RN PEDIATRIC NURSING ONLINE PRACTICE 2023 B |
COMPREHENSIVE BANK WITH 300 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
AND RATIONALES|ALREADY GRADED A+|
|BRAND NEW VERSION!!
TABLE OF CONTENTS
Section 1: Growth & Development – Infancy through Adolescence (Q1-Q45)
Section 2: Respiratory Disorders (Q46-Q80)
Section 3: Cardiovascular Disorders (Q81-Q110)
Section 4: Gastrointestinal & Nutritional Disorders (Q111-Q145)
Section 5: Neurological Disorders (Q146-Q175)
Section 6: Musculoskeletal Disorders (Q176-Q200)
Section 7: Infectious & Communicable Diseases (Q201-Q235)
Section 8: Hematological & Oncological Disorders (Q236-Q260)
Section 9: Endocrine & Metabolic Disorders (Q261-Q280)
Section 10: Safety, Emergency, & Psychosocial Nursing (Q281-Q300)
SECTION 1: GROWTH & DEVELOPMENT – INFANCY THROUGH ADOLESCENCE
Questions 1-45
Q1. A nurse is preparing to administer an immunization to a 4-year-old child.
Which of the following actions should the nurse plan to take?
A) Place the child in a prone position for the immunization.
B) Request that the child's caregiver leave the room during the immunization.
C) Administer the immunization using a 24-gauge needle.
D) Inject the immunization slowly after aspirating for 3 seconds.
Answer: C
Rationale : The nurse should administer an immunization for a 4-year-old child
using a 22 to 25-gauge needle to minimize the amount of pain the child
experiences. Preschoolers have a natural fear of needles and pain. A smaller
gauge needle (higher gauge number = smaller diameter) causes less tissue trauma
and pain. Aspiration is no longer recommended for immunizations per CDC
guidelines because it increases pain and is unnecessary for IM injections. The
caregiver should remain to provide comfort and distraction. Prone positioning is
unsafe and not indicated for immunizations.
1
,Q2. A nurse in an emergency department is performing a physical assessment on
a
2-week-old male newborn. Which of the following findings is the priority for the
nurse to report to the provider?
A) Excoriated scrotal area
B) Multiple capillary hemangiomas
C) Depressed posterior fontanel
D) Substernal retractions
Answer: D
Rationale : When using the airway, breathing, and circulation (ABC)
approach to client care, the nurse should determine that the priority finding to
report to the provider is substernal retractions. This finding indicates the
newborn is experiencing increased respiratory effort (intercostal and substernal
retractions are signs of respiratory distress), which could quickly progress to
respiratory failure. Newborns are obligate nose breathers and have small airways,
making them vulnerable to rapid decompensation. The posterior fontanel should
be depressed (flat) normally; a bulging fontanel would be concerning for
increased ICP. Excoriated scrotal area and hemangiomas are important but not
immediately life-threatening.
Q3. A nurse is teaching the guardian of a 6-month-old infant about teething.
Which of the following statements should the nurse make?
A) "Place a beaded teething necklace around your baby's neck."
B) "Rub your baby's gums with an aspirin to decrease discomfort."
C) "Your baby might pull at their ears when they are teething."
D) "Your baby's upper middle teeth will erupt first."
Answer: C
Rationale : The nurse should inform the guardian that teething can
result in discomfort for the infant. Therefore, the guardian should look for
indications such as pulling on the ears, difficulty sleeping, increased drooling,
2
,increased fussiness, and chewing on objects. Pain from teething (mandibular
central incisors typically erupt first at 6-10 months) can radiate to the ear
region, leading to ear pulling. Aspirin is contraindicated in children due to
Reye's syndrome risk. Beaded necklaces are a choking and strangulation hazard.
The lower central incisors typically erupt before the upper ones.
Q4. A nurse is assessing a 3-year-old toddler at a well-child visit. Which of
the following manifestations should the nurse report to the provider?
A) BP 90/30 mmHg
B) RR 45/min
C) Weight 14.5 kg (32 lb)
D) HR 110/min
Answer: B
Rationale : The nurse should identify that a RR of 45/min is above the
expected reference range of 20 to 25/min for a 3-year-old toddler and can
indicate respiratory dysfunction and acute respiratory distress. Tachypnea in a
toddler may be an early sign of pneumonia, asthma exacerbation, or metabolic
acidosis. The expected heart rate for a 3-year-old is 80-120/min, so 110/min is
normal. Weight of 14.5 kg (32 lb) is within expected range (approximately 14-15
kg for a 3-year-old). BP 90/30 mmHg is normal for a toddler (systolic typically 85-
100 + 2x age). The respiratory rate is the priority abnormal finding.
Q5. A nurse is planning developmental activities for a newly admitted 10-year-old
child who has neutropenia. Which of the following actions should the nurse plan
to take?
A) Provide the child with a book about adventure.
B) Arrange frequent visits from family members and peers.
C) Give the child a large piece puzzle.
D) Use puppets to entertain the child.
Answer: A
3
, Rationale : The nurse should provide a school-age child with a book
about adventure as a developmental activity because children are expanding their
knowledge and imagination during this age. Through reading, school-age children
can feel powerful and skillful as they imagine themselves in the stories they read.
Neutropenia requires infection precautions, which often means limiting visitors
and avoiding crowds. Large-piece puzzles are more appropriate for preschoolers.
Puppets are appropriate for toddlers and preschoolers, not school-age children
who prefer more complex activities. Reading also provides a safe, contained
activity that does not increase infection risk.
Q6. A nurse is teaching the guardian of a 6-month-old infant about car seat use.
Which of the following statements by the guardian indicates an understanding of
the teaching?
A) "I should secure the car seat using lower anchors and tether instead of the seat
belt."
B) "I should position the car seat harness 1 inch above my baby's shoulders."
C) "I will make sure that the car seat is placed at a 90-degree angle."
D) "I will pad my baby's car seat with a blanket for traveling long distances."
Answer: A
Rationale : Lower anchors and tethers, or the LATCH child safety seat
system, should be used to secure an infant's car seat in the vehicle. This system
provides anchors between the front cushion and the backrest for the car seat.
Therefore, if this system is available, the seat belt does not have to be used.
The harness should be at or below the infant's shoulders (rear-facing), not above.
The car seat should be at a 45-degree angle (not 90 degrees) to prevent airway
obstruction in infants. Padding should not be added as it can compress during a
crash and reduce protection. The safest position for a 6-month-old is rear-facing
in the back seat.
Q7. A nurse is teaching the parent of an infant about ways to prevent sudden
unexplained infant death (SUID). Which of the following instructions should the
nurse include?
4
COMPREHENSIVE BANK WITH 300 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
AND RATIONALES|ALREADY GRADED A+|
|BRAND NEW VERSION!!
TABLE OF CONTENTS
Section 1: Growth & Development – Infancy through Adolescence (Q1-Q45)
Section 2: Respiratory Disorders (Q46-Q80)
Section 3: Cardiovascular Disorders (Q81-Q110)
Section 4: Gastrointestinal & Nutritional Disorders (Q111-Q145)
Section 5: Neurological Disorders (Q146-Q175)
Section 6: Musculoskeletal Disorders (Q176-Q200)
Section 7: Infectious & Communicable Diseases (Q201-Q235)
Section 8: Hematological & Oncological Disorders (Q236-Q260)
Section 9: Endocrine & Metabolic Disorders (Q261-Q280)
Section 10: Safety, Emergency, & Psychosocial Nursing (Q281-Q300)
SECTION 1: GROWTH & DEVELOPMENT – INFANCY THROUGH ADOLESCENCE
Questions 1-45
Q1. A nurse is preparing to administer an immunization to a 4-year-old child.
Which of the following actions should the nurse plan to take?
A) Place the child in a prone position for the immunization.
B) Request that the child's caregiver leave the room during the immunization.
C) Administer the immunization using a 24-gauge needle.
D) Inject the immunization slowly after aspirating for 3 seconds.
Answer: C
Rationale : The nurse should administer an immunization for a 4-year-old child
using a 22 to 25-gauge needle to minimize the amount of pain the child
experiences. Preschoolers have a natural fear of needles and pain. A smaller
gauge needle (higher gauge number = smaller diameter) causes less tissue trauma
and pain. Aspiration is no longer recommended for immunizations per CDC
guidelines because it increases pain and is unnecessary for IM injections. The
caregiver should remain to provide comfort and distraction. Prone positioning is
unsafe and not indicated for immunizations.
1
,Q2. A nurse in an emergency department is performing a physical assessment on
a
2-week-old male newborn. Which of the following findings is the priority for the
nurse to report to the provider?
A) Excoriated scrotal area
B) Multiple capillary hemangiomas
C) Depressed posterior fontanel
D) Substernal retractions
Answer: D
Rationale : When using the airway, breathing, and circulation (ABC)
approach to client care, the nurse should determine that the priority finding to
report to the provider is substernal retractions. This finding indicates the
newborn is experiencing increased respiratory effort (intercostal and substernal
retractions are signs of respiratory distress), which could quickly progress to
respiratory failure. Newborns are obligate nose breathers and have small airways,
making them vulnerable to rapid decompensation. The posterior fontanel should
be depressed (flat) normally; a bulging fontanel would be concerning for
increased ICP. Excoriated scrotal area and hemangiomas are important but not
immediately life-threatening.
Q3. A nurse is teaching the guardian of a 6-month-old infant about teething.
Which of the following statements should the nurse make?
A) "Place a beaded teething necklace around your baby's neck."
B) "Rub your baby's gums with an aspirin to decrease discomfort."
C) "Your baby might pull at their ears when they are teething."
D) "Your baby's upper middle teeth will erupt first."
Answer: C
Rationale : The nurse should inform the guardian that teething can
result in discomfort for the infant. Therefore, the guardian should look for
indications such as pulling on the ears, difficulty sleeping, increased drooling,
2
,increased fussiness, and chewing on objects. Pain from teething (mandibular
central incisors typically erupt first at 6-10 months) can radiate to the ear
region, leading to ear pulling. Aspirin is contraindicated in children due to
Reye's syndrome risk. Beaded necklaces are a choking and strangulation hazard.
The lower central incisors typically erupt before the upper ones.
Q4. A nurse is assessing a 3-year-old toddler at a well-child visit. Which of
the following manifestations should the nurse report to the provider?
A) BP 90/30 mmHg
B) RR 45/min
C) Weight 14.5 kg (32 lb)
D) HR 110/min
Answer: B
Rationale : The nurse should identify that a RR of 45/min is above the
expected reference range of 20 to 25/min for a 3-year-old toddler and can
indicate respiratory dysfunction and acute respiratory distress. Tachypnea in a
toddler may be an early sign of pneumonia, asthma exacerbation, or metabolic
acidosis. The expected heart rate for a 3-year-old is 80-120/min, so 110/min is
normal. Weight of 14.5 kg (32 lb) is within expected range (approximately 14-15
kg for a 3-year-old). BP 90/30 mmHg is normal for a toddler (systolic typically 85-
100 + 2x age). The respiratory rate is the priority abnormal finding.
Q5. A nurse is planning developmental activities for a newly admitted 10-year-old
child who has neutropenia. Which of the following actions should the nurse plan
to take?
A) Provide the child with a book about adventure.
B) Arrange frequent visits from family members and peers.
C) Give the child a large piece puzzle.
D) Use puppets to entertain the child.
Answer: A
3
, Rationale : The nurse should provide a school-age child with a book
about adventure as a developmental activity because children are expanding their
knowledge and imagination during this age. Through reading, school-age children
can feel powerful and skillful as they imagine themselves in the stories they read.
Neutropenia requires infection precautions, which often means limiting visitors
and avoiding crowds. Large-piece puzzles are more appropriate for preschoolers.
Puppets are appropriate for toddlers and preschoolers, not school-age children
who prefer more complex activities. Reading also provides a safe, contained
activity that does not increase infection risk.
Q6. A nurse is teaching the guardian of a 6-month-old infant about car seat use.
Which of the following statements by the guardian indicates an understanding of
the teaching?
A) "I should secure the car seat using lower anchors and tether instead of the seat
belt."
B) "I should position the car seat harness 1 inch above my baby's shoulders."
C) "I will make sure that the car seat is placed at a 90-degree angle."
D) "I will pad my baby's car seat with a blanket for traveling long distances."
Answer: A
Rationale : Lower anchors and tethers, or the LATCH child safety seat
system, should be used to secure an infant's car seat in the vehicle. This system
provides anchors between the front cushion and the backrest for the car seat.
Therefore, if this system is available, the seat belt does not have to be used.
The harness should be at or below the infant's shoulders (rear-facing), not above.
The car seat should be at a 45-degree angle (not 90 degrees) to prevent airway
obstruction in infants. Padding should not be added as it can compress during a
crash and reduce protection. The safest position for a 6-month-old is rear-facing
in the back seat.
Q7. A nurse is teaching the parent of an infant about ways to prevent sudden
unexplained infant death (SUID). Which of the following instructions should the
nurse include?
4
