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Quizzes > Health & Medicine > Human Anatomy & Medicine

Pediatric NCLEX Practice Quiz - Test Your Peds RN Skills

Ready to tackle peds NCLEX questions and master NCLEX RN pediatric care? Start the quiz now!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Illustration for pediatric NCLEX quiz on growth milestones and respiratory disorders on sky blue background

Looking for a challenge with pediatric nclex questions? Calling all pediatric nurses! Dive into our free Pediatric NCLEX Questions Quiz and put your peds RN expertise to the test with realistic practice scenarios. You'll explore growth milestones in the engaging Growth and Development NCLEX Quiz and tackle challenging pediatric respiratory NCLEX questions that cover pediatric respiratory disorders NCLEX questions in depth. Whether you're reviewing nclex rn pediatric questions, peds nclex questions, or brushing up on nclex paediatric questions, this quiz is your perfect prep tool. Ready to prove your skills? Take the challenge today!

At what age do infants typically sit without support?
2 months
4 months
6 months
9 months
Most infants develop the ability to sit unassisted by around 6 months of age as their trunk and head control improves significantly by this time. This milestone indicates adequate strength and coordination of the neck and back muscles. Delays beyond 9 months may warrant further developmental evaluation. CDC Milestones – 6 Months
At what age does a typical infant develop the pincer grasp?
3 months
6 months
9 months
12 months
The pincer grasp, using the thumb and forefinger to pick up small objects, usually emerges between 8 and 10 months of age. This fine motor skill reflects maturation of the corticospinal tracts and hand-eye coordination. If an infant has not developed this skill by 12 months, further assessment may be warranted. HealthyChildren.org – Fine Motor Skills
At what age do most children begin walking independently?
9 months
12 months
15 months
18 months
Independent walking typically occurs around 12 months of age when muscle strength and balance are adequate. Some infants may walk as early as 9 months, while others may not walk until 15–18 months, which can still fall within the normal range. Persistent delay beyond 18 months may signal developmental concerns. CDC Milestones – 12 Months
A healthy toddler demonstrates which language milestone by 2 years?
Uses 2-word sentences
Uses 5-6 sentence paragraphs
Identifies primary colors
Counts to 10
By 2 years of age, toddlers typically combine two words into simple sentences to express needs and ideas. This milestone indicates expanding vocabulary and sentence structure skills. Identification of colors and counting usually develop closer to ages 3–4. Delayed two-word combinations by 2½ years may require speech evaluation. CDC Milestones – 2 Years
Which of the following is a classic sign of croup in pediatrics?
Drooling and dysphagia
Barking cough
Fine crackles
Wheezing without cough
Croup is characterized by an inspiratory stridor and a distinctive 'barking' cough due to subglottic narrowing. The cough often worsens at night and can be accompanied by hoarseness. Drooling and severe dysphagia are more suggestive of epiglottitis. AAP Guidance on Croup
Respiratory syncytial virus (RSV) bronchiolitis most commonly occurs during which season?
Summer
Autumn
Winter
Spring
RSV bronchiolitis outbreaks typically peak in the winter months in temperate climates. The virus spreads rapidly in daycare and hospital settings. Infants and young children under 2 years are most susceptible to severe disease. AAP RSV Toolkit
Nasal flaring in an infant is an early sign of:
Sepsis
Respiratory distress
Dehydration
Anemia
Nasal flaring indicates increased effort to breathe by widening the nostrils to reduce airway resistance. It is an early and sensitive sign of respiratory distress in infants. Other signs include tachypnea, grunting, and retractions. Prompt evaluation and support of airway and breathing are essential. NCBI – Pediatric Respiratory Assessment
Bronchiolitis in infants is most commonly caused by:
Influenza A
Respiratory syncytial virus (RSV)
Adenovirus
Parainfluenza virus type 3
RSV accounts for the majority of bronchiolitis cases in infants, leading to inflammation of the bronchioles and respiratory distress. Other viruses can cause similar presentations but are less common. Supportive care is the mainstay of treatment. CDC – RSV Clinical Info
The nurse should prepare for which intervention as first-line management in a child with suspected epiglottitis?
Throat culture
Rapid sequence intubation in OR
Nebulized racemic epinephrine
Oral corticosteroids
Epiglottitis can progress rapidly to complete airway obstruction. Securing the airway via controlled intubation in the operating room under expert supervision is the priority. Throat cultures or epinephrine may delay definitive airway protection. NCBI – Epiglottitis Management
A sweat chloride test greater than what value is diagnostic for cystic fibrosis?
>20 mmol/L
>40 mmol/L
>60 mmol/L
>80 mmol/L
A sweat chloride level above 60 mmol/L is diagnostic for cystic fibrosis when paired with clinical features and/or genotype confirmation. Values between 30–59 mmol/L are considered borderline. Timely diagnosis allows for early interventions that improve long-term outcomes. CFF Cystic Fibrosis Foundations Guidelines
A 2-year-old with tachypnea is breathing at 60 breaths per minute. This is:
Normal
Bradypnea
Tachypnea
Apnea
Normal respiratory rates for a 2-year-old range from 24 to 40 breaths per minute. A rate of 60 indicates tachypnea, suggesting respiratory distress or pathology. Evaluation of work of breathing and oxygenation is indicated. Peds in Review – Pediatric Vital Signs
According to Piaget, a 15-month-old child is in which stage of cognitive development?
Sensorimotor
Preoperational
Concrete operational
Formal operational
Piaget's sensorimotor stage spans birth to 2 years and is characterized by learning through direct sensory and motor interaction with the environment. Object permanence and trial-and-error experimentation develop during this phase. Preoperational thought begins after 2 years. Simply Psychology – Piaget’s Stages
Which finding is most specific for acute viral bronchiolitis?
Inspiratory stridor
Wheezing and crackles
Barking cough
High-pitched inspiratory noise
Bronchiolitis typically presents with diffuse wheezing and fine crackles due to small airway obstruction by mucus and inflammation. Stridor and barking cough suggest upper airway involvement like in croup. Treatment remains supportive with hydration and monitoring. AAP Bronchiolitis Guidelines
For a child with moderate persistent asthma, the recommended long-term controller therapy includes:
Short-acting beta agonist PRN only
Low-dose inhaled corticosteroid plus long-acting beta-agonist
Oral montelukast monotherapy
High-dose inhaled corticosteroid monotherapy
Moderate persistent asthma typically requires a daily low-dose inhaled corticosteroid combined with a long-acting beta-agonist to achieve control and reduce exacerbations. Short-acting beta-agonists alone are insufficient for persistent cases. Montelukast may be an adjunct but not first-line monotherapy. NHLBI Asthma Guidelines
In pediatric ARDS ventilation, permissive hypercapnia is used to:
Increase tidal volumes
Prevent ventilator-induced lung injury
Eliminate CO2 rapidly
Decrease PEEP requirement
Permissive hypercapnia allows lower tidal volumes to minimize barotrauma and volutrauma in diseased lungs, reducing ventilator-induced lung injury. Accepting a higher PaCO2 prevents high airway pressures. PEEP and oxygenation settings remain optimized to maintain adequate oxygenation. NCBI – ARDS Management
Separation anxiety typically peaks at what age in infants?
6 months
9 months
12-18 months
24 months
Separation anxiety tends to peak between 12 and 18 months when infants recognize themselves as distinct from caregivers. Crying and distress are normal at this stage when separated from parents. By around 24 months, many children begin to adjust more easily to brief separations. HealthyChildren.org – Separation Anxiety
Transient tachypnea of the newborn (TTN) is differentiated from neonatal respiratory distress syndrome (RDS) by:
Surfactant deficiency
Onset of symptoms within minutes of birth
Resolution within 72 hours
Ground-glass appearance on CXR
TTN symptoms typically resolve within 48–72 hours as excess lung fluid is absorbed. Neonatal RDS, caused by surfactant deficiency, often worsens without exogenous surfactant. Ground-glass CXR changes and earlier onset are more characteristic of RDS. UpToDate – TTN
Which class of CFTR mutation is characterized by defective protein folding and processing?
Class I
Class II
Class III
Class IV
Class II CFTR mutations, such as ?F508, result in misfolded proteins that are targeted for degradation before reaching the cell surface. This leads to absent or reduced CFTR function at the membrane. Other classes involve gating defects or altered conductance. NCBI – CFTR Mutation Classes
According to NHLBI asthma guidelines, step-up therapy for children with controlled asthma but symptoms more than twice weekly includes:
Increase short-acting beta agonist use
Add low-dose inhaled corticosteroid
Discontinue controller medications
Switch to leukotriene receptor antagonist alone
If asthma symptoms occur more than twice weekly, adding a low-dose inhaled corticosteroid is recommended to maintain control and reduce exacerbations. Increasing rescue inhaler use alone does not address underlying inflammation. Leukotriene antagonists may be adjunctive but are not first-line step-up monotherapy. NHLBI Asthma Guidelines
In pediatric cystic fibrosis, the most common organism to cause chronic lung infection is:
Haemophilus influenzae
Staphylococcus aureus
Pseudomonas aeruginosa
Moraxella catarrhalis
Pseudomonas aeruginosa colonizes the CF airway frequently and is associated with declining lung function and increased morbidity. Early eradication protocols may delay chronic infection. Staphylococcus aureus is common in younger children but Pseudomonas predominates chronically. CFF Pathogens in CF
During an acute asthma attack, peak expiratory flow rate (PEFR) is most significantly reduced due to:
Alveolar collapse
Bronchial smooth muscle relaxation
Airway inflammation and constriction
Increased surfactant production
Acute asthma exacerbations cause bronchoconstriction, airway inflammation, and mucus production, all of which narrow the airways and reduce PEFR. This measurement is a useful indicator of expiratory flow limitation. Relaxation of smooth muscle would improve PEFR, not reduce it. NCBI – Asthma Pathophysiology
In neonatal respiratory distress syndrome, administration of antenatal corticosteroids to the mother is to:
Lubricate the amniotic fluid
Stimulate surfactant production
Prevent neonatal sepsis
Increase fetal heart rate
Antenatal corticosteroids accelerate fetal lung maturity by enhancing type II pneumocyte differentiation and surfactant production. This reduces the incidence and severity of neonatal respiratory distress syndrome. They also decrease neonatal mortality and intraventricular hemorrhage. Cochrane Review – Antenatal Steroids
A toddler with suspected croup presents with inspiratory stridor at rest, marked retractions, and agitation. The nurse anticipates administering:
Oral dexamethasone only
Heliox therapy
Nebulized racemic epinephrine
Broad-spectrum antibiotics
Severe croup with stridor and retractions responds rapidly to nebulized racemic epinephrine, which reduces mucosal edema via vasoconstriction. Dexamethasone is also given but the epinephrine provides quick relief. Antibiotics are not indicated unless bacterial infection is suspected. NCBI – Croup Management
Bronchopulmonary dysplasia (BPD) in preterm infants is most often the result of:
Congenital lung malformation
Prolonged mechanical ventilation and oxygen therapy
In utero infection
Genetic abnormalities in surfactant
BPD is primarily a chronic lung disease resulting from lung injury due to prolonged mechanical ventilation and high oxygen levels in preterm infants. The immature lung is susceptible to barotrauma and oxygen toxicity. Prevention includes gentle ventilation strategies and minimizing supplemental oxygen. NCBI – Bronchopulmonary Dysplasia
Which of the following differentiates epiglottitis from viral croup in presentation and management?
Epiglottitis presents with a barking cough and responds to humidified air
Viral croup patients drool and prefer sitting leaning forward
Epiglottitis has rapid onset of high fever, drooling, and requires immediate airway management
Viral croup is usually bacterial and treated with IV antibiotics
Epiglottitis onset is rapid with high fever, severe sore throat, drooling, and child sitting in 'tripod' position, necessitating prompt airway protection. Viral croup has a slower onset, barking cough, and responds to steroids and humidification. Antibiotics are indicated for epiglottitis but not for viral croup. NCBI – Epiglottitis vs Croup
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Study Outcomes

  1. Analyze Growth Milestones -

    Identify and assess typical pediatric developmental milestones to answer pediatric nclex questions accurately.

  2. Apply Respiratory Disorder Concepts -

    Demonstrate critical interventions for common pediatric respiratory disorders to successfully tackle pediatric respiratory disorders nclex questions.

  3. Interpret NCLEX Question Stems -

    Examine and break down nclex rn pediatric questions and nclex paediatric questions to select the most appropriate nursing responses.

  4. Evaluate Clinical Scenarios -

    Prioritize nursing actions in varied pediatric scenarios to strengthen decision-making skills in peds nclex questions.

  5. Develop Test-Taking Strategies -

    Cultivate effective time management and question-review techniques to boost confidence and performance on the pediatric NCLEX quiz.

Cheat Sheet

  1. Developmental Milestones Mastery -

    Understanding typical growth milestones is vital for pediatric NCLEX questions. For example, use the mnemonic "Sit at 6, Stand at 11" to remember that most infants sit unassisted by 6 months and pull to stand by 11 months (American Academy of Pediatrics). Tracking milestone windows - such as social smiles by 2 months and first words by 12 months - helps you identify delays swiftly.

  2. Recognizing Pediatric Respiratory Distress -

    When tackling pediatric NCLEX questions on respiratory assessment, remember that tachypnea thresholds vary by age: infants 30 - 60 breaths/min and toddlers 24 - 40 breaths/min (NIH). Look for nasal flaring, intercostal retractions, and grunting as early red flags (WHO guidelines). Early recognition guides timely interventions like humidified oxygen or nebulized epinephrine.

  3. Differentiate Croup and Epiglottitis -

    In peds NCLEX questions, distinguish croup's barking "seal-like" cough from epiglottitis's sudden onset of drooling, dysphagia, and muffled "hot potato" voice (CDC). Use the "4 D's" mnemonic for epiglottitis: Dysphagia, Drooling, Distress, and Dysphonia. Correct identification ensures you prioritize airway management and avoid throat examinations in epiglottitis cases.

  4. Pediatric Medication Dosing Rules -

    Master the Clark's rule and Young's rule for nclex rn pediatric questions: Clark's = (weight in lbs/150) × adult dose; Young's = [age/(age+12)] × adult dose. For instance, a 30-lb child's antibiotic dose = (30/150) × 500 mg = 100 mg. Accurate calculations prevent under- or overdosing in pediatric clients.

  5. Pediatric Fluid Management: 4-2-1 Rule -

    In nclex paediatric questions on fluid balance, apply the 4-2-1 rule: 4 mL/kg/hr for first 10 kg, 2 mL/kg/hr for next 10 kg, and 1 mL/kg/hr for each kg above 20 (PALS guidelines). For a 25 kg child, maintenance = (4×10)+(2×10)+(1×5) = 65 mL/hr. Monitoring urine output ≥1 mL/kg/hr confirms adequate perfusion.

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