PEDS EXAM 3
Practice Questions and Answers with
Detailed Rationales | Pediatric
Nursing Exam Review
Resource Features
➢ Practice questions & answers
➢ Detailed rationales
➢ Pediatric clinical scenarios
➢ NCLEX-style questions
➢ Growth & development review
➢ Pediatric assessment
, Peds Exam 3 Practice Questions and Answers with
Detailed Rationales | Pediatric Nursing Exam
Review
QUESTION 1
SATA: Which signs best indicate increased ICP in an infant?
A. sunken anterior fontanel
B. complaints of blurred vision
C. high pitched cry
D. increased appetite
E. sleeping more than usual
Correct Answer: C, E
Rationale:
• C. High pitched cry - This is a classic sign of increased ICP in infants
due to irritation of the meninges and increased pressure on cranial
nerves. The cry is often described as "shrill" or "high-pitched" and is a
significant neurological finding.
• E. Sleeping more than usual - Lethargy and altered level of
consciousness (including excessive sleeping) are early signs of increased
ICP as the brain's function becomes compromised.
,• A. Sunken anterior fontanel - This indicates dehydration, not increased
ICP. A bulging fontanel would be concerning for increased ICP.
• B. Blurred vision - While this can occur with increased ICP, infants
cannot complain of blurred vision; this would be more applicable to
older children.
• D. Increased appetite - This is not associated with increased ICP; poor
feeding is more common.
QUESTION 2
You are caring for a patient with hydrocephalus who is post-op from a
shunt revision. Which assessment finding is your priority for increased
ICP?
A. nausea and refusal to eat post-operatively
B. complaint of a HA
C. irritability and wanting to sleep
D. decrease in HR over the last hour
Correct Answer: D
Rationale:
• D. Decrease in HR - This is a critical sign of Cushing's triad
(hypertension, bradycardia, irregular respirations) indicating
impending herniation. Bradycardia is a late and ominous sign of
increased ICP that requires immediate intervention. This is the priority
finding.
, • A. Nausea and refusal to eat - While these may indicate increased
ICP or other issues, they are less specific and less urgent than
bradycardia.
• B. Complaint of headache - This is a common symptom of increased
ICP but is subjective and less emergent than vital sign changes.
• C. Irritability and wanting to sleep - These can be signs of
increased ICP but are earlier, less specific findings compared to
bradycardia.
QUESTION 3
A child with a VP shunt complains of HA and blurry vision and now
experiences irritability and sleeping more than usual. The parent ask
the nurse what they should do. Select the nurse's best response.
A. Give her some acetaminophen, and see if her symptoms improve. If they
do not improve, bring her into the ped office.
B. It is common for girls to have these symptoms, especially prior to
beginning their menstrual cycle. Give her a few days and see if she
improves.
C. You are probably worried that she is having a problem with her shunt.
This is very unlikely as it has been working well for 9 years.
D. You should immediately take her to the ED as these may be symptoms
of a shunt malfunction.
Correct Answer: D
Rationale:
Practice Questions and Answers with
Detailed Rationales | Pediatric
Nursing Exam Review
Resource Features
➢ Practice questions & answers
➢ Detailed rationales
➢ Pediatric clinical scenarios
➢ NCLEX-style questions
➢ Growth & development review
➢ Pediatric assessment
, Peds Exam 3 Practice Questions and Answers with
Detailed Rationales | Pediatric Nursing Exam
Review
QUESTION 1
SATA: Which signs best indicate increased ICP in an infant?
A. sunken anterior fontanel
B. complaints of blurred vision
C. high pitched cry
D. increased appetite
E. sleeping more than usual
Correct Answer: C, E
Rationale:
• C. High pitched cry - This is a classic sign of increased ICP in infants
due to irritation of the meninges and increased pressure on cranial
nerves. The cry is often described as "shrill" or "high-pitched" and is a
significant neurological finding.
• E. Sleeping more than usual - Lethargy and altered level of
consciousness (including excessive sleeping) are early signs of increased
ICP as the brain's function becomes compromised.
,• A. Sunken anterior fontanel - This indicates dehydration, not increased
ICP. A bulging fontanel would be concerning for increased ICP.
• B. Blurred vision - While this can occur with increased ICP, infants
cannot complain of blurred vision; this would be more applicable to
older children.
• D. Increased appetite - This is not associated with increased ICP; poor
feeding is more common.
QUESTION 2
You are caring for a patient with hydrocephalus who is post-op from a
shunt revision. Which assessment finding is your priority for increased
ICP?
A. nausea and refusal to eat post-operatively
B. complaint of a HA
C. irritability and wanting to sleep
D. decrease in HR over the last hour
Correct Answer: D
Rationale:
• D. Decrease in HR - This is a critical sign of Cushing's triad
(hypertension, bradycardia, irregular respirations) indicating
impending herniation. Bradycardia is a late and ominous sign of
increased ICP that requires immediate intervention. This is the priority
finding.
, • A. Nausea and refusal to eat - While these may indicate increased
ICP or other issues, they are less specific and less urgent than
bradycardia.
• B. Complaint of headache - This is a common symptom of increased
ICP but is subjective and less emergent than vital sign changes.
• C. Irritability and wanting to sleep - These can be signs of
increased ICP but are earlier, less specific findings compared to
bradycardia.
QUESTION 3
A child with a VP shunt complains of HA and blurry vision and now
experiences irritability and sleeping more than usual. The parent ask
the nurse what they should do. Select the nurse's best response.
A. Give her some acetaminophen, and see if her symptoms improve. If they
do not improve, bring her into the ped office.
B. It is common for girls to have these symptoms, especially prior to
beginning their menstrual cycle. Give her a few days and see if she
improves.
C. You are probably worried that she is having a problem with her shunt.
This is very unlikely as it has been working well for 9 years.
D. You should immediately take her to the ED as these may be symptoms
of a shunt malfunction.
Correct Answer: D
Rationale:
