NURS 546 PEDIATRIC NURSING NCLEX FINAL EXAM
WITH LATEST AND UPDATED QUESTIONS WITH
CORRECT AND VERIFIED ANSWERS 2026 GRADED A+
166. The nurse is preparing to care for a 5-year-old who has been placed in traction follow-
ing a fracture of the femur. The nurse plans care, knowing that which is the most appropriate
activity for this child?
1. A radio
2. A sports video
3. Large picture books
4. Crayons and a colouring book
ANSWER⬛
✓
⬛
4. Crayons and a colouring book
393. A child has a right femur fracture caused by a motor vehicle crash and is placed in skin
traction temporarily until surgery can be performed. During assessment, the nurse notes
that the dorsalis pedis pulse is absent on the right foot. Which action should the nurse take?
1. Administer an analgesic.
2. Release the skin traction.
3. Apply ice to the extremity.
4. Notify the primary health care provider (PHCP).
ANSWER⬛
✓
4. Notify the primary health care provider (PHCP). (sign of compartment syndrome; immedi-
ately needs to be reported to provider to confirm, then surgery)
394. A child is placed in skeletal traction for treatment of a fractured femur. The nurse cre-
ates a plan of care and should include which intervention?
1. Ensure that all ropes are outside the pulleys.
2. Ensure that the weights are resting lightly on the floor.
3. Restrict diversional and play activities until the child is out of traction.
1
,4. Check the primary health care provider's (PHCP's) prescriptions for the amount of weight
to be applied.
AN SWER⬛
✓
4. Check the primary health care provider's (PHCP's) prescriptions for the amount of weight
to be applied.
397. A child who has undergone spinal fusion for scoliosis complains of abdominal discom-
fort and begins to have episodes of vomiting. On further assessment, the nurse notes ab-
dominal distention. On the basis of these findings, the nurse should take which action?
1. Administer an antiemetic.
2. Increase the intravenous fluids.
3. Place the child in a Sims' position.
4. Notify the primary health care provider (PHCP).
ANSWER⬛
⬛
✓
4. Notify the primary health care provider (PHCP).
(Postoperative vomiting in children with body casts or children who have undergone spinal
fusion warrants attention because of the possibility of superior mesenteric artery syn-
drome.)
395. A 4-year-old child sustains a fall at home. After an x-ray examination, the child is deter-
mined to have a fractured arm and a plaster cast is applied. The nurse provides instructions
to the parents regarding care for the child's cast. Which statement by the parents indicates a
need for further instruction?
1. "The cast may feel warm as the cast dries."
2. "I can use lotion or powder around the cast edges to relieve itching."
3. "A small amount of white shoe polish can touch up a soiled white cast."
4. "If the cast becomes wet, a blow drier set on the cool setting may be used to dry the cast."
ANSWER⬛
⬛
✓
2. "I can use lotion or powder around the cast edges to relieve itching."
2
,(lotions and powders should NOT be used bc they can become caked, leading to further irri-
tation and skin breakdown)
398. The nurse is providing instructions to the parents of a child with scoliosis regarding the
use of a brace. Which statement by the parents indicates a need for further instruction?
1. "I will encourage my child to perform prescribed exercises."
2. "I will have my child wear soft fabric clothing under the brace."
3. "I should apply lotion under the brace to prevent skin breakdown." 4. "I should avoid the
use of powder because it will cake under the brace."
ANSWER⬛
⬛
✓
3. "I should apply lotion under the brace to prevent skin breakdown."
402. The nurse prepares a list of home care instructions for the parents of a child who has a
plaster cast applied to the left forearm. Which instructions should be included on the list?
Select all that apply.
1. Use the fingertips to lift the cast while it is drying.
2. Keep small toys and sharp objects away from the cast.
3. Use a padded ruler or another padded object to scratch the skin under the cast if it itches.
4. Place a heating pad on the lower end of the cast and over the fingers if the fingers feel
cold.
5. Elevate the extremity on pillows for the first 24 to 48 hours after casting to prevent swell-
ing.
6. Contact the primary health care provider (PHCP) if the child complains of numbness or tin-
gling in the extremity.
AN SWER⬛
✓
2, 5, 6
294. The nurse is monitoring a child with burns during treatment. Which assessment pro-
vides the most accurate guide to determine the adequacy of fluid resuscitation?
1. Skin turgor
3
, 2. Level of edema at burn site
3. Adequacy of capillary filling
4. Amount of fluid tolerated in 24 hours
ANSWER⬛
✓
3. Adequacy of capillary filling
295. The mother of a 3-year-old child arrives at a clinic and tells the nurse that the child has
been scratching the skin continuously and has developed a rash. The nurse assesses the
child and suspects the presence of scabies. The nurse bases this suspicion on which finding
noted on assessment of the child's skin?
1. Fine grayish red lines
2. Purple-colored lesions
3. Thick, honey-colored crusts
4. Clusters of fluid-filled vesicles
ANSWER⬛
✓
1. Fine grayish red lines
297. The school nurse has provided an instructional session about impetigo to parents of the
children attending the school. Which statement, if made by a parent, indicates a need for
further instruction?
1. "It is extremely contagious."
2. "It is most common in humid weather."
3. "Lesions most often are located on the arms and chest."
4. "It might show up in an area of broken skin, such as an insect bite."
ANSWER⬛
✓
3. "Lesions most often are located on the arms and chest."
(Impetigo is a contagious bacterial infection of the skin caused by βhemolytic streptococci or
staphylococci, or both. Impetigo is most common during hot, humid summer months. Impe-
tigo may begin in an area of broken skin, such as an insect bite or atopic dermatitis. Impetigo
4
WITH LATEST AND UPDATED QUESTIONS WITH
CORRECT AND VERIFIED ANSWERS 2026 GRADED A+
166. The nurse is preparing to care for a 5-year-old who has been placed in traction follow-
ing a fracture of the femur. The nurse plans care, knowing that which is the most appropriate
activity for this child?
1. A radio
2. A sports video
3. Large picture books
4. Crayons and a colouring book
ANSWER⬛
✓
⬛
4. Crayons and a colouring book
393. A child has a right femur fracture caused by a motor vehicle crash and is placed in skin
traction temporarily until surgery can be performed. During assessment, the nurse notes
that the dorsalis pedis pulse is absent on the right foot. Which action should the nurse take?
1. Administer an analgesic.
2. Release the skin traction.
3. Apply ice to the extremity.
4. Notify the primary health care provider (PHCP).
ANSWER⬛
✓
4. Notify the primary health care provider (PHCP). (sign of compartment syndrome; immedi-
ately needs to be reported to provider to confirm, then surgery)
394. A child is placed in skeletal traction for treatment of a fractured femur. The nurse cre-
ates a plan of care and should include which intervention?
1. Ensure that all ropes are outside the pulleys.
2. Ensure that the weights are resting lightly on the floor.
3. Restrict diversional and play activities until the child is out of traction.
1
,4. Check the primary health care provider's (PHCP's) prescriptions for the amount of weight
to be applied.
AN SWER⬛
✓
4. Check the primary health care provider's (PHCP's) prescriptions for the amount of weight
to be applied.
397. A child who has undergone spinal fusion for scoliosis complains of abdominal discom-
fort and begins to have episodes of vomiting. On further assessment, the nurse notes ab-
dominal distention. On the basis of these findings, the nurse should take which action?
1. Administer an antiemetic.
2. Increase the intravenous fluids.
3. Place the child in a Sims' position.
4. Notify the primary health care provider (PHCP).
ANSWER⬛
⬛
✓
4. Notify the primary health care provider (PHCP).
(Postoperative vomiting in children with body casts or children who have undergone spinal
fusion warrants attention because of the possibility of superior mesenteric artery syn-
drome.)
395. A 4-year-old child sustains a fall at home. After an x-ray examination, the child is deter-
mined to have a fractured arm and a plaster cast is applied. The nurse provides instructions
to the parents regarding care for the child's cast. Which statement by the parents indicates a
need for further instruction?
1. "The cast may feel warm as the cast dries."
2. "I can use lotion or powder around the cast edges to relieve itching."
3. "A small amount of white shoe polish can touch up a soiled white cast."
4. "If the cast becomes wet, a blow drier set on the cool setting may be used to dry the cast."
ANSWER⬛
⬛
✓
2. "I can use lotion or powder around the cast edges to relieve itching."
2
,(lotions and powders should NOT be used bc they can become caked, leading to further irri-
tation and skin breakdown)
398. The nurse is providing instructions to the parents of a child with scoliosis regarding the
use of a brace. Which statement by the parents indicates a need for further instruction?
1. "I will encourage my child to perform prescribed exercises."
2. "I will have my child wear soft fabric clothing under the brace."
3. "I should apply lotion under the brace to prevent skin breakdown." 4. "I should avoid the
use of powder because it will cake under the brace."
ANSWER⬛
⬛
✓
3. "I should apply lotion under the brace to prevent skin breakdown."
402. The nurse prepares a list of home care instructions for the parents of a child who has a
plaster cast applied to the left forearm. Which instructions should be included on the list?
Select all that apply.
1. Use the fingertips to lift the cast while it is drying.
2. Keep small toys and sharp objects away from the cast.
3. Use a padded ruler or another padded object to scratch the skin under the cast if it itches.
4. Place a heating pad on the lower end of the cast and over the fingers if the fingers feel
cold.
5. Elevate the extremity on pillows for the first 24 to 48 hours after casting to prevent swell-
ing.
6. Contact the primary health care provider (PHCP) if the child complains of numbness or tin-
gling in the extremity.
AN SWER⬛
✓
2, 5, 6
294. The nurse is monitoring a child with burns during treatment. Which assessment pro-
vides the most accurate guide to determine the adequacy of fluid resuscitation?
1. Skin turgor
3
, 2. Level of edema at burn site
3. Adequacy of capillary filling
4. Amount of fluid tolerated in 24 hours
ANSWER⬛
✓
3. Adequacy of capillary filling
295. The mother of a 3-year-old child arrives at a clinic and tells the nurse that the child has
been scratching the skin continuously and has developed a rash. The nurse assesses the
child and suspects the presence of scabies. The nurse bases this suspicion on which finding
noted on assessment of the child's skin?
1. Fine grayish red lines
2. Purple-colored lesions
3. Thick, honey-colored crusts
4. Clusters of fluid-filled vesicles
ANSWER⬛
✓
1. Fine grayish red lines
297. The school nurse has provided an instructional session about impetigo to parents of the
children attending the school. Which statement, if made by a parent, indicates a need for
further instruction?
1. "It is extremely contagious."
2. "It is most common in humid weather."
3. "Lesions most often are located on the arms and chest."
4. "It might show up in an area of broken skin, such as an insect bite."
ANSWER⬛
✓
3. "Lesions most often are located on the arms and chest."
(Impetigo is a contagious bacterial infection of the skin caused by βhemolytic streptococci or
staphylococci, or both. Impetigo is most common during hot, humid summer months. Impe-
tigo may begin in an area of broken skin, such as an insect bite or atopic dermatitis. Impetigo
4
