Pediatric Assessment & Vital Signs Practice Exam
(Questions 1–150)
1. What is the most appropriate method to assess a newborn’s heart
rate immediately after birth?
a. Palpate the brachial pulse
b. Listen to heart sounds with a stethoscope
c. Assess femoral pulse
d. Count respiratory rate
b. Listen to heart sounds with a stethoscope
Rationale: The most accurate method for assessing a newborn's heart
rate immediately after birth is auscultation of the heart using a
stethoscope, as peripheral pulses may be weak or difficult to palpate.
2. Which vital sign is most sensitive to early signs of deterioration in
a pediatric patient?
a. Temperature
b. Heart rate
c. Blood pressure
d. Respiratory rate
b. Heart rate
Rationale: Heart rate changes often occur before other vital signs in
pediatric patients, making it a sensitive early indicator of distress.
3. When assessing a 6-month-old infant’s respiratory rate, which
method is most accurate?
a. Observe chest and abdomen movement for 1 full minute
b. Count breaths for 15 seconds and multiply by 4
, c. Ask the parent to estimate the breathing rate
d. Listen with a stethoscope for 30 seconds
a. Observe chest and abdomen movement for 1 full minute
Rationale: In infants, respiratory rates can be irregular. Observing for
a full minute provides the most accurate assessment.
4. A 4-year-old child presents with fever. Which temperature
measurement is most reliable?
a. Axillary
b. Oral
c. Rectal
d. Tympanic
c. Rectal
Rationale: Rectal temperatures provide the most accurate
measurement of core body temperature in young children, especially
under 5 years.
5. Which pulse site is preferred in infants for routine assessment?
a. Radial
b. Brachial
c. Femoral
d. Carotid
b. Brachial
Rationale: The brachial pulse is easily accessible in infants and
provides a reliable assessment for routine monitoring.
6. What is the normal heart rate range for a newborn (0–1 month)?
a. 60–100 bpm
b. 70–110 bpm
c. 100–180 bpm
d. 120–200 bpm
,c. 100–180 bpm
Rationale: Newborns typically have higher heart rates due to their
small stroke volume and higher metabolic demands.
7. During a pediatric assessment, which is the first step in the
"ABCs"?
a. Assess breathing
b. Assess circulation
c. Assess airway
d. Check vital signs
c. Assess airway
Rationale: Airway is always assessed first in emergency pediatric
evaluation to ensure patency and oxygenation.
8. Which assessment technique is most appropriate for evaluating a
toddler’s heart rate?
a. Palpate radial pulse only
b. Listen to apical pulse for 1 minute
c. Count femoral pulse for 15 seconds
d. Observe for skin color changes
b. Listen to apical pulse for 1 minute
Rationale: The apical pulse is most reliable in toddlers as peripheral
pulses may be irregular or difficult to palpate.
9. What is the normal respiratory rate for a 2-year-old child?
a. 20–30/min
b. 25–35/min
c. 30–40/min
d. 40–50/min
, b. 25–35/min
Rationale: Preschool-aged children have a slightly higher respiratory
rate than older children, typically between 25–35 breaths per minute.
10. Which sign indicates poor perfusion in a pediatric patient?
a. Capillary refill >2 seconds
b. Heart rate 120 bpm
c. Temperature 37°C
d. Respiratory rate 30/min
a. Capillary refill >2 seconds
Rationale: Delayed capillary refill is an early sign of decreased
perfusion and potential shock in children.
11. Which vital sign measurement is least affected by activity in
children?
a. Heart rate
b. Blood pressure
c. Respiratory rate
d. Temperature
d. Temperature
Rationale: Temperature is less affected by activity than heart rate,
blood pressure, or respiratory rate, though it may vary with infection.
12. The nurse measures a 3-year-old’s blood pressure as 90/50
mmHg. How should this value be interpreted?
a. Hypotensive
b. Normal
c. Prehypertensive
d. Hypertensive
(Questions 1–150)
1. What is the most appropriate method to assess a newborn’s heart
rate immediately after birth?
a. Palpate the brachial pulse
b. Listen to heart sounds with a stethoscope
c. Assess femoral pulse
d. Count respiratory rate
b. Listen to heart sounds with a stethoscope
Rationale: The most accurate method for assessing a newborn's heart
rate immediately after birth is auscultation of the heart using a
stethoscope, as peripheral pulses may be weak or difficult to palpate.
2. Which vital sign is most sensitive to early signs of deterioration in
a pediatric patient?
a. Temperature
b. Heart rate
c. Blood pressure
d. Respiratory rate
b. Heart rate
Rationale: Heart rate changes often occur before other vital signs in
pediatric patients, making it a sensitive early indicator of distress.
3. When assessing a 6-month-old infant’s respiratory rate, which
method is most accurate?
a. Observe chest and abdomen movement for 1 full minute
b. Count breaths for 15 seconds and multiply by 4
, c. Ask the parent to estimate the breathing rate
d. Listen with a stethoscope for 30 seconds
a. Observe chest and abdomen movement for 1 full minute
Rationale: In infants, respiratory rates can be irregular. Observing for
a full minute provides the most accurate assessment.
4. A 4-year-old child presents with fever. Which temperature
measurement is most reliable?
a. Axillary
b. Oral
c. Rectal
d. Tympanic
c. Rectal
Rationale: Rectal temperatures provide the most accurate
measurement of core body temperature in young children, especially
under 5 years.
5. Which pulse site is preferred in infants for routine assessment?
a. Radial
b. Brachial
c. Femoral
d. Carotid
b. Brachial
Rationale: The brachial pulse is easily accessible in infants and
provides a reliable assessment for routine monitoring.
6. What is the normal heart rate range for a newborn (0–1 month)?
a. 60–100 bpm
b. 70–110 bpm
c. 100–180 bpm
d. 120–200 bpm
,c. 100–180 bpm
Rationale: Newborns typically have higher heart rates due to their
small stroke volume and higher metabolic demands.
7. During a pediatric assessment, which is the first step in the
"ABCs"?
a. Assess breathing
b. Assess circulation
c. Assess airway
d. Check vital signs
c. Assess airway
Rationale: Airway is always assessed first in emergency pediatric
evaluation to ensure patency and oxygenation.
8. Which assessment technique is most appropriate for evaluating a
toddler’s heart rate?
a. Palpate radial pulse only
b. Listen to apical pulse for 1 minute
c. Count femoral pulse for 15 seconds
d. Observe for skin color changes
b. Listen to apical pulse for 1 minute
Rationale: The apical pulse is most reliable in toddlers as peripheral
pulses may be irregular or difficult to palpate.
9. What is the normal respiratory rate for a 2-year-old child?
a. 20–30/min
b. 25–35/min
c. 30–40/min
d. 40–50/min
, b. 25–35/min
Rationale: Preschool-aged children have a slightly higher respiratory
rate than older children, typically between 25–35 breaths per minute.
10. Which sign indicates poor perfusion in a pediatric patient?
a. Capillary refill >2 seconds
b. Heart rate 120 bpm
c. Temperature 37°C
d. Respiratory rate 30/min
a. Capillary refill >2 seconds
Rationale: Delayed capillary refill is an early sign of decreased
perfusion and potential shock in children.
11. Which vital sign measurement is least affected by activity in
children?
a. Heart rate
b. Blood pressure
c. Respiratory rate
d. Temperature
d. Temperature
Rationale: Temperature is less affected by activity than heart rate,
blood pressure, or respiratory rate, though it may vary with infection.
12. The nurse measures a 3-year-old’s blood pressure as 90/50
mmHg. How should this value be interpreted?
a. Hypotensive
b. Normal
c. Prehypertensive
d. Hypertensive
