NR 328 PEDIATRIC NURSING
COMPREHENSIVE EXAM STUDY GUIDE
2026
.
1. A 10-month-old infant is being assessed for developmental milestones. Which finding
would be most concerning to the pediatric nurse?
A. The infant cannot stand alone while holding onto furniture.
B. The infant exhibits a persistent Moro reflex.
C. The infant cannot say more than two recognizable words.
D. The infant is unable to pincer grasp small objects.
Answer: B
Conceptual Explanation: The Moro reflex should disappear by 3 to 4 months of age. A
persistent Moro reflex at 10 months suggests potential neurological damage and requires
further evaluation.
2. According to Erikson’s stages of psychosocial development, a 4-year-old child who is
constantly told ‘no’ and discouraged from exploring their environment is at risk for
developing which of the following?
A. Shame and doubt
,B. Inferiority
C. Guilt
D. Mistrust
Answer: C
Conceptual Explanation: Preschoolers (3-6 years) are in the Initiative vs. Guilt stage. If
their initiative is stifled or criticized, they develop a sense of guilt.
3. A nurse is teaching parents about safety precautions for a toddler. Which statement by the
parents indicates a need for further teaching?
A. We should place our child in a rear-facing car seat until age 2 or until they reach the
height/weight limit.
B. We will use syrup of ipecac immediately if we suspect our child has swallowed a
poisonous substance.
C. We will ensure the water heater is set to no higher than 120 degrees Fahrenheit.
D. We will keep all household cleaning supplies in a locked cabinet high above the floor.
Answer: B
Conceptual Explanation: Syrup of ipecac is no longer recommended for home use in
poisoning cases as it can cause more harm depending on the substance; parents should call
Poison Control first.
, 4. When assessing a child for suspected epiglottitis, which action is contraindicated?
A. Obtaining a lateral neck X-ray.
B. Placing the child in a tripod position.
C. Preparing for emergency intubation.
D. Inspecting the throat with a tongue depressor.
Answer: D
Conceptual Explanation: Using a tongue depressor can trigger a laryngospasm, causing
complete airway obstruction in a child with epiglottitis.
5. A child is diagnosed with Tetralogy of Fallot. The nurse observes the child squatting during
a play session. How should the nurse interpret this action?
A. The child is exhibiting signs of social anxiety.
B. The child is experiencing abdominal pain related to the cardiac defect.
C. The child is tired and needs a rest period.
D. Squatting increases systemic vascular resistance to improve oxygenation.
Answer: D
Conceptual Explanation: Squatting (or knee-chest position) is a compensatory
mechanism used by children with Tetralogy of Fallot to increase systemic resistance, which
decreases the right-to-left shunt and improves pulmonary blood flow.
COMPREHENSIVE EXAM STUDY GUIDE
2026
.
1. A 10-month-old infant is being assessed for developmental milestones. Which finding
would be most concerning to the pediatric nurse?
A. The infant cannot stand alone while holding onto furniture.
B. The infant exhibits a persistent Moro reflex.
C. The infant cannot say more than two recognizable words.
D. The infant is unable to pincer grasp small objects.
Answer: B
Conceptual Explanation: The Moro reflex should disappear by 3 to 4 months of age. A
persistent Moro reflex at 10 months suggests potential neurological damage and requires
further evaluation.
2. According to Erikson’s stages of psychosocial development, a 4-year-old child who is
constantly told ‘no’ and discouraged from exploring their environment is at risk for
developing which of the following?
A. Shame and doubt
,B. Inferiority
C. Guilt
D. Mistrust
Answer: C
Conceptual Explanation: Preschoolers (3-6 years) are in the Initiative vs. Guilt stage. If
their initiative is stifled or criticized, they develop a sense of guilt.
3. A nurse is teaching parents about safety precautions for a toddler. Which statement by the
parents indicates a need for further teaching?
A. We should place our child in a rear-facing car seat until age 2 or until they reach the
height/weight limit.
B. We will use syrup of ipecac immediately if we suspect our child has swallowed a
poisonous substance.
C. We will ensure the water heater is set to no higher than 120 degrees Fahrenheit.
D. We will keep all household cleaning supplies in a locked cabinet high above the floor.
Answer: B
Conceptual Explanation: Syrup of ipecac is no longer recommended for home use in
poisoning cases as it can cause more harm depending on the substance; parents should call
Poison Control first.
, 4. When assessing a child for suspected epiglottitis, which action is contraindicated?
A. Obtaining a lateral neck X-ray.
B. Placing the child in a tripod position.
C. Preparing for emergency intubation.
D. Inspecting the throat with a tongue depressor.
Answer: D
Conceptual Explanation: Using a tongue depressor can trigger a laryngospasm, causing
complete airway obstruction in a child with epiglottitis.
5. A child is diagnosed with Tetralogy of Fallot. The nurse observes the child squatting during
a play session. How should the nurse interpret this action?
A. The child is exhibiting signs of social anxiety.
B. The child is experiencing abdominal pain related to the cardiac defect.
C. The child is tired and needs a rest period.
D. Squatting increases systemic vascular resistance to improve oxygenation.
Answer: D
Conceptual Explanation: Squatting (or knee-chest position) is a compensatory
mechanism used by children with Tetralogy of Fallot to increase systemic resistance, which
decreases the right-to-left shunt and improves pulmonary blood flow.
