RN Pediatric Nursing Online
RN Pediatric Nursing Online Practice 2023 B
Exam Study Guide UPDATED 2025
A nurse is caring for a preschool-age child.
For each assessment finding, click to specify if the finding is consistent with nightmares
or sleep terrors. Each finding may support more than 1 disease process.
- Impulsivity
- Daytime alertness
- Child's responsiveness to guardian
- Child's description of the dream.
- Child's return to sleeping
- Child's concentration
- Timing of child's crying -Correct Answer ✔Nightmares:
- Child's concentration
- Daytime alertness
- Impulsivity
- Timing of child's crying
Rationale: When analyzing cues, the nurse should recognize that manifestations of
nightmares include awakening during the night after a scary dream. Nightmares are a
sleep disturbance after the dream is over. The child might be crying, fearful of returning
to sleep, & believe the dream is real. Sleep disturbances cause interruptions in the
sleep-wake cycle & can cause impaired concentration, daytime fatigue, & impulsive
behaviors.
Sleep Terrors:
- Child's return to sleeping
- Child's concentration
- Daytime alertness
- Impulsivity
- Child's responsiveness to guardian
Rationale: When analyzing cues, the nurse should recognize that manifestations of
sleep terrors include partial awakening during a deep sleep. Sleep terrors are sleep
disturbances that cause a child to exhibit behaviors such as thrashing, screaming,
moaning, & diaphoresis that disappear once the child awakens. The child does not
remember the episode & is not comforted by others during the disturbance. The child
usually falls asleep easily afterwards. Sleep terrors cause interruptions in the sleep-
wake cycle & can cause impaired concentration, daytime fatigue, & impulsive behaviors.
A nurse is caring for a toddler who has acute otitis media & a temperature of 40 C (104
F). After administering acetaminophen, which of the following actions should the nurse
plan to take to reduce the toddler's temperature?
- Apply a cooling blanket to the toddler.
RN Pediatric Nursing Online
,RN Pediatric Nursing Online
- Dress the toddler in minimal clothing.
- Give the toddler a tepid bath.
- Administer diphenhydramine to the toddler. -Correct Answer ✔- Dress the toddler in
minimal clothing.
Rationale: The nurse should recognize that dressing the toddler in minimal clothing will
expose the skin to air & maximize heat evaporation from the skin, thus reducing the
toddler's temperature.
A nurse on a pediatric unit is caring for a school-age child.
After reviewing the information in the child's medical record, which of the following
findings should the nurse report to the provider? Select the 4 findings that the nurse
should report to the provider.
- Arterial blood gases
- Cardiovascular assessment
- WBC count
- Hemoglobin
- O2 saturation level
- Respiratory assessment -Correct Answer ✔- Arterial blood gases
Rationale: The child's ABGs indicate respiratory alkalosis, which is associated with
complications of asthma, such as hyperventilation & hypoxia. Therefore, the nurse
should report these findings to the provider.
- WBC count
Rationale: The child's WBC count is above the expected reference range, which could
be an indication of infection or inflammation. Therefore, the nurse should report this
finding to the provider.
- O2 saturation level
Rationale: The child's O2 saturation is below the expected reference range despite the
use of supplemental O2. Therefore, the nurse should report this finding to the provider.
- Respiratory assessment
Rationale: The child's respiratory assessment indicates increased respiratory distress,
as evidenced by the presence of retractions, tachypnea, & increased wheezing.
Therefore, the nurse should report this finding to the provider.
A nurse is caring for a preschooler who has congestive heart failure. The nurse
observes wide QRS complexes & peaked T waves on the cardiac monitor. Which of the
following prescriptions should the nurse clarify with the provider?
- Furosemide
- Captopril
- Regular insulin
RN Pediatric Nursing Online
, RN Pediatric Nursing Online
- Potassium chloride -Correct Answer ✔- Potassium chloride
Rationale: The nurse should identify that a child who has congestive heart failure can
develop electrolyte imbalances, such as hyperkalemia or hypokalemia. The nurse
should identify that the child is exhibiting manifestations of hyperkalemia & contact the
provider about the administration of potassium chloride, which can increase the severity
of hyperkalemia.
A nurse is caring for a toddler.
Complete the diagram by dragging from the choices below to specify what condition the
client is most likely experiencing, 2 actions the nurse should take to address that
condition, & 2 parameters the nurse should monitor to assess the client's progress.
Potential Condition:
- Cystic fibrosis
- Otitis media
- Diabetes insipidus
- Gastroesophageal reflux
Actions To Take:
- Educate guardian about sweat chloride testing.
- Assess the toddler's tympanic membranes.
- Anticipate the performance of a water deprivation test.
- Prepare the toddler for chest physiotherapy.
- Request a prescription for cimetidine.
Parameters To Monitor:
- Stools
- Hearing
- Enuresis
- Regurgitation
- O2 saturation level -Correct Answer ✔Potential Condition:
- Cystic fibrosis
Actions To Take:
- Educate guardian about sweat chloride testing.
- Prepare the toddler for chest physiotherapy.
Parameters To Monitor:
- Stools
- O2 saturation level
Rationale: Upon recognizing & analyzing client findings, the nurse's priority hypothesis
is that the toddler is most likely experiencing cystic fibrosis & that is it important to
generate solutions & take actions by planning to educate the guardian about sweat
RN Pediatric Nursing Online
RN Pediatric Nursing Online Practice 2023 B
Exam Study Guide UPDATED 2025
A nurse is caring for a preschool-age child.
For each assessment finding, click to specify if the finding is consistent with nightmares
or sleep terrors. Each finding may support more than 1 disease process.
- Impulsivity
- Daytime alertness
- Child's responsiveness to guardian
- Child's description of the dream.
- Child's return to sleeping
- Child's concentration
- Timing of child's crying -Correct Answer ✔Nightmares:
- Child's concentration
- Daytime alertness
- Impulsivity
- Timing of child's crying
Rationale: When analyzing cues, the nurse should recognize that manifestations of
nightmares include awakening during the night after a scary dream. Nightmares are a
sleep disturbance after the dream is over. The child might be crying, fearful of returning
to sleep, & believe the dream is real. Sleep disturbances cause interruptions in the
sleep-wake cycle & can cause impaired concentration, daytime fatigue, & impulsive
behaviors.
Sleep Terrors:
- Child's return to sleeping
- Child's concentration
- Daytime alertness
- Impulsivity
- Child's responsiveness to guardian
Rationale: When analyzing cues, the nurse should recognize that manifestations of
sleep terrors include partial awakening during a deep sleep. Sleep terrors are sleep
disturbances that cause a child to exhibit behaviors such as thrashing, screaming,
moaning, & diaphoresis that disappear once the child awakens. The child does not
remember the episode & is not comforted by others during the disturbance. The child
usually falls asleep easily afterwards. Sleep terrors cause interruptions in the sleep-
wake cycle & can cause impaired concentration, daytime fatigue, & impulsive behaviors.
A nurse is caring for a toddler who has acute otitis media & a temperature of 40 C (104
F). After administering acetaminophen, which of the following actions should the nurse
plan to take to reduce the toddler's temperature?
- Apply a cooling blanket to the toddler.
RN Pediatric Nursing Online
,RN Pediatric Nursing Online
- Dress the toddler in minimal clothing.
- Give the toddler a tepid bath.
- Administer diphenhydramine to the toddler. -Correct Answer ✔- Dress the toddler in
minimal clothing.
Rationale: The nurse should recognize that dressing the toddler in minimal clothing will
expose the skin to air & maximize heat evaporation from the skin, thus reducing the
toddler's temperature.
A nurse on a pediatric unit is caring for a school-age child.
After reviewing the information in the child's medical record, which of the following
findings should the nurse report to the provider? Select the 4 findings that the nurse
should report to the provider.
- Arterial blood gases
- Cardiovascular assessment
- WBC count
- Hemoglobin
- O2 saturation level
- Respiratory assessment -Correct Answer ✔- Arterial blood gases
Rationale: The child's ABGs indicate respiratory alkalosis, which is associated with
complications of asthma, such as hyperventilation & hypoxia. Therefore, the nurse
should report these findings to the provider.
- WBC count
Rationale: The child's WBC count is above the expected reference range, which could
be an indication of infection or inflammation. Therefore, the nurse should report this
finding to the provider.
- O2 saturation level
Rationale: The child's O2 saturation is below the expected reference range despite the
use of supplemental O2. Therefore, the nurse should report this finding to the provider.
- Respiratory assessment
Rationale: The child's respiratory assessment indicates increased respiratory distress,
as evidenced by the presence of retractions, tachypnea, & increased wheezing.
Therefore, the nurse should report this finding to the provider.
A nurse is caring for a preschooler who has congestive heart failure. The nurse
observes wide QRS complexes & peaked T waves on the cardiac monitor. Which of the
following prescriptions should the nurse clarify with the provider?
- Furosemide
- Captopril
- Regular insulin
RN Pediatric Nursing Online
, RN Pediatric Nursing Online
- Potassium chloride -Correct Answer ✔- Potassium chloride
Rationale: The nurse should identify that a child who has congestive heart failure can
develop electrolyte imbalances, such as hyperkalemia or hypokalemia. The nurse
should identify that the child is exhibiting manifestations of hyperkalemia & contact the
provider about the administration of potassium chloride, which can increase the severity
of hyperkalemia.
A nurse is caring for a toddler.
Complete the diagram by dragging from the choices below to specify what condition the
client is most likely experiencing, 2 actions the nurse should take to address that
condition, & 2 parameters the nurse should monitor to assess the client's progress.
Potential Condition:
- Cystic fibrosis
- Otitis media
- Diabetes insipidus
- Gastroesophageal reflux
Actions To Take:
- Educate guardian about sweat chloride testing.
- Assess the toddler's tympanic membranes.
- Anticipate the performance of a water deprivation test.
- Prepare the toddler for chest physiotherapy.
- Request a prescription for cimetidine.
Parameters To Monitor:
- Stools
- Hearing
- Enuresis
- Regurgitation
- O2 saturation level -Correct Answer ✔Potential Condition:
- Cystic fibrosis
Actions To Take:
- Educate guardian about sweat chloride testing.
- Prepare the toddler for chest physiotherapy.
Parameters To Monitor:
- Stools
- O2 saturation level
Rationale: Upon recognizing & analyzing client findings, the nurse's priority hypothesis
is that the toddler is most likely experiencing cystic fibrosis & that is it important to
generate solutions & take actions by planning to educate the guardian about sweat
RN Pediatric Nursing Online
