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Home ∠ Practice Exams ∠ NCLEX Exam ∠ NCLEX Practice Exam for Pediatric Nursing 1

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1. Which of the following would be inappropriate when

administering chemotherapy to a child?

A. Monitoring the child for both general and speciQc

adverse effects
B. Observing the child for 10 minutes to note for signs of
anaphylaxis
C. Administering medication through a free-Zowing
intravenous line
D. Assessing for signs of infusion inQltration and irritation

2. Which of the following is the best method for performing a

physical examination on a toddler

A. From head to toe

B. Distally to proximally
C. From abdomen to toes, the to head
D. From least to most intrusive

3. Which of the following organisms is responsible for the

development of rheumatic fever?

A. Streptococcal pneumonia
B. Haemophilus inZuenza
C. Group A β-hemolytic streptococcus
 D. Staphylococcus aureus

4. Which of the following is most likely associated with a

cerebrovascular accident (CVA) resulting from congenital
heart disease?

A. Polycythemia
B. Cardiomyopathy
C. Endocarditis
D. Low blood pressure

5. How does the nurse appropriately administer mycostatin

suspension in an infant?

A. Have the infant drink water, and then administer

mycostatin in a syringe
B. Place mycostatin on the nipple of the feeding bottle and
have the infant suck it
C. Mix mycostatin with formula
D. Swab mycostatin on the affected areas

6. A mother tells the nurse that she is very worried because

her 2-year old child does not Qnish his meals. What should
the nurse advise the mother?

A. make the child seat with the family in the dining room
until he Qnishes his meal
B. provide quiet environment for the child before meals
C. do not give snacks to the child before meals
D. put the child on a chair and feed him

7. The nurse is assessing a newborn who had undergone

vaginal delivery. Which of the following Qndings is least likely
to be observed in a normal newborn?

A. uneven head shape

B. respirations are irregular, abdominal, 30-60 bpm
C. (+) moro reZex
 D. heart rate is 80 bpm

8. Which of the following situations increase risk of lead

poisoning in children?

A. playing in the park with heavy trahc and with many

vehicles passing by
B. playing sand in the park
C. playing plastic balls with other children
D. playing with stuffed toys at home

9. An inborn error of metabolism that causes premature

destruction of RBC?

A. G6PD
B. Hemocystinuria
C. Phenylketonuria
D. Celiac Disease

10. Which of the following blood study results would the

nurse expect as most likely when caring for the child with iron
deQciency anemia?

A. Increased hemoglobin
B. Normal hematocrit
C. Decreased mean corpuscular volume (MCV)
D. Normal total iron-binding capacity (TIBC)

11. The nurse answers a call bell and Qnds a frightened

mother whose child, the patient, is having a seizure. Which of
these actions should the nurse take?

A. The nurse should insert a padded tongue blade in the

patient’s mouth to prevent the child from swallowing or
choking on his tongue.
B. The nurse should help the mother restrain the child to
prevent him from injuring himself.
C. The nurse should call the operator to page for seizure
 assistance.
D. The nurse should clear the area and position the client
safely.

12. At the community center, the nurse leads an adolescent

health information group, which often expands into other
areas of discussion. She knows that these youths are trying
to Qnd out “who they are,” and discussion often focuses on
which directions they want to take in school and life, as well
as peer relationships. According to Erikson, this stage is
known as:

A. identity vs. role confusion.

B. adolescent rebellion.
C. career experimentation.
D. relationship testing

13. The nurse is assessing a 9-month-old boy for a well-baby

check up. Which of the following observations would be of
most concern?

A. The baby cannot say “mama” when he wants his mother.

B. The mother has not given him Qnger foods.
C. The child does not sit unsupported.
D. The baby cries whenever the mother goes out.

14. Cheska, the mother of an 11-month-old girl, KC, is in the

clinic for her daughter’s immunizations. She expresses
concern to the nurse that Shannon cannot yet walk. The
nurse correctly replies that, according to the Denver
Developmental Screen, the median age for walking is:

A. 12 months.
B. 15 months.
C. 10 months.
D. 14 months.

15. Sally Kent., age 13, has had a lumbar puncture to examine
the CSF to determine if bacterial infection exists. The best
position to keep her in after the procedure is:

A. prone for two hours to prevent aspiration, should she

vomit.
B. semi-fowler’s so she can watch TV for Qve hours and be
entertained.
C. supine for several hours, to prevent headache.
D. on her right sides to encourage return of CSF

16. Buck’s traction with a 10 lb. weight is securing a patient’s

leg while she is waiting for surgery to repair a hip fracture. It
is important to check circulation- sensation-movement:

A. every shift.
B. every day.
C. every 4 hours.
D. every 15 minutes.

17. Carol Smith is using bronchodilators for asthma. The side

effects of these drugs that you need to monitor this patient
for include:

A. tachycardia, nausea, vomiting, heart palpitations, inability

to sleep, restlessness, and seizures.
B. tachycardia, headache, dyspnea, temp . 101 F, and
wheezing.
C. blurred vision, tachycardia, hypertension, headache,
insomnia, and oliguria.
D. restlessness, insomnia, blurred vision, hypertension,
chest pain, and muscle weakness.

18. The adolescent patient has symptoms of meningitis:

nuchal rigidity, fever, vomiting, and lethargy. The nurse knows
to prepare for the following test:

A. blood culture.
B. throat and ear culture.
 C. CAT scan.
D. lumbar puncture.

19. The nurse is drawing blood from the diabetic patient for a
glycosolated hemoglobin test. She explains to the woman
that the test is used to determine:

A. the highest glucose level in the past week.

B. her insulin level.
C. glucose levels over the past several months.
D. her usual fasting glucose level.

20. The twelve-year-old boy has fractured his arm because of

a fall from his bike. After the injury has been casted, the nurse
knows it is most important to perform all of the following
assessments on the area distal to the injury except:

A. capillary reQll.
B. radial and ulnar pulse.
C. Qnger movement
D. skin integrity

Answers and Rationales

1. B. When administering chemotherapy, the nurse should

observe for an anaphylactic reaction for 20 minutes and
stop the medication if one is suspected. Chemotherapy
is associated with both general and speciQc adverse
effects, therefore close monitoring for them is important.
2. D. When examining a toddler or any small child, the best
way to perform the exam is from least to most intrusive.
Starting at the head or abdomen is intrusive and should
be avoided. Proceeding from distal to proximal is
inappropriate at any age.
3. C. Rheumatic fever results as a delayed reaction to
inadequately treated group A β-hemolytic streptococcal
infection.
4. A. The child with congenital heart disease develops
 polycythemia resulting from an inadequate mechanism
to compensate for decreased oxygen saturation
5. D. Mycostatin suspension is given as swab. Never mix
medications with food and formula.
6. C. If the child is hungry he/she more likely would Qnish
his meals. Therefore, the mother should be advised not
to give snacks to the child. The child is a “busy toddler.”
He/she will not able to keep still for a long time.
7. D. Normal heart rate of the newborn is 120 to 160 bpm.
Choices A, B, and C are normal assessment Qndings
(uneven head shape is molding).
8. A. Lead poisoning may be caused by inhalation of dusk
and smoke from leaded gas. It may also be caused by
lead-based paint, soil, water (especially from plumbings
of old houses).
9. A. Glucose-6-phosphate dehydrogenase deQciency
(G6PD) is an X-linked recessive hereditary disease
characterised by abnormally low levels of glucose-6-
phosphate dehydrogenase (abbreviated G6PD or
G6PDH), a metabolic enzyme involved in the pentose
phosphate pathway, especially important in red blood
cell metabolism.
10. C. For the child with iron deQciency anemia, the blood
study results most likely would reveal decreased mean
corpuscular volume (MCV) which demonstrates
microcytic anemia, decreased hemoglobin, decreased
hematocrit and elevated total iron binding capacity.
11. D. The primary role of the nurse when a patient has a
seizure is to protect the patient from harming him or
herself.
12. A. During this period, which lasts up to the age of 18-21
years, the individual develops a sense of “self.” Peers
have a major big inZuence over behavior, and the major
decision is to determine a vocational goal.
13. C. Over 90% percent of babies can sit unsupported by
nine months. Most babies cannot say “mama” in the
sense that it refers to their mother at this time.
14. A. By 12 months, 50 percent of children can walk well.
15. C. Lying Zat keeps the patient from having a “spinal
 headache.” Increasing the Zuid intake will assist in
replenishing the lost Zuid during this time.
16. C. The patient can lose vascular status without the nurse
being aware if left for more than 4 hours, yet checks
should not be so frequent that the patient becomes
anxious. Vital signs are generally checked q4h, at which
time the CSM checks can easily be performed.
17. A. Bronchodilators can produce the side effects listed in
answer choice (A) for a short time after the patient
begins using them.
18. D. Meningitis is an infection of the meninges, the outer
membrane of the brain. Since it is surrounded by
cerebrospinal Zuid, a lumbar puncture will help to identify
the organism involved.
19. C. The glycosolated hemoglobin test measures glucose
levels for the previous 3 to 4 months.
20. D. Capillary reQll, pulses, and skin temperature and color
are indicative of intact circulation and absence of
compartment syndrome. Skin integrity is less important.

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