NUR 214 PEDIATRIC NURSING WITH QUESTIONS AND
ANSWERS 2026
1. A 2-year-old child is admitted with suspected lead poisoning.
Which assessment finding would the nurse prioritize?
A. Increased appetite and weight gain
B. Irritability, abdominal pain, and developmental regression
C. Hyperactivity and improved sleep patterns
D. Frequent coughing and wheezing
Correct Answer: B
Explanation: Lead poisoning in children typically presents with
irritability, abdominal pain, constipation, and developmental
regression or loss of previously acquired skills. Increased appetite,
hyperactivity with improved sleep, and respiratory symptoms are
not characteristic of lead toxicity
2. A 6-month-old infant is diagnosed with congenital
hypothyroidism. Which intervention is most critical for preventing
long-term complications?
A. Starting thyroid hormone replacement within the first 2 weeks
of life
B. Implementing a high-protein diet immediately
C. Scheduling monthly developmental assessments
D. Administering vitamin D supplements daily
Correct Answer: A
Explanation: Early initiation of thyroid hormone replacement
(within 2 weeks) is crucial to prevent irreversible intellectual
, disability and growth failure in congenital hypothyroidism.
Delayed treatment leads to permanent cognitive impairment
3. Which assessment finding in a newborn would most concern the
nurse regarding potential congenital heart defect?
A. Mild acrocyanosis of hands and feet
B. Continuous machine-like murmur heard at left upper sternal
border
C. Transient jaundice at 24 hours of life
D. Epstein's pearls on the gums
Correct Answer: B
Explanation: A continuous machine-like murmur at the left upper
sternal border is classic for patent ductus arteriosus (PDA), a
congenital heart defect. Acrocyanosis, transient jaundice after 24
hours, and Epstein's pearls are normal newborn findings
4. A 4-year-old with asthma is experiencing an acute exacerbation.
Which medication should the nurse administer first?
A. Oral prednisone
B. Albuterol via nebulizer
C. Ipratropium bromide
D. Inhaled corticosteroids
Correct Answer: B
Explanation: Short-acting beta-agonists (albuterol) are the first-
line treatment for acute asthma exacerbations as they provide
rapid bronchodilation. Systemic corticosteroids are adjunctive, and
inhaled corticosteroids are for long-term control
,5. Which immunization is contraindicated in a child with severe
immunodeficiency?
A. Inactivated polio vaccine (IPV)
B. Measles, mumps, rubella (MMR) vaccine
C. Hepatitis B vaccine
D. Tetanus, diphtheria, pertussis (Tdap) vaccine
Correct Answer: B
Explanation: MMR is a live attenuated vaccine and is
contraindicated in severe immunodeficiency due to risk of vaccine-
derived infection. IPV, Hepatitis B, and Tdap are inactivated
vaccines and safe for immunocompromised children
6. A 3-year-old child presents with sudden onset of high fever,
drooling, and difficulty breathing. The child is sitting in tripod
position. What is the nurse's priority action?
A. Obtain a throat culture
B. Prepare for immediate airway management and avoid
examining the throat
C. Administer antipyretics and encourage oral fluids
D. Perform chest physiotherapy
Correct Answer: B
Explanation: These symptoms suggest epiglottitis, a medical
emergency. Throat examination can trigger complete airway
obstruction. Priority is securing the airway in a controlled setting
(OR) without agitating the child
, 7. Which finding in an infant with gastroesophageal reflux would
require immediate intervention?
A. Frequent spit-up after feedings
B. Weight loss and failure to thrive
C. Mild irritability after feeding
D. Occasional coughing during feeds
Correct Answer: B
Explanation: Weight loss and failure to thrive indicate severe GERD
with inadequate nutrition, requiring immediate medical
intervention. Frequent spit-up, mild irritability, and occasional
coughing are common in uncomplicated GERD
8. A 5-year-old child with type 1 diabetes presents with blood
glucose of 45 mg/dL. The child is conscious but confused. What is
the priority intervention?
A. Administer 1 mg glucagon intramuscularly
B. Give 15-20g rapid-acting carbohydrates orally
C. Start IV dextrose infusion
D. Monitor blood glucose every 30 minutes
Correct Answer: B
Explanation: For a conscious child with hypoglycemia, oral rapid-
acting carbohydrates (15-20g) are the first-line treatment.
Glucagon is for unconscious patients, and IV dextrose is reserved
for severe cases when oral route isn't possible
9. Which assessment finding is most indicative of impending
respiratory failure in a child with bronchiolitis?
ANSWERS 2026
1. A 2-year-old child is admitted with suspected lead poisoning.
Which assessment finding would the nurse prioritize?
A. Increased appetite and weight gain
B. Irritability, abdominal pain, and developmental regression
C. Hyperactivity and improved sleep patterns
D. Frequent coughing and wheezing
Correct Answer: B
Explanation: Lead poisoning in children typically presents with
irritability, abdominal pain, constipation, and developmental
regression or loss of previously acquired skills. Increased appetite,
hyperactivity with improved sleep, and respiratory symptoms are
not characteristic of lead toxicity
2. A 6-month-old infant is diagnosed with congenital
hypothyroidism. Which intervention is most critical for preventing
long-term complications?
A. Starting thyroid hormone replacement within the first 2 weeks
of life
B. Implementing a high-protein diet immediately
C. Scheduling monthly developmental assessments
D. Administering vitamin D supplements daily
Correct Answer: A
Explanation: Early initiation of thyroid hormone replacement
(within 2 weeks) is crucial to prevent irreversible intellectual
, disability and growth failure in congenital hypothyroidism.
Delayed treatment leads to permanent cognitive impairment
3. Which assessment finding in a newborn would most concern the
nurse regarding potential congenital heart defect?
A. Mild acrocyanosis of hands and feet
B. Continuous machine-like murmur heard at left upper sternal
border
C. Transient jaundice at 24 hours of life
D. Epstein's pearls on the gums
Correct Answer: B
Explanation: A continuous machine-like murmur at the left upper
sternal border is classic for patent ductus arteriosus (PDA), a
congenital heart defect. Acrocyanosis, transient jaundice after 24
hours, and Epstein's pearls are normal newborn findings
4. A 4-year-old with asthma is experiencing an acute exacerbation.
Which medication should the nurse administer first?
A. Oral prednisone
B. Albuterol via nebulizer
C. Ipratropium bromide
D. Inhaled corticosteroids
Correct Answer: B
Explanation: Short-acting beta-agonists (albuterol) are the first-
line treatment for acute asthma exacerbations as they provide
rapid bronchodilation. Systemic corticosteroids are adjunctive, and
inhaled corticosteroids are for long-term control
,5. Which immunization is contraindicated in a child with severe
immunodeficiency?
A. Inactivated polio vaccine (IPV)
B. Measles, mumps, rubella (MMR) vaccine
C. Hepatitis B vaccine
D. Tetanus, diphtheria, pertussis (Tdap) vaccine
Correct Answer: B
Explanation: MMR is a live attenuated vaccine and is
contraindicated in severe immunodeficiency due to risk of vaccine-
derived infection. IPV, Hepatitis B, and Tdap are inactivated
vaccines and safe for immunocompromised children
6. A 3-year-old child presents with sudden onset of high fever,
drooling, and difficulty breathing. The child is sitting in tripod
position. What is the nurse's priority action?
A. Obtain a throat culture
B. Prepare for immediate airway management and avoid
examining the throat
C. Administer antipyretics and encourage oral fluids
D. Perform chest physiotherapy
Correct Answer: B
Explanation: These symptoms suggest epiglottitis, a medical
emergency. Throat examination can trigger complete airway
obstruction. Priority is securing the airway in a controlled setting
(OR) without agitating the child
, 7. Which finding in an infant with gastroesophageal reflux would
require immediate intervention?
A. Frequent spit-up after feedings
B. Weight loss and failure to thrive
C. Mild irritability after feeding
D. Occasional coughing during feeds
Correct Answer: B
Explanation: Weight loss and failure to thrive indicate severe GERD
with inadequate nutrition, requiring immediate medical
intervention. Frequent spit-up, mild irritability, and occasional
coughing are common in uncomplicated GERD
8. A 5-year-old child with type 1 diabetes presents with blood
glucose of 45 mg/dL. The child is conscious but confused. What is
the priority intervention?
A. Administer 1 mg glucagon intramuscularly
B. Give 15-20g rapid-acting carbohydrates orally
C. Start IV dextrose infusion
D. Monitor blood glucose every 30 minutes
Correct Answer: B
Explanation: For a conscious child with hypoglycemia, oral rapid-
acting carbohydrates (15-20g) are the first-line treatment.
Glucagon is for unconscious patients, and IV dextrose is reserved
for severe cases when oral route isn't possible
9. Which assessment finding is most indicative of impending
respiratory failure in a child with bronchiolitis?
