PEDIATRIC NURSING CARE PROCTORED EXAM – QUESTIONS AND ANSWERS | VERIFIED
AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM
UPDATE
*CORE DOMAINS*
*Growth and Development*
*Pediatric Assessment and Physical Examination*
*Pediatric Pharmacology and Medication Administration*
*Acute and Chronic Respiratory Conditions*
*Childhood Infectious Diseases*
*Fluid, Electrolyte, and Acid-Base Balance*
*Pediatric Emergencies and Trauma Care*
*Chronic Illness and End-of-Life Care*
*Health Promotion and Injury Prevention*
*Family-Centered Care and Ethical Decision-Making*
*INTRODUCTION*
*The Pediatric Nursing Care Proctored Exam is designed to evaluate clinical competency
and theoretical knowledge in the nursing care of children from infancy through adolescence.
This assessment covers essential nursing skills, including developmental screening, age-
appropriate communication, safe medication administration, and the management of both
acute and chronic pediatric conditions. Utilizing a combination of multiple-choice and
complex scenario-based questions, the exam emphasizes real-world application of the
nursing process. Candidates must demonstrate critical thinking, professional decision-
making, and an understanding of family-centered care principles to ensure optimal health
outcomes and patient safety in diverse pediatric clinical settings.*
SECTION ONE: QUESTIONS 1–100
1. A nurse is assessing a 6-month-old infant. Which reflex should the nurse expect to be
absent? A. Babinski reflex B. Moro reflex C. Palmar grasp D. Rooting reflex B.
Moro reflex Explanation: The Moro reflex typically disappears around 4 months
of age. The Babinski reflex persists until about 12 to 24 months, while the palmar
grasp and rooting reflexes generally fade by 4 to 6 months.
2. A preschooler is admitted with dehydration. Which assessment finding is the most
reliable indicator of fluid status? A. Skin turgor B. Daily weight C. Mucous membranes
, D. Blood pressure B. Daily weight Explanation: Daily weight is the most
accurate indicator of fluid volume status in infants and children. A rapid change in
weight reflects fluid loss or gain.
3. When administering an intramuscular injection to an 18-month-old toddler, which
site is preferred? A. Dorsogluteal B. Deltoid C. Ventrogluteal D. Vastus lateralis D.
Vastus lateralis Explanation: The vastus lateralis is the preferred site for IM
injections in infants and toddlers due to the muscle's size and lack of major nerves or
blood vessels.
4. A child with asthma is prescribed a corticosteroid inhaler. What is the priority nursing
instruction? A. Use the inhaler only during an acute attack. B. Rinse the mouth after
using the inhaler. C. Shake the inhaler vigorously for 2 minutes. D. Increase fluid
intake to 2 liters daily. B. Rinse the mouth after using the inhaler. Explanation:
Rinsing the mouth prevents the development of oral candidiasis (thrush), a common
side effect of inhaled corticosteroids.
5. A nurse is caring for an adolescent with scoliosis. Which finding indicates a positive
screening result? A. Symmetrical scapula height B. Midline alignment of the spinous
processes C. A rib hump when bending forward D. Equal distance of iliac crests C.
A rib hump when bending forward Explanation: A rib hump or flank asymmetry
during the Adam forward bend test is a hallmark clinical sign of scoliosis.
6. Which developmental milestone is expected for a 12-month-old infant? A. Walking
with assistance B. Saying two words besides mama/dada C. Building a tower of three
blocks D. Using a spoon correctly A. Walking with assistance Explanation: By
12 months, most infants can stand alone and take their first steps or walk while
holding onto furniture or a person's hand.
7. A child presents with "barking" cough and inspiratory stridor. Which condition is
suspected? A. Epiglottitis B. Bronchiolitis C. Laryngotracheobronchitis (Croup) D.
Bacterial pneumonia C. Laryngotracheobronchitis (Croup) Explanation: The
classic presentation of croup includes a sudden onset of a barking or "seal-like"
cough and inspiratory stridor, usually caused by a viral infection.
8. When caring for a child with nephrotic syndrome, the nurse should prioritize: A.
Monitoring for proteinuria B. Encouraging high sodium intake C. Increasing physical
activity D. Monitoring serum potassium levels A. Monitoring for proteinuria
Explanation: Nephrotic syndrome is characterized by massive proteinuria, leading to
hypoalbuminemia and edema. Monitoring urine protein levels is essential.
9. An adolescent client expresses suicidal ideation. What is the nurse's priority action?
A. Notify the parents immediately. B. Document the conversation in the chart. C.
Ensure the client's environment is safe and supervised. D. Refer the client to the
, school counselor. C. Ensure the client's environment is safe and supervised.
Explanation: The priority is the immediate safety of the client. Suicide precautions
must be initiated to prevent self-harm while further assessment and interventions
are planned.
10. A nurse is teaching parents about iron-deficiency anemia in toddlers. Which drink
inhibits iron absorption? A. Orange juice B. Apple juice C. Cow's milk D. Water C.
Cow's milk Explanation: Excessive cow's milk consumption can lead to iron-
deficiency anemia because milk is a poor source of iron and can inhibit the
absorption of iron from other foods.
11. A child with cystic fibrosis is prescribed pancreatic enzymes. When should they be
administered? A. One hour before meals B. With every meal and snack C. Only in the
morning D. During bedtime B. With every meal and snack Explanation:
Pancreatic enzymes must be taken with every meal and snack to aid in the digestion
and absorption of fats, proteins, and carbohydrates.
12. A 3-year-old child is hospitalized. Which play activity is most appropriate? A. Playing a
competitive board game B. Playing with a dollhouse C. Reading a long novel D.
Engaging in contact sports B. Playing with a dollhouse Explanation:
Preschoolers engage in associative and imaginative play. A dollhouse allows for
creative play that is age-appropriate.
13. What is the primary sign of Hirschsprung disease in a newborn? A. Projectile
vomiting B. Failure to pass meconium C. Excessive crying D. Diarrhea B. Failure to
pass meconium Explanation: Failure to pass meconium within the first 24 to 48
hours of life is the classic clinical manifestation of Hirschsprung disease.
14. A nurse is assessing a child with Type 1 Diabetes Mellitus. Which symptom indicates
hypoglycemia? A. Flushed, dry skin B. Kussmaul respirations C. Tremors and
diaphoresis D. Polyuria C. Tremors and diaphoresis Explanation: Symptoms of
hypoglycemia include tremors, diaphoresis, tachycardia, hunger, and irritability.
15. When providing care for a child with Wilms tumor, the nurse must avoid: A.
Measuring abdominal circumference B. Palpating the abdomen C. Monitoring blood
pressure D. Assessing bowel sounds B. Palpating the abdomen Explanation:
Palpating the abdomen can cause the tumor to rupture and potentially spread cancer
cells to other parts of the body.
16. Which vaccine is contraindicated in a child with a severe allergy to neomycin? A.
Hepatitis B B. DTaP C. IPV (Inactivated Poliovirus) D. Varicella C. IPV (Inactivated
Poliovirus) Explanation: Some formulations of the IPV vaccine contain trace
amounts of neomycin, which can trigger an allergic reaction in sensitive individuals.
AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM
UPDATE
*CORE DOMAINS*
*Growth and Development*
*Pediatric Assessment and Physical Examination*
*Pediatric Pharmacology and Medication Administration*
*Acute and Chronic Respiratory Conditions*
*Childhood Infectious Diseases*
*Fluid, Electrolyte, and Acid-Base Balance*
*Pediatric Emergencies and Trauma Care*
*Chronic Illness and End-of-Life Care*
*Health Promotion and Injury Prevention*
*Family-Centered Care and Ethical Decision-Making*
*INTRODUCTION*
*The Pediatric Nursing Care Proctored Exam is designed to evaluate clinical competency
and theoretical knowledge in the nursing care of children from infancy through adolescence.
This assessment covers essential nursing skills, including developmental screening, age-
appropriate communication, safe medication administration, and the management of both
acute and chronic pediatric conditions. Utilizing a combination of multiple-choice and
complex scenario-based questions, the exam emphasizes real-world application of the
nursing process. Candidates must demonstrate critical thinking, professional decision-
making, and an understanding of family-centered care principles to ensure optimal health
outcomes and patient safety in diverse pediatric clinical settings.*
SECTION ONE: QUESTIONS 1–100
1. A nurse is assessing a 6-month-old infant. Which reflex should the nurse expect to be
absent? A. Babinski reflex B. Moro reflex C. Palmar grasp D. Rooting reflex B.
Moro reflex Explanation: The Moro reflex typically disappears around 4 months
of age. The Babinski reflex persists until about 12 to 24 months, while the palmar
grasp and rooting reflexes generally fade by 4 to 6 months.
2. A preschooler is admitted with dehydration. Which assessment finding is the most
reliable indicator of fluid status? A. Skin turgor B. Daily weight C. Mucous membranes
, D. Blood pressure B. Daily weight Explanation: Daily weight is the most
accurate indicator of fluid volume status in infants and children. A rapid change in
weight reflects fluid loss or gain.
3. When administering an intramuscular injection to an 18-month-old toddler, which
site is preferred? A. Dorsogluteal B. Deltoid C. Ventrogluteal D. Vastus lateralis D.
Vastus lateralis Explanation: The vastus lateralis is the preferred site for IM
injections in infants and toddlers due to the muscle's size and lack of major nerves or
blood vessels.
4. A child with asthma is prescribed a corticosteroid inhaler. What is the priority nursing
instruction? A. Use the inhaler only during an acute attack. B. Rinse the mouth after
using the inhaler. C. Shake the inhaler vigorously for 2 minutes. D. Increase fluid
intake to 2 liters daily. B. Rinse the mouth after using the inhaler. Explanation:
Rinsing the mouth prevents the development of oral candidiasis (thrush), a common
side effect of inhaled corticosteroids.
5. A nurse is caring for an adolescent with scoliosis. Which finding indicates a positive
screening result? A. Symmetrical scapula height B. Midline alignment of the spinous
processes C. A rib hump when bending forward D. Equal distance of iliac crests C.
A rib hump when bending forward Explanation: A rib hump or flank asymmetry
during the Adam forward bend test is a hallmark clinical sign of scoliosis.
6. Which developmental milestone is expected for a 12-month-old infant? A. Walking
with assistance B. Saying two words besides mama/dada C. Building a tower of three
blocks D. Using a spoon correctly A. Walking with assistance Explanation: By
12 months, most infants can stand alone and take their first steps or walk while
holding onto furniture or a person's hand.
7. A child presents with "barking" cough and inspiratory stridor. Which condition is
suspected? A. Epiglottitis B. Bronchiolitis C. Laryngotracheobronchitis (Croup) D.
Bacterial pneumonia C. Laryngotracheobronchitis (Croup) Explanation: The
classic presentation of croup includes a sudden onset of a barking or "seal-like"
cough and inspiratory stridor, usually caused by a viral infection.
8. When caring for a child with nephrotic syndrome, the nurse should prioritize: A.
Monitoring for proteinuria B. Encouraging high sodium intake C. Increasing physical
activity D. Monitoring serum potassium levels A. Monitoring for proteinuria
Explanation: Nephrotic syndrome is characterized by massive proteinuria, leading to
hypoalbuminemia and edema. Monitoring urine protein levels is essential.
9. An adolescent client expresses suicidal ideation. What is the nurse's priority action?
A. Notify the parents immediately. B. Document the conversation in the chart. C.
Ensure the client's environment is safe and supervised. D. Refer the client to the
, school counselor. C. Ensure the client's environment is safe and supervised.
Explanation: The priority is the immediate safety of the client. Suicide precautions
must be initiated to prevent self-harm while further assessment and interventions
are planned.
10. A nurse is teaching parents about iron-deficiency anemia in toddlers. Which drink
inhibits iron absorption? A. Orange juice B. Apple juice C. Cow's milk D. Water C.
Cow's milk Explanation: Excessive cow's milk consumption can lead to iron-
deficiency anemia because milk is a poor source of iron and can inhibit the
absorption of iron from other foods.
11. A child with cystic fibrosis is prescribed pancreatic enzymes. When should they be
administered? A. One hour before meals B. With every meal and snack C. Only in the
morning D. During bedtime B. With every meal and snack Explanation:
Pancreatic enzymes must be taken with every meal and snack to aid in the digestion
and absorption of fats, proteins, and carbohydrates.
12. A 3-year-old child is hospitalized. Which play activity is most appropriate? A. Playing a
competitive board game B. Playing with a dollhouse C. Reading a long novel D.
Engaging in contact sports B. Playing with a dollhouse Explanation:
Preschoolers engage in associative and imaginative play. A dollhouse allows for
creative play that is age-appropriate.
13. What is the primary sign of Hirschsprung disease in a newborn? A. Projectile
vomiting B. Failure to pass meconium C. Excessive crying D. Diarrhea B. Failure to
pass meconium Explanation: Failure to pass meconium within the first 24 to 48
hours of life is the classic clinical manifestation of Hirschsprung disease.
14. A nurse is assessing a child with Type 1 Diabetes Mellitus. Which symptom indicates
hypoglycemia? A. Flushed, dry skin B. Kussmaul respirations C. Tremors and
diaphoresis D. Polyuria C. Tremors and diaphoresis Explanation: Symptoms of
hypoglycemia include tremors, diaphoresis, tachycardia, hunger, and irritability.
15. When providing care for a child with Wilms tumor, the nurse must avoid: A.
Measuring abdominal circumference B. Palpating the abdomen C. Monitoring blood
pressure D. Assessing bowel sounds B. Palpating the abdomen Explanation:
Palpating the abdomen can cause the tumor to rupture and potentially spread cancer
cells to other parts of the body.
16. Which vaccine is contraindicated in a child with a severe allergy to neomycin? A.
Hepatitis B B. DTaP C. IPV (Inactivated Poliovirus) D. Varicella C. IPV (Inactivated
Poliovirus) Explanation: Some formulations of the IPV vaccine contain trace
amounts of neomycin, which can trigger an allergic reaction in sensitive individuals.
