Peds Proctored Exams 2026

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Sample questions from Peds Proctored Exams 2026

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a pediatric unit, report is received on four clients. Which client should the nurse assess first?

   • A.A 7-year-old with asthma who has audible wheezing, retractions, and an SpO2 of 88% on room air
   • B.A 5-year-old with gastroenteritis who has had one episode of emesis in the past hour
   • C.A 10-year-old with a tibial fracture who reports pain of 8/10 after receiving analgesia 20 minutes ago
   • D.A 12-year-old awaiting discharge who needs a review of crutch use

   Rationale: The child with asthma has hypoxemia and increased work of breathing, indicating an immediate threat to oxygenation. The fracture pain requires reassessment, but the child is not showing a more urgent airway or breathing problem. The emesis and crutch teaching can be addressed after the unstable client is assessed; prioritize airway and breathing.

2. 2.During a home visit, a community nurse assesses a 6-month-old with poor weight gain; the infant is alert, has a temperature of 36.8 C, and weighs below the expected growth curve. Which actions are appropriate? Select all that apply.

   • A.Recommend diluting formula to make it last longer
   • B.Ask the caregiver to describe a typical 24-hour feeding pattern
   • C.Plot current weight, length, and head circumference on the growth chart
   • D.Arrange follow-up with the primary care provider and appropriate nutrition services
   • E.Assess the infant's feeding technique and observe a feeding if possible

   Rationale: Growth measurements and a detailed feeding history help identify patterns contributing to poor growth, and observing a feed can reveal latch, preparation, or feeding-skill concerns. Coordinating follow-up supports timely evaluation and nutrition intervention. Diluting formula reduces nutrient intake and can cause dangerous electrolyte problems, so it is not appropriate.

3. 3.A provider prescribes an IV antibiotic for a 9-year-old admitted with pyelonephritis. The child has a documented history of anaphylaxis to the same medication; vital signs are T 39.1 C, HR 124/min, RR 24/min, and BP 104/66 mm Hg. What should the nurse do first?

   • A.Administer the medication slowly while monitoring for a reaction
   • B.Hold the medication and clarify the prescription with the provider
   • C.Request an antihistamine to give before the antibiotic
   • D.Ask the parent whether the child has taken the medication recently

   Rationale: A documented anaphylactic reaction is a serious contraindication, so the nurse should withhold the medication and promptly clarify the order. Slowing the infusion or premedicating does not make re-exposure safe. The parent's input may add history but does not replace acting on the documented allergy.

4. 4.In a pediatric clinic, a 14-year-old with type 1 diabetes has a blood glucose of 248 mg/dL and asks to discuss insulin dosing privately. Which action best supports the adolescent's participation in care?

   • A.Avoid discussing insulin changes until the adolescent reaches adulthood
   • B.Tell the adolescent that no information can ever be shared with the parent
   • C.Ask the parent to answer all questions because the adolescent is a minor
   • D.Offer confidential time with the adolescent while explaining applicable limits to confidentiality

   Answer and rationale are in the full material.

5. 5.On a pediatric medical unit, an RN is assigning care for a stable 8-year-old with a new cast, a 4-year-old needing routine oral medications, and a 3-year-old with new stridor. Which task is appropriate to delegate to an experienced unlicensed assistive personnel (UAP)?

   • A.Assess the cause of the new stridor
   • B.Teach the 4-year-old how to take the oral medication
   • C.Obtain routine vital signs for the stable child with the cast and report abnormalities
   • D.Evaluate the casted child's neurovascular status

   Answer and rationale are in the full material.