CPN Review Test
Questions & Answers
The nurse is caring for a pediatric patient admitted to the hospital. Which of the following
practices best promotes family centered care for this patient?
A) Allowing the child to sleep through vital signs.
B) Delaying interdisciplinary rounds until the family is available.
C) Encouraging the family to bring the child's comfort items from home.
D) Retiming medications to match the child's home routine. - ANSWERSB) Delaying
interdisciplinary rounds until the family is available.
Rationale: Having the family attend rounds promotes information sharing and collaboration,
two key components of family centered care. Domain: Growth & Development
The nurse is teaching a parenting group about patterns of growth & development. What is the
best example to use to explain cephalocaudal development?
A) After sitting independently, the baby will begin to reach for objects.
B) First the baby will play with sounds, like babbling, then say simple words.
C) Learning to run and jump comes after mastering walking.
D) The baby gets control of their head before their arms and hands. - ANSWERSD) The baby gets
control of their head before their arms and hands.
Rationale: Cephalocaudal means head to toe therefore head control develops before control of
the arms and hands. Domain: Growth & Development
An experienced nurse is teaching newly hired nurses in an orientation program. An orientee
asks, "Why do we have to listen to the heart and lungs for a minute?" What is the experienced
nurse's best response?
A) Breathing may be irregular and pulse varies with inspiration and expiration.
,B) Children may move during assessment requiring a longer listening time.
C) Counting for one minute eliminates mathematical errors.
D) Listening that long allows the nurse to assess lung and heart sounds while counting. -
ANSWERSA) Breathing may be irregular and pulse varies with inspiration and expiration.
Rationale: Infant breathing is irregular and the heart rate increases and decreases with
inspiration and expiration. Because of the irregularity, counting for less than 60 seconds and
multiplying may result in inaccurate rates.
Domain: Growth & Development
An 8 year old is diagnosed with chicken pox. At what stage may the child return to school?
A) Immediately, as chicken pox are not contagious
B) When all the lesions have scabbed over
C) 4-6 days from diagnose
D) When fever free for 24 hours - ANSWERSB) When all the lesions have scabbed over
Rationale: Keep the child home and away from susceptible individuals until vesicles have dried
(usually 1 week after onset of disease). Notify school or daycare of child's illness
(Hockenberry & Wilson, 2015). Domain: Infectious Disease
You are bathing a 2-year-old when you notice a red area on their back that resembles a bulls-
eye with a red outer ring, a central area of clearing, and a red center. You know that this is
caused by:
A) Tick bite
B) Black widow spider
C) Mosquito
D) Brown recluse spider - ANSWERSA) Tick bite
Rationale: A painless red rash that starts as a red macule or papule and expands over days or
weeks. It may have a bull's eye appearance or it may look like a bruise in a darker skin person
(Ball, Bindle, & Cowan, 2015). Domain: Infectious Disease
,A general contraindication for all immunizations is:
A) Vomiting
B) Headache
C) Common Cold
D) Febrile illness - ANSWERSD) Febrile illness
Rationale: This precaution avoids adding the risk of adverse side effects from the vaccine to an
already ill child or mistakenly identifying a symptom of the disease as having been caused by the
vaccine (Hockenberry & Wilson, 2015). Domain: Infectious Disease
Which laboratory finding is most concerning in the child with sickle cell disease, who reports
that they have recently had a viral illness?
A) Hemoglobin- 8.8 g/dL
B) Reticulocyte Count- 0.3%
C) BUN- 7 mg/dL
D) Urinalysis- bilirubin - ANSWERSB) Reticulocyte Count- 0.3%
Rationale: patients with sickle cell disease may develop aplastic crisis follow infection
(particularly with Parvovirus), which typically initially presents with a low reticulocyte count.
Without treatment and supportive care, the patient can become significantly anemic since the
bone marrow ceases RBC production, which is exacerbated by the hemolytic nature of sickle cell
disease. A hemoglobin of 8.8 may be considered at patient's baseline for children with sickle cell
disease. BUN is normal, and bilirubin present in the urine, while not considered a normal
finding, may occur in patients with more severe sickle cell disease (due to hemolysis) and is not
the most concerning at this time given the reticulocyte count. Domain: Hematologic Conditions
April, a 12 year old female with sickle cell disease is admitted with a pain crisis. Your nursing
interventions include all of the following except
A) Promoting pain management with ice packs to affected area
B) Administering IV hydration
C) Promoting ambulation
, D) Encouraging deep breathing and use of an incentive spirometer - ANSWERSA) Promoting pain
management with icepacks to affected area
Rationale: Ice may promote vaso-occlusion which may exacerbate the sickling process and
worsen the vaso-occlusive crisis. Hydration, ambulation, and encouraging deep breathing and
incentive spirometer use are all appropriate interventions to maximize patient outcomes and
prevent complications including acute chest syndrome. Domain: Hematologic Conditions
You are a nurse in a pediatric clinic and are performing teaching with a patient and parents of a
child with sickle cell disease who is taking hydroxyurea. Which of the following statements by
the patient's parents indicate that more teaching is needed?
A) "Supplementation with iron will not help to decrease my child's sickle cell anemia"
B) "I will ensure my child is dressed appropriately when the weather is cool and they are dried
off quickly after getting out of the pool"
C) "If my child has a fever, I will call his/her hematologist immediately"
D) "I will be sure not to give my child ibuprofen due to the risk of bleeding" - ANSWERSD) "I will
be sure not to give my child ibuprofen due to the risk of bleeding"
Rationale: NSAIDS are an appropriate pharmacologic intervention for children with sickle cell
disease. The other statements are correct: in sickle cell disease, anemia is caused by hemolysis,
not by a deficiency of iron. In fact, some children may be at risk for iron overload if they have
received multiple transfusions. Drying off a child quickly and protecting from cool/cold weather
can prevent a vaso-occlusive crisis. Fevers require immediate attention in children with sickle
cell disease due to their risk for infection and functional asplenia as they progress through
childhood. Domain: Hematologic Conditions
A 14 month old boy is admitted to the hospital with a Hb of 5.0 g/dL. When completing the
nursing history, what is an expected history finding with this patient admitted with iron
deficiency anemia?
A) "My son is a very picky eater. He love his cereal and will eat chicken fingers but does not eat
many vegetables."
B) "My son is a very active boy and goes to daycare full time since I am a full-time working
mother."
Questions & Answers
The nurse is caring for a pediatric patient admitted to the hospital. Which of the following
practices best promotes family centered care for this patient?
A) Allowing the child to sleep through vital signs.
B) Delaying interdisciplinary rounds until the family is available.
C) Encouraging the family to bring the child's comfort items from home.
D) Retiming medications to match the child's home routine. - ANSWERSB) Delaying
interdisciplinary rounds until the family is available.
Rationale: Having the family attend rounds promotes information sharing and collaboration,
two key components of family centered care. Domain: Growth & Development
The nurse is teaching a parenting group about patterns of growth & development. What is the
best example to use to explain cephalocaudal development?
A) After sitting independently, the baby will begin to reach for objects.
B) First the baby will play with sounds, like babbling, then say simple words.
C) Learning to run and jump comes after mastering walking.
D) The baby gets control of their head before their arms and hands. - ANSWERSD) The baby gets
control of their head before their arms and hands.
Rationale: Cephalocaudal means head to toe therefore head control develops before control of
the arms and hands. Domain: Growth & Development
An experienced nurse is teaching newly hired nurses in an orientation program. An orientee
asks, "Why do we have to listen to the heart and lungs for a minute?" What is the experienced
nurse's best response?
A) Breathing may be irregular and pulse varies with inspiration and expiration.
,B) Children may move during assessment requiring a longer listening time.
C) Counting for one minute eliminates mathematical errors.
D) Listening that long allows the nurse to assess lung and heart sounds while counting. -
ANSWERSA) Breathing may be irregular and pulse varies with inspiration and expiration.
Rationale: Infant breathing is irregular and the heart rate increases and decreases with
inspiration and expiration. Because of the irregularity, counting for less than 60 seconds and
multiplying may result in inaccurate rates.
Domain: Growth & Development
An 8 year old is diagnosed with chicken pox. At what stage may the child return to school?
A) Immediately, as chicken pox are not contagious
B) When all the lesions have scabbed over
C) 4-6 days from diagnose
D) When fever free for 24 hours - ANSWERSB) When all the lesions have scabbed over
Rationale: Keep the child home and away from susceptible individuals until vesicles have dried
(usually 1 week after onset of disease). Notify school or daycare of child's illness
(Hockenberry & Wilson, 2015). Domain: Infectious Disease
You are bathing a 2-year-old when you notice a red area on their back that resembles a bulls-
eye with a red outer ring, a central area of clearing, and a red center. You know that this is
caused by:
A) Tick bite
B) Black widow spider
C) Mosquito
D) Brown recluse spider - ANSWERSA) Tick bite
Rationale: A painless red rash that starts as a red macule or papule and expands over days or
weeks. It may have a bull's eye appearance or it may look like a bruise in a darker skin person
(Ball, Bindle, & Cowan, 2015). Domain: Infectious Disease
,A general contraindication for all immunizations is:
A) Vomiting
B) Headache
C) Common Cold
D) Febrile illness - ANSWERSD) Febrile illness
Rationale: This precaution avoids adding the risk of adverse side effects from the vaccine to an
already ill child or mistakenly identifying a symptom of the disease as having been caused by the
vaccine (Hockenberry & Wilson, 2015). Domain: Infectious Disease
Which laboratory finding is most concerning in the child with sickle cell disease, who reports
that they have recently had a viral illness?
A) Hemoglobin- 8.8 g/dL
B) Reticulocyte Count- 0.3%
C) BUN- 7 mg/dL
D) Urinalysis- bilirubin - ANSWERSB) Reticulocyte Count- 0.3%
Rationale: patients with sickle cell disease may develop aplastic crisis follow infection
(particularly with Parvovirus), which typically initially presents with a low reticulocyte count.
Without treatment and supportive care, the patient can become significantly anemic since the
bone marrow ceases RBC production, which is exacerbated by the hemolytic nature of sickle cell
disease. A hemoglobin of 8.8 may be considered at patient's baseline for children with sickle cell
disease. BUN is normal, and bilirubin present in the urine, while not considered a normal
finding, may occur in patients with more severe sickle cell disease (due to hemolysis) and is not
the most concerning at this time given the reticulocyte count. Domain: Hematologic Conditions
April, a 12 year old female with sickle cell disease is admitted with a pain crisis. Your nursing
interventions include all of the following except
A) Promoting pain management with ice packs to affected area
B) Administering IV hydration
C) Promoting ambulation
, D) Encouraging deep breathing and use of an incentive spirometer - ANSWERSA) Promoting pain
management with icepacks to affected area
Rationale: Ice may promote vaso-occlusion which may exacerbate the sickling process and
worsen the vaso-occlusive crisis. Hydration, ambulation, and encouraging deep breathing and
incentive spirometer use are all appropriate interventions to maximize patient outcomes and
prevent complications including acute chest syndrome. Domain: Hematologic Conditions
You are a nurse in a pediatric clinic and are performing teaching with a patient and parents of a
child with sickle cell disease who is taking hydroxyurea. Which of the following statements by
the patient's parents indicate that more teaching is needed?
A) "Supplementation with iron will not help to decrease my child's sickle cell anemia"
B) "I will ensure my child is dressed appropriately when the weather is cool and they are dried
off quickly after getting out of the pool"
C) "If my child has a fever, I will call his/her hematologist immediately"
D) "I will be sure not to give my child ibuprofen due to the risk of bleeding" - ANSWERSD) "I will
be sure not to give my child ibuprofen due to the risk of bleeding"
Rationale: NSAIDS are an appropriate pharmacologic intervention for children with sickle cell
disease. The other statements are correct: in sickle cell disease, anemia is caused by hemolysis,
not by a deficiency of iron. In fact, some children may be at risk for iron overload if they have
received multiple transfusions. Drying off a child quickly and protecting from cool/cold weather
can prevent a vaso-occlusive crisis. Fevers require immediate attention in children with sickle
cell disease due to their risk for infection and functional asplenia as they progress through
childhood. Domain: Hematologic Conditions
A 14 month old boy is admitted to the hospital with a Hb of 5.0 g/dL. When completing the
nursing history, what is an expected history finding with this patient admitted with iron
deficiency anemia?
A) "My son is a very picky eater. He love his cereal and will eat chicken fingers but does not eat
many vegetables."
B) "My son is a very active boy and goes to daycare full time since I am a full-time working
mother."
