NUR 203 PEDIATRICS (PDF) | 2026 EXAM QUESTIONS AND
ANSWERS + RATIONALES | STUDY GUIDE | 100% CORRECT
1. The nurse is teaching a parenting class on the prevention of sudden infant death
syndrome (SIDS). Which information should the nurse include?
A) Place the infant on the stomach to sleep to prevent aspiration.
B) Use soft bedding and stuffed animals in the crib for comfort.
C) Place the infant on the back to sleep on a firm mattress.
D) Place the infant in the parent's bed to encourage bonding.
Correct Answer: C) Place the infant on the back to sleep on a firm mattress.
Rationale: Placing the infant supine (on the back) on a firm mattress is the single most important
measure to reduce the risk of SIDS. Soft bedding, stuffed animals, and co-sleeping are known
risk factors for SIDS and should be avoided.
2. A 2-year-old child is brought to the clinic for a well-child visit. Which finding would be a
priority to report to the healthcare provider?
A) The child's head circumference exceeds the chest circumference.
B) The child's weight is at the 50th percentile for age.
C) The child has 20 primary teeth.
D) The child can walk up stairs with alternating feet.
Correct Answer: A) The child's head circumference exceeds the chest circumference.
Rationale: By 1-2 years of age, the head and chest circumference should be roughly equal. A
head circumference that exceeds the chest circumference in a toddler could indicate increased
intracranial pressure or hydrocephalus and should be reported immediately.
3. What is the single most important influence on growth at any age?
A) Sleep patterns
B) Physical activity
C) Nutrition
D) Psychological support
Correct Answer: C) Nutrition
Rationale: Nutrition is the single most important factor influencing growth and development at
all stages. Adequate nutrition provides the essential building blocks for physical growth, brain
development, and overall health. Inadequate nutrition can lead to failure to thrive and
developmental delays.
4. During adolescence, the psychosocial development focus is on establishing which of the
following?
A) Trust
B) Autonomy
, C) Initiative
D) Identity
Correct Answer: D) Identity
Rationale: According to Erikson's theory, the adolescent stage (ages 12-18) is characterized by
the conflict of Identity vs. Role Confusion. The primary task is developing a sense of personal
identity, which involves exploring values, beliefs, and roles.
5. When preparing a 4-year-old girl for open heart surgery, which age-appropriate
information is most important for the nurse to provide?
A) The detailed medical equipment that will be used.
B) What the environment will look and sound like when the child wakes up.
C) The specific statistics on surgical success and mortality.
D) The child's family should leave the room during the preparation.
Correct Answer: B) What the environment will look and sound like when the child wakes up.
Rationale: Preschoolers fear body mutilation and the unknown. Preparing them with sensory
information about the environment (sights, sounds) helps reduce anxiety. Providing details about
equipment is too advanced for a 4-year-old.
6. A child is admitted to the pediatric medical unit with a diagnosis of Kawasaki disease.
Which provider prescription is most important for the nurse to anticipate?
A) Intravenous immunoglobulin (IVIG)
B) Oral antibiotics
C) Antiviral medications
D) Antihistamines
Correct Answer: A) Intravenous immunoglobulin (IVIG)
Rationale: IVIG is the standard treatment for Kawasaki disease to reduce the risk of coronary
artery aneurysms. It is administered early in the disease course. Aspirin is also used, but IVIG is
the primary therapeutic intervention.
7. Which growth and development characteristic should the nurse consider when monitoring
the effects of a topical medication for an infant?
A) A thin stratum corneum increases topical absorption.
B) The skin is thicker and acts as a barrier to medication.
C) Infants have a high body fat content that absorbs medication.
D) The infant's skin produces more sebum than an adult's.
Correct Answer: A) A thin stratum corneum increases topical absorption.
Rationale: Infants have a thinner stratum corneum (outer skin layer) than adults, which increases
the absorption of topical medications. This makes them more susceptible to systemic effects
from topical agents.
, 8. A 9-month-old infant is found sleeping in the parent's arms. What is the nurse's priority
action?
A) Wake the infant to perform a full neurologic assessment.
B) Ask the parent to leave the room so the infant can rest.
C) Check the client's respiratory status.
D) Document the finding and leave the room.
Correct Answer: C) Check the client's respiratory status.
Rationale: The priority is always to assess airway and breathing. While the infant is sleeping, the
nurse should observe the respiratory effort and rate to ensure the infant is stable.
9. What is the expected fine motor skill for an 8-month-old infant?
A) Grasp a rattle by the handle and use a crude pincer grasp.
B) Stack two blocks.
C) Turn pages of a book one at a time.
D) Use a mature pincer grasp to pick up a small bead.
Correct Answer: A) Grasp a rattle by the handle and use a crude pincer grasp.
Rationale: At 8 months, infants typically develop the ability to grasp objects and use a crude
pincer grasp (using the thumb and forefinger). A mature pincer grasp develops later around 10-
12 months.
10. In general, an infant should triple their birth weight by which age?
A) 6 months
B) 9 months
C) 12 months
D) 18 months
Correct Answer: C) 12 months
Rationale: Infants typically triple their birth weight by their first birthday. They usually double
their birth weight by 6 months.
11. A child is diagnosed with infectious mononucleosis. Which information is most
important for the nurse to include in the teaching plan?
A) Instruct the client to avoid playing contact sports.
B) Advise the client to take aspirin for fever management.
C) Instruct the client to restrict fluid intake.
D) Inform the client that they can return to school immediately.
Correct Answer: A) Instruct the client to avoid playing contact sports.
Rationale: Splenomegaly is a common complication of mononucleosis. Avoiding contact sports
is crucial to prevent splenic rupture.
12. The mother of a one-month-old infant calls the clinic to report that the back of her
infant's head is flat. How should the nurse respond?
ANSWERS + RATIONALES | STUDY GUIDE | 100% CORRECT
1. The nurse is teaching a parenting class on the prevention of sudden infant death
syndrome (SIDS). Which information should the nurse include?
A) Place the infant on the stomach to sleep to prevent aspiration.
B) Use soft bedding and stuffed animals in the crib for comfort.
C) Place the infant on the back to sleep on a firm mattress.
D) Place the infant in the parent's bed to encourage bonding.
Correct Answer: C) Place the infant on the back to sleep on a firm mattress.
Rationale: Placing the infant supine (on the back) on a firm mattress is the single most important
measure to reduce the risk of SIDS. Soft bedding, stuffed animals, and co-sleeping are known
risk factors for SIDS and should be avoided.
2. A 2-year-old child is brought to the clinic for a well-child visit. Which finding would be a
priority to report to the healthcare provider?
A) The child's head circumference exceeds the chest circumference.
B) The child's weight is at the 50th percentile for age.
C) The child has 20 primary teeth.
D) The child can walk up stairs with alternating feet.
Correct Answer: A) The child's head circumference exceeds the chest circumference.
Rationale: By 1-2 years of age, the head and chest circumference should be roughly equal. A
head circumference that exceeds the chest circumference in a toddler could indicate increased
intracranial pressure or hydrocephalus and should be reported immediately.
3. What is the single most important influence on growth at any age?
A) Sleep patterns
B) Physical activity
C) Nutrition
D) Psychological support
Correct Answer: C) Nutrition
Rationale: Nutrition is the single most important factor influencing growth and development at
all stages. Adequate nutrition provides the essential building blocks for physical growth, brain
development, and overall health. Inadequate nutrition can lead to failure to thrive and
developmental delays.
4. During adolescence, the psychosocial development focus is on establishing which of the
following?
A) Trust
B) Autonomy
, C) Initiative
D) Identity
Correct Answer: D) Identity
Rationale: According to Erikson's theory, the adolescent stage (ages 12-18) is characterized by
the conflict of Identity vs. Role Confusion. The primary task is developing a sense of personal
identity, which involves exploring values, beliefs, and roles.
5. When preparing a 4-year-old girl for open heart surgery, which age-appropriate
information is most important for the nurse to provide?
A) The detailed medical equipment that will be used.
B) What the environment will look and sound like when the child wakes up.
C) The specific statistics on surgical success and mortality.
D) The child's family should leave the room during the preparation.
Correct Answer: B) What the environment will look and sound like when the child wakes up.
Rationale: Preschoolers fear body mutilation and the unknown. Preparing them with sensory
information about the environment (sights, sounds) helps reduce anxiety. Providing details about
equipment is too advanced for a 4-year-old.
6. A child is admitted to the pediatric medical unit with a diagnosis of Kawasaki disease.
Which provider prescription is most important for the nurse to anticipate?
A) Intravenous immunoglobulin (IVIG)
B) Oral antibiotics
C) Antiviral medications
D) Antihistamines
Correct Answer: A) Intravenous immunoglobulin (IVIG)
Rationale: IVIG is the standard treatment for Kawasaki disease to reduce the risk of coronary
artery aneurysms. It is administered early in the disease course. Aspirin is also used, but IVIG is
the primary therapeutic intervention.
7. Which growth and development characteristic should the nurse consider when monitoring
the effects of a topical medication for an infant?
A) A thin stratum corneum increases topical absorption.
B) The skin is thicker and acts as a barrier to medication.
C) Infants have a high body fat content that absorbs medication.
D) The infant's skin produces more sebum than an adult's.
Correct Answer: A) A thin stratum corneum increases topical absorption.
Rationale: Infants have a thinner stratum corneum (outer skin layer) than adults, which increases
the absorption of topical medications. This makes them more susceptible to systemic effects
from topical agents.
, 8. A 9-month-old infant is found sleeping in the parent's arms. What is the nurse's priority
action?
A) Wake the infant to perform a full neurologic assessment.
B) Ask the parent to leave the room so the infant can rest.
C) Check the client's respiratory status.
D) Document the finding and leave the room.
Correct Answer: C) Check the client's respiratory status.
Rationale: The priority is always to assess airway and breathing. While the infant is sleeping, the
nurse should observe the respiratory effort and rate to ensure the infant is stable.
9. What is the expected fine motor skill for an 8-month-old infant?
A) Grasp a rattle by the handle and use a crude pincer grasp.
B) Stack two blocks.
C) Turn pages of a book one at a time.
D) Use a mature pincer grasp to pick up a small bead.
Correct Answer: A) Grasp a rattle by the handle and use a crude pincer grasp.
Rationale: At 8 months, infants typically develop the ability to grasp objects and use a crude
pincer grasp (using the thumb and forefinger). A mature pincer grasp develops later around 10-
12 months.
10. In general, an infant should triple their birth weight by which age?
A) 6 months
B) 9 months
C) 12 months
D) 18 months
Correct Answer: C) 12 months
Rationale: Infants typically triple their birth weight by their first birthday. They usually double
their birth weight by 6 months.
11. A child is diagnosed with infectious mononucleosis. Which information is most
important for the nurse to include in the teaching plan?
A) Instruct the client to avoid playing contact sports.
B) Advise the client to take aspirin for fever management.
C) Instruct the client to restrict fluid intake.
D) Inform the client that they can return to school immediately.
Correct Answer: A) Instruct the client to avoid playing contact sports.
Rationale: Splenomegaly is a common complication of mononucleosis. Avoiding contact sports
is crucial to prevent splenic rupture.
12. The mother of a one-month-old infant calls the clinic to report that the back of her
infant's head is flat. How should the nurse respond?
