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NCLEX-RN 2026 Pediatric Nursing practice exam. This resource contains 190 questions covering child health
topics including growth and development, immunizations, common acute and chronic illnesses, pediatric
emergencies, medication administration, and family-centered care. Each question includes the correct
answer and rationale. Use this exam to strengthen your pediatric nursing knowledge and prepare for the
NCLEX.
Key Topics Covered
• Growth & Development – Milestones (infant, toddler, preschool, school-age, adolescent), developmental
theories (Piaget, Erikson), play, age-appropriate care
• Immunizations – CDC schedule, contraindications, vaccine administration, parental education
• Common Pediatric Illnesses – Respiratory (RSV, croup, bronchiolitis, asthma, pneumonia), GI
(gastroenteritis, dehydration, appendicitis, intussusception), infectious diseases (varicella, measles,
roseola, fifth disease, meningitis)
• Chronic Conditions – Cystic fibrosis, diabetes mellitus type 1, sickle cell disease, congenital heart defects,
nephrotic syndrome, acute glomerulonephritis, cerebral palsy, spina bifida
• Pediatric Emergencies – Status epilepticus, anaphylaxis, sepsis, shock, child abuse (physical, sexual,
neglect), foreign body aspiration, poisoning
• Medications & Calculations – Safe dosage, administration routes, side effects (e.g., albuterol, epinephrine,
insulin, anticonvulsants)
• Family-Centered Care – Hospitalization impact, pain management, child life specialist, sibling support,
discharge teaching
Questions 1–190
1. The nurse is assessing a 2-year-old child. Which fine motor skill is expected at this age?
A) Builds a tower of 9 blocks
B) Turns pages of a book one at a time
C) Copies a circle
D) Uses scissors to cut paper
Answer B: Turns pages of a book one at a time
,Rationale: A 2-year-old can turn pages one at a time, build a tower of 6-7 blocks, and scribble. Copies a circle
at age 3.
2. A mother asks the nurse when her infant should receive the first dose of the MMR vaccine.
According to the CDC schedule, when is it given?
A) At birth
B) At 12-15 months
C) At 6 months
D) At 4 years
Answer B: At 12-15 months
Rationale: The first dose of MMR is given at 12-15 months; the second dose at 4-6 years. If traveling
internationally, an earlier dose may be given.
3. A child with asthma is prescribed albuterol via nebulizer. Which side effect should the nurse teach
the family to expect?
A) Sedation
B) Tachycardia and jitteriness
C) Bradycardia
D) Hypotension
Answer B: Tachycardia and jitteriness
Rationale: Albuterol (beta-agonist) can cause tachycardia, tremors, and nervousness. These side effects are
usually mild and temporary.
4. A 4-month-old infant is brought to the clinic with a fever of 38.5°C (101.3°F), irritability, and poor
feeding. Which intervention is most important?
A) Administer acetaminophen
B) Assess for signs of serious bacterial infection (e.g., meningitis, UTI)
C) Encourage oral fluids
D) Provide a cool bath
Answer B: Assess for signs of serious bacterial infection (e.g., meningitis, UTI)
Rationale: Fever in an infant <3 months (or any age with ill appearance) warrants evaluation for sepsis, UTI,
or meningitis.
,5. The nurse is caring for a child with sickle cell disease in vaso-occlusive crisis. Which intervention is
highest priority?
A) Administer iron supplements
B) Hydration and pain management
C) Apply cold compresses to affected joints
D) Restrict oral fluids
Answer B: Hydration and pain management
Rationale: Vaso-occlusive crisis is treated with aggressive hydration, pain control (opioids), and warmth
(not cold). Cold causes vasoconstriction.
6. A toddler is admitted with suspected intussusception. Which finding is classic?
A) Bilious vomiting and abdominal distention
B) Currant jelly stools and intermittent abdominal pain
C) “Sausage-shaped” abdominal mass (palpable)
D) Fever and bloody diarrhea
Answer B: Currant jelly stools and intermittent abdominal pain
Rationale: Intussusception presents with episodic, colicky abdominal pain, vomiting, and currant jelly stools
(blood and mucus).
7. A child with diabetes mellitus type 1 is found unconscious. The nurse checks a blood glucose and it
is 45 mg/dL. Which action should the nurse take first?
A) Administer glucagon IM
B) If IV access is available, give D10W IV; otherwise, glucagon IM
C) Give oral glucose paste
D) Notify the provider
Answer B: Administer glucagon IM (if no IV)
Rationale: Unconscious child with severe hypoglycemia requires IV dextrose (D10W); if no IV, give glucagon
IM.
8. The nurse is assessing a 3-year-old child with respiratory distress. The child has stridor and a
barking cough. Which condition is most likely?
A) Epiglottitis
, B) Croup (laryngotracheobronchitis)
C) Asthma
D) Bronchiolitis
Answer B: Croup (laryngotracheobronchitis)
Rationale: Croup presents with barking cough, stridor, and often worse at night. Epiglottitis causes drooling
and toxic appearance.
9. A school-age child with nephrotic syndrome has generalized edema and proteinuria. Which dietary
modification is most appropriate?
A) High-protein, low-sodium
B) Low-sodium, normal protein (with salt restriction)
C) High-potassium, low-fluid
D) Low-fat, high-carbohydrate
Answer B: Low-sodium, normal protein (with salt restriction)
Rationale: Nephrotic syndrome requires sodium restriction to manage edema; protein is not restricted
unless renal function declines.
10. A 2-year-old child is prescribed amoxicillin 40 mg/kg/day divided every 8 hours. The child
weighs 12 kg. What is the dose per administration?
A) 160 mg
B) 160 mg (40×12=480 mg/day; 480/3=160 mg per dose)
C) 120 mg
D) 200 mg
Answer B: 160 mg
Rationale: 40 mg/kg × 12 kg = 480 mg/day; divided into 3 doses = 160 mg per dose.
11. The nurse is teaching parents about fever management in a 6-month-old. Which instruction is
correct?
A) Use rubbing alcohol to lower fever
B) Administer acetaminophen or ibuprofen (if >6 months) as directed
C) Give aspirin for fever
D) Keep the child bundled in blankets
Answer B: Administer acetaminophen or ibuprofen (if >6 months) as directed
INSTANT PDF DOWNLOAD
NCLEX-RN 2026 Pediatric Nursing practice exam. This resource contains 190 questions covering child health
topics including growth and development, immunizations, common acute and chronic illnesses, pediatric
emergencies, medication administration, and family-centered care. Each question includes the correct
answer and rationale. Use this exam to strengthen your pediatric nursing knowledge and prepare for the
NCLEX.
Key Topics Covered
• Growth & Development – Milestones (infant, toddler, preschool, school-age, adolescent), developmental
theories (Piaget, Erikson), play, age-appropriate care
• Immunizations – CDC schedule, contraindications, vaccine administration, parental education
• Common Pediatric Illnesses – Respiratory (RSV, croup, bronchiolitis, asthma, pneumonia), GI
(gastroenteritis, dehydration, appendicitis, intussusception), infectious diseases (varicella, measles,
roseola, fifth disease, meningitis)
• Chronic Conditions – Cystic fibrosis, diabetes mellitus type 1, sickle cell disease, congenital heart defects,
nephrotic syndrome, acute glomerulonephritis, cerebral palsy, spina bifida
• Pediatric Emergencies – Status epilepticus, anaphylaxis, sepsis, shock, child abuse (physical, sexual,
neglect), foreign body aspiration, poisoning
• Medications & Calculations – Safe dosage, administration routes, side effects (e.g., albuterol, epinephrine,
insulin, anticonvulsants)
• Family-Centered Care – Hospitalization impact, pain management, child life specialist, sibling support,
discharge teaching
Questions 1–190
1. The nurse is assessing a 2-year-old child. Which fine motor skill is expected at this age?
A) Builds a tower of 9 blocks
B) Turns pages of a book one at a time
C) Copies a circle
D) Uses scissors to cut paper
Answer B: Turns pages of a book one at a time
,Rationale: A 2-year-old can turn pages one at a time, build a tower of 6-7 blocks, and scribble. Copies a circle
at age 3.
2. A mother asks the nurse when her infant should receive the first dose of the MMR vaccine.
According to the CDC schedule, when is it given?
A) At birth
B) At 12-15 months
C) At 6 months
D) At 4 years
Answer B: At 12-15 months
Rationale: The first dose of MMR is given at 12-15 months; the second dose at 4-6 years. If traveling
internationally, an earlier dose may be given.
3. A child with asthma is prescribed albuterol via nebulizer. Which side effect should the nurse teach
the family to expect?
A) Sedation
B) Tachycardia and jitteriness
C) Bradycardia
D) Hypotension
Answer B: Tachycardia and jitteriness
Rationale: Albuterol (beta-agonist) can cause tachycardia, tremors, and nervousness. These side effects are
usually mild and temporary.
4. A 4-month-old infant is brought to the clinic with a fever of 38.5°C (101.3°F), irritability, and poor
feeding. Which intervention is most important?
A) Administer acetaminophen
B) Assess for signs of serious bacterial infection (e.g., meningitis, UTI)
C) Encourage oral fluids
D) Provide a cool bath
Answer B: Assess for signs of serious bacterial infection (e.g., meningitis, UTI)
Rationale: Fever in an infant <3 months (or any age with ill appearance) warrants evaluation for sepsis, UTI,
or meningitis.
,5. The nurse is caring for a child with sickle cell disease in vaso-occlusive crisis. Which intervention is
highest priority?
A) Administer iron supplements
B) Hydration and pain management
C) Apply cold compresses to affected joints
D) Restrict oral fluids
Answer B: Hydration and pain management
Rationale: Vaso-occlusive crisis is treated with aggressive hydration, pain control (opioids), and warmth
(not cold). Cold causes vasoconstriction.
6. A toddler is admitted with suspected intussusception. Which finding is classic?
A) Bilious vomiting and abdominal distention
B) Currant jelly stools and intermittent abdominal pain
C) “Sausage-shaped” abdominal mass (palpable)
D) Fever and bloody diarrhea
Answer B: Currant jelly stools and intermittent abdominal pain
Rationale: Intussusception presents with episodic, colicky abdominal pain, vomiting, and currant jelly stools
(blood and mucus).
7. A child with diabetes mellitus type 1 is found unconscious. The nurse checks a blood glucose and it
is 45 mg/dL. Which action should the nurse take first?
A) Administer glucagon IM
B) If IV access is available, give D10W IV; otherwise, glucagon IM
C) Give oral glucose paste
D) Notify the provider
Answer B: Administer glucagon IM (if no IV)
Rationale: Unconscious child with severe hypoglycemia requires IV dextrose (D10W); if no IV, give glucagon
IM.
8. The nurse is assessing a 3-year-old child with respiratory distress. The child has stridor and a
barking cough. Which condition is most likely?
A) Epiglottitis
, B) Croup (laryngotracheobronchitis)
C) Asthma
D) Bronchiolitis
Answer B: Croup (laryngotracheobronchitis)
Rationale: Croup presents with barking cough, stridor, and often worse at night. Epiglottitis causes drooling
and toxic appearance.
9. A school-age child with nephrotic syndrome has generalized edema and proteinuria. Which dietary
modification is most appropriate?
A) High-protein, low-sodium
B) Low-sodium, normal protein (with salt restriction)
C) High-potassium, low-fluid
D) Low-fat, high-carbohydrate
Answer B: Low-sodium, normal protein (with salt restriction)
Rationale: Nephrotic syndrome requires sodium restriction to manage edema; protein is not restricted
unless renal function declines.
10. A 2-year-old child is prescribed amoxicillin 40 mg/kg/day divided every 8 hours. The child
weighs 12 kg. What is the dose per administration?
A) 160 mg
B) 160 mg (40×12=480 mg/day; 480/3=160 mg per dose)
C) 120 mg
D) 200 mg
Answer B: 160 mg
Rationale: 40 mg/kg × 12 kg = 480 mg/day; divided into 3 doses = 160 mg per dose.
11. The nurse is teaching parents about fever management in a 6-month-old. Which instruction is
correct?
A) Use rubbing alcohol to lower fever
B) Administer acetaminophen or ibuprofen (if >6 months) as directed
C) Give aspirin for fever
D) Keep the child bundled in blankets
Answer B: Administer acetaminophen or ibuprofen (if >6 months) as directed
