NU225
Pediatric Nursing
Final Exam Prep
2026
(With Solutions)
Multiple Choice Questions
A 6-month-old infant with severe bronchiolitis is admitted to the pediatric ICU. Which intervention is
the priority? a) Administering broad-spectrum antibiotics b) Monitoring oxygen saturation and
providing supplemental oxygen c) Starting enteral feeding immediately d) Giving corticosteroids
routinely
Answer: b) Monitoring oxygen saturation and providing supplemental oxygen
Rationale: Bronchiolitis is usually viral, so antibiotics are not first-line. The priority is maintaining
effective oxygenation.
2. Which of the following findings would be most concerning in a toddler with suspected dehydration?
a) Moist mucous membranes
b) Capillary refill time 4 seconds
c) Urine output of 1 ml/kg/hr
d) Heart rate of 110 bpm
Answer: b) Capillary refill time 4 seconds
Rationale: Prolonged capillary refill (>3 seconds) indicates poor perfusion and significant dehydration.
3. In caring for a child with Nephrotic Syndrome, the nurse knows that the primary therapeutic goal is
to:
a) Prevent infection through strict isolation
b) Reduce proteinuria and edema
c) Maintain strict bed rest for 2 weeks
d) Avoid corticosteroids due to side effects
,Answer: b) Reduce proteinuria and edema
Rationale: Nephrotic Syndrome management focuses on decreasing protein loss and controlling edema,
often with corticosteroids.
4. A child with a cyanotic congenital heart defect is admitted. Which nursing action is most appropriate
during a hypercyanotic spell?
a) Place the child in a supine position
b) Administer 100% oxygen and knee-chest position
c) Encourage vigorous crying to promote circulation
d) Withhold fluids and medications
Answer: b) Administer 100% oxygen and knee-chest position
Rationale: Knee-chest position increases systemic vascular resistance, reducing right to left shunting and
improving oxygenation.
5. Which laboratory value indicates effective treatment in a child undergoing chemotherapy for
leukemia?
a) WBC 2000/mm³
b) Platelet count 500,000/mm³
c) Hemoglobin 6 g/dL
d) ANC (Absolute Neutrophil Count) of 1500/mm³
Answer: d) ANC of 1500/mm³
Rationale: ANC >1000 indicates recovering immune function; low WBC or platelets may be expected
during chemo.
True / False Questions
6. True or False: Administration of Live Vaccines is contraindicated in immunocompromised pediatric
patients.
Answer: True
Rationale: Live vaccines may cause disease in immunocompromised children.
7. True or False: A child with Kawasaki disease requires long-term antibiotic therapy.
,Answer: False
Rationale: Kawasaki disease is treated with IVIG and aspirin, not antibiotics.
8. True or False: In pediatric patients, the stomach can hold approximately 30-60 mL of fluid at birth.
Answer: True
Rationale: This small volume influences feeding frequency and tolerance in infants.
9. True or False: Pediatric patients have a higher metabolic rate and require proportionally more fluids
than adults.
Answer: True
Rationale: Higher metabolic demands increase fluid needs.
10. True or False: Continuous cardiac monitoring is unnecessary in infants with congenital heart surgery
in the immediate postoperative period.
Answer: False
Rationale: Continuous monitoring is critical due to high risk of arrhythmias and hemodynamic
instability.
Short Answer Questions
11. Describe the pathophysiology that results in stridor in croup.
Answer: Stridor in croup results from inflammation and swelling of the subglottic area, causing partial
airway obstruction during inspiration.
Rationale: Understanding airway anatomy helps in targeted nursing care.
12. List three nursing assessments critical when caring for a child with a shunt for hydrocephalus.
Answer: Level of consciousness, signs of increased intracranial pressure, and ventricular shunt site
inspection for infection or swelling.
Rationale: Early detection of shunt malfunction or infection prevents serious complications.
, 13. Explain why infants with cleft palate are at risk for otitis media.
Answer: The cleft palate affects the function of the Eustachian tube, impairing drainage and ventilation,
leading to fluid accumulation and infections.
Rationale: This anatomical defect predisposes to middle ear infections.
14. Name two major signs of hypoglycemia in a neonate.
Answer: Jitteriness and lethargy.
Rationale: Early signs allow prompt intervention to prevent neurological damage.
15. What is the priority nursing action when a pediatric patient develops seizure activity?
Answer: Ensure airway patency and prevent injury by positioning the child on their side.
Rationale: Protecting airway and safety minimizes complications from seizures.
Fill-in-the-Blank Questions
16. The preferred site for intramuscular injections in infants is the __________ muscle.
Answer: Vastus lateralis
Rationale: This site is well developed and avoids major nerves.
17. In toddlers, failure to thrive is most often due to nutritional __________.
Answer: Deficiency
Rationale: Inadequate intake is a common cause in this age group.
18. The hallmark laboratory finding in Iron Deficiency Anemia in children is __________.
Answer: Microcytic hypochromic anemia
Rationale: Small, pale red blood cells indicate iron deficiency.
19. Respiratory distress in neonates is often manifested by nasal flaring, grunting, and __________.
Pediatric Nursing
Final Exam Prep
2026
(With Solutions)
Multiple Choice Questions
A 6-month-old infant with severe bronchiolitis is admitted to the pediatric ICU. Which intervention is
the priority? a) Administering broad-spectrum antibiotics b) Monitoring oxygen saturation and
providing supplemental oxygen c) Starting enteral feeding immediately d) Giving corticosteroids
routinely
Answer: b) Monitoring oxygen saturation and providing supplemental oxygen
Rationale: Bronchiolitis is usually viral, so antibiotics are not first-line. The priority is maintaining
effective oxygenation.
2. Which of the following findings would be most concerning in a toddler with suspected dehydration?
a) Moist mucous membranes
b) Capillary refill time 4 seconds
c) Urine output of 1 ml/kg/hr
d) Heart rate of 110 bpm
Answer: b) Capillary refill time 4 seconds
Rationale: Prolonged capillary refill (>3 seconds) indicates poor perfusion and significant dehydration.
3. In caring for a child with Nephrotic Syndrome, the nurse knows that the primary therapeutic goal is
to:
a) Prevent infection through strict isolation
b) Reduce proteinuria and edema
c) Maintain strict bed rest for 2 weeks
d) Avoid corticosteroids due to side effects
,Answer: b) Reduce proteinuria and edema
Rationale: Nephrotic Syndrome management focuses on decreasing protein loss and controlling edema,
often with corticosteroids.
4. A child with a cyanotic congenital heart defect is admitted. Which nursing action is most appropriate
during a hypercyanotic spell?
a) Place the child in a supine position
b) Administer 100% oxygen and knee-chest position
c) Encourage vigorous crying to promote circulation
d) Withhold fluids and medications
Answer: b) Administer 100% oxygen and knee-chest position
Rationale: Knee-chest position increases systemic vascular resistance, reducing right to left shunting and
improving oxygenation.
5. Which laboratory value indicates effective treatment in a child undergoing chemotherapy for
leukemia?
a) WBC 2000/mm³
b) Platelet count 500,000/mm³
c) Hemoglobin 6 g/dL
d) ANC (Absolute Neutrophil Count) of 1500/mm³
Answer: d) ANC of 1500/mm³
Rationale: ANC >1000 indicates recovering immune function; low WBC or platelets may be expected
during chemo.
True / False Questions
6. True or False: Administration of Live Vaccines is contraindicated in immunocompromised pediatric
patients.
Answer: True
Rationale: Live vaccines may cause disease in immunocompromised children.
7. True or False: A child with Kawasaki disease requires long-term antibiotic therapy.
,Answer: False
Rationale: Kawasaki disease is treated with IVIG and aspirin, not antibiotics.
8. True or False: In pediatric patients, the stomach can hold approximately 30-60 mL of fluid at birth.
Answer: True
Rationale: This small volume influences feeding frequency and tolerance in infants.
9. True or False: Pediatric patients have a higher metabolic rate and require proportionally more fluids
than adults.
Answer: True
Rationale: Higher metabolic demands increase fluid needs.
10. True or False: Continuous cardiac monitoring is unnecessary in infants with congenital heart surgery
in the immediate postoperative period.
Answer: False
Rationale: Continuous monitoring is critical due to high risk of arrhythmias and hemodynamic
instability.
Short Answer Questions
11. Describe the pathophysiology that results in stridor in croup.
Answer: Stridor in croup results from inflammation and swelling of the subglottic area, causing partial
airway obstruction during inspiration.
Rationale: Understanding airway anatomy helps in targeted nursing care.
12. List three nursing assessments critical when caring for a child with a shunt for hydrocephalus.
Answer: Level of consciousness, signs of increased intracranial pressure, and ventricular shunt site
inspection for infection or swelling.
Rationale: Early detection of shunt malfunction or infection prevents serious complications.
, 13. Explain why infants with cleft palate are at risk for otitis media.
Answer: The cleft palate affects the function of the Eustachian tube, impairing drainage and ventilation,
leading to fluid accumulation and infections.
Rationale: This anatomical defect predisposes to middle ear infections.
14. Name two major signs of hypoglycemia in a neonate.
Answer: Jitteriness and lethargy.
Rationale: Early signs allow prompt intervention to prevent neurological damage.
15. What is the priority nursing action when a pediatric patient develops seizure activity?
Answer: Ensure airway patency and prevent injury by positioning the child on their side.
Rationale: Protecting airway and safety minimizes complications from seizures.
Fill-in-the-Blank Questions
16. The preferred site for intramuscular injections in infants is the __________ muscle.
Answer: Vastus lateralis
Rationale: This site is well developed and avoids major nerves.
17. In toddlers, failure to thrive is most often due to nutritional __________.
Answer: Deficiency
Rationale: Inadequate intake is a common cause in this age group.
18. The hallmark laboratory finding in Iron Deficiency Anemia in children is __________.
Answer: Microcytic hypochromic anemia
Rationale: Small, pale red blood cells indicate iron deficiency.
19. Respiratory distress in neonates is often manifested by nasal flaring, grunting, and __________.
