PEDIATRIC PRACTICE FREQUENTLY TESTED ACTUAL
EXAM QUESTIONS WITH CORRECT ANSWERS
Question 1.
A 3-week-old newborn is brought to the clinic for follow-up after a home birth.
The mother reports that her child bottle feeds for 5 minutes only and then falls asleep. The nurse
auscultates a loud murmur characteristic of a ventricular septal defect (VSD), and finds the newborn
is acyanotic with a respiratory rate of 64 breaths per minute. What instruction should the nurse
provide the mother to ensure the infant is receiving adequate intake? (Select all that apply.)
A. Monitor the the infant's weight and number of wet diapers per day.
B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
C. Mix the dose of prophylactic antibiotic in a full bottle of formula.
D. Allow the infant to rest and refeed on demand or every 2 hours.
E. Use a softer nipple or increase the size of the nipple opening.
ANSWER
A. Monitor the the infant's weight and number of wet diapers per day.
B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
D. Allow the infant to rest and refeed on demand or every 2 hours.
E. Use a softer nipple or increase the size of the nipple opening.
-Correct responses are (A, B, D, and E). Neonates who have VSD may fatigue quickly during
feeding and ingest inadequate amounts. They should be monitored for weight gain and at
least 6 wet diapers per day (A). A one-month old infant should ingest 2 to 4 ounces of formula
per feeding and progress
to about 30 ounces per day by 4-months of age (B). Due to fatigue, the infant should rest, but
feed at least every 2 hours to ensure adequate intake (D). A softer (preemie) nipple or a larger
slit in the nipple (E) helps to reduce the sucking effort and energy expenditure, thus allowing
the infant to ingest more with less effort. Antibiotic prophylaxis is recommended for infants
with VSDs, but should not be mixed in a bottle of formula (C) because it is difficult to ensure
that the total dose is consumed.
,Question 2.
A 3-month-old infant develops oral thrush. Which pharmacologic agent should the nurse plan to
administer for treatment of this disorder?
A. Nystatin (Mycostatin).
B. Nitrofurantoin (Macrodantin).
C. Norfloxacin (Noroxin).
D. Neomycin sulfate (Mycifradin).
ANSWER
A. Nystatin (Mycostatin).
-Nystatin (Mycostatin) (A) is an antifungal drug that is effective in treating thrush, an oral
fungal infection. (B, C, and D) are not indicated for the treatment of oral thrush.
Question 3.
When taking the health history of a child, the nurse knows that which finding is an early indication of
hypothyroidism in children?
A. Hyperactive behavioral traits.
B. Delay in the eruption of permanent teeth.
C. Slow sexual development, but within normal range.
D. Cessation of growth in a child that had been normal.
ANSWER
D. Cessation of growth in a child that had been normal.
-Since the thyroid gland is responsible for metabolism, cessation of growth (D) which was
previously within normal range, is the most common sign for hypothyroidism in children. The
child with hypothyroidism is likely to be HYPOactive, not (A). Although (B and C) may occur
with hypothyroidism, they are late signs (not early indications) and are signs more often
associated with a lack of growth hormone.
,Question 4.
Which measurements should be used to accurately calculate a pediatric medication dosage? (Select
all that apply.)
A. Child's height and weight.
B. Adult dosage of medication.
C. Body surface area of child.
D. Average adult's body surface area.
E. Average pediatric dosage of medication.
F. Nomogram determined mathematical constant.
ANSWER
A. Child's height and weight.
C. Body surface area of child.
F. Nomogram determined mathematical constant.
-Correct selections are (A, C, and F). The most accurate calculations of pediatric dosages use
the child's height and weight (A). The child's BSA is calculated using the square root of
weight in kg times height in cm divided by 3600 or the square root of weight in lb times height
in inches divided by 3131 (C), then the child's BSA is multiplied by the recommended
published dose per BSA. The nomogram (F) is used to plot the child's height and weight, and
the point at which they intersect is the BSA mathematical constant used to calculate the
child's dose. (B, D, and E) are not used to calculate pediatric dosages.
Question 5.
An infant is born with a ventricular septal defect (VSD) and surgery is planned to correct the defect.
The nurse recognizes that surgical correction is designed to achieve which outcome?
A. Stop the flow of unoxygenated blood into systemic circulation.
B. Increase the flow of unoxygenated blood to the lungs.
C. Prevent the return of oxygenated blood to the lungs.
D. Reduce peripheral tissue hypoxia and nailbed clubbing.
ANSWER
C. Prevent the return of oxygenated blood to the lungs
-Closure of VSDs stops oxygenated blood from being shunted from the left ventricle to the
right ventricle (C). VSDs are acyanotic defects, which means that no unoxygenated blood
enters the systemic circulation (A and B). (D) is common with Tetrology of Fallot, which is a
cyanotic defect.
, Question 6.
During routine screening at a school clinic, an otoscope examination of a child's ear reveals a
tympanic membrane that is pearly gray, slightly bulging, and not movable. What action should the
nurse take next?
A. No action required, as this is an expected finding for a school-aged child.
B. Ask the child if he/she has had a cold, runny nose, or any ear pain lately.
C. Send a note home advising the parents to have the child evaluated by a healthcare provider as
soon as possible.
D. Call the parents and have them take the child home from school for the rest of the day.
ANSWER
B. Ask the child if he/she has had a cold, runny nose, or any ear pain lately.
-More information is needed to interpret these findings (B). The tympanic membrane is
normally pearly gray, not bulging, and moves when the client blows against resistance or a
small puff of air is blown into the ear canal. Since this child's findings are not completely
normal, further assessment of history and related signs and symptoms is indicated for
accurate interpretation of the findings. (A, C, and D) are inappropriate actions based on the
data obtained from the otoscope examination.
Question 7.
A female teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. What is the most
important instruction for the nurse to include in this client's teaching plan?
A. "Use sunscreen when lying by the pool."
B. "Cleanse the skin at least 4 times a day."
C. "Take the medication with a glass of milk."
D. "Menstrual periods may become irregular."
ANSWER
A. "Use sunscreen when lying by the pool."
-Photosensitivity is a common side effect of tetracycline HCL (Achromycin V) therapy. Severe
sunburn can occur with minimal sun exposure and clients should be instructed to avoid
sunlight and to use sunscreen (A). (B and D) are not related to tetracycline HCL (Achromycin
V) therapy. (C) should be avoided because dairy products interfere with the absorption of
tetracyclines.
EXAM QUESTIONS WITH CORRECT ANSWERS
Question 1.
A 3-week-old newborn is brought to the clinic for follow-up after a home birth.
The mother reports that her child bottle feeds for 5 minutes only and then falls asleep. The nurse
auscultates a loud murmur characteristic of a ventricular septal defect (VSD), and finds the newborn
is acyanotic with a respiratory rate of 64 breaths per minute. What instruction should the nurse
provide the mother to ensure the infant is receiving adequate intake? (Select all that apply.)
A. Monitor the the infant's weight and number of wet diapers per day.
B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
C. Mix the dose of prophylactic antibiotic in a full bottle of formula.
D. Allow the infant to rest and refeed on demand or every 2 hours.
E. Use a softer nipple or increase the size of the nipple opening.
ANSWER
A. Monitor the the infant's weight and number of wet diapers per day.
B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
D. Allow the infant to rest and refeed on demand or every 2 hours.
E. Use a softer nipple or increase the size of the nipple opening.
-Correct responses are (A, B, D, and E). Neonates who have VSD may fatigue quickly during
feeding and ingest inadequate amounts. They should be monitored for weight gain and at
least 6 wet diapers per day (A). A one-month old infant should ingest 2 to 4 ounces of formula
per feeding and progress
to about 30 ounces per day by 4-months of age (B). Due to fatigue, the infant should rest, but
feed at least every 2 hours to ensure adequate intake (D). A softer (preemie) nipple or a larger
slit in the nipple (E) helps to reduce the sucking effort and energy expenditure, thus allowing
the infant to ingest more with less effort. Antibiotic prophylaxis is recommended for infants
with VSDs, but should not be mixed in a bottle of formula (C) because it is difficult to ensure
that the total dose is consumed.
,Question 2.
A 3-month-old infant develops oral thrush. Which pharmacologic agent should the nurse plan to
administer for treatment of this disorder?
A. Nystatin (Mycostatin).
B. Nitrofurantoin (Macrodantin).
C. Norfloxacin (Noroxin).
D. Neomycin sulfate (Mycifradin).
ANSWER
A. Nystatin (Mycostatin).
-Nystatin (Mycostatin) (A) is an antifungal drug that is effective in treating thrush, an oral
fungal infection. (B, C, and D) are not indicated for the treatment of oral thrush.
Question 3.
When taking the health history of a child, the nurse knows that which finding is an early indication of
hypothyroidism in children?
A. Hyperactive behavioral traits.
B. Delay in the eruption of permanent teeth.
C. Slow sexual development, but within normal range.
D. Cessation of growth in a child that had been normal.
ANSWER
D. Cessation of growth in a child that had been normal.
-Since the thyroid gland is responsible for metabolism, cessation of growth (D) which was
previously within normal range, is the most common sign for hypothyroidism in children. The
child with hypothyroidism is likely to be HYPOactive, not (A). Although (B and C) may occur
with hypothyroidism, they are late signs (not early indications) and are signs more often
associated with a lack of growth hormone.
,Question 4.
Which measurements should be used to accurately calculate a pediatric medication dosage? (Select
all that apply.)
A. Child's height and weight.
B. Adult dosage of medication.
C. Body surface area of child.
D. Average adult's body surface area.
E. Average pediatric dosage of medication.
F. Nomogram determined mathematical constant.
ANSWER
A. Child's height and weight.
C. Body surface area of child.
F. Nomogram determined mathematical constant.
-Correct selections are (A, C, and F). The most accurate calculations of pediatric dosages use
the child's height and weight (A). The child's BSA is calculated using the square root of
weight in kg times height in cm divided by 3600 or the square root of weight in lb times height
in inches divided by 3131 (C), then the child's BSA is multiplied by the recommended
published dose per BSA. The nomogram (F) is used to plot the child's height and weight, and
the point at which they intersect is the BSA mathematical constant used to calculate the
child's dose. (B, D, and E) are not used to calculate pediatric dosages.
Question 5.
An infant is born with a ventricular septal defect (VSD) and surgery is planned to correct the defect.
The nurse recognizes that surgical correction is designed to achieve which outcome?
A. Stop the flow of unoxygenated blood into systemic circulation.
B. Increase the flow of unoxygenated blood to the lungs.
C. Prevent the return of oxygenated blood to the lungs.
D. Reduce peripheral tissue hypoxia and nailbed clubbing.
ANSWER
C. Prevent the return of oxygenated blood to the lungs
-Closure of VSDs stops oxygenated blood from being shunted from the left ventricle to the
right ventricle (C). VSDs are acyanotic defects, which means that no unoxygenated blood
enters the systemic circulation (A and B). (D) is common with Tetrology of Fallot, which is a
cyanotic defect.
, Question 6.
During routine screening at a school clinic, an otoscope examination of a child's ear reveals a
tympanic membrane that is pearly gray, slightly bulging, and not movable. What action should the
nurse take next?
A. No action required, as this is an expected finding for a school-aged child.
B. Ask the child if he/she has had a cold, runny nose, or any ear pain lately.
C. Send a note home advising the parents to have the child evaluated by a healthcare provider as
soon as possible.
D. Call the parents and have them take the child home from school for the rest of the day.
ANSWER
B. Ask the child if he/she has had a cold, runny nose, or any ear pain lately.
-More information is needed to interpret these findings (B). The tympanic membrane is
normally pearly gray, not bulging, and moves when the client blows against resistance or a
small puff of air is blown into the ear canal. Since this child's findings are not completely
normal, further assessment of history and related signs and symptoms is indicated for
accurate interpretation of the findings. (A, C, and D) are inappropriate actions based on the
data obtained from the otoscope examination.
Question 7.
A female teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. What is the most
important instruction for the nurse to include in this client's teaching plan?
A. "Use sunscreen when lying by the pool."
B. "Cleanse the skin at least 4 times a day."
C. "Take the medication with a glass of milk."
D. "Menstrual periods may become irregular."
ANSWER
A. "Use sunscreen when lying by the pool."
-Photosensitivity is a common side effect of tetracycline HCL (Achromycin V) therapy. Severe
sunburn can occur with minimal sun exposure and clients should be instructed to avoid
sunlight and to use sunscreen (A). (B and D) are not related to tetracycline HCL (Achromycin
V) therapy. (C) should be avoided because dairy products interfere with the absorption of
tetracyclines.
