NURS250 Pediatric Nursing Updated 2026 | Comprehensive Study Guide,
Practice Exam Questions and Answers, Exam Prep Test Bank, Child
Growth and Development Milestones, Pediatric Health Assessment,
Common Childhood Illnesses and Disorders, Family-Centered Nursing
Care, Pediatric Pharmacology and Dosage Calculations, Health Promotion
and Safety in Children, and Detailed Rationales for Nursing Exam Success
Question 1: A 4-year-old child is admitted with acute gastroenteritis and is
exhibiting signs of moderate dehydration. Which of the following clinical
manifestations would the nurse expect to observe?
A. Sunken fontanels and absence of tears
B. Capillary refill of 5 seconds and deep, rapid respirations
C. Dry mucous membranes and decreased skin turgor
D. Bradycardia and hypertension
CORRECT ANSWER: C. Dry mucous membranes and decreased skin turgor
Rationale: Moderate dehydration (6-9% body weight loss) typically presents with dry
mucous membranes, decreased skin turgor, sunken eyes, and decreased urine output.
Sunken fontanels and absence of tears are signs of severe dehydration. Capillary refill
of 5 seconds indicates severe dehydration, while bradycardia and hypertension are not
typical findings in pediatric dehydration (tachycardia and hypotension are more
common).
Question 2: The nurse is caring for a 6-month-old infant with bronchiolitis caused
by Respiratory Syncytial Virus (RSV). Which intervention is the priority for this
infant?
A. Administering broad-spectrum antibiotics
B. Maintaining strict isolation precautions
C. Suctioning the nares as needed
D. Encouraging oral intake of clear fluids
CORRECT ANSWER: C. Suctioning the nares as needed
Rationale: The priority intervention for an infant with RSV bronchiolitis is maintaining a
patent airway. Nasal suctioning is essential to remove secretions, as infants are obligate
nose breathers. Antibiotics are ineffective against viral infections. Strict isolation
(contact precautions) is important but secondary to airway management. Oral intake
may be contraindicated due to respiratory distress and fatigue.
Question 3: A 10-year-old child with type 1 diabetes mellitus is experiencing
hypoglycemia. Which of the following symptoms would the nurse expect to
assess?
A. Fruity breath odor and Kussmaul respirations
B. Polydipsia, polyuria, and polyphagia
,C. Diaphoresis, tremors, and irritability
D. Weight loss and blurred vision
CORRECT ANSWER: C. Diaphoresis, tremors, and irritability
Rationale: Hypoglycemia (low blood glucose) triggers the release of epinephrine and
glucagon, leading to autonomic symptoms such as diaphoresis, tremors, tachycardia,
and irritability. Fruity breath and Kussmaul respirations are signs of diabetic
ketoacidosis (hyperglycemia). Polydipsia, polyuria, and polyphagia are classic signs of
hyperglycemia.
Question 4: The nurse is assessing a toddler with suspected iron deficiency
anemia. Which of the following findings is most consistent with this diagnosis?
A. Pallor of the conjunctiva and nail beds
B. Clubbing of the fingers and toes
C. Bounding pulses and murmur
D. Hepatosplenomegaly and jaundice
CORRECT ANSWER: A. Pallor of the conjunctiva and nail beds
Rationale: Iron deficiency anemia results in decreased hemoglobin, leading to pallor,
especially notable in the conjunctiva, nail beds, and skin. Clubbing is associated with
chronic hypoxemia, not anemia. Hepatosplenomegaly and jaundice are more indicative
of hemolytic anemia, while bounding pulses are not typical findings.
Question 5: A 2-year-old child is prescribed amoxicillin for acute otitis media. The
child's mother asks if she should give the medication with food. What is the nurse's
best response?
A. "Amoxicillin should be given on an empty stomach for best absorption."
B. "It does not matter, as long as you don't miss a dose."
C. "You may give it with food if it upsets his stomach."
D. "You must give it exactly 2 hours after meals."
CORRECT ANSWER: C. "You may give it with food if it upsets his stomach."
Rationale: Amoxicillin can be given with or without food. If gastrointestinal upset
occurs, administering it with food can help reduce nausea. It is not necessary to
administer on an empty stomach, and timing relative to meals (like 2 hours after) is not
required for amoxicillin.
Question 6: The nurse is performing a developmental assessment on a 15-month-
old toddler. Which milestone should the nurse expect the toddler to have
achieved?
A. Walking up stairs with assistance
B. Building a tower of six blocks
C. Using a spoon with minimal spilling
D. Kicking a ball forward
,CORRECT ANSWER: A. Walking up stairs with assistance
Rationale: By 15 months, most toddlers can walk up stairs with assistance and can
walk independently. Building a tower of six blocks is expected at 24 months. Using a
spoon well is typical at 18-24 months. Kicking a ball forward is a skill seen around 18-24
months.
Question 7: A school-age child is diagnosed with acute glomerulonephritis. The
nurse anticipates which of the following initial therapeutic interventions?
A. Intravenous antibiotic therapy
B. Fluid restriction and sodium restriction
C. High-protein, high-calorie diet
D. Regular administration of diuretics
CORRECT ANSWER: B. Fluid restriction and sodium restriction
Rationale: Acute glomerulonephritis involves inflammation of the glomeruli, leading to
fluid retention, hypertension, and edema. Management includes fluid and sodium
restriction to control hypertension and edema. Antibiotics are not used unless there is a
concurrent infection. A high-protein diet is not recommended, and diuretics are used
cautiously if at all.
Question 8: The nurse is caring for a neonate with neonatal abstinence syndrome
(NAS). Which finding is most characteristic of this condition?
A. Hypothermia and lethargy
B. Hypertonicity and high-pitched cry
C. Bradycardia and respiratory depression
D. Poor feeding and constipation
CORRECT ANSWER: B. Hypertonicity and high-pitched cry
Rationale: Neonatal abstinence syndrome results from withdrawal from in-utero opioid
exposure. Characteristic findings include central nervous system (CNS) irritability such
as hypertonicity, high-pitched cry, tremors, and irritability. Hypothermia, bradycardia,
and constipation are not typical; NAS often presents with poor feeding but diarrhea is
more common than constipation.
Question 9: A 7-year-old child presents with a sore throat, fever, and a "sandpaper-
like" rash on the trunk. Which of the following is the most likely diagnosis?
A. Rubella
B. Rubeola
C. Scarlet fever
D. Fifth disease
CORRECT ANSWER: C. Scarlet fever
, Rationale: Scarlet fever is caused by group A Streptococcus and presents with a sore
throat, fever, and a fine, erythematous, "sandpaper-like" rash that typically appears on
the trunk and spreads. Rubella (German measles) presents with a maculopapular rash
and lymphadenopathy. Rubeola (measles) presents with Koplik spots and a
maculopapular rash. Fifth disease (erythema infectiosum) presents with a "slapped
cheek" rash.
Question 10: The nurse is teaching a parent about managing a child's febrile seizure
at home. Which instruction is essential for the nurse to include?
A. Give the child a tepid sponge bath immediately.
B. Place a spoon in the child's mouth to prevent tongue-biting.
C. Place the child in a side-lying position during the seizure.
D. Administer acetaminophen rectally during the seizure.
CORRECT ANSWER: C. Place the child in a side-lying position during the seizure.
Rationale: The priority during a seizure is maintaining a patent airway and preventing
aspiration. Placing the child in a side-lying position helps achieve this. Tepid sponging is
not recommended, as it can cause shivering and raise temperature. Objects should
never be placed in the mouth during a seizure due to risk of injury and aspiration. Rectal
acetaminophen can be given after the seizure, not during.
Question 11: A child with a ventricular septal defect (VSD) is scheduled for surgical
repair. Preoperatively, the nurse should monitor the child most closely for which
complication?
A. Pulmonary hypertension
B. Systemic hypotension
C. Decreased cardiac output
D. Peripheral edema
CORRECT ANSWER: A. Pulmonary hypertension
Rationale: A VSD allows blood to shunt from the left ventricle to the right ventricle,
increasing pulmonary blood flow. Over time, this can lead to pulmonary hypertension
and, if left untreated, Eisenmenger syndrome. Monitoring for signs of pulmonary
hypertension (e.g., cyanosis, heart failure) is crucial. Decreased cardiac output is not
the primary concern in simple VSD, and systemic hypotension is rare.
Question 12: The nurse is preparing to administer an IM injection to a 3-month-old
infant. Which site is the most appropriate for this age group?
A. Deltoid
B. Ventrogluteal
C. Dorsogluteal
D. Vastus lateralis
CORRECT ANSWER: D. Vastus lateralis
Practice Exam Questions and Answers, Exam Prep Test Bank, Child
Growth and Development Milestones, Pediatric Health Assessment,
Common Childhood Illnesses and Disorders, Family-Centered Nursing
Care, Pediatric Pharmacology and Dosage Calculations, Health Promotion
and Safety in Children, and Detailed Rationales for Nursing Exam Success
Question 1: A 4-year-old child is admitted with acute gastroenteritis and is
exhibiting signs of moderate dehydration. Which of the following clinical
manifestations would the nurse expect to observe?
A. Sunken fontanels and absence of tears
B. Capillary refill of 5 seconds and deep, rapid respirations
C. Dry mucous membranes and decreased skin turgor
D. Bradycardia and hypertension
CORRECT ANSWER: C. Dry mucous membranes and decreased skin turgor
Rationale: Moderate dehydration (6-9% body weight loss) typically presents with dry
mucous membranes, decreased skin turgor, sunken eyes, and decreased urine output.
Sunken fontanels and absence of tears are signs of severe dehydration. Capillary refill
of 5 seconds indicates severe dehydration, while bradycardia and hypertension are not
typical findings in pediatric dehydration (tachycardia and hypotension are more
common).
Question 2: The nurse is caring for a 6-month-old infant with bronchiolitis caused
by Respiratory Syncytial Virus (RSV). Which intervention is the priority for this
infant?
A. Administering broad-spectrum antibiotics
B. Maintaining strict isolation precautions
C. Suctioning the nares as needed
D. Encouraging oral intake of clear fluids
CORRECT ANSWER: C. Suctioning the nares as needed
Rationale: The priority intervention for an infant with RSV bronchiolitis is maintaining a
patent airway. Nasal suctioning is essential to remove secretions, as infants are obligate
nose breathers. Antibiotics are ineffective against viral infections. Strict isolation
(contact precautions) is important but secondary to airway management. Oral intake
may be contraindicated due to respiratory distress and fatigue.
Question 3: A 10-year-old child with type 1 diabetes mellitus is experiencing
hypoglycemia. Which of the following symptoms would the nurse expect to
assess?
A. Fruity breath odor and Kussmaul respirations
B. Polydipsia, polyuria, and polyphagia
,C. Diaphoresis, tremors, and irritability
D. Weight loss and blurred vision
CORRECT ANSWER: C. Diaphoresis, tremors, and irritability
Rationale: Hypoglycemia (low blood glucose) triggers the release of epinephrine and
glucagon, leading to autonomic symptoms such as diaphoresis, tremors, tachycardia,
and irritability. Fruity breath and Kussmaul respirations are signs of diabetic
ketoacidosis (hyperglycemia). Polydipsia, polyuria, and polyphagia are classic signs of
hyperglycemia.
Question 4: The nurse is assessing a toddler with suspected iron deficiency
anemia. Which of the following findings is most consistent with this diagnosis?
A. Pallor of the conjunctiva and nail beds
B. Clubbing of the fingers and toes
C. Bounding pulses and murmur
D. Hepatosplenomegaly and jaundice
CORRECT ANSWER: A. Pallor of the conjunctiva and nail beds
Rationale: Iron deficiency anemia results in decreased hemoglobin, leading to pallor,
especially notable in the conjunctiva, nail beds, and skin. Clubbing is associated with
chronic hypoxemia, not anemia. Hepatosplenomegaly and jaundice are more indicative
of hemolytic anemia, while bounding pulses are not typical findings.
Question 5: A 2-year-old child is prescribed amoxicillin for acute otitis media. The
child's mother asks if she should give the medication with food. What is the nurse's
best response?
A. "Amoxicillin should be given on an empty stomach for best absorption."
B. "It does not matter, as long as you don't miss a dose."
C. "You may give it with food if it upsets his stomach."
D. "You must give it exactly 2 hours after meals."
CORRECT ANSWER: C. "You may give it with food if it upsets his stomach."
Rationale: Amoxicillin can be given with or without food. If gastrointestinal upset
occurs, administering it with food can help reduce nausea. It is not necessary to
administer on an empty stomach, and timing relative to meals (like 2 hours after) is not
required for amoxicillin.
Question 6: The nurse is performing a developmental assessment on a 15-month-
old toddler. Which milestone should the nurse expect the toddler to have
achieved?
A. Walking up stairs with assistance
B. Building a tower of six blocks
C. Using a spoon with minimal spilling
D. Kicking a ball forward
,CORRECT ANSWER: A. Walking up stairs with assistance
Rationale: By 15 months, most toddlers can walk up stairs with assistance and can
walk independently. Building a tower of six blocks is expected at 24 months. Using a
spoon well is typical at 18-24 months. Kicking a ball forward is a skill seen around 18-24
months.
Question 7: A school-age child is diagnosed with acute glomerulonephritis. The
nurse anticipates which of the following initial therapeutic interventions?
A. Intravenous antibiotic therapy
B. Fluid restriction and sodium restriction
C. High-protein, high-calorie diet
D. Regular administration of diuretics
CORRECT ANSWER: B. Fluid restriction and sodium restriction
Rationale: Acute glomerulonephritis involves inflammation of the glomeruli, leading to
fluid retention, hypertension, and edema. Management includes fluid and sodium
restriction to control hypertension and edema. Antibiotics are not used unless there is a
concurrent infection. A high-protein diet is not recommended, and diuretics are used
cautiously if at all.
Question 8: The nurse is caring for a neonate with neonatal abstinence syndrome
(NAS). Which finding is most characteristic of this condition?
A. Hypothermia and lethargy
B. Hypertonicity and high-pitched cry
C. Bradycardia and respiratory depression
D. Poor feeding and constipation
CORRECT ANSWER: B. Hypertonicity and high-pitched cry
Rationale: Neonatal abstinence syndrome results from withdrawal from in-utero opioid
exposure. Characteristic findings include central nervous system (CNS) irritability such
as hypertonicity, high-pitched cry, tremors, and irritability. Hypothermia, bradycardia,
and constipation are not typical; NAS often presents with poor feeding but diarrhea is
more common than constipation.
Question 9: A 7-year-old child presents with a sore throat, fever, and a "sandpaper-
like" rash on the trunk. Which of the following is the most likely diagnosis?
A. Rubella
B. Rubeola
C. Scarlet fever
D. Fifth disease
CORRECT ANSWER: C. Scarlet fever
, Rationale: Scarlet fever is caused by group A Streptococcus and presents with a sore
throat, fever, and a fine, erythematous, "sandpaper-like" rash that typically appears on
the trunk and spreads. Rubella (German measles) presents with a maculopapular rash
and lymphadenopathy. Rubeola (measles) presents with Koplik spots and a
maculopapular rash. Fifth disease (erythema infectiosum) presents with a "slapped
cheek" rash.
Question 10: The nurse is teaching a parent about managing a child's febrile seizure
at home. Which instruction is essential for the nurse to include?
A. Give the child a tepid sponge bath immediately.
B. Place a spoon in the child's mouth to prevent tongue-biting.
C. Place the child in a side-lying position during the seizure.
D. Administer acetaminophen rectally during the seizure.
CORRECT ANSWER: C. Place the child in a side-lying position during the seizure.
Rationale: The priority during a seizure is maintaining a patent airway and preventing
aspiration. Placing the child in a side-lying position helps achieve this. Tepid sponging is
not recommended, as it can cause shivering and raise temperature. Objects should
never be placed in the mouth during a seizure due to risk of injury and aspiration. Rectal
acetaminophen can be given after the seizure, not during.
Question 11: A child with a ventricular septal defect (VSD) is scheduled for surgical
repair. Preoperatively, the nurse should monitor the child most closely for which
complication?
A. Pulmonary hypertension
B. Systemic hypotension
C. Decreased cardiac output
D. Peripheral edema
CORRECT ANSWER: A. Pulmonary hypertension
Rationale: A VSD allows blood to shunt from the left ventricle to the right ventricle,
increasing pulmonary blood flow. Over time, this can lead to pulmonary hypertension
and, if left untreated, Eisenmenger syndrome. Monitoring for signs of pulmonary
hypertension (e.g., cyanosis, heart failure) is crucial. Decreased cardiac output is not
the primary concern in simple VSD, and systemic hypotension is rare.
Question 12: The nurse is preparing to administer an IM injection to a 3-month-old
infant. Which site is the most appropriate for this age group?
A. Deltoid
B. Ventrogluteal
C. Dorsogluteal
D. Vastus lateralis
CORRECT ANSWER: D. Vastus lateralis
