🎯 High-Yield Points for This Topic
- Paediatric vital signs differ significantly by age — know normal ranges for infant vs. toddler vs. school-age
- Weight-based medication dosing: always calculate mg/kg; have calculations verified
- Developmental milestones: 2 months = social smile; 6 months = sits with support; 12 months = first words
- Epiglottitis: do NOT examine throat; prepare for emergency airway management
- Febrile seizures: most common in 6 months - 5 years; rarely life-threatening; prevent injury
[Infographic: Pediatric NCLEX Questions Key Concepts — Clinical Manifestations, Nursing Interventions, Priority Actions]
Practice Questions
Question 1
A nurse is caring for a 2-year-old admitted with croup. Which assessment finding requires IMMEDIATE intervention?
✓ Correct: Stridor at rest
Stridor at REST (not just with crying or exertion) in croup indicates significant upper airway narrowing and impending respiratory compromise. Stridor at rest is a red flag requiring immediate intervention — cool mist, epinephrine nebulisation, and corticosteroids. Barking cough is characteristic of croup but not immediately dangerous. The nurse must prioritise airway assessment and intervention.
Stridor at REST (not just with crying or exertion) in croup indicates significant upper airway narrowing and impending respiratory compromise. Stridor at rest is a red flag requiring immediate intervention — cool mist, epinephrine nebulisation, and corticosteroids. Barking cough is characteristic of croup but not immediately dangerous. The nurse must prioritise airway assessment and intervention.
Question 2
A child is prescribed amoxicillin 25 mg/kg/day in two divided doses. The child weighs 22 kg. What is the dose for each administration?
✓ Correct: 275 mg
Step 1: Total daily dose = 25 mg/kg × 22 kg = 550 mg/day. Step 2: Divided into 2 doses = 550 ÷ 2 = 275 mg per dose. Always verify paediatric calculations with another nurse before administration. Weight-based dosing is a critical skill and calculation errors are a leading cause of paediatric medication errors.
Step 1: Total daily dose = 25 mg/kg × 22 kg = 550 mg/day. Step 2: Divided into 2 doses = 550 ÷ 2 = 275 mg per dose. Always verify paediatric calculations with another nurse before administration. Weight-based dosing is a critical skill and calculation errors are a leading cause of paediatric medication errors.
Question 3
The parents of a 4-year-old ask when their child should be able to ride a tricycle. Which response demonstrates knowledge of developmental milestones?
✓ Correct: Most children can ride a tricycle by 3 years of age
Riding a tricycle is a gross motor skill typically achieved by age 3. By age 4, most children can pump a swing and hop on one foot. Key gross motor milestones: 2 years = runs well; 3 years = rides tricycle, jumps; 4 years = hops on one foot; 5 years = skips. A 4-year-old not yet able to ride a tricycle warrants further developmental assessment.
Riding a tricycle is a gross motor skill typically achieved by age 3. By age 4, most children can pump a swing and hop on one foot. Key gross motor milestones: 2 years = runs well; 3 years = rides tricycle, jumps; 4 years = hops on one foot; 5 years = skips. A 4-year-old not yet able to ride a tricycle warrants further developmental assessment.
Question 4
A nurse suspects epiglottitis in a 5-year-old with sudden onset high fever, drooling, and refusal to swallow. Which action is the PRIORITY?
✓ Correct: Do not examine the throat; keep child calm and notify provider immediately
Epiglottitis is a life-threatening emergency. Examining the throat or using a tongue depressor can trigger a vagal response and complete laryngospasm, causing total airway obstruction. The nurse must NEVER examine the throat. Priority: keep the child calm (anxiety increases oxygen demand), allow them to sit in the position of comfort (tripod position), and immediately notify the provider and prepare for emergency airway management.
Epiglottitis is a life-threatening emergency. Examining the throat or using a tongue depressor can trigger a vagal response and complete laryngospasm, causing total airway obstruction. The nurse must NEVER examine the throat. Priority: keep the child calm (anxiety increases oxygen demand), allow them to sit in the position of comfort (tripod position), and immediately notify the provider and prepare for emergency airway management.
Question 5
The parents of a hospitalised toddler say they do not want the nurse to put a band-aid on their child because they believe it will hurt more when removed. Which response by the nurse BEST demonstrates family-centred care?
✓ Correct: Acknowledge the parents' concern and discuss alternative wound coverage options together
Family-centred care requires involving families as partners in care decisions. Acknowledging the parents' concern as valid, and then collaborating on alternatives (transparent film dressing, holding pressure instead, or using a non-adhesive dressing) respects parental authority and demonstrates culturally sensitive practice. Overriding parental preferences for non-critical decisions undermines trust and the therapeutic relationship.
Family-centred care requires involving families as partners in care decisions. Acknowledging the parents' concern as valid, and then collaborating on alternatives (transparent film dressing, holding pressure instead, or using a non-adhesive dressing) respects parental authority and demonstrates culturally sensitive practice. Overriding parental preferences for non-critical decisions undermines trust and the therapeutic relationship.
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[Clinical Concept Map: Pediatric NCLEX Questions — Pathophysiology, Assessment Findings, Nursing Actions]