PNR 204/PNR204 Exam 3 V3 | Pediatric Nursing
Q&A with Rationale | Fortis College
1. A nurse is teaching the parents of a child with Type 1 Diabetes Mellitus about managing
hypoglycemia. Which of the following statements by the parents indicates a correct
understanding of the treatment for a mild hypoglycemic episode?
A. We will administer a glucagon injection immediately.
B. We should give him 4 ounces of orange juice or a regular soda.
C. We should offer him a diet soda to raise his blood sugar quickly.
D. We will give him a large meal containing complex carbohydrates and proteins.
Correct Answer: B
Explanation: For mild hypoglycemia, the rule of 15 is applied, which includes consuming
15 grams of simple carbohydrates like 4 ounces of fruit juice. Glucagon is reserved for
severe episodes where the child is unconscious or unable to swallow safely. Diet soda is
incorrect because it does not contain the sugar necessary to raise glucose levels, and a full
meal is too slow to absorb for immediate correction.
2. A school nurse is screening adolescents for scoliosis. Which assessment finding is most
suggestive of this condition?
A. Increased lumbar lordosis when standing.
B. A visible rib hump when the child bends forward at the waist.
,C. Symmetric shoulder height while standing upright.
D. Equal distance between the arms and the trunk.
Correct Answer: B
Explanation: The Adam’s Forward Bend test is the standard screening tool for scoliosis,
where a rib hump or spinal asymmetry becomes evident. Scoliosis is characterized by a
lateral curvature of the spine often accompanied by spinal rotation. Other indicators
include asymmetric shoulder height and an uneven waistline, while lumbar lordosis is a
different type of spinal curvature.
3. A child is admitted with suspected bacterial meningitis. Which of the following is the
priority nursing action?
A. Administering the first dose of prescribed antibiotics.
B. Performing a lumbar puncture at the bedside.
C. Initiating droplet precautions for the patient.
D. Reducing environmental stimuli such as bright lights.
Correct Answer: C
Explanation: Safety and prevention of transmission are the highest priorities when
bacterial meningitis is suspected, necessitating immediate droplet precautions. While
antibiotics and lumbar punctures are critical medical interventions, the nurse must first
protect other patients and staff. Reducing stimuli is important for comfort but follows the
implementation of isolation protocols.
,4. A nurse is caring for an infant with developmental dysplasia of the hip (DDH) who is
wearing a Pavlik harness. Which instruction should the nurse include in the parent teaching?
A. The harness should be removed for diaper changes and bathing.
B. Apply lotion or powder under the straps to prevent skin irritation.
C. Adjust the straps weekly to accommodate the infant’s growth.
D. Check the skin under the straps 2 to 3 times per day for redness.
Correct Answer: D
Explanation: Skin integrity is a major concern for infants in a Pavlik harness, so regular
skin checks are essential. The harness is usually worn 23 to 24 hours a day and should
generally not be removed by parents unless specifically directed by the physician. Lotions
and powders should be avoided as they can cause moisture buildup and skin breakdown,
and strap adjustments must be performed only by a healthcare professional.
5. A 10-year-old child is diagnosed with Legg-Calve-Perthes disease. The nurse understands
that the primary goal of treatment for this condition is:
A. To prevent permanent damage to the spinal cord.
B. To increase muscle strength in the lower extremities.
C. To maintain the femoral head within the acetabulum.
D. To promote weight-bearing to stimulate bone growth.
Correct Answer: C
, Explanation: Legg-Calve-Perthes disease involves avascular necrosis of the femoral head,
and treatment focuses on ‘containment’ to ensure the head regains its round shape while
healing. This requires keeping the femoral head deep within the socket (acetabulum) to
prevent deformity. Weight-bearing is often restricted initially to avoid collapsing the
weakened bone, unlike other orthopedic conditions where mobility is encouraged.
6. Which clinical manifestation would the nurse expect to see in a child with Duchenne
Muscular Dystrophy (DMD)?
A. Hyperreflexia and spasticity in the lower limbs.
B. Positive Gower sign when rising from the floor.
C. Immediate loss of upper extremity function.
D. Decreased calf muscle size (atrophy).
Correct Answer: B
Explanation: The Gower sign is a classic finding in DMD, where the child uses their hands
to ‘walk up’ their legs to stand due to pelvic muscle weakness. DMD typically causes
pseudohypertrophy, meaning the calf muscles appear enlarged due to fatty infiltration
rather than atrophy. This progressive disease usually affects the lower extremities before
the upper extremities, leading to significant mobility issues by adolescence.
7. A child is being treated for Juvenile Idiopathic Arthritis (JIA). The nurse should advise the
parents that the most appropriate exercise for this child is:
A. High-impact aerobics.
Q&A with Rationale | Fortis College
1. A nurse is teaching the parents of a child with Type 1 Diabetes Mellitus about managing
hypoglycemia. Which of the following statements by the parents indicates a correct
understanding of the treatment for a mild hypoglycemic episode?
A. We will administer a glucagon injection immediately.
B. We should give him 4 ounces of orange juice or a regular soda.
C. We should offer him a diet soda to raise his blood sugar quickly.
D. We will give him a large meal containing complex carbohydrates and proteins.
Correct Answer: B
Explanation: For mild hypoglycemia, the rule of 15 is applied, which includes consuming
15 grams of simple carbohydrates like 4 ounces of fruit juice. Glucagon is reserved for
severe episodes where the child is unconscious or unable to swallow safely. Diet soda is
incorrect because it does not contain the sugar necessary to raise glucose levels, and a full
meal is too slow to absorb for immediate correction.
2. A school nurse is screening adolescents for scoliosis. Which assessment finding is most
suggestive of this condition?
A. Increased lumbar lordosis when standing.
B. A visible rib hump when the child bends forward at the waist.
,C. Symmetric shoulder height while standing upright.
D. Equal distance between the arms and the trunk.
Correct Answer: B
Explanation: The Adam’s Forward Bend test is the standard screening tool for scoliosis,
where a rib hump or spinal asymmetry becomes evident. Scoliosis is characterized by a
lateral curvature of the spine often accompanied by spinal rotation. Other indicators
include asymmetric shoulder height and an uneven waistline, while lumbar lordosis is a
different type of spinal curvature.
3. A child is admitted with suspected bacterial meningitis. Which of the following is the
priority nursing action?
A. Administering the first dose of prescribed antibiotics.
B. Performing a lumbar puncture at the bedside.
C. Initiating droplet precautions for the patient.
D. Reducing environmental stimuli such as bright lights.
Correct Answer: C
Explanation: Safety and prevention of transmission are the highest priorities when
bacterial meningitis is suspected, necessitating immediate droplet precautions. While
antibiotics and lumbar punctures are critical medical interventions, the nurse must first
protect other patients and staff. Reducing stimuli is important for comfort but follows the
implementation of isolation protocols.
,4. A nurse is caring for an infant with developmental dysplasia of the hip (DDH) who is
wearing a Pavlik harness. Which instruction should the nurse include in the parent teaching?
A. The harness should be removed for diaper changes and bathing.
B. Apply lotion or powder under the straps to prevent skin irritation.
C. Adjust the straps weekly to accommodate the infant’s growth.
D. Check the skin under the straps 2 to 3 times per day for redness.
Correct Answer: D
Explanation: Skin integrity is a major concern for infants in a Pavlik harness, so regular
skin checks are essential. The harness is usually worn 23 to 24 hours a day and should
generally not be removed by parents unless specifically directed by the physician. Lotions
and powders should be avoided as they can cause moisture buildup and skin breakdown,
and strap adjustments must be performed only by a healthcare professional.
5. A 10-year-old child is diagnosed with Legg-Calve-Perthes disease. The nurse understands
that the primary goal of treatment for this condition is:
A. To prevent permanent damage to the spinal cord.
B. To increase muscle strength in the lower extremities.
C. To maintain the femoral head within the acetabulum.
D. To promote weight-bearing to stimulate bone growth.
Correct Answer: C
, Explanation: Legg-Calve-Perthes disease involves avascular necrosis of the femoral head,
and treatment focuses on ‘containment’ to ensure the head regains its round shape while
healing. This requires keeping the femoral head deep within the socket (acetabulum) to
prevent deformity. Weight-bearing is often restricted initially to avoid collapsing the
weakened bone, unlike other orthopedic conditions where mobility is encouraged.
6. Which clinical manifestation would the nurse expect to see in a child with Duchenne
Muscular Dystrophy (DMD)?
A. Hyperreflexia and spasticity in the lower limbs.
B. Positive Gower sign when rising from the floor.
C. Immediate loss of upper extremity function.
D. Decreased calf muscle size (atrophy).
Correct Answer: B
Explanation: The Gower sign is a classic finding in DMD, where the child uses their hands
to ‘walk up’ their legs to stand due to pelvic muscle weakness. DMD typically causes
pseudohypertrophy, meaning the calf muscles appear enlarged due to fatty infiltration
rather than atrophy. This progressive disease usually affects the lower extremities before
the upper extremities, leading to significant mobility issues by adolescence.
7. A child is being treated for Juvenile Idiopathic Arthritis (JIA). The nurse should advise the
parents that the most appropriate exercise for this child is:
A. High-impact aerobics.
