PEDIATRIC NURSING PRACTICE EXAM
1 (NR 328 2026/2027) QUESTIONS AND
ANSWERS
1. A nurse is caring for a 2-year-old child admitted with croup. Which clinical manifestation
should the nurse prioritize as a sign of impending respiratory failure?
A. Barking cough and hoarseness
B. Inspiratory stridor at rest
C. N/A
D. Tachycardia and increased restlessness
E. Nasal flaring and intercostal retractions
Answer: E
Conceptual Explanation: While all options are signs of respiratory distress in croup, nasal
flaring and retractions indicate the use of accessory muscles and are significant signs of
impending respiratory failure.
2. When assessing a 4-year-old child, the nurse notes that the child is in Piaget’s
preoperational stage. Which behavior is most characteristic of this stage?
A. Understanding conservation of volume
,B. Egocentrism in thought and speech
C. Ability to perform abstract reasoning
D. Logical thinking about concrete events
Answer: B
Conceptual Explanation: In the preoperational stage (ages 2-7), children exhibit
egocentrism, meaning they are unable to see situations from another person’s perspective.
3. A mother brings her 6-month-old infant to the clinic. Which developmental milestone
should the nurse expect to observe?
A. Sitting steadily without support
B. Walking while holding onto furniture
C. Rolling from back to abdomen
D. Using a neat pincer grasp
Answer: C
Conceptual Explanation: By 6 months, infants typically roll from back to abdomen. Sitting
steadily usually occurs at 8 months, and the pincer grasp at 9-10 months.
4. A child is admitted with a suspected diagnosis of Wilms tumor. Which action is most
important for the nurse to include in the plan of care?
A. Palpate the abdomen for mass size every shift
B. Avoid all abdominal palpation
, C. Monitor urine output for gross hematuria
D. Measure abdominal girth daily
Answer: B
Conceptual Explanation: Palpation of a Wilms tumor can cause the encapsulated tumor to
rupture, leading to the seeding of cancer cells into the peritoneal cavity.
5. A 10-year-old child with Hemophilia A is brought to the ED after falling. The nurse should
anticipate administering which treatment first?
A. Nonsteroidal anti-inflammatory drugs
B. Fresh frozen plasma
C. Desmopressin (DDAVP)
D. Factor VIII concentrate
Answer: D
Conceptual Explanation: Hemophilia A is a deficiency in Factor VIII. Replacing the missing
clotting factor is the priority treatment for acute bleeding episodes.
6. Which assessment finding in an infant with Tetralogy of Fallot requires immediate nursing
intervention?
A. A loud systolic murmur
B. Clubbing of the fingernails
C. Hypercyanotic spell (Tet spell)
1 (NR 328 2026/2027) QUESTIONS AND
ANSWERS
1. A nurse is caring for a 2-year-old child admitted with croup. Which clinical manifestation
should the nurse prioritize as a sign of impending respiratory failure?
A. Barking cough and hoarseness
B. Inspiratory stridor at rest
C. N/A
D. Tachycardia and increased restlessness
E. Nasal flaring and intercostal retractions
Answer: E
Conceptual Explanation: While all options are signs of respiratory distress in croup, nasal
flaring and retractions indicate the use of accessory muscles and are significant signs of
impending respiratory failure.
2. When assessing a 4-year-old child, the nurse notes that the child is in Piaget’s
preoperational stage. Which behavior is most characteristic of this stage?
A. Understanding conservation of volume
,B. Egocentrism in thought and speech
C. Ability to perform abstract reasoning
D. Logical thinking about concrete events
Answer: B
Conceptual Explanation: In the preoperational stage (ages 2-7), children exhibit
egocentrism, meaning they are unable to see situations from another person’s perspective.
3. A mother brings her 6-month-old infant to the clinic. Which developmental milestone
should the nurse expect to observe?
A. Sitting steadily without support
B. Walking while holding onto furniture
C. Rolling from back to abdomen
D. Using a neat pincer grasp
Answer: C
Conceptual Explanation: By 6 months, infants typically roll from back to abdomen. Sitting
steadily usually occurs at 8 months, and the pincer grasp at 9-10 months.
4. A child is admitted with a suspected diagnosis of Wilms tumor. Which action is most
important for the nurse to include in the plan of care?
A. Palpate the abdomen for mass size every shift
B. Avoid all abdominal palpation
, C. Monitor urine output for gross hematuria
D. Measure abdominal girth daily
Answer: B
Conceptual Explanation: Palpation of a Wilms tumor can cause the encapsulated tumor to
rupture, leading to the seeding of cancer cells into the peritoneal cavity.
5. A 10-year-old child with Hemophilia A is brought to the ED after falling. The nurse should
anticipate administering which treatment first?
A. Nonsteroidal anti-inflammatory drugs
B. Fresh frozen plasma
C. Desmopressin (DDAVP)
D. Factor VIII concentrate
Answer: D
Conceptual Explanation: Hemophilia A is a deficiency in Factor VIII. Replacing the missing
clotting factor is the priority treatment for acute bleeding episodes.
6. Which assessment finding in an infant with Tetralogy of Fallot requires immediate nursing
intervention?
A. A loud systolic murmur
B. Clubbing of the fingernails
C. Hypercyanotic spell (Tet spell)
