2026/2027 UPDATE), WITH
CORRECT/ACCURATE ANSWERS
RELIAS PEDIATRIC RN A V1
All questions:
written in full exam-ready format
Include 4 multiple-choice options
Clearly identify the correct answer
Provide deep rationales (3–5 sentences) for the correct answer
Match clinical nursing / pediatric competency standards
RELIAS PEDIATRIC A v1 (2026/2027)
Questions 1–100
Question 1 of 100: Indication for Intubation
Which condition is the most appropriate indication for endotracheal intubation in a
pediatric patient?
A. Mild tachypnea
B. Intercostal retractions
C. Cyanosis or persistent hypoxia despite oxygen supplementation
D. Nasal flaring only
Correct Answer: C
Rationale:
Endotracheal intubation is indicated when a child cannot maintain adequate
oxygenation or ventilation using noninvasive measures. Persistent hypoxia or cyanosis
despite supplemental oxygen indicates respiratory failure. Signs such as tachypnea,
nasal flaring, or retractions suggest distress but do not alone mandate intubation.
Advanced airway management is required when oxygen delivery is ineffective.
,Question 2 of 100: Early Warning Sign of Increased Intracranial
Pressure
Which symptom is considered an early indicator of increased intracranial pressure
(ICP) in children?
A. Unresponsiveness
B. Seizures
C. Vomiting
D. Fixed pupils
Correct Answer: C
Rationale:
Vomiting is often one of the earliest signs of increased ICP in pediatric patients. It may
occur suddenly and without nausea due to stimulation of the brain’s vomiting center.
Later signs include changes in consciousness, pupillary abnormalities, and seizures.
Early identification is critical to prevent neurologic deterioration.
Question 3 of 100: Medication for Tylenol (Acetaminophen)
Overdose
Which medication is the antidote for acetaminophen (Tylenol) overdose?
A. Naloxone (Narcan)
B. Aluminum hydroxide
C. Ipecac
D. N-acetylcysteine (Mucomyst)
Correct Answer: D
Rationale:
N-acetylcysteine (NAC), marketed as Mucomyst, is the antidote for acetaminophen
overdose. It replenishes hepatic glutathione, allowing detoxification of the toxic
,metabolite NAPQI. Early administration significantly reduces liver damage. Other
options listed do not counteract acetaminophen toxicity.
Question 4 of 100: Indicator of Clinical Depression in Terminal
Illness
Which finding most strongly suggests clinical depression in a child with a terminal
illness?
A. Loss of appetite
B. Nausea
C. Frustration with pain
D. Feelings of hopelessness
Correct Answer: D
Rationale:
Feelings of hopelessness are a core psychological symptom of clinical depression.
While appetite loss and nausea may be related to illness or treatment, hopelessness
reflects a mood disorder requiring assessment and intervention. Recognizing
depression allows timely mental health support. Emotional symptoms should not be
dismissed as expected reactions to illness.
Question 5 of 100: Normal Pediatric Respiratory Rate
Which respiratory rate is normal for a 2-year-old child?
A. 10–15 breaths/min
B. 16–20 breaths/min
C. 20–30 breaths/min
D. 35–45 breaths/min
Correct Answer: C
, Rationale:
Toddlers typically have a respiratory rate between 20 and 30 breaths per minute.
Rates lower than this suggest hypoventilation, while higher rates indicate respiratory
distress or illness. Age-appropriate vital signs are essential for accurate assessment.
Pediatric norms differ significantly from adults.
Question 6 of 100: Most Accurate Pain Scale for Infants
Which pain assessment tool is most appropriate for infants?
A. Numeric rating scale
B. Wong-Baker FACES
C. FLACC scale
D. Visual analog scale
Correct Answer: C
Rationale:
The FLACC scale assesses pain based on facial expression, leg movement, activity,
cry, and consolability. It is designed for infants and nonverbal children. Numeric and
visual scales require verbal communication. Accurate pain assessment ensures
appropriate pain management.
Question 7 of 100: Priority Intervention for Febrile Seizure
What is the priority nursing action during an active febrile seizure?
A. Insert an oral airway
B. Restrain the child
C. Maintain airway and safety
D. Administer antipyretics immediately
Correct Answer: C