PED-BC Exam Prep: Pediatric Nursing (ANCC) Study Guide + 2,100+ Practice Questions

A 7-year-old child presents with periumbilical pain that has migrated to the right lower quadrant, accompanied by guarding and a low-grade fever. When performing the abdominal assessment, which sequence of techniques should the nurse follow to ensure accuracy?

A nurse is conducting an oral health assessment on a 2-year-old child. The nurse observes white, chalky spots along the gum line of the upper incisors. The parent mentions that the child still uses a bottle with milk to fall asleep at night. Which instruction is most important for the nurse to provide?

A 12-year-old child with a Body Mass Index (BMI) at the 96th percentile for age and sex is seen for a physical examination. The child’s medical history is unremarkable, but the family history is significant for Type 2 Diabetes. Which health promotion intervention should the nurse prioritize during this visit?

The nurse is providing injury prevention education to the parents of a 5-year-old child who weighs 42 pounds (19 kg) and has reached the upper height limit of their forward-facing car seat with a five-point harness. Which guidance regarding the next stage of passenger safety is most accurate?

During an 18-month-old well-child visit, the nurse administers the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R). The results indicate a medium risk for Autism Spectrum Disorder (ASD). The parents report that the child has limited eye contact and does not consistently respond to their name. Which action should the nurse take to ensure appropriate follow-up care?

A 6-month-old infant who has been exclusively breastfed is seen for a health maintenance visit. The mother reports the infant is meeting developmental milestones and is beginning to show interest in table foods. The nurse notes the infant’s weight has shifted from the 50th percentile to the 25th percentile over the last two months. Which nutritional recommendation is most appropriate for this infant?

A 15-month-old child presents for a well-child visit with mild rhinorrhea and a low-grade fever of 100.1°F (37.8°C). The parent expresses concern about the number of scheduled immunizations, including MMR and Varicella, and asks to delay them until the child is fully recovered. Which action by the nurse most effectively addresses the parent’s concerns while following evidence-based guidelines?

A 10-year-old child with bacterial pneumonia reports sharp chest pain upon inspiration and is leaning toward the left side. Assessment reveals dullness to percussion and decreased vocal fremitus over the left lower base. Which nursing action is most appropriate for this patient?

A 5-year-old child is admitted with a barking cough and stridor. Despite receiving standard cool mist and initial nebulized treatments, the child develops a high fever, appears toxic, and prefers to lie flat. The nurse notes thick, purulent secretions. Which complication should the nurse suspect?

A 2-year-old child is brought to the clinic after a sudden coughing fit while eating peanuts. The child is currently stable but exhibits localized wheezing on the right side and decreased breath sounds in the right lower lobe. Which diagnostic step should the nurse anticipate next?

A 6-month-old infant is hospitalized with bronchiolitis and is experiencing significant nasal flaring, intercostal retractions, and thick nasal secretions. The infant is struggling to coordinate sucking and breathing during feedings. Which action should the nurse take to improve the infant’s respiratory status?

An 8-year-old child with a history of asthma is admitted for an acute exacerbation. Upon assessment, the nurse notes the child has become somnolent, breath sounds are nearly inaudible despite significant accessory muscle use, and the respiratory rate has decreased from 40 to 18 breaths per minute. Which intervention is most appropriate?

A 4-year-old child presents to the emergency department with a sudden onset of high fever, muffled voice, and drooling. The child is sitting upright, leaning forward with the chin thrusted out, and appears highly anxious. Which action should the pediatric nurse prioritize?

A 9-month-old infant is brought to the clinic with a two-day history of acute gastroenteritis, exhibiting decreased urine output and a sunken anterior fontanelle. To best assess the child’s skin turgor and hydration status, which technique should the nurse use?

A 5-month-old infant is being assessed for delayed motor milestones. During the neurological portion of the physical examination, the nurse identifies a finding that warrants further neurological referral. Which finding is most concerning for this infant’s age?

A 30-month-old child is brought to the clinic for a wellness visit. The parent reports the child uses two-word phrases, follows simple commands, and can jump in place with both feet. The nurse observes the child stacking eight blocks but notices the child does not yet take turns during play with others. Which action should the nurse take based on these findings?

A 3-week-old neonate is being evaluated for a suspected cardiac defect after the nurse notes weak femoral pulses during a routine assessment. To further investigate the possibility of coarctation of the aorta, which assessment technique should the nurse perform next?

A 4-year-old child with a history of asthma presents to the emergency department with acute tachypnea and visible subcostal retractions. The nurse needs to determine the adequacy of air entry and the presence of adventitious sounds. Which technique provides the most reliable data for this specific patient?

An 18-month-old toddler is brought to the clinic for a wellness visit. The child is currently clinging to the parent and crying as the nurse enters the room. To obtain the most accurate physical assessment data while minimizing distress, which approach should the nurse implement?

A nurse is conducting a discharge teaching session for the family of a toddler with a newly placed gastrostomy tube. The family speaks English as a second language and appears hesitant to perform the site care. Which strategy is most effective for ensuring the family is prepared for home care?

A 2-year-old child is being treated for a complex illness, and the parents have been at the bedside for several days. The nurse notices the parents are becoming increasingly irritable with the staff and are neglecting their own basic needs. Which intervention best aligns with the principles of family-centered care?

The nurse is caring for a 10-year-old patient from a culture that emphasizes collective decision-making. The medical team is proposing a new treatment plan, but the parents state they must consult with extended family members before consenting. How should the nurse best facilitate family-centered communication in this situation?

A 5-year-old child is scheduled for a procedure, and the parents express significant anxiety about how their child will react to the hospital environment. The child has had a previous negative experience with a painful needle stick. To promote a family-centered environment and minimize psychological distress, which action is most appropriate?

A 14-year-old adolescent is admitted for management of a chronic condition. During the admission assessment, the patient’s parents are present and answer most of the questions directed at the adolescent. The nurse notes the adolescent is looking at the floor and providing one-word answers. Which approach best demonstrates family-centered care while respecting the developmental needs of the patient?

An 8-year-old child with a history of recurrent hospitalizations for asthma is preparing for discharge. The nurse observes that the primary caregiver appears overwhelmed by the new home management plan and has previously struggled with health literacy. To ensure the family-centered care goal of competence in home management is met, which communication strategy should the nurse implement?

A 6-year-old child is in the clinic for a school physical. The nurse observes the child can tie their shoelaces, draw a person with at least six body parts, and is eager to show the nurse a collection of stickers. The parent mentions the child is struggling to share toys with a younger sibling. Which developmental stage is best reflected?

A 12-month-old infant is being evaluated during a well-child visit. The infant was born at 32 weeks gestation. The nurse notes the infant can pull to a standing position, says “mama” and “dada” specifically, and can sit from a standing position. The infant is not yet walking independently or using a cup. Which assessment is the most accurate?

A 4-year-old child is hospitalized for a respiratory infection. During the assessment, the child tells the nurse that they got sick because they “were mean to their little brother yesterday.” The child is cooperative but becomes very upset when the nurse prepares to use a stethoscope. Which approach should the nurse utilize?

An 18-month-old toddler is seen for a routine checkup. The nurse notes the child can walk up stairs while holding a hand, uses a spoon with some spilling, and has a vocabulary of approximately fifteen words. The parent is concerned because the child cannot yet remove their own clothing or pedal a tricycle. How should the nurse respond?

A 9-month-old infant who was born at full term is being assessed during a nutrition consultation. The infant can sit unsupported for long periods and is beginning to use a crude pincer grasp to pick up cereal. The parent notes the infant is not yet crawling or pulling to a standing position. Which intervention is most appropriate for the nurse to implement?