Pediatric Nursing Practice Questions With Correct Answers

What is the recommended serving size of vegetables for a toddler? a. 1 tablespoon. b. 1 teaspoon. c. 1/2 teaspoon. d. 1/2 tablespoon. - Answer a The nurse is providing emergency care for an unconscious child who presents with a head injury sustained in a fall. Which is the highest nursing priority? a. Establish an airway. b. Assess neurological status. c. Stabilize the spine. d. Obtain vital signs. - Answer a he vital signs of a 4-year-old child with polyuria are: BP 80/40, Pulse 118, and Respirations 24. The child's pedal pulses are present with a volume of +1, and no edema is observed. What action should the nurse implement first? a. Insert an indwelling urinary catheter. b. Start an IV infusion of normal saline. c. Send a specimen to the lab for urinalysis. d. Document the child's vital signs and pulses. - Answer b The nurse is assessing a 2-year-old child. What behavior indicates that the child's language development is within normal limits? a. Is able to name four colors. b. Can count five blocks. c. Is capable of making a three word sentence. d. Half of child's speech is understandable. - Answer c At 8 a.m. the unlicensed assistive personnel (UAP) informs the charge nurse that a female adolescent client with acute glomerulonephritis has a blood pressure of 210/110. The 4 a.m. blood pressure reading was 170/88. The client reports to the UAP that she is upset because her boyfriend did not visit last night. What action should the nurse take first? a. Give the client her 9 a.m. prescription for an oral diuretic early. b. Administer PRN prescription of nifedipine (Procardia) sublingually. c. Notify the healthcare provider and inform the nursing supervisor of the client's condition. d. Attempt to calm the client and retake the blood pressure in thirty minutes. - Answer b During administration of a blood transfusion, a child complains of chills, headache, and nausea. Which action should the nurse implement? a. Start another IV of dextrose solution and stay with the child. b. Continue the transfusion and monitor the child's vital signs. c. Stop the infusion immediately and notify the healthcare provider. d. Slow the transfusion and assess for cessation of symptoms. - Answer c The nurse is preparing a health teaching program for parents of toddlers and preschoolers and plans to include information about prevention of accidental poisonings. It is most important for the nurse to include which instruction? a. Tell children they should not taste anything but food. b. Store all toxic agents and medicines in locked cabinets. c. Provide special play areas in the house and restrict play in other areas. d. Punish children if they open cabinets that contain household chemicals. - Answer b What preoperative nursing intervention should be included in the plan of care for an infant with pyloric stenosis? a. Monitor for signs of metabolic acidosis. b. Estimate the quantity of diarrhea stools. c. Place in a supine position after feeding. d. Observe for projectile vomiting. - Answer d 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,c,f The nurse is assessing the neurovascular status of a child in Russell's traction. Which finding should the nurse report to the healthcare provider? a. Pale bluish coloration of the toes. b. Skin is warm and dry to the touch. c. Toes are wiggled upon command. d. Capillary refill less than 3 seconds. - Answer a The mother of a preschool-aged child asks the nurse if it is all right to administer bismuth subsalicylate (Pepto Bismol, Bismylate) to her son when he "has a tummy ache." After reminding the mother to check the label of all over-the-counter drugs for the presence of aspirin, which instruction should the nurse include when replying to this mother's question? a. If the child's tongue darkens, discontinue the Pepto Bismol immediately. b. Do not give if the child has chickenpox, the flu, or any other viral illness. c. Avoid the use of Pepto Bismol until the child is at least 16 years old. d/ Pepto Bismol may cause a rebound hyperacidity, worsening the "tummy ache." - Answer b A 12-month-old boy is admitted with a respiratory infection and possible pneumonia. He is placed in a mist tent with oxygen. Which nursing intervention has the greatest priority for this infant? a. Give small, frequent feedings of fluids. b. Accurately chart observations regarding breath sounds. c. Have a bulb syringe readily available to remove secretions. d. Encourage older siblings to visit. - Answer c The nurse is assessing a two-month-old in preparation for surgery for coarctation of the aorta repair. Which best describes the pathophysiology of coarctation of the aorta? a. Acyanotic defect, increased pulmonary blood flow. b. Cyanotic defect, obstructed blood flow from ventricles. c. Acyanotic defect, obstructed blood flow from ventricles. d. Cyanotic defect, decreased pulmonary blood flow. - Answer c The emergency department nurse is assessing a three-month-old infant suspected to be a victim of "shaken baby syndrome". Which type of intracranial hemorrhage is caused by tearing of a meningeal artery that causes an inward expansion of blood from the inner surface of the skull? a. Subarachnoid. b. Epidural. c. Subdural. d. Intracerebral. - Answer b The nurse recognizes signs that a 9-month-old toddler may be living in an abusive home. Which action is the priority for the nurse? a. Encourage the child to speak freely. b. Report the suspected abuse to local authorities. c. Document from head to feet, the physical signs of abuse. d. Test the child for sexually-transmitted diseases. - Answer b The nurse is caring for a client with gastroesophageal reflux disease (GERD) who has not responded to conventional medical treatments. The nurse should anticipate the need for which surgical intervention? a. Nissen fundoplication. b. Esophagectomy. c. Heller myotomy. d. Whipple procedure. - Answer a Which class of antiinfective drugs is contraindicated for use in children under 8 years of age? a. Aminoglycosides. b. Tetracyclines. c. Penicillins. d. Quinolones. - Answer b A 6-month-old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which observation by the nurse warrants immediate intervention? a. Apical heart rate of 60. b. Sweating across the forehead. c. Doesn't suck well. d. Respiratory rate of 30 breaths per minute. - Answer a A 2-year-old child with gastro-esophageal reflux has developed a fear of eating. What instruction should the nurse include in the parents' teaching plan? a. Invite other children home to share meals. b. Accept that he will eat when he is hungry. c. Reward the child with a nap after eating. d. Consistently follow a set mealtime routine. - Answer d A 16-year-old is brought to the Emergency Center with a crushed leg after falling off a horse. The adolescent's last tetanus toxoid booster was received eight years ago. What action should the nurse take? a. Dispense a tetanus antitoxin. b. Prepare human tetanus immune globulin. c. Administer tetanus toxoid booster. d. Delay the tetanus toxoid booster until due. - Answer c The parents of a 3-week-old infant report that the child eats well but, vomits after each feeding. What information is most important for the nurse to obtain? a. Description of vomiting episodes in past 24 hours. b. Number of wet diapers in last 24 hours. c. Feeding and sleep schedule. d. Amount of formula consumed during the past 24 hours. - Answer a Which restraint should be used for a toddler after a cleft palate repair? a. Clove hitch. b. Mummy. c. Elbow. d. Jacket. - Answer c As part of the physical assessment of children, the nurse observes and palpates the fontanels. Which child's fontanel finding should be reported to the healthcare provider? a. A 6-month-old with failure to thrive that has a closed anterior fontanel. b. A 24-month-old with gastroenteritis that has a closed posterior fontanel. c. A 2-month-old with chickenpox that has an open posterior fontanel. d. A 28-month-old with hydrocephalus that has an open anterior fontanel. - Answer a A premature newborn girl, born 24 hours ago, is diagnosed with a patent ductus arteriosus (PDA) and placed under an oxygen hood at 35%. The parents visit the nursery and ask to hold her. Which response should the nurse provide to the parents? a. "Studies have shown that handling a sick newborn is not good for the baby and upsets the parents." b. "The oxygen hood is holding the baby's oxygen level just at the point which is needed. You may stroke and talk to her." c. "Since your baby has been doing well under oxygen for 24 hours, I can let you hold the baby without oxygen." d. "You can hold the baby with the oxygen blowing in the baby's face since the level is very close to room air." - Answer b Which immunosuppressive medication is used to manage the symptoms of systemic lupus erythematosus (SLE) in the pediatric population? a. Otezla. b. Quinine. c. Methotrexate. d. Mefloquine. - Answer c The nurse is caring for a client with a suspected diagnosis of celiac disease. In order to confirm this diagnosis, the nurse should prepare the client for which examination? a. Magnetic resonance imaging scan. b. Fluoroscopy with barium contrast. c. Computerized tomography scan. d. Endoscopy with small bowel biopsy. - Answer d The nurse is reviewing an electronic medical record (EMR) of a four-year-old child who is scheduled for an outpatient cardiac catheterization. The child has midazolam prescribed pre-procedure to alleviate anxiety. Which prescription should the nurse seek further clarification from the healthcare provider? a. Parents may administered the medication just prior to coming to hospital. b. The child may have clear liquids up to two hours prior to administration of medicine. c. The child is to be accompanied with resuscitative equipment during transport to cardiac suite. d. Parents may accompany the child during transportation to cardiac procedure room. - Answer a A child with cystic fibrosis is having stools that float and are foul smelling. Which descriptive term should the nurse use to document the finding? a. Diarrhea. b. Rhinorrhea. c. Galactorrhea. d. Steatorrhea. - Answer d A 4-year-old boy was admitted to the emergency room with a fractured right ulna and a short arm cast was applied. When preparing the parents to take the child home, which discharge instruction has the highest priority? a. "Call the healthcare provider immediately if his nail beds appear blue." b. "Check his fingers hourly for the first 48 hours to see that he is able to move them without pain." c. "Be sure your child's arm remains above his heart for the first 24 hours." d. "Take his temperature every four hours for the next two days and call if an elevation is noted." - Answer a The mother of a 6-month-old asks the nurse when her baby will get the first measles, mumps, and rubella (MMR) vaccine. Based on the recommended childhood immunization schedule published by the Centers for Disease Control, which response is accurate? a. 3 to 6 months. b. 12 to 15 months. c. 18 to 24 months. d. 4 to 6 years. - Answer b The nurse is teaching the parents of a 5-year-old child with cystic fibrosis about respiratory treatments. Which statement indicates to the nurse that the parents understand? a. Perform postural drainage before starting the aerosol therapy. b. Give respiratory treatments when the child is coughing a lot. c. Administer aerosol therapy followed by postural drainage before meals. d. Ensure respiratory therapy is done daily during any respiratory infection. - Answer c In developing a teaching plan for a 5-year-old child with diabetes, which component of diabetic management should the nurse plan for the child to manage first? a. Food planning and selection. b. Administering insulin injections. c. Process of glucose testing. d. Drawing up the correct insulin dose. - Answer c The nurse is providing anticipatory guidance to a group of new parents. How should the nurse explain the sequence in the development of fine and gross motor skills? a. Development predictably occurs from the head to the toes. b. The distal part of the body develops first, followed by the proximal. c. For right-handed dominance, the right side of body develops first, then left. d. The central portion of the body develops after peripheral growth. - Answer a The nurse is providing pre-operative teaching for a 12-year old child who will have a tonsillectomy in the morning. Which statement by the child best demonstrates the expected level of understanding about the concept of illness? a. "I need to save my tonsils in case I want them back in my mouth." b. "Tonsils were important for my immunity and infection prevention when I was a baby." c. "When I wake up my throat will hurt but I can eat all the ice cream I want and then I go home." d. "My friend had a tonsillectomy and threw up after surgery, so I guess that will happen to me." - Answer d The nurse is assessing a 2-year-old child at the pediatrician's office. The child's history is significant for prenatal brain trauma and low Apgar scores. The child exhibits hypertonia of the extremities, poor speech intonation, and is failing to meet expected motor skills milestones. Which disorder should the nurse suspect? a. Guillain-Barré syndrome. b. Spina bifida. c. Muscular dystrophy. d. Cerebral palsy. - Answer d The nurse is developing a plan of care for a 3-year-old who is scheduled for a cardiac catheterization. To assist in decreasing anxiety for the child on the day of the procedure, which intervention is best for the nurse to implement? a. Reassure the parents that 3-year-olds are cooperative and therefore are less likely to be anxious. b. Obtain a video film of a cardiac catheterization to show to the child prior to the procedure. c. Give the child a ride on a gurney to visit the cardiac catheterization lab and meet a nurse who works there. d. Obtain a cardiac catheter and demonstrate the procedure by pretending to put the catheter in a doll or stuffed animal. - Answer c A 2-year-old child with Down syndrome is brought to the clinic for his regular physical examination. The nurse knows which problem is frequently associated with Down syndrome? a. Congenital heart disease. b. Fragile X chromosome. c. Trisomy 13. d. Pyloric stenosis. - Answer a The mother of a 4-year-old child asks the nurse what she can do to help her other children cope with their sibling's repeated hospitalizations. Which is the best response that the nurse should offer? a. Inform the parent that the other children are too young to visit the hospital. b. Suggest that the other children visit a grandmother until the sibling returns home. c. Ask the mother if the children ask when the sibling will be discharged. d. Encourage the mother to have the children visit the hospitalized sibling. - Answer d Which behavior would the nurse expect a two-year-old child to exhibit? a. Build a house with blocks. b. Ride a tricycle. c. Display possessiveness of toys. d. Look at a picture book for 15 minutes. - Answer c The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which approach by the nurse is most helpful in establishing communication? a. Engage the child through drawing pictures. b. Suggest that the parent read a book to the child. c. Provide paper and pencil for the child to keep a diary. d. Ask the parent if the child is always uncommunicative. - Answer a A preschool-age child who is hospitalized for hypospadias repair is most strongly influenced by which behavior? a. Ability to communicate verbally. b. Response to separation from family. c. Concern for body integrity. d. Socialization with other children. - Answer c When discussing discipline with the mother of a 4-year-old child, the nurse should include which guideline? a. Parental control should be consistent. b. Children as young as 4 years rarely need reprimand or punishment. c. Withdrawal of approval is effective. d. Parents should enforce rigid rules to be followed without question. - Answer a Which action by the nurse is most helpful in communicating with a preschool-aged child? a. Speak clearly and directly to the child. b. Use a doll to play and communicate. c. Approach when a parent is not present. d. Play a board game with the child. - Answer b A 6-year-old is admitted to the pediatric unit after falling off a bicycle. Which intervention should the nurse implement to assist the child's adjustment to hospitalization? a. Explain hospital schedules to the child, such as mealtimes. b. Use terms, such as "honey" and "dear," to show a caring attitude. c. Provide a list of rules that limits visitation of siblings in the hospital. d. Orient the parents to the hospital unit and refreshment areas. - Answer a What clinical manifestation is the nurse likely to observe in a child with human immunodeficiency virus (HIV)? a. Petechiae. b. Visual disturbances. c. Bruising. d. Oral candidiasis. - Answer d A school nurse presented a parent-approved lesson about "Prevention transmitting Herpes Simplex Virus 2" (HSV-2) to a group of adolescent students. Which statement from one of the students would demonstrate a proper understanding of the lesson? a. There is currently no cure for HSV-2. b. Condoms are 100% effective in protecting again HSV-2. c. HSV-2 cannot be passed through vaginal secretions. d. When no lesions are visibly, the HSV-2 cannot be passed on. - Answer a The nurse is counseling a teenage girl who was recently diagnosed with gonorrhea. The nurse should inform the client that untreated gonorrhea may lead to which complication? a. Pelvic inflammatory disease. b. Gastrointestinal bleeding. c. Renal failure. d. Pyelonephritis. - Answer a