PEDIATRIC NURSING
COMPREHENSIVE PRACTICE EXAM
(NR 328 - 2026/2027)
1. A 10-month-old infant is brought to the clinic for a well-baby visit. The nurse notes the
infant’s weight has tripled since birth. How should the nurse interpret this finding?
A. The infant is underweight for their age.
B. The infant is experiencing normal physical growth.
C. The infant is at risk for childhood obesity.
D. The infant’s birth weight was likely abnormally low.
Answer: B
Conceptual Explanation: Typically, an infant’s birth weight doubles by 6 months and
triples by 12 months. Tripling at 10 months is slightly early but within the expected range
of normal growth.
2. When assessing a 4-year-old child’s cognitive development, the nurse recognizes which
characteristic as typical of Piaget’s preoperational stage?
A. The ability to understand conservation of matter.
B. Egocentrism, or the inability to see things from another’s perspective.
,C. Logical reasoning regarding abstract concepts.
D. Mastery of object permanence.
Answer: B
Conceptual Explanation: Egocentrism is a hallmark of the preoperational stage (ages 2-7).
Conservation and logic develop in the concrete operational stage (ages 7-11).
3. A nurse is caring for a child with Tetralogy of Fallot who suddenly becomes cyanotic and
dyspneic. Which action should the nurse take first?
A. Administer 100% oxygen via non-rebreather mask.
B. Notify the pediatric cardiologist on call.
C. Prepare for immediate administration of Morphine sulfate.
D. Place the child in a knee-chest position.
Answer: D
Conceptual Explanation: During a ‘Tet spell’ (hypercyanotic spell), the knee-chest
position increases systemic vascular resistance, reducing the right-to-left shunt and
improving pulmonary blood flow.
4. A child is diagnosed with Acute Glomerulonephritis. Which finding in the child’s history is
most significant to this diagnosis?
A. A history of urinary tract infections.
B. Congenital heart defects.
, C. Exposure to lead-based paint.
D. A recent skin or throat infection with Group A Strep.
Answer: D
Conceptual Explanation: Acute post-streptococcal glomerulonephritis (APSGN) typically
follows a respiratory or skin infection (impetigo) caused by Group A beta-hemolytic
streptococci.
5. The mother of a child with Celiac disease asks which snack is safe to include in a gluten-free
diet. Which is the best choice?
A. Graham crackers with peanut butter.
B. Rice cakes with sliced bananas.
C. Whole wheat toast with jelly.
D. Oatmeal cookies.
Answer: B
Conceptual Explanation: Gluten is found in wheat, barley, rye, and frequently oats (due to
cross-contamination). Rice and fruit are naturally gluten-free.
6. A 2-year-old is admitted with suspected Epiglottitis. Which nursing intervention is
contraindicated?
A. Visualizing the throat with a tongue depressor.
B. Allowing the child to sit in a tripod position.
COMPREHENSIVE PRACTICE EXAM
(NR 328 - 2026/2027)
1. A 10-month-old infant is brought to the clinic for a well-baby visit. The nurse notes the
infant’s weight has tripled since birth. How should the nurse interpret this finding?
A. The infant is underweight for their age.
B. The infant is experiencing normal physical growth.
C. The infant is at risk for childhood obesity.
D. The infant’s birth weight was likely abnormally low.
Answer: B
Conceptual Explanation: Typically, an infant’s birth weight doubles by 6 months and
triples by 12 months. Tripling at 10 months is slightly early but within the expected range
of normal growth.
2. When assessing a 4-year-old child’s cognitive development, the nurse recognizes which
characteristic as typical of Piaget’s preoperational stage?
A. The ability to understand conservation of matter.
B. Egocentrism, or the inability to see things from another’s perspective.
,C. Logical reasoning regarding abstract concepts.
D. Mastery of object permanence.
Answer: B
Conceptual Explanation: Egocentrism is a hallmark of the preoperational stage (ages 2-7).
Conservation and logic develop in the concrete operational stage (ages 7-11).
3. A nurse is caring for a child with Tetralogy of Fallot who suddenly becomes cyanotic and
dyspneic. Which action should the nurse take first?
A. Administer 100% oxygen via non-rebreather mask.
B. Notify the pediatric cardiologist on call.
C. Prepare for immediate administration of Morphine sulfate.
D. Place the child in a knee-chest position.
Answer: D
Conceptual Explanation: During a ‘Tet spell’ (hypercyanotic spell), the knee-chest
position increases systemic vascular resistance, reducing the right-to-left shunt and
improving pulmonary blood flow.
4. A child is diagnosed with Acute Glomerulonephritis. Which finding in the child’s history is
most significant to this diagnosis?
A. A history of urinary tract infections.
B. Congenital heart defects.
, C. Exposure to lead-based paint.
D. A recent skin or throat infection with Group A Strep.
Answer: D
Conceptual Explanation: Acute post-streptococcal glomerulonephritis (APSGN) typically
follows a respiratory or skin infection (impetigo) caused by Group A beta-hemolytic
streptococci.
5. The mother of a child with Celiac disease asks which snack is safe to include in a gluten-free
diet. Which is the best choice?
A. Graham crackers with peanut butter.
B. Rice cakes with sliced bananas.
C. Whole wheat toast with jelly.
D. Oatmeal cookies.
Answer: B
Conceptual Explanation: Gluten is found in wheat, barley, rye, and frequently oats (due to
cross-contamination). Rice and fruit are naturally gluten-free.
6. A 2-year-old is admitted with suspected Epiglottitis. Which nursing intervention is
contraindicated?
A. Visualizing the throat with a tongue depressor.
B. Allowing the child to sit in a tripod position.
