NCLEX RN Paediatric Pharmacology
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. The nurse is preparing to administer amoxicillin to a child. Which assessment
is most important before administering the medication?
A. Last bowel movement
B. History of penicillin allergy
C. Daily fluid intake
D. Sleep pattern
Answer: B. History of penicillin allergy
Rationale: A history of a serious penicillin allergy can indicate a risk for
anaphylaxis after amoxicillin administration. The nurse should verify allergies
before giving the medication.
2. A child is prescribed acetaminophen. Which instruction should the nurse
provide to the parents?
A. Give aspirin if the fever persists
B. Use an accurate measuring device for liquid medication
C. Double the dose if the child vomits
D. Give the medication every hour for fever
Answer: B. Use an accurate measuring device for liquid medication
Rationale: Pediatric liquid medications should be measured accurately using
an oral syringe or medication-measuring device to prevent dosing errors.
,3. The nurse is administering digoxin to an infant. Which assessment should
occur immediately before administration?
A. Respiratory rate only
B. Apical pulse for 1 full minute
C. Blood pressure in both arms
D. Temperature
Answer: B. Apical pulse for 1 full minute
Rationale: Digoxin can cause bradycardia. The infant's apical pulse should be
assessed for a full minute before administration, and the dose should be
withheld according to prescribed parameters if the heart rate is too low.
4. Which finding in a child receiving digoxin should the nurse report
immediately?
A. Increased appetite
B. Vomiting and bradycardia
C. Mild thirst
D. Increased activity
Answer: B. Vomiting and bradycardia
Rationale: Vomiting, anorexia, dysrhythmias, and bradycardia can indicate
digoxin toxicity.
5. A child receiving gentamicin has a rising serum creatinine level. What should
the nurse do?
A. Administer the next dose early
B. Notify the healthcare provider
C. Encourage high-sodium foods
D. Give an additional dose
Answer: B. Notify the healthcare provider
,Rationale: Gentamicin is an aminoglycoside associated with nephrotoxicity.
Rising creatinine may indicate impaired renal function and requires prompt
evaluation.
6. Which adverse effect is particularly important to monitor in a child receiving
gentamicin?
A. Ototoxicity
B. Constipation
C. Hyperactivity
D. Increased appetite
Answer: A. Ototoxicity
Rationale: Aminoglycosides such as gentamicin can cause ototoxicity and
nephrotoxicity. Hearing changes, tinnitus, or balance problems should be
reported.
7. A child receiving vancomycin develops flushing and hypotension during the
infusion. Which reaction should the nurse suspect?
A. Red man syndrome
B. Hypoglycemia
C. Serum sickness
D. Stevens-Johnson syndrome
Answer: A. Red man syndrome
Rationale: Rapid IV administration of vancomycin can cause flushing,
hypotension, and erythema known as vancomycin infusion reaction,
historically called red man syndrome.
8. Which action helps reduce the risk of a vancomycin infusion reaction?
A. Administer the drug rapidly
B. Infuse the medication slowly as prescribed
, C. Mix it with enteral formula
D. Give it intramuscularly
Answer: B. Infuse the medication slowly as prescribed
Rationale: Slowing the IV infusion decreases the risk of histamine-mediated
flushing and hypotension associated with rapid vancomycin administration.
9. A child receiving phenytoin develops swollen, tender gums. Which
intervention is appropriate?
A. Encourage meticulous oral hygiene
B. Stop brushing the teeth
C. Give aspirin
D. Restrict fluids
Answer: A. Encourage meticulous oral hygiene
Rationale: Gingival hyperplasia is a common adverse effect of phenytoin.
Good oral hygiene and regular dental care can reduce its severity.
10. Which instruction is most important for parents of a child taking
phenytoin?
A. Stop the medication when seizures stop
B. Give doses consistently and do not discontinue abruptly
C. Double the next dose if one is missed
D. Restrict oral fluids
Answer: B. Give doses consistently and do not discontinue abruptly
Rationale: Abrupt withdrawal of antiseizure medications can precipitate
seizures or status epilepticus.
11. A child taking carbamazepine develops a sore throat and fever. Which
action is most appropriate?
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. The nurse is preparing to administer amoxicillin to a child. Which assessment
is most important before administering the medication?
A. Last bowel movement
B. History of penicillin allergy
C. Daily fluid intake
D. Sleep pattern
Answer: B. History of penicillin allergy
Rationale: A history of a serious penicillin allergy can indicate a risk for
anaphylaxis after amoxicillin administration. The nurse should verify allergies
before giving the medication.
2. A child is prescribed acetaminophen. Which instruction should the nurse
provide to the parents?
A. Give aspirin if the fever persists
B. Use an accurate measuring device for liquid medication
C. Double the dose if the child vomits
D. Give the medication every hour for fever
Answer: B. Use an accurate measuring device for liquid medication
Rationale: Pediatric liquid medications should be measured accurately using
an oral syringe or medication-measuring device to prevent dosing errors.
,3. The nurse is administering digoxin to an infant. Which assessment should
occur immediately before administration?
A. Respiratory rate only
B. Apical pulse for 1 full minute
C. Blood pressure in both arms
D. Temperature
Answer: B. Apical pulse for 1 full minute
Rationale: Digoxin can cause bradycardia. The infant's apical pulse should be
assessed for a full minute before administration, and the dose should be
withheld according to prescribed parameters if the heart rate is too low.
4. Which finding in a child receiving digoxin should the nurse report
immediately?
A. Increased appetite
B. Vomiting and bradycardia
C. Mild thirst
D. Increased activity
Answer: B. Vomiting and bradycardia
Rationale: Vomiting, anorexia, dysrhythmias, and bradycardia can indicate
digoxin toxicity.
5. A child receiving gentamicin has a rising serum creatinine level. What should
the nurse do?
A. Administer the next dose early
B. Notify the healthcare provider
C. Encourage high-sodium foods
D. Give an additional dose
Answer: B. Notify the healthcare provider
,Rationale: Gentamicin is an aminoglycoside associated with nephrotoxicity.
Rising creatinine may indicate impaired renal function and requires prompt
evaluation.
6. Which adverse effect is particularly important to monitor in a child receiving
gentamicin?
A. Ototoxicity
B. Constipation
C. Hyperactivity
D. Increased appetite
Answer: A. Ototoxicity
Rationale: Aminoglycosides such as gentamicin can cause ototoxicity and
nephrotoxicity. Hearing changes, tinnitus, or balance problems should be
reported.
7. A child receiving vancomycin develops flushing and hypotension during the
infusion. Which reaction should the nurse suspect?
A. Red man syndrome
B. Hypoglycemia
C. Serum sickness
D. Stevens-Johnson syndrome
Answer: A. Red man syndrome
Rationale: Rapid IV administration of vancomycin can cause flushing,
hypotension, and erythema known as vancomycin infusion reaction,
historically called red man syndrome.
8. Which action helps reduce the risk of a vancomycin infusion reaction?
A. Administer the drug rapidly
B. Infuse the medication slowly as prescribed
, C. Mix it with enteral formula
D. Give it intramuscularly
Answer: B. Infuse the medication slowly as prescribed
Rationale: Slowing the IV infusion decreases the risk of histamine-mediated
flushing and hypotension associated with rapid vancomycin administration.
9. A child receiving phenytoin develops swollen, tender gums. Which
intervention is appropriate?
A. Encourage meticulous oral hygiene
B. Stop brushing the teeth
C. Give aspirin
D. Restrict fluids
Answer: A. Encourage meticulous oral hygiene
Rationale: Gingival hyperplasia is a common adverse effect of phenytoin.
Good oral hygiene and regular dental care can reduce its severity.
10. Which instruction is most important for parents of a child taking
phenytoin?
A. Stop the medication when seizures stop
B. Give doses consistently and do not discontinue abruptly
C. Double the next dose if one is missed
D. Restrict oral fluids
Answer: B. Give doses consistently and do not discontinue abruptly
Rationale: Abrupt withdrawal of antiseizure medications can precipitate
seizures or status epilepticus.
11. A child taking carbamazepine develops a sore throat and fever. Which
action is most appropriate?
