Pediatrics NCLEX-RN Practice Exam (2026 Edition)
Questions and Answers with Detailed Rationales
Question 1
A pediatric nurse is assessing a 4-year-old child during a routine visit.
Which developmental behavior is expected?
A. Enjoys cooperative play with other children
B. Reads complex books independently
C. Solves advanced mathematical problems
D. Performs all self-care activities without assistance
Correct Answer: A. Enjoys Cooperative Play With Other Children
Rationale:
Preschool-aged children (3–5 years) develop social skills through
cooperative play and increased interaction with peers.
Question 2
A nurse caring for an infant should recognize that the safest sleeping
position is:
A. Side-lying with pillows
B. Prone position
C. Supine position on a firm surface
D. Sitting position in a car seat
Correct Answer: C. Supine Position on a Firm Surface
,Rationale:
Placing infants on their backs to sleep reduces the risk of sudden infant
death syndrome (SIDS).
Question 3
A nurse is assessing a child with respiratory distress. Which finding
requires immediate intervention?
A. Mild cough
B. Oxygen saturation of 88%
C. Increased appetite
D. Clear nasal drainage
Correct Answer: B. Oxygen Saturation of 88%
Rationale:
Low oxygen saturation indicates impaired oxygenation and requires
immediate assessment and intervention.
Question 4
A child with asthma is experiencing an acute exacerbation. Which
medication should the nurse expect to administer first?
A. Albuterol inhaler
B. Long-term corticosteroid
C. Antibiotic medication
D. Antihistamine
Correct Answer: A. Albuterol Inhaler
,Rationale:
Short-acting beta-agonists such as albuterol provide rapid
bronchodilation during acute asthma attacks.
Question 5
A nurse is caring for a child with dehydration caused by vomiting and
diarrhea. Which finding indicates worsening dehydration?
A. Increased urine output
B. Moist mucous membranes
C. Lethargy and decreased urine output
D. Normal skin turgor
Correct Answer: C. Lethargy and Decreased Urine Output
Rationale:
Lethargy and reduced urination indicate significant fluid loss and
possible severe dehydration.
Question 6
A nurse caring for a child experiencing a seizure should first:
A. Insert a tongue blade into the mouth
B. Restrain the child
C. Protect the child from injury and maintain airway safety
D. Offer fluids immediately
Correct Answer: C. Protect the Child From Injury and Maintain Airway
Safety
, Rationale:
During seizures, the priority is preventing injury and maintaining airway
protection. Objects should never be placed in the child's mouth.
Question 7
A child diagnosed with type 1 diabetes mellitus is at risk for
hypoglycemia. Which symptom should the nurse recognize?
A. Sweating and shakiness
B. Fruity breath
C. Deep rapid breathing
D. Increased thirst only
Correct Answer: A. Sweating and Shakiness
Rationale:
Hypoglycemia causes adrenergic symptoms such as sweating, tremors,
hunger, and irritability.
Question 8
A nurse is caring for a child with suspected epiglottitis. Which action
should the nurse avoid?
A. Keeping emergency airway equipment available
B. Allowing the child to remain in a comfortable position
C. Inspecting the throat with a tongue depressor
D. Providing oxygen as prescribed
Correct Answer: C. Inspecting the Throat With a Tongue Depressor
Questions and Answers with Detailed Rationales
Question 1
A pediatric nurse is assessing a 4-year-old child during a routine visit.
Which developmental behavior is expected?
A. Enjoys cooperative play with other children
B. Reads complex books independently
C. Solves advanced mathematical problems
D. Performs all self-care activities without assistance
Correct Answer: A. Enjoys Cooperative Play With Other Children
Rationale:
Preschool-aged children (3–5 years) develop social skills through
cooperative play and increased interaction with peers.
Question 2
A nurse caring for an infant should recognize that the safest sleeping
position is:
A. Side-lying with pillows
B. Prone position
C. Supine position on a firm surface
D. Sitting position in a car seat
Correct Answer: C. Supine Position on a Firm Surface
,Rationale:
Placing infants on their backs to sleep reduces the risk of sudden infant
death syndrome (SIDS).
Question 3
A nurse is assessing a child with respiratory distress. Which finding
requires immediate intervention?
A. Mild cough
B. Oxygen saturation of 88%
C. Increased appetite
D. Clear nasal drainage
Correct Answer: B. Oxygen Saturation of 88%
Rationale:
Low oxygen saturation indicates impaired oxygenation and requires
immediate assessment and intervention.
Question 4
A child with asthma is experiencing an acute exacerbation. Which
medication should the nurse expect to administer first?
A. Albuterol inhaler
B. Long-term corticosteroid
C. Antibiotic medication
D. Antihistamine
Correct Answer: A. Albuterol Inhaler
,Rationale:
Short-acting beta-agonists such as albuterol provide rapid
bronchodilation during acute asthma attacks.
Question 5
A nurse is caring for a child with dehydration caused by vomiting and
diarrhea. Which finding indicates worsening dehydration?
A. Increased urine output
B. Moist mucous membranes
C. Lethargy and decreased urine output
D. Normal skin turgor
Correct Answer: C. Lethargy and Decreased Urine Output
Rationale:
Lethargy and reduced urination indicate significant fluid loss and
possible severe dehydration.
Question 6
A nurse caring for a child experiencing a seizure should first:
A. Insert a tongue blade into the mouth
B. Restrain the child
C. Protect the child from injury and maintain airway safety
D. Offer fluids immediately
Correct Answer: C. Protect the Child From Injury and Maintain Airway
Safety
, Rationale:
During seizures, the priority is preventing injury and maintaining airway
protection. Objects should never be placed in the child's mouth.
Question 7
A child diagnosed with type 1 diabetes mellitus is at risk for
hypoglycemia. Which symptom should the nurse recognize?
A. Sweating and shakiness
B. Fruity breath
C. Deep rapid breathing
D. Increased thirst only
Correct Answer: A. Sweating and Shakiness
Rationale:
Hypoglycemia causes adrenergic symptoms such as sweating, tremors,
hunger, and irritability.
Question 8
A nurse is caring for a child with suspected epiglottitis. Which action
should the nurse avoid?
A. Keeping emergency airway equipment available
B. Allowing the child to remain in a comfortable position
C. Inspecting the throat with a tongue depressor
D. Providing oxygen as prescribed
Correct Answer: C. Inspecting the Throat With a Tongue Depressor
