1
NR 328 Exam Pediatric Nursing EXAM
NR 328 Exam 4 Pediatric Nursing EXAM
PREDICTOR VERIFIED QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
DETAILED RATIONALES GRADED A+
GUARANTEED PASS ACE YR EXAM
To minimize separation anxiety in a hospitalized 2 year old, which nursing intervention is
best for the practical nurse to implement?
a. Provide for privacy.
b. Encourage parents to room-in.
c. Explain procedures and routines.
d. Encourage contact with children of the same age.
b. Encourage parents to room-in.
Rationale:
, 2
NR 328 Exam Pediatric Nursing EXAM
Separation anxiety is especially threatening for toddlers, so encouraging parents to room-in
helps the toddler cope with this threat.
The nurse is reinforcing instructions for a child diagnosed with iron deficiency anemia. The
nurse realizes instructions were effective if the parent/child make which statement? (Select
all that apply.)
a. "If possible the iron replacement tablets should be taken on an empty stomach."
b. "I should make sure the iron tablets are taken with milk or another type of milk product."
c. "I should try to provide five or six 8 ounce glasses of milk every day to treat the anemia."
d. "I will need to keep this out of the reach of the younger children we have in the home."
e. "I will need to still provide foods that are high in iron such as meat and green leafy
vegetables."
a. "If possible the iron replacement tablets should be taken on an empty stomach."
d. "I will need to keep this out of the reach of the younger children we have in the home."
e. "I will need to still provide foods that are high in iron such as meat and green leafy
vegetables."
Rationale:
The nurse should encourage the parents to try giving the iron on an empty stomach
whenever possible. Iron toxicity can be fatal, so it should be out of the reach of very young
children. The client who has iron-deficiency anemia will still need to eat foods high in iron.
The child should take in no more than 32 ounces (four 8 ounce cups) of milk in a 24-hour
period
A 7-year-old child is diagnosed with a streptococcal infection of the throat (strept throat).
The parent asks the nurse "Why does my child need to take antibiotics? His sister had a sore
throat last month and all she took was acetaminophen and diphenhydramine." The nurse
responds by explaining that "strept throat" is associated with which complications? (Select
all that apply.)
a. Rheumatic heart disease
b. Ventral septal defects
c. Complete heart block
d. Nephrotic syndrome
e. Acute glomerulonephritis
f. Vesicoureteral reflux
a. Rheumatic heart disease
e. Acute glomerulonephritis
Rationale:
"Strept throat" is a serious streptococcal infection which can lead to serious complications
such as rheumatic heart disease and acute glomerulonephritis. Ventral septal defects are
congenital. Complete heart block is a dysrhythmia not associated with strept throat.
, 3
NR 328 Exam Pediatric Nursing EXAM
Nephrotic syndrome often has an idiopathic causation. Vesicoureteral reflux is frequently
congenital.
A newborn who has mild transitional (positional) clubfeet is placed in bilateral casts in an
overcorrected valgus (outward) position. What is the primary issue the practical nurse
should review with the parents during discharge teaching?
a. Prevent cast soiling and maintain the cast's edge by petaling.
b. Observe for skin and circulation compromise from the cast.
c. Manipulate the cast surfaces with the palms of the hands.
d. Support and elevate both legs on pillows continuously.
b. Observe for skin and circulation compromise from the cast.
Rationale:
Reinforcing information with parents about their role in care and about vigilant observation
for potential problems of the infant at home such as skin and circulation compromise is the
most important nursing intervention.
The nurse is preparing a child for transport to the operating room for an emergency
appendectomy. The anesthesiologist prescribes atropine sulfate IM STAT. What is the
primary purpose for administering this drug to the child at this time?
a. Decrease the oral secretions.
b. Reduce the child's anxiety.
c. Potentiate the opioid effects.
d. Prevent possible peritonitis.
a. Decrease the oral secretions.
Rationale:
Atropine sulfate (Atropine), an anticholinergic agent, is given to decrease oral secretions
during a surgical procedure.
The practical nurse (PN) is examining a child with an exacerbation of juvenile rheumatoid
arthritis (JRA) and notes that the child's mobility is greatly reduced. What factor should the
PN observe that affects the child's mobility?
a. Pathological fractures
b. Poor alignment of joints
c. Dyspnea on exertion
d. Joint inflammation
d. Joint inflammation
Rationale:
Joint inflammation and pain are the typical manifestations of an exacerbation of JRA.
The practical nurse (PN) has reviewed signs and symptoms of congestive heart failure with
the parents of a 2-year-old child with a congenital heart defect. The nurse realizes the
, 4
NR 328 Exam Pediatric Nursing EXAM
education has been effective if the parents identify which behavior as most important for
the parents to report to the health care provider?
a. Sits or squats frequently when playing outdoors.
b. Exhibits a sudden and unexplained weight gain.
c. Is not completely toilet trained and has some "accidents."
d. Demonstrates irritation and fatigue 1 hour before bedtime.
b. Exhibits a sudden and unexplained weight gain.
Rationale:
Sudden and unexplained weight gain can indicate fluid retention and is a sign of congestive
heart failure.
The parents of a 1-year-old child, who was recently diagnosed with hypospadias, state that
they plan to delay the corrective surgery to see if the child will outgrow the problem. What
information is best for the practical nurse (PN) to provide to these parents?
a. The prognosis will worsen if surgery is delayed.
b. Some children do outgrow this type of problem and waiting may be beneficial.
c. Regardless of the decision, the staff is available to assist with the process.
d. Discuss the child's diagnosis with the health care provider for additional information and
clarity.
d. Discuss the child's diagnosis with the health care provider for additional information and
clarity.
Rationale:
The PN should first ensure that the parents have adequate and correct information.
Hypospadias is a congenital anomaly resulting in an abnormally located urethral meatus.
Surgical correction is usually done early in childhood, which is considered the best time for
the child to face surgery with the fewest fears.
An 18-month-old child is taken to the emergency department with symptoms of epiglottitis.
The nurse anticipates which aspect will be included in the plan of care?
a. Soft diet
b. Semi-Fowler's position
c. Discourage child from sitting upright with chin out
d. Prepare to assist with bedside tracheostomy placement
d. Prepare to assist with bedside tracheostomy placement
Rationale:
The nurse will need to prepare for bedside intubation or tracheostomy, as epiglottitis can
progress rapidly, causing acute airway obstruction. The child will not likely be able to
tolerate a soft diet, and if airway obstruction occurs, the child could aspirate. The child will
likely breathe more easily if allowed to sit in an upright sitting position (not Semi-Fowler's)
with the chin out, and the tongue protruding. This is sometimes called the tripod position.
NR 328 Exam Pediatric Nursing EXAM
NR 328 Exam 4 Pediatric Nursing EXAM
PREDICTOR VERIFIED QUESTIONS AND
CORRECT DETAILED ANSWERS WITH
DETAILED RATIONALES GRADED A+
GUARANTEED PASS ACE YR EXAM
To minimize separation anxiety in a hospitalized 2 year old, which nursing intervention is
best for the practical nurse to implement?
a. Provide for privacy.
b. Encourage parents to room-in.
c. Explain procedures and routines.
d. Encourage contact with children of the same age.
b. Encourage parents to room-in.
Rationale:
, 2
NR 328 Exam Pediatric Nursing EXAM
Separation anxiety is especially threatening for toddlers, so encouraging parents to room-in
helps the toddler cope with this threat.
The nurse is reinforcing instructions for a child diagnosed with iron deficiency anemia. The
nurse realizes instructions were effective if the parent/child make which statement? (Select
all that apply.)
a. "If possible the iron replacement tablets should be taken on an empty stomach."
b. "I should make sure the iron tablets are taken with milk or another type of milk product."
c. "I should try to provide five or six 8 ounce glasses of milk every day to treat the anemia."
d. "I will need to keep this out of the reach of the younger children we have in the home."
e. "I will need to still provide foods that are high in iron such as meat and green leafy
vegetables."
a. "If possible the iron replacement tablets should be taken on an empty stomach."
d. "I will need to keep this out of the reach of the younger children we have in the home."
e. "I will need to still provide foods that are high in iron such as meat and green leafy
vegetables."
Rationale:
The nurse should encourage the parents to try giving the iron on an empty stomach
whenever possible. Iron toxicity can be fatal, so it should be out of the reach of very young
children. The client who has iron-deficiency anemia will still need to eat foods high in iron.
The child should take in no more than 32 ounces (four 8 ounce cups) of milk in a 24-hour
period
A 7-year-old child is diagnosed with a streptococcal infection of the throat (strept throat).
The parent asks the nurse "Why does my child need to take antibiotics? His sister had a sore
throat last month and all she took was acetaminophen and diphenhydramine." The nurse
responds by explaining that "strept throat" is associated with which complications? (Select
all that apply.)
a. Rheumatic heart disease
b. Ventral septal defects
c. Complete heart block
d. Nephrotic syndrome
e. Acute glomerulonephritis
f. Vesicoureteral reflux
a. Rheumatic heart disease
e. Acute glomerulonephritis
Rationale:
"Strept throat" is a serious streptococcal infection which can lead to serious complications
such as rheumatic heart disease and acute glomerulonephritis. Ventral septal defects are
congenital. Complete heart block is a dysrhythmia not associated with strept throat.
, 3
NR 328 Exam Pediatric Nursing EXAM
Nephrotic syndrome often has an idiopathic causation. Vesicoureteral reflux is frequently
congenital.
A newborn who has mild transitional (positional) clubfeet is placed in bilateral casts in an
overcorrected valgus (outward) position. What is the primary issue the practical nurse
should review with the parents during discharge teaching?
a. Prevent cast soiling and maintain the cast's edge by petaling.
b. Observe for skin and circulation compromise from the cast.
c. Manipulate the cast surfaces with the palms of the hands.
d. Support and elevate both legs on pillows continuously.
b. Observe for skin and circulation compromise from the cast.
Rationale:
Reinforcing information with parents about their role in care and about vigilant observation
for potential problems of the infant at home such as skin and circulation compromise is the
most important nursing intervention.
The nurse is preparing a child for transport to the operating room for an emergency
appendectomy. The anesthesiologist prescribes atropine sulfate IM STAT. What is the
primary purpose for administering this drug to the child at this time?
a. Decrease the oral secretions.
b. Reduce the child's anxiety.
c. Potentiate the opioid effects.
d. Prevent possible peritonitis.
a. Decrease the oral secretions.
Rationale:
Atropine sulfate (Atropine), an anticholinergic agent, is given to decrease oral secretions
during a surgical procedure.
The practical nurse (PN) is examining a child with an exacerbation of juvenile rheumatoid
arthritis (JRA) and notes that the child's mobility is greatly reduced. What factor should the
PN observe that affects the child's mobility?
a. Pathological fractures
b. Poor alignment of joints
c. Dyspnea on exertion
d. Joint inflammation
d. Joint inflammation
Rationale:
Joint inflammation and pain are the typical manifestations of an exacerbation of JRA.
The practical nurse (PN) has reviewed signs and symptoms of congestive heart failure with
the parents of a 2-year-old child with a congenital heart defect. The nurse realizes the
, 4
NR 328 Exam Pediatric Nursing EXAM
education has been effective if the parents identify which behavior as most important for
the parents to report to the health care provider?
a. Sits or squats frequently when playing outdoors.
b. Exhibits a sudden and unexplained weight gain.
c. Is not completely toilet trained and has some "accidents."
d. Demonstrates irritation and fatigue 1 hour before bedtime.
b. Exhibits a sudden and unexplained weight gain.
Rationale:
Sudden and unexplained weight gain can indicate fluid retention and is a sign of congestive
heart failure.
The parents of a 1-year-old child, who was recently diagnosed with hypospadias, state that
they plan to delay the corrective surgery to see if the child will outgrow the problem. What
information is best for the practical nurse (PN) to provide to these parents?
a. The prognosis will worsen if surgery is delayed.
b. Some children do outgrow this type of problem and waiting may be beneficial.
c. Regardless of the decision, the staff is available to assist with the process.
d. Discuss the child's diagnosis with the health care provider for additional information and
clarity.
d. Discuss the child's diagnosis with the health care provider for additional information and
clarity.
Rationale:
The PN should first ensure that the parents have adequate and correct information.
Hypospadias is a congenital anomaly resulting in an abnormally located urethral meatus.
Surgical correction is usually done early in childhood, which is considered the best time for
the child to face surgery with the fewest fears.
An 18-month-old child is taken to the emergency department with symptoms of epiglottitis.
The nurse anticipates which aspect will be included in the plan of care?
a. Soft diet
b. Semi-Fowler's position
c. Discourage child from sitting upright with chin out
d. Prepare to assist with bedside tracheostomy placement
d. Prepare to assist with bedside tracheostomy placement
Rationale:
The nurse will need to prepare for bedside intubation or tracheostomy, as epiglottitis can
progress rapidly, causing acute airway obstruction. The child will not likely be able to
tolerate a soft diet, and if airway obstruction occurs, the child could aspirate. The child will
likely breathe more easily if allowed to sit in an upright sitting position (not Semi-Fowler's)
with the chin out, and the tongue protruding. This is sometimes called the tripod position.
