NR 328 CMS EXAM -PEDIATRIC NURSING |ACTUAL
QUESTIONS AND VERIFIED ANSWERS|BRAND NEW
2026-2027 UPDATE|GRADED A+
Question 1
Which interventions are included in the management of nosebleeds in children? Select all
that apply.
a. Apply warm compresses to the bridge of the nose if bleeding is persistent.
b. Apply continuous pressure to the nose with thumb and forefinger for at least 10 minutes.
c. Have the child sit down and tilt the head backward.
d. Insert cotton or wadded tissue into each nostril if bleeding persists.
e. Instruct the child to breathe through the mouth.
CORRECT ANSWER
Answer: B, D, E
Rationale: During a nosebleed, the child should be instructed to breathe through the
mouth, cotton or wadded tissue can be inserted into the nostrils to stop bleeding, and
continuous pressure using the thumb and forefinger should be applied for at least 10
minutes. The child should be instructed to sit up and lean forward, not tilt the head
backward. Ice or cold cloths, not warm compresses, can be used on the bridge of the
nose if bleeding persists.
Question 2
The nurse is developing a teaching plan for the family of a toddler recently diagnosed with
sickle cell disease. Of which does the nurse include as important for the family to be aware
and to report in order to recognize signs of the major cause of death for children under
age 5 with sickle cell disease?
a. Presence of respiratory problems
b. Signs and symptoms of stroke
c. Localized swelling over joints
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@THE STUDY VAULT
,d. Presence of fever
CORRECT ANSWER
Answer: D
Rationale: The major cause of death for children with sickle cell disease under the age of
5 is overwhelming infections; thus the family needs to monitor the child closely for
presence of fever. Signs and symptoms of stroke, presence of respiratory problems, and
localized swelling over joints are also symptoms of issues related to sickle cell disease,
but are not directly related to the leading cause of death for children under the age of 5.
Question 3
Which symptom would the nurse recognize as an acquired immunodeficiency syndrome
(AIDS)-defining condition in an American child with human immunodeficiency virus (HIV)?
a. Parotitis
b. Cytomegalovirus
c. Oral candidiasis
d. Hepatosplenomegaly
CORRECT ANSWER
Answer: B
Rationale: Cytomegalovirus is a defining condition for AIDS in an HIV-infected American
child. Parotitis, oral candidiasis, and hepatosplenomegaly are common clinical
manifestations of HIV infection in children but not AIDS-defining conditions.
Question 4
The nurse is administering a blood transfusion to a child for treatment of hemophilia.
Upon assessment, the nurse notes that the child is cyanotic, has difficulty breathing, and
has rales upon inspiration throughout the lung fields. What is the nurse's best response to
these findings?
a. Stop the transfusion immediately.
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@THE STUDY VAULT
, b. Administer epinephrine immediately.
c. Insert a urinary catheter and monitor hourly outputs.
d. Reassess the patient again in five minutes.
CORRECT ANSWER
Answer: A
Rationale: Cyanosis, rales, and difficulty breathing are all potential signs of circulatory
overload. If signs of circulatory overload occur, the transfusion should be stopped
immediately. Reassessing the patient in five minutes would not provide an immediate
response to the situation. Epinephrine is administered for allergic reactions. Insertion of
a urinary catheter may be done to treat an incompatibility reaction.
Question 5
The nurse is teaching the family of a child diagnosed with iron-deficiency anemia about
the proper administration of iron supplements. Which points should the nurse include in
the education session? Select all that apply.
a. Stop the medication and call the primary care provider if tarry stools are noted.
b. Administer with milk products to alter the taste if taste is an issue.
c. Administer in two divided doses between meals.
d. Administer with citrus fruits or juices to increase absorption.
e. Use a straw to administer the iron if it is in liquid form.
CORRECT ANSWER
Answer: C, D, E
Rationale: The family should be instructed to administer the iron supplement in two
divided doses between meals, when free hydrochloric acid is at its greatest levels to aid
in absorption. Using a straw for liquid iron is recommended to avoid staining the teeth.
Citrus fruits or juices also help increase acidity and therefore absorption of the iron. Milk
products bind the iron and interfere with absorption and should not be used with
administration of iron. Tarry stools are an expected change with iron supplements, and
therefore calling the primary care provider is not necessary
3
@THE STUDY VAULT
QUESTIONS AND VERIFIED ANSWERS|BRAND NEW
2026-2027 UPDATE|GRADED A+
Question 1
Which interventions are included in the management of nosebleeds in children? Select all
that apply.
a. Apply warm compresses to the bridge of the nose if bleeding is persistent.
b. Apply continuous pressure to the nose with thumb and forefinger for at least 10 minutes.
c. Have the child sit down and tilt the head backward.
d. Insert cotton or wadded tissue into each nostril if bleeding persists.
e. Instruct the child to breathe through the mouth.
CORRECT ANSWER
Answer: B, D, E
Rationale: During a nosebleed, the child should be instructed to breathe through the
mouth, cotton or wadded tissue can be inserted into the nostrils to stop bleeding, and
continuous pressure using the thumb and forefinger should be applied for at least 10
minutes. The child should be instructed to sit up and lean forward, not tilt the head
backward. Ice or cold cloths, not warm compresses, can be used on the bridge of the
nose if bleeding persists.
Question 2
The nurse is developing a teaching plan for the family of a toddler recently diagnosed with
sickle cell disease. Of which does the nurse include as important for the family to be aware
and to report in order to recognize signs of the major cause of death for children under
age 5 with sickle cell disease?
a. Presence of respiratory problems
b. Signs and symptoms of stroke
c. Localized swelling over joints
1
@THE STUDY VAULT
,d. Presence of fever
CORRECT ANSWER
Answer: D
Rationale: The major cause of death for children with sickle cell disease under the age of
5 is overwhelming infections; thus the family needs to monitor the child closely for
presence of fever. Signs and symptoms of stroke, presence of respiratory problems, and
localized swelling over joints are also symptoms of issues related to sickle cell disease,
but are not directly related to the leading cause of death for children under the age of 5.
Question 3
Which symptom would the nurse recognize as an acquired immunodeficiency syndrome
(AIDS)-defining condition in an American child with human immunodeficiency virus (HIV)?
a. Parotitis
b. Cytomegalovirus
c. Oral candidiasis
d. Hepatosplenomegaly
CORRECT ANSWER
Answer: B
Rationale: Cytomegalovirus is a defining condition for AIDS in an HIV-infected American
child. Parotitis, oral candidiasis, and hepatosplenomegaly are common clinical
manifestations of HIV infection in children but not AIDS-defining conditions.
Question 4
The nurse is administering a blood transfusion to a child for treatment of hemophilia.
Upon assessment, the nurse notes that the child is cyanotic, has difficulty breathing, and
has rales upon inspiration throughout the lung fields. What is the nurse's best response to
these findings?
a. Stop the transfusion immediately.
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@THE STUDY VAULT
, b. Administer epinephrine immediately.
c. Insert a urinary catheter and monitor hourly outputs.
d. Reassess the patient again in five minutes.
CORRECT ANSWER
Answer: A
Rationale: Cyanosis, rales, and difficulty breathing are all potential signs of circulatory
overload. If signs of circulatory overload occur, the transfusion should be stopped
immediately. Reassessing the patient in five minutes would not provide an immediate
response to the situation. Epinephrine is administered for allergic reactions. Insertion of
a urinary catheter may be done to treat an incompatibility reaction.
Question 5
The nurse is teaching the family of a child diagnosed with iron-deficiency anemia about
the proper administration of iron supplements. Which points should the nurse include in
the education session? Select all that apply.
a. Stop the medication and call the primary care provider if tarry stools are noted.
b. Administer with milk products to alter the taste if taste is an issue.
c. Administer in two divided doses between meals.
d. Administer with citrus fruits or juices to increase absorption.
e. Use a straw to administer the iron if it is in liquid form.
CORRECT ANSWER
Answer: C, D, E
Rationale: The family should be instructed to administer the iron supplement in two
divided doses between meals, when free hydrochloric acid is at its greatest levels to aid
in absorption. Using a straw for liquid iron is recommended to avoid staining the teeth.
Citrus fruits or juices also help increase acidity and therefore absorption of the iron. Milk
products bind the iron and interfere with absorption and should not be used with
administration of iron. Tarry stools are an expected change with iron supplements, and
therefore calling the primary care provider is not necessary
3
@THE STUDY VAULT
