ATI RN
PEDIATRICS
350+ QUESTIONS BANK
(NGN-STYLE QUESTIONS & CASE SCENARIOS)
Some Answers with detailed Rationale
1
,1. A nurse in the emergency department is caring for a 2-year-old child who was found
by his parents crying and holding a container of toilet bowl cleaner. The child's lips are
edematous and inflamed, and he is drooling. Which of the following is the priority
action by the nurse?
A. Remove the child's contaminated clothing.
B. Check the child's respiratory status.
C. Administer an antidote to the child.
D. Establish IV access for the child.
B. Check the child's respiratory status.
Rationale: The nurse should apply the ABC priority-setting
2. A nurse is teaching a parent of a 12-month old child about development during the
toddler years. Which of the following statements should the nurse include?
A. "Your child should be referring to himself using the appropriate pronoun by 18
months of age."
B. "A toddler's interest in looking at pictures occurs at 20 months of age."
C. "A toddler should have davtime control of his bowel and bladder by 24 months of
age.
D. "Your child should be able to scribble spontaneously using a crayon at the age of 15
months."
D. "Your child should be able to scribble spontaneously using a crayon at the age of
15 months."
3. A nurse is caring for a toddler and is preparing to administer 0.9% sodium chloride
100 mL IV to infuse over 4 hr. The drop factor of the manual IV tubing is 60 gtt/mL. The
nurse should set the manual IV infusion to deliver how many gtt/min? (Round the
answer to the nearest whole number. Use a leading zero if it applies. Do not use a
trailing zero.)
25 GTT
4. A nurse in a pediatric clinic is assessing a toddler at a well-child visit. Which of the
following actions should the nurse take?
A. Perform the assessment in a head to toe sequence.
B. Minimize physical contact with the child initially.
C. Explain procedures using medical terminology.
D. Stop the assessment if the child becomes uncooperative.
B. Minimize physical contact with the child initially.
2
,5. A nurse is caring for an 18-year-old adolescent who is up-to-date on immunizations
and is planning to attend college. The nurse should inform the client that he should
receive which of the following immunizations prior to moving into a campus
dormitory?
A. Pneumococcal polysaccharide
B. Meningococcal polysaccharide
C. Rotavirus
D. Herpes zoster
B. Meningococcal polysaccharide
6. A nurse is teaching the parent of a toddler about home safety. Which of the following
statements by the parent indicates an understanding of the teaching?
A. "I lock my medications in the medicine cabinet."
B. "I keep my child's crib mattress at the highest level."
C. "I turn pot handles to the side of my stove while cooking."
D. "I will give my child syrup of ipecac if she swallows something poisonous."
A. "I lock my medications in the medicine cabinet."
7. A nurse is performing a physical assessment on a 6-month-old infant. Which of the
following reflexes should the nurse expect to find?
A. Stepping
B. Babinski
C. Extrusion
D. Moro
B. Babinski
8. A nurse is teaching the parent of an infant about food allergens. Which of the
following foods should the nurse include as being the most common food allergy in
children?
A. Cow's milk
B. Wheat bread
C. Corn syrup
D. Eggs
A. Cow's milk
9. A nurse is preparing to administer recommended immunizations to a 2-month-old
infant. Which of the following immunizations should the nurse plan to administer?
A. Human papillomavirus (HPV) and hepatitis A
B. Measles, mumps, rubella (MMR) and tetanus, diphtheria, and acellular pertussis
(TDaP)
C. Haemophilus influenzae type B (Hib) and inactivated polio virus (IPV)
D. Varicella (VAR) and live attenuated influenza vaccine (LAIV)
C. Haemophilus influenzae type B (Hib) and inactivated polio virus (IPV)
10. A nurse is developing a plan of care for a school-age child who underwent a
surgical procedure that resulted in temporary loss of vision. Which of the following
3
,interventions should the nurse include in the plan of care?
A. Assign an assistive personnel to feed the child.
B. Explain sounds the child is hearing.
C. Have the child use a cane when ambulating.
D. Rotate nurses caring for the child.
B. Explain sounds the child is hearing.
11. A nurse is assessing a 3-year-old child who is 1 day postoperative following a
tonsillectomy. Which of the following methods should the nurse use to determine if the
child is experiencing pain?
A. Ask the parents.
B. Use the FACES scale.
C. Use the numeric rating scale.
D. Check the child's temperature.
B. Use the FACES scale.
12. A nurse is assessing a 6-month-old infant at a well-child visit. Which of the
following findings indicates the need for further assessment?
A. Grabs feet and pulls them to her mouth
B. Posterior fontanel is closed
C. Legs remain crossed and extended when supine
D. Birth weight has doubled
C. Legs remain crossed and extended when supine
13. A nurse is observing a mother who is playing peek-a-boo with her 8-month-old
child. The mother asks if this game has any developmental significance. The nurse
should inform the mother that peek-a-boo helps develop which of the following
concepts in the child?
A. Hand-eye coordination
B. Sense of trust
C. Object permanence
D. Egocentrism
C. Object permanence
14. A nurse is caring for a 15-month-old toddler who requires droplet precautions.
Which of the following actions should the nurse take?
A. Have the toddler wear a disposable gown when in the unit's playroom.
B. Wear sterile gloves when changing the toddler's diapers.
C. Wear a mask when assisting the toddler with meals.
D. Ask visitors to wear an N-95 mask when entering the room.
C. Wear a mask when assisting the toddler with meals.
15. A nurse at a pediatric clinic is assessing a 5-month-old infant during a well-child
visit. Which of the following findings should the nurse report to the provider?
A. Head lags when pulled from a lying to a sitting position
B. Absence of startle and crawl reflexes
4
,C. Inability to pick up a rattle after dropping it
D. Rolls from back to side
A. Head lags when pulled from a lying to a sitting position
16. A nurse is planning to collect a specimen from a male infant using a urine
collection bag. Which of the following actions should the nurse take?
A. Wash and dry the infant's genitalia and perineum thoroughly.
B. Apply a small coating of water-soluble lubricant to the skin of the infant's perineal
area.
C. Avoid placing the scrotum inside the collection bag.
D. Wait several hours after positioning the device before checking it.
A. Wash and dry the infant's genitalia and perineum thoroughly.
17. A nurse in a pediatric clinic is caring for a 3-year-old child who has a blood lead
level of 3 mcg/dL. When teaching the toddler's parents about the correlation of
nutrition with lead poisoning, which of the following information is appropriate for the
nurse to include in the teaching?
A. Decrease the child's vitamin C intake until the blood lead level decreases to zero.
B. Administer a folic acid supplement to the child each day.
C. Give pancreatic enzymes to the child with meals and snacks.
D. Ensure the child's dietary intake of calcium and iron is adequate.
D. Ensure the child's dietary intake of calcium and iron is adequate.
18. A nurse is planning care for a 10-month-old infant who has suspected failure to
thrive (FTT). Which of the following interventions should the nurse include in the plan
of care? (Select all that apply.)
A. Observe the parents' actions when feeding the child.
B. Maintain a detailed record of food and fluid intake.
C. Follow the child's cues as to when food and fluids are provided.
D. Sit beside the child's high chair when feeding the child.
E. Play music videos during scheduled meal times.
A. Observe the parents' actions when feeding the child.
B. Maintain a detailed record of food and fluid intake.
19. A nurse is assessing a 7-year-old child's psychosocial development. Which of the
following findings should the nurse recognize as requiring further evaluation?
A. The child prefers playmates of the same sex.
B. The child is competitive when playing board games.
C. The child complains daily about going to school.
D. The child enjoys spending time alone.
C. The child complains daily about going to school.
20. A nurse is providing education to the parent of a toddler who is about to receive her
first dose of the MMR (measles, mumps and rubella) immunization. Which of the
following statements by the parent indicates an understanding of the teaching?
A. "I am not going to let my child play with other children for 2 days."
5
,B. "I will need to return in 2 weeks for my child to receive the varicella immunization."
C. "I can give my child acetaminophen for discomfort associated with the
immunization."
C. "I can give my child acetaminophen for discomfort associated with the
immunization."
21. A nurse is providing teaching to the parents of a 4-year-old child about fine motor
development. Which of the following tasks should the nurse include in the teaching as
an expected finding for this age group?
A. Copies a circle
B. Cuts foods using a table knife
C. Begins writing in cursive
D. Prints first and last name clearly
A. Copies a circle
22. A nurse is providing teaching to the parents of a 4-year-old child about fine motor
development. Which of the following tasks should the nurse include in the teaching as
an expected finding for this age group?
A. Brightly colored mobile
B. Plastic stethoscope
C. Small piece jigsaw puzzle
D. A book of short stories
B. Plastic stethoscope
23. A nurse in an emergency department is caring for an 8-year old who is up-to-date
with current immunization recommendations and has a deep puncture injury. Which of
the following should the nurse anticipate administering?
A. Diphtheria, tetanus, and acellular pertussis (DTaP) vaccine
B. A single injection of tetanus immune globulin (TIG) mixed with the pediatric tetanus
booster (DT)
C. Tetanus, diphtheria, and acellular pertussis (Tdap) vaccine
D. Adult tetanus booster (Td)
D. Adult tetanus booster (Td)
24. A nurse is providing teaching about promoting sleep with the parent of a 3-year-old
toddler. Which of the following information should the nurse include?
A. Follow a nightly routine and established bedtime.
B. Encourage active play prior to bedtime.
C. Let the child remain awake until tired enough to go to sleep.
D. Reward the child with a food treat just prior to sleep if the child goes to bed on time.
A. Follow a nightly routine and established bedtime.
25. A nurse is planning to implement relaxation strategies with a young child prior to a
painful procedure. Which of the following actions should the nurse take?
A. Ask the child to hold his breath and then blow it out slowly.
B. Ask the child to describe a pleasurable event.
6
,C. Bounce the child gently while holding him upright.
D. Rock the child in long rhythmic movements.
D. Rock the child in long rhythmic movements.
26. A nurse is assessing a 6-year-old child at a well-child visit. Which of the following
findings requires further assessment by the nurse?
A. Presence of sparse, fine pubic hair
B. Decreased head circumference compared to full height
C. Increased leg length related to height
D. Presence of a loose, central incisor
A. Presence of sparse, fine pubic hair
27. A nurse is caring for a preschool-age child who is dying. Which of the following
findings is an age-appropriate reaction to death by the child? (Select all that apply.)
A. The child views death as similar to sleep.
B. The child is interested in what happens to his body after death.
C. The child recognizes that death is permanent.
D. The child believes his thoughts can cause death.
E. The child thinks death is a punishment.
A. The child views death as similar to sleep.
B. The child is interested in what happens to his body after death.
E. The child thinks death is a punishment.
28. A nurse is teaching the parent of an infant about home safety. Which of the
following information should the nurse include?
A. Use a wheeled infant walker.
B. Place soft pillows around the edge of the infant's crib.
C. Position the car seat so it is rear-facing.
D. Secure a safety gate at the top and bottom of the stairs.
E. Maintain the water heater temperature at 49° C (120° F).
C. Position the car seat so it is rear-facing.
D. Secure a safety gate at the top and bottom of the stairs.
E. Maintain the water heater temperature at 49° C (120° F).
29. A nurse is caring for an adolescent who is receiving pain medication via a PCA
pump. When the nurse assess the client's pain at 0800, the client describes the pain as
a 3 on a scale of 1 to 10. At 100, the client describes the pain as a 5. The nurse
discovers the client has not pushed the button to deliver medication in the past 2 hr.
Which of the following actions should the nurse take?
A. Ask the provider to discontinue the PCA so the nurse can administer PRN pain
medication.
B. Suggest the client's parent push the button for the client if the parent thinks the
adolescent is having pain.
C. Reevaluate the client in 1 hr since a pain level of 5 is acceptable on a scale of 1 to
10. Reinforce teaching with the client about how to push the button to deliver themed.
Reinforce teaching with the client about how to push the button to deliver themed.
7
,30. A nurse is assessing a 12-month-old male infant's vital signs during a well-child
visit. The infant is in the 90th percentile of height. Which of the following findings
should the nurse report to the provider?
A. Heart rate 175/min
B. Respiratory rate 26/min
C. Blood pressure 88/40 mm Hg)
D. Temperature 37.6° C (99.7° F
A. Heart rate 175/min
31. A nurse is teaching the parent of a 12-month-old infant about nutrition. Which of the
following statements by the parent indicates a need for further teaching?
A. "I can give my baby 4 ounces of juice to drink each day."
B. "I will offer my baby dry cereal and chilled banana slices as snacks."
C. "I am introducing my baby to the same foods the family eats."
D. "My infant drinks at least 2 quarts of skim milk each day."
D. "My infant drinks at least 2 quarts of skim milk each day."
32. A nurse is assisting a provider during a femoral venipuncture on a toddler. The
nurse should place the child in which of the following positions?
A. Side-lying
B. Semi-recumbent
C. Flexed sitting
D. Supine
D. Supine
33. A nurse is assessing a 9-month-old infant during a well-child visit. Which of the
following findings indicates that the infant has a developmental delay?
A. Creeps on hands and knees
B. Inability to vocalize vowel sounds
C. Uses crude pincer grasp
D. Stands by holding onto support
B. Inability to vocalize vowel sounds
34. A nurse is preparing to administer a liquid medication to an infant. Which of the
following actions should the nurse take?
A. Administer the medication while the infant is supine.
B. Give the medication at the side of the infant's mouth.
C. Add the medication to a full bottle of the infant's formula.
D. Administer the medication slowly while holding the nares closed.
B. Give the medication at the side of the infant's mouth.
35. A nurse on a pediatric unit is reviewing the health record of a client who is
demonstrating increasing levels of stress after admission. The nurse should identify
which of the following findings as a risk factor for a stress-related reaction to
hospitalization?
A. Age 10
8
,B. First hospitalization
C. Male gender
D. Calm, quiet demeanor
C. Male gender
36. A nurse in the emergency department is caring for a 12-year-old child who has
ingested bleach. Which of the following statements by the nurse indicated an
understanding of this ingestion?
A. "The absence of oral burns excludes the possibility of esophageal burns."
B. "Treatment focuses on neutralization of the chemical."
C. "Injury by a corrosive liquid is more extensive than by a corrosive solid."
D. "Immediate administration of activated charcoal is warranted."
C. "Injury by a corrosive liquid is more extensive than by a corrosive solid."
37. A nurse is caring for a child who has a bacterial endocarditis. The child is
scheduled to receive moderate term antibiotic therapy and requires a peripherally
inserted central catheter (PICC). Which of the following statements should the nurse
include when teaching the child's parent?
A. "The PICC line will last several weeks with proper care."
B. "The public health nurse will rotate the insertion site every 3 days."
C. "You will need to make certain the arm board is in place at all times."
D. "Your child will go to the operating room to have the line placed."
A. "The PICC line will last several weeks with proper care."
38. A nurse is providing anticipatory guidance about accidental ingestion of a toxic
substance to the parents of a toddler. The nurse should instruct the parents to take
which of the following actions first if the child ingests a hazardous substance?
A. Give the toddler milk.
B. Go to an emergency department.
C. Call the poison control center.
D. Induce vomiting.
C. Call the poison control center.
39. A nurse is caring for a 2-year-old child who has cystic fibrosis. The nurse is
planning to take the child to the plavroom. Which of the following activities would be
appropriate for the child?
A. Cutting figures from colored paper
B. Drawing stick figures using cravons
C. Riding a tricycle
D. Building towers of blocks
D. Building towers of blocks
40. A nurse is assessing a 30-month-old toddler during a well-child visit. Which of the
following findings requires further assessment by the nurse?
A. Primary dentition is complete
B. Unable to hop on one foot
9
, C. Birth weight is tripled
D. Able to state first and last name
C. Birth weight is tripled
41. A nurse is providing discharge teaching to the parents of a 6-month-old infant who I
postoperative following hypospadias repair with a stent placement. Which of the
following instructions should the nurse include in the teaching?a) "You may bathe
your infant in an infant bathtub when you go home." "Apply hydrocortisone cream to
your infant's penis daily." "You should clamp your infant's stent twice daily." "Allow
the stent to drain directly into your infant's diaper."
"Allow the stent to drain
directly into your infant's diaper."
42. A nurse is monitoring the oxygen saturation level of an infant using pulse
oximetry.The nurse should secure the sensor to which of the following areas on the
infant?
A. Wrist
B. Great toe
C. Index finger
D. Heel
B. Great toe
43. A nurse is caring for a school-age child who has primary nephrotic syndrome and
is taking prednisone. Following I week of treatment, which of the following
manifestations indicates to the nurse that the medication is effective?
A. a Decreased edema
B. Increased abdominal girth
C. Decreased appetite
D. Increased protein in the urine
A. a Decreased edema
44. A nurse is receiving change-of-shift report for four children. Which of the following
children should the nurse assess first?
A. A toddler who has a concussion and an episode of forceful vomiting
B. An adolescent who has infective endocarditis and reports having a headache
C. An adolescent who was placed into halo traction 1 hr ago and reports pain as 6 on a
scale of 0 to 10
D. A school-age child who has acute glomerulonephritis and brown-colored urine
A. A toddler who has a concussion and an episode of forceful vomiting
45. A nurse is providing dietary teaching to the guardian of a school-age child who has
cystic fibrosis. Which of the following statements should the nurse make?
A. "You should offer your child high-protein meals and snacks throughout the day."
B. "You should decrease your child's dietary fat intake to less than 10% of their caloric
intake."
10
PEDIATRICS
350+ QUESTIONS BANK
(NGN-STYLE QUESTIONS & CASE SCENARIOS)
Some Answers with detailed Rationale
1
,1. A nurse in the emergency department is caring for a 2-year-old child who was found
by his parents crying and holding a container of toilet bowl cleaner. The child's lips are
edematous and inflamed, and he is drooling. Which of the following is the priority
action by the nurse?
A. Remove the child's contaminated clothing.
B. Check the child's respiratory status.
C. Administer an antidote to the child.
D. Establish IV access for the child.
B. Check the child's respiratory status.
Rationale: The nurse should apply the ABC priority-setting
2. A nurse is teaching a parent of a 12-month old child about development during the
toddler years. Which of the following statements should the nurse include?
A. "Your child should be referring to himself using the appropriate pronoun by 18
months of age."
B. "A toddler's interest in looking at pictures occurs at 20 months of age."
C. "A toddler should have davtime control of his bowel and bladder by 24 months of
age.
D. "Your child should be able to scribble spontaneously using a crayon at the age of 15
months."
D. "Your child should be able to scribble spontaneously using a crayon at the age of
15 months."
3. A nurse is caring for a toddler and is preparing to administer 0.9% sodium chloride
100 mL IV to infuse over 4 hr. The drop factor of the manual IV tubing is 60 gtt/mL. The
nurse should set the manual IV infusion to deliver how many gtt/min? (Round the
answer to the nearest whole number. Use a leading zero if it applies. Do not use a
trailing zero.)
25 GTT
4. A nurse in a pediatric clinic is assessing a toddler at a well-child visit. Which of the
following actions should the nurse take?
A. Perform the assessment in a head to toe sequence.
B. Minimize physical contact with the child initially.
C. Explain procedures using medical terminology.
D. Stop the assessment if the child becomes uncooperative.
B. Minimize physical contact with the child initially.
2
,5. A nurse is caring for an 18-year-old adolescent who is up-to-date on immunizations
and is planning to attend college. The nurse should inform the client that he should
receive which of the following immunizations prior to moving into a campus
dormitory?
A. Pneumococcal polysaccharide
B. Meningococcal polysaccharide
C. Rotavirus
D. Herpes zoster
B. Meningococcal polysaccharide
6. A nurse is teaching the parent of a toddler about home safety. Which of the following
statements by the parent indicates an understanding of the teaching?
A. "I lock my medications in the medicine cabinet."
B. "I keep my child's crib mattress at the highest level."
C. "I turn pot handles to the side of my stove while cooking."
D. "I will give my child syrup of ipecac if she swallows something poisonous."
A. "I lock my medications in the medicine cabinet."
7. A nurse is performing a physical assessment on a 6-month-old infant. Which of the
following reflexes should the nurse expect to find?
A. Stepping
B. Babinski
C. Extrusion
D. Moro
B. Babinski
8. A nurse is teaching the parent of an infant about food allergens. Which of the
following foods should the nurse include as being the most common food allergy in
children?
A. Cow's milk
B. Wheat bread
C. Corn syrup
D. Eggs
A. Cow's milk
9. A nurse is preparing to administer recommended immunizations to a 2-month-old
infant. Which of the following immunizations should the nurse plan to administer?
A. Human papillomavirus (HPV) and hepatitis A
B. Measles, mumps, rubella (MMR) and tetanus, diphtheria, and acellular pertussis
(TDaP)
C. Haemophilus influenzae type B (Hib) and inactivated polio virus (IPV)
D. Varicella (VAR) and live attenuated influenza vaccine (LAIV)
C. Haemophilus influenzae type B (Hib) and inactivated polio virus (IPV)
10. A nurse is developing a plan of care for a school-age child who underwent a
surgical procedure that resulted in temporary loss of vision. Which of the following
3
,interventions should the nurse include in the plan of care?
A. Assign an assistive personnel to feed the child.
B. Explain sounds the child is hearing.
C. Have the child use a cane when ambulating.
D. Rotate nurses caring for the child.
B. Explain sounds the child is hearing.
11. A nurse is assessing a 3-year-old child who is 1 day postoperative following a
tonsillectomy. Which of the following methods should the nurse use to determine if the
child is experiencing pain?
A. Ask the parents.
B. Use the FACES scale.
C. Use the numeric rating scale.
D. Check the child's temperature.
B. Use the FACES scale.
12. A nurse is assessing a 6-month-old infant at a well-child visit. Which of the
following findings indicates the need for further assessment?
A. Grabs feet and pulls them to her mouth
B. Posterior fontanel is closed
C. Legs remain crossed and extended when supine
D. Birth weight has doubled
C. Legs remain crossed and extended when supine
13. A nurse is observing a mother who is playing peek-a-boo with her 8-month-old
child. The mother asks if this game has any developmental significance. The nurse
should inform the mother that peek-a-boo helps develop which of the following
concepts in the child?
A. Hand-eye coordination
B. Sense of trust
C. Object permanence
D. Egocentrism
C. Object permanence
14. A nurse is caring for a 15-month-old toddler who requires droplet precautions.
Which of the following actions should the nurse take?
A. Have the toddler wear a disposable gown when in the unit's playroom.
B. Wear sterile gloves when changing the toddler's diapers.
C. Wear a mask when assisting the toddler with meals.
D. Ask visitors to wear an N-95 mask when entering the room.
C. Wear a mask when assisting the toddler with meals.
15. A nurse at a pediatric clinic is assessing a 5-month-old infant during a well-child
visit. Which of the following findings should the nurse report to the provider?
A. Head lags when pulled from a lying to a sitting position
B. Absence of startle and crawl reflexes
4
,C. Inability to pick up a rattle after dropping it
D. Rolls from back to side
A. Head lags when pulled from a lying to a sitting position
16. A nurse is planning to collect a specimen from a male infant using a urine
collection bag. Which of the following actions should the nurse take?
A. Wash and dry the infant's genitalia and perineum thoroughly.
B. Apply a small coating of water-soluble lubricant to the skin of the infant's perineal
area.
C. Avoid placing the scrotum inside the collection bag.
D. Wait several hours after positioning the device before checking it.
A. Wash and dry the infant's genitalia and perineum thoroughly.
17. A nurse in a pediatric clinic is caring for a 3-year-old child who has a blood lead
level of 3 mcg/dL. When teaching the toddler's parents about the correlation of
nutrition with lead poisoning, which of the following information is appropriate for the
nurse to include in the teaching?
A. Decrease the child's vitamin C intake until the blood lead level decreases to zero.
B. Administer a folic acid supplement to the child each day.
C. Give pancreatic enzymes to the child with meals and snacks.
D. Ensure the child's dietary intake of calcium and iron is adequate.
D. Ensure the child's dietary intake of calcium and iron is adequate.
18. A nurse is planning care for a 10-month-old infant who has suspected failure to
thrive (FTT). Which of the following interventions should the nurse include in the plan
of care? (Select all that apply.)
A. Observe the parents' actions when feeding the child.
B. Maintain a detailed record of food and fluid intake.
C. Follow the child's cues as to when food and fluids are provided.
D. Sit beside the child's high chair when feeding the child.
E. Play music videos during scheduled meal times.
A. Observe the parents' actions when feeding the child.
B. Maintain a detailed record of food and fluid intake.
19. A nurse is assessing a 7-year-old child's psychosocial development. Which of the
following findings should the nurse recognize as requiring further evaluation?
A. The child prefers playmates of the same sex.
B. The child is competitive when playing board games.
C. The child complains daily about going to school.
D. The child enjoys spending time alone.
C. The child complains daily about going to school.
20. A nurse is providing education to the parent of a toddler who is about to receive her
first dose of the MMR (measles, mumps and rubella) immunization. Which of the
following statements by the parent indicates an understanding of the teaching?
A. "I am not going to let my child play with other children for 2 days."
5
,B. "I will need to return in 2 weeks for my child to receive the varicella immunization."
C. "I can give my child acetaminophen for discomfort associated with the
immunization."
C. "I can give my child acetaminophen for discomfort associated with the
immunization."
21. A nurse is providing teaching to the parents of a 4-year-old child about fine motor
development. Which of the following tasks should the nurse include in the teaching as
an expected finding for this age group?
A. Copies a circle
B. Cuts foods using a table knife
C. Begins writing in cursive
D. Prints first and last name clearly
A. Copies a circle
22. A nurse is providing teaching to the parents of a 4-year-old child about fine motor
development. Which of the following tasks should the nurse include in the teaching as
an expected finding for this age group?
A. Brightly colored mobile
B. Plastic stethoscope
C. Small piece jigsaw puzzle
D. A book of short stories
B. Plastic stethoscope
23. A nurse in an emergency department is caring for an 8-year old who is up-to-date
with current immunization recommendations and has a deep puncture injury. Which of
the following should the nurse anticipate administering?
A. Diphtheria, tetanus, and acellular pertussis (DTaP) vaccine
B. A single injection of tetanus immune globulin (TIG) mixed with the pediatric tetanus
booster (DT)
C. Tetanus, diphtheria, and acellular pertussis (Tdap) vaccine
D. Adult tetanus booster (Td)
D. Adult tetanus booster (Td)
24. A nurse is providing teaching about promoting sleep with the parent of a 3-year-old
toddler. Which of the following information should the nurse include?
A. Follow a nightly routine and established bedtime.
B. Encourage active play prior to bedtime.
C. Let the child remain awake until tired enough to go to sleep.
D. Reward the child with a food treat just prior to sleep if the child goes to bed on time.
A. Follow a nightly routine and established bedtime.
25. A nurse is planning to implement relaxation strategies with a young child prior to a
painful procedure. Which of the following actions should the nurse take?
A. Ask the child to hold his breath and then blow it out slowly.
B. Ask the child to describe a pleasurable event.
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,C. Bounce the child gently while holding him upright.
D. Rock the child in long rhythmic movements.
D. Rock the child in long rhythmic movements.
26. A nurse is assessing a 6-year-old child at a well-child visit. Which of the following
findings requires further assessment by the nurse?
A. Presence of sparse, fine pubic hair
B. Decreased head circumference compared to full height
C. Increased leg length related to height
D. Presence of a loose, central incisor
A. Presence of sparse, fine pubic hair
27. A nurse is caring for a preschool-age child who is dying. Which of the following
findings is an age-appropriate reaction to death by the child? (Select all that apply.)
A. The child views death as similar to sleep.
B. The child is interested in what happens to his body after death.
C. The child recognizes that death is permanent.
D. The child believes his thoughts can cause death.
E. The child thinks death is a punishment.
A. The child views death as similar to sleep.
B. The child is interested in what happens to his body after death.
E. The child thinks death is a punishment.
28. A nurse is teaching the parent of an infant about home safety. Which of the
following information should the nurse include?
A. Use a wheeled infant walker.
B. Place soft pillows around the edge of the infant's crib.
C. Position the car seat so it is rear-facing.
D. Secure a safety gate at the top and bottom of the stairs.
E. Maintain the water heater temperature at 49° C (120° F).
C. Position the car seat so it is rear-facing.
D. Secure a safety gate at the top and bottom of the stairs.
E. Maintain the water heater temperature at 49° C (120° F).
29. A nurse is caring for an adolescent who is receiving pain medication via a PCA
pump. When the nurse assess the client's pain at 0800, the client describes the pain as
a 3 on a scale of 1 to 10. At 100, the client describes the pain as a 5. The nurse
discovers the client has not pushed the button to deliver medication in the past 2 hr.
Which of the following actions should the nurse take?
A. Ask the provider to discontinue the PCA so the nurse can administer PRN pain
medication.
B. Suggest the client's parent push the button for the client if the parent thinks the
adolescent is having pain.
C. Reevaluate the client in 1 hr since a pain level of 5 is acceptable on a scale of 1 to
10. Reinforce teaching with the client about how to push the button to deliver themed.
Reinforce teaching with the client about how to push the button to deliver themed.
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,30. A nurse is assessing a 12-month-old male infant's vital signs during a well-child
visit. The infant is in the 90th percentile of height. Which of the following findings
should the nurse report to the provider?
A. Heart rate 175/min
B. Respiratory rate 26/min
C. Blood pressure 88/40 mm Hg)
D. Temperature 37.6° C (99.7° F
A. Heart rate 175/min
31. A nurse is teaching the parent of a 12-month-old infant about nutrition. Which of the
following statements by the parent indicates a need for further teaching?
A. "I can give my baby 4 ounces of juice to drink each day."
B. "I will offer my baby dry cereal and chilled banana slices as snacks."
C. "I am introducing my baby to the same foods the family eats."
D. "My infant drinks at least 2 quarts of skim milk each day."
D. "My infant drinks at least 2 quarts of skim milk each day."
32. A nurse is assisting a provider during a femoral venipuncture on a toddler. The
nurse should place the child in which of the following positions?
A. Side-lying
B. Semi-recumbent
C. Flexed sitting
D. Supine
D. Supine
33. A nurse is assessing a 9-month-old infant during a well-child visit. Which of the
following findings indicates that the infant has a developmental delay?
A. Creeps on hands and knees
B. Inability to vocalize vowel sounds
C. Uses crude pincer grasp
D. Stands by holding onto support
B. Inability to vocalize vowel sounds
34. A nurse is preparing to administer a liquid medication to an infant. Which of the
following actions should the nurse take?
A. Administer the medication while the infant is supine.
B. Give the medication at the side of the infant's mouth.
C. Add the medication to a full bottle of the infant's formula.
D. Administer the medication slowly while holding the nares closed.
B. Give the medication at the side of the infant's mouth.
35. A nurse on a pediatric unit is reviewing the health record of a client who is
demonstrating increasing levels of stress after admission. The nurse should identify
which of the following findings as a risk factor for a stress-related reaction to
hospitalization?
A. Age 10
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,B. First hospitalization
C. Male gender
D. Calm, quiet demeanor
C. Male gender
36. A nurse in the emergency department is caring for a 12-year-old child who has
ingested bleach. Which of the following statements by the nurse indicated an
understanding of this ingestion?
A. "The absence of oral burns excludes the possibility of esophageal burns."
B. "Treatment focuses on neutralization of the chemical."
C. "Injury by a corrosive liquid is more extensive than by a corrosive solid."
D. "Immediate administration of activated charcoal is warranted."
C. "Injury by a corrosive liquid is more extensive than by a corrosive solid."
37. A nurse is caring for a child who has a bacterial endocarditis. The child is
scheduled to receive moderate term antibiotic therapy and requires a peripherally
inserted central catheter (PICC). Which of the following statements should the nurse
include when teaching the child's parent?
A. "The PICC line will last several weeks with proper care."
B. "The public health nurse will rotate the insertion site every 3 days."
C. "You will need to make certain the arm board is in place at all times."
D. "Your child will go to the operating room to have the line placed."
A. "The PICC line will last several weeks with proper care."
38. A nurse is providing anticipatory guidance about accidental ingestion of a toxic
substance to the parents of a toddler. The nurse should instruct the parents to take
which of the following actions first if the child ingests a hazardous substance?
A. Give the toddler milk.
B. Go to an emergency department.
C. Call the poison control center.
D. Induce vomiting.
C. Call the poison control center.
39. A nurse is caring for a 2-year-old child who has cystic fibrosis. The nurse is
planning to take the child to the plavroom. Which of the following activities would be
appropriate for the child?
A. Cutting figures from colored paper
B. Drawing stick figures using cravons
C. Riding a tricycle
D. Building towers of blocks
D. Building towers of blocks
40. A nurse is assessing a 30-month-old toddler during a well-child visit. Which of the
following findings requires further assessment by the nurse?
A. Primary dentition is complete
B. Unable to hop on one foot
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, C. Birth weight is tripled
D. Able to state first and last name
C. Birth weight is tripled
41. A nurse is providing discharge teaching to the parents of a 6-month-old infant who I
postoperative following hypospadias repair with a stent placement. Which of the
following instructions should the nurse include in the teaching?a) "You may bathe
your infant in an infant bathtub when you go home." "Apply hydrocortisone cream to
your infant's penis daily." "You should clamp your infant's stent twice daily." "Allow
the stent to drain directly into your infant's diaper."
"Allow the stent to drain
directly into your infant's diaper."
42. A nurse is monitoring the oxygen saturation level of an infant using pulse
oximetry.The nurse should secure the sensor to which of the following areas on the
infant?
A. Wrist
B. Great toe
C. Index finger
D. Heel
B. Great toe
43. A nurse is caring for a school-age child who has primary nephrotic syndrome and
is taking prednisone. Following I week of treatment, which of the following
manifestations indicates to the nurse that the medication is effective?
A. a Decreased edema
B. Increased abdominal girth
C. Decreased appetite
D. Increased protein in the urine
A. a Decreased edema
44. A nurse is receiving change-of-shift report for four children. Which of the following
children should the nurse assess first?
A. A toddler who has a concussion and an episode of forceful vomiting
B. An adolescent who has infective endocarditis and reports having a headache
C. An adolescent who was placed into halo traction 1 hr ago and reports pain as 6 on a
scale of 0 to 10
D. A school-age child who has acute glomerulonephritis and brown-colored urine
A. A toddler who has a concussion and an episode of forceful vomiting
45. A nurse is providing dietary teaching to the guardian of a school-age child who has
cystic fibrosis. Which of the following statements should the nurse make?
A. "You should offer your child high-protein meals and snacks throughout the day."
B. "You should decrease your child's dietary fat intake to less than 10% of their caloric
intake."
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