WGU D236 – Pediatric Nursing Exam
Questions With Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf.
1. A nurse is assessing a 6-month-old infant during a routine well-child
visit. Which finding requires the nurse to follow up with the healthcare
provider?
A. Rolls from abdomen to back
B. Reaches for objects
C. Sits independently without support
D. Laughs and squeals
Answer: C. Sits independently without support
Rationale: At approximately 6 months, infants typically begin sitting
with support and may briefly sit independently, but consistent
independent sitting is generally expected closer to 7–9 months. The
other findings are appropriate developmental behaviors for a 6-month-
old. Developmental assessment should consider the child's overall
pattern of milestones rather than relying on a single isolated finding.
2. A nurse is caring for a toddler hospitalized with gastroenteritis. Which
assessment finding is most concerning for dehydration?
A. Moist mucous membranes
B. Capillary refill of 4 seconds
,C. Heart rate of 100 beats/minute
D. Urine output of 2 mL/kg/hr
Answer: B. Capillary refill of 4 seconds
Rationale: Prolonged capillary refill indicates decreased peripheral
perfusion and can be a sign of significant dehydration in a child. Other
concerning findings may include tachycardia, dry mucous membranes,
decreased urine output, sunken eyes, lethargy, and poor skin turgor.
Urine output of approximately 1–2 mL/kg/hr is generally considered
adequate in infants and young children.
3. A 4-year-old child is admitted with suspected bacterial meningitis.
Which nursing intervention is the priority?
A. Encourage oral fluids
B. Place the child on appropriate isolation precautions
C. Provide age-appropriate toys
D. Encourage ambulation
Answer: B. Place the child on appropriate isolation precautions
Rationale: Suspected bacterial meningitis requires prompt
implementation of appropriate transmission-based precautions,
including droplet precautions for organisms such as Neisseria
meningitidis and Haemophilus influenzae until the child has received
adequate antimicrobial therapy as directed by facility policy. Protecting
healthcare workers, visitors, and other patients is an immediate priority
while treatment is initiated.
,4. A nurse is teaching the parents of a child with asthma about the use
of a metered-dose inhaler with a spacer. Which statement by the parent
indicates correct understanding?
A. "My child should breathe rapidly through the mouthpiece."
B. "My child should inhale slowly after the medication is released."
C. "The spacer is unnecessary if my child uses the inhaler correctly."
D. "My child should exhale into the spacer before inhaling the
medication."
Answer: B. "My child should inhale slowly after the medication is
released."
Rationale: A spacer improves medication delivery from a metered-dose
inhaler to the lower airways. The child should place the mouthpiece
appropriately, release one dose, and inhale slowly and deeply, followed
by a breath hold when developmentally appropriate. Rapid inhalation
can reduce effective deposition of medication in the lungs.
5. A child with suspected epiglottitis is brought to the emergency
department. Which action should the nurse avoid?
A. Keeping the child calm
B. Administering oxygen as tolerated
C. Inspecting the throat with a tongue blade
D. Preparing for emergency airway management
Answer: C. Inspecting the throat with a tongue blade
Rationale: Epiglottitis is a potentially life-threatening emergency
because manipulation of the inflamed epiglottis can precipitate sudden
, airway obstruction. The nurse should keep the child calm, avoid
unnecessary throat examination, provide oxygen as tolerated, and
prepare for controlled airway management by appropriately trained
personnel. Classic findings may include drooling, dysphagia, muffled
voice, fever, and tripod positioning.
6. A nurse is assessing a child with heart failure caused by a congenital
heart defect. Which finding would the nurse expect?
A. Bradycardia and hypertension
B. Poor weight gain and tachypnea
C. Increased activity tolerance
D. Decreased respiratory effort
Answer: B. Poor weight gain and tachypnea
Rationale: Pediatric heart failure commonly manifests as tachypnea,
increased work of breathing, feeding difficulties, diaphoresis with
feeding, fatigue, hepatomegaly, and poor weight gain. Infants may
expend significant energy while feeding, making adequate caloric intake
difficult. Early recognition is important because pediatric heart failure
can progress rapidly.
7. A nurse is caring for an infant with bronchiolitis caused by respiratory
syncytial virus (RSV). Which intervention is most appropriate?
A. Encourage frequent small feedings if tolerated
B. Administer routine antibiotics
Questions With Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf.
1. A nurse is assessing a 6-month-old infant during a routine well-child
visit. Which finding requires the nurse to follow up with the healthcare
provider?
A. Rolls from abdomen to back
B. Reaches for objects
C. Sits independently without support
D. Laughs and squeals
Answer: C. Sits independently without support
Rationale: At approximately 6 months, infants typically begin sitting
with support and may briefly sit independently, but consistent
independent sitting is generally expected closer to 7–9 months. The
other findings are appropriate developmental behaviors for a 6-month-
old. Developmental assessment should consider the child's overall
pattern of milestones rather than relying on a single isolated finding.
2. A nurse is caring for a toddler hospitalized with gastroenteritis. Which
assessment finding is most concerning for dehydration?
A. Moist mucous membranes
B. Capillary refill of 4 seconds
,C. Heart rate of 100 beats/minute
D. Urine output of 2 mL/kg/hr
Answer: B. Capillary refill of 4 seconds
Rationale: Prolonged capillary refill indicates decreased peripheral
perfusion and can be a sign of significant dehydration in a child. Other
concerning findings may include tachycardia, dry mucous membranes,
decreased urine output, sunken eyes, lethargy, and poor skin turgor.
Urine output of approximately 1–2 mL/kg/hr is generally considered
adequate in infants and young children.
3. A 4-year-old child is admitted with suspected bacterial meningitis.
Which nursing intervention is the priority?
A. Encourage oral fluids
B. Place the child on appropriate isolation precautions
C. Provide age-appropriate toys
D. Encourage ambulation
Answer: B. Place the child on appropriate isolation precautions
Rationale: Suspected bacterial meningitis requires prompt
implementation of appropriate transmission-based precautions,
including droplet precautions for organisms such as Neisseria
meningitidis and Haemophilus influenzae until the child has received
adequate antimicrobial therapy as directed by facility policy. Protecting
healthcare workers, visitors, and other patients is an immediate priority
while treatment is initiated.
,4. A nurse is teaching the parents of a child with asthma about the use
of a metered-dose inhaler with a spacer. Which statement by the parent
indicates correct understanding?
A. "My child should breathe rapidly through the mouthpiece."
B. "My child should inhale slowly after the medication is released."
C. "The spacer is unnecessary if my child uses the inhaler correctly."
D. "My child should exhale into the spacer before inhaling the
medication."
Answer: B. "My child should inhale slowly after the medication is
released."
Rationale: A spacer improves medication delivery from a metered-dose
inhaler to the lower airways. The child should place the mouthpiece
appropriately, release one dose, and inhale slowly and deeply, followed
by a breath hold when developmentally appropriate. Rapid inhalation
can reduce effective deposition of medication in the lungs.
5. A child with suspected epiglottitis is brought to the emergency
department. Which action should the nurse avoid?
A. Keeping the child calm
B. Administering oxygen as tolerated
C. Inspecting the throat with a tongue blade
D. Preparing for emergency airway management
Answer: C. Inspecting the throat with a tongue blade
Rationale: Epiglottitis is a potentially life-threatening emergency
because manipulation of the inflamed epiglottis can precipitate sudden
, airway obstruction. The nurse should keep the child calm, avoid
unnecessary throat examination, provide oxygen as tolerated, and
prepare for controlled airway management by appropriately trained
personnel. Classic findings may include drooling, dysphagia, muffled
voice, fever, and tripod positioning.
6. A nurse is assessing a child with heart failure caused by a congenital
heart defect. Which finding would the nurse expect?
A. Bradycardia and hypertension
B. Poor weight gain and tachypnea
C. Increased activity tolerance
D. Decreased respiratory effort
Answer: B. Poor weight gain and tachypnea
Rationale: Pediatric heart failure commonly manifests as tachypnea,
increased work of breathing, feeding difficulties, diaphoresis with
feeding, fatigue, hepatomegaly, and poor weight gain. Infants may
expend significant energy while feeding, making adequate caloric intake
difficult. Early recognition is important because pediatric heart failure
can progress rapidly.
7. A nurse is caring for an infant with bronchiolitis caused by respiratory
syncytial virus (RSV). Which intervention is most appropriate?
A. Encourage frequent small feedings if tolerated
B. Administer routine antibiotics
