RELIAS COMPETENCY PEDIATRIC NURSING
EXAMINATION COMPLETE QUESTIONS AND
DETAILED SOLUTIONS LATEST UPDATE THIS YEAR
JUST RELEASED
1. A pediatric nurse is assessing a 6-month-old infant during a routine wellness
examination for developmental milestones. What finding should the nurse
identify as expected for this age?
A. Walking independently across the examination room
B. Rolling from front to back and back to front
C. Speaking in two-word phrases clearly
D. Using a spoon without assistance
Correct Answer: B
Rationale: A 6-month-old infant is expected to roll in both directions. Independent
walking, two-word phrases, and self-feeding with a spoon occur later in
development.
2. A nurse is preparing to administer an oral antibiotic to a 2-year-old child who
refuses medication. Which nursing intervention is most appropriate to promote
safe administration?
A. Force the medication into the child’s mouth immediately
B. Mix the medication with a small amount of acceptable food
C. Tell the child the medicine is candy to encourage cooperation
D. Delay the medication until the next scheduled dose
,Correct Answer: B
Rationale: Mixing medication with a small amount of acceptable food can
improve cooperation while ensuring the full dose is taken. Forcing medication or
misrepresenting it as candy is unsafe.
3. A child with acute asthma exacerbation arrives in the emergency department
with wheezing and increased work of breathing. Which assessment finding
requires the nurse’s immediate attention?
A. Mild expiratory wheezes in both lungs
B. Oxygen saturation of 89% on room air
C. Respiratory rate of 32 breaths per minute
D. Occasional nonproductive cough
Correct Answer: B
Rationale: An oxygen saturation of 89% indicates significant hypoxemia and
requires immediate intervention. The other findings may occur with asthma but
are less urgent.
4. A nurse is caring for a child with gastroenteritis who has experienced
frequent vomiting and diarrhea for 24 hours. Which finding suggests moderate
dehydration?
A. Moist mucous membranes and normal tears
B. Sunken eyes and decreased urine output
C. Bounding pulses and hypertension
D. Weight gain of 0.5 kg
Correct Answer: B
,Rationale: Sunken eyes and decreased urine output are classic signs of moderate
dehydration in children. Moist mucous membranes and weight gain would not
support dehydration.
5. A pediatric nurse is teaching parents about immunizations for their 4-year-old
child before kindergarten entry. Which statement by the parents indicates
correct understanding?
A. “Vaccines should be avoided if my child has a mild cold.”
B. “Immunizations help protect both my child and the community.”
C. “Natural infection is always safer than vaccination.”
D. “Booster doses are unnecessary after infancy.”
Correct Answer: B
Rationale: Vaccinations provide individual and community protection through
herd immunity. Mild illness is not usually a contraindication, and booster doses
are often required.
6. A nurse is assessing a school-age child who reports severe sore throat, fever,
and difficulty swallowing. Which additional finding is most consistent with
streptococcal pharyngitis?
A. Vesicular lesions on the hands and feet
B. Strawberry tongue and enlarged cervical lymph nodes
C. Barking cough and inspiratory stridor
D. Gray membrane that bleeds when removed
Correct Answer: B
Rationale: Streptococcal pharyngitis commonly presents with fever, sore throat,
tender cervical lymphadenopathy, and sometimes a strawberry tongue.
, 7. A nurse is caring for a child after a tonsillectomy and adenoidectomy
performed earlier today. Which postoperative finding should the nurse report
immediately?
A. Swallowing small amounts of saliva
B. Complaining of throat pain when swallowing
C. Frequent swallowing and restlessness
D. Refusing solid foods at dinner
Correct Answer: C
Rationale: Frequent swallowing and restlessness may indicate postoperative
bleeding, which is a priority complication requiring immediate assessment.
8. A child with type 1 diabetes mellitus becomes pale, shaky, and irritable during
play therapy. What should the nurse do first?
A. Administer the scheduled insulin dose
B. Check the child’s blood glucose level
C. Encourage vigorous exercise to reduce stress
D. Restrict oral fluids temporarily
Correct Answer: B
Rationale: These symptoms suggest hypoglycemia. The nurse should first check
the blood glucose level and then treat accordingly.
9. A nurse is teaching an adolescent newly diagnosed with type 1 diabetes about
insulin administration. Which statement by the adolescent indicates a need for
further teaching?
A. “I will rotate my injection sites regularly.”
B. “I should check my blood glucose as instructed.”
EXAMINATION COMPLETE QUESTIONS AND
DETAILED SOLUTIONS LATEST UPDATE THIS YEAR
JUST RELEASED
1. A pediatric nurse is assessing a 6-month-old infant during a routine wellness
examination for developmental milestones. What finding should the nurse
identify as expected for this age?
A. Walking independently across the examination room
B. Rolling from front to back and back to front
C. Speaking in two-word phrases clearly
D. Using a spoon without assistance
Correct Answer: B
Rationale: A 6-month-old infant is expected to roll in both directions. Independent
walking, two-word phrases, and self-feeding with a spoon occur later in
development.
2. A nurse is preparing to administer an oral antibiotic to a 2-year-old child who
refuses medication. Which nursing intervention is most appropriate to promote
safe administration?
A. Force the medication into the child’s mouth immediately
B. Mix the medication with a small amount of acceptable food
C. Tell the child the medicine is candy to encourage cooperation
D. Delay the medication until the next scheduled dose
,Correct Answer: B
Rationale: Mixing medication with a small amount of acceptable food can
improve cooperation while ensuring the full dose is taken. Forcing medication or
misrepresenting it as candy is unsafe.
3. A child with acute asthma exacerbation arrives in the emergency department
with wheezing and increased work of breathing. Which assessment finding
requires the nurse’s immediate attention?
A. Mild expiratory wheezes in both lungs
B. Oxygen saturation of 89% on room air
C. Respiratory rate of 32 breaths per minute
D. Occasional nonproductive cough
Correct Answer: B
Rationale: An oxygen saturation of 89% indicates significant hypoxemia and
requires immediate intervention. The other findings may occur with asthma but
are less urgent.
4. A nurse is caring for a child with gastroenteritis who has experienced
frequent vomiting and diarrhea for 24 hours. Which finding suggests moderate
dehydration?
A. Moist mucous membranes and normal tears
B. Sunken eyes and decreased urine output
C. Bounding pulses and hypertension
D. Weight gain of 0.5 kg
Correct Answer: B
,Rationale: Sunken eyes and decreased urine output are classic signs of moderate
dehydration in children. Moist mucous membranes and weight gain would not
support dehydration.
5. A pediatric nurse is teaching parents about immunizations for their 4-year-old
child before kindergarten entry. Which statement by the parents indicates
correct understanding?
A. “Vaccines should be avoided if my child has a mild cold.”
B. “Immunizations help protect both my child and the community.”
C. “Natural infection is always safer than vaccination.”
D. “Booster doses are unnecessary after infancy.”
Correct Answer: B
Rationale: Vaccinations provide individual and community protection through
herd immunity. Mild illness is not usually a contraindication, and booster doses
are often required.
6. A nurse is assessing a school-age child who reports severe sore throat, fever,
and difficulty swallowing. Which additional finding is most consistent with
streptococcal pharyngitis?
A. Vesicular lesions on the hands and feet
B. Strawberry tongue and enlarged cervical lymph nodes
C. Barking cough and inspiratory stridor
D. Gray membrane that bleeds when removed
Correct Answer: B
Rationale: Streptococcal pharyngitis commonly presents with fever, sore throat,
tender cervical lymphadenopathy, and sometimes a strawberry tongue.
, 7. A nurse is caring for a child after a tonsillectomy and adenoidectomy
performed earlier today. Which postoperative finding should the nurse report
immediately?
A. Swallowing small amounts of saliva
B. Complaining of throat pain when swallowing
C. Frequent swallowing and restlessness
D. Refusing solid foods at dinner
Correct Answer: C
Rationale: Frequent swallowing and restlessness may indicate postoperative
bleeding, which is a priority complication requiring immediate assessment.
8. A child with type 1 diabetes mellitus becomes pale, shaky, and irritable during
play therapy. What should the nurse do first?
A. Administer the scheduled insulin dose
B. Check the child’s blood glucose level
C. Encourage vigorous exercise to reduce stress
D. Restrict oral fluids temporarily
Correct Answer: B
Rationale: These symptoms suggest hypoglycemia. The nurse should first check
the blood glucose level and then treat accordingly.
9. A nurse is teaching an adolescent newly diagnosed with type 1 diabetes about
insulin administration. Which statement by the adolescent indicates a need for
further teaching?
A. “I will rotate my injection sites regularly.”
B. “I should check my blood glucose as instructed.”
