NUR 254 Exam 4 – Maternal and Pediatric
Nursing (Pediatric Disorders and Pediatric
Emergencies) Questions And Well Graded
Solutions With Rationales Updated 2026-2027
1. A 2-year-old child is brought to the clinic with a fever of 102°F, barking cough, and
stridor. What condition should the nurse suspect?
A. Epiglottitis
B. Croup
C. Bronchiolitis
D. Pneumonia
Answer in italic bold: B. Croup.
Rationale in italic: Croup presents with a barking cough, stridor, and fever,
typically in children 6 months to 3 years. It is caused by parainfluenza virus and
leads to subglottic swelling .
2. A 4-year-old child is brought to the emergency department with drooling, stridor,
and a high fever. The child is sitting upright in a tripod position. What condition
should the nurse suspect?
A. Croup
B. Epiglottitis
C. Bronchiolitis
D. Tonsillitis
Answer in italic bold: B. Epiglottitis.
Rationale in italic: Epiglottitis presents with drooling, stridor, high fever, and
tripod positioning. It is a medical emergency caused by Haemophilus influenzae
type B. The child should not be examined orally to avoid airway obstruction .
3. A child with epiglottitis is being admitted. What is the priority nursing intervention?
A. Prepare for intubation
B. Administer oral antibiotics
C. Perform a throat culture
D. Place the child in a supine position
Answer in italic bold: A. Prepare for intubation.
Rationale in italic: Epiglottitis can rapidly progress to airway obstruction. The
priority is to prepare for intubation or tracheostomy. Throat examination
should be avoided .
4. A 6-month-old infant is brought to the clinic with wheezing, coughing, and difficulty
feeding. The nurse notes the infant has respiratory syncytial virus (RSV). What
condition is most likely?
, A. Croup
B. Epiglottitis
C. Bronchiolitis
D. Pneumonia
Answer in italic bold: C. Bronchiolitis.
Rationale in italic: Bronchiolitis is caused by RSV and presents with wheezing,
coughing, and respiratory distress in infants under 12 months .
5. An infant with RSV bronchiolitis has a respiratory rate of 70 breaths/min, nasal
flaring, and retractions. What is the priority nursing action?
A. Administer antibiotics
B. Provide oxygen and suction
C. Administer bronchodilators
D. Notify the provider
Answer in italic bold: B. Provide oxygen and suction.
Rationale in italic: The priority is to maintain oxygenation and clear the airway
with suctioning. Bronchodilators may be used but are not the first-line
treatment for RSV .
6. A child with bronchiolitis is receiving ribavirin. What is the purpose of this
medication?
A. Bronchodilator
B. Antiviral
C. Antibiotic
D. Corticosteroid
Answer in italic bold: B. Antiviral.
Rationale in italic: Ribavirin is an antiviral medication used in severe cases of
RSV bronchiolitis .
7. A 5-year-old child with asthma is having an acute exacerbation. The nurse notes the
child is using accessory muscles and has a prolonged expiratory phase. What is the
priority action?
A. Administer oral corticosteroids
B. Administer albuterol via nebulizer
C. Administer oxygen
D. Notify the provider
Answer in italic bold: B. Administer albuterol via nebulizer.
Rationale in italic: Albuterol is a fast-acting bronchodilator used for acute
asthma exacerbations. It should be administered immediately to relieve
bronchospasm .
8. A child with asthma is prescribed a peak flow meter. The nurse teaches the child to
monitor which parameter?
A. Peak expiratory flow rate
B. Forced vital capacity
C. Tidal volume
D. Inspiratory capacity
, Answer in italic bold: A. Peak expiratory flow rate.
Rationale in italic: A peak flow meter measures peak expiratory flow rate
(PEFR), which indicates how well the lungs are functioning .
9. A child with asthma has a peak flow reading in the yellow zone. What should the
nurse instruct the child to do?
A. Continue current medications
B. Use rescue medications and monitor
C. Go to the emergency department
D. Call the provider immediately
Answer in italic bold: B. Use rescue medications and monitor.
Rationale in italic: The yellow zone (50-80% of personal best) indicates caution.
The child should use rescue medications and monitor symptoms .
10. A child with asthma has a peak flow reading in the red zone. What is the priority
action?
A. Continue current medications
B. Use rescue medications and go to the emergency department
C. Call the provider
D. Rest and monitor
Answer in italic bold: B. Use rescue medications and go to the emergency
department.
Rationale in italic: The red zone (<50% of personal best) indicates a medical
emergency. The child should use rescue medications and seek immediate
emergency care .
11. A 2-year-old child is diagnosed with acute otitis media (AOM). Which finding would
the nurse expect?
A. Ear pain and fever
B. Nausea and vomiting
C. Cough and runny nose
D. All of the above
Answer in italic bold: D. All of the above.
Rationale in italic: AOM presents with ear pain, fever, irritability, and
sometimes nausea, vomiting, and respiratory symptoms .
12. A child with AOM is prescribed amoxicillin. What is the priority nursing intervention?
A. Administer with food
B. Complete the full course of antibiotics
C. Monitor for allergic reactions
D. All of the above
Answer in italic bold: D. All of the above.
Rationale in italic: Amoxicillin should be administered with food to reduce GI
upset, and the full course must be completed. Allergic reactions should be
monitored .
13. A 3-year-old child has a fever of 104°F and is diagnosed with a urinary tract infection
(UTI). What is the priority nursing action?
, A. Administer antibiotics
B. Obtain a urine culture
C. Notify the provider
D. Administer antipyretics
Answer in italic bold: B. Obtain a urine culture.
Rationale in italic: A urine culture should be obtained before starting antibiotics
to identify the causative organism and guide treatment .
14. A child with a UTI is at risk for which complication?
A. Pyelonephritis
B. Sepsis
C. Renal scarring
D. All of the above
Answer in italic bold: D. All of the above.
Rationale in italic: UTIs in children can lead to pyelonephritis, sepsis, and renal
scarring if not treated promptly .
15. A 4-year-old child is diagnosed with gastroenteritis and has had vomiting and
diarrhea for 2 days. Which finding indicates dehydration?
A. Sunken fontanel
B. Dry mucous membranes
C. Decreased urine output
D. All of the above
Answer in italic bold: D. All of the above.
Rationale in italic: Signs of dehydration include sunken fontanel, dry mucous
membranes, decreased urine output, and poor skin turgor .
16. A child with gastroenteritis is receiving oral rehydration therapy (ORT). Which
solution is appropriate?
A. Pedialyte
B. Gatorade
C. Water
D. Juice
Answer in italic bold: A. Pedialyte.
Rationale in italic: Oral rehydration solutions like Pedialyte contain the correct
balance of electrolytes and glucose for rehydration .
17. A child with severe dehydration is ordered IV fluids. What is the priority nursing
action?
A. Administer IV fluids as prescribed
B. Monitor urine output
C. Monitor electrolyte levels
D. All of the above
Answer in italic bold: D. All of the above.
Rationale in italic: IV fluids should be administered, and urine output and
electrolytes should be monitored .
Nursing (Pediatric Disorders and Pediatric
Emergencies) Questions And Well Graded
Solutions With Rationales Updated 2026-2027
1. A 2-year-old child is brought to the clinic with a fever of 102°F, barking cough, and
stridor. What condition should the nurse suspect?
A. Epiglottitis
B. Croup
C. Bronchiolitis
D. Pneumonia
Answer in italic bold: B. Croup.
Rationale in italic: Croup presents with a barking cough, stridor, and fever,
typically in children 6 months to 3 years. It is caused by parainfluenza virus and
leads to subglottic swelling .
2. A 4-year-old child is brought to the emergency department with drooling, stridor,
and a high fever. The child is sitting upright in a tripod position. What condition
should the nurse suspect?
A. Croup
B. Epiglottitis
C. Bronchiolitis
D. Tonsillitis
Answer in italic bold: B. Epiglottitis.
Rationale in italic: Epiglottitis presents with drooling, stridor, high fever, and
tripod positioning. It is a medical emergency caused by Haemophilus influenzae
type B. The child should not be examined orally to avoid airway obstruction .
3. A child with epiglottitis is being admitted. What is the priority nursing intervention?
A. Prepare for intubation
B. Administer oral antibiotics
C. Perform a throat culture
D. Place the child in a supine position
Answer in italic bold: A. Prepare for intubation.
Rationale in italic: Epiglottitis can rapidly progress to airway obstruction. The
priority is to prepare for intubation or tracheostomy. Throat examination
should be avoided .
4. A 6-month-old infant is brought to the clinic with wheezing, coughing, and difficulty
feeding. The nurse notes the infant has respiratory syncytial virus (RSV). What
condition is most likely?
, A. Croup
B. Epiglottitis
C. Bronchiolitis
D. Pneumonia
Answer in italic bold: C. Bronchiolitis.
Rationale in italic: Bronchiolitis is caused by RSV and presents with wheezing,
coughing, and respiratory distress in infants under 12 months .
5. An infant with RSV bronchiolitis has a respiratory rate of 70 breaths/min, nasal
flaring, and retractions. What is the priority nursing action?
A. Administer antibiotics
B. Provide oxygen and suction
C. Administer bronchodilators
D. Notify the provider
Answer in italic bold: B. Provide oxygen and suction.
Rationale in italic: The priority is to maintain oxygenation and clear the airway
with suctioning. Bronchodilators may be used but are not the first-line
treatment for RSV .
6. A child with bronchiolitis is receiving ribavirin. What is the purpose of this
medication?
A. Bronchodilator
B. Antiviral
C. Antibiotic
D. Corticosteroid
Answer in italic bold: B. Antiviral.
Rationale in italic: Ribavirin is an antiviral medication used in severe cases of
RSV bronchiolitis .
7. A 5-year-old child with asthma is having an acute exacerbation. The nurse notes the
child is using accessory muscles and has a prolonged expiratory phase. What is the
priority action?
A. Administer oral corticosteroids
B. Administer albuterol via nebulizer
C. Administer oxygen
D. Notify the provider
Answer in italic bold: B. Administer albuterol via nebulizer.
Rationale in italic: Albuterol is a fast-acting bronchodilator used for acute
asthma exacerbations. It should be administered immediately to relieve
bronchospasm .
8. A child with asthma is prescribed a peak flow meter. The nurse teaches the child to
monitor which parameter?
A. Peak expiratory flow rate
B. Forced vital capacity
C. Tidal volume
D. Inspiratory capacity
, Answer in italic bold: A. Peak expiratory flow rate.
Rationale in italic: A peak flow meter measures peak expiratory flow rate
(PEFR), which indicates how well the lungs are functioning .
9. A child with asthma has a peak flow reading in the yellow zone. What should the
nurse instruct the child to do?
A. Continue current medications
B. Use rescue medications and monitor
C. Go to the emergency department
D. Call the provider immediately
Answer in italic bold: B. Use rescue medications and monitor.
Rationale in italic: The yellow zone (50-80% of personal best) indicates caution.
The child should use rescue medications and monitor symptoms .
10. A child with asthma has a peak flow reading in the red zone. What is the priority
action?
A. Continue current medications
B. Use rescue medications and go to the emergency department
C. Call the provider
D. Rest and monitor
Answer in italic bold: B. Use rescue medications and go to the emergency
department.
Rationale in italic: The red zone (<50% of personal best) indicates a medical
emergency. The child should use rescue medications and seek immediate
emergency care .
11. A 2-year-old child is diagnosed with acute otitis media (AOM). Which finding would
the nurse expect?
A. Ear pain and fever
B. Nausea and vomiting
C. Cough and runny nose
D. All of the above
Answer in italic bold: D. All of the above.
Rationale in italic: AOM presents with ear pain, fever, irritability, and
sometimes nausea, vomiting, and respiratory symptoms .
12. A child with AOM is prescribed amoxicillin. What is the priority nursing intervention?
A. Administer with food
B. Complete the full course of antibiotics
C. Monitor for allergic reactions
D. All of the above
Answer in italic bold: D. All of the above.
Rationale in italic: Amoxicillin should be administered with food to reduce GI
upset, and the full course must be completed. Allergic reactions should be
monitored .
13. A 3-year-old child has a fever of 104°F and is diagnosed with a urinary tract infection
(UTI). What is the priority nursing action?
, A. Administer antibiotics
B. Obtain a urine culture
C. Notify the provider
D. Administer antipyretics
Answer in italic bold: B. Obtain a urine culture.
Rationale in italic: A urine culture should be obtained before starting antibiotics
to identify the causative organism and guide treatment .
14. A child with a UTI is at risk for which complication?
A. Pyelonephritis
B. Sepsis
C. Renal scarring
D. All of the above
Answer in italic bold: D. All of the above.
Rationale in italic: UTIs in children can lead to pyelonephritis, sepsis, and renal
scarring if not treated promptly .
15. A 4-year-old child is diagnosed with gastroenteritis and has had vomiting and
diarrhea for 2 days. Which finding indicates dehydration?
A. Sunken fontanel
B. Dry mucous membranes
C. Decreased urine output
D. All of the above
Answer in italic bold: D. All of the above.
Rationale in italic: Signs of dehydration include sunken fontanel, dry mucous
membranes, decreased urine output, and poor skin turgor .
16. A child with gastroenteritis is receiving oral rehydration therapy (ORT). Which
solution is appropriate?
A. Pedialyte
B. Gatorade
C. Water
D. Juice
Answer in italic bold: A. Pedialyte.
Rationale in italic: Oral rehydration solutions like Pedialyte contain the correct
balance of electrolytes and glucose for rehydration .
17. A child with severe dehydration is ordered IV fluids. What is the priority nursing
action?
A. Administer IV fluids as prescribed
B. Monitor urine output
C. Monitor electrolyte levels
D. All of the above
Answer in italic bold: D. All of the above.
Rationale in italic: IV fluids should be administered, and urine output and
electrolytes should be monitored .
