Spring Semester 2026 NURS250 Pediatric Nursing | Comprehensive
Study Guide, Practice Exam Questions and Answers, Exam Prep Test
Bank, Pediatric Growth and Development Milestones, Child Health
Assessment Techniques, Common Childhood Disorders and Diseases,
Pediatric Pharmacology and Medication Administration, Family-Centered
Nursing Care, Immunization Schedules and Preventive Health, Pediatric
Clinical Judgment, NCLEX-Style Practice Questions, Updated 2026
Question 1: A 4-year-old child is brought to the clinic with a chief complaint of a
harsh, barking cough that worsens at night. The parent states the child was playing
normally earlier in the day but woke up with this cough and stridor. Which of the
following is the priority nursing intervention for this child?
A. Administer a nebulized beta-agonist treatment
B. Prepare the child for an emergent tracheostomy
C. Provide cool mist humidification and observe for respiratory distress
D. Administer oral corticosteroids as prescribed
CORRECT ANSWER: C. Provide cool mist humidification and observe for respiratory
distress
Rationale: The presentation of a harsh, barking cough and stridor in a child is classic for
croup (laryngotracheobronchitis). The priority nursing action is to provide cool mist (or
humidified oxygen) to reduce airway edema and observe the child for signs of increasing
respiratory distress. Nebulized beta-agonists are used for bronchospasm, not primarily
for croup. A tracheostomy is a last resort for severe airway obstruction. Corticosteroids
are a treatment but not the immediate priority over providing humidification and
assessment.
Question 2: A 10-year-old with type 1 diabetes mellitus is brought to the emergency
department with a blood glucose of 450 mg/dL, deep rapid respirations, and fruity-
smelling breath. Which of the following arterial blood gas findings would the nurse
anticipate?
A. pH 7.30, PaCO2 50 mmHg, HCO3 22 mEq/L
B. pH 7.50, PaCO2 30 mmHg, HCO3 28 mEq/L
C. pH 7.25, PaCO2 25 mmHg, HCO3 14 mEq/L
D. pH 7.35, PaCO2 45 mmHg, HCO3 24 mEq/L
CORRECT ANSWER: C. pH 7.25, PaCO2 25 mmHg, HCO3 14 mEq/L
Rationale: This child is presenting with diabetic ketoacidosis (DKA). DKA is
characterized by metabolic acidosis with a compensatory respiratory alkalosis. The
arterial blood gas (ABG) would show a low pH (acidosis), a low HCO3 (metabolic
acidosis), and a low PaCO2 (compensatory hyperventilation to blow off CO2). The
correct choice reflects metabolic acidosis with respiratory compensation.
, Question 3: The nurse is assessing a newborn and notes a single umbilical artery.
This finding is most commonly associated with which congenital anomaly?
A. Congenital heart defects
B. Renal anomalies
C. Neural tube defects
D. Tracheoesophageal fistula
CORRECT ANSWER: B. Renal anomalies
Rationale: A single umbilical artery (two-vessel cord) is a common finding that warrants
further evaluation. It is most frequently associated with renal and urinary tract
anomalies. While it can be an isolated finding, it is a marker for other congenital issues,
and a renal ultrasound is often recommended.
Question 4: The nurse is teaching a group of parents about the safety of over-the-
counter (OTC) medications for children. Which statement by a parent indicates a
need for further education?
A. "I should use a measuring device that came with the medication."
B. "If my child's fever doesn't come down, I can give a double dose of the next
medication."
C. "I need to know my child's weight before giving any medication."
D. "I should never give aspirin to my child for a viral infection."
CORRECT ANSWER: B. "If my child's fever doesn't come down, I can give a double
dose of the next medication."
Rationale: This statement indicates a need for further education. Giving a double dose
of a medication is dangerous and can lead to toxicity. Parents must be taught to adhere
to weight-based dosing and appropriate dosing intervals. Using the correct measuring
device, knowing the child's weight, and avoiding aspirin (due to Reye's syndrome) are all
correct safety practices.
Question 5: A 2-month-old infant is brought to the clinic for a well-child visit. The
parents are concerned that the infant still has a startle reflex. Which of the
following responses is most appropriate for the nurse to provide?
A. "The startle reflex should have disappeared by 1 month of age."
B. "The startle reflex is normal until about 4 to 6 months of age."
C. "This indicates a possible neurological deficit and needs a referral."
D. "The startle reflex is replaced by the tonic neck reflex at 2 months."
CORRECT ANSWER: B. "The startle reflex is normal until about 4 to 6 months of
age."
Rationale: The Moro (startle) reflex is a normal primitive reflex present at birth and
typically disappears around 4 to 6 months of age. Its presence at 2 months is
developmentally appropriate and does not indicate a neurological deficit. The tonic
Study Guide, Practice Exam Questions and Answers, Exam Prep Test
Bank, Pediatric Growth and Development Milestones, Child Health
Assessment Techniques, Common Childhood Disorders and Diseases,
Pediatric Pharmacology and Medication Administration, Family-Centered
Nursing Care, Immunization Schedules and Preventive Health, Pediatric
Clinical Judgment, NCLEX-Style Practice Questions, Updated 2026
Question 1: A 4-year-old child is brought to the clinic with a chief complaint of a
harsh, barking cough that worsens at night. The parent states the child was playing
normally earlier in the day but woke up with this cough and stridor. Which of the
following is the priority nursing intervention for this child?
A. Administer a nebulized beta-agonist treatment
B. Prepare the child for an emergent tracheostomy
C. Provide cool mist humidification and observe for respiratory distress
D. Administer oral corticosteroids as prescribed
CORRECT ANSWER: C. Provide cool mist humidification and observe for respiratory
distress
Rationale: The presentation of a harsh, barking cough and stridor in a child is classic for
croup (laryngotracheobronchitis). The priority nursing action is to provide cool mist (or
humidified oxygen) to reduce airway edema and observe the child for signs of increasing
respiratory distress. Nebulized beta-agonists are used for bronchospasm, not primarily
for croup. A tracheostomy is a last resort for severe airway obstruction. Corticosteroids
are a treatment but not the immediate priority over providing humidification and
assessment.
Question 2: A 10-year-old with type 1 diabetes mellitus is brought to the emergency
department with a blood glucose of 450 mg/dL, deep rapid respirations, and fruity-
smelling breath. Which of the following arterial blood gas findings would the nurse
anticipate?
A. pH 7.30, PaCO2 50 mmHg, HCO3 22 mEq/L
B. pH 7.50, PaCO2 30 mmHg, HCO3 28 mEq/L
C. pH 7.25, PaCO2 25 mmHg, HCO3 14 mEq/L
D. pH 7.35, PaCO2 45 mmHg, HCO3 24 mEq/L
CORRECT ANSWER: C. pH 7.25, PaCO2 25 mmHg, HCO3 14 mEq/L
Rationale: This child is presenting with diabetic ketoacidosis (DKA). DKA is
characterized by metabolic acidosis with a compensatory respiratory alkalosis. The
arterial blood gas (ABG) would show a low pH (acidosis), a low HCO3 (metabolic
acidosis), and a low PaCO2 (compensatory hyperventilation to blow off CO2). The
correct choice reflects metabolic acidosis with respiratory compensation.
, Question 3: The nurse is assessing a newborn and notes a single umbilical artery.
This finding is most commonly associated with which congenital anomaly?
A. Congenital heart defects
B. Renal anomalies
C. Neural tube defects
D. Tracheoesophageal fistula
CORRECT ANSWER: B. Renal anomalies
Rationale: A single umbilical artery (two-vessel cord) is a common finding that warrants
further evaluation. It is most frequently associated with renal and urinary tract
anomalies. While it can be an isolated finding, it is a marker for other congenital issues,
and a renal ultrasound is often recommended.
Question 4: The nurse is teaching a group of parents about the safety of over-the-
counter (OTC) medications for children. Which statement by a parent indicates a
need for further education?
A. "I should use a measuring device that came with the medication."
B. "If my child's fever doesn't come down, I can give a double dose of the next
medication."
C. "I need to know my child's weight before giving any medication."
D. "I should never give aspirin to my child for a viral infection."
CORRECT ANSWER: B. "If my child's fever doesn't come down, I can give a double
dose of the next medication."
Rationale: This statement indicates a need for further education. Giving a double dose
of a medication is dangerous and can lead to toxicity. Parents must be taught to adhere
to weight-based dosing and appropriate dosing intervals. Using the correct measuring
device, knowing the child's weight, and avoiding aspirin (due to Reye's syndrome) are all
correct safety practices.
Question 5: A 2-month-old infant is brought to the clinic for a well-child visit. The
parents are concerned that the infant still has a startle reflex. Which of the
following responses is most appropriate for the nurse to provide?
A. "The startle reflex should have disappeared by 1 month of age."
B. "The startle reflex is normal until about 4 to 6 months of age."
C. "This indicates a possible neurological deficit and needs a referral."
D. "The startle reflex is replaced by the tonic neck reflex at 2 months."
CORRECT ANSWER: B. "The startle reflex is normal until about 4 to 6 months of
age."
Rationale: The Moro (startle) reflex is a normal primitive reflex present at birth and
typically disappears around 4 to 6 months of age. Its presence at 2 months is
developmentally appropriate and does not indicate a neurological deficit. The tonic
