PN Nursing Care of Children (Pediatric Nursing) __NGN-Style
Proctored Exam Questions with Verified Answers
Introduction
This document contains pediatric nursing practice and proctored-
exam preparation questions covering respiratory emergencies,
dehydration, diabetes, sickle cell disease, neurological conditions,
cardiac disorders, renal disorders, oncology, medication safety,
infection control, and other pediatric nursing priorities. It includes
160 multiple-choice questions with answers and rationales, followed
by NGN-style clinical judgment cases addressing asthma, acute chest
syndrome, severe dehydration, febrile neutropenia, and VP shunt
complications.
Instructions
Select the single best answer unless an item states otherwise.
Apply pediatric prioritization, safety, developmental,
pharmacologic, and clinical-judgment principles.
Answers and rationales are provided immediately after each
question.
,1. A 4-year-old with suspected bacterial meningitis has fever,
headache, and increasing irritability. What is the priority nursing
action?
A. Initiate appropriate precautions and perform frequent neurologic
assessments.
B. Encourage vigorous activity.
C. Place the child in bright light.
D. Offer a large meal.
Correct answer: A
Rationale: Meningitis can deteriorate rapidly. Infection-control
measures and frequent neurologic assessment help identify seizures,
increased intracranial pressure, and other complications early.
2. A 6-month-old with bronchiolitis has nasal congestion and difficulty
feeding. What should the nurse do first?
A. Gently suction the nares before feeding.
B. Offer a large bottle quickly.
C. Place the infant flat.
D. Restrict all fluids.
Correct answer: A
Rationale: Infants are primarily nasal breathers. Gentle suctioning can
improve airway patency and make breathing and feeding safer.
,3. An alert child with type 1 diabetes has a glucose of 48 mg/dL and is
shaky and diaphoretic. What is the priority?
A. Give a rapid-acting carbohydrate.
B. Administer long-acting insulin.
C. Restrict fluids.
D. Encourage exercise.
Correct answer: A
Rationale: These findings indicate hypoglycemia. An alert child who
can swallow should receive a rapid source of glucose and then be
reassessed.
4. A child with vomiting and diarrhea has lethargy and capillary refill
of 4 seconds. What is the priority?
A. Urgently assess and treat dehydration and poor perfusion.
B. Offer only solid food.
C. Delay fluids for several hours.
D. Encourage strenuous activity.
Correct answer: A
Rationale: Lethargy and delayed capillary refill indicate significant
dehydration and impaired perfusion requiring prompt treatment.
, 5. A child with asthma receives a prescribed short-acting
bronchodilator. Which finding shows improvement?
A. Improved air movement with decreased work of breathing.
B. Increasing cyanosis.
C. Increasing retractions.
D. Decreasing level of consciousness.
Correct answer: A
Rationale: Improved air movement and reduced respiratory effort
indicate decreased bronchospasm. The other findings indicate
deterioration.
6. A child with nephrotic syndrome has generalized edema. Which
assessment best evaluates fluid changes?
A. Daily weight.
B. Hair texture.
C. Visual acuity.
D. Hearing acuity.
Correct answer: A
Rationale: Daily weight is a sensitive indicator of changes in total
body fluid and is useful for monitoring edema and treatment response.
Proctored Exam Questions with Verified Answers
Introduction
This document contains pediatric nursing practice and proctored-
exam preparation questions covering respiratory emergencies,
dehydration, diabetes, sickle cell disease, neurological conditions,
cardiac disorders, renal disorders, oncology, medication safety,
infection control, and other pediatric nursing priorities. It includes
160 multiple-choice questions with answers and rationales, followed
by NGN-style clinical judgment cases addressing asthma, acute chest
syndrome, severe dehydration, febrile neutropenia, and VP shunt
complications.
Instructions
Select the single best answer unless an item states otherwise.
Apply pediatric prioritization, safety, developmental,
pharmacologic, and clinical-judgment principles.
Answers and rationales are provided immediately after each
question.
,1. A 4-year-old with suspected bacterial meningitis has fever,
headache, and increasing irritability. What is the priority nursing
action?
A. Initiate appropriate precautions and perform frequent neurologic
assessments.
B. Encourage vigorous activity.
C. Place the child in bright light.
D. Offer a large meal.
Correct answer: A
Rationale: Meningitis can deteriorate rapidly. Infection-control
measures and frequent neurologic assessment help identify seizures,
increased intracranial pressure, and other complications early.
2. A 6-month-old with bronchiolitis has nasal congestion and difficulty
feeding. What should the nurse do first?
A. Gently suction the nares before feeding.
B. Offer a large bottle quickly.
C. Place the infant flat.
D. Restrict all fluids.
Correct answer: A
Rationale: Infants are primarily nasal breathers. Gentle suctioning can
improve airway patency and make breathing and feeding safer.
,3. An alert child with type 1 diabetes has a glucose of 48 mg/dL and is
shaky and diaphoretic. What is the priority?
A. Give a rapid-acting carbohydrate.
B. Administer long-acting insulin.
C. Restrict fluids.
D. Encourage exercise.
Correct answer: A
Rationale: These findings indicate hypoglycemia. An alert child who
can swallow should receive a rapid source of glucose and then be
reassessed.
4. A child with vomiting and diarrhea has lethargy and capillary refill
of 4 seconds. What is the priority?
A. Urgently assess and treat dehydration and poor perfusion.
B. Offer only solid food.
C. Delay fluids for several hours.
D. Encourage strenuous activity.
Correct answer: A
Rationale: Lethargy and delayed capillary refill indicate significant
dehydration and impaired perfusion requiring prompt treatment.
, 5. A child with asthma receives a prescribed short-acting
bronchodilator. Which finding shows improvement?
A. Improved air movement with decreased work of breathing.
B. Increasing cyanosis.
C. Increasing retractions.
D. Decreasing level of consciousness.
Correct answer: A
Rationale: Improved air movement and reduced respiratory effort
indicate decreased bronchospasm. The other findings indicate
deterioration.
6. A child with nephrotic syndrome has generalized edema. Which
assessment best evaluates fluid changes?
A. Daily weight.
B. Hair texture.
C. Visual acuity.
D. Hearing acuity.
Correct answer: A
Rationale: Daily weight is a sensitive indicator of changes in total
body fluid and is useful for monitoring edema and treatment response.
