NSG 3600 Exam 1 Pediatrics Practice Test Newest
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1. A four-year-old child is admitted with dehydration due to acute
gastroenteritis. The child is lethargic, has dry mucous membranes, and
a capillary refill time of four seconds. Which intervention should the
nurse anticipate initiating first?
A) Administer an oral rehydration solution.
B) Insert a peripheral intravenous line and begin isotonic fluid
resuscitation.
C) Obtain a stool culture and complete blood count.
D) Place the child on a clear liquid diet.
Answer: B. The child exhibits signs of severe dehydration, including
lethargy, dry mucous membranes, and prolonged capillary refill, which
indicate hemodynamic instability. Intravenous isotonic fluid
resuscitation is the priority in severe dehydration to restore
intravascular volume rapidly and prevent hypovolemic shock. Oral
rehydration is appropriate for mild to moderate dehydration but is
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insufficient in severe cases. Stool cultures and dietary changes are
secondary to stabilization.
2. A two-month-old infant presents with a fever of 38.5°C, poor
feeding, and irritability. The infant's anterior fontanel is bulging. Which
diagnostic procedure is most critical for this infant?
A) Lumbar puncture.
B) Complete blood count.
C) Urinalysis and culture.
D) Chest x-ray.
Answer: A. A bulging fontanel in a febrile infant under three months of
age is a classic sign of increased intracranial pressure and is highly
concerning for meningitis. A lumbar puncture is essential to obtain
cerebrospinal fluid for analysis and culture to confirm or rule out this
life-threatening infection. While blood tests and cultures are important,
they do not confirm meningitis. A chest x-ray is not indicated based on
the presented symptoms.
3. A school-age child with type 1 diabetes reports feeling shaky,
diaphoretic, and hungry. The child's blood glucose level is 58 mg/dL.
Which nursing action should be taken first?
A) Administer the prescribed insulin dose.
B) Give the child one-half cup of orange juice.
C) Encourage the child to rest and recheck in 15 minutes.
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D) Provide a snack of peanut butter and crackers.
Answer: B. The child is exhibiting symptoms of hypoglycemia, confirmed
by a blood glucose level below 70 mg/dL. The immediate treatment is to
administer a rapidly absorbed simple carbohydrate, such as orange
juice or glucose tablets, to quickly elevate blood glucose. Following the
rapid-acting sugar, a complex carbohydrate with protein should be
provided to sustain glucose levels. Administering insulin would worsen
the hypoglycemia. Rest alone is insufficient.
4. A nurse is assessing a six-month-old infant during a routine well-child
visit. Which developmental milestone is most consistent with this age?
A) Sitting without support.
B) Pincer grasp.
C) Transferring objects from one hand to the other.
D) Standing while holding onto furniture.
Answer: C. Transferring objects from one hand to the other is a typical
fine motor milestone for a six-month-old infant. Sitting without support
usually occurs around eight months. The pincer grasp typically emerges
at nine to ten months. Standing while holding onto furniture, known as
cruising, is expected around nine to twelve months.
5. The mother of a three-year-old child expresses concern that the child
still wets the bed most nights. The nurse's best response is based on
which understanding of normal development?
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A) This is typical, as most children do not achieve nighttime continence
until age four or five.
B) This is abnormal and requires immediate referral to a pediatric
urologist.
C) Bedwetting at this age is usually a sign of an underlying emotional
disturbance.
D) The child should be awakened every two hours to use the bathroom.
Answer: A. Nighttime bladder control is a developmental process that
varies considerably among children. By age three, most children are dry
during the day, but nighttime continence is not typically expected until
age four or five. It is important to reassure the parent that this is within
the range of normal development and that punitive measures or
awakening are not recommended.
6. A child is prescribed oral amoxicillin for acute otitis media. Which
parental statement indicates understanding of the teaching regarding
this medication?
A) "I can stop the medication when the child's fever is gone."
B) "I will give this medication until the prescription is finished."
C) "It is safe to give the medication with milk if the child refuses it."
D) "The medication can be refrigerated to improve the taste."
Answer: B. Antibiotics must be administered for the full prescribed
course to ensure the infection is completely eradicated and to prevent