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PEDS TEST PAPER 2026 COMPLETE
(Q &A)Grade A+
The practical nurse (PN) is monitoring a child who is manifesting signs of shock after a motor vehicle collision. Which finding is most important for the PN to report to the charge nurse? a) narrowing pulse pressure b) apprehension c) irritability d) thirst - answerAnswer: A Rationale: As shock progresses, perfusion in the microcirculation becomes marginal despite compensatory adjustments, and the signs of decompensated shock become pronounced, such as tachycardia and narrowing pulse pressure (A). (The difference between systolic and diastolic blood pressure), which should be reported immediately. (B,C, and D) are not as significant as (A). The mother of a 9 month old male infant is concerned because he cries whenever she leaves him with a sitter. What is the best response for the practical nurse (PN) to provide? a) "Have you noticed whether your baby is teething?" b) "Crying when you leave him in a healthy sign of attachment." c) "Consider taking the baby to the doctor because he may be ill." d) "You could consider leaving the infant more often so he can adjust." - answerAnswer: B Rationale:
Healthy attachment is manifested by stranger anxiety in late infancy (B). Pain from teething expressed by the infant's cries does not occur only when the mother leaves the infant with another person (A). The PN should evaluate the infant's developmental needs (C) before suggesting the infant may be ill. An infant who manifests stranger anxiety is best supported by the mother if the infant is left for shorter periods of time, not (D). Which preoperative action is most important for the practical nurse (PN) to implement for a newborn with meningomyelocele? a) document vital signs b) prevent skin breakdown c) minimize the risk for infection d) monitor neurologic functioning - answerAnswer: C Rationale: A meningomyelocele provides a direct entry for bacteria into the central nervous system, leading to meningitis. Measures that protect the integrity of the meningomyelocele sac and infection control measures should be implemented to minimize the risk of infection (C). (A,B, and D) should be implemented but do not have the priority of (C). The practical nurse is caring for a 6 year old girl who had surgery 12 hours ago. The child tells the PN that she does not have pain but a few minutes later, tells her parents that she does. What child development concept is relevant to this situation? a) inconsistency in pain reporting suggests that pain not present b) a child may have pain yet deny its presence to the nurse c) truthful reporting of pain should occur by this age d) children use pain experiences to manipulate their parents - answerAnswer: B
Rationale: Crust formation is part of the healing process and should be removed (A). (C) is not indicated at this time. The diaper should be fastened loosely, not tightly (D) which can place pressure on the incision site. (B) assists in the healing process and should not be discontinued. The mother of a child with croup is having barking, coughing episodes calls the clinic for assistance. What action should the practical nurse (PN) recommend that the mother implement first? a) take the child outside in the cool air b) bring the child directly to the emergency room c) sit with the child in bathroom with a hot shower running d) have the child drink plenty of fluids - answerAnswer: C Rationale: Croup (laryngotracheobronchitis) is a viral infection that causes a "barking" cough and varying degrees of inspiratory stridor, which often responds to a high humidity environment. Most children can be managed at home using the stream from a hot shower in a closed bathroom (C) which often stops laryngeal spasm. Increasing the child's fluid intake is important (D), but not a priority at this time.Although exposure to cold air (A) also relieves stridor, parents should be encouraged to use mist humidifier in the child's room. (B) is not necessary unless the child is having increasingly difficulty breathing that may lead to a compromised airway. Which finding should the practical nurse confirm with the parents of an infant who is admitted with possible intussusception? a) red currant jelly stools b) clay colored stools c) constant abdominal pain
d) projectile vomiting after meals - answerAnswer: A Rationale: Red currant jelly stools (A) is a sign of intussusception, which causes a mixture of stool, mucous, and blood as the intestines telescopes inside itself. (D) is associated with pyloric stenosis. (B) is consistent with biliary obstruction. Infants with intussusception usually have periods of severe pain followed by intervals in which they appear comfortable, not (C). The practical nurse (PN) is observing a group of children at a day care center to determine whether children are achieving developmental milestones. Which activity should the PN identify as typical for a 2 year old child's cognitive development? a) has a vocabulary of about 1000 words b) uses short sentences to express self c) initiates play with other children d) recognizes right and wrong - answerAnswer: B Rationale: Although children develop at different rates, a 2 year old typically uses short sentences to express independence and control (B) and has a vocabulary of up to 300 words, not (A). At the age of 2 years, a toddler is developing negativism without understanding the concepts of right and wrong (D). A 2 year old engages in solitary play and parallel play but does not initiate or cooperative with other children (C) in play, which begins with socialization of the preschool child. The practical nurse (PN) is interviewing a 10 year old girl about school and her extracurricular activities. She responds, "I like school. I play the flute in the school band, and I take tennis lessons." Based on Erikson's psychosocial theory, the PN identifies that this child is in what stage of development?
a) maternal iron stores persist during the first 12 months of life b) anterior fontanel closes by 6 to 10 months of age c) binocularity is well established by 8 months of age d) birth weight double by age 5 months and triples by 1 year - answerAnswer: D Rationale: Infants gain approximately 1.5 pounds/month until age 5 to 6 months, when the birth weight doubles, and by 1 year of age, the birth weight usually triples (D). The anterior fontanel closes by 12 to 18 months of age, with the average being 14 months, not (B). Binocularity begins to develop by 6 weeks of age and should be well established by age 4 months, not (C). Maternally derived iron stores ares present for the first 5 to 6 months and gradually diminish, which results in an expected lowered hemoglobin levels toward the end of the first 6 months (A). Which nonfood item is the most common cause of respiratory arrest in young children? a) latex balloons b) broken rattles c) buttons d) pacifiers - answerAnswer: A Rationale: Nonfood items cause the majority of choking deaths in young children. Latex balloons (A), whether partially inflated, uninflated, or popped, are the leading cause of pediatric choking that leads to aspiration of small objects (A,B, and D) because they experience the environment by placing objects in the mouth, but (A) is the leading cause of death causing respiratory obstruction and arrest. The practical nurse (PN) is talking with a group of elementary students about bicycle safety. Which information should the PN provide?
a) wearing protective gear on a bicycle is a voluntary measure b) children should wear a bicycle helmet when riding a bicycle c) bicycle injuries involve a collision with an automobile d) riding double is allowed if the bicycle has an extra large seat - answerAnswer: B Rationale: Bicycle accidents that result in head injuries are a common, accidental cause of morbidity and mortality, so bicycle safety and some state laws mandate that children should wear a protective helmet (B). (A, C, and D) do not provide accurate information. An adolescent female who comes to the school clinic is reluctant to confide her concerns to the practical nurse (PN). The PN tells the teen that confidentiality and privacy are maintained unless a life-threatening situation arises. Which principal supports the PN's response? a) disclosures from the adolescent should be kept confidential b) minor adolescents should not be encouraged to disclose private concerns c) the adolescent should be encouraged to seek help outside of the school clinic d) honest information ensures establishing a trusting relationship - answerAnswer: D Rationale: Critical elements in establishing trusting relationships include active listening, responding to the adolescent's emotions, and ensuring confidentiality and privacy, but situations that pose a life- threatening situation for the adolescent must be reported. Minor-aged adolescents have the right to confidential communication with providers unless the client is being abused or a life- threatening situation is evident. Honesty (D) is vital in the development of trust between an adolescent and a health professional. (A,B, and C) do not provide immediate intervention for the adolescent's concerns about self integrity and safety.
The practical nurse (PN) arrives at the playgrounds and sees a school-aged boy who has eaten something he is allergic to and is demonstrating a stridor. Which action should the PN implement first? a) ask if the child is alone b) call for an ambulance c) mov the child to a different environment d) determine what the child has eaten - answerAnswer: B Rationale: Food allergy hypersensitivity can cause an anaphylactic reaction that can occur shortly after ingestion (5-30 minutes) or exposure to an allergen, and manifest with hives, rash, flushing, asthmatic episode, or airway compromise, such as stridor. The first action is to call for an ambulance (B) immediately, since the condition may progress and become life-threatening. (A,C, and D) do not have the same priority of (B). A child who is admitted with acute abdominal pain and possible appendicitis. Which action should the practical nurse (PN) implement for the child's abdominal discomfort? a) assist the child to any position of comfort. b) give a saline enema to cleanse the bowel c) lay a heating pad on the abdomen d) place the bed in trendelenburg - answerAnswer: A Rationale: Abdominal pain is a common childhood complaint, but this child should be assisted to any position of comfort (A) that relieves the pain. (B and D) are contraindicated with possible appendicitis and increase the risk of ruptured appendix. If the appendix should rupture, (C) increases the spread of the infection.
A child is admitted for observation following a closed head injury. Which assessment is most essential for the practical nues (PN) to monitor for an early sign of a worsening condition? a) level of consciousness b) posturing c) focal neurologic signs d) vital signs - answerAnswer: A Rationale: Following a head injury, determining a change in the child's LOC (A) provides the first indication that a progression of the injury is possible. (C) is a symptom of advanced neurologic insult. Alterations in consciousness appear earlier than alterations of (B and D). A 3 year old boy with cerebral palsy (CP) has difficulty swallowing, cannot hold a utensil, and is slightly underweight for his height. Which action should the practical nurse implement when feeding this child? a) put the child in a well-supported semi-reclining position b) offer a specialized formula per tube feeding c) place the child in a sitting position with the neck hyperextended d) stabilize the child's jaw with the caregiver's hand - answerAnswer: D Rationale: A child with CP should be fed in an upright, eating position, and manual stability of the oral mechanisms during swallowing should be provided to minimize the risk of aspiration. Hold the child's jaw (D) from the side or front of the face assists with head control, correction of the neck and trunk hyperextension, and jaw stabilization. (A, B, and C) are not indicated.
sexuality or the genitalia. Success in this stage results in mastery over internal processes and impulses. Latency, ages 7 years to puberty, is a stage of development where one's attention is turned toward learning and successful achieving the ability to delay gratification. The practical nurse (PN) is caring a 6 year old who is hospitalized with asthma. Which developmentally correct activity should the PN provide the child? a) an audio cassette and player b) crayons and a coloring book c) a ball to throw into a basket d) a 1000 piece jigsaw puzzle - answerAnswer: B Painting, drawing, playing computer games, and modeling allow children to practice and improve newly refined skills, so crayons and a coloring book (B) are an age appropriate activity for a 6 year old child who is hospitalized with asthma. A 1000 piece puzzle (D) requires conceptualization of a bigger picture, which a 6 year old may not be able to conceptualize. Throwing a soft foam ball (C) around the room stresses the oxygen demand for the child with acute asthma and poses a safety issue with equipment in a hospital room if unsupervised. An audio cassette play (A) may not provide the best diversion for a 6 year old. A child is prescribed radiographs of the hand and wrist. The child's parent asks the practical nurse (PN) the purpose of this procedure. What finding should the PN explain is provided by the diagnostic study? a) skeletal age b) linear growth c) external proportions d) neurologic maturation - answerAnswer: A
Rationale: Skeletal age (A) can be determined with radiologic examinations that analysis carpal bones maturity and degree of ossification, which is most useful for determining skeletal age before 6 years of age. (B, C, and D) do not describe the correct rationale for this procedure. A mother asks the practical nurse (PN), "When will I know if my daughter has entered puberty?" Which finding should the PN tell the mother to observe for with the onset of puberty? a) mood swings b) growth of pubic hair c) heterosexual interest d) menarche - answerAnswer: B Rationale: The onset of puberty in girls is observed with the development of secondary sex characteristics, such as breast development and the growth of pubic hair (B). (A,C, and D) are not consistently found with pubescence. The PN is checking the musculoskeletal system of a one month old infant during a well child visit. Which finding should the PN report to the healthcare provider? a) one leg is shorter than the other. b) 2 skin folds on the back of each thigh c) broadening & flattening of the buttocks d) hypotonicity of the leg muscles - answerAnswer: A Rationale:
The vastus lateralis (D) has minimal nerves or blood vessels and is the best site for intramuscular (IM) injections in children younger than 3 years of age. The deltoid muscle (C) is a small muscle mass that accommodates small volumes, less than 0.5 mL, and is not recommended for IM use in young children. The gluteal muscles (A and B) are used as an injection site in children whose musculature develops after walking. The mother of a young child with Type 1 diabetes mellitus (DM) who needs insulin injections at home tells the practical nurse (PN) that she is afraid she does not know what to do properly. Which action is most important for the PN implement to decrease the mother's apprehension? a) have the mother verbalize the importance of follow up care b) help the mother devise a schedule for rotating the injections c) observe the mother while she administers an insulin injection d) review the side effects of insulin with the mother - answerAnswer: C Rationale: Observing the mother's ability to give the insulin injection (C) provides an opportunity to reinforce information & provide validation to increase the mother's confidence and relieve apprehension about caring for her child with DM. (A, B, and D) are of less priority than (C). Which first aid action should the practical nurse implement for a child who has sustained a second degree thermal burn? a) apply petroleum jelly to the burned skin b) apply ice to the burned area c) immerse the burned area in cold water d) break any blisters that are present - answerAnswer: C Rationale:
First aid treatment of a second degree thermal burn is immersion of the burned area in cold water (C) to halt the burning process. (A, B, and D) are not indicated due tot he risk of increased skin damage or infection. What information should the practical nurse (PN) reinforce with the parents of a 3 month old infant about liquid medication administration? a) pour the medication into a small cup and allow the infant to drink it b) place the medication in a nipple and have infant suck the nipple c) administer the medication with a dropper to the back of the infant's tongue d) use an oral syringe to place the medication in the side of the infant's mouth - answerAnswer: D Rationale: An oral syringe is a useful device for measuring small quantities of medications for infants. The syringe is placed in the side of the mouth. (B) increases the amount of air the infant swallows, which cause excessive gas. (B and D) increase the risk for aspiration. What action should the practical nurse (PN) implement when caring for a dying child and the family? a) Provide adequate oral intake on a regular schedule b) Organize care to minimize contact that interrupts rests c) Allow family to give basic care when the child is alert d) Tell family to continue talking to the child until time of death - answerAnswer: D Rationale:
d) "Your child is showing a normal response to the stress of hospitalization." - answerAnswer: D Rationale: The child is exhibiting a healthy attachment to the father (D). Leaving while your child is asleep creates mistrust in the child (C). To minimize the child's stress hospital policy often require someone to stay with their child during hospitalization, not (A). The child's behavior represents the protest stage of separation and does not represent maladaptive behavior (B). Which action is best for the practical nurse (PN) to implement to help a 7 year old child cope with a lengthy course of IV antibiotics therapy? a) give the child stickers for cooperative behavior b) arrange for the child to go to the playroom daily c) ask the child to draw a picture about himself d) allow the child to participate in injection play - answerAnswer: D Supervised injection play (D) is an effective coping strategy for a school aged child who is receiving extended IV therapy, or any other therapy involving syringes and needles. Rewards, such as stickers (A) may enhance cooperative behavior but do not address coping with painful treatments. The hospitalized child should have opportunities for play each day, if his condition warrants, but free play (B) does not have any specific therapeutic purpose in preparing for painful experiences. (C) may not elicit the child's feeling about IV treatment. A 3 year old male child who has been toilet trained has had several urinary "accidents" since hospital admission. What action should the practical nuse (PN) implement? a) provide the child with frequent opportunities to urinate b) inform the parent that the child will need to be retrained c) determine how the long the child has been toilet trained d) place a bedpan on the bedside table for the child to use - answerAnswer: A
Rationale: Offering choices and allowing the child to make a decision increases the child's sense of control. Asking the child frequently if he has to go to the bathroom (A) helps reduce the incidents of accidental urinations. Regression to previous behaviors is common during hospitalization, even when the child has been practicing the skill successfully (B). A 3 year old child is not developmentally able to use a bedpan independently (D). Relearning a skill such as toilet training, contributes to the child's stress and should not be attempted during hospitalization. The practical nurse (PN) is caring for a school aged male child who is having problems adjusting to a new school. Which action should the PN recommend to the parents that may foster their child's developmental task of industry. a) identify failures immediately for feedback from the child and his peers b) structure the tasks in the home environment and recreational settings c) decrease their expectations of home tasks and school success d) ask the child what the child wants to achieve in his new school - answerAnswer: B Rationale: Structuring the environment (B) provides opportunities to solve increasingly more complex problems, which enhances self-confidence and promotes a sense of mastery. (C) is not as important as structuring the environment so that the child is successful. (D) Does not promote a sense of achievement or mastery. Sharing failures with the child's peers (A) for feedback reinforces the child's feelings of failure. During a well child visit, the mother of an infant states, "I will probably not have my baby immunized because I am concerned about the risk of a severe reaction." Which response should the PN provide? a) have you talked with other parents about this decision
