Pediatric NCLEX Questions and Answers A+ Level 2023

Pediatric NCLEX Questions and Answers A+ Level 2023 After a tonsillectomy and adenoidectomy, which finding should alert the nurse to suspect early hemorrhage in a 5-year-old child? a. drooling of bright red secretions b. pulse rate of 95 bpm c. vomiting of 25 mL of dark brown emesis d. BP of 95/56 mm HG - Answer: a. drooling of bright red secretions A nurse is teaching the parents of a pre-schooler about the possibility of postoperative hemorrhage after a tonsillectomy and adenoidectomy. When should the nurse explain that the risk of bleeding is the greatest? a. 1-3 days post-op b. 4-6 days post-op c. 7-10 days post-op d. 11-14 days post-op - Answer: c. 7-10 days post-op Which assessment findings should lead the nurse to suspect that a toddler is experiencing respiratory distress? Select all that apply. a. coughing b. respiratory rate of 35 breaths/min c. heart rate of 95 beats/min d. restlessness e. malaise f. diaphoresis - Answers: a. coughing b. respiratory rate of 35 breaths/min d. restlessness f. diaphoresis A child with cystic fibrosis is receiving gentamicin. Which nursing action is most appropriate? a. monitoring intake and output b. obtaining daily weights c. monitoring the client for indications of constipation d. obtaining stool samples for hemoccult testing - Answer: a. monitoring intake and output What type of diet should the nurse teach the parents to give an older infant with cystic fibrosis? a. low-protein diet b. high-fat diet c. low-carbohydrate diet d. high-calorie diet - Answer: d. high-calorie diet At a follow-up appointment after being hospitalized, an adolescent with a history of cystic fibrosis describes his stool to the nurse. Which description should the nurse interpret as indicative of continued problems with malabsorption? a. soft with little odor b. large and foul-smelling c. loose with bits of food d. hard with streaks of blood - Answer: b. large and foul-smelling When explaining to parents how to reduce the risk of sudden infant death syndrome (SIDS), the nurse should teach about which measures? Select all that apply. a. maintain a smoke-free environment b. use a wedge for side-lying positions c. breast-feed the baby d. place the baby on his or her back to sleep e. use bumper pads over the bed rails f. have the baby sleep in the parent's bed - Answer: a. maintain a smoke-free environment c. breast-feed the baby d. place the baby on his or her back to sleep The parent of a 16-month-old child calls the clinic because the child has a low-grade fever, cold symptoms, and a hoarse cough. What should the nurse suggest that the parent do? a. offer extra fluids frequently b. bring the child to the clinic immediately c. count the child's respiratory rate d. use a hot air vaporizer - Answer: a. offer extra fluids frequently A child has viral pharyngitis. What should the nurse advise the parents to do? Select all that apply. a. use a cool mist vaporizer b. offer a soft-to-liquid diet c. administer amoxicillin d. administer acetaminophen e. place the child on secretion precautions - Answer: a. use a cool mist vaporizer b. offer a soft-to-liquid diet d. administer acetaminophen An infant is being treated at home for bronchiolitis. What should the nurse teach the parent about home care? Select all that apply. a. offering small amounts of fluids frequently b. allowing the infant to sleep prone c. calling the clinic if the infant vomits d. writing down how much the infant drinks e. performing chest physiotherapy every 4 hours f. watching for difficulty breathing - Answer: a. offering small amounts of fluids frequently f. watching for difficulty breathing A teaching care plan to prevent transmission of respiratory syncytial virus (RSV) should include what information? Select all that apply. a. the virus can be spread by direct contact b. the virus can be spread by indirect contact c. palivizumab is recommended to prevent RSV for all toddlers in daycare d. the virus is typically contagious for 3 weeks e. older children seldom spread RSV f. frequent hand-washing helps reduce the spread of RSV - Answer: a. the virus can be spread by direct contact b. the virus can be spread by indirect contact f. frequent hand-washing helps reduce the spread of RSV A charge nurse is making assignments for a group of children on a pediatric unit. The nurse should MOST avoid assigning the same nurse to care for a 2-year-old with RSV and: a. an 18-month-old with RSV b. a 9-year-old 8 hours postappendectomy c. a 1-year-old with a heart defect d. a 6-year-old with sickle cell crisis - Answer: c. a 1-year-old with a heart defect The triage nurse in the emergency department must prioritize the children waiting to be seen. Which child is in the GREATEST need of emergency medical treatment? a. a 6-year-old with a fever of 104 F (40 C), a muffled voice, no spontaneous cough, and drooling b. a 3-year-old with a fever of 100 F (37.8 C), a barky cough, and mild intercostal retractions c. a 4-year-old with a fever of 101 F (38.3 C), a hoarse cough, inspiratory stridor, and restlessness d. a 12-year-old with a fever of 104 F (40 C), chills, and a cough with thick yellow secretions - Answer: a. a 6-year-old with a fever of 104 F (40 C), a muffled voice, no spontaneous cough, and drooling Rationale: this child is exhibiting signs and symptoms of epiglottitis, which is a medical emergency A child with cystic fibrosis has been admitted to the pediatric unit. What type of diet should the nurse request for the client? a. high-fat, high-carbohydrate b. high-calorie, high-protein c. high-calorie, high-carbohydrate d. high-carbohydrate, high-protein - Answer: b. high-calorie, high-protein Rationale: necessary to ensure adequate growth The nurse is caring for a 7-year-old who has undergone a cardiac catheterization 2 hours ago finds the dressing and bed saturated with blood. The nurse should FIRST: a. assess the vital signs b. reinforce the dressing c. apply pressure just above the catheter insertion site d. notify the healthcare provider - Answer: c. apply pressure just above the catheter insertion site A 4-year-old has been scheduled for a cardiac catheterization. To help prepare the family, the nurse should: a. advise the family to bring the child to the hospital for a tour a week in advance b. explain that the child will need a large bandage after the procedure c. discourage bringing favorite toys that might become associated with pain d. explain that the child may get up as soon as the vital signs are stable - Answer: b. explain that the child will need a large bandage after the procedure When teaching the parents of a child with a ventricular septal defect who is scheduled for a cardiac catheterization, the nurse explains that this procedure involves the use of which technique? a. ultra-high-frequency sound waves b. catheter placed in the right femoral vein c. cutdown procedure to place a catheter d. general anesthesia - Answer: b. catheter placed in the right femoral vein Rationale: in children, cardiac catheterization usually involves a right-sided approach because septal defects permit entry into the left side of the heart When developing the discharge teaching plan for the parents of a child who has undergone a cardiac catheterization for ventricular septal defect, which information should the nurse expect to include? a. restriction of the child's activities for the next 3 weeks b. use of sponge baths until the stitches are removed c. use of prophylactic antibiotics before receiving any dental work d. maintenance of a pressure dressing until a return visit with the healthcare provider - Answer: c. use of prophylactic antibiotics before receiving any dental work Discharge teaching for a 3-month-old infant with a cardiac defect who is to receive digoxin should include which information? Select all that apply. a. give the medication at regular intervals b. mix the medication with a small volume of breast milk or formula c. repeat the dose one time if the child vomits immediately after administration d. notify the healthcare provider of poor feeding or vomiting e. make up any missed doses as soon as realized f. notify the healthcare provider if more than two consecutive doses are missed - Answer: a. give the medication at regular intervals d. notify the healthcare provider of poor feeding or vomiting f. notify the healthcare provider if more than two consecutive doses are missed An 18-month-old with a congenital heart defect is to receive digoxin twice a day. Which instructions should the nurse give to the parents? a. digoxin enable the heart to pump more effectively with a slower and more regular rhythm b. signs of toxicity include increased pulse and visual disturbances c. digoxin is absorbed better if taken with meals d. if the child vomits within 15 minutes of administration, the dosage should be repeated - Answer: a. digoxin enable the heart to pump more effectively with a slower and more regular rhythm Which signs and symptoms would lead the nurse to suspect a child has Tetralogy of Fallot? Select all that apply. a. murmur b. history of squatting c. bounding pulses d. cyanosis e. faint pulse f. tachypnea - Answer: a. murmur b. history of squatting d. cyanosis f. tachypnea The nurse is caring for a newborn with a large ventricular septal defect. The client has undergone pulmonary artery banding. Which assessment findings indicate that the pulmonary artery band is functioning effectively? a. capillary refill is less than 3 seconds b. urine output is greater than 1 mL/kg/hr c. breath sounds are clear and equal bilaterally d. radial pulses are bounding - Answer: c. breath sounds are clear and equal bilaterally Rationale: Pulmonary artery banding is a palliative treatment used in pediatric clients with congenital cardiac defects with increased pulmonary blood flow. The pulmonary artery band reduces excessive pulmonary blood flow and protects the lungs from irreversible damage. A child with Tetralogy of Fallot becomes upset, cries, and thrashes around when a blood specimen is obtained. The child becomes cyanotic, and the respiratory rate increases to 44 breaths/min. Which action should the nurse do FIRST? a. obtain a prescription for sedation for the child b. assess for an irregular heart rate and rhythm c. explain to the child that it will only hurt for a short time d. place the child in a knee-to-chest position - Answer: the child in a knee-to-chest position Rationale: the child is experiencing a "tet" or cyanotic episode When assessing a child after heart surgery to correct Tetralogy of Fallot, which finding should alert the nurse to suspect a low cardiac output? a. bounding pulses and mottled skin b. altered level of consciousness and thready pulses c. capillary refill of 2 seconds and BP of 96/67 mm Hg d. extremities warm to the touch and pale skin - Answer: b. altered level of consciousness and thready pulses