NCLEX RN Paediatric Infectious
Diseases Practice Exam 100 Questions
And Correct Answers (Verified
Answers) Plus Rationales 2026
1. A child with suspected bacterial meningitis is admitted to the pediatric
unit. Which action should the nurse take first?
A. Encourage oral fluids
B. Place the child on droplet precautions
C. Obtain a urine specimen
D. Dim the room lights
Answer: Place the child on droplet precautions
Rationale: Droplet precautions help prevent transmission of organisms that
can cause bacterial meningitis, particularly during the initial period of
treatment.
2. Which assessment finding is most concerning in an infant with suspected
meningitis?
A. Poor appetite
B. Irritability
C. Bulging fontanel
D. Mild nasal congestion
Answer: Bulging fontanel
Rationale: A bulging fontanel can indicate increased intracranial pressure and
is a significant finding in infants with meningitis.
3. A child is receiving antibiotics for bacterial meningitis. Which finding
requires immediate intervention?
,A. Temperature of 38.2°C (100.8°F)
B. Headache
C. Increasing lethargy and decreased responsiveness
D. Decreased appetite
Answer: Increasing lethargy and decreased responsiveness
Rationale: A declining level of consciousness may indicate increased
intracranial pressure, seizures, or worsening infection and requires
immediate assessment.
4. Which vaccine provides protection against Haemophilus influenzae type
b?
A. MMR
B. Hib
C. Varicella
D. IPV
Answer: Hib
Rationale: The Hib vaccine protects children against invasive disease caused
by Haemophilus influenzae type b, including meningitis and epiglottitis.
5. Which symptom is characteristic of measles?
A. Vesicular rash beginning on the trunk
B. Koplik spots
C. Strawberry tongue only
D. Parotid swelling
Answer: Koplik spots
Rationale: Koplik spots are small bluish-white lesions on a red background
inside the cheeks and are characteristic of measles.
6. A child with measles should be placed on which type of precautions?
A. Contact
B. Droplet
C. Airborne
D. Protective isolation
,Answer: Airborne
Rationale: Measles is highly contagious and is transmitted through airborne
particles. Airborne precautions are required.
7. Which finding is most characteristic of mumps?
A. Parotid gland swelling
B. Vesicular lesions
C. Severe diarrhea
D. Koplik spots
Answer: Parotid gland swelling
Rationale: Painful swelling of the parotid glands is a classic manifestation of
mumps.
8. Which complication should the nurse monitor for in an adolescent with
mumps?
A. Orchitis
B. Appendicitis
C. Croup
D. Pyloric stenosis
Answer: Orchitis
Rationale: Orchitis is a recognized complication of mumps in postpubertal
males and can cause testicular pain and swelling.
9. A child with varicella has vesicular lesions. Which instruction is most
appropriate?
A. Encourage scratching to remove crusts
B. Keep fingernails short
C. Apply antibiotic ointment to all lesions routinely
D. Encourage hot baths
Answer: Keep fingernails short
Rationale: Keeping nails short reduces skin trauma and secondary bacterial
infection caused by scratching.
, 10.Which description best characterizes the rash of varicella?
A. Vesicles appearing in successive crops
B. Petechiae limited to the legs
C. A single large erythematous patch
D. Nonpruritic macules only
Answer: Vesicles appearing in successive crops
Rationale: Varicella lesions appear in crops, so macules, papules, vesicles, and
crusted lesions may be present simultaneously.
11.Which isolation precaution is appropriate for a hospitalized child with
varicella?
A. Standard only
B. Droplet only
C. Airborne and contact
D. Protective isolation
Answer: Airborne and contact
Rationale: Varicella spreads through airborne transmission and direct contact
with vesicular fluid.
12.Which infection is commonly associated with a “slapped-cheek” facial
appearance?
A. Roseola
B. Fifth disease
C. Measles
D. Rubella
Answer: Fifth disease
Rationale: Fifth disease, caused by parvovirus B19, commonly produces an
erythematous “slapped-cheek” rash followed by a lacy body rash.
13.Which child with parvovirus B19 infection requires particularly careful
assessment?
A. A child with seasonal allergies
B. A child with sickle cell disease
Diseases Practice Exam 100 Questions
And Correct Answers (Verified
Answers) Plus Rationales 2026
1. A child with suspected bacterial meningitis is admitted to the pediatric
unit. Which action should the nurse take first?
A. Encourage oral fluids
B. Place the child on droplet precautions
C. Obtain a urine specimen
D. Dim the room lights
Answer: Place the child on droplet precautions
Rationale: Droplet precautions help prevent transmission of organisms that
can cause bacterial meningitis, particularly during the initial period of
treatment.
2. Which assessment finding is most concerning in an infant with suspected
meningitis?
A. Poor appetite
B. Irritability
C. Bulging fontanel
D. Mild nasal congestion
Answer: Bulging fontanel
Rationale: A bulging fontanel can indicate increased intracranial pressure and
is a significant finding in infants with meningitis.
3. A child is receiving antibiotics for bacterial meningitis. Which finding
requires immediate intervention?
,A. Temperature of 38.2°C (100.8°F)
B. Headache
C. Increasing lethargy and decreased responsiveness
D. Decreased appetite
Answer: Increasing lethargy and decreased responsiveness
Rationale: A declining level of consciousness may indicate increased
intracranial pressure, seizures, or worsening infection and requires
immediate assessment.
4. Which vaccine provides protection against Haemophilus influenzae type
b?
A. MMR
B. Hib
C. Varicella
D. IPV
Answer: Hib
Rationale: The Hib vaccine protects children against invasive disease caused
by Haemophilus influenzae type b, including meningitis and epiglottitis.
5. Which symptom is characteristic of measles?
A. Vesicular rash beginning on the trunk
B. Koplik spots
C. Strawberry tongue only
D. Parotid swelling
Answer: Koplik spots
Rationale: Koplik spots are small bluish-white lesions on a red background
inside the cheeks and are characteristic of measles.
6. A child with measles should be placed on which type of precautions?
A. Contact
B. Droplet
C. Airborne
D. Protective isolation
,Answer: Airborne
Rationale: Measles is highly contagious and is transmitted through airborne
particles. Airborne precautions are required.
7. Which finding is most characteristic of mumps?
A. Parotid gland swelling
B. Vesicular lesions
C. Severe diarrhea
D. Koplik spots
Answer: Parotid gland swelling
Rationale: Painful swelling of the parotid glands is a classic manifestation of
mumps.
8. Which complication should the nurse monitor for in an adolescent with
mumps?
A. Orchitis
B. Appendicitis
C. Croup
D. Pyloric stenosis
Answer: Orchitis
Rationale: Orchitis is a recognized complication of mumps in postpubertal
males and can cause testicular pain and swelling.
9. A child with varicella has vesicular lesions. Which instruction is most
appropriate?
A. Encourage scratching to remove crusts
B. Keep fingernails short
C. Apply antibiotic ointment to all lesions routinely
D. Encourage hot baths
Answer: Keep fingernails short
Rationale: Keeping nails short reduces skin trauma and secondary bacterial
infection caused by scratching.
, 10.Which description best characterizes the rash of varicella?
A. Vesicles appearing in successive crops
B. Petechiae limited to the legs
C. A single large erythematous patch
D. Nonpruritic macules only
Answer: Vesicles appearing in successive crops
Rationale: Varicella lesions appear in crops, so macules, papules, vesicles, and
crusted lesions may be present simultaneously.
11.Which isolation precaution is appropriate for a hospitalized child with
varicella?
A. Standard only
B. Droplet only
C. Airborne and contact
D. Protective isolation
Answer: Airborne and contact
Rationale: Varicella spreads through airborne transmission and direct contact
with vesicular fluid.
12.Which infection is commonly associated with a “slapped-cheek” facial
appearance?
A. Roseola
B. Fifth disease
C. Measles
D. Rubella
Answer: Fifth disease
Rationale: Fifth disease, caused by parvovirus B19, commonly produces an
erythematous “slapped-cheek” rash followed by a lacy body rash.
13.Which child with parvovirus B19 infection requires particularly careful
assessment?
A. A child with seasonal allergies
B. A child with sickle cell disease
