NCLEX RN Paediatric Nursing Exam 3
100 Questions And Correct Answers
(Verified Answers) Plus Rationales
2026
1.
A nurse is assessing a child with suspected epiglottitis. Which finding requires
immediate intervention?
A. Barking cough
B. Drooling and difficulty swallowing
C. Expiratory wheezing
D. Low-grade fever
Answer: Drooling and difficulty swallowing
Rationale: Epiglottitis can rapidly cause complete airway obstruction. The
child should be kept calm, and the nurse should avoid inspecting the throat
with a tongue blade because this may precipitate airway closure.
2.
A child with asthma is experiencing acute respiratory distress. Which
medication should the nurse expect to administer first?
A. Montelukast
B. Fluticasone
C. Albuterol
D. Salmeterol
Answer: Albuterol
,Rationale: Albuterol is a short-acting beta₂-adrenergic agonist that rapidly
relaxes bronchial smooth muscle and is the first-line rescue medication for
acute bronchospasm.
3.
A nurse is caring for a child with cystic fibrosis. Which intervention is most
appropriate?
A. Restrict dietary fat
B. Administer pancreatic enzymes with meals and snacks
C. Limit fluid intake
D. Avoid physical activity
Answer: Administer pancreatic enzymes with meals and snacks
Rationale: Pancreatic insufficiency causes malabsorption in cystic fibrosis.
Pancreatic enzymes are given with meals and snacks to improve digestion
and nutrient absorption.
4.
A child with type 1 diabetes mellitus is experiencing hypoglycemia and is
conscious. Which intervention is appropriate?
A. Administer regular insulin
B. Give a rapid-acting carbohydrate
C. Restrict oral fluids
D. Administer glucagon immediately
Answer: Give a rapid-acting carbohydrate
Rationale: A conscious child with hypoglycemia should receive approximately
15 g of rapid-acting carbohydrate, followed by reassessment of blood
glucose. Glucagon is generally used when the child cannot safely take
carbohydrates orally.
5.
A nurse is teaching parents about preventing otitis media in an infant. Which
instruction is appropriate?
,A. Bottle-feed the infant while lying flat
B. Avoid breastfeeding
C. Keep the infant upright during bottle-feeding
D. Clean the ear canal daily with cotton swabs
Answer: Keep the infant upright during bottle-feeding
Rationale: Feeding an infant in a supine position increases the risk of milk
entering the eustachian tube. Keeping the infant upright helps reduce this
risk.
6.
A child with nephrotic syndrome is receiving corticosteroid therapy. Which
finding should the nurse report?
A. Increased appetite
B. Mild facial fullness
C. Fever
D. Increased activity
Answer: Fever
Rationale: Children with nephrotic syndrome are at increased risk for
infection because of urinary protein losses and immunosuppressive therapy.
Fever requires prompt evaluation.
7.
A child with acute glomerulonephritis has edema and hypertension. Which
dietary intervention is appropriate?
A. High-sodium diet
B. Sodium restriction
C. High-protein diet
D. Unlimited fluids
Answer: Sodium restriction
Rationale: Sodium restriction helps decrease fluid retention and edema and
can assist in controlling hypertension associated with acute
glomerulonephritis.
, 8.
A nurse is assessing a child with meningitis. Which finding is most concerning?
A. Mild headache
B. Photophobia
C. Decreased level of consciousness
D. Poor appetite
Answer: Decreased level of consciousness
Rationale: A declining level of consciousness may indicate increasing
intracranial pressure or neurologic deterioration and requires immediate
intervention.
9.
Which isolation precaution is appropriate for a child with bacterial meningitis
during the initial period of treatment?
A. Contact precautions only
B. Droplet precautions
C. Airborne precautions
D. Protective isolation
Answer: Droplet precautions
Rationale: Bacterial meningitis caused by organisms such as meningococci
requires droplet precautions, particularly during the initial period after
effective antimicrobial therapy begins.
10.
A child with increased intracranial pressure is being monitored. Which position
is generally appropriate?
A. Flat with the neck flexed
B. Head elevated with the neck in neutral alignment
C. Trendelenburg position
D. Prone with the head turned sharply
Answer: Head elevated with the neck in neutral alignment
100 Questions And Correct Answers
(Verified Answers) Plus Rationales
2026
1.
A nurse is assessing a child with suspected epiglottitis. Which finding requires
immediate intervention?
A. Barking cough
B. Drooling and difficulty swallowing
C. Expiratory wheezing
D. Low-grade fever
Answer: Drooling and difficulty swallowing
Rationale: Epiglottitis can rapidly cause complete airway obstruction. The
child should be kept calm, and the nurse should avoid inspecting the throat
with a tongue blade because this may precipitate airway closure.
2.
A child with asthma is experiencing acute respiratory distress. Which
medication should the nurse expect to administer first?
A. Montelukast
B. Fluticasone
C. Albuterol
D. Salmeterol
Answer: Albuterol
,Rationale: Albuterol is a short-acting beta₂-adrenergic agonist that rapidly
relaxes bronchial smooth muscle and is the first-line rescue medication for
acute bronchospasm.
3.
A nurse is caring for a child with cystic fibrosis. Which intervention is most
appropriate?
A. Restrict dietary fat
B. Administer pancreatic enzymes with meals and snacks
C. Limit fluid intake
D. Avoid physical activity
Answer: Administer pancreatic enzymes with meals and snacks
Rationale: Pancreatic insufficiency causes malabsorption in cystic fibrosis.
Pancreatic enzymes are given with meals and snacks to improve digestion
and nutrient absorption.
4.
A child with type 1 diabetes mellitus is experiencing hypoglycemia and is
conscious. Which intervention is appropriate?
A. Administer regular insulin
B. Give a rapid-acting carbohydrate
C. Restrict oral fluids
D. Administer glucagon immediately
Answer: Give a rapid-acting carbohydrate
Rationale: A conscious child with hypoglycemia should receive approximately
15 g of rapid-acting carbohydrate, followed by reassessment of blood
glucose. Glucagon is generally used when the child cannot safely take
carbohydrates orally.
5.
A nurse is teaching parents about preventing otitis media in an infant. Which
instruction is appropriate?
,A. Bottle-feed the infant while lying flat
B. Avoid breastfeeding
C. Keep the infant upright during bottle-feeding
D. Clean the ear canal daily with cotton swabs
Answer: Keep the infant upright during bottle-feeding
Rationale: Feeding an infant in a supine position increases the risk of milk
entering the eustachian tube. Keeping the infant upright helps reduce this
risk.
6.
A child with nephrotic syndrome is receiving corticosteroid therapy. Which
finding should the nurse report?
A. Increased appetite
B. Mild facial fullness
C. Fever
D. Increased activity
Answer: Fever
Rationale: Children with nephrotic syndrome are at increased risk for
infection because of urinary protein losses and immunosuppressive therapy.
Fever requires prompt evaluation.
7.
A child with acute glomerulonephritis has edema and hypertension. Which
dietary intervention is appropriate?
A. High-sodium diet
B. Sodium restriction
C. High-protein diet
D. Unlimited fluids
Answer: Sodium restriction
Rationale: Sodium restriction helps decrease fluid retention and edema and
can assist in controlling hypertension associated with acute
glomerulonephritis.
, 8.
A nurse is assessing a child with meningitis. Which finding is most concerning?
A. Mild headache
B. Photophobia
C. Decreased level of consciousness
D. Poor appetite
Answer: Decreased level of consciousness
Rationale: A declining level of consciousness may indicate increasing
intracranial pressure or neurologic deterioration and requires immediate
intervention.
9.
Which isolation precaution is appropriate for a child with bacterial meningitis
during the initial period of treatment?
A. Contact precautions only
B. Droplet precautions
C. Airborne precautions
D. Protective isolation
Answer: Droplet precautions
Rationale: Bacterial meningitis caused by organisms such as meningococci
requires droplet precautions, particularly during the initial period after
effective antimicrobial therapy begins.
10.
A child with increased intracranial pressure is being monitored. Which position
is generally appropriate?
A. Flat with the neck flexed
B. Head elevated with the neck in neutral alignment
C. Trendelenburg position
D. Prone with the head turned sharply
Answer: Head elevated with the neck in neutral alignment
