Comprehensive NCLEX-RN® Pediatric
Nursing Mastery: Questions with
Evidence-Based Rationales for Child
Health Nursing
Growth and Development
1. A nurse is assessing a 3-year-old child. Which milestone should the
nurse expect?
A. Skips on one foot
B. Uses a spoon and fork
C. Can ride a bicycle
D. Ties shoelaces
Answer: B. Uses a spoon and fork
Rationale: By age 3, children typically can use a spoon and fork
independently. Skipping develops around age 4-5, riding a bicycle occurs at
school age, and tying shoelaces is a fine motor skill expected around age 5-
6.
2. A nurse is teaching parents about play activities for social
development in a preschooler. Which activity should the nurse
,recommend?
A. Playing pat-a-cake
B. Using a push-pull toy
C. Creating a scrapbook
D. Playing dress-up
Answer: D. Playing dress-up
Rationale: Preschoolers engage in imaginative play that develops social
skills, creativity, and understanding of social roles. Dress-up encourages
cooperation, language development, and social interaction .
3. A parent asks the nurse when their child with varicella will no longer
be contagious. Which response is correct?
A. "When the fever resolves"
B. "When the rash disappears completely"
C. "When lesions are crusted, usually 6 days after they appear"
D. "After 14 days from the onset of symptoms"
Answer: C. "When lesions are crusted, usually 6 days after they
appear"
Rationale: Children with varicella are contagious 1 day before lesion
eruption and until all vesicles have crusted over, which typically takes about
6 days .
Respiratory Disorders
,4. A child presents with epiglottitis. What is the nurse's priority action?
A. Obtain a throat culture
B. Prepare for intubation
C. Administer antibiotics
D. Assess for stridor
Answer: B. Prepare for intubation
Rationale: Epiglottitis can cause sudden, complete airway obstruction.
Maintaining airway patency is the highest priority. Throat examination and
cultures should be deferred as they may precipitate laryngospasm .
5. A nurse is caring for a child with croup. Which statement by the
parent indicates a need for further teaching?
A. "I should give acetaminophen if my child develops a fever"
B. "I should keep my child well hydrated"
C. "I should give cough syrup to help with the cough"
D. "I can take my child to a cool basement during an attack"
Answer: C. "I should give cough syrup to help with the cough"
Rationale: Cough syrups and cold medicines should not be given to
children with croup as they may dry and thicken secretions, worsening
airway obstruction. Cool mist, hydration, and antipyretics are appropriate
interventions .
6. A nurse is caring for an infant with RSV. Which isolation precaution
is most important?
, A. Airborne precautions
B. Droplet precautions
C. Contact precautions with meticulous hand washing
D. Enteric precautions
Answer: C. Contact precautions with meticulous hand washing
Rationale: RSV is highly communicable and transmitted primarily via
contaminated hands. Meticulous hand washing is essential to prevent
spread. The infant should be isolated in a single room or with another RSV-
positive child .
7. A school-age child with cystic fibrosis is admitted. Which dietary
recommendation should the nurse include?
A. Low-fat, low-calorie diet
B. High-calorie, high-protein diet with fat-soluble vitamin supplements
C. Strict fat restriction only
D. Low-protein, high-carbohydrate diet
Answer: B. High-calorie, high-protein diet with fat-soluble vitamin
supplements
Rationale: Children with CF need increased calories and protein to meet
energy requirements. Pancreatic enzyme replacement and fat-soluble
vitamin supplements (A, D, E, K) are essential. Fats are not restricted unless
steatorrhea cannot be controlled .
Nursing Mastery: Questions with
Evidence-Based Rationales for Child
Health Nursing
Growth and Development
1. A nurse is assessing a 3-year-old child. Which milestone should the
nurse expect?
A. Skips on one foot
B. Uses a spoon and fork
C. Can ride a bicycle
D. Ties shoelaces
Answer: B. Uses a spoon and fork
Rationale: By age 3, children typically can use a spoon and fork
independently. Skipping develops around age 4-5, riding a bicycle occurs at
school age, and tying shoelaces is a fine motor skill expected around age 5-
6.
2. A nurse is teaching parents about play activities for social
development in a preschooler. Which activity should the nurse
,recommend?
A. Playing pat-a-cake
B. Using a push-pull toy
C. Creating a scrapbook
D. Playing dress-up
Answer: D. Playing dress-up
Rationale: Preschoolers engage in imaginative play that develops social
skills, creativity, and understanding of social roles. Dress-up encourages
cooperation, language development, and social interaction .
3. A parent asks the nurse when their child with varicella will no longer
be contagious. Which response is correct?
A. "When the fever resolves"
B. "When the rash disappears completely"
C. "When lesions are crusted, usually 6 days after they appear"
D. "After 14 days from the onset of symptoms"
Answer: C. "When lesions are crusted, usually 6 days after they
appear"
Rationale: Children with varicella are contagious 1 day before lesion
eruption and until all vesicles have crusted over, which typically takes about
6 days .
Respiratory Disorders
,4. A child presents with epiglottitis. What is the nurse's priority action?
A. Obtain a throat culture
B. Prepare for intubation
C. Administer antibiotics
D. Assess for stridor
Answer: B. Prepare for intubation
Rationale: Epiglottitis can cause sudden, complete airway obstruction.
Maintaining airway patency is the highest priority. Throat examination and
cultures should be deferred as they may precipitate laryngospasm .
5. A nurse is caring for a child with croup. Which statement by the
parent indicates a need for further teaching?
A. "I should give acetaminophen if my child develops a fever"
B. "I should keep my child well hydrated"
C. "I should give cough syrup to help with the cough"
D. "I can take my child to a cool basement during an attack"
Answer: C. "I should give cough syrup to help with the cough"
Rationale: Cough syrups and cold medicines should not be given to
children with croup as they may dry and thicken secretions, worsening
airway obstruction. Cool mist, hydration, and antipyretics are appropriate
interventions .
6. A nurse is caring for an infant with RSV. Which isolation precaution
is most important?
, A. Airborne precautions
B. Droplet precautions
C. Contact precautions with meticulous hand washing
D. Enteric precautions
Answer: C. Contact precautions with meticulous hand washing
Rationale: RSV is highly communicable and transmitted primarily via
contaminated hands. Meticulous hand washing is essential to prevent
spread. The infant should be isolated in a single room or with another RSV-
positive child .
7. A school-age child with cystic fibrosis is admitted. Which dietary
recommendation should the nurse include?
A. Low-fat, low-calorie diet
B. High-calorie, high-protein diet with fat-soluble vitamin supplements
C. Strict fat restriction only
D. Low-protein, high-carbohydrate diet
Answer: B. High-calorie, high-protein diet with fat-soluble vitamin
supplements
Rationale: Children with CF need increased calories and protein to meet
energy requirements. Pancreatic enzyme replacement and fat-soluble
vitamin supplements (A, D, E, K) are essential. Fats are not restricted unless
steatorrhea cannot be controlled .
