Pediatric Nursing A Case-Based Approach
2nd Edition | Tagher Knapp Test Bank |
Questions and Answers | Complete Review
Question 1
Which intervention is appropriate for the infant hospitalized with bronchiolitis?
A) Administer antibiotics as prescribed
B) Give cool, humidified oxygen
C) Restrict oral fluids
D) Place in a mist tent with high humidity
Answer: B) Give cool, humidified oxygen
Explanation: Cool, humidified oxygen relieves dyspnea and hypoxemia associated with bronchiolitis. The
etiology is viral, so antibiotics are not routinely given. Tachypnea increases insensible fluid loss, so fluids
are often given parenterally if needed.
Question 2
An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial virus (RSV).
The nurse knows that a child infected with this virus requires what type of isolation?
A) Airborne Precautions
B) Droplet Precautions
C) Contact Precautions
D) Standard Precautions only
Answer: C) Contact Precautions
Explanation: RSV is transmitted through droplets and contact. In addition to Standard Precautions,
Contact Precautions (gloves, gown) are required. It is not airborne.
,Question 3
The nurse is caring for a child hospitalized for status asthmaticus. Which assessment finding suggests
that the child's condition is worsening?
A) Tachycardia
B) Hypoventilation
C) Increased wheezing
D) Restlessness
Answer: B) Hypoventilation
Explanation: As a child tires from the increased work of breathing, hypoventilation occurs, leading to
increased carbon dioxide levels. Bradycardia is not a sign of hypoxia; tachycardia is.
Question 4
A 2-year-old child is brought to the emergency department with a sudden onset of a harsh, barking
cough, stridor, and respiratory distress that is worse at night. Which of the following nursing
interventions is the priority?
A) Administer prescribed antibiotics
B) Provide cool mist humidification and maintain a calm environment
C) Place the child in a supine position
D) Obtain a throat culture immediately
Answer: B) Provide cool mist humidification and maintain a calm environment
Explanation: The symptoms are classic for croup. Cool mist helps reduce airway edema. Keeping the
child calm is critical because crying and agitation can worsen airway obstruction.
Question 5
When evaluating a child's hydration status, the nurse knows that the earliest sign of dehydration is:
A) Sunken fontanel
B) Tachycardia
C) Decreased urine output
D) Dry mucous membranes
Answer: B) Tachycardia
Explanation: Tachycardia is often the earliest cardiovascular compensatory sign. Late signs include
sunken fontanel and oliguria (decreased urine output).
Question 6
,A nurse is assessing a 6-month-old infant who has been vomiting and has had diarrhea for two days.
Which of the following findings indicates the most severe dehydration?
A) Sunken fontanel
B) Dry mucous membranes
C) Lethargy and delayed capillary refill greater than 3 seconds
D) Decreased tear production
Answer: C) Lethargy and delayed capillary refill greater than 3 seconds
Explanation: Lethargy and prolonged capillary refill are signs of severe dehydration (shock) indicating a
critical decrease in intravascular volume.
Question 7
Non-pharmacological pain management for an infant undergoing a heel stick includes:
A) Distraction with a mobile
B) Sucrose solution and non-nutritive sucking
C) Guided imagery
D) Deep breathing exercises
Answer: B) Sucrose solution and non-nutritive sucking
Explanation: Sucrose with a pacifier is an evidence-based intervention for procedural pain in infants less
than 12 months old.
Question 8
The nurse understands that which statement about children and opioids is true?
A) PCA is contraindicated in children under 12 years
B) PCA is safe for children as young as 7 years
C) Opioids should never be used in children
D) Meperidine is the preferred opioid for children
Answer: B) PCA is safe for children as young as 7 years
Explanation: PCA is safe for children as young as 7 years old, as they can understand the concept of
pressing a button for pain relief.
Question 9
Which pain assessment tool is most appropriate for a nonverbal child with cognitive impairment?
A) Numeric rating scale
B) Wong-Baker FACES scale
, C) FLACC scale
D) Visual analog scale
Answer: C) FLACC scale
Explanation: The FLACC (or revised FLACC) scale is validated for nonverbal or cognitively impaired
children.
Question 10
When infants are seen for fractures, which nursing intervention is a priority?
A) Apply a splint immediately
B) Assess for child abuse
C) Obtain a complete blood count
D) Administer pain medication
Answer: B) Assess for child abuse
Explanation: Fractures in infants are not common due to the cartilaginous quality of the skeleton. A
large amount of force is necessary to fracture their bones, so fractures in infancy are often
nonaccidental and warrant further investigation.
Question 11
A mother whose 7-year-old child has been placed in a cast for a fractured right arm reports he will not
stop crying even after taking Tylenol with codeine. He also will not straighten the fingers on his right
arm. The nurse tells the mother to do which?
A) Elevate the arm and apply ice
B) Give another dose of pain medication
C) Take him to the emergency department
D) Loosen the cast at home
Answer: C) Take him to the emergency department
Explanation: Unrelieved pain and the inability to extend fingers are signs of compartmental syndrome, a
medical emergency requiring immediate attention.
Question 12
The nurse assessing a child with acute poststreptococcal glomerulonephritis should be alert for which
finding?
A) Tea-colored urine
B) Polyuria
2nd Edition | Tagher Knapp Test Bank |
Questions and Answers | Complete Review
Question 1
Which intervention is appropriate for the infant hospitalized with bronchiolitis?
A) Administer antibiotics as prescribed
B) Give cool, humidified oxygen
C) Restrict oral fluids
D) Place in a mist tent with high humidity
Answer: B) Give cool, humidified oxygen
Explanation: Cool, humidified oxygen relieves dyspnea and hypoxemia associated with bronchiolitis. The
etiology is viral, so antibiotics are not routinely given. Tachypnea increases insensible fluid loss, so fluids
are often given parenterally if needed.
Question 2
An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial virus (RSV).
The nurse knows that a child infected with this virus requires what type of isolation?
A) Airborne Precautions
B) Droplet Precautions
C) Contact Precautions
D) Standard Precautions only
Answer: C) Contact Precautions
Explanation: RSV is transmitted through droplets and contact. In addition to Standard Precautions,
Contact Precautions (gloves, gown) are required. It is not airborne.
,Question 3
The nurse is caring for a child hospitalized for status asthmaticus. Which assessment finding suggests
that the child's condition is worsening?
A) Tachycardia
B) Hypoventilation
C) Increased wheezing
D) Restlessness
Answer: B) Hypoventilation
Explanation: As a child tires from the increased work of breathing, hypoventilation occurs, leading to
increased carbon dioxide levels. Bradycardia is not a sign of hypoxia; tachycardia is.
Question 4
A 2-year-old child is brought to the emergency department with a sudden onset of a harsh, barking
cough, stridor, and respiratory distress that is worse at night. Which of the following nursing
interventions is the priority?
A) Administer prescribed antibiotics
B) Provide cool mist humidification and maintain a calm environment
C) Place the child in a supine position
D) Obtain a throat culture immediately
Answer: B) Provide cool mist humidification and maintain a calm environment
Explanation: The symptoms are classic for croup. Cool mist helps reduce airway edema. Keeping the
child calm is critical because crying and agitation can worsen airway obstruction.
Question 5
When evaluating a child's hydration status, the nurse knows that the earliest sign of dehydration is:
A) Sunken fontanel
B) Tachycardia
C) Decreased urine output
D) Dry mucous membranes
Answer: B) Tachycardia
Explanation: Tachycardia is often the earliest cardiovascular compensatory sign. Late signs include
sunken fontanel and oliguria (decreased urine output).
Question 6
,A nurse is assessing a 6-month-old infant who has been vomiting and has had diarrhea for two days.
Which of the following findings indicates the most severe dehydration?
A) Sunken fontanel
B) Dry mucous membranes
C) Lethargy and delayed capillary refill greater than 3 seconds
D) Decreased tear production
Answer: C) Lethargy and delayed capillary refill greater than 3 seconds
Explanation: Lethargy and prolonged capillary refill are signs of severe dehydration (shock) indicating a
critical decrease in intravascular volume.
Question 7
Non-pharmacological pain management for an infant undergoing a heel stick includes:
A) Distraction with a mobile
B) Sucrose solution and non-nutritive sucking
C) Guided imagery
D) Deep breathing exercises
Answer: B) Sucrose solution and non-nutritive sucking
Explanation: Sucrose with a pacifier is an evidence-based intervention for procedural pain in infants less
than 12 months old.
Question 8
The nurse understands that which statement about children and opioids is true?
A) PCA is contraindicated in children under 12 years
B) PCA is safe for children as young as 7 years
C) Opioids should never be used in children
D) Meperidine is the preferred opioid for children
Answer: B) PCA is safe for children as young as 7 years
Explanation: PCA is safe for children as young as 7 years old, as they can understand the concept of
pressing a button for pain relief.
Question 9
Which pain assessment tool is most appropriate for a nonverbal child with cognitive impairment?
A) Numeric rating scale
B) Wong-Baker FACES scale
, C) FLACC scale
D) Visual analog scale
Answer: C) FLACC scale
Explanation: The FLACC (or revised FLACC) scale is validated for nonverbal or cognitively impaired
children.
Question 10
When infants are seen for fractures, which nursing intervention is a priority?
A) Apply a splint immediately
B) Assess for child abuse
C) Obtain a complete blood count
D) Administer pain medication
Answer: B) Assess for child abuse
Explanation: Fractures in infants are not common due to the cartilaginous quality of the skeleton. A
large amount of force is necessary to fracture their bones, so fractures in infancy are often
nonaccidental and warrant further investigation.
Question 11
A mother whose 7-year-old child has been placed in a cast for a fractured right arm reports he will not
stop crying even after taking Tylenol with codeine. He also will not straighten the fingers on his right
arm. The nurse tells the mother to do which?
A) Elevate the arm and apply ice
B) Give another dose of pain medication
C) Take him to the emergency department
D) Loosen the cast at home
Answer: C) Take him to the emergency department
Explanation: Unrelieved pain and the inability to extend fingers are signs of compartmental syndrome, a
medical emergency requiring immediate attention.
Question 12
The nurse assessing a child with acute poststreptococcal glomerulonephritis should be alert for which
finding?
A) Tea-colored urine
B) Polyuria
