10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
The PED-BC exam has 150 questions and runs 3 hours.
These 10 free PED-BC questions are organized by exam domain, so you can see how each part of the Pediatric Nursing Certification (PED-BC) blueprint is tested. Reveal the answer and explanation under each question.
A 6-week-old with a large ventricular septal defect fed comfortably after birth but now becomes tachypneic and sweaty midway through feedings. Weight gain has slowed, although oxygen saturation is 98% on room air. What best explains the emergence of these symptoms several weeks after birth?
Correct answer: C - Pulmonary vascular resistance has fallen, increasing the left-to-right shunt and blood flow through the lungs.
One week after bloody diarrhea, a 6-year-old develops pallor, scattered bruises, and markedly reduced urine output. Hemoglobin is 7.8 g/dL, platelets are 58,000/mm³, and creatinine is 1.6 mg/dL compared with a previous value of 0.3 mg/dL. The blood smear shows fragmented red cells. Which disorder unifies the preceding illness and the current findings?
Correct answer: B - Hemolytic uremic syndrome
At a 12-month visit, a parent says, 'Her cousin walked at 10 months, but she still holds onto furniture.' The term-born child pulls to stand, cruises, picks up finger foods between thumb and forefinger to feed herself, waves, and uses 'mama' specifically. Examination is normal, and no skills have been lost. How should the nurse interpret this developmental pattern?
Correct answer: B - These skills are consistent with expected development and support continued routine surveillance.
After eight days of fentanyl and midazolam infusions, a 3-year-old begins a medication taper following extubation. Loose stools, tremor, and agitation appear after a dose reduction. The Withdrawal Assessment Tool-1 score rises from 1 to 5; temperature and oxygenation remain stable. How should the nurse characterize the meaning of the new score?
Correct answer: C - Clinically significant withdrawal requiring further assessment and review of the medication taper.
Minutes after an intravenous antibiotic is started, an 8-year-old develops generalized hives, wheezing, a hoarse voice, and a blood pressure of 72/40 mm Hg. The nurse stops the infusion and activates the emergency response. Oxygen and airway support are being prepared. Which medication should be administered without delay?
Correct answer: A - Intramuscular epinephrine into the anterolateral thigh
A 4-year-old weighing 16 kg is prescribed amoxicillin 680 mg orally every 12 hours for acute otitis media. The hospital's pediatric dosing reference specifies 80-90 mg/kg/day in two divided doses, with a maximum of 1,000 mg per dose. The suspension contains 400 mg/5 mL. Which action follows accurate verification of both the prescribed dose and the administration volume?
Correct answer: D - Administer 8.5 mL per dose; the prescribed total is 85 mg/kg/day and is within range.
An alert, thirsty 2-year-old with watery diarrhea vomits after rapidly drinking a large cup of fluid. The child has dry lips but still produces tears; extremities are warm and capillary refill is 2 seconds. The abdomen is soft, and the emesis contains no blood or bile. How should rehydration begin?
Correct answer: A - Offer small, frequent amounts of oral rehydration solution and increase the volume as tolerated.
At an asthma follow-up, an 8-year-old still has nighttime cough despite receiving every prescribed fluticasone dose. During return demonstration, the child shakes the pressurized metered-dose inhaler, sprays both prescribed puffs into the spacer, then inhales slowly and holds the breath. Before concluding that the controller dose is inadequate, what should the nurse address?
Correct answer: D - Teach one puff at a time, then verify the technique with another demonstration.
During treatment of diabetic ketoacidosis, a 14-year-old's glucose falls from 450 to 240 mg/dL. Venous pH is still 7.23, bicarbonate is 12 mmol/L, and beta-hydroxybutyrate is 3.4 mmol/L. A new order adds dextrose to the intravenous fluids while the insulin infusion continues. The parent asks, 'Why are you giving sugar when high blood sugar brought us here?' The nurse's explanation is:
Correct answer: A - Insulin must continue until ketoacidosis resolves; dextrose prevents hypoglycemia while insulin treatment clears the ketones.
A 9-year-old with cystic fibrosis and pancreatic insufficiency has persistent greasy stools and poor weight gain. The family correctly gives the prescribed pancreatic enzymes with three daily meals. A food record also shows two high-calorie milk-based supplements between meals, but no enzymes with either drink. Both meal and snack enzyme doses are prescribed. Which adjustment addresses the gap revealed by this review?
Correct answer: D - Give enzymes with the supplements according to the prescribed dosing plan.
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