Nursing Licensure Exam and NCLEX Pediatric Nursing Test with Rationale

This covers various topics in Pediatric Nursing from Erikson’s psychosocial theory, Nursing Prioritization,
Management and Care of Cleft Lip, and Palate. This approach is a comprehensive type of exam since
the Nursing Board Exam is also a comprehensive one.

This is a multiple-choice type of examination. Choose the BEST answer. Read the questions carefully
before answering them.

1. In the pediatric surgical ward, you have been assigned to a one-month-old child with cleft lip and
palate.You have to teach the mother a proper way of providing nutrition to the child. The following are
correct steps except:
A. Use rubber nipples with a small opening in order to prevent aspiration
B. Place the child in a semi-upright position when feeding
C. Feeding session should be done slowly
D. Teach the mother to stimulate the sucking reflex by rubbing the nipple against the lower lip of the baby

2. You were then asked by the mother when is the best time for surgical intervention for a cleft palate?
A. one to three months old
B. four to seven months old only
C. eight to eleven months old
D. six months to eighteen months old

3. A child has been recovering from an operation on the cleft lip. What is your priority nursing care?
A. Bleeding tendency
B. Wound care
C. Airway patency
D. Risk for Infection
4. Which of the following is the most common problem in infants when it comes to their gastrointestinal
problem?
A. Achalasia
B. Gastric Ulcer
C. Intussusceptions
D. None of the above 

5. Which of the following effective nursing intervention in order to prevent the occurrence of
Gastroesophageal reflux?

A. Giving solid foods

B. Giving frequent small feedings
C. Giving semi-solid foods
D. Giving oshterized feeding

6. The following are signs and symptoms of asthma except:

A. Fatigue
B. Yellowish skin
C. Moist skin
D. Use of accessory muscles

7. A mother would like to know the reason why there is asthma in her child. How would you explain it?

A. An asthma attack is a response to the release of inflammatory mediators to epithelial cells. The
autonomic neural control of the airway is affected.
B. An asthma attack can happen when the child is exposed to certain allergens that would trigger an
allergic reaction to the bronchioles causing constriction of the bronchial tree. This is either acquired or
being hereditary.
C. An asthma attack is an inborn problem of a child that involves abnormal growth of the bronchial tree
causing restriction.
D. All of these

8. According to the National Asthma Education, mild intermittent asthma is occurring when the symptoms
are:

A. Symptoms can happen twice a week

B. Symptoms can happen more than twice a week
C. There is no symptom only a sudden attack
D. Symptoms can happen continuously in a week

9. In the emergency room department, a child was rushed due to difficulty of breathing due to an asthma
attack. What is the least nursing action?

A. Provide health teaching to the family

B. Check for airway patency
C. Request for Chest X-ray STAT
D. Give hydrocortisone STAT

10. These are common irritants that would start an asthma attack, except:

A. Psychological stress
B. Fast and binge eating
C. Environmental factors such as air pollution and smoke
D. Dust mites

11. In assessing a toddler, which of the following options is a sign of delay growth and development?

A. Growth rate is about 3 inches

B. Bowleggedness
C. Weight is 38 lbs
D. Protruding abdomen

12. A mother started to complain that her 2-year-old daughter starts to be picky in food choices. What is the
appropriate health teaching?

A. Tell the mother that it will just go away when she is hungry.
B. Tell the mother that it is a normal development of toddlers, the best way to cope with this is not to force
them but encourage them to eat nutritious snacks in between meals.
C. Tell the mother to resort to bottle-feeding
D. Tell the mother to give whatever the child wants in order to stop being picky.

13. A mother would like to ask when is the best time to teach the child to use utensils.

A. 12 months old
B. 2 years old and beyond
C. 6 years old
D. Both B and C

14. According to Erikson’s stage, what is the stage of a toddler going through?

A. Trust versus mistrust

B. Initiative versus Guilt
C. Autonomy versus Shame
D. Identity versus Role Confusion

15. As a nurse, what is the best way to prevent rheumatic fever in a child who has always tonsillitis?

A. Give anti-inflammatory medications

B. Give corticosteroids
C. Giving antibiotic prophylaxis
D. Giving Zalpen

16. What is the earliest time that a child can be diagnosed to have autism?

A. 2 years old
B.2 months old
C. 6 years old
D. 6 months old

17. A nurse can observe autism when a child exhibits:

A. Hyperactivity
B. Silent at all times
C. Being shy
D. Crying all the time

18. A mother would like to know what a good activity is for a child with autism, the best response would be:

A. Loud music
B. Various playmates
C. Self-stimulating activities
D. Small group activity

19. Since autism has no cure, how can you teach a parent to cope with autism?

A. Teach the parent the proper way for legal adoption

B. Teach the parent to join groups that would discuss autism
C. Teach the parent to allow the child to be educated using an alternative learning system appropriate to
his degree of autism
D. Teach the parent to accept the fact since the child is after all helpless

20. These are the possible causes of autism except:

A. Maternal illness
B. Hereditary
C. Phenylketonuria
D. Traumatic brain injury

21. One night, a child was rushed to an emergency room with the following symptoms: fear of physical
contact, apprehensive, bruises all over the body. These are possible signs of:

A. Physical abuse
B. Fall
C. Vehicular accident
D. Victim of Neglect

22. In caring for a child as a victim of physical abuse, what is the nursing priority?

A. Clean the wounds

B. Keep the child warm
C. Keep the child well hydrated
D. Preserve the bruises or wounds as part of the investigation

23. As a nurse, which of the following options is true about abused children?

1.The injuries of abused children can be used against the perpetrator.

2.Abusive parents come from lower socioeconomic status
3.The abused child is actually a victim of projection of anger
4.The abused child is to be blamed since they are stubborn.
A. 1, 2 & 4
B. 1, 2, 3 only
C. 1 to 4
D. 1, 3, 4 only

24. A 14-year-old child is brought to the emergency room department for an acute asthma attack after
basketball practice, what is the initial assessment a nurse can have in a form of a nursing diagnosis?

A. Activity intolerance
B. Impaired gas exchange
C. Ineffective breathing pattern
D. Altered tissue perfusion

25. When assessing the development of this 14-year-old child, as a nurse you must recognize that his
developmental task is:

A. Being shy with his age groups

B. Being an achiever
C. Developing a sense of identity
D. Developing intimate love with the opposite sex
1. Answer: A. Use rubber nipples with a small opening in order to prevent aspiration – does not belong to
the group since it is advised to use rather soft nipples with large opening.
2. Answer: D. six months to eighteen months old. The surgical intervention is planned on this stage since it
may require a series of operations for the child to undergo.

3. Answer: C. Airway patency – this is still the most important nursing care at the moment. While the rest
are also correct, however after the surgical procedure airway and oxygenation are important aspects for
faster healing.

4. Answer: A. Achalasia – Otherwise known as Gastroesophageal reflux is a disorder wherein the

stomach contents would return to the esophagus resulting to vomiting of previously eating milk.

5. Answer: B. Giving frequent small feedings – This is the best way in order to give the stomach time to
digest the food. The rest of the options were not appropriate in the situation.

6. Answer: B. Yellowish skin – This is a symptom of the liver problem rather than a respiratory problem.
The rest are typical symptoms of asthma.

7. Answer: B. An asthma attack can happen when the child is exposed to certain allergens that would
trigger an allergic reaction to the bronchioles causing constriction of the bronchial tree. This is either
acquired or being hereditary. – Talking to a mother means giving information according to the level of their
understanding. Informing the mother using medical terms can generally be misunderstood. As a general
rule, it is always important to gauge the level of understanding. 

8. Answer: A. Symptoms can happen twice a week – This is the correct answer according to the National
Asthma Education. The rest are symptoms of persistent or chronic asthma.

9. Answer: A. Provide health teaching to the family –Teaching the family about caring for a child with
asthma can be the least nursing action since there is a higher need for attention to the child’s respiratory
status.

10. Answer: B. Fast and binge eating – The rate of eating does not necessarily cause asthma rather than
the food additives in it. The rest of the options were proven to be contributing factors to cause asthma.

11. Answer: C. Weight is 38 lbs – The average weight of a toddler would be 27 lbs. anything more than 30
lbs may also pose a warning that the child is going to be overweight.

12. Answer: B. Tell the mother that it is a normal development of toddlers, the best way to cope with this is
not to force them but encourage them to eat nutritious snacks in between meals. –This way would
encourage continuous growth and development a child needs even though they are undergoing the stage
of being too picky. The rest of the options were not correct for the situation.

13. Answer: B. 2 years old and beyond – The toddler stage is a time wherein the child wants to be
independent in feeding themselves. Introducing utensils can help the child to avoid picking the food with
their bare hands which can be a way of getting infection and diarrhea.

14. Answer: C. Autonomy versus Shame – A toddler is seen to be going through a stage of what to hold on
to or letting it go.

Object 1
15. Answer: D. Giving Zalpen – This is can be done only with the doctor’s direction. The rest of the options
were only indicative for tonsillitis that is acute.

16. Answer: A. 2 years old – This is the time wherein a child can be observed to have obvious signs of
autism.

 17. Answer: B. Silent at all times – Language delay can be evident in autism. A problem with
communication can also pose a social difficulty but a child can also be shy does not suffer from autism.

 18. Answer: C. Self-stimulating activities – A child with autism may lack the ability to use their senses
especially communication problems. It is important to provide activities that would stimulate senses in order
to appropriately react to the outside world.

 19. Answer: C. Teach the parent to allow the child to be educated using an alternative learning system
appropriate to his degree of autism – The good news about coping with autism is that the child can have a
chance to use the skills that they have even though they may lack some of it compared to a normal child.

20. Answer: D. Traumatic brain injury – According to the research, the other options were proven to be
linked to autism except for physical injury such as traumatic brain injury.

 21. Answer: A. Physical abuse – A child victim of physical abuse can have a huge array of signs and
symptoms. Generally, a child has a problem with trusting people that’s why he or she avoids physical
contact.

22. Answer: D. Preserve the bruises or wounds as part of the investigation – Physical abuse is a medico-
legal case, any evidence is important, so it is important to take note that these are also evidence that may
aggravate the action done against the child. Cleaning the wounds may also destroy the evidence and any
markings.

23. Answer: B. 1, 2, and 3 only – These are true regarding abused children and the abuser. The last option
is totally not true about abused children, even though they stubborn they do not deserve to be abused.

24. Answer: B. Impaired gas exchange – A child with an asthma attack is suffering from an inadequate
supply of oxygen due to constriction of the bronchioles.

25. Answer: C. Developing a sense of identity – Since adolescence is the stage recognizing the roles that
are essential for his adjustment in adulthood.

5.