Peds Nclex Final Exam 230 Questions and Answers
with Rationale 2024-2025
The nurse is discussing sexuality with the parents of an adolescent girl with moderate cognitive
impairment. Which of the following should the nurse consider when dealing with this issue?
a. Sterilization is recommended for any adolescent with cognitive impairment.
b. Sexual drive and interest are limited in individuals with cognitive impairment.
c. Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct.
d. Sexual intercourse rarely occurs unless the individual with cognitive impairment is sexually abused.
c. Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct.
Rationale: Adolescents with moderate cognitive impairment may be easily persuaded and lack
judgment. A well-defined, concrete code of conduct with specific instructions for handling certain
situations should be laid out for the adolescent.
When caring for a newborn with Down syndrome, the nurse should be aware that the most common
congenital anomaly associated with Down syndrome is which of the following?
a. Hypospadias
b. Pyloric stenosis
c. Congenital heart disease
d. Congenital hip dysplasia
c. Congenital heart disease
Rationale: Congenital heart malformations, primarily septal defects, are the most common congenital
anomaly in Down syndrome.
,Mark, a 9 year old with Down syndrome, is mainstreamed into a regular third grade for part of the
school day. His mother asks the school nurse about programs, such as Cub Scouts, that he might join.
The nurse's recommendation should be based on which of the following?
a. Programs like Cub Scouts are inappropriate for children who are mentally retarded.
b. Children with Down syndrome have the same need for socialization as other children.
c. Children with Down syndrome socialize better with children who have similar disabilities.
d. Parents of children with Down syndrome encourage programs, such as scouting, because they deny
that their children have disabilities.
b. Children with Down syndrome have the same need for socialization as other children.
Rationale: Children of all ages need peer relationships. Children with Down syndrome should have peer
experiences similar to those of other children, such as group outings, Cub Scouts, and Special Olympics.
What is one of the major physical characteristics of the child with Down syndrome?
a. Excessive height
b. Spots on the palms
c. Inflexibility of the joints
d. Hypotonic musculature
d. Hypotonic musculature
Rationale: Hypotonic musculature is one of the major characteristics.
A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal
bridge, protruding tongue, and transverse palmar creases. These findings are most suggestive of which
of the following?
a. Microcephaly
b. Down syndrome
c. Cerebral palsy
d. Fragile X syndrome
b. Down syndrome
Rationale: These are characteristics associated with Down syndrome.
,The child with Down syndrome should be evaluated for which of the following before participating in
some sports?
a. Hyperflexibility
b. Cutis marmorata
c. Atlantoaxial instability
d. Speckling of iris (Brushfield spots)
c. Atlantoaxial instability
Rationale: Children with Down syndrome are at risk for atlantoaxial instability. Before participating in
sports that put stress on the head and neck, a radiologic examination should be done.
Many of the physical characteristics of Down syndrome present nursing problems. Care of the child
should include which of the following?
a. Delay feeding solid foods until the tongue thrust has stopped.
b. Modify diet as necessary to minimize the diarrhea that often occurs.
c. Provide calories appropriate to child's age.
d. Use a cool-mist vaporizer to keep mucous membranes moist.
d. Use a cool-mist vaporizer to keep mucous membranes moist.
Rationale: The constant stuffy nose forces the child to breathe by mouth, drying the mucous membranes
and increasing the susceptibility to upper respiratory tract infections. A cool-mist vaporizer will keep the
mucous membranes moist and liquefy secretions.
Fragile X syndrome is which of the following?
a. Chromosomal defect affecting only females
b. Chromosomal defect that follows the pattern of X-linked recessive disorders
c. Second most common genetic cause of mental retardation
d. Most common cause of noninherited mental retardation
, c. Second most common genetic cause of mental retardation
Rationale: Fragile X syndrome is the second most common cause of mental retardation after Down
syndrome.
Distortion of sound and problems in discrimination are characteristic of what type of hearing loss?
a. Conductive
b. Sensorineural
c. Mixed conductive-sensorineural
d. Central auditory imperceptive
b. Sensorineural
Rationale: Sensorineural hearing loss, also known as perceptive or nerve deafness, involves damage to
the inner ear structures or the auditory nerve. It results in distortion of sounds and problems in
discrimination.
The most common type of hearing loss, which results from interference of transmission of sound to the
middle ear, is called:
a. conductive.
b. sensorineural.
c. mixed conductive-sensorineural.
d. central auditory imperceptive.
a. conductive
Rationale: Conductive or middle-ear hearing loss is the most common type. It results from interference
of transmission of sound to the middle ear, most often from recurrent otitis media.
Hearing is expressed in decibels (dB), or units of loudness. Which of the following is, in decibels, the
softest sound a normal ear can hear?
a. 0
b. 10
with Rationale 2024-2025
The nurse is discussing sexuality with the parents of an adolescent girl with moderate cognitive
impairment. Which of the following should the nurse consider when dealing with this issue?
a. Sterilization is recommended for any adolescent with cognitive impairment.
b. Sexual drive and interest are limited in individuals with cognitive impairment.
c. Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct.
d. Sexual intercourse rarely occurs unless the individual with cognitive impairment is sexually abused.
c. Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct.
Rationale: Adolescents with moderate cognitive impairment may be easily persuaded and lack
judgment. A well-defined, concrete code of conduct with specific instructions for handling certain
situations should be laid out for the adolescent.
When caring for a newborn with Down syndrome, the nurse should be aware that the most common
congenital anomaly associated with Down syndrome is which of the following?
a. Hypospadias
b. Pyloric stenosis
c. Congenital heart disease
d. Congenital hip dysplasia
c. Congenital heart disease
Rationale: Congenital heart malformations, primarily septal defects, are the most common congenital
anomaly in Down syndrome.
,Mark, a 9 year old with Down syndrome, is mainstreamed into a regular third grade for part of the
school day. His mother asks the school nurse about programs, such as Cub Scouts, that he might join.
The nurse's recommendation should be based on which of the following?
a. Programs like Cub Scouts are inappropriate for children who are mentally retarded.
b. Children with Down syndrome have the same need for socialization as other children.
c. Children with Down syndrome socialize better with children who have similar disabilities.
d. Parents of children with Down syndrome encourage programs, such as scouting, because they deny
that their children have disabilities.
b. Children with Down syndrome have the same need for socialization as other children.
Rationale: Children of all ages need peer relationships. Children with Down syndrome should have peer
experiences similar to those of other children, such as group outings, Cub Scouts, and Special Olympics.
What is one of the major physical characteristics of the child with Down syndrome?
a. Excessive height
b. Spots on the palms
c. Inflexibility of the joints
d. Hypotonic musculature
d. Hypotonic musculature
Rationale: Hypotonic musculature is one of the major characteristics.
A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal
bridge, protruding tongue, and transverse palmar creases. These findings are most suggestive of which
of the following?
a. Microcephaly
b. Down syndrome
c. Cerebral palsy
d. Fragile X syndrome
b. Down syndrome
Rationale: These are characteristics associated with Down syndrome.
,The child with Down syndrome should be evaluated for which of the following before participating in
some sports?
a. Hyperflexibility
b. Cutis marmorata
c. Atlantoaxial instability
d. Speckling of iris (Brushfield spots)
c. Atlantoaxial instability
Rationale: Children with Down syndrome are at risk for atlantoaxial instability. Before participating in
sports that put stress on the head and neck, a radiologic examination should be done.
Many of the physical characteristics of Down syndrome present nursing problems. Care of the child
should include which of the following?
a. Delay feeding solid foods until the tongue thrust has stopped.
b. Modify diet as necessary to minimize the diarrhea that often occurs.
c. Provide calories appropriate to child's age.
d. Use a cool-mist vaporizer to keep mucous membranes moist.
d. Use a cool-mist vaporizer to keep mucous membranes moist.
Rationale: The constant stuffy nose forces the child to breathe by mouth, drying the mucous membranes
and increasing the susceptibility to upper respiratory tract infections. A cool-mist vaporizer will keep the
mucous membranes moist and liquefy secretions.
Fragile X syndrome is which of the following?
a. Chromosomal defect affecting only females
b. Chromosomal defect that follows the pattern of X-linked recessive disorders
c. Second most common genetic cause of mental retardation
d. Most common cause of noninherited mental retardation
, c. Second most common genetic cause of mental retardation
Rationale: Fragile X syndrome is the second most common cause of mental retardation after Down
syndrome.
Distortion of sound and problems in discrimination are characteristic of what type of hearing loss?
a. Conductive
b. Sensorineural
c. Mixed conductive-sensorineural
d. Central auditory imperceptive
b. Sensorineural
Rationale: Sensorineural hearing loss, also known as perceptive or nerve deafness, involves damage to
the inner ear structures or the auditory nerve. It results in distortion of sounds and problems in
discrimination.
The most common type of hearing loss, which results from interference of transmission of sound to the
middle ear, is called:
a. conductive.
b. sensorineural.
c. mixed conductive-sensorineural.
d. central auditory imperceptive.
a. conductive
Rationale: Conductive or middle-ear hearing loss is the most common type. It results from interference
of transmission of sound to the middle ear, most often from recurrent otitis media.
Hearing is expressed in decibels (dB), or units of loudness. Which of the following is, in decibels, the
softest sound a normal ear can hear?
a. 0
b. 10
