PEDIATRIC NURSING FINAL EXAM 2026/2027 – EXAM
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALE | 2027 Q&A | INSTANT
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1. A pediatric nurse is assessing a healthy newborn immediately after birth. Which
finding is most consistent with normal newborn adaptation?
A. Persistent central cyanosis
B. Heart rate of 80 beats/min
C. Respiratory rate of 40 breaths/min
D. Absence of spontaneous movement
Rationale: A respiratory rate of approximately 30–60 breaths/min is expected in a healthy
newborn. Persistent central cyanosis, marked bradycardia, or absent spontaneous movement
requires prompt evaluation.
2. When assessing a toddler, which approach is most likely to promote cooperation
during the physical examination?
A. Ask the parent to leave the room
B. Allow the child to handle safe examination equipment
C. Complete the examination without speaking to the child
D. Begin immediately with the most invasive procedure
Rationale: Toddlers are more likely to cooperate when they can explore unfamiliar equipment
and participate in care. A calm, play-oriented approach reduces anxiety and supports a trusting
relationship.
3. A nurse is calculating a medication dose for a child based on body weight. Which
information is most important to obtain before calculating the dose?
A. The child's birth order
B. The child's favorite food
C. The child's school grade
D. The child's current weight in kilograms
Rationale: Pediatric medication doses are frequently weight-based, so an accurate current
weight in kilograms is essential. Using pounds without conversion can result in a significant
dosing error.
4. A 6-month-old infant is brought to the clinic for routine assessment. Which
developmental finding would the nurse expect?
,A. Walking independently
B. Using two-word phrases
C. Rolling from the abdomen to the back
D. Drawing a recognizable person
Rationale: Rolling and increasing control of the trunk are expected during infancy. Independent
walking and two-word phrases occur later in development.
5. A nurse is teaching parents about safe sleep practices for a healthy infant. Which
statement by the parents indicates correct understanding?
A. “We will place the baby on the stomach after feeding.”
B. “We will use a soft pillow to support the baby's head.”
C. “We will place stuffed animals around the baby for comfort.”
D. “We will place the baby on the back on a firm, flat sleep surface.”
Rationale: Placing infants supine on a firm, flat sleep surface without loose bedding or soft
objects reduces the risk of sleep-related infant death.
6. During a pediatric assessment, which finding should cause the nurse to
investigate the child's hydration status further?
A. Moist oral mucosa
B. Normal tears when crying
C. Decreased urine output
D. Warm extremities with normal capillary refill
Rationale: Decreased urine output can indicate inadequate fluid intake, increased fluid loss, or
impaired renal perfusion. Other findings listed are generally consistent with adequate hydration.
7. A child with acute gastroenteritis has had several episodes of vomiting and
diarrhea. Which assessment finding is most concerning for significant
dehydration?
A. Slight thirst
B. Mildly dry lips
C. Increased appetite
D. Delayed capillary refill with lethargy
Rationale: Lethargy and delayed capillary refill can indicate impaired circulation associated
with significant fluid loss. These findings require prompt assessment and intervention.
8. A nurse is caring for a child with fever. Which nursing intervention is appropriate?
A. Apply multiple heavy blankets
B. Restrict all oral fluids
, C. Encourage appropriate fluid intake
D. Use ice water immersion routinely
Rationale: Fever increases insensible fluid losses, making hydration important. Excessive
bundling can impair heat loss, while ice water immersion may cause shivering and discomfort.
9. A 2-year-old child is hospitalized and begins crying when the parent leaves.
Which behavior is most consistent with normal separation anxiety?
A. Permanent loss of previously acquired skills
B. Crying and searching for the absent parent
C. Complete indifference to the parent's departure
D. Consistent acceptance of unfamiliar caregivers
Rationale: Separation anxiety commonly occurs in young children and may involve crying,
searching, protesting, and difficulty being comforted after a parent leaves.
10. Which intervention is most appropriate when preparing a preschool-aged child for
a simple procedure?
A. Provide no explanation until the procedure begins
B. Give a lengthy technical explanation using medical terminology
C. Ask the child to make all decisions independently
D. Use simple language and demonstrate the procedure with play materials
Rationale: Preschool children benefit from concrete explanations, demonstrations, and
therapeutic play. These strategies make unfamiliar procedures easier to understand and reduce
fear.
11. A nurse is assessing pain in a 3-year-old child who cannot reliably describe the
intensity using numbers. Which approach is appropriate?
A. Assume the child has no pain if the child is quiet
B. Use an adult numeric scale only
C. Use an age-appropriate behavioral or faces pain scale
D. Ask the parent to assign the pain score without assessing the child
Rationale: Young children may not have the cognitive ability to use numeric pain scales reliably.
Behavioral and faces-based tools are designed to improve pain assessment in this age group.
12. A hospitalized school-aged child asks why a procedure is necessary. Which
response by the nurse is most appropriate?
A. “You are too young to understand.”
B. “Your parents know everything you need to know.”
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALE | 2027 Q&A | INSTANT
DOWNLOAD PDF
1. A pediatric nurse is assessing a healthy newborn immediately after birth. Which
finding is most consistent with normal newborn adaptation?
A. Persistent central cyanosis
B. Heart rate of 80 beats/min
C. Respiratory rate of 40 breaths/min
D. Absence of spontaneous movement
Rationale: A respiratory rate of approximately 30–60 breaths/min is expected in a healthy
newborn. Persistent central cyanosis, marked bradycardia, or absent spontaneous movement
requires prompt evaluation.
2. When assessing a toddler, which approach is most likely to promote cooperation
during the physical examination?
A. Ask the parent to leave the room
B. Allow the child to handle safe examination equipment
C. Complete the examination without speaking to the child
D. Begin immediately with the most invasive procedure
Rationale: Toddlers are more likely to cooperate when they can explore unfamiliar equipment
and participate in care. A calm, play-oriented approach reduces anxiety and supports a trusting
relationship.
3. A nurse is calculating a medication dose for a child based on body weight. Which
information is most important to obtain before calculating the dose?
A. The child's birth order
B. The child's favorite food
C. The child's school grade
D. The child's current weight in kilograms
Rationale: Pediatric medication doses are frequently weight-based, so an accurate current
weight in kilograms is essential. Using pounds without conversion can result in a significant
dosing error.
4. A 6-month-old infant is brought to the clinic for routine assessment. Which
developmental finding would the nurse expect?
,A. Walking independently
B. Using two-word phrases
C. Rolling from the abdomen to the back
D. Drawing a recognizable person
Rationale: Rolling and increasing control of the trunk are expected during infancy. Independent
walking and two-word phrases occur later in development.
5. A nurse is teaching parents about safe sleep practices for a healthy infant. Which
statement by the parents indicates correct understanding?
A. “We will place the baby on the stomach after feeding.”
B. “We will use a soft pillow to support the baby's head.”
C. “We will place stuffed animals around the baby for comfort.”
D. “We will place the baby on the back on a firm, flat sleep surface.”
Rationale: Placing infants supine on a firm, flat sleep surface without loose bedding or soft
objects reduces the risk of sleep-related infant death.
6. During a pediatric assessment, which finding should cause the nurse to
investigate the child's hydration status further?
A. Moist oral mucosa
B. Normal tears when crying
C. Decreased urine output
D. Warm extremities with normal capillary refill
Rationale: Decreased urine output can indicate inadequate fluid intake, increased fluid loss, or
impaired renal perfusion. Other findings listed are generally consistent with adequate hydration.
7. A child with acute gastroenteritis has had several episodes of vomiting and
diarrhea. Which assessment finding is most concerning for significant
dehydration?
A. Slight thirst
B. Mildly dry lips
C. Increased appetite
D. Delayed capillary refill with lethargy
Rationale: Lethargy and delayed capillary refill can indicate impaired circulation associated
with significant fluid loss. These findings require prompt assessment and intervention.
8. A nurse is caring for a child with fever. Which nursing intervention is appropriate?
A. Apply multiple heavy blankets
B. Restrict all oral fluids
, C. Encourage appropriate fluid intake
D. Use ice water immersion routinely
Rationale: Fever increases insensible fluid losses, making hydration important. Excessive
bundling can impair heat loss, while ice water immersion may cause shivering and discomfort.
9. A 2-year-old child is hospitalized and begins crying when the parent leaves.
Which behavior is most consistent with normal separation anxiety?
A. Permanent loss of previously acquired skills
B. Crying and searching for the absent parent
C. Complete indifference to the parent's departure
D. Consistent acceptance of unfamiliar caregivers
Rationale: Separation anxiety commonly occurs in young children and may involve crying,
searching, protesting, and difficulty being comforted after a parent leaves.
10. Which intervention is most appropriate when preparing a preschool-aged child for
a simple procedure?
A. Provide no explanation until the procedure begins
B. Give a lengthy technical explanation using medical terminology
C. Ask the child to make all decisions independently
D. Use simple language and demonstrate the procedure with play materials
Rationale: Preschool children benefit from concrete explanations, demonstrations, and
therapeutic play. These strategies make unfamiliar procedures easier to understand and reduce
fear.
11. A nurse is assessing pain in a 3-year-old child who cannot reliably describe the
intensity using numbers. Which approach is appropriate?
A. Assume the child has no pain if the child is quiet
B. Use an adult numeric scale only
C. Use an age-appropriate behavioral or faces pain scale
D. Ask the parent to assign the pain score without assessing the child
Rationale: Young children may not have the cognitive ability to use numeric pain scales reliably.
Behavioral and faces-based tools are designed to improve pain assessment in this age group.
12. A hospitalized school-aged child asks why a procedure is necessary. Which
response by the nurse is most appropriate?
A. “You are too young to understand.”
B. “Your parents know everything you need to know.”
