Pediatric Nursing for NCLEX and HESI: Questions, Answers, and
Rationales | 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
1|Page
,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 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.
2|Page
,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 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.
3|Page
, 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 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.
4|Page
Rationales | 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
1|Page
,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 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.
2|Page
,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 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.
3|Page
, 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 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.
4|Page
