NCLEX Pediatric Practice Questions

15 free NCLEX-RN pediatrics questions with answers and rationales — perfect for peds nclex questions practice. Want them as an interactive timed quiz?

Take the interactive quiz →Unlock full bank

1. A 2-month-old infant is brought to the clinic for a routine check-up. The nurse is preparing to administer the first dose of the rotavirus vaccine. What is the best action by the nurse?
- A. Administer the vaccine orally. ✓
- B. Administer the vaccine intramuscularly.
- C. Administer the vaccine subcutaneously.
- D. Delay vaccination until 6 months.
Answer: A. Administer the vaccine orally. — The rotavirus vaccine is administered orally and typically given at 2 and 4 months of age.
2. A 4-year-old child is diagnosed with acute otitis media. Which of the following is the most appropriate nursing intervention to provide comfort?
- A. Encourage chewing gum.
- B. Apply warm compresses to the ear. ✓
- C. Administer a decongestant nasal spray.
- D. Advise fluid restriction.
Answer: B. Apply warm compresses to the ear. — Warm compresses can help alleviate pain and discomfort associated with ear infections.
3. A mother of a 6-month-old infant asks about introducing solid foods. Which food should the nurse recommend introducing first?
- A. Cow's milk
- B. Rice cereal ✓
- C. Pureed meat
- D. Honey
Answer: B. Rice cereal — Rice cereal is usually the first solid food introduced due to its low allergenic potential and ease of digestion.
4. A 5-year-old child with asthma is prescribed albuterol. What is the most important teaching point for the parents regarding the use of a metered-dose inhaler (MDI) with a spacer?
- A. Shake the inhaler well before use. ✓
- B. Rinse the spacer with warm water after each use.
- C. Administer the medication before meals.
- D. Store the inhaler in the refrigerator.
Answer: A. Shake the inhaler well before use. — Shaking the inhaler ensures that the medication is properly mixed and delivered effectively.
5. A 10-year-old child is admitted with suspected appendicitis. Which clinical manifestation should the nurse recognize as most indicative of appendicitis?
- A. Generalized abdominal pain
- B. Pain in the right lower quadrant ✓
- C. Intermittent diarrhea
- D. High-grade fever
Answer: B. Pain in the right lower quadrant — Right lower quadrant pain is a classic sign of appendicitis, indicating inflammation of the appendix.
6. A 12-month-old infant is due for immunizations. Which vaccine is contraindicated at this age if the child has a severe egg allergy?
- A. Hepatitis B
- B. MMR (Measles, Mumps, Rubella) ✓
- C. Varicella
- D. Polio
Answer: B. MMR (Measles, Mumps, Rubella) — MMR vaccine is generally avoided in children with severe egg allergies due to potential anaphylactic reactions.
7. A 16-year-old female with cystic fibrosis is admitted for a respiratory infection. What is the priority nursing intervention?
- A. Administer pancreatic enzymes with meals.
- B. Perform chest physiotherapy.
- C. Encourage a high-protein diet.
- D. Administer bronchodilator therapy. ✓
Answer: D. Administer bronchodilator therapy. — Bronchodilator therapy should be administered to open the airways, which is crucial during respiratory infections.
8. A 7-year-old child with type 1 diabetes presents with a blood glucose level of 45 mg/dL. Which is the best immediate action for the nurse to take?
- A. Administer 1 mg glucagon intramuscularly.
- B. Give 15 grams of oral glucose. ✓
- C. Start an insulin drip.
- D. Encourage the child to exercise.
Answer: B. Give 15 grams of oral glucose. — Administering oral glucose is the fastest way to raise blood sugar levels in a conscious child with hypoglycemia.
9. A 3-year-old child is admitted with dehydration due to gastroenteritis. What is the most appropriate initial rehydration method?
- A. Oral rehydration solution (ORS) ✓
- B. Intravenous normal saline
- C. Clear juices
- D. Carbonated beverages
Answer: A. Oral rehydration solution (ORS) — ORS is the preferred method for mild to moderate dehydration in children due to gastroenteritis.
10. A 9-month-old infant is brought to the emergency department with a fever of 103°F and irritability. The mother reports a recent upper respiratory infection. Which assessment finding would be most concerning?
- A. Nasal congestion
- B. Bulging fontanel ✓
- C. Diaper rash
- D. Mild diarrhea
Answer: B. Bulging fontanel — A bulging fontanel in an infant can indicate increased intracranial pressure and is a sign of possible meningitis.
11. A 6-year-old child is scheduled for a tonsillectomy. What is the most important preoperative instruction the nurse should give to the parents?
- A. Ensure the child fasts for 6 hours before surgery. ✓
- B. Stop all medications 2 days prior to surgery.
- C. Bring the child's favorite toy to the hospital.
- D. Avoid dairy products after surgery.
Answer: A. Ensure the child fasts for 6 hours before surgery. — Fasting is necessary to reduce the risk of aspiration during anesthesia.
12. A 15-year-old male with a history of ADHD is prescribed methylphenidate. Which side effect should the nurse instruct the parents to monitor?
- A. Increased appetite
- B. Weight loss ✓
- C. Bradycardia
- D. Hyperglycemia
Answer: B. Weight loss — Weight loss is a common side effect of methylphenidate due to decreased appetite.
13. A school nurse is planning a health education session for a group of 8-year-old children about hand hygiene. What is the most effective strategy?
- A. Show a video about germs.
- B. Provide a lecture on handwashing.
- C. Demonstrate handwashing with soap and water. ✓
- D. Distribute pamphlets on hygiene.
Answer: C. Demonstrate handwashing with soap and water. — A demonstration is the most effective way to teach young children new skills, such as proper handwashing technique.
14. A 2-year-old child has ingested a small amount of household bleach. What is the nurse's priority action?
- A. Induce vomiting immediately.
- B. Give the child milk to drink.
- C. Administer activated charcoal.
- D. Call Poison Control for guidance. ✓
Answer: D. Call Poison Control for guidance. — Poison Control provides specific guidance for managing ingestion of hazardous substances and should be contacted immediately.
15. A 3-month-old infant is in the clinic for a well-baby checkup. Which developmental milestone should the nurse expect the infant to have reached?
- A. Rolling over from back to front
- B. Sitting without support
- C. Holding head up steadily ✓
- D. Crawling
Answer: C. Holding head up steadily — By 3 months, infants typically can hold their head up steadily, indicating good neck muscle development.

+ 45 more Pediatrics questions in the full bank

Unlock full NCLEX bank →

NCLEX Pediatric Practice Questions

More NCLEX practice topics