NCLEX RN Pediatric Questions
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Question 1 of 5.
A 12-year-old client with asthma is receiving I.V. hydrocortisone, ampicillin, and theophylline. The client vomits after breakfast and lunch, is very irritable, and has a heart rate of 120 beats/minute. The nurse should:
A. Offer small amounts of clear liquids.
B. Inform the primary health care provider that the child is having an allergic reaction to the ampicillin.
C. Add the missed dose of theophylline and inform the primary health care provider of the vomiting.
D. Administer oxygen to decrease the heart rate.
Explanation: Vomiting, irritability, and tachycardia (heart rate of 120 bpm) are signs of theophylline toxicity. The nurse should withhold further doses, inform the provider of the vomiting, and monitor for toxicity, as additional theophylline could worsen symptoms.
Question 2 of 5.
After reading the vaccine information sheets, the parent of a 2-month-old infant is hesitant to consent to the recommended vaccinations. The nurse should first ask the parent:
A. Did you know that vaccinations are required by law for school entry?
B. What personal beliefs or safety concerns do you have about vaccinations?
C. Would you prefer that fewer vaccines are given at a time?
D. Can you please sign this vaccine waiver form?
Explanation: Addressing the parent's specific concerns fosters trust and encourages informed decision-making.
Question 3 of 5.
A parent brings a 4-month-old to the clinic for a regular well visit and expresses concern that the infant is not developing appropriately. Which findings in the infant would indicate the need for further developmental screening?
A. Has no interest in peek-a-boo games.
B. Does not turn front to back.
C. Does not babble.
D. Continues to have head lag.
Explanation: Head lag at 4 months suggests delayed motor development, requiring further evaluation.
Question 4 of 5.
The parent of a 9-month-old infant is concerned that the infant's front soft spot is still open. The nurse should tell the parent:
A. I will measure your baby's head to see if it is a normal size.
B. Your infant will need to be referred for more testing.
C. You should contact your physician immediately.
D. It is normal because this soft spot usually closes between 12 and 18 months.
Explanation: The anterior fontanelle typically closes between 12-18 months, so this is normal.
Question 5 of 5.
A mother brings her 18-month-old to the clinic because the child 'eats ashes, crayons, and paper.' Which of the following information about the toddler should the nurse assess first?
A. Evidence of eruption of large teeth.
B. Amount of attention from the mother.
C. Any changes in the home environment.
D. Intake of a soft, low-roughage diet.
Explanation: Changes in the home environment may contribute to pica, which requires immediate assessment.
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