NURS240 Pediatric Nursing Exam Prep – Real Practice Questions,
Answers & Detailed Rationales (Updated 2026) | Growth &
Development Milestones, Pediatric Assessment, Childhood Diseases &
Infections, Pediatric Pharmacology, Respiratory & Cardiac Disorders,
Fluid & Electrolyte Balance, Immunizations & Safety, Family-Centered
Care, NCLEX-Style Pediatric Clinical Scenarios
Question 1: Which of the following is the most appropriate method for assessing
pain in a nonverbal 2-year-old child?
A. Visual Analog Scale
B. Numeric Rating Scale
C. McGill Pain Questionnaire
D. FLACC Pain Assessment Tool
CORRECT ANSWER: D. FLACC Pain Assessment Tool
Rationale: The FLACC (Face, Legs, Activity, Cry, Consolability) scale is specifically
designed for assessing pain in infants and young children who are unable to self-report
pain. It evaluates observable behaviors and is validated for use in pediatric populations
aged 2 months to 7 years.
Question 2: What is the primary reason for administering vitamin K to newborns
shortly after birth?
A. To enhance calcium absorption
B. To stimulate red blood cell production
C. To prevent hemorrhagic disease of the newborn
D. To support immune system development
CORRECT ANSWER: C. To prevent hemorrhagic disease of the newborn
Rationale: Newborns have low levels of vitamin K at birth due to limited placental
transfer and sterile gut flora, which impairs synthesis of clotting factors II, VII, IX, and X.
Vitamin K administration prevents vitamin K deficiency bleeding (formerly called
hemorrhagic disease of the newborn).
Question 3: Which developmental milestone is typically expected in a healthy 6-
month-old infant?
A. Walking independently
B. Speaking in two-word sentences
C. Rolling from back to front
D. Building a tower of three blocks
CORRECT ANSWER: C. Rolling from back to front
Rationale: By 6 months of age, most infants can roll from back to front and often front to
back. Independent walking usually occurs around 12–15 months, two-word sentences
emerge around 18–24 months, and stacking blocks develops closer to 12–18 months.
,Question 4: A nurse is caring for a child with suspected epiglottitis. Which action
should be avoided?
A. Administering supplemental oxygen
B. Preparing for possible intubation
C. Obtaining a throat culture using a tongue depressor
D. Maintaining a calm environment
CORRECT ANSWER: C. Obtaining a throat culture using a tongue depressor
Rationale: Manipulating the throat in a child with suspected epiglottitis can trigger
laryngospasm and complete airway obstruction. Visualization of the epiglottis or throat
examination should only be performed in a controlled setting with immediate airway
support available.
Question 5: Which immunization is contraindicated in a child with a severe egg
allergy?
A. DTaP
B. Hepatitis B
C. MMR
D. Influenza (live attenuated nasal spray)
CORRECT ANSWER: D. Influenza (live attenuated nasal spray)
Rationale: The live attenuated influenza vaccine (LAIV), administered intranasally, is
cultured in eggs and may contain residual egg protein. Although current guidelines state
that even egg-allergic individuals can receive inactivated influenza vaccines under
supervision, LAIV is generally not recommended for those with severe egg allergies.
Question 6: What is the most common cause of acute gastroenteritis in children
under 5 years of age?
A. Escherichia coli
B. Salmonella
C. Rotavirus
D. Norovirus
CORRECT ANSWER: C. Rotavirus
Rationale: Rotavirus is the leading cause of severe dehydrating gastroenteritis in infants
and young children worldwide, though vaccination has significantly reduced its
incidence. Norovirus is also common but typically causes milder illness and affects all
age groups.
Question 7: Which finding is most indicative of dehydration in an infant?
A. Increased urine output
B. Sunken fontanelle
, C. Hyperactive bowel sounds
D. Flushed skin
CORRECT ANSWER: B. Sunken fontanelle
Rationale: A sunken anterior fontanelle is a classic sign of moderate to severe
dehydration in infants. Other signs include decreased urine output, dry mucous
membranes, poor skin turgor, and lethargy.
Question 8: A 4-year-old child with asthma is prescribed a short-acting beta-
agonist (SABA). What is the primary purpose of this medication?
A. Reduce airway inflammation
B. Prevent future asthma attacks
C. Provide immediate bronchodilation during an acute attack
D. Suppress mucus production
CORRECT ANSWER: C. Provide immediate bronchodilation during an acute attack
Rationale: Short-acting beta-agonists like albuterol act rapidly to relax bronchial
smooth muscle, providing quick relief of acute bronchospasm. They are rescue
medications, not controllers for long-term inflammation management.
Question 9: Which condition is characterized by a "barking" cough and stridor in a
young child?
A. Pneumonia
B. Bronchiolitis
C. Croup
D. Pertussis
CORRECT ANSWER: C. Croup
Rationale: Croup (laryngotracheobronchitis) is typically caused by parainfluenza virus
and presents with a seal-like barking cough, inspiratory stridor, and hoarseness due to
subglottic inflammation.
Question 10: What is the priority nursing intervention for a child experiencing a
febrile seizure?
A. Administer antipyretics immediately
B. Restrain the child to prevent injury
C. Maintain airway and monitor vital signs
D. Initiate cooling measures with ice packs
CORRECT ANSWER: C. Maintain airway and monitor vital signs
Rationale: During a febrile seizure, the priority is ensuring a patent airway, preventing
aspiration, and monitoring for respiratory compromise. Restraint can cause injury, and
antipyretics do not stop the seizure once it has started.
Answers & Detailed Rationales (Updated 2026) | Growth &
Development Milestones, Pediatric Assessment, Childhood Diseases &
Infections, Pediatric Pharmacology, Respiratory & Cardiac Disorders,
Fluid & Electrolyte Balance, Immunizations & Safety, Family-Centered
Care, NCLEX-Style Pediatric Clinical Scenarios
Question 1: Which of the following is the most appropriate method for assessing
pain in a nonverbal 2-year-old child?
A. Visual Analog Scale
B. Numeric Rating Scale
C. McGill Pain Questionnaire
D. FLACC Pain Assessment Tool
CORRECT ANSWER: D. FLACC Pain Assessment Tool
Rationale: The FLACC (Face, Legs, Activity, Cry, Consolability) scale is specifically
designed for assessing pain in infants and young children who are unable to self-report
pain. It evaluates observable behaviors and is validated for use in pediatric populations
aged 2 months to 7 years.
Question 2: What is the primary reason for administering vitamin K to newborns
shortly after birth?
A. To enhance calcium absorption
B. To stimulate red blood cell production
C. To prevent hemorrhagic disease of the newborn
D. To support immune system development
CORRECT ANSWER: C. To prevent hemorrhagic disease of the newborn
Rationale: Newborns have low levels of vitamin K at birth due to limited placental
transfer and sterile gut flora, which impairs synthesis of clotting factors II, VII, IX, and X.
Vitamin K administration prevents vitamin K deficiency bleeding (formerly called
hemorrhagic disease of the newborn).
Question 3: Which developmental milestone is typically expected in a healthy 6-
month-old infant?
A. Walking independently
B. Speaking in two-word sentences
C. Rolling from back to front
D. Building a tower of three blocks
CORRECT ANSWER: C. Rolling from back to front
Rationale: By 6 months of age, most infants can roll from back to front and often front to
back. Independent walking usually occurs around 12–15 months, two-word sentences
emerge around 18–24 months, and stacking blocks develops closer to 12–18 months.
,Question 4: A nurse is caring for a child with suspected epiglottitis. Which action
should be avoided?
A. Administering supplemental oxygen
B. Preparing for possible intubation
C. Obtaining a throat culture using a tongue depressor
D. Maintaining a calm environment
CORRECT ANSWER: C. Obtaining a throat culture using a tongue depressor
Rationale: Manipulating the throat in a child with suspected epiglottitis can trigger
laryngospasm and complete airway obstruction. Visualization of the epiglottis or throat
examination should only be performed in a controlled setting with immediate airway
support available.
Question 5: Which immunization is contraindicated in a child with a severe egg
allergy?
A. DTaP
B. Hepatitis B
C. MMR
D. Influenza (live attenuated nasal spray)
CORRECT ANSWER: D. Influenza (live attenuated nasal spray)
Rationale: The live attenuated influenza vaccine (LAIV), administered intranasally, is
cultured in eggs and may contain residual egg protein. Although current guidelines state
that even egg-allergic individuals can receive inactivated influenza vaccines under
supervision, LAIV is generally not recommended for those with severe egg allergies.
Question 6: What is the most common cause of acute gastroenteritis in children
under 5 years of age?
A. Escherichia coli
B. Salmonella
C. Rotavirus
D. Norovirus
CORRECT ANSWER: C. Rotavirus
Rationale: Rotavirus is the leading cause of severe dehydrating gastroenteritis in infants
and young children worldwide, though vaccination has significantly reduced its
incidence. Norovirus is also common but typically causes milder illness and affects all
age groups.
Question 7: Which finding is most indicative of dehydration in an infant?
A. Increased urine output
B. Sunken fontanelle
, C. Hyperactive bowel sounds
D. Flushed skin
CORRECT ANSWER: B. Sunken fontanelle
Rationale: A sunken anterior fontanelle is a classic sign of moderate to severe
dehydration in infants. Other signs include decreased urine output, dry mucous
membranes, poor skin turgor, and lethargy.
Question 8: A 4-year-old child with asthma is prescribed a short-acting beta-
agonist (SABA). What is the primary purpose of this medication?
A. Reduce airway inflammation
B. Prevent future asthma attacks
C. Provide immediate bronchodilation during an acute attack
D. Suppress mucus production
CORRECT ANSWER: C. Provide immediate bronchodilation during an acute attack
Rationale: Short-acting beta-agonists like albuterol act rapidly to relax bronchial
smooth muscle, providing quick relief of acute bronchospasm. They are rescue
medications, not controllers for long-term inflammation management.
Question 9: Which condition is characterized by a "barking" cough and stridor in a
young child?
A. Pneumonia
B. Bronchiolitis
C. Croup
D. Pertussis
CORRECT ANSWER: C. Croup
Rationale: Croup (laryngotracheobronchitis) is typically caused by parainfluenza virus
and presents with a seal-like barking cough, inspiratory stridor, and hoarseness due to
subglottic inflammation.
Question 10: What is the priority nursing intervention for a child experiencing a
febrile seizure?
A. Administer antipyretics immediately
B. Restrain the child to prevent injury
C. Maintain airway and monitor vital signs
D. Initiate cooling measures with ice packs
CORRECT ANSWER: C. Maintain airway and monitor vital signs
Rationale: During a febrile seizure, the priority is ensuring a patent airway, preventing
aspiration, and monitoring for respiratory compromise. Restraint can cause injury, and
antipyretics do not stop the seizure once it has started.
