KAPLAN PEDIATRIC NURSING EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027.
Core Domains
Growth and Development (Infancy through Adolescence)
Health Promotion and Disease Prevention
Acute and Chronic Illness Management
Pediatric Pharmacology and Dosage Calculations
Family-Centered Care and Communication
Legal, Ethical, and Professional Standards in Pediatric Nursing
Psychosocial and Behavioral Health
Pediatric Emergency and Critical Care
Introduction
This comprehensive examination is designed to assess the essential knowledge, critical thinking, and clinical
judgment required for safe and effective pediatric nursing practice. The exam encompasses a wide range of topics,
including developmental milestones, acute and chronic disease management, family dynamics, and legal-ethical
considerations. Utilizing a multiple-choice and scenario-based format, this assessment challenges the learner to
integrate theoretical knowledge with practical application, focusing on real-world decision-making in various
healthcare settings. Success in this examination reflects a holistic understanding of pediatric nursing that
prioritizes the physical, emotional, and developmental well-being of the child within the context of the family unit.
,Section One: Questions 1-100
Question 1
A nurse is assessing a 12-month-old infant during a routine well-child visit. Which finding requires immediate
further investigation?
A. The infant is unable to sit unsupported.
B. The infant's anterior fontanel is closed.
C. The infant displays separation anxiety when the parent leaves the room.
D. The infant has a closed posterior fontanel.
🟢 A. The infant is unable to sit unsupported.
🔴 RATIONALE: By 12 months of age, a child should be able to sit unsupported and many are pulling to stand
or walking. Failure to sit unsupported by this age is a significant developmental red flag that warrants further
assessment. Closure of the anterior fontanel typically occurs between 12-18 months, so closure at 12 months is
within normal limits. Separation anxiety is developmentally appropriate for this age, and the posterior fontanel
normally closes by 2-3 months of age.
Question 2
A nurse is educating the parents of a preschool-aged child about nutrition. Which statement by the parent
indicates a need for further teaching?
A. "I will offer my child a variety of foods from all food groups."
B. "I will allow my child to self-regulate food intake based on hunger and satiety cues."
C. "I will force my child to finish everything on the plate to ensure adequate nutrition."
D. "I will make mealtimes a positive and relaxed experience."
,🟢 C. "I will force my child to finish everything on the plate to ensure adequate nutrition."
🔴 RATIONALE: Forcing a child to eat or "clean the plate" can lead to power struggles, negative associations
with food, and potential overeating or eating disorders. It interferes with the child's ability to self-regulate
intake and should be avoided. The other statements reflect positive and appropriate approaches to feeding a
preschooler, focusing on variety, self-regulation, and a positive environment.
Question 3
A pediatric nurse is calculating a dose of acetaminophen for a child weighing 22 kg. The safe dose range is 10-
15 mg/kg/dose. What is the maximum safe dose for this child?
A. 220 mg
B. 330 mg
C. 440 mg
D. 550 mg
🟢 B. 330 mg
🔴 RATIONALE: The maximum safe dose is calculated by multiplying the child's weight in kg by the maximum
mg/kg dose (22 kg x 15 mg/kg = 330 mg). The other options are incorrect calculations. The 220 mg option
represents the minimum dose, and the other two represent calculations using incorrect weights or dosage
ranges.
Question 4
A nurse is caring for a 4-year-old child diagnosed with pneumonia. The child’s respiratory rate is 40 breaths per
minute, and the oxygen saturation is 91% on room air. Which intervention should the nurse implement first?
A. Administer a prescribed bronchodilator.
B. Apply a non-rebreather mask at 15 L/min.
, C. Place the child in a high Fowler's position.
D. Notify the healthcare provider of the assessment findings.
🟢 B. Apply a non-rebreather mask at 15 L/min.
🔴 RATIONALE: The child is experiencing respiratory distress with tachypnea and hypoxia (SpO2 of 91% on
room air). The immediate priority is to address the hypoxia. Applying a non-rebreather mask provides the
highest concentration of oxygen. While positioning is helpful, it does not directly correct the hypoxemia.
Administering medication is important but not the first priority, and while notifying the provider is necessary,
the nurse must act independently to correct the life-threatening low oxygen saturation first.
Question 5
A nurse is assessing a school-aged child with sickle cell disease who is experiencing a painful vaso-occlusive
crisis. Which intervention is the highest priority for this child?
A. Administering oral ibuprofen as prescribed.
B. Encouraging fluid restriction to prevent fluid overload.
C. Applying cold compresses to the affected joints.
D. Initiating an IV for opioid analgesia and hydration.
🟢 D. Initiating an IV for opioid analgesia and hydration.
🔴 RATIONALE: The priority in a vaso-occlusive crisis is pain management and hydration. IV access allows for
administration of potent opioid analgesics and intravenous fluids to reduce blood viscosity and improve blood
flow. Oral medications like ibuprofen are a first step for mild pain but may be insufficient for a crisis. Fluid
restriction is contraindicated; hydration is essential. Cold compresses can cause vasoconstriction and worsen the
sickling process.
RATIONALES 2026 Q&A |LATEST EXAM UPDATE 2026/2027.
Core Domains
Growth and Development (Infancy through Adolescence)
Health Promotion and Disease Prevention
Acute and Chronic Illness Management
Pediatric Pharmacology and Dosage Calculations
Family-Centered Care and Communication
Legal, Ethical, and Professional Standards in Pediatric Nursing
Psychosocial and Behavioral Health
Pediatric Emergency and Critical Care
Introduction
This comprehensive examination is designed to assess the essential knowledge, critical thinking, and clinical
judgment required for safe and effective pediatric nursing practice. The exam encompasses a wide range of topics,
including developmental milestones, acute and chronic disease management, family dynamics, and legal-ethical
considerations. Utilizing a multiple-choice and scenario-based format, this assessment challenges the learner to
integrate theoretical knowledge with practical application, focusing on real-world decision-making in various
healthcare settings. Success in this examination reflects a holistic understanding of pediatric nursing that
prioritizes the physical, emotional, and developmental well-being of the child within the context of the family unit.
,Section One: Questions 1-100
Question 1
A nurse is assessing a 12-month-old infant during a routine well-child visit. Which finding requires immediate
further investigation?
A. The infant is unable to sit unsupported.
B. The infant's anterior fontanel is closed.
C. The infant displays separation anxiety when the parent leaves the room.
D. The infant has a closed posterior fontanel.
🟢 A. The infant is unable to sit unsupported.
🔴 RATIONALE: By 12 months of age, a child should be able to sit unsupported and many are pulling to stand
or walking. Failure to sit unsupported by this age is a significant developmental red flag that warrants further
assessment. Closure of the anterior fontanel typically occurs between 12-18 months, so closure at 12 months is
within normal limits. Separation anxiety is developmentally appropriate for this age, and the posterior fontanel
normally closes by 2-3 months of age.
Question 2
A nurse is educating the parents of a preschool-aged child about nutrition. Which statement by the parent
indicates a need for further teaching?
A. "I will offer my child a variety of foods from all food groups."
B. "I will allow my child to self-regulate food intake based on hunger and satiety cues."
C. "I will force my child to finish everything on the plate to ensure adequate nutrition."
D. "I will make mealtimes a positive and relaxed experience."
,🟢 C. "I will force my child to finish everything on the plate to ensure adequate nutrition."
🔴 RATIONALE: Forcing a child to eat or "clean the plate" can lead to power struggles, negative associations
with food, and potential overeating or eating disorders. It interferes with the child's ability to self-regulate
intake and should be avoided. The other statements reflect positive and appropriate approaches to feeding a
preschooler, focusing on variety, self-regulation, and a positive environment.
Question 3
A pediatric nurse is calculating a dose of acetaminophen for a child weighing 22 kg. The safe dose range is 10-
15 mg/kg/dose. What is the maximum safe dose for this child?
A. 220 mg
B. 330 mg
C. 440 mg
D. 550 mg
🟢 B. 330 mg
🔴 RATIONALE: The maximum safe dose is calculated by multiplying the child's weight in kg by the maximum
mg/kg dose (22 kg x 15 mg/kg = 330 mg). The other options are incorrect calculations. The 220 mg option
represents the minimum dose, and the other two represent calculations using incorrect weights or dosage
ranges.
Question 4
A nurse is caring for a 4-year-old child diagnosed with pneumonia. The child’s respiratory rate is 40 breaths per
minute, and the oxygen saturation is 91% on room air. Which intervention should the nurse implement first?
A. Administer a prescribed bronchodilator.
B. Apply a non-rebreather mask at 15 L/min.
, C. Place the child in a high Fowler's position.
D. Notify the healthcare provider of the assessment findings.
🟢 B. Apply a non-rebreather mask at 15 L/min.
🔴 RATIONALE: The child is experiencing respiratory distress with tachypnea and hypoxia (SpO2 of 91% on
room air). The immediate priority is to address the hypoxia. Applying a non-rebreather mask provides the
highest concentration of oxygen. While positioning is helpful, it does not directly correct the hypoxemia.
Administering medication is important but not the first priority, and while notifying the provider is necessary,
the nurse must act independently to correct the life-threatening low oxygen saturation first.
Question 5
A nurse is assessing a school-aged child with sickle cell disease who is experiencing a painful vaso-occlusive
crisis. Which intervention is the highest priority for this child?
A. Administering oral ibuprofen as prescribed.
B. Encouraging fluid restriction to prevent fluid overload.
C. Applying cold compresses to the affected joints.
D. Initiating an IV for opioid analgesia and hydration.
🟢 D. Initiating an IV for opioid analgesia and hydration.
🔴 RATIONALE: The priority in a vaso-occlusive crisis is pain management and hydration. IV access allows for
administration of potent opioid analgesics and intravenous fluids to reduce blood viscosity and improve blood
flow. Oral medications like ibuprofen are a first step for mild pain but may be insufficient for a crisis. Fluid
restriction is contraindicated; hydration is essential. Cold compresses can cause vasoconstriction and worsen the
sickling process.
