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Quizzes > Health & Medicine

Pediatric Nursing 3.0 Test: NCLEX Practice Quiz

Quick, free quiz for pediatric NCLEX practice. Instant results.

Editorial: Review CompletedCreated By: Brandon JohnUpdated Aug 28, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration for Pediatric Nursing 3.0 NCLEX quiz on dark blue background

Use this Pediatric Nursing 3.0 test to check your pediatric care knowledge with NCLEX-style questions and quick results. Build confidence as you review key topics, then keep going with our rn vati pediatric nursing quiz and pediatric growth and development nclex. For systems review, sharpen skills with NCLEX respiratory practice.

At what age does the Moro reflex typically disappear in infants?
8 months
2 months
4 months
6 months
The Moro reflex is a primitive reflex present at birth that normally fades by around 3 to 4 months of age. Persistence beyond this age may indicate neurological abnormalities. Monitoring reflex integration helps assess infant neurodevelopment.
In the APGAR score, what does the 'A' stand for?
Auscultation
Appearance (skin color)
Activity
Airway
APGAR is an acronym for Appearance, Pulse, Grimace, Activity, and Respiration. 'Appearance' evaluates the infant's skin color, indicating oxygenation. Assessing appearance helps determine immediate newborn adaptation.
By what age does an infant typically triple their birth weight?
9 months
6 months
1 year
18 months
Healthy infants generally triple their birth weight by about 12 months of age. Tracking growth milestones ensures proper nutritional intake and development. Failure to meet this milestone warrants further evaluation.
What is the normal axillary temperature range for a toddler (1 - 3 years)?
36.5 - 37.5 °C (97.7 - 99.5 °F)
38.5 - 39.5 °C (101.3 - 103.1 °F)
37.5 - 38.5 °C (99.5 - 101.3 °F)
35.0 - 36.0 °C (95.0 - 96.8 °F)
Axillary temperatures in toddlers usually range from 36.5 to 37.5 °C. Axillary readings are typically 0.5 °C lower than oral temperatures. Always consider age and method when evaluating fever.
At what age does an infant typically begin to roll from back to stomach?
6 months
2 months
4 months
8 months
Rolling from back to stomach typically starts around 4 months as muscle strength and coordination improve. Early rolling demonstrates developing gross motor control. Delays may require assessment for developmental concerns.
Which site is recommended for intramuscular injections in infants under 12 months?
Gluteus maximus
Vastus lateralis
Deltoid muscle
Dorsogluteal
The vastus lateralis is the preferred IM injection site in infants under one year due to well-developed muscle mass and minimal risk to major nerves. The deltoid and gluteal sites are less developed or carry risk in this age group. Proper site choice reduces complications.
At what age is the first dose of the MMR vaccine recommended?
15 months
12 months
18 months
9 months
The first MMR dose is recommended at 12 to 15 months of age to ensure maternal antibody waning and optimal immune response. Delaying beyond this window may increase susceptibility. Following immunization schedules is critical for community immunity.
Which of the following is an early sign of dehydration in an infant?
Excessive drooling
Sunken fontanelle
High-pitched cry
Rash
A sunken anterior fontanelle indicates decreased intracranial volume often due to fluid loss. Early recognition of dehydration is vital to prevent complications. Other signs include decreased urine output and dry mucous membranes.
Which toy is developmentally appropriate for a 4-month-old infant?
Shape sorter
Rattle
Stackable blocks
Coloring book
At 4 months, infants explore objects by grasping and shaking, making a rattle ideal for sensorimotor development. Toys that provide auditory feedback enhance hand-eye coordination. Complex manipulatives are introduced later.
According to Erikson's stages, what psychosocial crisis is typical for toddlers?
Initiative vs guilt
Autonomy vs shame and doubt
Trust vs mistrust
Industry vs inferiority
Toddlers (18 months to 3 years) navigate the crisis of autonomy vs shame and doubt as they assert independence. Successful resolution builds self-confidence; failure leads to feelings of shame. Knowledge of developmental stages guides therapeutic play.
Why is codeine contraindicated in children under 12 years old?
Risk of respiratory depression due to variable metabolism
High risk of hepatotoxicity
Potential to cause seizures
Increased risk of nephrotoxicity
Codeine's metabolism by CYP2D6 can produce unpredictable morphine levels, leading to life-threatening respiratory depression in young children. Regulatory agencies advise against its use in those under 12. Alternative pain management should be considered.
The therapeutic serum level of digoxin in pediatric patients is generally:
2.5 - 4.5 ng/mL
0.1 - 0.5 ng/mL
2.0 - 4.0 ng/mL
0.5 - 2.0 ng/mL
Pediatric digoxin levels are maintained between 0.5 and 2.0 ng/mL to optimize cardiac output while minimizing toxicity. Levels above 2.0 ng/mL increase risk of arrhythmias and GI symptoms. Regular monitoring ensures safe therapy.
Which of the following is an early sign of increased intracranial pressure in a school-age child?
Pupillary dilation
Bradycardia
Morning headache
Seizures
Morning headaches are often one of the earliest subjective signs of increased intracranial pressure due to overnight accumulation of CSF. Recognizing this symptom can prompt early intervention. More advanced signs include bradycardia and altered consciousness.
Calculate the dose: A 20 kg child requires 10 mg/kg of medication. How many milligrams should be administered?
150 mg
200 mg
100 mg
250 mg
Dose calculation: 20 kg × 10 mg/kg = 200 mg. Accurate weight-based dosing is critical in pediatrics to ensure efficacy and avoid toxicity. Always verify calculations with a second nurse.
Which nursing action is the highest priority for a pediatric leukemia patient with neutropenia?
Strict hand hygiene and infection control
Allowing numerous visitors
Encouraging ambulation
Increasing dietary protein
Neutropenia greatly increases infection risk; rigorous hand hygiene and protective isolation prevent pathogens. Ambulation and nutrition are important but secondary. Limiting visitors further reduces exposure.
How should you explain a blood draw procedure to a preschooler?
Explain the sterile technique in medical jargon
Avoid any explanation to prevent anxiety
Give them a detailed explanation of veins and arteries
Use simple, concrete terms and allow them to practice with a toy syringe
Preschoolers benefit from simple language and play demonstrations to reduce fear and build trust. Detailed anatomical discussions exceed their developmental level. Clear but minimal explanations foster cooperation.
Which pain assessment tool is most appropriate for a 3-year-old child?
FLACC scale
Numeric rating scale (0 - 10)
Visual analog scale
Wong-Baker FACES Pain Rating Scale
The Wong-Baker FACES scale uses facial expressions and is validated for preschool-aged children to self-report pain. Numeric scales require higher cognitive ability. Observational scales are secondary if self-report is unreliable.
Strawberry tongue and conjunctivitis are hallmark signs of which pediatric condition?
Rubella
Measles
Scarlet fever
Kawasaki disease
Kawasaki disease is characterized by mucocutaneous inflammation, including strawberry tongue and bilateral conjunctivitis without exudate. Early diagnosis and IVIG therapy prevent coronary artery aneurysms. Prompt recognition is key.
Iron supplements are best absorbed when given with:
Milk
Water
Vitamin C - rich juice
Antacids
Vitamin C enhances non-heme iron absorption by reducing it to a more absorbable form and maintaining solubility. Milk and antacids inhibit absorption. Administer with orange juice when possible.
Palivizumab prophylaxis against RSV is recommended monthly for which high-risk infants?
Infants born at <29 weeks' gestation
All infants under 12 months
Children with asthma only
Term infants with no risk factors
Palivizumab is recommended for high-risk infants, including those born before 29 weeks' gestation, to prevent severe RSV. Term infants without risk factors do not require prophylaxis. Administration is monthly during RSV season.
What sweat chloride level is diagnostic for cystic fibrosis in infants?
>100 mmol/L
>60 mmol/L
40 mmol/L
20 mmol/L
A sweat chloride value greater than 60 mmol/L on two separate tests confirms cystic fibrosis. Values below 30 mmol/L are considered normal. Early diagnosis allows timely management of respiratory and GI complications.
Duchenne muscular dystrophy is inherited in which pattern?
X-linked recessive
Autosomal recessive
Autosomal dominant
Mitochondrial
Duchenne muscular dystrophy is an X-linked recessive disorder primarily affecting males. Carrier females are usually asymptomatic or have mild symptoms. Genetics counseling is important for affected families.
In pediatric diabetic ketoacidosis, when should potassium be added to IV fluids?
After discontinuing insulin
Immediately upon diagnosis
Once urine output is adequate and serum K+ ?5 mEq/L
Only if serum K+ <2 mEq/L
Potassium is added after establishing adequate urine output and confirming serum K+ is ?5 mEq/L to avoid hyperkalemia. Insulin drives K+ intracellularly, risking hypokalemia if not monitored. Careful electrolyte management prevents cardiac complications.
What dietary modification is recommended for a child with phenylketonuria (PKU)?
High-phenylalanine diet
Unlimited natural protein
High-protein diet
Low-phenylalanine diet
PKU results from inability to metabolize phenylalanine to tyrosine, so dietary restriction of phenylalanine prevents neurotoxicity. Special medical formulas provide necessary protein without phenylalanine. Lifetime adherence is essential.
A child experiencing a 'tet spell' due to tetralogy of Fallot should be placed in which position?
Supine with legs extended
Trendelenburg
High Fowler's
Knee-chest position
The knee-chest position increases systemic vascular resistance, reducing the right-to-left shunt and improving oxygenation during a 'tet spell.' Recognizing and promptly positioning the child can be lifesaving. Supplemental oxygen and morphine may also be used.
The presence of an olive-shaped mass in the epigastric region of an infant suggests:
Appendicitis
Malrotation
Intussusception
Pyloric stenosis
An olive-shaped, palpable mass in the right upper quadrant or epigastrium is classic for hypertrophic pyloric stenosis in infants. It is accompanied by projectile nonbilious vomiting. Early detection allows prompt surgical correction.
Which radiographic finding is characteristic of laryngotracheobronchitis (croup)?
Ground-glass appearance
String sign
Steeple sign on a neck X-ray
Apple core lesion
The 'steeple sign' on frontal neck X-ray shows subglottic narrowing in croup. This radiographic sign supports diagnosis alongside clinical presentation of barking cough and stridor. Management includes humidified air and nebulized epinephrine.
A bulging anterior fontanelle in an infant is most indicative of:
Hypoglycemia
Congenital heart defect
Hydrocephalus or increased intracranial pressure
Dehydration
A bulging anterior fontanelle suggests elevated intracranial pressure or hydrocephalus in infants. It warrants immediate neurologic evaluation and imaging. Other signs include irritability and vomiting.
Children with myelomeningocele are at increased risk for latex allergy because of:
Genetic predisposition
Exposure to latex in toys
High dietary latex intake
Frequent surgical and catheterization procedures
Repeated exposure to latex during surgeries and catheterizations sensitizes children with myelomeningocele, raising allergic risk. Prevention includes latex-free environments and equipment. Early identification of sensitization improves safety.
A child with sickle cell disease presents with priapism. The initial emergency intervention should be:
Immediate surgical shunt placement
Alpha-adrenergic eye drops
Application of cold compresses only
Intravenous fluids and analgesia
Priapism in sickle cell patients is a medical emergency requiring IV fluids to reduce viscosity and opioid analgesia for pain control. If unresponsive, urology may perform aspiration or irrigation. Early management prevents permanent damage.
At what Finnegan Neonatal Abstinence Score is pharmacologic treatment usually initiated?
Score >8 on two consecutive assessments
Score >6 on two consecutive assessments
Score >12 on two consecutive assessments
Score >10 on any single assessment
Pharmacologic treatment for neonatal abstinence syndrome is typically started when the Finnegan score exceeds 8 on two consecutive evaluations. This threshold balances treatment benefits against medication exposure. Nonpharmacologic care continues alongside.
In DiGeorge syndrome, hypocalcemia results primarily from which endocrine abnormality?
Adrenal hyperfunction
Hypoparathyroidism
Thyroid hormone deficiency
Hyperparathyroidism
DiGeorge syndrome features the congenital absence or hypoplasia of the parathyroid glands, leading to hypoparathyroidism and resultant hypocalcemia. Calcium supplementation and vitamin D analogs manage symptoms. Early detection prevents tetany and seizures.
According to PALS guidelines, what is the recommended epinephrine dose for pediatric cardiac arrest?
1 mg/kg IV
0.01 mg/kg IV
0.001 mg/kg IV
0.1 mg/kg IV
PALS recommends 0.01 mg/kg of 1:10,000 epinephrine IV/IO every 3 - 5 minutes during pediatric cardiac arrest. This dosage optimizes perfusion without excessive tachyarrhythmias. Proper dosing is crucial for effective resuscitation.
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Study Outcomes

  1. Understand Core Pediatric Nursing 3.0 Concepts -

    Engage with essential topics covered in the pediatric nursing 3.0 test, ensuring you grasp foundational principles before tackling more advanced NCLEX pediatric nursing questions.

  2. Apply Critical Thinking to NCLEX Pediatric Nursing Questions -

    Develop analytical skills by working through sample items in the pediatric nursing practice quiz, enhancing your ability to select the most appropriate interventions under exam conditions.

  3. Identify Strengths and Knowledge Gaps -

    Use your quiz performance data to pinpoint areas for further study, allowing you to focus your review on weak spots and streamline your pediatric nursing exam prep.

  4. Interpret Realistic Pediatric Patient Scenarios -

    Practice applying theory to practice with case-based questions, sharpening your assessment and decision-making skills for real-world pediatric nursing care.

  5. Utilize Instant Feedback for Targeted Review -

    Benefit from immediate explanations and rationales to reinforce correct answers and rectify misconceptions, maximizing learning efficiency in your NCLEX preparation.

  6. Build Confidence for Exam Day Success -

    Leverage repeated practice and self-assessment to reduce test anxiety and approach the pediatric nursing portion of the NCLEX with poise and assurance.

Cheat Sheet

  1. Growth and Development Milestones -

    Master Erikson's psychosocial stages and Piaget's cognitive levels to anticipate age-specific behaviors, using the mnemonic "SPECF" (Sensorimotor, Preoperational, Concrete, Formal). Tracking head circumference, length/height, and weight percentiles from the CDC's growth charts helps you spot deviations early. This foundation strengthens your performance on pediatric nursing 3.0 test questions about developmental norms.

  2. Pediatric Medication Calculations -

    Apply Clark's Rule (Child's dose = weight (lb) ÷ 150 × adult dose) or mg/kg dosing for precise drug administration. Remember the phrase "Leftover Milk? Multiply!" for converting mg to mL: (Ordered dose ÷ Stock dose) × Stock volume. Accurate calculations are essential in NCLEX pediatric nursing questions to avoid dosage errors.

  3. Pain Assessment Tools -

    Familiarize yourself with FLACC (Face, Legs, Activity, Cry, Consolability) and Wong-Baker FACES scales from the American Academy of Pediatrics. Use the acronym "FIVE C's" (Face, Legs, Vocal, Consolability, Movement) to recall FLACC parameters quickly. Reliable pain scoring is critical in pediatric nursing practice quiz scenarios to guide timely interventions.

  4. Fluid and Electrolyte Maintenance -

    Use the Holliday-Segar 100-50-20 rule to calculate maintenance fluids: 100 mL/kg for first 10 kg, 50 mL/kg for next 10 kg, then 20 mL/kg thereafter. Monitor serum electrolytes per hospital protocols (e.g., sodium 135 - 145 mEq/L) and watch for signs of imbalance like irritability or oliguria. Solid mastery of these formulas will boost your confidence in pediatric nursing exam prep.

  5. Immunization Schedule & Safety -

    Memorize the CDC's recommended timeline for DTaP, MMR, Hib, and other vaccines, noting live attenuated vaccines are given at or after 12 months. The phrase "I Did My MMR at Twelve" can help you recall key immunizations and timing. Understanding contraindications and proper administration techniques is a must for NCLEX pediatric nursing questions and real-world practice.

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