NR 328 Pediatric Nursing ACTUAL EXAM
2026/2027: 100% Verified Questions &
Correct Answers
Question 1: A 4-year-old child is admitted with pneumonia. Which finding indicates the child is in
the compensatory stage of respiratory distress?
A. Bradycardia and lethargy
B. Nasal flaring and intercostal retractions
C. Apnea and cyanosis
D. Hypotension and poor peripheral perfusion
Correct Answer: B
Rationale: Nasal flaring and intercostal retractions are early compensatory signs of increased work
of breathing in pediatric patients (AAP, 2025).
Question 2: An 18-month-old toddler is scheduled for MMR and varicella vaccines. Which injection
site is developmentally and anatomically appropriate?
A. Deltoid of left arm
B. Vastus lateralis of right thigh
,C. Dorsogluteal muscle
D. Ventrogluteal muscle
Correct Answer: B
Rationale: Vastus lateralis is the preferred site for IM injections in toddlers <2 years due to
adequate muscle mass and absence of major nerves (AAP Red Book, 2026).
Question 3: A 6-year-old with asthma is prescribed albuterol MDI 2 puffs q4h. The dose per puff is
90 mcg. What is the total daily dose (mcg) if administered 4 times?
A. 360 mcg
B. 720 mcg
C. 1080 mcg
D. 1440 mcg
Correct Answer: B
Rationale: 90 mcg × 2 puffs × 4 administrations = 720 mcg/day.
Question 4: A 3-month-old infant weighs 5.2 kg. Acetaminophen 15 mg/kg is ordered q6h PRN for
fever. What is the single dose in mg?
A. 52 mg
B. 65 mg
,C. 78 mg
D. 104 mg
Correct Answer: C
Rationale: 5.2 kg × 15 mg/kg = 78 mg per dose.
Question 5: A 7-year-old child with sickle cell disease is receiving a blood transfusion. Fifteen
minutes into the infusion, the child reports chills and fever of 38.9 °C. What is the priority nursing
action?
A. Slow the infusion and give acetaminophen
B. Stop the transfusion immediately and maintain IV access
C. Check the cross-match tag with another nurse
D. Administer diphenhydramine IV
Correct Answer: B
Rationale: Immediate cessation prevents further hemolytic or febrile reaction; maintain saline lock
for possible emergency meds (AAP, 2025).
Question 6: A 9-month-old infant is brought to the clinic for a well-child visit. Which gross-motor
milestone is expected at this age?
A. Walks alone
B. Pulls to stand
, C. Rides tricycle
D. Hops on one foot
Correct Answer: B
Rationale: Pulling to stand is a 9-month milestone; independent walking occurs ~12 months (CDC,
2026).
Question 7: A 2-day-old newborn is jittery, tachypneic, and has a high-pitched cry. Blood glucose is
32 mg/dL. What is the initial management?
A. Feed 5 mL of sterile water
B. Give 2 mL/kg 10 % dextrose IV push
C. Apply warmed blankets only
D. Offer 15 mL of formula
Correct Answer: B
Rationale: Symptomatic hypoglycemia <40 mg/dL requires 2 mL/kg of 10 % dextrose IV followed by
continuous infusion (AAP, 2025).
Question 8: A 5-year-old with acute lymphoblastic leukemia is on methotrexate PO weekly. Which
vitamin is routinely supplemented to reduce mucositis?
A. Vitamin A
B. Folic acid
2026/2027: 100% Verified Questions &
Correct Answers
Question 1: A 4-year-old child is admitted with pneumonia. Which finding indicates the child is in
the compensatory stage of respiratory distress?
A. Bradycardia and lethargy
B. Nasal flaring and intercostal retractions
C. Apnea and cyanosis
D. Hypotension and poor peripheral perfusion
Correct Answer: B
Rationale: Nasal flaring and intercostal retractions are early compensatory signs of increased work
of breathing in pediatric patients (AAP, 2025).
Question 2: An 18-month-old toddler is scheduled for MMR and varicella vaccines. Which injection
site is developmentally and anatomically appropriate?
A. Deltoid of left arm
B. Vastus lateralis of right thigh
,C. Dorsogluteal muscle
D. Ventrogluteal muscle
Correct Answer: B
Rationale: Vastus lateralis is the preferred site for IM injections in toddlers <2 years due to
adequate muscle mass and absence of major nerves (AAP Red Book, 2026).
Question 3: A 6-year-old with asthma is prescribed albuterol MDI 2 puffs q4h. The dose per puff is
90 mcg. What is the total daily dose (mcg) if administered 4 times?
A. 360 mcg
B. 720 mcg
C. 1080 mcg
D. 1440 mcg
Correct Answer: B
Rationale: 90 mcg × 2 puffs × 4 administrations = 720 mcg/day.
Question 4: A 3-month-old infant weighs 5.2 kg. Acetaminophen 15 mg/kg is ordered q6h PRN for
fever. What is the single dose in mg?
A. 52 mg
B. 65 mg
,C. 78 mg
D. 104 mg
Correct Answer: C
Rationale: 5.2 kg × 15 mg/kg = 78 mg per dose.
Question 5: A 7-year-old child with sickle cell disease is receiving a blood transfusion. Fifteen
minutes into the infusion, the child reports chills and fever of 38.9 °C. What is the priority nursing
action?
A. Slow the infusion and give acetaminophen
B. Stop the transfusion immediately and maintain IV access
C. Check the cross-match tag with another nurse
D. Administer diphenhydramine IV
Correct Answer: B
Rationale: Immediate cessation prevents further hemolytic or febrile reaction; maintain saline lock
for possible emergency meds (AAP, 2025).
Question 6: A 9-month-old infant is brought to the clinic for a well-child visit. Which gross-motor
milestone is expected at this age?
A. Walks alone
B. Pulls to stand
, C. Rides tricycle
D. Hops on one foot
Correct Answer: B
Rationale: Pulling to stand is a 9-month milestone; independent walking occurs ~12 months (CDC,
2026).
Question 7: A 2-day-old newborn is jittery, tachypneic, and has a high-pitched cry. Blood glucose is
32 mg/dL. What is the initial management?
A. Feed 5 mL of sterile water
B. Give 2 mL/kg 10 % dextrose IV push
C. Apply warmed blankets only
D. Offer 15 mL of formula
Correct Answer: B
Rationale: Symptomatic hypoglycemia <40 mg/dL requires 2 mL/kg of 10 % dextrose IV followed by
continuous infusion (AAP, 2025).
Question 8: A 5-year-old with acute lymphoblastic leukemia is on methotrexate PO weekly. Which
vitamin is routinely supplemented to reduce mucositis?
A. Vitamin A
B. Folic acid
