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PEDIATRIC PROCEDURES 2026 ACTUAL EXAM
QUESTIONS 2026 – 2027 LATEST VERSION SOLVED
QUESTIONS & ANSWERS
Pediatric Procedures Questions with Rationales
This comprehensive practice exam covers essential pediatric procedures and nursing
care, including medication administration, developmental assessments,
immunizations, respiratory interventions, and emergency management.
SECTION 1: SAFETY & EMERGENCY PROCEDURES (Questions 1-30)
1. A nurse in the emergency department is caring for a 2-year-old child who was
found by his parents crying and holding a container of toilet bowl cleaner. The
child's lips are edematous and inflamed, and he is drooling. Which of the following
is the priority action by the nurse?
A. Remove the child's contaminated clothing.
B. Check the child's respiratory status.
C. Administer an antidote to the child.
D. Establish IV access for the child.
Answer: B
Rationale: When applying the ABC priority setting framework, airway is always the
highest priority because the airway must be clear and open for oxygen exchange to
occur. The child's edematous, inflamed lips and drooling suggest possible airway
compromise from a caustic ingestion. Breathing is the second highest priority in the
ABC framework because adequate ventilatory effort is essential for oxygen exchange to
occur.
2. A nurse is teaching the parent of a toddler about home safety. Which of the
following statements by the parent indicates an understanding of the teaching?
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A. "I lock my medications in the medicine cabinet."
B. "I keep my child's crib mattress at the highest level."
C. "I turn pot handles to the side of my stove while cooking."
D. "I will give my child syrup of ipecac if she swallows something poisonous."
Answer: A
Rationale: Locking up medications and other potential poisons prevents access.
Toddlers have improved gross and fine motor skills that allow for further exploration of
the environment and possible access to hazardous substances. Syrup of ipecac is no
longer recommended for poison management.
3. A nurse is caring for a toddler and is preparing to administer 0.9% sodium
chloride 100 mL IV to infuse over 4 hours. The drop factor of the manual IV tubing is
60 gtt/mL. The nurse should set the manual IV infusion to deliver how many
gtt/min?
A. 15 gtt/min
B. 20 gtt/min
C. 25 gtt/min
D. 30 gtt/min
Answer: C
Rationale: Use the formula: (Volume in mL × Drop factor) / Time in minutes = Flow rate in
gtt/min. (100 mL × 60 gtt/mL) / 240 minutes = 25 gtt/min.
4. A nurse is performing a physical assessment on a 6-month-old infant. Which of
the following reflexes should the nurse expect to find?
A. Stepping
B. Babinski
C. Extrusion
D. Moro
Answer: B
Rationale: The Babinski reflex, elicited by stroking the bottom of the foot and causing the
toes to fan and the big toe to dorsiflex, should be present until the age of 1 year. The
stepping reflex disappears by 4-6 weeks, the Moro reflex by 4-6 months, and the
extrusion reflex by 4-6 months.
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5. A nurse is preparing to administer recommended immunizations to a 2-month-
old infant. Which of the following immunizations should the nurse plan to
administer?
A. Human papillomavirus (HPV) and hepatitis A
B. Measles, mumps, rubella (MMR) and tetanus, diphtheria, and acellular pertussis
(TDaP)
C. Haemophilus influenzae type B (Hib) and inactivated polio virus (IPV)
D. Varicella (VAR) and live attenuated influenza vaccine (LAIV)
Answer: C
Rationale: The recommended immunizations for a 2-month-old infant include Hib and
IPV. The Hib immunization series consists of 3 to 4 doses and is administered at 2
months, 4 months, and 12 to 15 months. The IPV series consists of 4 doses and is
administered at 2 months, 4 months, 6 to 18 months, and 4 to 6 years.
6. A nurse is caring for an 18-year-old adolescent who is up to date on
immunizations and is planning to attend college. The nurse should inform the client
that he should receive which of the following immunizations prior to moving into a
campus dormitory?
A. Pneumococcal polysaccharide
B. Meningococcal polysaccharide
C. Rotavirus
D. Herpes zoster
Answer: B
Rationale: College freshmen, particularly those who live in dormitories, are at an
increased risk for meningococcal disease relative to other persons their age. The CDC
has issued a recommendation that all incoming college students receive the
meningococcal immunization.
7. A 4-year-old child presents with a high fever, cough, and difficulty breathing. The
nurse notes wheezing upon auscultation. What is the priority nursing intervention?
A. Administer oral antibiotics
B. Administer a bronchodilator
C. Perform a throat culture
D. Encourage fluid intake
Answer: B
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Rationale: Administering a bronchodilator is the priority intervention to relieve wheezing
and improve the child's breathing. Airway and breathing are always the priority in
respiratory distress.
8. A 6-month-old infant is admitted with RSV bronchiolitis. Which intervention is
most important for this infant?
A. Administering antibiotics
B. Suctioning the nares as needed
C. Placing the infant in a prone position
D. Restricting fluids
Answer: B
Rationale: Suctioning the nares as needed helps clear airway secretions and maintain a
patent airway. RSV bronchiolitis is a viral infection, so antibiotics are not indicated
unless secondary bacterial infection is present. Infants should be placed in an upright
position for easier breathing, and fluids should be encouraged to maintain hydration.
9. A 10-year-old child with asthma is experiencing an exacerbation. The child is
using a rescue inhaler every 2 hours. What should the nurse assess for next?
A. Increase in physical activity
B. Improvement in appetite
C. Signs of respiratory failure
D. Decreased heart rate
Answer: C
Rationale: Frequent use of a rescue inhaler (more than every 4 hours) indicates poor
asthma control and may precede respiratory failure. The nurse should assess for signs
of impending respiratory failure, including tachypnea, use of accessory muscles, and
altered mental status.
10. A nurse is caring for a child with a burn injury. The child's pain level is reported
as 8/10. What is the most appropriate intervention?
A. Apply a cold compress
B. Administer prescribed analgesics
C. Distract the child with toys
D. Reassure the child that pain is normal
PEDIATRIC PROCEDURES 2026 ACTUAL EXAM
QUESTIONS 2026 – 2027 LATEST VERSION SOLVED
QUESTIONS & ANSWERS
Pediatric Procedures Questions with Rationales
This comprehensive practice exam covers essential pediatric procedures and nursing
care, including medication administration, developmental assessments,
immunizations, respiratory interventions, and emergency management.
SECTION 1: SAFETY & EMERGENCY PROCEDURES (Questions 1-30)
1. A nurse in the emergency department is caring for a 2-year-old child who was
found by his parents crying and holding a container of toilet bowl cleaner. The
child's lips are edematous and inflamed, and he is drooling. Which of the following
is the priority action by the nurse?
A. Remove the child's contaminated clothing.
B. Check the child's respiratory status.
C. Administer an antidote to the child.
D. Establish IV access for the child.
Answer: B
Rationale: When applying the ABC priority setting framework, airway is always the
highest priority because the airway must be clear and open for oxygen exchange to
occur. The child's edematous, inflamed lips and drooling suggest possible airway
compromise from a caustic ingestion. Breathing is the second highest priority in the
ABC framework because adequate ventilatory effort is essential for oxygen exchange to
occur.
2. A nurse is teaching the parent of a toddler about home safety. Which of the
following statements by the parent indicates an understanding of the teaching?
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A. "I lock my medications in the medicine cabinet."
B. "I keep my child's crib mattress at the highest level."
C. "I turn pot handles to the side of my stove while cooking."
D. "I will give my child syrup of ipecac if she swallows something poisonous."
Answer: A
Rationale: Locking up medications and other potential poisons prevents access.
Toddlers have improved gross and fine motor skills that allow for further exploration of
the environment and possible access to hazardous substances. Syrup of ipecac is no
longer recommended for poison management.
3. A nurse is caring for a toddler and is preparing to administer 0.9% sodium
chloride 100 mL IV to infuse over 4 hours. The drop factor of the manual IV tubing is
60 gtt/mL. The nurse should set the manual IV infusion to deliver how many
gtt/min?
A. 15 gtt/min
B. 20 gtt/min
C. 25 gtt/min
D. 30 gtt/min
Answer: C
Rationale: Use the formula: (Volume in mL × Drop factor) / Time in minutes = Flow rate in
gtt/min. (100 mL × 60 gtt/mL) / 240 minutes = 25 gtt/min.
4. A nurse is performing a physical assessment on a 6-month-old infant. Which of
the following reflexes should the nurse expect to find?
A. Stepping
B. Babinski
C. Extrusion
D. Moro
Answer: B
Rationale: The Babinski reflex, elicited by stroking the bottom of the foot and causing the
toes to fan and the big toe to dorsiflex, should be present until the age of 1 year. The
stepping reflex disappears by 4-6 weeks, the Moro reflex by 4-6 months, and the
extrusion reflex by 4-6 months.
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5. A nurse is preparing to administer recommended immunizations to a 2-month-
old infant. Which of the following immunizations should the nurse plan to
administer?
A. Human papillomavirus (HPV) and hepatitis A
B. Measles, mumps, rubella (MMR) and tetanus, diphtheria, and acellular pertussis
(TDaP)
C. Haemophilus influenzae type B (Hib) and inactivated polio virus (IPV)
D. Varicella (VAR) and live attenuated influenza vaccine (LAIV)
Answer: C
Rationale: The recommended immunizations for a 2-month-old infant include Hib and
IPV. The Hib immunization series consists of 3 to 4 doses and is administered at 2
months, 4 months, and 12 to 15 months. The IPV series consists of 4 doses and is
administered at 2 months, 4 months, 6 to 18 months, and 4 to 6 years.
6. A nurse is caring for an 18-year-old adolescent who is up to date on
immunizations and is planning to attend college. The nurse should inform the client
that he should receive which of the following immunizations prior to moving into a
campus dormitory?
A. Pneumococcal polysaccharide
B. Meningococcal polysaccharide
C. Rotavirus
D. Herpes zoster
Answer: B
Rationale: College freshmen, particularly those who live in dormitories, are at an
increased risk for meningococcal disease relative to other persons their age. The CDC
has issued a recommendation that all incoming college students receive the
meningococcal immunization.
7. A 4-year-old child presents with a high fever, cough, and difficulty breathing. The
nurse notes wheezing upon auscultation. What is the priority nursing intervention?
A. Administer oral antibiotics
B. Administer a bronchodilator
C. Perform a throat culture
D. Encourage fluid intake
Answer: B
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Rationale: Administering a bronchodilator is the priority intervention to relieve wheezing
and improve the child's breathing. Airway and breathing are always the priority in
respiratory distress.
8. A 6-month-old infant is admitted with RSV bronchiolitis. Which intervention is
most important for this infant?
A. Administering antibiotics
B. Suctioning the nares as needed
C. Placing the infant in a prone position
D. Restricting fluids
Answer: B
Rationale: Suctioning the nares as needed helps clear airway secretions and maintain a
patent airway. RSV bronchiolitis is a viral infection, so antibiotics are not indicated
unless secondary bacterial infection is present. Infants should be placed in an upright
position for easier breathing, and fluids should be encouraged to maintain hydration.
9. A 10-year-old child with asthma is experiencing an exacerbation. The child is
using a rescue inhaler every 2 hours. What should the nurse assess for next?
A. Increase in physical activity
B. Improvement in appetite
C. Signs of respiratory failure
D. Decreased heart rate
Answer: C
Rationale: Frequent use of a rescue inhaler (more than every 4 hours) indicates poor
asthma control and may precede respiratory failure. The nurse should assess for signs
of impending respiratory failure, including tachypnea, use of accessory muscles, and
altered mental status.
10. A nurse is caring for a child with a burn injury. The child's pain level is reported
as 8/10. What is the most appropriate intervention?
A. Apply a cold compress
B. Administer prescribed analgesics
C. Distract the child with toys
D. Reassure the child that pain is normal
