PEDS EXAM 2 | QUESTIONS • ANSWERS • RATIONALES
PEDS EXAM 2 STUDY GUIDE
55 Numbered Questions with Answers and Nursing Rationales
Study note: Questions were cleaned and numbered from the uploaded text. Clinically unsafe, incomplete,
or misleading supplied answers were corrected. Verify exact wording against your course resources,
especially items that originally depended on missing images or answer choices.
Oncology and hematology
1. A child with leukemia has a neutrophil count below 500/mm³. What infection-prevention
measure should the nurse include in the plan of care?
Answer: Require meticulous hand hygiene for the child, staff, and visitors when entering and leaving the room.
Rationale: Severe neutropenia greatly increases infection risk. Hand hygiene is the most effective way to reduce
transmission. Avoid sick visitors, fresh flowers/plants, and raw or undercooked foods according to facility policy.
2. Which statement about osteosarcoma indicates a need for additional teaching?
Answer: “The sternum is the most common site of osteosarcoma.”
Rationale: This statement is incorrect. Osteosarcoma most often arises in the metaphysis of long bones, especially
near the knee, such as the distal femur or proximal tibia.
3. A child is suspected of having a Wilms tumor. Which nursing action indicates a need for
additional training?
Answer: Palpating the child’s abdomen.
Rationale: The abdomen should not be palpated because pressure can rupture the tumor and spread malignant
cells. Place a sign above the bed reminding staff not to palpate the abdomen.
End-of-life and grief
4. A mother whose child died 2 weeks ago says, “Sometimes I can still hear my child’s voice. I feel
like I’m going crazy.” What is the nurse’s best response?
Answer: “This can be a normal response to the loss of your child and part of the grieving process.”
Rationale: Brief sensory experiences of the deceased can occur during acute grief. The response normalizes the
experience without dismissing the parent’s feelings; the nurse should further assess coping and safety.
Oncology and hematology
5. A child is admitted with a vaso-occlusive sickle cell crisis. Which interventions should the nurse
anticipate?
Answer: Hydration and aggressive pain management; provide oxygen only if the child is hypoxemic.
Rationale: Hydration decreases blood viscosity, and opioid analgesia treats severe ischemic pain. Rest and warmth
are helpful. Routine oxygen is not indicated when oxygen saturation is normal.
Page 1
, PEDS EXAM 2 | QUESTIONS • ANSWERS • RATIONALES
6. A child with hemophilia develops a swollen knee after a fall. What home-care actions should
the parents use for a similar episode?
Answer: Rest the joint, apply ice, use gentle compression as directed, elevate it, and administer prescribed clotting
factor promptly.
Rationale: A swollen painful joint suggests hemarthrosis. Factor replacement controls bleeding; rest, ice,
compression, and elevation help limit bleeding and swelling. Avoid aspirin and intramuscular injections.
7. Which findings are expected manifestations of hemophilia?
Answer: Excessive or prolonged bleeding, hemarthrosis, and easy bruising.
Rationale: Hemophilia is a clotting-factor deficiency that causes prolonged bleeding, bleeding into joints, and
bruising. Platelet count and bleeding time are usually normal; aPTT is typically prolonged.
8. Which statement about preventing iron-deficiency anemia in infants is correct?
Answer: “Whole cow’s milk should not be given before 12 months, and intake should be limited after it is
introduced.”
Rationale: Cow’s milk is low in iron and may contribute to occult intestinal blood loss in young infants. Use iron-
fortified formula or iron-rich complementary foods and avoid excessive milk intake after age 1.
9. Which assessment finding is expected in a child with severe iron-deficiency anemia?
Answer: Pallor.
Rationale: Reduced hemoglobin decreases oxygen delivery and produces pallor. Fatigue, tachycardia, irritability,
pica, and poor activity tolerance may also occur.
10. A 4-year-old is 36 hours postoperative after removal of a Wilms tumor. Which finding requires
prompt follow-up?
Answer: Absent bowel sounds.
Rationale: Bowel sounds commonly decrease immediately after abdominal surgery, but continued absence with
distention, pain, vomiting, or failure to pass flatus can indicate postoperative ileus and requires assessment and
provider notification.
11. Which parent statement after a child’s neuroblastoma resection indicates understanding of
discharge care?
Answer: “We will give pain medication as prescribed, encourage rest, and report fever, worsening pain, drainage,
redness, vomiting, or abdominal swelling.”
Rationale: Effective discharge teaching includes pain control, activity limits, incision care, and recognition of
infection or postoperative complications. Pain that worsens despite medication needs evaluation.
12. What should parents expect after a child returns from an enucleation for retinoblastoma?
Answer: Facial or orbital edema and ecchymosis can occur initially.
Rationale: Postoperative swelling and bruising around the operative eye are expected. The nurse should still
monitor for excessive bleeding, infection, severe pain, or disruption of the dressing.
Page 2
PEDS EXAM 2 STUDY GUIDE
55 Numbered Questions with Answers and Nursing Rationales
Study note: Questions were cleaned and numbered from the uploaded text. Clinically unsafe, incomplete,
or misleading supplied answers were corrected. Verify exact wording against your course resources,
especially items that originally depended on missing images or answer choices.
Oncology and hematology
1. A child with leukemia has a neutrophil count below 500/mm³. What infection-prevention
measure should the nurse include in the plan of care?
Answer: Require meticulous hand hygiene for the child, staff, and visitors when entering and leaving the room.
Rationale: Severe neutropenia greatly increases infection risk. Hand hygiene is the most effective way to reduce
transmission. Avoid sick visitors, fresh flowers/plants, and raw or undercooked foods according to facility policy.
2. Which statement about osteosarcoma indicates a need for additional teaching?
Answer: “The sternum is the most common site of osteosarcoma.”
Rationale: This statement is incorrect. Osteosarcoma most often arises in the metaphysis of long bones, especially
near the knee, such as the distal femur or proximal tibia.
3. A child is suspected of having a Wilms tumor. Which nursing action indicates a need for
additional training?
Answer: Palpating the child’s abdomen.
Rationale: The abdomen should not be palpated because pressure can rupture the tumor and spread malignant
cells. Place a sign above the bed reminding staff not to palpate the abdomen.
End-of-life and grief
4. A mother whose child died 2 weeks ago says, “Sometimes I can still hear my child’s voice. I feel
like I’m going crazy.” What is the nurse’s best response?
Answer: “This can be a normal response to the loss of your child and part of the grieving process.”
Rationale: Brief sensory experiences of the deceased can occur during acute grief. The response normalizes the
experience without dismissing the parent’s feelings; the nurse should further assess coping and safety.
Oncology and hematology
5. A child is admitted with a vaso-occlusive sickle cell crisis. Which interventions should the nurse
anticipate?
Answer: Hydration and aggressive pain management; provide oxygen only if the child is hypoxemic.
Rationale: Hydration decreases blood viscosity, and opioid analgesia treats severe ischemic pain. Rest and warmth
are helpful. Routine oxygen is not indicated when oxygen saturation is normal.
Page 1
, PEDS EXAM 2 | QUESTIONS • ANSWERS • RATIONALES
6. A child with hemophilia develops a swollen knee after a fall. What home-care actions should
the parents use for a similar episode?
Answer: Rest the joint, apply ice, use gentle compression as directed, elevate it, and administer prescribed clotting
factor promptly.
Rationale: A swollen painful joint suggests hemarthrosis. Factor replacement controls bleeding; rest, ice,
compression, and elevation help limit bleeding and swelling. Avoid aspirin and intramuscular injections.
7. Which findings are expected manifestations of hemophilia?
Answer: Excessive or prolonged bleeding, hemarthrosis, and easy bruising.
Rationale: Hemophilia is a clotting-factor deficiency that causes prolonged bleeding, bleeding into joints, and
bruising. Platelet count and bleeding time are usually normal; aPTT is typically prolonged.
8. Which statement about preventing iron-deficiency anemia in infants is correct?
Answer: “Whole cow’s milk should not be given before 12 months, and intake should be limited after it is
introduced.”
Rationale: Cow’s milk is low in iron and may contribute to occult intestinal blood loss in young infants. Use iron-
fortified formula or iron-rich complementary foods and avoid excessive milk intake after age 1.
9. Which assessment finding is expected in a child with severe iron-deficiency anemia?
Answer: Pallor.
Rationale: Reduced hemoglobin decreases oxygen delivery and produces pallor. Fatigue, tachycardia, irritability,
pica, and poor activity tolerance may also occur.
10. A 4-year-old is 36 hours postoperative after removal of a Wilms tumor. Which finding requires
prompt follow-up?
Answer: Absent bowel sounds.
Rationale: Bowel sounds commonly decrease immediately after abdominal surgery, but continued absence with
distention, pain, vomiting, or failure to pass flatus can indicate postoperative ileus and requires assessment and
provider notification.
11. Which parent statement after a child’s neuroblastoma resection indicates understanding of
discharge care?
Answer: “We will give pain medication as prescribed, encourage rest, and report fever, worsening pain, drainage,
redness, vomiting, or abdominal swelling.”
Rationale: Effective discharge teaching includes pain control, activity limits, incision care, and recognition of
infection or postoperative complications. Pain that worsens despite medication needs evaluation.
12. What should parents expect after a child returns from an enucleation for retinoblastoma?
Answer: Facial or orbital edema and ecchymosis can occur initially.
Rationale: Postoperative swelling and bruising around the operative eye are expected. The nurse should still
monitor for excessive bleeding, infection, severe pain, or disruption of the dressing.
Page 2
