NCLEX RN Paediatric Nursing Exam 1
Practice Test 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A nurse is assessing a 2-month-old infant. Which finding requires
immediate follow-up?
A. Respiratory rate of 40/min
B. Heart rate of 140/min
C. Anterior fontanelle soft and flat
D. Temperature of 38.1°C (100.6°F)
Answer: Temperature of 38.1°C (100.6°F)
Rationale: A rectal temperature of 38°C (100.4°F) or higher in an infant
younger than 3 months requires prompt evaluation because serious bacterial
infection can present with fever.
2. Which developmental milestone should the nurse expect in a 6-month-
old infant?
A. Walking independently
B. Using two-word phrases
C. Sitting with minimal support
D. Riding a tricycle
Answer: Sitting with minimal support
Rationale: By approximately 6 months, infants typically develop improved
trunk control and can sit with support or briefly sit independently.
3. A nurse is teaching parents about preventing sudden infant death
syndrome (SIDS). Which statement indicates correct understanding?
,A. “I will place my baby on the stomach for sleep.”
B. “I will use a soft pillow under my baby's head.”
C. “I will let my baby sleep on a couch if supervised.”
D. “I will place my baby on the back on a firm sleep surface.”
Answer: “I will place my baby on the back on a firm sleep surface.”
Rationale: Supine positioning on a firm, flat sleep surface without pillows,
loose bedding, or soft objects reduces the risk of sleep-related infant death.
4. A 9-month-old infant is hospitalized. Which behavior is most consistent
with normal development?
A. Fear of strangers
B. Stranger anxiety and separation anxiety
C. Cooperative play with other children
D. Ability to understand abstract concepts
Answer: Stranger anxiety and separation anxiety
Rationale: Infants around 6–12 months commonly develop stranger anxiety
and become distressed when separated from familiar caregivers.
5. A nurse is assessing a toddler's growth. Which characteristic is expected
during the toddler period?
A. Rapid increase in head circumference
B. Slower growth compared with infancy
C. Complete development of abstract reasoning
D. Loss of all primary teeth
Answer: Slower growth compared with infancy
Rationale: Growth velocity decreases significantly after infancy. Toddlers
typically gain weight and height more slowly than infants.
6. A parent reports that a 2-year-old frequently says “no” and insists on
doing things independently. How should the nurse interpret this
behavior?
A. Evidence of delayed development
B. Sign of conduct disorder
,C. Normal expression of autonomy
D. Indication of impaired attachment
Answer: Normal expression of autonomy
Rationale: Toddlers commonly assert independence through negativism,
ritualism, and attempts to control their environment.
7. Which activity is most appropriate for a hospitalized 3-year-old child?
A. Complex board game
B. Crossword puzzle
C. Large-piece building blocks
D. Abstract strategy game
Answer: Large-piece building blocks
Rationale: Preschool children benefit from activities involving manipulation,
imagination, and simple construction. Large pieces also reduce choking risk.
8. A 4-year-old child asks whether an illness occurred because the child was
“bad.” Which response is best?
A. “Yes, sometimes bad behavior causes illness.”
B. “You should not ask questions like that.”
C. “Your parents know why you became sick.”
D. “Being sick is not caused by being a bad person.”
Rationale: Preschoolers may use magical thinking and believe illness is
punishment. The nurse should provide simple reassurance and correct
misconceptions.
9. Which developmental behavior is expected in a school-age child?
A. Parallel play
B. Stranger anxiety
C. Increasing interest in peer relationships
D. Complete dependence on parents for decision-making
Answer: Increasing interest in peer relationships
Rationale: School-age children increasingly value friendships, peer
acceptance, teamwork, and achievement.
, 10.A nurse is teaching an adolescent about health promotion. Which topic is
especially important?
A. Toilet training
B. Stranger anxiety
C. Risk-taking behaviors and injury prevention
D. Introduction of solid foods
Answer: Risk-taking behaviors and injury prevention
Rationale: Adolescents may engage in risk-taking behaviors. Counseling
should address driving safety, substance use, sexual health, violence
prevention, and mental health.
11.A child with suspected epiglottitis arrives in the emergency department.
Which action should the nurse take first?
A. Inspect the throat with a tongue blade.
B. Obtain a throat culture immediately.
C. Place the child supine.
D. Keep the child calm and prepare for airway management.
Answer: Keep the child calm and prepare for airway management.
Rationale: Epiglottitis can cause rapid airway obstruction. Agitating the child
or examining the throat can worsen obstruction.
12.Which assessment finding is most characteristic of croup?
A. Drooling with tripod positioning
B. Barking cough and inspiratory stridor
C. Productive cough with hemoptysis
D. Expiratory wheezing only
Answer: Barking cough and inspiratory stridor
Rationale: Viral croup commonly produces a characteristic barking cough,
hoarseness, and inspiratory stridor caused by upper-airway inflammation.
13.A child with asthma develops severe respiratory distress. Which finding
indicates worsening airway obstruction?
Practice Test 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A nurse is assessing a 2-month-old infant. Which finding requires
immediate follow-up?
A. Respiratory rate of 40/min
B. Heart rate of 140/min
C. Anterior fontanelle soft and flat
D. Temperature of 38.1°C (100.6°F)
Answer: Temperature of 38.1°C (100.6°F)
Rationale: A rectal temperature of 38°C (100.4°F) or higher in an infant
younger than 3 months requires prompt evaluation because serious bacterial
infection can present with fever.
2. Which developmental milestone should the nurse expect in a 6-month-
old infant?
A. Walking independently
B. Using two-word phrases
C. Sitting with minimal support
D. Riding a tricycle
Answer: Sitting with minimal support
Rationale: By approximately 6 months, infants typically develop improved
trunk control and can sit with support or briefly sit independently.
3. A nurse is teaching parents about preventing sudden infant death
syndrome (SIDS). Which statement indicates correct understanding?
,A. “I will place my baby on the stomach for sleep.”
B. “I will use a soft pillow under my baby's head.”
C. “I will let my baby sleep on a couch if supervised.”
D. “I will place my baby on the back on a firm sleep surface.”
Answer: “I will place my baby on the back on a firm sleep surface.”
Rationale: Supine positioning on a firm, flat sleep surface without pillows,
loose bedding, or soft objects reduces the risk of sleep-related infant death.
4. A 9-month-old infant is hospitalized. Which behavior is most consistent
with normal development?
A. Fear of strangers
B. Stranger anxiety and separation anxiety
C. Cooperative play with other children
D. Ability to understand abstract concepts
Answer: Stranger anxiety and separation anxiety
Rationale: Infants around 6–12 months commonly develop stranger anxiety
and become distressed when separated from familiar caregivers.
5. A nurse is assessing a toddler's growth. Which characteristic is expected
during the toddler period?
A. Rapid increase in head circumference
B. Slower growth compared with infancy
C. Complete development of abstract reasoning
D. Loss of all primary teeth
Answer: Slower growth compared with infancy
Rationale: Growth velocity decreases significantly after infancy. Toddlers
typically gain weight and height more slowly than infants.
6. A parent reports that a 2-year-old frequently says “no” and insists on
doing things independently. How should the nurse interpret this
behavior?
A. Evidence of delayed development
B. Sign of conduct disorder
,C. Normal expression of autonomy
D. Indication of impaired attachment
Answer: Normal expression of autonomy
Rationale: Toddlers commonly assert independence through negativism,
ritualism, and attempts to control their environment.
7. Which activity is most appropriate for a hospitalized 3-year-old child?
A. Complex board game
B. Crossword puzzle
C. Large-piece building blocks
D. Abstract strategy game
Answer: Large-piece building blocks
Rationale: Preschool children benefit from activities involving manipulation,
imagination, and simple construction. Large pieces also reduce choking risk.
8. A 4-year-old child asks whether an illness occurred because the child was
“bad.” Which response is best?
A. “Yes, sometimes bad behavior causes illness.”
B. “You should not ask questions like that.”
C. “Your parents know why you became sick.”
D. “Being sick is not caused by being a bad person.”
Rationale: Preschoolers may use magical thinking and believe illness is
punishment. The nurse should provide simple reassurance and correct
misconceptions.
9. Which developmental behavior is expected in a school-age child?
A. Parallel play
B. Stranger anxiety
C. Increasing interest in peer relationships
D. Complete dependence on parents for decision-making
Answer: Increasing interest in peer relationships
Rationale: School-age children increasingly value friendships, peer
acceptance, teamwork, and achievement.
, 10.A nurse is teaching an adolescent about health promotion. Which topic is
especially important?
A. Toilet training
B. Stranger anxiety
C. Risk-taking behaviors and injury prevention
D. Introduction of solid foods
Answer: Risk-taking behaviors and injury prevention
Rationale: Adolescents may engage in risk-taking behaviors. Counseling
should address driving safety, substance use, sexual health, violence
prevention, and mental health.
11.A child with suspected epiglottitis arrives in the emergency department.
Which action should the nurse take first?
A. Inspect the throat with a tongue blade.
B. Obtain a throat culture immediately.
C. Place the child supine.
D. Keep the child calm and prepare for airway management.
Answer: Keep the child calm and prepare for airway management.
Rationale: Epiglottitis can cause rapid airway obstruction. Agitating the child
or examining the throat can worsen obstruction.
12.Which assessment finding is most characteristic of croup?
A. Drooling with tripod positioning
B. Barking cough and inspiratory stridor
C. Productive cough with hemoptysis
D. Expiratory wheezing only
Answer: Barking cough and inspiratory stridor
Rationale: Viral croup commonly produces a characteristic barking cough,
hoarseness, and inspiratory stridor caused by upper-airway inflammation.
13.A child with asthma develops severe respiratory distress. Which finding
indicates worsening airway obstruction?
