Pediatric Nursing Exam Review (2026–2027): 200
NCLEX-Style Practice Questions with Detailed
Rationales Covering Newborn Care, Growth &
Development, Pediatric Disorders, Pharmacology,
Emergency Care, Family-Centered Nursing, and
Clinical Judgment for NCLEX-RN Success
Introduction
Pediatric nursing requires specialized knowledge of growth and development, family-centered care,
disease prevention, health promotion, and management of acute and chronic illnesses in infants,
children, and adolescents. This comprehensive review includes NCLEX-style questions designed to
strengthen critical thinking and prepare nursing students for pediatric nursing exams, HESI, ATI,
NCLEX-RN, and clinical practice. Each question includes the correct answer and detailed rationale to
reinforce key concepts commonly tested in nursing programs and licensure examinations.
1. A nurse is assessing a newborn immediately after birth. Which finding requires immediate
intervention?
A. Heart rate of 140 beats/min
B. Respiratory rate of 42 breaths/min
C. Central cyanosis
D. Acrocyanosis
Answer: C. Central cyanosis
Rationale: Central cyanosis indicates inadequate oxygenation and requires immediate evaluation and
intervention. Acrocyanosis is common during the first 24–48 hours of life.
2. Which reflex is present at birth and disappears by 4 months of age?
A. Babinski reflex
B. Moro reflex
,C. Plantar grasp reflex
D. Parachute reflex
Answer: B. Moro reflex
Rationale: The Moro (startle) reflex is present at birth and typically disappears by 4 months.
Persistence may indicate neurological dysfunction.
3. A nurse is teaching parents about safe sleep practices for infants. Which instruction is most
appropriate?
A. Place the infant on the stomach to sleep
B. Use soft blankets in the crib
C. Place the infant on the back to sleep
D. Allow co-sleeping with parents
Answer: C. Place the infant on the back to sleep
Rationale: Infants should always be placed on their backs to reduce the risk of sudden infant death
syndrome (SIDS).
4. Which developmental milestone is expected for a 6-month-old infant?
A. Walks independently
B. Sits with support
C. Uses two-word phrases
D. Rides a tricycle
Answer: B. Sits with support
Rationale: A 6-month-old infant typically sits with support and may begin rolling over and transferring
objects.
5. A toddler is hospitalized and exhibits separation anxiety. What behavior is expected during the
protest phase?
A. Appears uninterested in parents
B. Cries loudly and searches for parents
C. Forms attachment to caregivers
D. Sleeps excessively
Answer: B. Cries loudly and searches for parents
Rationale: During the protest phase, toddlers actively resist separation through crying, screaming, and
seeking parents.
,6. Which toy is most appropriate for a hospitalized 2-year-old child?
A. Puzzle with many pieces
B. Coloring book
C. Push-and-pull toy
D. Video game console
Answer: C. Push-and-pull toy
Rationale: Toddlers enjoy gross motor activities and simple toys that encourage movement.
7. A nurse is assessing a preschool-age child. Which developmental task is characteristic of this age
group?
A. Trust versus mistrust
B. Industry versus inferiority
C. Initiative versus guilt
D. Identity versus role confusion
Answer: C. Initiative versus guilt
Rationale: According to Erikson, preschool children are in the initiative versus guilt stage and enjoy
imaginative play and exploration.
8. Which statement by a parent indicates understanding of immunizations?
A. "Vaccines can cause the diseases they prevent."
B. "Immunizations help protect children from serious infections."
C. "My child does not need vaccines after age two."
D. "Vaccines weaken the immune system."
Answer: B. Immunizations help protect children from serious infections.
Rationale: Vaccines stimulate immunity and significantly reduce the incidence of infectious diseases.
9. A child with dehydration has a sunken fontanel. This finding indicates:
A. Fluid overload
B. Increased intracranial pressure
C. Moderate to severe dehydration
D. Normal assessment finding
Answer: C. Moderate to severe dehydration
Rationale: A sunken fontanel is a classic sign of dehydration in infants.
, 10. Which laboratory value is most important to monitor in a child receiving IV fluids for dehydration?
A. Hemoglobin
B. Platelet count
C. Serum electrolytes
D. White blood cell count
Answer: C. Serum electrolytes
Rationale: Electrolyte imbalances commonly occur with dehydration and fluid replacement therapy.
11. A nurse is caring for a child with acute otitis media. Which symptom is expected?
A. Ear pain
B. Bradycardia
C. Hematuria
D. Cyanosis
Answer: A. Ear pain
Rationale: Ear pain, irritability, and fever are common manifestations of acute otitis media.
12. Which finding is most characteristic of croup?
A. Barking cough
B. Productive cough
C. Hemoptysis
D. Chest pain
Answer: A. Barking cough
Rationale: Croup causes inflammation of the upper airway, producing a distinctive barking cough.
13. A nurse is caring for a child experiencing an asthma attack. What is the priority intervention?
A. Encourage exercise
B. Administer prescribed bronchodilator
C. Restrict fluids
D. Place the child flat in bed
Answer: B. Administer prescribed bronchodilator
Rationale: Bronchodilators relieve bronchospasm and improve airway patency during acute asthma
exacerbations.
NCLEX-Style Practice Questions with Detailed
Rationales Covering Newborn Care, Growth &
Development, Pediatric Disorders, Pharmacology,
Emergency Care, Family-Centered Nursing, and
Clinical Judgment for NCLEX-RN Success
Introduction
Pediatric nursing requires specialized knowledge of growth and development, family-centered care,
disease prevention, health promotion, and management of acute and chronic illnesses in infants,
children, and adolescents. This comprehensive review includes NCLEX-style questions designed to
strengthen critical thinking and prepare nursing students for pediatric nursing exams, HESI, ATI,
NCLEX-RN, and clinical practice. Each question includes the correct answer and detailed rationale to
reinforce key concepts commonly tested in nursing programs and licensure examinations.
1. A nurse is assessing a newborn immediately after birth. Which finding requires immediate
intervention?
A. Heart rate of 140 beats/min
B. Respiratory rate of 42 breaths/min
C. Central cyanosis
D. Acrocyanosis
Answer: C. Central cyanosis
Rationale: Central cyanosis indicates inadequate oxygenation and requires immediate evaluation and
intervention. Acrocyanosis is common during the first 24–48 hours of life.
2. Which reflex is present at birth and disappears by 4 months of age?
A. Babinski reflex
B. Moro reflex
,C. Plantar grasp reflex
D. Parachute reflex
Answer: B. Moro reflex
Rationale: The Moro (startle) reflex is present at birth and typically disappears by 4 months.
Persistence may indicate neurological dysfunction.
3. A nurse is teaching parents about safe sleep practices for infants. Which instruction is most
appropriate?
A. Place the infant on the stomach to sleep
B. Use soft blankets in the crib
C. Place the infant on the back to sleep
D. Allow co-sleeping with parents
Answer: C. Place the infant on the back to sleep
Rationale: Infants should always be placed on their backs to reduce the risk of sudden infant death
syndrome (SIDS).
4. Which developmental milestone is expected for a 6-month-old infant?
A. Walks independently
B. Sits with support
C. Uses two-word phrases
D. Rides a tricycle
Answer: B. Sits with support
Rationale: A 6-month-old infant typically sits with support and may begin rolling over and transferring
objects.
5. A toddler is hospitalized and exhibits separation anxiety. What behavior is expected during the
protest phase?
A. Appears uninterested in parents
B. Cries loudly and searches for parents
C. Forms attachment to caregivers
D. Sleeps excessively
Answer: B. Cries loudly and searches for parents
Rationale: During the protest phase, toddlers actively resist separation through crying, screaming, and
seeking parents.
,6. Which toy is most appropriate for a hospitalized 2-year-old child?
A. Puzzle with many pieces
B. Coloring book
C. Push-and-pull toy
D. Video game console
Answer: C. Push-and-pull toy
Rationale: Toddlers enjoy gross motor activities and simple toys that encourage movement.
7. A nurse is assessing a preschool-age child. Which developmental task is characteristic of this age
group?
A. Trust versus mistrust
B. Industry versus inferiority
C. Initiative versus guilt
D. Identity versus role confusion
Answer: C. Initiative versus guilt
Rationale: According to Erikson, preschool children are in the initiative versus guilt stage and enjoy
imaginative play and exploration.
8. Which statement by a parent indicates understanding of immunizations?
A. "Vaccines can cause the diseases they prevent."
B. "Immunizations help protect children from serious infections."
C. "My child does not need vaccines after age two."
D. "Vaccines weaken the immune system."
Answer: B. Immunizations help protect children from serious infections.
Rationale: Vaccines stimulate immunity and significantly reduce the incidence of infectious diseases.
9. A child with dehydration has a sunken fontanel. This finding indicates:
A. Fluid overload
B. Increased intracranial pressure
C. Moderate to severe dehydration
D. Normal assessment finding
Answer: C. Moderate to severe dehydration
Rationale: A sunken fontanel is a classic sign of dehydration in infants.
, 10. Which laboratory value is most important to monitor in a child receiving IV fluids for dehydration?
A. Hemoglobin
B. Platelet count
C. Serum electrolytes
D. White blood cell count
Answer: C. Serum electrolytes
Rationale: Electrolyte imbalances commonly occur with dehydration and fluid replacement therapy.
11. A nurse is caring for a child with acute otitis media. Which symptom is expected?
A. Ear pain
B. Bradycardia
C. Hematuria
D. Cyanosis
Answer: A. Ear pain
Rationale: Ear pain, irritability, and fever are common manifestations of acute otitis media.
12. Which finding is most characteristic of croup?
A. Barking cough
B. Productive cough
C. Hemoptysis
D. Chest pain
Answer: A. Barking cough
Rationale: Croup causes inflammation of the upper airway, producing a distinctive barking cough.
13. A nurse is caring for a child experiencing an asthma attack. What is the priority intervention?
A. Encourage exercise
B. Administer prescribed bronchodilator
C. Restrict fluids
D. Place the child flat in bed
Answer: B. Administer prescribed bronchodilator
Rationale: Bronchodilators relieve bronchospasm and improve airway patency during acute asthma
exacerbations.
