Pediatric Nursing for NCLEX, HESI, and ATI Questions, Answers,
and Rationales |Very Comprehensive | Latest 2025-2026 |
1. Question: A nurse is providing teaching to the parents of a school-aged child
who has ADHD. Which of the following instructions should the nurse include?
Answer: a. Place the child’s daily activities on an organizational chart
Rationale: Children with ADHD benefit from structured routines to manage impulsivity
and inattention. An organizational chart visually outlines daily tasks, promoting
consistency and reducing overwhelm. This tool helps the child anticipate activities,
improving focus and time management. Other options, like rewarding positive behavior,
are useful but less specific to daily structure. The chart directly addresses the need for
predictability, a key strategy in ADHD management, as it aligns with evidence-based
behavioral interventions for school-aged children.
2. Question: A nurse is completing an admission assessment on an adolescent child
who is a vegetarian. He eats milk products but does not like beans. Which of the
following items should the nurse suggest the client order for lunch to provide
nutrients most likely to be lacking in his diet?
Answer: a. Peanut butter and jelly sandwich
Rationale: A vegetarian adolescent who consumes milk but avoids beans may lack
protein and iron. A peanut butter and jelly sandwich provides plant-based protein and
1|Page
,some iron, addressing these deficiencies. Milk products supply calcium and vitamin D,
but protein sources are limited without beans. This choice supports nutritional balance,
aligning with pediatric dietary guidelines for vegetarians to ensure adequate growth and
development.
3. Question: A nurse is caring for a child who has sickle cell anemia. Which of the
following findings is a priority for the nurse to report to the provider?
Answer: a. Facial twitching
Rationale: Facial twitching in a child with sickle cell anemia may indicate a neurological
complication, such as a stroke, due to vaso-occlusion in cerebral blood vessels. This is a
medical emergency requiring immediate reporting to the provider. Other findings, like
pain or fever, are common but less urgent unless severe. Stroke risk is significant in
sickle cell disease, and early intervention can prevent long-term damage, making facial
twitching the priority finding to address promptly.
4. Question: A nurse is caring for a 1-month-old infant who weighs 3540 g and is
prescribed a dose of cefazolin 50 mg/kg IV bolus TID. How many mg should the
nurse administer per dose?
Answer: 177 mg
Rationale: To calculate the dose, multiply the infant’s weight (3540 g = 3.54 kg) by the
prescribed dose (50 mg/kg): 3.54 kg × 50 mg/kg = 177 mg per dose. This ensures the
2|Page
,infant receives the correct antibiotic amount for effective treatment while avoiding
toxicity. Accurate weight-based dosing is critical in pediatric care to account for rapid
growth and metabolism, aligning with pharmacological safety standards.
5. Question: A nurse in the PACU is caring for a school-aged child immediately
after a tonsillectomy. Which of the following actions should the nurse take?
Answer: a. Place the child in a side-lying position
Rationale: After a tonsillectomy, placing the child in a side-lying position promotes
drainage of oral secretions and prevents aspiration, a critical concern due to
postoperative bleeding risk. This position also maintains airway patency. Other actions,
like encouraging swallowing, may increase bleeding risk. The side-lying position aligns
with postoperative care standards to ensure safety and comfort while minimizing
complications in the immediate recovery period for pediatric patients.
6. Question: A nurse is performing a pre-college assessment on an adolescent.
Which of the following immunizations should the nurse anticipate administering?
Answer: a. Meningococcal polysaccharide vaccine
Rationale: Adolescents require the meningococcal vaccine (MCV4) before college due to
increased risk of meningococcal disease in communal settings like dormitories. This
vaccine is typically administered at ages 11–12 with a booster at 16–18, aligning with
pre-college assessments. Other vaccines, like Tdap, may also be given, but MCV4 is a
3|Page
, priority. This aligns with CDC immunization schedules to prevent outbreaks in high-risk
settings.
7. Question: A nurse in the ER is caring for an adolescent who was requesting
testing for STIs. Which of the following actions is appropriate for the nurse to
take?
Answer: a. Obtain written consent from the client
Rationale: Adolescents can often consent to STI testing without parental involvement,
depending on state laws, as it falls under confidential reproductive health services.
Obtaining written consent from the client ensures legal and ethical compliance while
respecting their autonomy. Other options, like requiring parental consent, may violate
confidentiality rights. This approach supports the adolescent’s ability to seek care
independently, which is critical for public health and timely treatment of STIs.
8. Question: A nurse is assessing a client who has left-sided heart failure. Which of
the following findings should the nurse expect?
Answer: a. Dependent edema
Rationale: Left-sided heart failure causes blood to back up into the pulmonary
circulation, leading to pulmonary edema, not dependent edema. However, the question
likely refers to right-sided heart failure, where dependent edema (swelling in lower
extremities) occurs due to systemic venous congestion. This is a common finding in
4|Page
and Rationales |Very Comprehensive | Latest 2025-2026 |
1. Question: A nurse is providing teaching to the parents of a school-aged child
who has ADHD. Which of the following instructions should the nurse include?
Answer: a. Place the child’s daily activities on an organizational chart
Rationale: Children with ADHD benefit from structured routines to manage impulsivity
and inattention. An organizational chart visually outlines daily tasks, promoting
consistency and reducing overwhelm. This tool helps the child anticipate activities,
improving focus and time management. Other options, like rewarding positive behavior,
are useful but less specific to daily structure. The chart directly addresses the need for
predictability, a key strategy in ADHD management, as it aligns with evidence-based
behavioral interventions for school-aged children.
2. Question: A nurse is completing an admission assessment on an adolescent child
who is a vegetarian. He eats milk products but does not like beans. Which of the
following items should the nurse suggest the client order for lunch to provide
nutrients most likely to be lacking in his diet?
Answer: a. Peanut butter and jelly sandwich
Rationale: A vegetarian adolescent who consumes milk but avoids beans may lack
protein and iron. A peanut butter and jelly sandwich provides plant-based protein and
1|Page
,some iron, addressing these deficiencies. Milk products supply calcium and vitamin D,
but protein sources are limited without beans. This choice supports nutritional balance,
aligning with pediatric dietary guidelines for vegetarians to ensure adequate growth and
development.
3. Question: A nurse is caring for a child who has sickle cell anemia. Which of the
following findings is a priority for the nurse to report to the provider?
Answer: a. Facial twitching
Rationale: Facial twitching in a child with sickle cell anemia may indicate a neurological
complication, such as a stroke, due to vaso-occlusion in cerebral blood vessels. This is a
medical emergency requiring immediate reporting to the provider. Other findings, like
pain or fever, are common but less urgent unless severe. Stroke risk is significant in
sickle cell disease, and early intervention can prevent long-term damage, making facial
twitching the priority finding to address promptly.
4. Question: A nurse is caring for a 1-month-old infant who weighs 3540 g and is
prescribed a dose of cefazolin 50 mg/kg IV bolus TID. How many mg should the
nurse administer per dose?
Answer: 177 mg
Rationale: To calculate the dose, multiply the infant’s weight (3540 g = 3.54 kg) by the
prescribed dose (50 mg/kg): 3.54 kg × 50 mg/kg = 177 mg per dose. This ensures the
2|Page
,infant receives the correct antibiotic amount for effective treatment while avoiding
toxicity. Accurate weight-based dosing is critical in pediatric care to account for rapid
growth and metabolism, aligning with pharmacological safety standards.
5. Question: A nurse in the PACU is caring for a school-aged child immediately
after a tonsillectomy. Which of the following actions should the nurse take?
Answer: a. Place the child in a side-lying position
Rationale: After a tonsillectomy, placing the child in a side-lying position promotes
drainage of oral secretions and prevents aspiration, a critical concern due to
postoperative bleeding risk. This position also maintains airway patency. Other actions,
like encouraging swallowing, may increase bleeding risk. The side-lying position aligns
with postoperative care standards to ensure safety and comfort while minimizing
complications in the immediate recovery period for pediatric patients.
6. Question: A nurse is performing a pre-college assessment on an adolescent.
Which of the following immunizations should the nurse anticipate administering?
Answer: a. Meningococcal polysaccharide vaccine
Rationale: Adolescents require the meningococcal vaccine (MCV4) before college due to
increased risk of meningococcal disease in communal settings like dormitories. This
vaccine is typically administered at ages 11–12 with a booster at 16–18, aligning with
pre-college assessments. Other vaccines, like Tdap, may also be given, but MCV4 is a
3|Page
, priority. This aligns with CDC immunization schedules to prevent outbreaks in high-risk
settings.
7. Question: A nurse in the ER is caring for an adolescent who was requesting
testing for STIs. Which of the following actions is appropriate for the nurse to
take?
Answer: a. Obtain written consent from the client
Rationale: Adolescents can often consent to STI testing without parental involvement,
depending on state laws, as it falls under confidential reproductive health services.
Obtaining written consent from the client ensures legal and ethical compliance while
respecting their autonomy. Other options, like requiring parental consent, may violate
confidentiality rights. This approach supports the adolescent’s ability to seek care
independently, which is critical for public health and timely treatment of STIs.
8. Question: A nurse is assessing a client who has left-sided heart failure. Which of
the following findings should the nurse expect?
Answer: a. Dependent edema
Rationale: Left-sided heart failure causes blood to back up into the pulmonary
circulation, leading to pulmonary edema, not dependent edema. However, the question
likely refers to right-sided heart failure, where dependent edema (swelling in lower
extremities) occurs due to systemic venous congestion. This is a common finding in
4|Page
