Proctored on Pediatric 2026

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Sample questions from Proctored on Pediatric 2026

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

1. 1.A nurse assesses a 2-year-old with suspected dehydration. Which finding is the most reliable indicator of moderate to severe fluid deficit?

   • A.Dry mucous membranes
   • B.Capillary refill of 4 seconds
   • C.Decreased urine output
   • D.A 5% decrease in weight from baseline

   Rationale: Acute weight loss compared with a recent baseline is the most objective measure of fluid loss; a 5% loss generally indicates clinically important dehydration. Dry mucous membranes and delayed capillary refill can support the assessment but are less precise and may be influenced by other factors. Decreased urine output is important but can be difficult to quantify in a young child. The exam takeaway is to compare current weight with a reliable pre-illness weight when available.

2. 2.A 4-month-old with bronchiolitis has nasal congestion and difficulty feeding. Which nursing action should be performed before offering a feeding?

   • A.Administer a cough suppressant
   • B.Suction the nares with a bulb syringe
   • C.Place the infant supine and offer a bottle
   • D.Encourage oral fluids by syringe while the infant is tachypneic

   Rationale: Gentle nasal suctioning before feeding can improve airflow and the infant's ability to coordinate sucking, swallowing, and breathing. Cough suppressants are generally not recommended for infants with bronchiolitis. Supine positioning is appropriate for sleep but does not address the immediate feeding difficulty. Offering fluids during significant tachypnea increases aspiration risk; assess respiratory status and support hydration safely.

3. 3.A child with asthma is using an albuterol metered-dose inhaler and a prescribed inhaled corticosteroid. Which instruction is correct?

   • A.Use the corticosteroid first so it coats the airways
   • B.Use albuterol first, then the corticosteroid
   • C.Use both inhalers at exactly the same time
   • D.Stop the corticosteroid when symptoms improve

   Rationale: Albuterol is a short-acting bronchodilator that opens airways, allowing the subsequently administered inhaled corticosteroid to reach them more effectively. Giving the corticosteroid first may reduce its delivery when airflow is obstructed. The inhalers should not be actuated simultaneously because each requires correct technique and timing. Inhaled corticosteroids are controller medications and should not be stopped solely because symptoms improve; rinse the mouth after use.

4. 4.A 6-year-old with asthma has severe retractions, speaks only one or two words at a time, and has markedly diminished breath sounds. What is the priority nursing response?

   • A.Encourage slow deep breathing and reassess in 30 minutes
   • B.Administer the prescribed rapid-acting bronchodilator and activate urgent assistance
   • C.Offer oral fluids to thin respiratory secretions
   • D.Teach the child to use a peak-flow meter

   Answer and rationale are in the full material.

5. 5.A 5-year-old with suspected epiglottitis is drooling, sitting upright, and appears anxious. Which action should the nurse take?

   • A.Inspect the throat with a tongue blade
   • B.Obtain a throat culture before notifying the provider
   • C.Keep the child calm and prepare for controlled airway management
   • D.Place the child flat for a complete examination

   Answer and rationale are in the full material.