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LPN/LVN Pediatric Nursing Competency
Exam — Code: LPN-PEDS-COMP | 100-
Question Advanced Practice Exam 2026
| Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1. A 4-year-old child with suspected bacterial meningitis is admitted with
fever, nuchal rigidity, photophobia, and vomiting. Which nursing action is
the priority?
A. Encourage oral fluids
B. Place the child in a darkened room
C. Initiate appropriate isolation precautions
D. Obtain a detailed dietary history
Answer: Initiate appropriate isolation precautions
Rationale: Suspected bacterial meningitis requires prompt implementation of
appropriate transmission-based precautions, particularly droplet precautions
,initially, to reduce exposure to respiratory secretions while definitive treatment
is initiated.
2. A 6-month-old infant with bronchiolitis has nasal flaring, intercostal
retractions, and an oxygen saturation of 88%. Which intervention should
the LPN/LVN perform first?
A. Offer oral fluids
B. Suction the airway as indicated
C. Place the infant supine
D. Administer a cough suppressant
Answer: Suction the airway as indicated
Rationale: Infants are primarily nasal breathers, and excessive secretions can
significantly increase respiratory effort. Airway clearance is an immediate
priority when respiratory distress is present.
3. A child with nephrotic syndrome is receiving corticosteroid therapy. Which
assessment finding requires the most immediate attention?
A. Increased appetite
B. Mild facial rounding
C. Temperature of 38.5°C (101.3°F)
D. Increased urine output
Answer: Temperature of 38.5°C (101.3°F)
Rationale: Children with nephrotic syndrome are particularly vulnerable to
infection because of urinary protein losses and altered immune defenses. Fever
may indicate a serious infection requiring prompt evaluation.
4. A 7-year-old child with type 1 diabetes mellitus becomes pale, diaphoretic,
and confused before lunch. Which action is most appropriate if the child is
awake and able to swallow?
A. Administer rapid-acting insulin
B. Give a fast-acting carbohydrate
,C. Encourage exercise
D. Restrict oral intake
Answer: Give a fast-acting carbohydrate
Rationale: Pallor, diaphoresis, and confusion are classic manifestations of
hypoglycemia. A conscious child who can safely swallow should receive a rapidly
absorbed carbohydrate.
5. A child with tetralogy of Fallot suddenly becomes severely cyanotic and
dyspneic while crying. Which position should the nurse use?
A. Supine with legs extended
B. Trendelenburg
C. Knee-chest position
D. Prone with the head elevated
Answer: Knee-chest position
Rationale: The knee-chest position increases systemic vascular resistance and
reduces right-to-left shunting during a hypercyanotic spell, improving
pulmonary blood flow.
6. A 3-year-old with gastroenteritis has lethargy, dry mucous membranes, and
markedly decreased urine output. Which finding best indicates severe
dehydration?
A. Capillary refill of less than 2 seconds
B. Bounding peripheral pulses
C. Delayed capillary refill and weak pulses
D. Increased urine output
Answer: Delayed capillary refill and weak pulses
Rationale: Delayed capillary refill and weak peripheral pulses indicate decreased
circulating volume and impaired tissue perfusion, consistent with significant
dehydration.
, 7. A child with epiglottitis is drooling, sitting upright, and leaning forward.
Which action should the nurse avoid?
A. Providing humidified oxygen as prescribed
B. Keeping the child calm
C. Inspecting the throat with a tongue blade
D. Preparing for emergency airway management
Answer: Inspecting the throat with a tongue blade
Rationale: Manipulation of the airway in suspected epiglottitis can precipitate
complete airway obstruction. The child should remain calm while emergency
airway support is prepared.
8. A 2-year-old child has a barking cough, inspiratory stridor, and retractions.
Which finding indicates worsening airway obstruction?
A. Hoarse voice
B. Mild rhinorrhea
C. Stridor at rest with increasing fatigue
D. Occasional cough
Answer: Stridor at rest with increasing fatigue
Rationale: Stridor occurring at rest and increasing fatigue indicate significant
upper-airway obstruction and possible impending respiratory failure.
9. A child with Kawasaki disease is receiving intravenous immunoglobulin.
Which assessment is most important during and after treatment?
A. Monitoring for coronary complications
B. Measuring abdominal girth every hour
C. Assessing for hypoglycemia
D. Restricting all fluids
Answer: Monitoring for coronary complications
LPN/LVN Pediatric Nursing Competency
Exam — Code: LPN-PEDS-COMP | 100-
Question Advanced Practice Exam 2026
| Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1. A 4-year-old child with suspected bacterial meningitis is admitted with
fever, nuchal rigidity, photophobia, and vomiting. Which nursing action is
the priority?
A. Encourage oral fluids
B. Place the child in a darkened room
C. Initiate appropriate isolation precautions
D. Obtain a detailed dietary history
Answer: Initiate appropriate isolation precautions
Rationale: Suspected bacterial meningitis requires prompt implementation of
appropriate transmission-based precautions, particularly droplet precautions
,initially, to reduce exposure to respiratory secretions while definitive treatment
is initiated.
2. A 6-month-old infant with bronchiolitis has nasal flaring, intercostal
retractions, and an oxygen saturation of 88%. Which intervention should
the LPN/LVN perform first?
A. Offer oral fluids
B. Suction the airway as indicated
C. Place the infant supine
D. Administer a cough suppressant
Answer: Suction the airway as indicated
Rationale: Infants are primarily nasal breathers, and excessive secretions can
significantly increase respiratory effort. Airway clearance is an immediate
priority when respiratory distress is present.
3. A child with nephrotic syndrome is receiving corticosteroid therapy. Which
assessment finding requires the most immediate attention?
A. Increased appetite
B. Mild facial rounding
C. Temperature of 38.5°C (101.3°F)
D. Increased urine output
Answer: Temperature of 38.5°C (101.3°F)
Rationale: Children with nephrotic syndrome are particularly vulnerable to
infection because of urinary protein losses and altered immune defenses. Fever
may indicate a serious infection requiring prompt evaluation.
4. A 7-year-old child with type 1 diabetes mellitus becomes pale, diaphoretic,
and confused before lunch. Which action is most appropriate if the child is
awake and able to swallow?
A. Administer rapid-acting insulin
B. Give a fast-acting carbohydrate
,C. Encourage exercise
D. Restrict oral intake
Answer: Give a fast-acting carbohydrate
Rationale: Pallor, diaphoresis, and confusion are classic manifestations of
hypoglycemia. A conscious child who can safely swallow should receive a rapidly
absorbed carbohydrate.
5. A child with tetralogy of Fallot suddenly becomes severely cyanotic and
dyspneic while crying. Which position should the nurse use?
A. Supine with legs extended
B. Trendelenburg
C. Knee-chest position
D. Prone with the head elevated
Answer: Knee-chest position
Rationale: The knee-chest position increases systemic vascular resistance and
reduces right-to-left shunting during a hypercyanotic spell, improving
pulmonary blood flow.
6. A 3-year-old with gastroenteritis has lethargy, dry mucous membranes, and
markedly decreased urine output. Which finding best indicates severe
dehydration?
A. Capillary refill of less than 2 seconds
B. Bounding peripheral pulses
C. Delayed capillary refill and weak pulses
D. Increased urine output
Answer: Delayed capillary refill and weak pulses
Rationale: Delayed capillary refill and weak peripheral pulses indicate decreased
circulating volume and impaired tissue perfusion, consistent with significant
dehydration.
, 7. A child with epiglottitis is drooling, sitting upright, and leaning forward.
Which action should the nurse avoid?
A. Providing humidified oxygen as prescribed
B. Keeping the child calm
C. Inspecting the throat with a tongue blade
D. Preparing for emergency airway management
Answer: Inspecting the throat with a tongue blade
Rationale: Manipulation of the airway in suspected epiglottitis can precipitate
complete airway obstruction. The child should remain calm while emergency
airway support is prepared.
8. A 2-year-old child has a barking cough, inspiratory stridor, and retractions.
Which finding indicates worsening airway obstruction?
A. Hoarse voice
B. Mild rhinorrhea
C. Stridor at rest with increasing fatigue
D. Occasional cough
Answer: Stridor at rest with increasing fatigue
Rationale: Stridor occurring at rest and increasing fatigue indicate significant
upper-airway obstruction and possible impending respiratory failure.
9. A child with Kawasaki disease is receiving intravenous immunoglobulin.
Which assessment is most important during and after treatment?
A. Monitoring for coronary complications
B. Measuring abdominal girth every hour
C. Assessing for hypoglycemia
D. Restricting all fluids
Answer: Monitoring for coronary complications
