,NUR 2513 Exam 3 | Maternal-Child Nursing (2026) Actual
Q&A PDF | Rasmussen College
1. Which of the following is the priority nursing intervention for a hospitalized child
who is experiencing significant stress from being in an unfamiliar environment?
A) Encourage the parents to visit only during designated hours
B) Maintain a strict schedule of all nursing procedures
C) Provide age-appropriate activities and allow parental presence
D) Limit the child's contact with other children on the unit
Correct Answer: Provide age-appropriate activities and allow parental presence
Rationale: Hospitalization is a major stressor for children, often leading to anxiety
and regression. The primary intervention to reduce this stress is to maintain the
child's routine as much as possible, provide age-appropriate play and activities, and
encourage parental presence and participation in care. This approach supports the
child's emotional and developmental needs.
2. A nurse is calculating the daily maintenance fluid requirement for a child who
weighs 22 kg. Using the 4-2-1 rule, which of the following is the correct rate in
mL/hr?
A) 55 mL/hr
B) 62 mL/hr
C) 70 mL/hr
D) 88 mL/hr
Correct Answer: 62 mL/hr
,Rationale: The 4-2-1 rule calculates hourly maintenance fluids: 4 mL/kg for the first
10 kg (40 mL), 2 mL/kg for the next 10 kg (20 mL), and 1 mL/kg for each remaining
kg (2 mL). The total is 62 mL/hr. This formula is a standard method for estimating
fluid needs in pediatric patients.
3. A school-age child is prescribed oral liquid medication. Which of the following
actions by the nurse is most appropriate to ensure the child takes the full dose?
A) Mix the medication with a full glass of the child's favorite juice
B) Administer the medication using a calibrated oral syringe
C) Ask the child to hold their nose while swallowing
D) Allow the child to drink the medication directly from the medicine bottle
Correct Answer: Administer the medication using a calibrated oral syringe
Rationale: A calibrated oral syringe ensures accurate measurement of the prescribed
dose. Mixing medication with a large volume of juice may result in the child not
consuming the entire dose. The nurse should use a syringe for precise administration
and to ensure the full dose is given.
4. The mother of a 3-year-old child asks the nurse for tips on how to help the child
take oral medication. Which of the following suggestions is most appropriate?
A) "Tell the child it is candy to make it more appealing."
B) "Mix the medication into a small amount of applesauce or pudding."
C) "Hold the child's nose to force them to swallow."
D) "Offer the medication only when the child is crying."
Correct Answer: "Mix the medication into a small amount of applesauce or
pudding."
, Rationale: Mixing medication with a small amount of soft food, like applesauce or
pudding, can make it more palatable for a young child. The child should be told the
truth about the medication, and forcing or tricking the child can lead to distrust. The
medication should be given when the child is calm.
5. A nurse is administering ear drops to a 6-month-old infant. To properly instill the
drops, how should the nurse position the pinna?
A) Pull the pinna down and back
B) Pull the pinna up and back
C) Pull the pinna straight out
D) Leave the pinna in its natural position
Correct Answer: Pull the pinna down and back
Rationale: For children under 3 years of age, the pinna should be pulled down and
back to straighten the ear canal. For children over 3 years, the pinna is pulled up and
back. This technique ensures proper delivery of the drops to the tympanic
membrane.
6. A nurse is providing teaching to the parents of a child who requires a metered-
dose inhaler (MDI) with a spacer. Which of the following instructions should the
nurse include?
A) "Administer two puffs into the spacer at the same time."
B) "Have the child exhale fully before placing the spacer in the mouth."
C) "Hold the spacer with the mouthpiece pointing downward."
D) "Have the child inhale rapidly and deeply."
Correct Answer: "Have the child exhale fully before placing the spacer in the
mouth."
Q&A PDF | Rasmussen College
1. Which of the following is the priority nursing intervention for a hospitalized child
who is experiencing significant stress from being in an unfamiliar environment?
A) Encourage the parents to visit only during designated hours
B) Maintain a strict schedule of all nursing procedures
C) Provide age-appropriate activities and allow parental presence
D) Limit the child's contact with other children on the unit
Correct Answer: Provide age-appropriate activities and allow parental presence
Rationale: Hospitalization is a major stressor for children, often leading to anxiety
and regression. The primary intervention to reduce this stress is to maintain the
child's routine as much as possible, provide age-appropriate play and activities, and
encourage parental presence and participation in care. This approach supports the
child's emotional and developmental needs.
2. A nurse is calculating the daily maintenance fluid requirement for a child who
weighs 22 kg. Using the 4-2-1 rule, which of the following is the correct rate in
mL/hr?
A) 55 mL/hr
B) 62 mL/hr
C) 70 mL/hr
D) 88 mL/hr
Correct Answer: 62 mL/hr
,Rationale: The 4-2-1 rule calculates hourly maintenance fluids: 4 mL/kg for the first
10 kg (40 mL), 2 mL/kg for the next 10 kg (20 mL), and 1 mL/kg for each remaining
kg (2 mL). The total is 62 mL/hr. This formula is a standard method for estimating
fluid needs in pediatric patients.
3. A school-age child is prescribed oral liquid medication. Which of the following
actions by the nurse is most appropriate to ensure the child takes the full dose?
A) Mix the medication with a full glass of the child's favorite juice
B) Administer the medication using a calibrated oral syringe
C) Ask the child to hold their nose while swallowing
D) Allow the child to drink the medication directly from the medicine bottle
Correct Answer: Administer the medication using a calibrated oral syringe
Rationale: A calibrated oral syringe ensures accurate measurement of the prescribed
dose. Mixing medication with a large volume of juice may result in the child not
consuming the entire dose. The nurse should use a syringe for precise administration
and to ensure the full dose is given.
4. The mother of a 3-year-old child asks the nurse for tips on how to help the child
take oral medication. Which of the following suggestions is most appropriate?
A) "Tell the child it is candy to make it more appealing."
B) "Mix the medication into a small amount of applesauce or pudding."
C) "Hold the child's nose to force them to swallow."
D) "Offer the medication only when the child is crying."
Correct Answer: "Mix the medication into a small amount of applesauce or
pudding."
, Rationale: Mixing medication with a small amount of soft food, like applesauce or
pudding, can make it more palatable for a young child. The child should be told the
truth about the medication, and forcing or tricking the child can lead to distrust. The
medication should be given when the child is calm.
5. A nurse is administering ear drops to a 6-month-old infant. To properly instill the
drops, how should the nurse position the pinna?
A) Pull the pinna down and back
B) Pull the pinna up and back
C) Pull the pinna straight out
D) Leave the pinna in its natural position
Correct Answer: Pull the pinna down and back
Rationale: For children under 3 years of age, the pinna should be pulled down and
back to straighten the ear canal. For children over 3 years, the pinna is pulled up and
back. This technique ensures proper delivery of the drops to the tympanic
membrane.
6. A nurse is providing teaching to the parents of a child who requires a metered-
dose inhaler (MDI) with a spacer. Which of the following instructions should the
nurse include?
A) "Administer two puffs into the spacer at the same time."
B) "Have the child exhale fully before placing the spacer in the mouth."
C) "Hold the spacer with the mouthpiece pointing downward."
D) "Have the child inhale rapidly and deeply."
Correct Answer: "Have the child exhale fully before placing the spacer in the
mouth."
