RN Pediatric Nursing 2026 Actual Proctored
Exam NGN Questions and for Level 3 Pass
**1.** A nurse is assessing a 6-month-old infant. Which finding should
the nurse recognize as an expected developmental milestone?
A. Walks independently
B. Uses a pincer grasp
C. Rolls from abdomen to back
D. Speaks in two-word phrases
**Answer: C. Rolls from abdomen to back**
**Rationale:** Rolling is an expected gross-motor milestone around 4–6
months. Independent walking and two-word phrases occur later. A
refined pincer grasp develops closer to 9–12 months.
---
**2.** A nurse is caring for a child with suspected epiglottitis. Which
action is the priority?
A. Obtain a throat culture
B. Keep the child calm and prepare for airway management
C. Inspect the throat with a tongue depressor
D. Encourage the child to drink fluids
,**Answer: B. Keep the child calm and prepare for airway management**
**Rationale:** Epiglottitis can cause rapid, life-threatening airway
obstruction. The child should be kept calm, and the airway team should
be prepared. Throat inspection can precipitate complete obstruction.
---
**3.** A 2-year-old child is admitted with dehydration from
gastroenteritis. Which finding requires the most immediate
intervention?
A. Dry lips
B. Capillary refill of 4 seconds
C. Heart rate of 128/min
D. One wet diaper in 8 hours
**Answer: D. One wet diaper in 8 hours**
**Rationale:** Markedly decreased urine output indicates significant
dehydration and decreased renal perfusion. It requires prompt
evaluation and fluid management.
---
**4.** A nurse is teaching parents about administering oral iron to their
child. Which instruction is appropriate?
A. Give the medication with milk
,B. Mix it with a full bottle of formula
C. Give it with a vitamin-C-containing beverage
D. Stop the medication when the child's appetite improves
**Answer: C. Give it with a vitamin-C-containing beverage**
**Rationale:** Vitamin C enhances iron absorption. Milk can decrease
absorption. Iron should generally be continued for the prescribed
duration even after symptoms improve.
---
**5.** A school-age child with asthma develops wheezing and shortness
of breath during physical activity. Which medication should the nurse
expect to administer for rapid relief?
A. Albuterol
B. Montelukast
C. Fluticasone
D. Budesonide
**Answer: A. Albuterol**
**Rationale:** Albuterol is a short-acting beta₂ agonist used as a rescue
medication for acute bronchospasm. Inhaled corticosteroids are
controller medications rather than immediate rescue therapy.
---
, **6.** A nurse is assessing a child with meningitis. Which finding should
the nurse report immediately?
A. Photophobia
B. Headache
C. Nuchal rigidity
D. Decreased level of consciousness
**Answer: D. Decreased level of consciousness**
**Rationale:** A declining level of consciousness can indicate increased
intracranial pressure or worsening neurologic status and requires
immediate intervention.
---
**7.** A nurse is caring for a child with nephrotic syndrome. Which
assessment finding is most characteristic?
A. Generalized edema
B. Severe hypertension
C. Hemoptysis
D. Increased urine output
**Answer: A. Generalized edema**
Exam NGN Questions and for Level 3 Pass
**1.** A nurse is assessing a 6-month-old infant. Which finding should
the nurse recognize as an expected developmental milestone?
A. Walks independently
B. Uses a pincer grasp
C. Rolls from abdomen to back
D. Speaks in two-word phrases
**Answer: C. Rolls from abdomen to back**
**Rationale:** Rolling is an expected gross-motor milestone around 4–6
months. Independent walking and two-word phrases occur later. A
refined pincer grasp develops closer to 9–12 months.
---
**2.** A nurse is caring for a child with suspected epiglottitis. Which
action is the priority?
A. Obtain a throat culture
B. Keep the child calm and prepare for airway management
C. Inspect the throat with a tongue depressor
D. Encourage the child to drink fluids
,**Answer: B. Keep the child calm and prepare for airway management**
**Rationale:** Epiglottitis can cause rapid, life-threatening airway
obstruction. The child should be kept calm, and the airway team should
be prepared. Throat inspection can precipitate complete obstruction.
---
**3.** A 2-year-old child is admitted with dehydration from
gastroenteritis. Which finding requires the most immediate
intervention?
A. Dry lips
B. Capillary refill of 4 seconds
C. Heart rate of 128/min
D. One wet diaper in 8 hours
**Answer: D. One wet diaper in 8 hours**
**Rationale:** Markedly decreased urine output indicates significant
dehydration and decreased renal perfusion. It requires prompt
evaluation and fluid management.
---
**4.** A nurse is teaching parents about administering oral iron to their
child. Which instruction is appropriate?
A. Give the medication with milk
,B. Mix it with a full bottle of formula
C. Give it with a vitamin-C-containing beverage
D. Stop the medication when the child's appetite improves
**Answer: C. Give it with a vitamin-C-containing beverage**
**Rationale:** Vitamin C enhances iron absorption. Milk can decrease
absorption. Iron should generally be continued for the prescribed
duration even after symptoms improve.
---
**5.** A school-age child with asthma develops wheezing and shortness
of breath during physical activity. Which medication should the nurse
expect to administer for rapid relief?
A. Albuterol
B. Montelukast
C. Fluticasone
D. Budesonide
**Answer: A. Albuterol**
**Rationale:** Albuterol is a short-acting beta₂ agonist used as a rescue
medication for acute bronchospasm. Inhaled corticosteroids are
controller medications rather than immediate rescue therapy.
---
, **6.** A nurse is assessing a child with meningitis. Which finding should
the nurse report immediately?
A. Photophobia
B. Headache
C. Nuchal rigidity
D. Decreased level of consciousness
**Answer: D. Decreased level of consciousness**
**Rationale:** A declining level of consciousness can indicate increased
intracranial pressure or worsening neurologic status and requires
immediate intervention.
---
**7.** A nurse is caring for a child with nephrotic syndrome. Which
assessment finding is most characteristic?
A. Generalized edema
B. Severe hypertension
C. Hemoptysis
D. Increased urine output
**Answer: A. Generalized edema**
