Pediatric Nursing NCLEX Practice Exam (2026 /2027 Edition)
Questions and Answers with Detailed Rationales
Question 1
A nurse is caring for a 3-year-old child admitted to the hospital. Which
intervention best supports the child’s developmental needs?
A. Allow the child to make simple choices
B. Provide long explanations of procedures
C. Limit parental visits
D. Expect independent self-care
Correct Answer: A. Allow the Child to Make Simple Choices
Rationale:
Toddlers and preschool children develop independence. Offering limited
choices supports autonomy and reduces anxiety.
Question 2
A nurse is teaching parents about infant sleep safety. Which statement
indicates correct understanding?
A. “I will place my baby on the back to sleep.”
B. “I will use pillows to support my baby.”
C. “I will place stuffed toys in the crib.”
D. “I will let my baby sleep in my bed.”
Correct Answer: A. “I will place my baby on the back to sleep.”
,Rationale:
Supine positioning on a firm mattress reduces the risk of sudden infant
death syndrome (SIDS).
Question 3
A nurse is assessing a child with respiratory distress. Which finding
requires immediate action?
A. Oxygen saturation of 88%
B. Mild cough
C. Clear nasal drainage
D. Slight decrease in appetite
Correct Answer: A. Oxygen Saturation of 88%
Rationale:
Low oxygen saturation indicates impaired oxygenation and requires
immediate respiratory intervention.
Question 4
A child with asthma is having difficulty breathing. Which medication
should the nurse administer first?
A. Albuterol
B. Fluticasone
C. Montelukast
D. Antibiotic therapy
Correct Answer: A. Albuterol
,Rationale:
Albuterol is a short-acting bronchodilator used for rapid relief during an
asthma attack.
Question 5
A nurse is caring for a child with dehydration. Which assessment finding
indicates worsening condition?
A. Decreased urine output
B. Moist mucous membranes
C. Increased activity level
D. Normal skin turgor
Correct Answer: A. Decreased Urine Output
Rationale:
Reduced urine output indicates decreased kidney perfusion and
worsening dehydration.
Question 6
A child begins having a seizure. What is the nurse’s priority action?
A. Protect the child from injury
B. Insert an object into the mouth
C. Restrain the child
D. Offer fluids immediately
Correct Answer: A. Protect the Child From Injury
, Rationale:
The priority during a seizure is maintaining safety and protecting the
airway.
Question 7
A nurse is caring for a child with type 1 diabetes mellitus. Which finding
suggests hypoglycemia?
A. Sweating and trembling
B. Fruity breath odor
C. Deep rapid breathing
D. Increased thirst
Correct Answer: A. Sweating and Trembling
Rationale:
Hypoglycemia causes symptoms such as sweating, shakiness, hunger,
irritability, and confusion.
Question 8
A nurse caring for a child with cystic fibrosis should expect which
intervention?
A. Chest physiotherapy
B. Fluid restriction
C. Low-calorie diet
D. Avoiding exercise
Correct Answer: A. Chest Physiotherapy
Questions and Answers with Detailed Rationales
Question 1
A nurse is caring for a 3-year-old child admitted to the hospital. Which
intervention best supports the child’s developmental needs?
A. Allow the child to make simple choices
B. Provide long explanations of procedures
C. Limit parental visits
D. Expect independent self-care
Correct Answer: A. Allow the Child to Make Simple Choices
Rationale:
Toddlers and preschool children develop independence. Offering limited
choices supports autonomy and reduces anxiety.
Question 2
A nurse is teaching parents about infant sleep safety. Which statement
indicates correct understanding?
A. “I will place my baby on the back to sleep.”
B. “I will use pillows to support my baby.”
C. “I will place stuffed toys in the crib.”
D. “I will let my baby sleep in my bed.”
Correct Answer: A. “I will place my baby on the back to sleep.”
,Rationale:
Supine positioning on a firm mattress reduces the risk of sudden infant
death syndrome (SIDS).
Question 3
A nurse is assessing a child with respiratory distress. Which finding
requires immediate action?
A. Oxygen saturation of 88%
B. Mild cough
C. Clear nasal drainage
D. Slight decrease in appetite
Correct Answer: A. Oxygen Saturation of 88%
Rationale:
Low oxygen saturation indicates impaired oxygenation and requires
immediate respiratory intervention.
Question 4
A child with asthma is having difficulty breathing. Which medication
should the nurse administer first?
A. Albuterol
B. Fluticasone
C. Montelukast
D. Antibiotic therapy
Correct Answer: A. Albuterol
,Rationale:
Albuterol is a short-acting bronchodilator used for rapid relief during an
asthma attack.
Question 5
A nurse is caring for a child with dehydration. Which assessment finding
indicates worsening condition?
A. Decreased urine output
B. Moist mucous membranes
C. Increased activity level
D. Normal skin turgor
Correct Answer: A. Decreased Urine Output
Rationale:
Reduced urine output indicates decreased kidney perfusion and
worsening dehydration.
Question 6
A child begins having a seizure. What is the nurse’s priority action?
A. Protect the child from injury
B. Insert an object into the mouth
C. Restrain the child
D. Offer fluids immediately
Correct Answer: A. Protect the Child From Injury
, Rationale:
The priority during a seizure is maintaining safety and protecting the
airway.
Question 7
A nurse is caring for a child with type 1 diabetes mellitus. Which finding
suggests hypoglycemia?
A. Sweating and trembling
B. Fruity breath odor
C. Deep rapid breathing
D. Increased thirst
Correct Answer: A. Sweating and Trembling
Rationale:
Hypoglycemia causes symptoms such as sweating, shakiness, hunger,
irritability, and confusion.
Question 8
A nurse caring for a child with cystic fibrosis should expect which
intervention?
A. Chest physiotherapy
B. Fluid restriction
C. Low-calorie diet
D. Avoiding exercise
Correct Answer: A. Chest Physiotherapy