PEDS FINAL EXAM 2025 MULTIPLE CHOICES 100 QUESTIONS AND ANSWERS WITH RATIONALES

PEDS FINAL EXAM 2025 MULTIPLE CHOICES 100 QUESTIONS AND ANSWERS WITH RATIONALES Which clinical manifestation is MOST characteristic of Fifth's disease (Erythema Infectiosum)? A. A vesicular rash starting on the trunk B. Bright red cheeks with a lacy rash on the body C. Honey-colored crusted lesions around the nose D. A maculopapular rash starting at the hairline Answer: B. Bright red cheeks with a lacy rash on the body Rationale: Fifth’s disease presents with a “slapped cheek” appearance followed by a lacy, reticular rash on the body. It is caused by Parvovirus B19. What is the primary nursing intervention for a child with thrombocytopenia secondary to chemotherapy? A. Encourage frequent ambulation B. Apply heat to painful joints pg. 2 C. Avoid IM injections and monitor for bleeding D. Increase dietary iron intake Answer: C. Avoid IM injections and monitor for bleeding Rationale: Thrombocytopenia increases bleeding risk. Avoiding trauma and minimizing invasive procedures like intramuscular injections helps prevent hemorrhage. Which pain scale is most appropriate for a non-verbal 6-month-old infant? A. Numeric Visual Analogue Scale B. Wong-Baker FACES C. FLACC scale D. Numeric Rating Scale (0-10) Answer: C. FLACC scale Rationale: The FLACC scale assesses pain in infants and non-verbal children by observing facial expression, leg movement, activity, cry, and consolability. What electrolyte imbalance is most likely in a child with prolonged vomiting? A. Hypernatremia B. Hyperkalemia pg. 3 C. Hypokalemia D. Hypocalcemia Answer: C. Hypokalemia Rationale: Vomiting leads to potassium loss through gastric fluids, resulting in hypokalemia. Monitoring and replacing electrolytes is crucial in these patients. Which is an appropriate intervention for a preschool-aged child during hospitalization? A. Provide structured learning activities B. Encourage parallel play with others C. Offer solitary play options D. Engage in formal teaching sessions Answer: B. Encourage parallel play with others Rationale: Preschoolers engage in parallel play—playing alongside other children without direct interaction. This supports development and reduces anxiety during hospitalization. Which laboratory finding is most consistent with a diagnosis of acute poststreptococcal glomerulonephritis (APSGN)? A. Elevated potassium, decreased BUN B. Elevated ASO titer, hematuria, proteinuria C. Positive nitrites, elevated WBC D. Low hematocrit, high reticulocyte count pg. 4 Answer: B. Elevated ASO titer, hematuria, proteinuria Rationale: APSGN typically occurs after a streptococcal infection and presents with hematuria, proteinuria, hypertension, and a positive ASO titer indicating recent strep exposure. What is the most important pre-operative nursing implication for a child diagnosed with Wilms' Tumor (nephroblastoma)? A. Administer diuretics before surgery B. Avoid palpating the abdomen C. Monitor for signs of hypoglycemia D. Start high-protein TPN Answer: B. Avoid palpating the abdomen Rationale: Palpation of the abdomen could rupture the encapsulated tumor and cause dissemination of cancer cells. Which of the following findings is most characteristic of increased intracranial pressure in an infant? A. Positive Babinski reflex B. High-pitched cry and bulging fontanel C. Hyperreflexia and tremors D. Dry mucous membranes and sunken fontanel Answer: B. High-pitched cry and bulging fontanel Rationale: These are hallmark signs of increased ICP in infants, along with irritability and increased head circumference. pg. 5 Which intervention is appropriate for a child in sickle cell crisis experiencing vaso-occlusive pain? A. Administer oxygen and restrict fluids B. Apply cold compresses and give aspirin C. Administer IV fluids and opioids for pain D. Limit movement and elevate extremities Answer: C. Administer IV fluids and opioids for pain Rationale: Vaso-occlusive episodes are managed with hydration and pain control to improve circulation and relieve ischemic pain. What is the most appropriate intervention for an infant diagnosed with gastroesophageal reflux (GERD)? A. Encourage large, infrequent feedings B. Place infant in supine position immediately after feeding C. Hold the infant upright for 20-30 minutes after feedings D. Administer antacids before each feeding Answer: C. Hold the infant upright for 20–30 minutes after feedings Rationale: Upright positioning after feeding helps reduce reflux episodes and promotes gastric emptying, which is critical for GERD management in infants. *Remember It's only GER if under 1 years old* A child with pyloric stenosis is likely to present with which of the following symptoms?