calculations based on alternative
formulas or arithmetic errors.
3. A 6-month-old infant is scheduled for a well-child visit. The
nurse anticipates administering which vaccines at this visit
according to the standard CDC immunization schedule?
A. DTaP, IPV, PCV13, Rotavirus
B. MMR, Varicella, HepA
C. DTaP, IPV, PCV13, Hib, Rotavirus
D. HepB, DTaP, IPV, PCV13
Correct Answer: C
Explanation: At the 6-month visit, the recommended vaccines
include DTaP (diphtheria, tetanus, pertussis), IPV (inactivated
poliovirus), PCV13 (pneumococcal conjugate), Hib
, (Haemophilus influenzae type b), and Rotavirus. MMR and
Varicella are given at 12-15 months. HepB is given at birth, 1-
2 months, and 6-18 months (often at the 6-month visit, but
not always). However, the standard core set at 6 months
includes DTaP, IPV, PCV13, Hib, and Rotavirus. Option C is the
most comprehensive and correct answer.
4. The nurse is assessing a 2-year-old child with suspected iron
deficiency anemia. Which clinical manifestation is most
consistent with this condition?
A. Hyperactivity and impulsivity
B. Pallor and conjunctival pallor
C. Jaundice and dark urine
D. Short stature and delayed dentition
Correct Answer: B
Explanation: Iron deficiency anemia in a toddler typically
presents with pallor (of the skin and conjunctiva), fatigue, and
irritability. Hyperactivity is not characteristic. Jaundice and
dark urine are signs of hemolytic anemias (e.g., sickle cell
crisis) or liver issues. Short stature and delayed dentition are
more associated with chronic malnutrition or endocrine
disorders, not specifically iron deficiency anemia.
5. A 10-year-old child with type 1 diabetes mellitus is brought
to the school nurse with confusion, diaphoresis, and
tachycardia. The child ate lunch one hour ago but did not
, finish the meal. Which immediate action should the school
nurse take?
A. Administer a glucagon injection
B. Give 15 grams of fast-acting carbohydrate (e.g., glucose
tablets)
C. Check blood glucose and then give insulin if it is high
D. Send the child to the emergency department immediately
Correct Answer: B
Explanation: The child is displaying classic signs of
hypoglycemia (confusion, diaphoresis, tachycardia). The
immediate treatment for a conscious child experiencing
hypoglycemia is to provide 15 grams of fast-acting
carbohydrate. The rule of 15 is standard. Glucagon is for
unconscious children or those who cannot swallow. Insulin
would worsen the hypoglycemia. Sending to the ED is
unnecessary before trying the simple intervention.
6. The nurse is performing a developmental screening using the
Denver II on a 9-month-old infant. Which milestone would
the nurse expect this infant to have achieved?
A. Walks alone
B. Uses a pincer grasp
C. Builds a tower of two blocks
D. Follows a one-step command
Correct Answer: B
Explanation: At 9 months, a typical infant can use a pincer
grasp (thumb and forefinger), sit without support, and begin to
crawl. Walking alone is expected around 12-15 months.
