Learning System RN 30 Nursing Care of Children
Ultimate Exam
**Question 1.** Which of the following best describes the legal requirement for obtaining informed
consent for a minor undergoing a tonsillectomy?
A) The child alone can give consent if over 12 years old.
B) The parent or legal guardian must give consent, and the child’s assent is also recommended.
C) Only the physician’s verbal consent is required.
D) Consent is not required for emergency surgeries.
Answer: B
Explanation: For minors, a parent or legal guardian provides consent, while obtaining the child’s assent
respects the child’s developing autonomy.
**Question 2.** A 3-month-old infant’s fontanelle is bulging. Which assessment finding is most
concerning?
A) Fontanelle is flat and soft.
B) Fontanelle is sunken.
C) Fontanelle is bulging and tense.
D) Fontanelle is slightly open.
Answer: C
Explanation: A bulging fontanelle indicates increased intracranial pressure, requiring immediate
evaluation.
**Question 3.** Which immunization is scheduled at 2 months of age in the standard U.S. pediatric
schedule?
A) Measles-Mumps-Rubella (MMR)
B) Hepatitis B (first dose)
C) DTaP (first dose)
D) Varicella (first dose)
Answer: C
Explanation: DTaP (diphtheria, tetanus, pertussis) is given at 2 months, along with other vaccines such as
IPV and Hib.
,Learning System RN 30 Nursing Care of Children
Ultimate Exam
**Question 4.** The FLACC pain scale is most appropriate for which age group?
A) Newborns (0-2 weeks)
B) Infants (2-12 months)
C) Children 2-7 years unable to verbalize pain
D) Adolescents over 12 years
Answer: C
Explanation: FLACC (Face, Legs, Activity, Cry, Consolability) is designed for children 2-7 years who cannot
self-report pain reliably.
**Question 5.** A 4-year-old child is playing “doctor” with a toy stethoscope. This type of play reflects
which developmental concept?
A) Egocentrism
B) Symbolic play
C) Concrete operational thought
D) Formal operational thought
Answer: B
Explanation: Symbolic or pretend play is typical of the preoperational stage (roughly 2-7 years), allowing
children to use objects to represent something else.
**Question 6.** Which of the following is a hallmark sign of bronchiolitis in infants?
A) Productive cough with green sputum
B) High-pitched inspiratory wheeze (stridor)
C) Rapid, shallow breathing with diffuse crackles
D) Hemoptysis
Answer: C
Explanation: Bronchiolitis (often RSV) presents with tachypnea, wheezing, and diffuse crackles due to
airway inflammation and mucus plugging.
,Learning System RN 30 Nursing Care of Children
Ultimate Exam
**Question 7.** In the assessment of a toddler’s readiness for toilet training, the nurse should observe
for which behavior?
A) Ability to walk alone for 10 minutes
B) Interest in wearing underwear and telling when urine is soiled
C) Preference for solid foods only
D) Consistent sleep through the night
Answer: B
Explanation: Interest in clothing, ability to communicate the need to void, and staying dry for two
consecutive hours indicate readiness.
**Question 8.** Which pediatric pain scale uses a series of faces ranging from a happy face to a crying
face?
A) Wong-Baker FACES
B) Numeric Rating Scale (NRS)
C) Visual Analog Scale (VAS)
D) Behavioral Pain Scale (BPS)
Answer: A
Explanation: The Wong-Baker FACES scale is designed for children ≥3 years and uses facial expressions
to indicate pain intensity.
**Question 9.** A 7-year-old child presents with a “strawberry tongue,” sand-paper rash, and fever.
Which disease is most likely?
A) Scarlet fever
B) Kawasaki disease
C) Measles
D) Roseola
Answer: B
Explanation: Kawasaki disease presents with mucocutaneous changes (strawberry tongue),
polymorphous rash, and fever lasting ≥5 days.
, Learning System RN 30 Nursing Care of Children
Ultimate Exam
**Question 10.** Which of the following is the most appropriate fluid maintenance calculation for a
15-kg child?
A) 500 mL/24 hr
B) 1500 mL/24 hr
C) 2500 mL/24 hr
D) 3500 mL/24 hr
Answer: B
Explanation: Maintenance fluid = 100 mL/kg for first 10 kg (1000 mL) + 50 mL/kg for next 5 kg (250 mL) =
1250 mL ≈ 1500 mL rounding.
**Question 11.** Which of the following best describes the “pincer grasp” developmental milestone?
A) Grasping objects with whole hand, typical at 3 months
B) Using thumb and index finger to pick up small objects, typical at 9-12 months
C) Holding a spoon with a fist, typical at 6 months
D) Manipulating objects with both hands, typical at 2 years
Answer: B
Explanation: The pincer grasp emerges around 9-12 months as the thumb and index finger coordinate.
**Question 12.** A child with cystic fibrosis is receiving chest physiotherapy. The primary goal of this
intervention is to:
A) Increase cardiac output
B) Reduce airway inflammation
C) Mobilize secretions and improve ventilation
D) Decrease renal blood flow
Answer: C
Explanation: Chest physiotherapy (percussion, vibration, postural drainage) helps mobilize thick mucus,
improving ventilation and preventing infection.
**Question 13.** Which sign is most indicative of increased intracranial pressure in an infant?
Ultimate Exam
**Question 1.** Which of the following best describes the legal requirement for obtaining informed
consent for a minor undergoing a tonsillectomy?
A) The child alone can give consent if over 12 years old.
B) The parent or legal guardian must give consent, and the child’s assent is also recommended.
C) Only the physician’s verbal consent is required.
D) Consent is not required for emergency surgeries.
Answer: B
Explanation: For minors, a parent or legal guardian provides consent, while obtaining the child’s assent
respects the child’s developing autonomy.
**Question 2.** A 3-month-old infant’s fontanelle is bulging. Which assessment finding is most
concerning?
A) Fontanelle is flat and soft.
B) Fontanelle is sunken.
C) Fontanelle is bulging and tense.
D) Fontanelle is slightly open.
Answer: C
Explanation: A bulging fontanelle indicates increased intracranial pressure, requiring immediate
evaluation.
**Question 3.** Which immunization is scheduled at 2 months of age in the standard U.S. pediatric
schedule?
A) Measles-Mumps-Rubella (MMR)
B) Hepatitis B (first dose)
C) DTaP (first dose)
D) Varicella (first dose)
Answer: C
Explanation: DTaP (diphtheria, tetanus, pertussis) is given at 2 months, along with other vaccines such as
IPV and Hib.
,Learning System RN 30 Nursing Care of Children
Ultimate Exam
**Question 4.** The FLACC pain scale is most appropriate for which age group?
A) Newborns (0-2 weeks)
B) Infants (2-12 months)
C) Children 2-7 years unable to verbalize pain
D) Adolescents over 12 years
Answer: C
Explanation: FLACC (Face, Legs, Activity, Cry, Consolability) is designed for children 2-7 years who cannot
self-report pain reliably.
**Question 5.** A 4-year-old child is playing “doctor” with a toy stethoscope. This type of play reflects
which developmental concept?
A) Egocentrism
B) Symbolic play
C) Concrete operational thought
D) Formal operational thought
Answer: B
Explanation: Symbolic or pretend play is typical of the preoperational stage (roughly 2-7 years), allowing
children to use objects to represent something else.
**Question 6.** Which of the following is a hallmark sign of bronchiolitis in infants?
A) Productive cough with green sputum
B) High-pitched inspiratory wheeze (stridor)
C) Rapid, shallow breathing with diffuse crackles
D) Hemoptysis
Answer: C
Explanation: Bronchiolitis (often RSV) presents with tachypnea, wheezing, and diffuse crackles due to
airway inflammation and mucus plugging.
,Learning System RN 30 Nursing Care of Children
Ultimate Exam
**Question 7.** In the assessment of a toddler’s readiness for toilet training, the nurse should observe
for which behavior?
A) Ability to walk alone for 10 minutes
B) Interest in wearing underwear and telling when urine is soiled
C) Preference for solid foods only
D) Consistent sleep through the night
Answer: B
Explanation: Interest in clothing, ability to communicate the need to void, and staying dry for two
consecutive hours indicate readiness.
**Question 8.** Which pediatric pain scale uses a series of faces ranging from a happy face to a crying
face?
A) Wong-Baker FACES
B) Numeric Rating Scale (NRS)
C) Visual Analog Scale (VAS)
D) Behavioral Pain Scale (BPS)
Answer: A
Explanation: The Wong-Baker FACES scale is designed for children ≥3 years and uses facial expressions
to indicate pain intensity.
**Question 9.** A 7-year-old child presents with a “strawberry tongue,” sand-paper rash, and fever.
Which disease is most likely?
A) Scarlet fever
B) Kawasaki disease
C) Measles
D) Roseola
Answer: B
Explanation: Kawasaki disease presents with mucocutaneous changes (strawberry tongue),
polymorphous rash, and fever lasting ≥5 days.
, Learning System RN 30 Nursing Care of Children
Ultimate Exam
**Question 10.** Which of the following is the most appropriate fluid maintenance calculation for a
15-kg child?
A) 500 mL/24 hr
B) 1500 mL/24 hr
C) 2500 mL/24 hr
D) 3500 mL/24 hr
Answer: B
Explanation: Maintenance fluid = 100 mL/kg for first 10 kg (1000 mL) + 50 mL/kg for next 5 kg (250 mL) =
1250 mL ≈ 1500 mL rounding.
**Question 11.** Which of the following best describes the “pincer grasp” developmental milestone?
A) Grasping objects with whole hand, typical at 3 months
B) Using thumb and index finger to pick up small objects, typical at 9-12 months
C) Holding a spoon with a fist, typical at 6 months
D) Manipulating objects with both hands, typical at 2 years
Answer: B
Explanation: The pincer grasp emerges around 9-12 months as the thumb and index finger coordinate.
**Question 12.** A child with cystic fibrosis is receiving chest physiotherapy. The primary goal of this
intervention is to:
A) Increase cardiac output
B) Reduce airway inflammation
C) Mobilize secretions and improve ventilation
D) Decrease renal blood flow
Answer: C
Explanation: Chest physiotherapy (percussion, vibration, postural drainage) helps mobilize thick mucus,
improving ventilation and preventing infection.
**Question 13.** Which sign is most indicative of increased intracranial pressure in an infant?
