NR328/NR 328 Exam 4 V3 | Pediatric Nursing Q&A
with Rationale | Chamberlain University
1. A 10-year-old child with type 1 diabetes mellitus is found confused and diaphoretic. What
is the priority nursing action?
A. Administer 15 grams of simple carbohydrates.
B. Administer the scheduled dose of regular insulin.
C. Check the child’s blood glucose level.
D. Provide a high-protein snack like peanut butter.
Correct Answer: C
Explanation: The nurse’s first priority is to assess the blood glucose level to confirm
hypoglycemia before initiating treatment. Once confirmed, the child should be treated with
15 grams of simple carbohydrates such as 4 ounces of orange juice. This assessment
ensures that the interventions provided are appropriate for the child’s clinical status.
2. A nurse is teaching parents of a child with growth hormone deficiency about somatropin
injections. Which statement indicates understanding?
A. I will give the injection every morning before breakfast.
B. We will stop the medication once he reaches the 10th percentile.
C. The injections should be given subcutaneously at bedtime.
D. I will administer the medication only when he has a growth spurt.
,Correct Answer: C
Explanation: Growth hormone (somatropin) is most effective when administered
subcutaneously at bedtime to mimic the body’s natural physiological release. Treatment is
typically continued until the child’s growth plates close or a near-final height is achieved.
Consistency in administration is vital for achieving optimal growth outcomes in children
with this deficiency.
3. An infant is diagnosed with congenital hypothyroidism. What is the most significant
consequence if this condition remains untreated?
A. Precocious puberty
B. Chronic renal failure
C. Severe intellectual disability
D. Pathological bone fractures
Correct Answer: C
Explanation: Thyroid hormone is essential for the normal development and maturation of
the central nervous system in infants. If congenital hypothyroidism is not treated promptly,
it can lead to permanent and severe intellectual disabilities. Early screening and life-long
hormone replacement therapy are critical to ensure normal cognitive and physical
development.
,4. A child is admitted with suspected Diabetes Insipidus (DI). Which clinical manifestation
should the nurse expect to observe?
A. Weight gain and edema
B. Low urine specific gravity
C. High serum glucose levels
D. Excessive sweat production
Correct Answer: B
Explanation: Diabetes Insipidus is characterized by a deficiency in antidiuretic hormone,
leading to the inability of the kidneys to concentrate urine. This results in polyuria with a
very low urine specific gravity, typically less than 1.005. Patients will also experience
intense thirst (polydipsia) and are at high risk for dehydration and hypernatremia.
5. Which assessment finding is a classic sign of SIADH in a pediatric patient?
A. Increased serum osmolality
B. Urine output of 5 mL/kg/hr
C. Dry mucous membranes
D. Serum sodium of 125 mEq/L
Correct Answer: D
Explanation: Syndrome of Inappropriate Antidiuretic Hormone (SIADH) causes the body
to retain excessive water, leading to dilutional hyponatremia. A serum sodium level of 125
, mEq/L reflects this imbalance and can lead to neurological complications such as seizures.
Treatment primarily focuses on fluid restriction and monitoring neurological status closely.
6. A nurse is performing a school screening for scoliosis. Which instruction should the nurse
give to the student?
A. Walk across the room while I watch your gait.
B. Bend forward at the waist with your arms hanging freely.
C. Stand straight with your arms raised above your head.
D. Sit on the floor and try to touch your toes.
Correct Answer: B
Explanation: The Adam’s Forward Bend test is the standard screening tool for identifying
scoliosis in school-aged children. The nurse observes for rib hump or spinal asymmetry
while the child bends forward at the waist. If asymmetry is noted, the child should be
referred to an orthopedic specialist for further evaluation and imaging.
7. A child with scoliosis is prescribed a Boston brace. Which statement by the adolescent
indicates a need for further teaching?
A. I will wear a thin cotton t-shirt under my brace.
B. I can take the brace off to participate in gym class.
C. I will check my skin every day for redness or irritation.
D. I only need to wear the brace while I am at school.
with Rationale | Chamberlain University
1. A 10-year-old child with type 1 diabetes mellitus is found confused and diaphoretic. What
is the priority nursing action?
A. Administer 15 grams of simple carbohydrates.
B. Administer the scheduled dose of regular insulin.
C. Check the child’s blood glucose level.
D. Provide a high-protein snack like peanut butter.
Correct Answer: C
Explanation: The nurse’s first priority is to assess the blood glucose level to confirm
hypoglycemia before initiating treatment. Once confirmed, the child should be treated with
15 grams of simple carbohydrates such as 4 ounces of orange juice. This assessment
ensures that the interventions provided are appropriate for the child’s clinical status.
2. A nurse is teaching parents of a child with growth hormone deficiency about somatropin
injections. Which statement indicates understanding?
A. I will give the injection every morning before breakfast.
B. We will stop the medication once he reaches the 10th percentile.
C. The injections should be given subcutaneously at bedtime.
D. I will administer the medication only when he has a growth spurt.
,Correct Answer: C
Explanation: Growth hormone (somatropin) is most effective when administered
subcutaneously at bedtime to mimic the body’s natural physiological release. Treatment is
typically continued until the child’s growth plates close or a near-final height is achieved.
Consistency in administration is vital for achieving optimal growth outcomes in children
with this deficiency.
3. An infant is diagnosed with congenital hypothyroidism. What is the most significant
consequence if this condition remains untreated?
A. Precocious puberty
B. Chronic renal failure
C. Severe intellectual disability
D. Pathological bone fractures
Correct Answer: C
Explanation: Thyroid hormone is essential for the normal development and maturation of
the central nervous system in infants. If congenital hypothyroidism is not treated promptly,
it can lead to permanent and severe intellectual disabilities. Early screening and life-long
hormone replacement therapy are critical to ensure normal cognitive and physical
development.
,4. A child is admitted with suspected Diabetes Insipidus (DI). Which clinical manifestation
should the nurse expect to observe?
A. Weight gain and edema
B. Low urine specific gravity
C. High serum glucose levels
D. Excessive sweat production
Correct Answer: B
Explanation: Diabetes Insipidus is characterized by a deficiency in antidiuretic hormone,
leading to the inability of the kidneys to concentrate urine. This results in polyuria with a
very low urine specific gravity, typically less than 1.005. Patients will also experience
intense thirst (polydipsia) and are at high risk for dehydration and hypernatremia.
5. Which assessment finding is a classic sign of SIADH in a pediatric patient?
A. Increased serum osmolality
B. Urine output of 5 mL/kg/hr
C. Dry mucous membranes
D. Serum sodium of 125 mEq/L
Correct Answer: D
Explanation: Syndrome of Inappropriate Antidiuretic Hormone (SIADH) causes the body
to retain excessive water, leading to dilutional hyponatremia. A serum sodium level of 125
, mEq/L reflects this imbalance and can lead to neurological complications such as seizures.
Treatment primarily focuses on fluid restriction and monitoring neurological status closely.
6. A nurse is performing a school screening for scoliosis. Which instruction should the nurse
give to the student?
A. Walk across the room while I watch your gait.
B. Bend forward at the waist with your arms hanging freely.
C. Stand straight with your arms raised above your head.
D. Sit on the floor and try to touch your toes.
Correct Answer: B
Explanation: The Adam’s Forward Bend test is the standard screening tool for identifying
scoliosis in school-aged children. The nurse observes for rib hump or spinal asymmetry
while the child bends forward at the waist. If asymmetry is noted, the child should be
referred to an orthopedic specialist for further evaluation and imaging.
7. A child with scoliosis is prescribed a Boston brace. Which statement by the adolescent
indicates a need for further teaching?
A. I will wear a thin cotton t-shirt under my brace.
B. I can take the brace off to participate in gym class.
C. I will check my skin every day for redness or irritation.
D. I only need to wear the brace while I am at school.
