USMLE PEDIATRICS FINAL EXAM
QUESTIONS AND ANSWERS.
A 3-year-old female is hospitalized for a femur fracture. As her nurse,
what nursing action would help foster the child's sense of autonomy?
1. Allow the child to choose what time to take her oral antibiotics
2. Allow the child to have a doll for medical play
3. Allow the child to administer her own dose of Keflex (cephalexin) via
oral syringe
4. Allow the child to watch age-appropriate videos - Answer 3. Allowing
toddlers to participate in actions of which they are capable is an
excellent way to enhance their autonomy.
A 16-year-old male is hospitalized for cystic fibrosis. He will be an
inpatient for 2 weeks while he receives IV antibiotics. As the nurse
caring for this patient, what action can you take that will most enhance
his psychosocial development?
1. Fax the teen's teacher, and have her send in his homework
2. Encourage the teen's friends to visit him in the hospital
3. Encourage the teen's grandparent's to visit frequently
4. Tell the teen he is free to use his phone to call friends - Answer 2.
Teens are most concerned about being like their peers. Having the teen's
friends visit will help him feel he is still part of the school and social
environment.
A 6-month-old male is at his well-child checkup. The nurse weighs him,
and his mother asks if his weight is normal for his age. The nurse's
response is:
1. "At 6 months his weight should be approximately three times his birth
weight."
2. "Each child gains weight at his or her own pace."
3. "At 6 months his weight should be approximately twice his birth
weight."
,4. "At 6 months a child should weigh about 10 lb. more than his or her
birth weight." - Answer 3. Children should double their birth weight by
4 to 6 months of age.
The nurse caring for a 4-year-old female in the ER is about to start a
peripheral IV. The nurse's best method for explaining the procedure to
the child is to:
1. Show the child a pamphlet with pictures showing the IV placement
procedure
2. Have the 5-year-old patient next door tell the 4-year-old about her
experience with her IV placement
3. Show the child the IV placement equipment, and demonstrate the
procedure on a doll
4. Tell the child that if she remains still, the procedure will be over
quickly - Answer 3. A 4-year-old child understands things in very
concrete and simple terms. Therefore, medical play is an excellent
method for helping her understand the procedure.
A 17-year-old male is being seen in the E.R. In order to obtain the
adolescent's health information, his nurse should:
1. Interview the adolescent using direct questions
2. Gather information during a casual conversation
3. Interview the adolescent only in the presence of his parents
4. Gather information only from the parents - Answer 2. Frequently
adolescents will share more information when it is gathered during a
casual conversation.
A 7-year-old female is being admitted to the hospital for a diagnosis of
acute lymphocytic leukemia. The nurse wants to gather information
from the child regarding her feelings about her diagnosis. Which nursing
action is most appropriate to gain information about how the child is
feeling?
1. The nurse should actively attempt to make friends with the child
before asking her about her feelings
,2. The nurse should ask the child's parents what feelings she has
expressed in regard to her diagnosis
3. The nurse should provide the child with some paper to draw a picture
of how she is feeling
4. The nurse should ask the child direct questions about how she is
feeling - Answer 3. Often children will include much more detail of their
feelings in drawings. They will often express things in pictures they are
unable to verbalize.
How can the nurse best facilitate the trust relationship between infant
and parent while the infant is hospitalized?
1. The nurse should encourage the parents to remain at their child's
bedside as much as possible
2. The nurse should keep the parents informed about all aspects of their
child's condition
3. The nurse should encourage the parents to hold their child as much as
possible
4. The nurse should encourage the parents to participate actively in their
child's care - Answer 3. Having the parents hold their child while in the
hospital is an excellent means of building the trust relationship. Infants
are most secure when they are being held, patted, and spoken to.
The nurse is caring for a 7-year-old female on the school-age unit. Her
mother is concerned that she may have some developmental delays.
Which of the following statements would indicate to the nurse that the
child is not developmentally on track for her age:
1. The child is able to follow a four-to-five-step command
2. The child started wetting the bed on this admission to the hospital
3. The child has an imaginary friend named Kelly
4. The child enjoys playing board games with her sister - Answer 3.
Most school-age children do not have imaginary friends. This is much
more common for children of 3 to 4 years of age.
, The nurse is caring for a 6-month-old in the ER. The physician orders
the nurse to give the child a dose of Rocephin IM. The 1.5-mL dose
arrives from the pharmacy. The nurse must do which of the following?
1. Administer the injection in the deltoid muscle
2. Split the dose into two injections
3. Administer the injection in the dorsogluteal muscle
4. Administer the dose as a single injection to the vests lateralis muscle -
Answer 2. A nurse should not deliver more than 1 mL per IM injection
to a child of 6 months.
A 3-year-old female is hospitalized for an ASD repair. Her parents have
decided to go home for a few hours to spend time with her siblings. The
child asks when her mommy and daddy will be back. The nurse's best
response is:
1. "Your mommy and daddy will be back after your nap."
2. "Your mommy and daddy will be back at 6 p.m."
3. "Your mommy and daddy will be back later this evening"
4. "Your mommy and daddy will be back in 3 hours" - Answer 1.
Preschoolers understand time in relation to events.
A male infant is visiting the pediatrician for his 6-month well-child
checkup. His mother tells the nurse she wants to advance the infant's
diet. Which statement by the infant's mother leads the nurse to believe
that she needs further education about the nutritional needs of a 6-
month-old?
1. "I will continue to breastfeed my son and will give him rice cereal
three times a day."
2. "I will start my son on fruits and gradually introduce vegetables."
3. "I will start my son on carrots and will introduce one new vegetable
every few days."
4. "I will not give my son any more than 8 oz. of baby juice per day." -
Answer 2. Infants should be started on vegetables prior to fruits. The
sweetness of the fruits may inhibit them from taking vegetables.
QUESTIONS AND ANSWERS.
A 3-year-old female is hospitalized for a femur fracture. As her nurse,
what nursing action would help foster the child's sense of autonomy?
1. Allow the child to choose what time to take her oral antibiotics
2. Allow the child to have a doll for medical play
3. Allow the child to administer her own dose of Keflex (cephalexin) via
oral syringe
4. Allow the child to watch age-appropriate videos - Answer 3. Allowing
toddlers to participate in actions of which they are capable is an
excellent way to enhance their autonomy.
A 16-year-old male is hospitalized for cystic fibrosis. He will be an
inpatient for 2 weeks while he receives IV antibiotics. As the nurse
caring for this patient, what action can you take that will most enhance
his psychosocial development?
1. Fax the teen's teacher, and have her send in his homework
2. Encourage the teen's friends to visit him in the hospital
3. Encourage the teen's grandparent's to visit frequently
4. Tell the teen he is free to use his phone to call friends - Answer 2.
Teens are most concerned about being like their peers. Having the teen's
friends visit will help him feel he is still part of the school and social
environment.
A 6-month-old male is at his well-child checkup. The nurse weighs him,
and his mother asks if his weight is normal for his age. The nurse's
response is:
1. "At 6 months his weight should be approximately three times his birth
weight."
2. "Each child gains weight at his or her own pace."
3. "At 6 months his weight should be approximately twice his birth
weight."
,4. "At 6 months a child should weigh about 10 lb. more than his or her
birth weight." - Answer 3. Children should double their birth weight by
4 to 6 months of age.
The nurse caring for a 4-year-old female in the ER is about to start a
peripheral IV. The nurse's best method for explaining the procedure to
the child is to:
1. Show the child a pamphlet with pictures showing the IV placement
procedure
2. Have the 5-year-old patient next door tell the 4-year-old about her
experience with her IV placement
3. Show the child the IV placement equipment, and demonstrate the
procedure on a doll
4. Tell the child that if she remains still, the procedure will be over
quickly - Answer 3. A 4-year-old child understands things in very
concrete and simple terms. Therefore, medical play is an excellent
method for helping her understand the procedure.
A 17-year-old male is being seen in the E.R. In order to obtain the
adolescent's health information, his nurse should:
1. Interview the adolescent using direct questions
2. Gather information during a casual conversation
3. Interview the adolescent only in the presence of his parents
4. Gather information only from the parents - Answer 2. Frequently
adolescents will share more information when it is gathered during a
casual conversation.
A 7-year-old female is being admitted to the hospital for a diagnosis of
acute lymphocytic leukemia. The nurse wants to gather information
from the child regarding her feelings about her diagnosis. Which nursing
action is most appropriate to gain information about how the child is
feeling?
1. The nurse should actively attempt to make friends with the child
before asking her about her feelings
,2. The nurse should ask the child's parents what feelings she has
expressed in regard to her diagnosis
3. The nurse should provide the child with some paper to draw a picture
of how she is feeling
4. The nurse should ask the child direct questions about how she is
feeling - Answer 3. Often children will include much more detail of their
feelings in drawings. They will often express things in pictures they are
unable to verbalize.
How can the nurse best facilitate the trust relationship between infant
and parent while the infant is hospitalized?
1. The nurse should encourage the parents to remain at their child's
bedside as much as possible
2. The nurse should keep the parents informed about all aspects of their
child's condition
3. The nurse should encourage the parents to hold their child as much as
possible
4. The nurse should encourage the parents to participate actively in their
child's care - Answer 3. Having the parents hold their child while in the
hospital is an excellent means of building the trust relationship. Infants
are most secure when they are being held, patted, and spoken to.
The nurse is caring for a 7-year-old female on the school-age unit. Her
mother is concerned that she may have some developmental delays.
Which of the following statements would indicate to the nurse that the
child is not developmentally on track for her age:
1. The child is able to follow a four-to-five-step command
2. The child started wetting the bed on this admission to the hospital
3. The child has an imaginary friend named Kelly
4. The child enjoys playing board games with her sister - Answer 3.
Most school-age children do not have imaginary friends. This is much
more common for children of 3 to 4 years of age.
, The nurse is caring for a 6-month-old in the ER. The physician orders
the nurse to give the child a dose of Rocephin IM. The 1.5-mL dose
arrives from the pharmacy. The nurse must do which of the following?
1. Administer the injection in the deltoid muscle
2. Split the dose into two injections
3. Administer the injection in the dorsogluteal muscle
4. Administer the dose as a single injection to the vests lateralis muscle -
Answer 2. A nurse should not deliver more than 1 mL per IM injection
to a child of 6 months.
A 3-year-old female is hospitalized for an ASD repair. Her parents have
decided to go home for a few hours to spend time with her siblings. The
child asks when her mommy and daddy will be back. The nurse's best
response is:
1. "Your mommy and daddy will be back after your nap."
2. "Your mommy and daddy will be back at 6 p.m."
3. "Your mommy and daddy will be back later this evening"
4. "Your mommy and daddy will be back in 3 hours" - Answer 1.
Preschoolers understand time in relation to events.
A male infant is visiting the pediatrician for his 6-month well-child
checkup. His mother tells the nurse she wants to advance the infant's
diet. Which statement by the infant's mother leads the nurse to believe
that she needs further education about the nutritional needs of a 6-
month-old?
1. "I will continue to breastfeed my son and will give him rice cereal
three times a day."
2. "I will start my son on fruits and gradually introduce vegetables."
3. "I will start my son on carrots and will introduce one new vegetable
every few days."
4. "I will not give my son any more than 8 oz. of baby juice per day." -
Answer 2. Infants should be started on vegetables prior to fruits. The
sweetness of the fruits may inhibit them from taking vegetables.
