At a 4-month well visit, a nurse reviews feeding and soothing with the mother of an exclusively breastfed girl. Which statement by the mother indicates a need for further teaching?

I can dip her pacifier in a little honey when she is fussy at night.

I should not put cereal in her bottle to help her sleep longer.

I will keep giving her the vitamin D drops of 400 IU every day.

I will wait until about 6 months and signs of readiness to start solid foods.

A nurse is assessing postoperative pain in a 14-year-old boy with cerebral palsy and a severe cognitive impairment who does not use words to communicate. Which pain assessment tool is most appropriate?

Revised FLACC (r-FLACC) scale, with parent input on his usual pain behaviors

Neonatal Infant Pain Scale (NIPS), since he is unable to give self-report

Wong-Baker FACES scale, pointing to each face and asking him to choose one

Numeric 0-10 rating scale, because the tool is validated for adolescents

A nurse is reviewing diet teaching with the parents of a 7-year-old recently diagnosed with celiac disease. Which statement by the parent indicates a need for further teaching?

"Regular oatmeal from the grocery store is a good breakfast choice for him."

"We need to check the food labels for wheat, barley and rye in every product."

"He should stay on a gluten-free diet even when his symptoms go away."

"Rice, corn and potatoes can be part of his meals without any problem."

A term newborn is born with an intact lumbosacral myelomeningocele and is awaiting surgical closure. Which nursing action is the priority?

Cover the sac with a sterile saline-moistened dressing and position the infant prone

Wrap the infant warmly in a blanket and encourage the parents to hold her

Place the infant supine with a rolled towel under the sac to support it and prevent rupture

Apply a dry gauze dressing and diaper snugly to keep stool off the sac

The mother of a 1-month-old exclusively breastfed boy asks whether he needs any supplements. Which response by the nurse is correct?

He needs vitamin D drops, 400 IU every day.

He needs a daily iron drop starting this week.

He needs no supplements while breastfeeding.

He needs fluoride drops from now until age 2.

A nurse obtains a blood pressure of 136/88 mm Hg in a calm 14-year-old girl using a cuff whose bladder covers only about one third of her upper arm length and does not fully encircle the arm. Which action is most appropriate?

Recheck with a cuff whose bladder width is about 40% of her arm circumference.

Recheck in her leg with the same cuff, because leg pressures are more accurate.

Document the reading and plan to recheck it again at her next routine visit.

Report the reading to the provider as stage 1 hypertension for a teen of her age.

A 17-year-old with ulcerative colitis is admitted with a flare and bloody diarrhea. Which finding should the nurse report immediately?

A distended, tender abdomen with fever and a heart rate of 128/min

Fatigue, a decreased appetite and a 1 kg weight loss since last week

Six loose stools with small amounts of blood over the past 12 hours

Cramping lower abdominal pain that eases after a bowel movement

A 2-year-old boy with spastic quadriplegic cerebral palsy is fed by mouth by his mother. Which finding observed during a feeding most strongly suggests aspiration?

Coughing and a wet, gurgly voice while he is swallowing

Taking about 30 minutes to finish a small bowl of pureed food

Spilling some puree from his lips because of poor lip closure

Pushing food out with his tongue after it enters his mouth

A 3-year-old boy is admitted with swelling of his eyelids, abdomen and scrotum that developed over 1 week. His blood pressure is 98/60 mm Hg. His laboratory results are shown. Test Result Urine protein 4+ Urine blood Negative Serum albumin 1.6 g/dL Total cholesterol 380 mg/dL Oral prednisolone has been started. Which nursing intervention is most appropriate?

Weigh him daily, protect edematous skin and monitor for infection

Check blood pressure every 15 minutes for a hypertensive crisis

Restrict all dietary protein to slow the protein loss in his urine

Keep him on strict bed rest until all of the edema has resolved

Pediatric Nurse Exam

Free Pediatric Nurse Practice Questions

10 sample questions for the Pediatric Nurse Exam, with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.

Sections covered on the exam: Growth, Development and Health Promotion, Family-Centered and Psychosocial Care, Pediatric Assessment, Pain and Nursing Procedures, Respiratory Disorders, Behavioral and Mental Health, Infectious Diseases, Neurological Disorders, Endocrine and Metabolic Disorders, Hematologic and Oncologic Disorders, Cardiovascular Disorders, Genitourinary, Renal and Reproductive Health, Skin, Wounds, Burns, Allergy and Immunology, Palliative and End-of-Life Care, Professional Responsibilities.

Question 1 · Growth, Development and Health Promotion
At a 4-month well visit, a nurse reviews feeding and soothing with the mother of an exclusively breastfed girl. Which statement by the mother indicates a need for further teaching?
- A.I can dip her pacifier in a little honey when she is fussy at night.
- B.I should not put cereal in her bottle to help her sleep longer.
- C.I will keep giving her the vitamin D drops of 400 IU every day.
- D.I will wait until about 6 months and signs of readiness to start solid foods.
Show answer and explanation
Answer: A. I can dip her pacifier in a little honey when she is fussy at night.
Honey must be avoided before 12 months because it can carry Clostridium botulinum spores that cause infant botulism, so this statement shows a need for more teaching. Starting solids around 6 months with readiness signs, daily vitamin D 400 IU for breastfed infants, and avoiding cereal in the bottle are all correct.
Question 2 · Pediatric Assessment, Pain and Nursing Procedures
A nurse is assessing postoperative pain in a 14-year-old boy with cerebral palsy and a severe cognitive impairment who does not use words to communicate. Which pain assessment tool is most appropriate?
- A.Neonatal Infant Pain Scale (NIPS), since he is unable to give self-report
- B.Revised FLACC (r-FLACC) scale, with parent input on his usual pain behaviors
- C.Wong-Baker FACES scale, pointing to each face and asking him to choose one
- D.Numeric 0-10 rating scale, because the tool is validated for adolescents
Show answer and explanation
Answer: B. Revised FLACC (r-FLACC) scale, with parent input on his usual pain behaviors
The r-FLACC is designed for children with cognitive impairment and lets parents add the child's individual pain behaviors. FACES and numeric scales require self-report the teen cannot give, and the NIPS is validated only for neonates.
Question 3 · Pediatric Assessment, Pain and Nursing Procedures
A nurse is reviewing diet teaching with the parents of a 7-year-old recently diagnosed with celiac disease. Which statement by the parent indicates a need for further teaching?
- A."Regular oatmeal from the grocery store is a good breakfast choice for him."
- B."We need to check the food labels for wheat, barley and rye in every product."
- C."He should stay on a gluten-free diet even when his symptoms go away."
- D."Rice, corn and potatoes can be part of his meals without any problem."
Show answer and explanation
Answer: A. "Regular oatmeal from the grocery store is a good breakfast choice for him."
Regular oats are often cross-contaminated with wheat during growing and processing, so only oats labeled certified gluten-free are acceptable. Wheat, barley and rye must be avoided for life, and rice, corn and potatoes are naturally gluten free. The diet must continue even when the child feels well because gluten still damages the intestinal lining.
Question 4 · Neurological Disorders
A term newborn is born with an intact lumbosacral myelomeningocele and is awaiting surgical closure. Which nursing action is the priority?
- A.Wrap the infant warmly in a blanket and encourage the parents to hold her
- B.Place the infant supine with a rolled towel under the sac to support it and prevent rupture
- C.Cover the sac with a sterile saline-moistened dressing and position the infant prone
- D.Apply a dry gauze dressing and diaper snugly to keep stool off the sac
Show answer and explanation
Answer: C. Cover the sac with a sterile saline-moistened dressing and position the infant prone
The exposed sac must be kept moist and protected from rupture and infection with a sterile saline-moistened, nonadherent dressing, and the infant is placed prone so no pressure is put on the sac. Lying supine or diapering over the sac risks pressure, contamination and rupture, and dry gauze adheres to and damages the membrane. Latex precautions begin from birth.
Question 5 · Genitourinary, Renal and Reproductive Health
A 7-year-old boy is admitted with puffy eyelids and dark, cola-colored urine. He had a sore throat about 2 weeks ago. His admission data are shown.
Measure Result
Blood pressure 136/88 mm Hg
Urinalysis Hematuria with red blood cell casts, 1+ protein
Weight 1.5 kg above his clinic weight last month
Urine output 0.6 mL/kg/hour
Six hours after admission, which finding should the nurse report to the provider immediately?
- A.Mild periorbital puffiness that is more noticeable in the morning
- B.A repeat urinalysis that still shows protein and red cell casts
- C.Tea-colored urine that looks unchanged from the time of admission
- D.Severe headache and vomiting with blood pressure of 164/104 mm Hg
Show answer and explanation
Answer: D. Severe headache and vomiting with blood pressure of 164/104 mm Hg
Acute post-streptococcal glomerulonephritis causes fluid and sodium retention and hypertension; severe headache, vomiting and a rising blood pressure suggest hypertensive encephalopathy, which can progress to seizures. Dark urine, morning periorbital edema and casts are expected features that resolve over days to weeks. The nurse monitors blood pressure closely and maintains fluid and sodium restriction as ordered.
Question 6 · Growth, Development and Health Promotion
The mother of a 1-month-old exclusively breastfed boy asks whether he needs any supplements. Which response by the nurse is correct?
- A.He needs a daily iron drop starting this week.
- B.He needs no supplements while breastfeeding.
- C.He needs fluoride drops from now until age 2.
- D.He needs vitamin D drops, 400 IU every day.
Show answer and explanation
Answer: D. He needs vitamin D drops, 400 IU every day.
Breastfed and partially breastfed infants should receive 400 IU of vitamin D daily starting in the first days of life, because breast milk alone does not provide enough. Routine iron or fluoride drops are not started at this age for a healthy term infant, and saying no supplements are needed is incorrect.
Question 7 · Pediatric Assessment, Pain and Nursing Procedures
A nurse obtains a blood pressure of 136/88 mm Hg in a calm 14-year-old girl using a cuff whose bladder covers only about one third of her upper arm length and does not fully encircle the arm. Which action is most appropriate?
- A.Recheck in her leg with the same cuff, because leg pressures are more accurate.
- B.Recheck with a cuff whose bladder width is about 40% of her arm circumference.
- C.Document the reading and plan to recheck it again at her next routine visit.
- D.Report the reading to the provider as stage 1 hypertension for a teen of her age.
Show answer and explanation
Answer: B. Recheck with a cuff whose bladder width is about 40% of her arm circumference.
A cuff that is too small gives a falsely high reading; the bladder width should be about 40% of arm circumference and its length should encircle 80-100% of the arm. The nurse rechecks with the correct cuff before reporting or documenting, and leg pressures normally run higher than arm pressures.
Question 8 · Pediatric Assessment, Pain and Nursing Procedures
A 17-year-old with ulcerative colitis is admitted with a flare and bloody diarrhea. Which finding should the nurse report immediately?
- A.A distended, tender abdomen with fever and a heart rate of 128/min
- B.Fatigue, a decreased appetite and a 1 kg weight loss since last week
- C.Six loose stools with small amounts of blood over the past 12 hours
- D.Cramping lower abdominal pain that eases after a bowel movement
Show answer and explanation
Answer: A. A distended, tender abdomen with fever and a heart rate of 128/min
Abdominal distension with fever, tachycardia and tenderness in a child with ulcerative colitis suggests toxic megacolon or perforation, a surgical emergency. Frequent bloody stools, cramping relieved by defecation, fatigue and modest weight loss are expected features of a flare that are monitored and managed. The nurse should report the distension at once and expect the child to be kept NPO.
Question 9 · Neurological Disorders
A 2-year-old boy with spastic quadriplegic cerebral palsy is fed by mouth by his mother. Which finding observed during a feeding most strongly suggests aspiration?
- A.Taking about 30 minutes to finish a small bowl of pureed food
- B.Spilling some puree from his lips because of poor lip closure
- C.Coughing and a wet, gurgly voice while he is swallowing
- D.Pushing food out with his tongue after it enters his mouth
Show answer and explanation
Answer: C. Coughing and a wet, gurgly voice while he is swallowing
Coughing, choking or a wet voice quality during or right after swallowing suggests that food or liquid is entering the airway, and the nurse reports it for a swallow evaluation. Drooling, slow feeding and tongue thrust are common oral-motor problems in cerebral palsy that affect nutrition but do not by themselves indicate aspiration.
Question 10 · Genitourinary, Renal and Reproductive Health
A 3-year-old boy is admitted with swelling of his eyelids, abdomen and scrotum that developed over 1 week. His blood pressure is 98/60 mm Hg. His laboratory results are shown.
Test Result
Urine protein 4+
Urine blood Negative
Serum albumin 1.6 g/dL
Total cholesterol 380 mg/dL
Oral prednisolone has been started. Which nursing intervention is most appropriate?
- A.Check blood pressure every 15 minutes for a hypertensive crisis
- B.Restrict all dietary protein to slow the protein loss in his urine
- C.Weigh him daily, protect edematous skin and monitor for infection
- D.Keep him on strict bed rest until all of the edema has resolved
Show answer and explanation
Answer: C. Weigh him daily, protect edematous skin and monitor for infection
Massive proteinuria, low albumin, high cholesterol and edema with normal blood pressure and no hematuria fit nephrotic syndrome rather than post-streptococcal glomerulonephritis. Care focuses on daily weights, skin care of edematous areas, a no-added-salt diet and infection monitoring, since steroids and protein loss raise infection risk. Protein is not restricted, blood pressure is normal, and strict bed rest increases clot risk.

Measure	Result
Blood pressure	136/88 mm Hg
Urinalysis	Hematuria with red blood cell casts, 1+ protein
Weight	1.5 kg above his clinic weight last month
Urine output	0.6 mL/kg/hour

Test	Result
Urine protein	4+
Urine blood	Negative
Serum albumin	1.6 g/dL
Total cholesterol	380 mg/dL

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