Pediatrics
Pediatric NCLEX questions combine normal growth and development with recognizing when a child is getting sicker. Children compensate well and then decline quickly, so early signs matter. This topic covers milestones, pediatric danger signs, common conditions and the family teaching the NCLEX likes to test.
Key facts
- Infants and children have faster heart and breathing rates than adults. Compare findings with age-based norms.
- Early signs of respiratory distress: nasal flaring, retractions, grunting and restlessness.
- Suspected epiglottitis: do not examine the throat with a tongue blade.
- Signs of dehydration in infants: sunken fontanelle, fewer wet diapers, no tears.
- Rear-facing car seats are recommended for young children for as long as the seat allows.
- Explain procedures in a way that fits the child's developmental stage.
Growth and development
Milestones help you judge whether a finding is expected. Most infants roll over by about 4 to 6 months, sit without support by about 6 to 8 months and walk around 12 months. Toddlers push for independence, and preschoolers engage in magical thinking.
Match play and teaching to the child's stage. Toddlers benefit from simple choices, school-age children from concrete explanations, and adolescents from privacy and involvement in decisions.
Respiratory emergencies
Croup, bronchiolitis, asthma and epiglottitis all appear in NCLEX questions. Drooling, tripod positioning and difficulty swallowing suggest epiglottitis, which is an airway emergency. Keep the child calm and do not inspect the throat.
Worsening signs include increased work of breathing, falling oxygen saturation, lethargy and a silent chest in asthma, which may mean airflow is severely limited.
Fluids and GI illness
Children become dehydrated faster than adults. Assess wet diapers, mucous membranes, tears, fontanelles in infants, heart rate and capillary refill. Oral rehydration solution is often the first treatment for mild to moderate dehydration.
Report signs of severe dehydration or shock, such as lethargy, cool extremities and delayed capillary refill, right away.
Safety and teaching
Injury prevention is a major pediatric topic: car seats, water safety, locking away medications and cleaning products, and safe sleep for infants.
Family-centered care means including caregivers in teaching and encouraging their presence during procedures when appropriate.
Practice: 3 original questions
1. A child is drooling, sitting forward and has a high fever. Which action should the nurse avoid?
Answer and rationale
Correct: B. These signs suggest epiglottitis. Inspecting the throat can trigger complete airway obstruction.
2. Which finding in a 9-month-old suggests dehydration?
Answer and rationale
Correct: C. A sunken fontanelle suggests fluid loss. The other findings are expected in a well-hydrated infant.
3. How should the nurse best prepare a 4-year-old for a procedure?
Answer and rationale
Correct: B. Preschoolers do best with brief, concrete explanations given close to the procedure and a chance to explore safe equipment.
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