2026 Nursing Care of Children Practice
Assessment B Pediatric Nursing Clinical
Competency Exam Questions Answers
and Rationales With PDF Download
1. A nurse is assessing a 6-month-old infant during a well-child
visit. Which developmental milestone should the nurse
expect?
A. Walking independently
B. Sitting without support
C. Riding a tricycle
D. Copying a circle
Answer: B. Sitting without support
Rationale: At approximately 6 months of age, most infants are
able to sit without support for short periods. Walking, riding a
tricycle, and copying a circle occur later in childhood.
,2. A nurse is caring for a child with acute otitis media. Which
assessment finding is expected?
A. Nuchal rigidity
B. Ear pain with fever
C. Productive cough
D. Bilateral ankle edema
Answer: B. Ear pain with fever
Rationale: Acute otitis media commonly presents with ear pain,
irritability, fever, and sometimes decreased hearing.
3. Which vaccine is routinely administered to infants beginning
at 2 months of age?
A. Human papillomavirus (HPV)
B. DTaP
C. Herpes zoster
D. Meningococcal B
Answer: B. DTaP
Rationale: The DTaP vaccine series begins at 2 months of age as
part of the routine childhood immunization schedule.
4. A nurse is teaching parents about sudden infant death
syndrome (SIDS) prevention. Which instruction is appropriate?
,A. Place the infant on the stomach to sleep.
B. Use soft blankets around the infant.
C. Place the infant on the back for sleep.
D. Allow bed-sharing with parents.
Answer: C. Place the infant on the back for sleep.
Rationale: Infants should always be placed on their backs on a
firm sleep surface to reduce the risk of SIDS.
5. A child with dehydration has delayed capillary refill and dry
mucous membranes. Which action is the nurse's priority?
A. Encourage physical activity.
B. Begin fluid replacement as prescribed.
C. Restrict oral fluids.
D. Delay assessment until laboratory results return.
Answer: B. Begin fluid replacement as prescribed.
Rationale: Prompt fluid replacement restores circulating volume
and prevents progression of dehydration.
6. Which finding indicates respiratory distress in an infant?
A. Respiratory rate of 28/min
B. Nasal flaring and retractions
, C. Pink oral mucosa
D. Regular breathing pattern
Answer: B. Nasal flaring and retractions
Rationale: Nasal flaring and chest retractions are classic signs of
increased work of breathing in infants.
7. A nurse is caring for a child receiving digoxin. Which finding
requires withholding the medication and notifying the
provider?
A. Apical pulse below the expected range for age
B. Mild hunger before breakfast
C. Blood pressure within normal limits
D. Temperature of 37°C (98.6°F)
Answer: A. Apical pulse below the expected range for age
Rationale: Digoxin should be withheld when the apical pulse is
below the recommended rate for the child's age because of the
risk of bradycardia.
8. Which intervention is appropriate for a toddler experiencing
separation anxiety during hospitalization?
A. Frequently change caregivers.
B. Encourage parental presence.
Assessment B Pediatric Nursing Clinical
Competency Exam Questions Answers
and Rationales With PDF Download
1. A nurse is assessing a 6-month-old infant during a well-child
visit. Which developmental milestone should the nurse
expect?
A. Walking independently
B. Sitting without support
C. Riding a tricycle
D. Copying a circle
Answer: B. Sitting without support
Rationale: At approximately 6 months of age, most infants are
able to sit without support for short periods. Walking, riding a
tricycle, and copying a circle occur later in childhood.
,2. A nurse is caring for a child with acute otitis media. Which
assessment finding is expected?
A. Nuchal rigidity
B. Ear pain with fever
C. Productive cough
D. Bilateral ankle edema
Answer: B. Ear pain with fever
Rationale: Acute otitis media commonly presents with ear pain,
irritability, fever, and sometimes decreased hearing.
3. Which vaccine is routinely administered to infants beginning
at 2 months of age?
A. Human papillomavirus (HPV)
B. DTaP
C. Herpes zoster
D. Meningococcal B
Answer: B. DTaP
Rationale: The DTaP vaccine series begins at 2 months of age as
part of the routine childhood immunization schedule.
4. A nurse is teaching parents about sudden infant death
syndrome (SIDS) prevention. Which instruction is appropriate?
,A. Place the infant on the stomach to sleep.
B. Use soft blankets around the infant.
C. Place the infant on the back for sleep.
D. Allow bed-sharing with parents.
Answer: C. Place the infant on the back for sleep.
Rationale: Infants should always be placed on their backs on a
firm sleep surface to reduce the risk of SIDS.
5. A child with dehydration has delayed capillary refill and dry
mucous membranes. Which action is the nurse's priority?
A. Encourage physical activity.
B. Begin fluid replacement as prescribed.
C. Restrict oral fluids.
D. Delay assessment until laboratory results return.
Answer: B. Begin fluid replacement as prescribed.
Rationale: Prompt fluid replacement restores circulating volume
and prevents progression of dehydration.
6. Which finding indicates respiratory distress in an infant?
A. Respiratory rate of 28/min
B. Nasal flaring and retractions
, C. Pink oral mucosa
D. Regular breathing pattern
Answer: B. Nasal flaring and retractions
Rationale: Nasal flaring and chest retractions are classic signs of
increased work of breathing in infants.
7. A nurse is caring for a child receiving digoxin. Which finding
requires withholding the medication and notifying the
provider?
A. Apical pulse below the expected range for age
B. Mild hunger before breakfast
C. Blood pressure within normal limits
D. Temperature of 37°C (98.6°F)
Answer: A. Apical pulse below the expected range for age
Rationale: Digoxin should be withheld when the apical pulse is
below the recommended rate for the child's age because of the
risk of bradycardia.
8. Which intervention is appropriate for a toddler experiencing
separation anxiety during hospitalization?
A. Frequently change caregivers.
B. Encourage parental presence.
