NR 328: Pediatric Nursing Comprehensive Study
Bank with Detailed Rationales
Course Code: NR 328
Course Name: Pediatric Nursing
Topic: Pediatric Triage, Developmental Milestones, Fluid Management, and
Congenital Pathologies
Academic Year: 2026/2027
1. A nurse in the emergency department is caring for a 2-year-old child who was
found by his parents crying and holding a container of toilet bowl cleaner. The
child's lips are edematous and inflamed, and he is drooling. Which of the following
is the priority action by the nurse?
A. Check the child's respiratory status.
B. Administer syrup of ipecac to induce vomiting.
C. Insert a nasogastric tube for gastric lavage.
D. Apply a soothing topical ointment to the inflamed lips.
CORRECT ANSWER: A
RATIONALE: Following the airway, breathing, and circulation (ABC)
framework, the nurse's absolute priority action is to assess the child's respiratory
status and airway patency. Ingestion of a corrosive chemical like toilet bowl
cleaner causes severe caustic burns to the oral mucosa, pharynx, and larynx.
Edema and inflammation can progress rapidly, causing complete upper airway
obstruction. Swallowing a corrosive substance is a strict contraindication for
inducing vomiting (syrup of ipecac) or performing gastric lavage, as re-exposing
the esophagus and oral cavity to the chemical can cause transmural perforation and
fatal mediastinitis.
2. A nurse is teaching a parent of a 12-month-old child about development during
the toddler years. Which of the following statements should the nurse include?
A. "Your child should be able to ride a tricycle by 18 months of age."
B. "Your child should be able to scribble spontaneously using a crayon at the
age of 15 months."
,C. "Your child should be able to build a tower of eight blocks by 15 months."
D. "Your child should be able to use safety scissors to cut shapes at 24 months."
CORRECT ANSWER: B
RATIONALE: Fine motor development milestones dictate that a toddler
should be able to scribble spontaneously using a crayon by 15 months of age.
Riding a tricycle is a gross motor milestone expected of a 3-year-old preschooler
(36 months). Building a tower of eight blocks requires advanced fine motor
coordination and is typically achieved by 24 to 30 months of age. Using safety
scissors to cut shapes is an advanced fine motor task expected closer to 4 years of
age.
3. A nurse is caring for a toddler and is preparing to administer 0.9% sodium
chloride 100 mL IV to infuse over 4 hours. The drop factor of the manual IV
tubing is 60 gtt/mL. The nurse should set the manual IV infusion to deliver how
many gtt/min?
A. 15 gtt/min
B. 25 gtt/min
C. 40 gtt/min
D. 60 gtt/min
CORRECT ANSWER: B
RATIONALE: To find the manual IV flow rate in drops per minute (gtt/min),
utilize the standard intravenous infusion formula:
Flow Rate (gtt/min)=Total Volume (mL)×Drop Factor (gtt/mL)Total Time
(minutes)Flow Rate (gtt/min) equals the fraction with numerator Total Volume
(mL) cross Drop Factor (gtt/mL) and denominator Total Time (minutes) end-
fraction
Flow Rate (gtt/min)=Total Volume (mL)×Drop Factor (gtt/mL)Total Time
(minutes)
Convert hours to minutes: 4 hours × 60 minutes/hour = 240 minutes.
, Flow Rate=100 mL×60 gtt/mL240 minutes=6000240=25 gtt/minFlow Rate equals
the fraction with numerator 100 mL cross 60 gtt/mL and denominator 240 minutes
end-fraction equals 6000 over 240 end-fraction equals 25 gtt/min
Flow Rate=100 mL×60 gtt/mL240 minutes=6000240=25 gtt/min
The manual IV infusion must be set to deliver exactly 25 gtt/min.
4. A nurse in a pediatric clinic is assessing a toddler at a well-child visit. Which of
the following actions should the nurse take?
A. Perform the most invasive assessments first.
B. Maintain direct, unblinking eye contact with the child.
C. Minimize physical contact with the child initially.
D. Address the child using complex medical terms.
CORRECT ANSWER: C
RATIONALE: To reduce situational anxiety and build rapport with a toddler,
the nurse should minimize direct physical contact at the beginning of the exam.
The nurse can engage with the guardian first, allowing the toddler to observe that
the environment is safe. Invasive or distressing assessments (such as examining the
ears, mouth, and throat) should always be delayed until the end of the examination.
Prolonged, direct eye contact can be perceived as threatening by a toddler and may
increase distress.
5. A nurse is caring for an 18-year-old adolescent who is up-to-date on
immunizations and is planning to attend college. The nurse should inform the
client that he should receive which of the following immunizations prior to moving
into a campus dormitory?
A. Rotavirus vaccine
B. Pneumococcal conjugate vaccine
C. Meningococcal polysaccharide vaccine
D. Inactivated poliovirus vaccine
CORRECT ANSWER: C
RATIONALE: The meningococcal vaccine is strongly recommended and
often required for older adolescents transitioning into high-density communal
living environments, such as college dormitories. This protects against Neisseria
Bank with Detailed Rationales
Course Code: NR 328
Course Name: Pediatric Nursing
Topic: Pediatric Triage, Developmental Milestones, Fluid Management, and
Congenital Pathologies
Academic Year: 2026/2027
1. A nurse in the emergency department is caring for a 2-year-old child who was
found by his parents crying and holding a container of toilet bowl cleaner. The
child's lips are edematous and inflamed, and he is drooling. Which of the following
is the priority action by the nurse?
A. Check the child's respiratory status.
B. Administer syrup of ipecac to induce vomiting.
C. Insert a nasogastric tube for gastric lavage.
D. Apply a soothing topical ointment to the inflamed lips.
CORRECT ANSWER: A
RATIONALE: Following the airway, breathing, and circulation (ABC)
framework, the nurse's absolute priority action is to assess the child's respiratory
status and airway patency. Ingestion of a corrosive chemical like toilet bowl
cleaner causes severe caustic burns to the oral mucosa, pharynx, and larynx.
Edema and inflammation can progress rapidly, causing complete upper airway
obstruction. Swallowing a corrosive substance is a strict contraindication for
inducing vomiting (syrup of ipecac) or performing gastric lavage, as re-exposing
the esophagus and oral cavity to the chemical can cause transmural perforation and
fatal mediastinitis.
2. A nurse is teaching a parent of a 12-month-old child about development during
the toddler years. Which of the following statements should the nurse include?
A. "Your child should be able to ride a tricycle by 18 months of age."
B. "Your child should be able to scribble spontaneously using a crayon at the
age of 15 months."
,C. "Your child should be able to build a tower of eight blocks by 15 months."
D. "Your child should be able to use safety scissors to cut shapes at 24 months."
CORRECT ANSWER: B
RATIONALE: Fine motor development milestones dictate that a toddler
should be able to scribble spontaneously using a crayon by 15 months of age.
Riding a tricycle is a gross motor milestone expected of a 3-year-old preschooler
(36 months). Building a tower of eight blocks requires advanced fine motor
coordination and is typically achieved by 24 to 30 months of age. Using safety
scissors to cut shapes is an advanced fine motor task expected closer to 4 years of
age.
3. A nurse is caring for a toddler and is preparing to administer 0.9% sodium
chloride 100 mL IV to infuse over 4 hours. The drop factor of the manual IV
tubing is 60 gtt/mL. The nurse should set the manual IV infusion to deliver how
many gtt/min?
A. 15 gtt/min
B. 25 gtt/min
C. 40 gtt/min
D. 60 gtt/min
CORRECT ANSWER: B
RATIONALE: To find the manual IV flow rate in drops per minute (gtt/min),
utilize the standard intravenous infusion formula:
Flow Rate (gtt/min)=Total Volume (mL)×Drop Factor (gtt/mL)Total Time
(minutes)Flow Rate (gtt/min) equals the fraction with numerator Total Volume
(mL) cross Drop Factor (gtt/mL) and denominator Total Time (minutes) end-
fraction
Flow Rate (gtt/min)=Total Volume (mL)×Drop Factor (gtt/mL)Total Time
(minutes)
Convert hours to minutes: 4 hours × 60 minutes/hour = 240 minutes.
, Flow Rate=100 mL×60 gtt/mL240 minutes=6000240=25 gtt/minFlow Rate equals
the fraction with numerator 100 mL cross 60 gtt/mL and denominator 240 minutes
end-fraction equals 6000 over 240 end-fraction equals 25 gtt/min
Flow Rate=100 mL×60 gtt/mL240 minutes=6000240=25 gtt/min
The manual IV infusion must be set to deliver exactly 25 gtt/min.
4. A nurse in a pediatric clinic is assessing a toddler at a well-child visit. Which of
the following actions should the nurse take?
A. Perform the most invasive assessments first.
B. Maintain direct, unblinking eye contact with the child.
C. Minimize physical contact with the child initially.
D. Address the child using complex medical terms.
CORRECT ANSWER: C
RATIONALE: To reduce situational anxiety and build rapport with a toddler,
the nurse should minimize direct physical contact at the beginning of the exam.
The nurse can engage with the guardian first, allowing the toddler to observe that
the environment is safe. Invasive or distressing assessments (such as examining the
ears, mouth, and throat) should always be delayed until the end of the examination.
Prolonged, direct eye contact can be perceived as threatening by a toddler and may
increase distress.
5. A nurse is caring for an 18-year-old adolescent who is up-to-date on
immunizations and is planning to attend college. The nurse should inform the
client that he should receive which of the following immunizations prior to moving
into a campus dormitory?
A. Rotavirus vaccine
B. Pneumococcal conjugate vaccine
C. Meningococcal polysaccharide vaccine
D. Inactivated poliovirus vaccine
CORRECT ANSWER: C
RATIONALE: The meningococcal vaccine is strongly recommended and
often required for older adolescents transitioning into high-density communal
living environments, such as college dormitories. This protects against Neisseria
