FLORIDA BOARD OF NURSING CERTIFIED
PEDIATRIC NURSE EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS,
PLUS EXPLAINED RATIONALES/EXPERT
VERIFIED FOR GUARANTEED 100% PASS
2026/LATEST UPDATE/INSTANT
DOWNLOAD PDF
1.
A 4-year-old child is brought to the emergency department with a 2-day
history of fever, vomiting, poor oral intake, and diarrhea. The child is
lethargic, has dry mucous membranes, sunken eyes, tachycardia, and
delayed capillary refill of 4 seconds. Blood pressure is 78/42 mmHg.
Which finding is the nurse's highest priority?
A. Dry mucous membranes
B. Sunken eyes
C. Delayed capillary refill
D. Hypotension with altered level of consciousness
Answer: D. Hypotension with altered level of consciousness
Rationale: Hypotension accompanied by altered consciousness
indicates severe circulatory compromise and possible hypovolemic
shock. In pediatric patients, hypotension is a late and ominous sign of
significant fluid loss because children can maintain blood pressure
through compensatory tachycardia and vasoconstriction for a
considerable period. Immediate stabilization of airway, breathing, and
circulation and rapid isotonic fluid resuscitation are priorities. Dry
mucous membranes, sunken eyes, and delayed capillary refill support
dehydration but are less immediately life-threatening than hypotension
with neurologic deterioration.
1
,2.
A nurse is preparing to administer digoxin to an infant with congenital
heart disease. The infant's apical pulse is 88 beats/minute. Which action
should the nurse take?
A. Administer the medication because the pulse is within the normal
infant range
B. Hold the medication and notify the provider
C. Administer half of the prescribed dose
D. Recheck the pulse after giving the medication
Answer: B. Hold the medication and notify the provider
Rationale: Digoxin can cause significant bradycardia and
dysrhythmias. Before administration, the nurse should assess the
apical pulse for a full minute. An infant's ventricular rate of 88
beats/minute may be below the expected range and may warrant
withholding digoxin according to the prescribed parameters and
institutional protocol. The medication should not be independently
reduced, and administering it before reassessment could worsen
bradycardia.
3.
A 7-year-old child with asthma suddenly develops severe wheezing,
difficulty speaking, intercostal retractions, and oxygen saturation of 88%
despite supplemental oxygen. Which finding would indicate impending
respiratory failure?
A. Expiratory wheezing
B. Tachypnea
C. Decreasing wheezing with increasing lethargy
D. Productive cough
2
,Answer: C. Decreasing wheezing with increasing lethargy
Rationale: A critically ill asthmatic child may initially have intense
wheezing. As airflow becomes severely restricted, however, air
movement may become so poor that wheezing diminishes or
disappears. A "silent chest" accompanied by lethargy is an ominous
sign of impending respiratory failure. Tachypnea and wheezing are
common manifestations of respiratory distress, whereas declining
mental status indicates worsening hypoxemia and fatigue.
4.
A 2-year-old child is admitted with suspected bacterial meningitis.
Which nursing intervention is most appropriate initially?
A. Place the child on airborne precautions
B. Place the child on droplet precautions
C. Encourage frequent ambulation
D. Keep the child in a brightly lit room
Answer: B. Place the child on droplet precautions
Rationale: Suspected bacterial meningitis caused by organisms such
as Neisseria meningitidis or Haemophilus influenzae requires droplet
precautions in addition to standard precautions until the child has
received appropriate antimicrobial therapy for the required period.
Airborne precautions are used for diseases such as measles, varicella,
and pulmonary tuberculosis. A quiet environment with reduced
stimulation is generally more appropriate for a child with meningeal
irritation.
5.
3
, A 6-month-old infant with bronchiolitis has nasal congestion, tachypnea,
poor feeding, and subcostal retractions. Which nursing intervention is
most important before feeding?
A. Administer a large feeding rapidly
B. Suction the nares gently
C. Place the infant completely flat
D. Encourage oral fluids while the infant is tachypneic
Answer: B. Suction the nares gently
Rationale: Infants are preferential nasal breathers, and nasal
congestion can significantly interfere with breathing and feeding.
Gentle nasal suctioning before feeding can improve airway patency
and reduce respiratory effort. Large or rapid feedings increase the risk
of aspiration, particularly in a tachypneic infant. The infant should be
positioned appropriately to optimize ventilation rather than placed
completely flat.
6.
A child with sickle cell disease is admitted with severe pain. Which
intervention should the nurse prioritize?
A. Restrict fluids
B. Encourage hydration and administer prescribed analgesia
C. Apply ice packs to painful joints
D. Encourage vigorous exercise
Answer: B. Encourage hydration and administer prescribed
analgesia
Rationale: Vaso-occlusive episodes in sickle cell disease cause tissue
ischemia and severe pain. Adequate hydration helps reduce blood
viscosity, while timely analgesia is essential for effective pain control.
Cold application can cause vasoconstriction and potentially worsen
4
PEDIATRIC NURSE EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS,
PLUS EXPLAINED RATIONALES/EXPERT
VERIFIED FOR GUARANTEED 100% PASS
2026/LATEST UPDATE/INSTANT
DOWNLOAD PDF
1.
A 4-year-old child is brought to the emergency department with a 2-day
history of fever, vomiting, poor oral intake, and diarrhea. The child is
lethargic, has dry mucous membranes, sunken eyes, tachycardia, and
delayed capillary refill of 4 seconds. Blood pressure is 78/42 mmHg.
Which finding is the nurse's highest priority?
A. Dry mucous membranes
B. Sunken eyes
C. Delayed capillary refill
D. Hypotension with altered level of consciousness
Answer: D. Hypotension with altered level of consciousness
Rationale: Hypotension accompanied by altered consciousness
indicates severe circulatory compromise and possible hypovolemic
shock. In pediatric patients, hypotension is a late and ominous sign of
significant fluid loss because children can maintain blood pressure
through compensatory tachycardia and vasoconstriction for a
considerable period. Immediate stabilization of airway, breathing, and
circulation and rapid isotonic fluid resuscitation are priorities. Dry
mucous membranes, sunken eyes, and delayed capillary refill support
dehydration but are less immediately life-threatening than hypotension
with neurologic deterioration.
1
,2.
A nurse is preparing to administer digoxin to an infant with congenital
heart disease. The infant's apical pulse is 88 beats/minute. Which action
should the nurse take?
A. Administer the medication because the pulse is within the normal
infant range
B. Hold the medication and notify the provider
C. Administer half of the prescribed dose
D. Recheck the pulse after giving the medication
Answer: B. Hold the medication and notify the provider
Rationale: Digoxin can cause significant bradycardia and
dysrhythmias. Before administration, the nurse should assess the
apical pulse for a full minute. An infant's ventricular rate of 88
beats/minute may be below the expected range and may warrant
withholding digoxin according to the prescribed parameters and
institutional protocol. The medication should not be independently
reduced, and administering it before reassessment could worsen
bradycardia.
3.
A 7-year-old child with asthma suddenly develops severe wheezing,
difficulty speaking, intercostal retractions, and oxygen saturation of 88%
despite supplemental oxygen. Which finding would indicate impending
respiratory failure?
A. Expiratory wheezing
B. Tachypnea
C. Decreasing wheezing with increasing lethargy
D. Productive cough
2
,Answer: C. Decreasing wheezing with increasing lethargy
Rationale: A critically ill asthmatic child may initially have intense
wheezing. As airflow becomes severely restricted, however, air
movement may become so poor that wheezing diminishes or
disappears. A "silent chest" accompanied by lethargy is an ominous
sign of impending respiratory failure. Tachypnea and wheezing are
common manifestations of respiratory distress, whereas declining
mental status indicates worsening hypoxemia and fatigue.
4.
A 2-year-old child is admitted with suspected bacterial meningitis.
Which nursing intervention is most appropriate initially?
A. Place the child on airborne precautions
B. Place the child on droplet precautions
C. Encourage frequent ambulation
D. Keep the child in a brightly lit room
Answer: B. Place the child on droplet precautions
Rationale: Suspected bacterial meningitis caused by organisms such
as Neisseria meningitidis or Haemophilus influenzae requires droplet
precautions in addition to standard precautions until the child has
received appropriate antimicrobial therapy for the required period.
Airborne precautions are used for diseases such as measles, varicella,
and pulmonary tuberculosis. A quiet environment with reduced
stimulation is generally more appropriate for a child with meningeal
irritation.
5.
3
, A 6-month-old infant with bronchiolitis has nasal congestion, tachypnea,
poor feeding, and subcostal retractions. Which nursing intervention is
most important before feeding?
A. Administer a large feeding rapidly
B. Suction the nares gently
C. Place the infant completely flat
D. Encourage oral fluids while the infant is tachypneic
Answer: B. Suction the nares gently
Rationale: Infants are preferential nasal breathers, and nasal
congestion can significantly interfere with breathing and feeding.
Gentle nasal suctioning before feeding can improve airway patency
and reduce respiratory effort. Large or rapid feedings increase the risk
of aspiration, particularly in a tachypneic infant. The infant should be
positioned appropriately to optimize ventilation rather than placed
completely flat.
6.
A child with sickle cell disease is admitted with severe pain. Which
intervention should the nurse prioritize?
A. Restrict fluids
B. Encourage hydration and administer prescribed analgesia
C. Apply ice packs to painful joints
D. Encourage vigorous exercise
Answer: B. Encourage hydration and administer prescribed
analgesia
Rationale: Vaso-occlusive episodes in sickle cell disease cause tissue
ischemia and severe pain. Adequate hydration helps reduce blood
viscosity, while timely analgesia is essential for effective pain control.
Cold application can cause vasoconstriction and potentially worsen
4
