★ Free NCLEX practice · 2026
NCLEX Pediatrics Practice Questions
Practice pediatric safety, development, family teaching and acute-care nursing decisions. The goal is not to memorize a letter pattern. Read the stem, identify the clinical problem, decide what matters most for safety, and compare every option against that priority.
These questions are original Free NCLEX Prep educational items, not official NCSBN questions. Use each rationale to review why the best option fits and why the alternatives are less appropriate. For stronger learning, answer before opening the explanation, then write one short takeaway from any item you miss.
6 examples
with rationales
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Do not chase perfect scores. Chase better reasoning.Every reviewed mistake can become a safer decision on the next question.
Question 1 · moderate · Physiological Adaptation
Which infant finding is the most concerning for significant dehydration?
- Sunken fontanel, no tears, and listlessness
- One wet diaper in a well-appearing playful infant after a long nap
- Mild sweat after a walk
- Asking for a favorite toy
Show answer & rationale
Best answer: A — Sunken fontanel, no tears, and listlessnessSunken fontanel, absent tears, and altered activity mark significant volume loss.
Question 2 · moderate · Physiological Adaptation
A toddler with tetralogy of Fallot becomes cyanotic and agitated after crying. First action?
- Place in knee-chest position and calm the child
- Force the child to run
- Give a bottle of ice water rapidly while supine
- Ignore cyanosis as expected forever
Show answer & rationale
Best answer: A — Place in knee-chest position and calm the childKnee-chest increases systemic resistance and reduces right-to-left shunting. Calm decreases oxygen demand.
Question 3 · moderate · Safety and Infection Prevention and Control
A parent asks for aspirin for a 7-year-old with influenza-like illness. Best response?
- Aspirin is preferred in viral illness
- Avoid aspirin in children with viral illness because of Reye syndrome risk; use an approved alternative
- Give adult-strength aspirin to work faster
- Mix aspirin with honey for infants
Show answer & rationale
Best answer: B — Avoid aspirin in children with viral illness because of Reye syndrome risk; use an approved alternativeSalicylates + viral illness raise Reye risk. Honey is contraindicated under age 1 anyway.
Question 4 · moderate · Physiological Adaptation
A child is drooling and sitting in a tripod position. Which action is contraindicated?
- Keep the child calm with a parent present
- Inspect the throat with a tongue blade at the bedside
- Prepare for possible airway support
- Allow the position of comfort
Show answer & rationale
Best answer: B — Inspect the throat with a tongue blade at the bedsideInstrumenting the throat can precipitate complete obstruction.
Question 5 · moderate · Safety and Infection Prevention and Control
Which discharge teaching is correct for a newborn car seat?
- Rear-facing in the back seat, harness snug at or below the shoulders per seat instructions
- Front-facing in the passenger seat with the airbag on
- Held in a caregiver’s lap
- On the dashboard so the infant can see
Show answer & rationale
Best answer: A — Rear-facing in the back seat, harness snug at or below the shoulders per seat instructionsRear-facing back seat is the safe standard for newborns.
Question 6 · moderate · Physiological Adaptation
An infant with bronchiolitis is feeding poorly with RR 72 and nasal flaring. Priority?
- Force a full bottle while supine
- Support airway/oxygenation and pause oral feeding while work of breathing is high
- Give aspirin
- Discharge immediately for home steam only
Show answer & rationale
Best answer: B — Support airway/oxygenation and pause oral feeding while work of breathing is highHigh RR and flaring mean aspiration risk with oral feeds. Support breathing first.
How to use this practice well
Start with one pass without notes. On review, separate a knowledge gap from a decision-making gap. If you did not know a fact, review that concept. If you knew the facts but chose the wrong action, identify the cue or priority rule you overlooked. This keeps practice focused on clinical reasoning instead of raw question volume.
Build a repeatable NCLEX routine
Mix focused practice with broader daily sets. Focused pages help repair a specific weakness; mixed sets test whether you can recognize the problem when the category is not announced. As your exam approaches, add timed work and longer sessions, but keep rationale review central. Accuracy, reasoning and consistency matter more than rushing through a large bank.