NCLEX Pediatric Nursing Practice Questions
NCLEX pediatric nursing practice questions on growth and development, medication safety, and common childhood illnesses, with rationales for every answer.
Pediatric questions test both developmental milestones and the unique physiology of children, especially around medication dosing, fever, and respiratory illness. Here's a sample from the full pediatric set.
Practice questions
1. Which developmental milestone is expected in a healthy 9-month-old?
- A. Walking independently
- B. Sitting without support and beginning to pull to stand
- C. Speaking in two-word phrases
- D. Riding a tricycle
Show answer & rationale
Correct answer: B
By 9 months, infants typically sit unsupported and begin pulling to stand; independent walking and two-word phrases are later milestones (12–18 months).
2. A 2-year-old is admitted with a barking cough, inspiratory stridor, and low-grade fever. Which condition does the nurse suspect?
- A. Epiglottitis
- B. Croup (laryngotracheobronchitis)
- C. Bronchiolitis
- D. Asthma exacerbation
Show answer & rationale
Correct answer: B
A barking cough with stridor and low-grade fever is the classic presentation of croup, most often caused by parainfluenza virus. Epiglottitis presents more abruptly with high fever, drooling, and a toxic appearance.
3. The nurse is calculating a pediatric medication dose based on weight. The order is 15 mg/kg/day divided every 8 hours for a 20 kg child. How many mg should the child receive per dose?
- A. 50 mg
- B. 75 mg
- C. 100 mg
- D. 150 mg
Show answer & rationale
Correct answer: C
15 mg/kg × 20 kg = 300 mg/day ÷ 3 doses (every 8 hours) = 100 mg per dose.
4. Which action best supports a toddler's developmental need for autonomy during a hospital stay?
- A. Making all care decisions for the child
- B. Offering limited choices, such as which arm to use for a blood pressure check
- C. Keeping the same rigid schedule as home without flexibility
- D. Discouraging the child from participating in care
Show answer & rationale
Correct answer: B
Toddlers are in Erikson's autonomy vs. shame/doubt stage; offering limited, safe choices supports their developmental need for control without overwhelming them.
5. A child with suspected epiglottitis arrives in the emergency department. What should the nurse avoid?
- A. Keeping the child calm and upright
- B. Examining the throat with a tongue depressor
- C. Preparing for possible intubation
- D. Keeping emergency airway equipment at the bedside
Show answer & rationale
Correct answer: B
Examining the throat can trigger complete airway obstruction in epiglottitis; the airway should only be visualized in a controlled setting (OR) with intubation equipment ready.
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Frequently asked questions
How much pediatric content is on the NCLEX?
Pediatrics is woven throughout the Health Promotion and Physiological Integrity categories rather than tested as a standalone section, but growth/development and medication safety questions appear consistently.
What's the biggest pediatric medication safety concept to know?
Weight-based dosing (mg/kg) is tested constantly — practice these calculations until they're automatic, since a decimal error in pediatrics can be fatal.