NUR 272/NURS 272 Final Exam Comprehensive Review | Questions and
Answers with Rationales | 2026/2027 Updated | 100% Correct - Medgar Evers
College.
I. Growth, Development, Pediatric Assessment & Safety
1. A nurse is assessing a 12-month-old infant during a well-child visit. Which finding is
most consistent with expected growth?
A. Birth weight has doubled
B. Birth weight has approximately tripled
C. Birth weight has quadrupled
D. Birth weight remains unchanged
Correct Answer: B. Birth weight has approximately tripled
Rationale: Most healthy infants approximately double birth weight by 4–6 months and triple it
by about 12 months. Growth trends should always be interpreted over time rather than from a
single measurement.
2. A hospitalized toddler repeatedly says “No!” when the nurse offers assistance. Which
developmental interpretation is most appropriate?
A. The child is demonstrating autonomy
B. The child has severe separation disorder
C. The behavior indicates cognitive regression
D. The behavior is abnormal after 12 months
Correct Answer: A. The child is demonstrating autonomy
Rationale: Toddlers are developing independence and control. Negativism is common as they
test boundaries and establish autonomy.
3. Which type of play should the nurse expect most commonly in toddlers?
A. Cooperative play
B. Competitive team play
C. Parallel play
D. Organized dramatic play
Correct Answer: C. Parallel play
,Rationale: Toddlers commonly play beside other children with similar toys but without
sustained cooperative interaction.
4. Which intervention is most appropriate when preparing a preschool child for a blood
draw?
A. Explain it several weeks in advance using detailed anatomy
B. Use simple, concrete language shortly before the procedure
C. Tell the child it will not hurt
D. Avoid discussing the procedure
Correct Answer: B
Rationale: Preschool-age children benefit from brief, concrete explanations given close to the
procedure. Telling a child something will not hurt when discomfort is possible can damage trust.
5. Which assessment technique is most appropriate when examining a fearful young child?
A. Begin with the throat examination
B. Separate the child immediately from the caregiver
C. Observe first and perform the least invasive assessments before more invasive ones
D. Restrain the child before beginning
Correct Answer: C
Rationale: Observation and less threatening assessments first help establish trust and reduce
distress.
6. Which sleep instruction should the nurse give the parent of a healthy infant?
A. Use a side-lying position with a positioning pillow
B. Place the infant prone after feeding
C. Place the infant supine on a firm, flat sleep surface
D. Elevate the mattress approximately 30 degrees
Correct Answer: C
Rationale: Current AAP guidance recommends back sleeping for every sleep on a firm, flat,
noninclined surface, without pillows, loose bedding, or other soft objects. American Academy
of Pediatrics
,7. Which pain-assessment strategy is most appropriate for a preverbal child?
A. Numeric 0–10 self-rating only
B. Behavioral assessment including facial expression, activity, cry, and consolability
C. Ask the parent to select a pain number instead of assessing the child
D. Assume sleeping means absence of pain
Correct Answer: B
Rationale: Preverbal children require behavioral and physiologic assessment because they
cannot reliably provide a numeric self-report.
8. A medication is prescribed in mg/kg. What is the most important nursing action before
calculating the child's dose?
A. Convert the child's current weight to kilograms
B. Estimate weight from age
C. Use the parent's weight
D. Divide the adult dose by two
Correct Answer: A
Rationale: Pediatric weight-based medication calculations should use an accurate current weight
in kilograms.
II. Respiratory, Cardiovascular & Hematologic Review
9. A child experiencing an acute asthma exacerbation has increasing respiratory distress.
Which finding is most concerning?
A. Expiratory wheezing
B. Mild coughing
C. Markedly diminished breath sounds with increasing fatigue
D. Respiratory rate slightly above baseline
Correct Answer: C
Rationale: Diminishing air movement in a child who is tiring may indicate severe airway
obstruction and impending respiratory failure.
, 10. Which medication is generally used for rapid relief of acute bronchospasm in asthma?
A. Short-acting beta₂ agonist
B. Oral iron
C. Digoxin
D. Pancreatic enzyme
Correct Answer: A
Rationale: Short-acting inhaled bronchodilators such as albuterol provide rapid bronchodilation
during acute symptoms.
11. A child with cystic fibrosis has pancreatic insufficiency. Which intervention should the
nurse expect?
A. Pancreatic enzymes with meals and snacks
B. Severe calorie restriction
C. Complete elimination of dietary fat
D. Fluid restriction
Correct Answer: A
Rationale: Pancreatic enzyme replacement improves digestion and nutrient absorption when
pancreatic insufficiency is present.
12. Which finding is characteristic of coarctation of the aorta?
A. Stronger lower-extremity pulses than upper-extremity pulses
B. Higher blood pressure in the arms than in the legs
C. Equal blood pressure with no pulse differences in all clients
D. Continuous cyanosis in every affected child
Correct Answer: B
Rationale: Narrowing of the aorta can produce upper-extremity hypertension with diminished
femoral pulses and lower pressures in the legs.
Answers with Rationales | 2026/2027 Updated | 100% Correct - Medgar Evers
College.
I. Growth, Development, Pediatric Assessment & Safety
1. A nurse is assessing a 12-month-old infant during a well-child visit. Which finding is
most consistent with expected growth?
A. Birth weight has doubled
B. Birth weight has approximately tripled
C. Birth weight has quadrupled
D. Birth weight remains unchanged
Correct Answer: B. Birth weight has approximately tripled
Rationale: Most healthy infants approximately double birth weight by 4–6 months and triple it
by about 12 months. Growth trends should always be interpreted over time rather than from a
single measurement.
2. A hospitalized toddler repeatedly says “No!” when the nurse offers assistance. Which
developmental interpretation is most appropriate?
A. The child is demonstrating autonomy
B. The child has severe separation disorder
C. The behavior indicates cognitive regression
D. The behavior is abnormal after 12 months
Correct Answer: A. The child is demonstrating autonomy
Rationale: Toddlers are developing independence and control. Negativism is common as they
test boundaries and establish autonomy.
3. Which type of play should the nurse expect most commonly in toddlers?
A. Cooperative play
B. Competitive team play
C. Parallel play
D. Organized dramatic play
Correct Answer: C. Parallel play
,Rationale: Toddlers commonly play beside other children with similar toys but without
sustained cooperative interaction.
4. Which intervention is most appropriate when preparing a preschool child for a blood
draw?
A. Explain it several weeks in advance using detailed anatomy
B. Use simple, concrete language shortly before the procedure
C. Tell the child it will not hurt
D. Avoid discussing the procedure
Correct Answer: B
Rationale: Preschool-age children benefit from brief, concrete explanations given close to the
procedure. Telling a child something will not hurt when discomfort is possible can damage trust.
5. Which assessment technique is most appropriate when examining a fearful young child?
A. Begin with the throat examination
B. Separate the child immediately from the caregiver
C. Observe first and perform the least invasive assessments before more invasive ones
D. Restrain the child before beginning
Correct Answer: C
Rationale: Observation and less threatening assessments first help establish trust and reduce
distress.
6. Which sleep instruction should the nurse give the parent of a healthy infant?
A. Use a side-lying position with a positioning pillow
B. Place the infant prone after feeding
C. Place the infant supine on a firm, flat sleep surface
D. Elevate the mattress approximately 30 degrees
Correct Answer: C
Rationale: Current AAP guidance recommends back sleeping for every sleep on a firm, flat,
noninclined surface, without pillows, loose bedding, or other soft objects. American Academy
of Pediatrics
,7. Which pain-assessment strategy is most appropriate for a preverbal child?
A. Numeric 0–10 self-rating only
B. Behavioral assessment including facial expression, activity, cry, and consolability
C. Ask the parent to select a pain number instead of assessing the child
D. Assume sleeping means absence of pain
Correct Answer: B
Rationale: Preverbal children require behavioral and physiologic assessment because they
cannot reliably provide a numeric self-report.
8. A medication is prescribed in mg/kg. What is the most important nursing action before
calculating the child's dose?
A. Convert the child's current weight to kilograms
B. Estimate weight from age
C. Use the parent's weight
D. Divide the adult dose by two
Correct Answer: A
Rationale: Pediatric weight-based medication calculations should use an accurate current weight
in kilograms.
II. Respiratory, Cardiovascular & Hematologic Review
9. A child experiencing an acute asthma exacerbation has increasing respiratory distress.
Which finding is most concerning?
A. Expiratory wheezing
B. Mild coughing
C. Markedly diminished breath sounds with increasing fatigue
D. Respiratory rate slightly above baseline
Correct Answer: C
Rationale: Diminishing air movement in a child who is tiring may indicate severe airway
obstruction and impending respiratory failure.
, 10. Which medication is generally used for rapid relief of acute bronchospasm in asthma?
A. Short-acting beta₂ agonist
B. Oral iron
C. Digoxin
D. Pancreatic enzyme
Correct Answer: A
Rationale: Short-acting inhaled bronchodilators such as albuterol provide rapid bronchodilation
during acute symptoms.
11. A child with cystic fibrosis has pancreatic insufficiency. Which intervention should the
nurse expect?
A. Pancreatic enzymes with meals and snacks
B. Severe calorie restriction
C. Complete elimination of dietary fat
D. Fluid restriction
Correct Answer: A
Rationale: Pancreatic enzyme replacement improves digestion and nutrient absorption when
pancreatic insufficiency is present.
12. Which finding is characteristic of coarctation of the aorta?
A. Stronger lower-extremity pulses than upper-extremity pulses
B. Higher blood pressure in the arms than in the legs
C. Equal blood pressure with no pulse differences in all clients
D. Continuous cyanosis in every affected child
Correct Answer: B
Rationale: Narrowing of the aorta can produce upper-extremity hypertension with diminished
femoral pulses and lower pressures in the legs.
