RN PEDIATRIC NURSING ONLINE PRACTICE
2024/2025 B EXAM WITH CORRECT DETAILED
ANSWERS.
A nurse in an emergency department is caring for a school-age child who is
experiencing an anaphylactic reaction. Which of the following is the priority action by the
nurse? - Answer-Administer epinephrine IM
Rationale: When using the urgent vs. non-urgent approach to client care, the nurse
should determine that the priority action is administering epinephrine IM to the child.
During an anaphylactic reaction, histamine release causes bronchoconstriction and
vasodilation. This is an emergency because ultimately it causes decreased blood return
to the heart.
/.A nurse in a pediatric emergency department is planning care for an adolescent.
Based on the information in the adolescent's medical record, which of the following
actions should the nurse plan to take?
Select all that apply. - Answer-Apply supplemental oxygen
Rationale: According to the medical record and chest x-ray report, the adolescent could
potentially have a pneumothorax. Also according to the medical record and chest x-ray
report, the adolescent's oxygen saturation level is decreasing, which indicates hypoxia.
Therefore, the nurse should plan to administer supplemental oxygen.
Prepare for chest tube insertion
Rationale: According to the medical record and chest x-ray report, the adolescent could
potentially have a pneumothorax. A pneumothorax is the presence of air in the pleural
cavity, which results in decreased lung expansion. The adolescent could experience
dyspnea, tachypnea, tachycardia, hypoxia, and pain. This requires prompt intervention
by the provider, such as the placement of a chest tube into the thoracic cavity to remove
air and fluid from the pleural space, if present, allowing the lung to re-expand.
/.A nurse in an emergency department is caring for a school-age child who has
epiglottitis. Which of the following actions should the nurse take? - Answer-Monitor the
child's oxygen saturation
Rationale: The nurse should monitor the child's oxygen saturation level because the
child is experiencing acute respiratory distress and it is necessary to determine if the
child is responding to treatment.
/.A nurse is providing teaching about play activities for social development to the
guardians of a preschooler. Which of the following play activities should the nurse
recommend for the child? - Answer-Playing dress-up
,Rationale: The nurse should instruct the guardians that at the preschool age, play
should focus on social, mental, and physical development. Therefore, playing dress-up
is a recommended play activity for this child.
/.A nurse is receiving change-of-shift report for four children. Which of the following
children should the nurse see first? - Answer-A school-age child who has sickle cell
anemia and reports decreased vision in the left eye
Rationale: When using the urgent vs. non-urgent approach to client care, the nurse
should determine the priority finding is a report of decreased vision in the left eye. This
finding indicates that the child is experiencing a vaso-occlusive crisis and should be
reported to the provider immediately. Therefore, the nurse should see this child first.
/.A nurse is providing teaching to the parents of a preschooler who has heart failure and
a new prescription for digoxin twice daily. Which of the following instructions should the
nurse include in the teaching? - Answer-"Brush the child's teeth after giving the
medication."
Rationale: The nurse should instruct the parents to brush the child's teeth after
administering digoxin to prevent tooth decay caused by the medication, which comes as
a sweetened liquid to enhance the taste.
/.A nurse is providing teaching to the parent of an infant who has diaper dermatitis. The
nurse should instruct the parent to apply which of the following to the affected area? -
Answer-Zinc oxide
Rationale: Diaper dermatitis is a common inflammatory skin disorder caused by contact
with an irritant such as urine, feces, soap, or friction, and takes the form of scaling,
blisters, or papules with erythema. Providing a protective barrier, such as zinc oxide,
against the irritants allows the skin to heal.
/.A nurse is caring for a client who has been receiving IV fluids via a peripheral IV
catheter. When preparing to discontinue the IV fluids and catheter, which of the
following actions should the nurse plan to take? (Move the steps into the box on the
right, placing them in the order of performance. Use all the steps.) - Answer-First, the
nurse should turn off the IV pump. Next, the nurse should occlude the IV tubing, and
then remove the tape securing the catheter. Last, the nurse should apply pressure over
the catheter insertion site.
/.A nurse is assessing a school-age child who has an acute spinal cord injury following a
sports injury 1 week ago. Identify the area the nurse should tap to elicit the biceps
reflex. (You will find hot spots to select in the artwork below. Select only the hot spot
that corresponds to your answer.) - Answer-A
, /.A nurse is caring for a school-age child who is receiving chemotherapy and is severely
immunocompromised. Which of the following actions should the nurse take? - Answer-
Screen the child's visitors for indications of infection.
Rationale: A child who is severely immunocompromised is unable to adequately
respond to infectious organisms, resulting in the potential for overwhelming infection.
Therefore, the nurse should screen the child's visitors for indications of infection.
/.A nurse is providing teaching to the parent of a school-age child who has a new
prescription for oral nystatin for the treatment of oral candidiasis. Which of the following
instructions should the nurse include? - Answer-"Shake the medication prior to
administration."
Rationale: The nurse should instruct the parent to shake the medication prior to
administration to disperse the medication evenly within the suspension.
/.A nurse is teaching a group of parents about infectious mononucleosis. Which of the
following statements by a parent indicates an understanding the teaching? - Answer-
"Mononucleosis is caused by an infection with the Epstein-Barr virus."
Rationale: The nurse should identify that mononucleosis is a mildly contagious illness
that occurs sporadically or in groups, and is primarily caused by the Epstein-Barr virus.
/.A nurse is creating a plan of care for a school-age child who has heart disease and
has developed heart failure. Which of the following interventions should the nurse
include in the plan? - Answer-Provide small, frequent meals for the child.
Rationale: The metabolic rate of a child who has heart failure is high because of poor
cardiac function. Therefore, the nurse should provide small, frequent meals for the child
because it helps to conserve energy.
/.A nurse is providing anticipatory guidance to the guardian of a toddler. Which of the
following expected behavior characteristics of toddlers should the nurse include? -
Answer-Expresses likes and dislikes
Rationale: The nurse should include that expressing likes and dislikes is an expected
behavior of toddlers. This is the time in life when a toddler is developing autonomy and
self-concept. They will try to assert themselves and frequently refuse to comply. The
guardian should allow the child to have some control, but also set limits for them so they
learn from their behavior and learn to control their actions.
/.A charge nurse is preparing to make a room assignment for a newly admitted school-
age child. Which of the following considerations is the nurse's priority? - Answer-
Disease process
2024/2025 B EXAM WITH CORRECT DETAILED
ANSWERS.
A nurse in an emergency department is caring for a school-age child who is
experiencing an anaphylactic reaction. Which of the following is the priority action by the
nurse? - Answer-Administer epinephrine IM
Rationale: When using the urgent vs. non-urgent approach to client care, the nurse
should determine that the priority action is administering epinephrine IM to the child.
During an anaphylactic reaction, histamine release causes bronchoconstriction and
vasodilation. This is an emergency because ultimately it causes decreased blood return
to the heart.
/.A nurse in a pediatric emergency department is planning care for an adolescent.
Based on the information in the adolescent's medical record, which of the following
actions should the nurse plan to take?
Select all that apply. - Answer-Apply supplemental oxygen
Rationale: According to the medical record and chest x-ray report, the adolescent could
potentially have a pneumothorax. Also according to the medical record and chest x-ray
report, the adolescent's oxygen saturation level is decreasing, which indicates hypoxia.
Therefore, the nurse should plan to administer supplemental oxygen.
Prepare for chest tube insertion
Rationale: According to the medical record and chest x-ray report, the adolescent could
potentially have a pneumothorax. A pneumothorax is the presence of air in the pleural
cavity, which results in decreased lung expansion. The adolescent could experience
dyspnea, tachypnea, tachycardia, hypoxia, and pain. This requires prompt intervention
by the provider, such as the placement of a chest tube into the thoracic cavity to remove
air and fluid from the pleural space, if present, allowing the lung to re-expand.
/.A nurse in an emergency department is caring for a school-age child who has
epiglottitis. Which of the following actions should the nurse take? - Answer-Monitor the
child's oxygen saturation
Rationale: The nurse should monitor the child's oxygen saturation level because the
child is experiencing acute respiratory distress and it is necessary to determine if the
child is responding to treatment.
/.A nurse is providing teaching about play activities for social development to the
guardians of a preschooler. Which of the following play activities should the nurse
recommend for the child? - Answer-Playing dress-up
,Rationale: The nurse should instruct the guardians that at the preschool age, play
should focus on social, mental, and physical development. Therefore, playing dress-up
is a recommended play activity for this child.
/.A nurse is receiving change-of-shift report for four children. Which of the following
children should the nurse see first? - Answer-A school-age child who has sickle cell
anemia and reports decreased vision in the left eye
Rationale: When using the urgent vs. non-urgent approach to client care, the nurse
should determine the priority finding is a report of decreased vision in the left eye. This
finding indicates that the child is experiencing a vaso-occlusive crisis and should be
reported to the provider immediately. Therefore, the nurse should see this child first.
/.A nurse is providing teaching to the parents of a preschooler who has heart failure and
a new prescription for digoxin twice daily. Which of the following instructions should the
nurse include in the teaching? - Answer-"Brush the child's teeth after giving the
medication."
Rationale: The nurse should instruct the parents to brush the child's teeth after
administering digoxin to prevent tooth decay caused by the medication, which comes as
a sweetened liquid to enhance the taste.
/.A nurse is providing teaching to the parent of an infant who has diaper dermatitis. The
nurse should instruct the parent to apply which of the following to the affected area? -
Answer-Zinc oxide
Rationale: Diaper dermatitis is a common inflammatory skin disorder caused by contact
with an irritant such as urine, feces, soap, or friction, and takes the form of scaling,
blisters, or papules with erythema. Providing a protective barrier, such as zinc oxide,
against the irritants allows the skin to heal.
/.A nurse is caring for a client who has been receiving IV fluids via a peripheral IV
catheter. When preparing to discontinue the IV fluids and catheter, which of the
following actions should the nurse plan to take? (Move the steps into the box on the
right, placing them in the order of performance. Use all the steps.) - Answer-First, the
nurse should turn off the IV pump. Next, the nurse should occlude the IV tubing, and
then remove the tape securing the catheter. Last, the nurse should apply pressure over
the catheter insertion site.
/.A nurse is assessing a school-age child who has an acute spinal cord injury following a
sports injury 1 week ago. Identify the area the nurse should tap to elicit the biceps
reflex. (You will find hot spots to select in the artwork below. Select only the hot spot
that corresponds to your answer.) - Answer-A
, /.A nurse is caring for a school-age child who is receiving chemotherapy and is severely
immunocompromised. Which of the following actions should the nurse take? - Answer-
Screen the child's visitors for indications of infection.
Rationale: A child who is severely immunocompromised is unable to adequately
respond to infectious organisms, resulting in the potential for overwhelming infection.
Therefore, the nurse should screen the child's visitors for indications of infection.
/.A nurse is providing teaching to the parent of a school-age child who has a new
prescription for oral nystatin for the treatment of oral candidiasis. Which of the following
instructions should the nurse include? - Answer-"Shake the medication prior to
administration."
Rationale: The nurse should instruct the parent to shake the medication prior to
administration to disperse the medication evenly within the suspension.
/.A nurse is teaching a group of parents about infectious mononucleosis. Which of the
following statements by a parent indicates an understanding the teaching? - Answer-
"Mononucleosis is caused by an infection with the Epstein-Barr virus."
Rationale: The nurse should identify that mononucleosis is a mildly contagious illness
that occurs sporadically or in groups, and is primarily caused by the Epstein-Barr virus.
/.A nurse is creating a plan of care for a school-age child who has heart disease and
has developed heart failure. Which of the following interventions should the nurse
include in the plan? - Answer-Provide small, frequent meals for the child.
Rationale: The metabolic rate of a child who has heart failure is high because of poor
cardiac function. Therefore, the nurse should provide small, frequent meals for the child
because it helps to conserve energy.
/.A nurse is providing anticipatory guidance to the guardian of a toddler. Which of the
following expected behavior characteristics of toddlers should the nurse include? -
Answer-Expresses likes and dislikes
Rationale: The nurse should include that expressing likes and dislikes is an expected
behavior of toddlers. This is the time in life when a toddler is developing autonomy and
self-concept. They will try to assert themselves and frequently refuse to comply. The
guardian should allow the child to have some control, but also set limits for them so they
learn from their behavior and learn to control their actions.
/.A charge nurse is preparing to make a room assignment for a newly admitted school-
age child. Which of the following considerations is the nurse's priority? - Answer-
Disease process
