Growth & Development
Cardiac
Neuro
Musculoskeletal
Infection
NCLEX Priority
100

A 6-month-old should be able to:

A. Walk

B. Sit unsupported

C. Ride a tricycle

D. Skip

B. Sit unsupported

100

An infant with Tetralogy of Fallot suddenly becomes cyanotic. First intervention?

Knee-to-chest position

100

Infant with fever, bulging fontanel, poor feeding and difficult to arouse...

meningitis 

100

A child has pain out of proportion after a fracture. What complication?

Compartment syndrome

100

Precautions for MRSA

contact

100

Which child do you assess first?

A. JIA with knee pain

B. Child with increasing pain despite morphine after fracture

C. Clubfoot

D. Otitis Media

B. Compartment Syndrome

200

What is the first sign of puberty in females?

Breast development

200

Name 3 clinical manifestations of a large VSD

Murmur, tachypnea, fatigue with feeds

200

What is the priority nursing intervention for an infant with a myelomeningocele?

Cover sac with a sterile moist dressing

200

A 4 year old male presents with frequent falls and large calves. Diagnosis?

Duchenne muscular dystrophy

200

When is the first MMR vaccine given?

12-15 months

200

Parent states "my baby with heart failure sweats during feeding." What should you think?

Heart failure is worsening

300

A toddler keeps saying "NO!". What should the parents do?

Reduce opportunities for a "no" answer

300

Kawasaki disease primarily affects what arteries?

Coronary

300

What is the cause of a febrile seizure?

A rapid rise in temperature

300

A patient present with a limp, hip stiffness, limited ROM, and complaint of knee pain. Diagnosis?

Legg-Calve-Perthes 

300

Which vaccines have dramatically reduced bacterial meningitis?

Hib, PCV

300

The nurse receives report on four pediatric patients. Which patient should the nurse assess first?

A. A toddler with gastroenteritis who has vomited twice.

B. A child with asthma whose oxygen saturation is 89%.

C. A school-age child requesting pain medication after surgery.

D. An infant with reflux crying after feeding.

B. A child with asthma whose oxygen saturation is 89%.

400

A nurse is preparing to administer an intramuscular vaccine to a 2-year-old. Which nursing intervention is most appropriate?

A. Explain the procedure in detail several hours before the injection.

B. Allow the child to choose whether to receive the vaccine.

C. Use simple explanations immediately before the procedure and allow the child to sit on the parent's lap.

D. Tell the child the injection will not hurt.

C. Use simple explanations immediately before the procedure and allow the child to sit on the parent's lap.

400

A nurse is caring for a 3-month-old with a ventricular septal defect (VSD). Which assessment finding requires immediate intervention?

A. Grade III/VI murmur
B. Sweating while feeding
C. Respiratory rate of 68/min with retractions
D. Weight gain of 3 ounces this week

C. Respiratory rate of 68/min with retractions

400

A child with bacterial meningitis suddenly develops seizure activity. What is the nurse's priority action?

A. Administer diazepam
B. Insert an oral airway
C. Protect the child from injury
D. Lower the head of the bed

C. Protect the child from injury

400

A child has a newly applied cast following a fractured tibia. Which finding should the nurse report immediately?

A. Mild edema
B. Pain relieved by medication
C. Inability to move the toes with severe pain
D. Warm skin over the cast

C. Inability to move the toes with severe pain

400

A toddler with epiglottitis arrives in the emergency department. Which nursing action is most appropriate?

A. Inspect the throat with a tongue blade
B. Obtain a throat culture
C. Keep the child calm and prepare for airway management
D. Encourage fluids

C. Keep the child calm and prepare for airway management

400

Which pediatric patient should the nurse assess first?

A. Child with Kawasaki disease whose fever returned after IVIG.

B. Child with nephrotic syndrome who gained one pound overnight.

C. Toddler with bronchiolitis whose respiratory rate increased from 42 to 70/min.

D. Child with juvenile idiopathic arthritis reporting knee pain.

C. Toddler with bronchiolitis whose respiratory rate increased from 42 to 70/min.

500

A nurse is caring for four pediatric clients. Which child demonstrates a developmental milestone that requires further evaluation?

A. A 6-month-old who rolls from front to back and transfers objects between hands.

B. A 12-month-old who pulls to stand and says "mama" and "dada."

C. An 18-month-old who is unable to walk independently and speaks only one word.

D. A 4-year-old who hops on one foot and speaks in complete sentences.

C. An 18-month-old who is unable to walk independently and speaks only one word.

500

A 2-year-old with tetralogy of Fallot suddenly becomes cyanotic and begins squatting after playing. Which nursing action is the priority?

A. Notify the provider
B. Place the child in the knee-chest position
C. Encourage oral fluids
D. Obtain a blood pressure

 B. Place the child in the knee-chest position

500

The nurse is caring for a child with increased intracranial pressure. Which assessment finding requires immediate intervention?

A. Headache
B. Projectile vomiting
C. Bradycardia with irregular respirations
D. Photophobia

C. Bradycardia with irregular respirations

500

A nurse is assessing a school-age child. Which assessment finding is most indicative of osteomyelitis?

A. Bilateral joint stiffness that improves with activity

B. Fever, localized bone pain, swelling, and refusal to bear weight

C. Muscle weakness that worsens throughout the day

D. A painless limp with limited hip abduction

B. Fever, localized bone pain, swelling, and refusal to bear weight

500

A child hospitalized with RSV develops nasal flaring, grunting, and an oxygen saturation of 84% despite oxygen therapy. What should the nurse do first?

A. Notify respiratory therapy
B. Increase oral fluids
C. Activate the rapid response team
D. Administer acetaminophen

C. Activate the rapid response team

500

The nurse receives report on four pediatric patients. Which patient should the nurse see first?

A. Infant with pyloric stenosis who has not voided in 8 hours.

B. Child with leukemia whose platelet count is 18,000/mm³ but has no bleeding.

C. Toddler with epiglottitis sitting upright, drooling, and struggling to breathe.

D. School-age child with nephrotic syndrome and facial edema.

C. Toddler with epiglottitis sitting upright, drooling, and struggling to breathe.

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