Pediatric Nursing Licensure Prep | 150 Practice
Questions + Rationale | 2025/2026 Edition
1. A 4-year-old child is diagnosed with acute otitis media. The most
common causative organism is: A. Streptococcus pyogenes
B. Haemophilus influenzae
C. Streptococcus pneumoniae
D. Staphylococcus aureus
Rationale: Streptococcus pneumoniae is the most common cause
of acute otitis media in children due to its ability to evade host
immunity.
2. A nurse is caring for a child with cystic fibrosis. Which of the
following findings is expected?
A. Hyperglycemia
B. Frequent urinary tract infections
C. Thick, sticky mucus in the lungs
D. Hypotension
Rationale: Cystic fibrosis affects exocrine glands leading to thick,
sticky mucus, especially in the lungs and pancreas.
3. A nurse is educating parents about febrile seizures. Which
statement indicates understanding?
A. “My child should be restricted from physical activities
permanently.”
B. “Most febrile seizures are harmless and resolve
spontaneously.”
, C. “Febrile seizures always indicate epilepsy.”
D. “We should induce fever to prevent seizures.”
Rationale: Febrile seizures are usually benign, self-limiting, and
do not indicate epilepsy in most cases.
4. A child with Kawasaki disease is at risk for which complication?
A. Meningitis
B. Coronary artery aneurysm
C. Renal failure
D. Pneumothorax
Rationale: Kawasaki disease causes inflammation of blood
vessels, particularly the coronary arteries, increasing the risk of
aneurysm.
5. A child with nephrotic syndrome is being treated. Which
nursing intervention is most appropriate? A. Encourage
high-salt diet
B. Monitor daily weight and edema
C. Restrict protein intake
D. Avoid all immunizations
Rationale: Monitoring weight and edema helps assess fluid
status and effectiveness of treatment in nephrotic syndrome.
6. A 6-year-old child is admitted with dehydration. Which sign
indicates severe dehydration?
A. Slight thirst
B. Dry mucous membranes
C. Tachycardia
D. Hypotension and lethargy
, Rationale: Hypotension and lethargy indicate severe dehydration
requiring urgent intervention.
7. A nurse is preparing to administer the MMR vaccine. Which
age is recommended for the first dose?
A. Birth
B. 12–15 months
C. 6 months
D. 4 years
Rationale: The first MMR vaccine dose is recommended at 12–15
months to ensure adequate immunity.
8. A toddler presents with sudden onset of wheezing,
coughing, and difficulty breathing. The nurse suspects:
A. Bronchiolitis
B. Croup
C. Foreign body aspiration
D. Asthma
Rationale: Sudden onset with choking and respiratory distress
suggests foreign body aspiration, which is common in toddlers.
9. A child with type 1 diabetes mellitus is at risk for:
A. Hyperthyroidism
B. Diabetic ketoacidosis (DKA)
C. Cushing’s syndrome
D. Hyperaldosteronism
Rationale: Children with type 1 diabetes are at risk for DKA due
to insulin deficiency.
, 10. Which is the priority nursing action for a child with
epiglottitis?
A. Obtain throat culture
B. Administer antibiotics orally
C. Ensure airway patency
D. Encourage oral fluids
Rationale: Epiglottitis can rapidly lead to airway obstruction;
airway management is the highest priority.
11. A 2-year-old child has a fever of 102°F, irritability, and a
vesicular rash. Which infection is likely?
A. Measles
B. Rubella
C. Varicella (chickenpox)
D. Scarlet fever
Rationale: Varicella presents with fever, irritability, and vesicular
rash that progresses in crops.
12. A child with iron-deficiency anemia is prescribed ferrous
sulfate. Which instruction is important?
A. Administer with milk
B. Give at bedtime
C. Administer on an empty stomach with vitamin C
D. Limit fluid intake
Rationale: Iron is best absorbed on an empty stomach and with
vitamin C to enhance absorption.
13. A newborn is assessed 24 hours after birth. Which finding
requires immediate attention?
Questions + Rationale | 2025/2026 Edition
1. A 4-year-old child is diagnosed with acute otitis media. The most
common causative organism is: A. Streptococcus pyogenes
B. Haemophilus influenzae
C. Streptococcus pneumoniae
D. Staphylococcus aureus
Rationale: Streptococcus pneumoniae is the most common cause
of acute otitis media in children due to its ability to evade host
immunity.
2. A nurse is caring for a child with cystic fibrosis. Which of the
following findings is expected?
A. Hyperglycemia
B. Frequent urinary tract infections
C. Thick, sticky mucus in the lungs
D. Hypotension
Rationale: Cystic fibrosis affects exocrine glands leading to thick,
sticky mucus, especially in the lungs and pancreas.
3. A nurse is educating parents about febrile seizures. Which
statement indicates understanding?
A. “My child should be restricted from physical activities
permanently.”
B. “Most febrile seizures are harmless and resolve
spontaneously.”
, C. “Febrile seizures always indicate epilepsy.”
D. “We should induce fever to prevent seizures.”
Rationale: Febrile seizures are usually benign, self-limiting, and
do not indicate epilepsy in most cases.
4. A child with Kawasaki disease is at risk for which complication?
A. Meningitis
B. Coronary artery aneurysm
C. Renal failure
D. Pneumothorax
Rationale: Kawasaki disease causes inflammation of blood
vessels, particularly the coronary arteries, increasing the risk of
aneurysm.
5. A child with nephrotic syndrome is being treated. Which
nursing intervention is most appropriate? A. Encourage
high-salt diet
B. Monitor daily weight and edema
C. Restrict protein intake
D. Avoid all immunizations
Rationale: Monitoring weight and edema helps assess fluid
status and effectiveness of treatment in nephrotic syndrome.
6. A 6-year-old child is admitted with dehydration. Which sign
indicates severe dehydration?
A. Slight thirst
B. Dry mucous membranes
C. Tachycardia
D. Hypotension and lethargy
, Rationale: Hypotension and lethargy indicate severe dehydration
requiring urgent intervention.
7. A nurse is preparing to administer the MMR vaccine. Which
age is recommended for the first dose?
A. Birth
B. 12–15 months
C. 6 months
D. 4 years
Rationale: The first MMR vaccine dose is recommended at 12–15
months to ensure adequate immunity.
8. A toddler presents with sudden onset of wheezing,
coughing, and difficulty breathing. The nurse suspects:
A. Bronchiolitis
B. Croup
C. Foreign body aspiration
D. Asthma
Rationale: Sudden onset with choking and respiratory distress
suggests foreign body aspiration, which is common in toddlers.
9. A child with type 1 diabetes mellitus is at risk for:
A. Hyperthyroidism
B. Diabetic ketoacidosis (DKA)
C. Cushing’s syndrome
D. Hyperaldosteronism
Rationale: Children with type 1 diabetes are at risk for DKA due
to insulin deficiency.
, 10. Which is the priority nursing action for a child with
epiglottitis?
A. Obtain throat culture
B. Administer antibiotics orally
C. Ensure airway patency
D. Encourage oral fluids
Rationale: Epiglottitis can rapidly lead to airway obstruction;
airway management is the highest priority.
11. A 2-year-old child has a fever of 102°F, irritability, and a
vesicular rash. Which infection is likely?
A. Measles
B. Rubella
C. Varicella (chickenpox)
D. Scarlet fever
Rationale: Varicella presents with fever, irritability, and vesicular
rash that progresses in crops.
12. A child with iron-deficiency anemia is prescribed ferrous
sulfate. Which instruction is important?
A. Administer with milk
B. Give at bedtime
C. Administer on an empty stomach with vitamin C
D. Limit fluid intake
Rationale: Iron is best absorbed on an empty stomach and with
vitamin C to enhance absorption.
13. A newborn is assessed 24 hours after birth. Which finding
requires immediate attention?
