ADVANCED Wong’s Nursing Care of Infants and
Children – 12th Edition with Questions and
Answers/Plus a Rationale Updated 2026 A+/Instant
Download PDF
Table of Contents
1. Growth and Development of the Infant, Child, and Adolescent
2. Pediatric Assessment and Communication
3. Nursing Care of the Hospitalized Child
4. Pain Assessment and Management
5. Respiratory Dysfunction
6. Cardiovascular Dysfunction
7. Hematologic and Immunologic Dysfunction
8. Gastrointestinal Dysfunction
9. Genitourinary Dysfunction
10. Neurologic and Sensory Dysfunction
,1. A 6-month-old infant is brought to the clinic for a well-child checkup. The parent expresses
concern that the infant is not yet pulling to a standing position. Which clinical response is most
appropriate?
A. Recommend immediate referral to early intervention services for motor delay.
B. Explain that pulling to a stand is typically a milestone achieved between 9 and 10
months of age.
C. Assess the infant for signs of hip dysplasia as the primary cause of this developmental lag.
D. Suggest intensive physical therapy sessions to accelerate gross motor acquisition.
Answer: B
Rationale: Pulling to a standing position is a gross motor skill expected at 9 to 10 months, not 6
months. Option A is inappropriate because the child is not delayed. Option C is a common
orthopedic concern but unrelated to normal developmental progression timelines. Option D is
unnecessary, as the infant is meeting other 6-month milestones.
2. A nurse is caring for a 4-year-old child diagnosed with acute laryngotracheobronchitis (croup).
The child exhibits inspiratory stridor and mild retractions at rest. Which intervention is the
priority?
A. Administer oral antibiotics to prevent secondary bacterial infection.
B. Provide cool mist humidification and maintain a calm, supportive environment.
C. Prepare the child for immediate endotracheal intubation.
D. Administer high-dose systemic corticosteroids via intramuscular injection.
Answer: B
Rationale: Cool mist therapy is standard for managing mild to moderate croup symptoms.
Option A is incorrect because croup is typically viral. Option C is reserved for impending
respiratory failure, which this child does not yet exhibit. Option D is aggressive for mild
symptoms; oral or nebulized steroids are preferred.
3. A nurse is educating parents on preventing Sudden Infant Death Syndrome (SIDS). Which
instruction is most critical to include?
A. Use a thick quilt to ensure the infant stays warm during sleep.
B. Place the infant in a supine position for every sleep period.
, C. Co-sleep with the infant to monitor breathing patterns closely.
D. Provide a pacifier only during nap times, not at night.
Answer: B
Rationale: The "Back to Sleep" campaign emphasizes supine positioning as the single most
effective way to reduce SIDS risk. Option A increases overheating and suffocation risks. Option
C increases the risk of accidental suffocation. Option D is incorrect; pacifier use at night is
actually associated with a decreased risk of SIDS.
4. A 10-year-old child with Type 1 Diabetes Mellitus presents with a blood glucose of 45 mg/dL.
The child is conscious but diaphoretic and shaky. What is the most appropriate initial nursing
action?
A. Administer 10 units of rapid-acting insulin.
B. Provide 15 grams of a simple carbohydrate, such as 4 ounces of orange juice.
C. Immediately insert an intravenous line for D50W administration.
D. Place the child in a side-lying position and monitor vital signs.
Answer: B
Rationale: The 15/15 rule for conscious, alert hypoglycemic patients involves consuming 15g of
simple carbs and rechecking blood glucose in 15 minutes. Option A would cause a fatal drop in
glucose. Option C is reserved for patients who are unconscious or unable to swallow. Option D
is passive and fails to address the hypoglycemia.
5. A nurse is assessing a child with suspected dehydration. Which clinical finding best indicates
moderate to severe dehydration?
A. Moist mucous membranes and increased urine output.
B. A slight increase in heart rate with active play.
C. Delayed capillary refill greater than 3 seconds and sunken fontanel in an infant.
D. Increased appetite and desire for oral fluids.
Answer: C
Rationale: Delayed capillary refill and sunken fontanels are classic physical signs of significant
fluid volume deficit. Option A describes a well-hydrated child. Option B is a normal
, physiological response to activity, not dehydration. Option D is common in early dehydration
but not a diagnostic indicator of severity.
6. When caring for a preschooler with a fractured femur in traction, which nursing action is
essential to prevent neurovascular compromise?
A. Loosen the traction weights to increase comfort.
B. Perform hourly neurovascular checks of the affected extremity.
C. Elevate the affected limb above the level of the heart.
D. Encourage the child to ambulate to prevent venous stasis.
Answer: B
Rationale: Frequent neurovascular assessment (CMS checks) is vital for children in traction to
detect compartment syndrome early. Option A compromises the integrity of the fracture
reduction. Option C may be difficult depending on the traction type. Option D is contraindicated
as the child is immobilized.
7. A nurse is planning care for an infant with tetralogy of Fallot. During a "tet spell," what is the
most important nursing intervention?
A. Place the infant in a flat, supine position to facilitate sleep.
B. Place the infant in a knee-chest position to increase systemic vascular resistance.
C. Administer a bolus of intravenous fluids to increase preload.
D. Encourage the child to cry to release pent-up frustration.
Answer: B
Rationale: The knee-chest position increases systemic vascular resistance, which shunts blood
from the aorta into the pulmonary artery, reducing hypoxemia. Option A fails to resolve the
shunt. Option C is not the primary intervention for a hypercyanotic spell. Option D would
exacerbate the spell by increasing oxygen demand.
8. An adolescent is diagnosed with scoliosis. Which assessment finding is most characteristic of
this condition?
A. Pain during physical exertion and exercise.
B. Asymmetry of shoulder height and scapular prominence during the Adams forward
bend test.
Children – 12th Edition with Questions and
Answers/Plus a Rationale Updated 2026 A+/Instant
Download PDF
Table of Contents
1. Growth and Development of the Infant, Child, and Adolescent
2. Pediatric Assessment and Communication
3. Nursing Care of the Hospitalized Child
4. Pain Assessment and Management
5. Respiratory Dysfunction
6. Cardiovascular Dysfunction
7. Hematologic and Immunologic Dysfunction
8. Gastrointestinal Dysfunction
9. Genitourinary Dysfunction
10. Neurologic and Sensory Dysfunction
,1. A 6-month-old infant is brought to the clinic for a well-child checkup. The parent expresses
concern that the infant is not yet pulling to a standing position. Which clinical response is most
appropriate?
A. Recommend immediate referral to early intervention services for motor delay.
B. Explain that pulling to a stand is typically a milestone achieved between 9 and 10
months of age.
C. Assess the infant for signs of hip dysplasia as the primary cause of this developmental lag.
D. Suggest intensive physical therapy sessions to accelerate gross motor acquisition.
Answer: B
Rationale: Pulling to a standing position is a gross motor skill expected at 9 to 10 months, not 6
months. Option A is inappropriate because the child is not delayed. Option C is a common
orthopedic concern but unrelated to normal developmental progression timelines. Option D is
unnecessary, as the infant is meeting other 6-month milestones.
2. A nurse is caring for a 4-year-old child diagnosed with acute laryngotracheobronchitis (croup).
The child exhibits inspiratory stridor and mild retractions at rest. Which intervention is the
priority?
A. Administer oral antibiotics to prevent secondary bacterial infection.
B. Provide cool mist humidification and maintain a calm, supportive environment.
C. Prepare the child for immediate endotracheal intubation.
D. Administer high-dose systemic corticosteroids via intramuscular injection.
Answer: B
Rationale: Cool mist therapy is standard for managing mild to moderate croup symptoms.
Option A is incorrect because croup is typically viral. Option C is reserved for impending
respiratory failure, which this child does not yet exhibit. Option D is aggressive for mild
symptoms; oral or nebulized steroids are preferred.
3. A nurse is educating parents on preventing Sudden Infant Death Syndrome (SIDS). Which
instruction is most critical to include?
A. Use a thick quilt to ensure the infant stays warm during sleep.
B. Place the infant in a supine position for every sleep period.
, C. Co-sleep with the infant to monitor breathing patterns closely.
D. Provide a pacifier only during nap times, not at night.
Answer: B
Rationale: The "Back to Sleep" campaign emphasizes supine positioning as the single most
effective way to reduce SIDS risk. Option A increases overheating and suffocation risks. Option
C increases the risk of accidental suffocation. Option D is incorrect; pacifier use at night is
actually associated with a decreased risk of SIDS.
4. A 10-year-old child with Type 1 Diabetes Mellitus presents with a blood glucose of 45 mg/dL.
The child is conscious but diaphoretic and shaky. What is the most appropriate initial nursing
action?
A. Administer 10 units of rapid-acting insulin.
B. Provide 15 grams of a simple carbohydrate, such as 4 ounces of orange juice.
C. Immediately insert an intravenous line for D50W administration.
D. Place the child in a side-lying position and monitor vital signs.
Answer: B
Rationale: The 15/15 rule for conscious, alert hypoglycemic patients involves consuming 15g of
simple carbs and rechecking blood glucose in 15 minutes. Option A would cause a fatal drop in
glucose. Option C is reserved for patients who are unconscious or unable to swallow. Option D
is passive and fails to address the hypoglycemia.
5. A nurse is assessing a child with suspected dehydration. Which clinical finding best indicates
moderate to severe dehydration?
A. Moist mucous membranes and increased urine output.
B. A slight increase in heart rate with active play.
C. Delayed capillary refill greater than 3 seconds and sunken fontanel in an infant.
D. Increased appetite and desire for oral fluids.
Answer: C
Rationale: Delayed capillary refill and sunken fontanels are classic physical signs of significant
fluid volume deficit. Option A describes a well-hydrated child. Option B is a normal
, physiological response to activity, not dehydration. Option D is common in early dehydration
but not a diagnostic indicator of severity.
6. When caring for a preschooler with a fractured femur in traction, which nursing action is
essential to prevent neurovascular compromise?
A. Loosen the traction weights to increase comfort.
B. Perform hourly neurovascular checks of the affected extremity.
C. Elevate the affected limb above the level of the heart.
D. Encourage the child to ambulate to prevent venous stasis.
Answer: B
Rationale: Frequent neurovascular assessment (CMS checks) is vital for children in traction to
detect compartment syndrome early. Option A compromises the integrity of the fracture
reduction. Option C may be difficult depending on the traction type. Option D is contraindicated
as the child is immobilized.
7. A nurse is planning care for an infant with tetralogy of Fallot. During a "tet spell," what is the
most important nursing intervention?
A. Place the infant in a flat, supine position to facilitate sleep.
B. Place the infant in a knee-chest position to increase systemic vascular resistance.
C. Administer a bolus of intravenous fluids to increase preload.
D. Encourage the child to cry to release pent-up frustration.
Answer: B
Rationale: The knee-chest position increases systemic vascular resistance, which shunts blood
from the aorta into the pulmonary artery, reducing hypoxemia. Option A fails to resolve the
shunt. Option C is not the primary intervention for a hypercyanotic spell. Option D would
exacerbate the spell by increasing oxygen demand.
8. An adolescent is diagnosed with scoliosis. Which assessment finding is most characteristic of
this condition?
A. Pain during physical exertion and exercise.
B. Asymmetry of shoulder height and scapular prominence during the Adams forward
bend test.
