Pediatric Nursing – LPN Practice Questions

These practice questions target NCLEX-PN level content in pediatric nursing: routine pediatric assessment and measurement, growth and developmental screening, safe basic care, caregiver teaching reinforcement, and recognizing which findings must be reported to the registered nurse. Answers reflect the licensed practical nurse scope of practice, in which the LPN contributes to assessment and care under the direction of the RN and does not independently develop or revise the plan of care.

Question 1

The LPN is measuring vital signs on a 5-month-old infant. Which technique is correct?

1. Count the respiratory rate for 15 seconds and multiply by 4.
2. Count respirations for a full minute before undressing or disturbing the infant.
3. Take a radial pulse for 30 seconds and multiply by 2.
4. Measure the temperature only after the infant has been fed and is crying.

Answer: 2. Count respirations for a full minute before undressing or disturbing the infant.

Rationale: Infant breathing is irregular, so a full 60-second count is required for accuracy, and it is taken before any disturbing procedure because crying alters the rate. Option 1 gives an unreliable number in an irregular breather. Option 3 is incorrect because the apical pulse is taken for a full minute in children under 2 years; radial pulses are difficult to palpate accurately in infants. Option 4 describes conditions that falsely raise the reading.

Question 2

The LPN is assisting at a well-child visit for a 12-month-old. Which findings are expected at this age? Select all that apply.

1. Birth weight has tripled
2. Pulls to a stand and cruises along furniture
3. Says 1 to 3 recognizable words in addition to "mama" and "dada"
4. Uses a neat pincer grasp to pick up small pieces of food
5. Speaks in two-word phrases
6. The posterior fontanel is closed

Answer: 1, 2, 3, 4, and 6.

Rationale: At 12 months, birth weight typically triples, the infant pulls to stand and cruises, says a few meaningful words, and uses a refined pincer grasp. The posterior fontanel closes at 2 to 3 months, so it should indeed be closed. Option 5 is a 24-month milestone; a 12-month-old who spoke in two-word phrases would be advanced, and expecting it at 12 months would falsely label a normal infant as delayed.

Question 3

The LPN measures a 22 lb toddler and is preparing acetaminophen 15 mg/kg by mouth. The suspension is 160 mg per 5 mL. How many milliliters should be administered? Record your answer to the nearest tenth.

1. 2.3 mL
2. 4.7 mL
3. 6.9 mL
4. 10.3 mL

Answer: 2. 4.7 mL

Rationale: 22 lb divided by 2.2 equals 10 kg. 10 kg x 15 mg/kg equals 150 mg. 150 mg divided by 160 mg x 5 mL equals 4.7 mL. Option 4 results from failing to convert pounds to kilograms. Draw the dose in an oral syringe calibrated in milliliters; household spoons must never be used.

Question 4

While obtaining vital signs, the LPN finds that a 2-week-old infant has a rectal temperature of 38.3 degrees Celsius (100.9 degrees Fahrenheit). The infant is feeding a little less than usual. What should the LPN do?

1. Remove the infant's blankets and recheck the temperature in 2 hours.
2. Report the finding to the registered nurse immediately.
3. Document the finding as a normal newborn variation.
4. Give the infant extra formula and observe.

Answer: 2. Report the finding to the registered nurse immediately.

Rationale: A temperature of 38.0 degrees Celsius (100.4 degrees Fahrenheit) or higher in an infant younger than 28 days is a medical emergency requiring urgent evaluation, because young infants can be seriously infected without any localizing signs. The LPN reports promptly so the RN can assess and notify the provider. Options 1, 3, and 4 all delay recognition of possible sepsis.

Question 5

The LPN is reinforcing safe sleep teaching with the parents of a 2-month-old. Which parent statement indicates that further teaching is needed?

1. "We put her on her back for every sleep, including naps."
2. "Her crib has a firm mattress with only a fitted sheet."
3. "We keep her bassinet in our room next to our bed."
4. "We use a soft bumper pad so she does not bump her head on the slats."

Answer: 4. "We use a soft bumper pad so she does not bump her head on the slats."

Rationale: Crib bumpers, pillows, loose blankets, and soft toys are suffocation and entrapment hazards and are not used. The other three statements are correct: supine positioning for every sleep, a firm surface with a fitted sheet only, and room-sharing without bed-sharing are all recommended (Moon et al., 2022).

Question 6

The LPN is collecting data on children in a pediatric clinic. Which findings should be reported to the registered nurse? Select all that apply.

1. An 18-month-old who is not yet walking independently
2. A 3-year-old whose speech the parent says only family members can understand
3. A 9-month-old whose anterior fontanel is soft and flat
4. A 4-year-old who cannot hop on one foot or copy a cross
5. A 2-year-old who plays alongside other children without playing with them
6. A 6-month-old who does not roll in either direction and cannot hold the head steady

Answer: 1, 2, 4, and 6.

Rationale: Independent walking is expected by about 15 months, so a non-walking 18-month-old needs evaluation. Speech should be roughly 75 percent intelligible to strangers by 3 years. Hopping on one foot and copying a cross are 4-year skills. Rolling and steady head control are established by 4 to 6 months, so their absence at 6 months is a significant delay. Option 3 is a normal fontanel finding; the anterior fontanel normally remains open until 12 to 18 months. Option 5 describes parallel play, which is normal and expected for a toddler.

Question 7

The LPN is caring for a hospitalized 2-year-old who screams and clings to the parent at bedtime and refuses to let staff approach. Which nursing action is most appropriate?

1. Explain to the parent that visiting is disruptive and should be limited.
2. Encourage the parent to leave quickly without saying goodbye to avoid upsetting the child.
3. Support the parent in staying with the child and allow the child's comfort object and home bedtime routine.
4. Tell the child that big kids do not cry when their parents leave.

Answer: 3. Support the parent in staying with the child and allow the child's comfort object and home bedtime routine.

Rationale: Protest behavior is a normal response to separation in a toddler. Family-centered care keeps the caregiver present, and familiar rituals and transitional objects reduce distress. Option 1 contradicts family-centered care. Option 2 undermines trust and worsens anxiety. Option 4 shames the child for a developmentally normal response.

Question 8

The LPN reinforces teaching about food safety with the parent of a 15-month-old. Which foods should the LPN advise the parent to avoid or modify? Select all that apply.

1. Whole grapes
2. Popcorn
3. Hot dogs cut into round slices
4. Soft cooked and diced carrots
5. Hard candy
6. Whole milk with meals

Answer: 1, 2, 3, and 5.

Rationale: Whole grapes, popcorn, round hot dog slices, and hard candy are classic choking hazards for children under about 4 years of age; round foods should be cut lengthwise into small pieces. Option 4 describes an appropriately modified vegetable, and option 6 is appropriate because whole cow's milk is introduced after 12 months. A related teaching point for younger siblings in the home: honey is never given before 12 months because of the risk of infant botulism.

Question 9

A 4-year-old is scheduled for an intravenous catheter insertion. Which statement by the LPN is most developmentally appropriate?

1. "The nurse is going to put a small tube in your arm so medicine can help you get better. This is not because you did anything wrong."
2. "We are going to cannulate a peripheral vein for fluid administration."
3. "You will not feel anything at all, I promise."
4. "If you are good and do not cry, you can have a treat."

Answer: 1. "The nurse is going to put a small tube in your arm so medicine can help you get better. This is not because you did anything wrong."

Rationale: Preschoolers think magically and often believe illness and procedures are punishment, so explicitly correcting that belief is important, along with simple, concrete language. Option 2 uses vocabulary the child cannot understand. Option 3 is a false promise that destroys trust. Option 4 links cooperation to reward and implies that showing distress is bad behavior.

Question 10

The LPN is preparing to give an intramuscular immunization to a 5-month-old. Which site should be used?

1. Dorsogluteal
2. Ventrogluteal
3. Deltoid
4. Vastus lateralis

Answer: 4. Vastus lateralis.

Rationale: The vastus lateralis is the preferred intramuscular site for infants and young toddlers because it is the largest developed muscle mass at this age and has no major nerves or vessels nearby. The dorsogluteal site is not used in children because of the risk of sciatic nerve injury. The deltoid is too small in an infant and is reserved for older children and adolescents with adequate muscle mass.

Question 11

The LPN is caring for a 10-month-old with gastroenteritis. Which findings should be reported to the registered nurse promptly? Select all that apply.

1. No wet diaper in the last 8 hours
2. Sunken anterior fontanel
3. Crying without tears
4. Capillary refill of 1 second
5. Weight decreased from 9.0 kg on admission to 8.4 kg today
6. Skin that tents when gently pinched

Answer: 1, 2, 3, 5, and 6.

Rationale: Decreased urine output, a sunken fontanel, absent tears, acute weight loss, and poor skin turgor all indicate worsening dehydration. Weight change is the most accurate indicator of fluid loss in children, and a 0.6 kg drop in a 9 kg infant is roughly 7 percent of body weight. Option 4 is normal; capillary refill of 1 second reflects adequate perfusion, whereas refill longer than 2 to 3 seconds would be concerning.

Question 12

The LPN is reinforcing car seat teaching for a parent of a 14-month-old who weighs 22 lb. Which instruction is correct?

1. "Now that she is over a year old, you can turn the seat forward-facing."
2. "Keep her rear-facing in the back seat until at least age 2 and ideally until she reaches the highest weight or height allowed by the seat."
3. "She can use a booster seat with the vehicle seat belt now."
4. "It is fine for her to ride in the front seat if the air bag is turned on."

Answer: 2. "Keep her rear-facing in the back seat until at least age 2 and ideally until she reaches the highest weight or height allowed by the seat."

Rationale: Rear-facing seats support the head, neck, and spine in a crash and are recommended for as long as the seat allows (Durbin & Hoffman, 2018). Option 1 reflects the outdated one-year rule. Option 3 skips the forward-facing harness stage entirely; boosters are for much older children whose harnessed seat has been outgrown. Option 4 is dangerous, since all children under 13 ride in the back seat and a rear-facing seat is never placed in front of an active air bag.

Question 13

The LPN is assisting with a school-age child who is hospitalized for a fracture. Which action best supports this child's developmental stage?

1. Restricting schoolwork so the child can rest completely
2. Encouraging the child to participate in care, keep up with schoolwork, and contact friends
3. Discouraging questions about the injury to reduce anxiety
4. Providing only solitary activities in the room

Answer: 2. Encouraging the child to participate in care, keep up with schoolwork, and contact friends.

Rationale: The school-age child is in Erikson's stage of industry versus inferiority and needs opportunities for accomplishment, competence, and peer connection. Options 1 and 4 remove sources of mastery and social contact. Option 3 blocks the honest information that school-age children need and want.

Question 14

While bathing a 3-year-old, the LPN observes several circular burns of similar size on the child's back, along with bruises in various stages of healing. The parent states the child "fell against the heater." What should the LPN do?

1. Confront the parent about the inconsistency between the injuries and the explanation.
2. Document the findings objectively and report them to the registered nurse right away.
3. Wait to see whether additional injuries appear before saying anything.
4. Ask the child directly whether the parent hurt him, in front of the parent.

Answer: 2. Document the findings objectively and report them to the registered nurse right away.

Rationale: Injuries inconsistent with the reported mechanism, patterned burns, and bruises in different stages of healing are warning signs of maltreatment. Nurses are mandated reporters, and reporting requires suspicion, not proof. The LPN documents observations factually, using the parent's exact words in quotation marks, and reports to the RN so the team can act. Option 1 may escalate the situation and endanger the child. Option 3 delays protection. Option 4 questions the child in front of a possible perpetrator, which is unsafe and can contaminate the investigation.

Question 15

The LPN is reinforcing teaching with the parent of a 6-year-old who has a viral illness with fever. Which statement by the parent indicates correct understanding?

1. "I will give him aspirin for the fever."
2. "I will use acetaminophen or ibuprofen and call if the fever lasts more than a few days."
3. "I will bathe him in cool alcohol to bring the fever down quickly."
4. "I will bundle him in blankets so he sweats the fever out."

Answer: 2. "I will use acetaminophen or ibuprofen and call if the fever lasts more than a few days."

Rationale: Acetaminophen and ibuprofen are appropriate antipyretics for a child of this age, and persistent fever should be reported. Option 1 is unsafe because aspirin given during a viral illness such as influenza or varicella is associated with Reye syndrome. Option 3 is dangerous; alcohol is absorbed through the skin and inhaled, and cool baths cause shivering that raises the temperature. Option 4 traps heat and worsens the fever.

References

Durbin, D. R., & Hoffman, B. D. (2018). Child passenger safety. Pediatrics, 142(5), Article e20182460. https://doi.org/10.1542/peds.2018-2460

Moon, R. Y., Carlin, R. F., & Hand, I. (2022). Sleep-related infant deaths: Updated 2022 recommendations for reducing infant deaths in the sleep environment. Pediatrics, 150(1), Article e2022057990. https://doi.org/10.1542/peds.2022-057990

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