NR 328 COMPREHENSIVE PEDIATRIC
NURSING EXAM 2026/2027 QUESTIONS
AND ANSWERS
1. A nurse is assessing a 4-month-old infant. Which of the following findings should be
reported to the provider as a potential developmental delay?
A. Failure to sit up without support
B. Persistent Moro reflex
C. Inability to roll from back to abdomen
D. Failure to reach for objects
Answer: B
Conceptual Explanation: The Moro reflex should disappear by 3 to 4 months of age. A
persistent reflex beyond this age can indicate neurological maturation delay. Sitting
without support occurs around 6-8 months, and rolling back to front occurs around 5-6
months.
2. A 2-year-old child is admitted for surgical repair of a patent ductus arteriosus (PDA). Which
clinical manifestation is characteristic of this condition?
A. Cyanosis that worsens with crying
,B. Profound polycythemia
C. Weak femoral pulses compared to upper extremities
D. Machine-like murmur heard at the left upper sternal border
Answer: D
Conceptual Explanation: A machine-like murmur is the classic clinical sign of PDA due to
the continuous flow from the high-pressure aorta to the low-pressure pulmonary artery.
Weak femoral pulses are seen in Coarctation of the Aorta, and cyanosis/polycythemia are
associated with right-to-left shunts.
3. According to Erikson, which developmental task is primary for a 10-year-old child?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Identity vs. Role Confusion
D. Industry vs. Inferiority
Answer: D
Conceptual Explanation: School-age children (6-12 years) are in the Industry
vs. Inferiority stage, where they focus on mastering skills and competing with peers.
4. A toddler is diagnosed with intussusception. Which characteristic of the stool does the
nurse expect the parent to report?
A. Ribbon-like and foul-smelling
, B. Bloody mucus, described as currant jelly
C. Loose and yellow with white seeds
D. Hard and marble-like
Answer: B
Conceptual Explanation: Intussusception causes intestinal obstruction and ischemia,
leading to the passage of ‘currant jelly’ stools, which consist of blood and mucus. Ribbon-
like stools are associated with Hirschsprung’s disease.
5. When administering digoxin to a 6-month-old infant, the nurse should withhold the dose
and contact the provider if the heart rate is below:
A. 60 beats/min
B. 80 beats/min
C. 90 beats/min
D. 110 beats/min
Answer: C
Conceptual Explanation: For infants, digoxin is typically withheld if the apical heart rate
is less than 90 beats/min. For older children, the cutoff is usually 70 beats/min.
6. A child is admitted with suspected Epiglottitis. Which nursing action is contraindicated?
A. Placing the child in a tripod position
B. Obtaining a throat culture with a sterile swab
NURSING EXAM 2026/2027 QUESTIONS
AND ANSWERS
1. A nurse is assessing a 4-month-old infant. Which of the following findings should be
reported to the provider as a potential developmental delay?
A. Failure to sit up without support
B. Persistent Moro reflex
C. Inability to roll from back to abdomen
D. Failure to reach for objects
Answer: B
Conceptual Explanation: The Moro reflex should disappear by 3 to 4 months of age. A
persistent reflex beyond this age can indicate neurological maturation delay. Sitting
without support occurs around 6-8 months, and rolling back to front occurs around 5-6
months.
2. A 2-year-old child is admitted for surgical repair of a patent ductus arteriosus (PDA). Which
clinical manifestation is characteristic of this condition?
A. Cyanosis that worsens with crying
,B. Profound polycythemia
C. Weak femoral pulses compared to upper extremities
D. Machine-like murmur heard at the left upper sternal border
Answer: D
Conceptual Explanation: A machine-like murmur is the classic clinical sign of PDA due to
the continuous flow from the high-pressure aorta to the low-pressure pulmonary artery.
Weak femoral pulses are seen in Coarctation of the Aorta, and cyanosis/polycythemia are
associated with right-to-left shunts.
3. According to Erikson, which developmental task is primary for a 10-year-old child?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Identity vs. Role Confusion
D. Industry vs. Inferiority
Answer: D
Conceptual Explanation: School-age children (6-12 years) are in the Industry
vs. Inferiority stage, where they focus on mastering skills and competing with peers.
4. A toddler is diagnosed with intussusception. Which characteristic of the stool does the
nurse expect the parent to report?
A. Ribbon-like and foul-smelling
, B. Bloody mucus, described as currant jelly
C. Loose and yellow with white seeds
D. Hard and marble-like
Answer: B
Conceptual Explanation: Intussusception causes intestinal obstruction and ischemia,
leading to the passage of ‘currant jelly’ stools, which consist of blood and mucus. Ribbon-
like stools are associated with Hirschsprung’s disease.
5. When administering digoxin to a 6-month-old infant, the nurse should withhold the dose
and contact the provider if the heart rate is below:
A. 60 beats/min
B. 80 beats/min
C. 90 beats/min
D. 110 beats/min
Answer: C
Conceptual Explanation: For infants, digoxin is typically withheld if the apical heart rate
is less than 90 beats/min. For older children, the cutoff is usually 70 beats/min.
6. A child is admitted with suspected Epiglottitis. Which nursing action is contraindicated?
A. Placing the child in a tripod position
B. Obtaining a throat culture with a sterile swab
