NUR 254 Maternal & Pediatric Nursing Exam
4: 70 Practice Questions with Answers &
Rationales latest update this year Download
now and pass first try!
SECTION 1: PEDIATRIC HEMATOLOGY (Questions 1-15)
1. The nurse is caring for a child with leukemia who has a white blood cell (WBC)
count of 1,000 mm³. Which of the following should the nurse include in the child's
plan of care?
A) Place the child in a private room with positive pressure
B) Administer the prescribed influenza vaccination
C) Encourage the child to eat fresh fruits and vegetables
D) Avoid all physical activity
Answer: B. With a WBC count of 1,000 mm³ (severe neutropenia), the child is
immunocompromised. Administering the influenza vaccination is an important preventive
measure. Positive pressure rooms are for protective isolation, but standard neutropenic
precautions are also needed. Fresh fruits and vegetables should be washed thoroughly or
avoided due to infection risk.
,2. The nurse is caring for a child who is suspected of having a Wilms' tumor. Which
action by the nurse indicates the need for additional teaching?
A) Palpating the child's abdomen
B) Monitoring the child's blood pressure
C) Assessing the child for hematuria
D) Preparing the child for surgery
Answer: A. Palpating the abdomen of a child with a suspected Wilms' tumor is
contraindicated because it can cause the tumor to rupture and spread cancer cells. A
Wilms' tumor is an encapsulated mass that should not be manipulated.
3. The nurse is caring for a 5-year-old child who has sickle cell disease (SCD).
Assessment findings include: respirations 10/min and unarousable. The child is on IV
fluids and continuous IV morphine sulfate. Which action should the nurse take first?
A) Increase the IV fluids
B) Elevate the head of the bed
C) Administer naloxone to reverse the effect of the morphine
D) Notify the provider
,Answer: C. The child is exhibiting signs of an opioid overdose (respiratory depression of 10
breaths/min and unresponsiveness). Naloxone is an opioid antagonist that reverses these
effects, making it the priority to restore respiratory drive.
4. The nurse is admitting a child who has a vaso-occlusive sickle cell crisis. Which
intervention should the nurse anticipate?
A) Administering packed red blood cell transfusions
B) Encouraging bed rest and minimizing movement
C) Providing hydration and pain management
D) Applying cold compresses to painful joints
Answer: C. A vaso-occlusive crisis is caused by sickled red blood cells blocking blood flow,
leading to severe pain and ischemia. Aggressive hydration improves blood flow, and
analgesics manage the severe pain. Transfusions are not first-line therapy, and cold
compresses can worsen vasoconstriction.
5. The nurse is caring for a child who has hemophilia and developed a swollen knee
after falling. Which action should the nurse teach the parents for future incidents?
A) Apply a warm compress to the knee
B) Apply an ice pack and compression dressings to the knee
C) Massage the knee to promote circulation
, D) Encourage the child to bear weight on the knee
Answer: B. For a child with hemophilia who has a joint bleed, the priority is to apply RICE
(Rest, Ice, Compression, Elevation). Ice and compression help reduce swelling and
bleeding. Warm compresses and massage could increase bleeding.
6. The nurse is teaching about prevention of iron-deficiency anemia in infants. Which
statement is correct?
A) "Iron-fortified commercial formula should be given for the first 6 months of life."
B) "Cow's milk should be introduced at 4 months of age."
C) "Infants do not need iron supplementation until they are 1 year old."
D) "Breastfed infants should receive iron supplementation starting at 2 months of
age."
Answer: A. Iron-fortified formula is recommended for the first 12 months of life to prevent
iron-deficiency anemia. Cow's milk should not be introduced before 12 months. Breastfed
infants typically need iron supplementation starting around 4-6 months of age.
7. A child with sickle cell anemia is admitted with a pain crisis. Which assessment
finding requires immediate intervention?
A) The child rates pain as 8/10
B) The child has a fever of 101.5°F (38.6°C)
4: 70 Practice Questions with Answers &
Rationales latest update this year Download
now and pass first try!
SECTION 1: PEDIATRIC HEMATOLOGY (Questions 1-15)
1. The nurse is caring for a child with leukemia who has a white blood cell (WBC)
count of 1,000 mm³. Which of the following should the nurse include in the child's
plan of care?
A) Place the child in a private room with positive pressure
B) Administer the prescribed influenza vaccination
C) Encourage the child to eat fresh fruits and vegetables
D) Avoid all physical activity
Answer: B. With a WBC count of 1,000 mm³ (severe neutropenia), the child is
immunocompromised. Administering the influenza vaccination is an important preventive
measure. Positive pressure rooms are for protective isolation, but standard neutropenic
precautions are also needed. Fresh fruits and vegetables should be washed thoroughly or
avoided due to infection risk.
,2. The nurse is caring for a child who is suspected of having a Wilms' tumor. Which
action by the nurse indicates the need for additional teaching?
A) Palpating the child's abdomen
B) Monitoring the child's blood pressure
C) Assessing the child for hematuria
D) Preparing the child for surgery
Answer: A. Palpating the abdomen of a child with a suspected Wilms' tumor is
contraindicated because it can cause the tumor to rupture and spread cancer cells. A
Wilms' tumor is an encapsulated mass that should not be manipulated.
3. The nurse is caring for a 5-year-old child who has sickle cell disease (SCD).
Assessment findings include: respirations 10/min and unarousable. The child is on IV
fluids and continuous IV morphine sulfate. Which action should the nurse take first?
A) Increase the IV fluids
B) Elevate the head of the bed
C) Administer naloxone to reverse the effect of the morphine
D) Notify the provider
,Answer: C. The child is exhibiting signs of an opioid overdose (respiratory depression of 10
breaths/min and unresponsiveness). Naloxone is an opioid antagonist that reverses these
effects, making it the priority to restore respiratory drive.
4. The nurse is admitting a child who has a vaso-occlusive sickle cell crisis. Which
intervention should the nurse anticipate?
A) Administering packed red blood cell transfusions
B) Encouraging bed rest and minimizing movement
C) Providing hydration and pain management
D) Applying cold compresses to painful joints
Answer: C. A vaso-occlusive crisis is caused by sickled red blood cells blocking blood flow,
leading to severe pain and ischemia. Aggressive hydration improves blood flow, and
analgesics manage the severe pain. Transfusions are not first-line therapy, and cold
compresses can worsen vasoconstriction.
5. The nurse is caring for a child who has hemophilia and developed a swollen knee
after falling. Which action should the nurse teach the parents for future incidents?
A) Apply a warm compress to the knee
B) Apply an ice pack and compression dressings to the knee
C) Massage the knee to promote circulation
, D) Encourage the child to bear weight on the knee
Answer: B. For a child with hemophilia who has a joint bleed, the priority is to apply RICE
(Rest, Ice, Compression, Elevation). Ice and compression help reduce swelling and
bleeding. Warm compresses and massage could increase bleeding.
6. The nurse is teaching about prevention of iron-deficiency anemia in infants. Which
statement is correct?
A) "Iron-fortified commercial formula should be given for the first 6 months of life."
B) "Cow's milk should be introduced at 4 months of age."
C) "Infants do not need iron supplementation until they are 1 year old."
D) "Breastfed infants should receive iron supplementation starting at 2 months of
age."
Answer: A. Iron-fortified formula is recommended for the first 12 months of life to prevent
iron-deficiency anemia. Cow's milk should not be introduced before 12 months. Breastfed
infants typically need iron supplementation starting around 4-6 months of age.
7. A child with sickle cell anemia is admitted with a pain crisis. Which assessment
finding requires immediate intervention?
A) The child rates pain as 8/10
B) The child has a fever of 101.5°F (38.6°C)
