PN PEDIATRICS – PRACTICAL NURSING PEDIATRIC
CARE REVIEW WITH PRACTICE QUESTIONS AND
ANSWERS (2025 EDITION) WITH MOST TESTED
QUESTIONS
The nurse is caring for an infant born to a mother who abused cocaine during her pregnancy. The
nurse would likely notice that this infant: - CORRECT ANSWER-cries when touched.
Four weeks before the birth of a client's already large child, the primary care provider has told the
client that if the baby gets bigger and the baby's lungs are ready, the care provider would like to
perform a cesarean birth. The woman asks the nurse what the downside is to having a cesarean
rather than a vaginal birth. What is an appropriate response by the nurse? - CORRECT ANSWER-
"As the baby passes through the birth canal some of the excess fluid is expelled from the lungs, if
that doesn't happen there's a higher risk of respiratory distress."
A nursing student is caring for a newborn with a defect in the neural arch where the posterior
laminae of the vertebrae have failed to close. The nurse knows that this infant is suffering from
which disorder? - CORRECT ANSWER-Spina bifida
A nursing instructor is teaching about newborn congenital disorders and realizes that the student
needs further instruction after making which statement? - CORRECT ANSWER-All congenital
disorders can be diagnosed at birth.
An infant was born with a severely deformed hand. He is now 6 months old. The nurse informs the
parents that the orthopedic surgeon has recommended amputation of the hand and fitting of a
prosthesis. The mother objects and tells the nurse that they would like to wait and see how the hand
develops. Which of the following should the nurse say in response? - CORRECT ANSWER-"With
a deformity such as this, the hand is highly unlikely to improve."
Depending on the condition, in many children, there is a potential for better function if the
malformed portion of an extremity is amputated before a prosthesis is fitted. This creates a difficult
decision for parents because it is one they cannot undo later. They need assurance hands with
malformed fingers, for example, will not later grow to become normal and a well-fitted prosthesis
will allow their child a more usual childhood and adult life than if the original disorder was left
unchanged. It is not the nurse's place to insert her opinion about the matter.
The nurse is caring for 22-hour-old neonate Antonio, who had a good Apgar score, nursed without
difficulty, and seemed healthy when the nursing shift began. As the nurse's shift goes on, the nurse
,notices that the whites of his eyes and his skin have begun to take on a yellow hue. The nurse would
report this as a possible indication of what condition? - CORRECT ANSWER-hemolytic disease
Any infant admitted to the newborn nursery should be examined for jaundice during the first 36
hours or more. Early development of jaundice (within the first 24-48 hours) is a probable indication
of hemolytic disease. Heroin withdrawal symptoms commonly include tremors, restlessness,
hyperactivity, disorganized or hyperactive reflexes, increased muscle tone, sneezing, tachypnea,
vomiting, diarrhea, disturbed sleep patterns, and a shrill high-pitched cry. The hypoglycemic
newborn's blood glucose would be low and a newborn with hypoxia would show signs of respiratory
distress.
The nurse is caring for a pregnant woman with gestational diabetes mellitus, which the woman is
having great difficulty keeping under control. What effect is the woman's condition most likely to
have on the fetus? The fetus might - CORRECT ANSWER-Grow to an unsusually large size
Maternal diabetes is the most widely known contributing factor to large-for-gestational-age
newborns. LGA babies are frequently born to diabetic mothers with poor glucose control. Continued
high blood glucose levels in the mother lead to an increase in insulin production in the fetus.
Increased insulin levels act as a fetal growth hormone causing macrosomia, an unusually large
newborn with a birth weight of greater than 4,500 grams (9 pounds, 14 ounces). The incidence of
birth defects in the gestational diabetic is not greatly increased. IUGR is not a typical outcome of
uncontrolled gestational diabetes. It is more likely that the baby will be large-for-gestational-age
A nurse is caring for a newborn with a repaired cleft lip. What intervention can the nurse provide to
facilitate drainage of mucus and secretions to prevent aspiration? - CORRECT ANSWER-Position
the child on the side
To facilitate drainage of mucus and secretions, the nurse should position the infant on the side,
never on the abdomen, after a cleft lip repair.
A baby is born with spina bifida with meningocele. The parents are visibly upset. The father states,
"What did we do wrong? How will I ever love this child?" What is the priority action by the nurse? -
CORRECT ANSWER-Encourage the parents to express their feelings and emotions openly
The family of a newborn with such a major anomaly is in a state of shock on first learning of the
problems. The nurse should be especially sensitive to their needs and emotions. He or she should
encourage family members to express their feelings and emotions as openly as possible.
A nurse is working with a child who has spina bifida. The highest priority nursing goal for this child
would be which of the following? - CORRECT ANSWER-Preventing infection
The highest priority nursing goal is preventing infection because of the vulnerability of the
myelomeningocele sac. Promoting comfort is important but not as high a priority because the child
,does not usually have severe pain with this diagnosis. Reducing anxiety and teaching are lower
priorities; physical is a higher priority than psychosocial.
Immediately after delivery, the nurse is caring for a newborn with a myeolomeningocele. What
intervention should the nurse provide to prevent drying out of the sac to avoid damage? -
CORRECT ANSWER-Apply a sterile dressing moistened in a warm sterile saline solution
Until surgery is performed, the sac must be covered with a sterile dressing moistened in a warm
sterile solution (often saline). The nurse should change this dressing every 2 hours and not allow it to
dry to avoid damage to the covering of the sac.
In addition to newborns of diabetic mothers being at risk for hypoglycemia, these newborns are also
at risk for which of the following? - CORRECT ANSWER-Hypocalcemia
The newborn of the diabetic mother is at risk for hypocalcemia, hypomagnesemia, polycythemia
with hyperviscosity, and hyperbilirubinemia. Potassium concerns are not a risk for these newborns
The nurse is caring for an infant born to a mother who abused cocaine during her pregnancy. Which
of the following characteristics would the nurse likely see in this infant? - CORRECT ANSWER-
The infant cries when touched
In the child diagnosed with hydrocephalus, an obstruction occurs that blocks the normal process of
which of the following? - CORRECT ANSWER-Cerebrospinal fluid
The nurse is changing the diaper on a newborn and notices that there is a musty smell to the infant's
urine. This finding is a characteristic sign of which of the following disorders? - CORRECT
ANSWER-Phenylketonuria
There is a characteristic musty smell to the urine in the child with Phenylketonuria. None of the
other disorders effect the urine or the smell of the urine.
Immediately after delivery, the nurse is caring for a newborn with a myeolomeningocele. What
intervention should the nurse provide to prevent drying out of the sac to avoid damage? -
CORRECT ANSWER-Apply a sterile dressing moistened in a warm sterile saline solution
Until surgery is performed, the sac must be covered with a sterile dressing moistened in a warm
sterile solution (often saline). The nurse should change this dressing every 2 hours and not allow it to
dry to avoid damage to the covering of the sac.
, The nurse is working with a group of parents of children who have congenital heart disorders. Which
of the following statements made by the parents would most likely be an indication the child is
showing signs of congestive heart failure. - CORRECT ANSWER-"She gets so tired when she is
eating"
Hydrocephalus has the clinical manifestations of a larger head than normal with widening cranial
sutures. As the head enlarges, the suture lines separate and the spaces are felt through the scalp.
The anterior fontanelle becomes tense and bulging, the skull enlarges, the scalp becomes shiny, and
its veins dilate. If pressure continues, the eyes appear to be pushed downward slightly and the
sclerae visible above the irises. Spina bifida is a defect in the neural arch and is a failure of the
posterior laminae of the vertebrae to close. Both septal defect and coarctation are both defects that
involve the heart.
A nursing student is learning about newborn congenital defects. The defect with symptoms that
include a shiny scalp, dilated scalp veins, a bulging anterior fontanelle, and eyes pushed downward
with the sclerae visible above the irises is known as which of the following? - CORRECT
ANSWER-Hydrocephalus
Hydrocephalus has the clinical manifestations of a larger head than normal with widening cranial
sutures. As the head enlarges, the suture lines separate and the spaces are felt through the scalp.
The anterior fontanelle becomes tense and bulging, the skull enlarges, the scalp becomes shiny, and
its veins dilate. If pressure continues, the eyes appear to be pushed downward slightly and the
sclerae visible above the irises. Spina bifida is a defect in the neural arch and is a failure of the
posterior laminae of the vertebrae to close. Both septal defect and coarctation are both defects that
involve the heart
The nurse is caring for a newborn with hemolytic disease of the newborn who is receiving
phototherapy. Which of the following nursing interventions would be most appropriate for the nurse
to do? - CORRECT ANSWER-The nurse turns the newborn every 3 or 4 hours
Turn the newborn every 3 or 4 hours to rotate the area of exposure. Do not turn off the lights except
to feed and to change the diaper. The infant is nude to maximize the skin surface area exposed to
the light. Remove the patches every four hours to cleanse the eyes and examine for irritation,
inflammation, and/or dryness. Clean and change the patches daily.
After teaching a group of students about the physiologic jaundice in breast-fed and bottle-fed
newborns, the instructor determines that the teaching was successful when the students state
which of the following? - CORRECT ANSWER-The decline in bilirubin levels occurs more quickly
in bottle-fed newborns
Breast-fed newborns typically have peak bilirubin levels on the fourth day of life; bottle-fed
newborns usually have peak bilirubin levels on the third day of life. The rate of bilirubin decline is
less rapid in breast-fed newborns compared with bottle-fed newborns. Jaundice associated with
breastfeeding presents in two distinct patterns: early-onset and late-onset. Bottle-fed newborns
CARE REVIEW WITH PRACTICE QUESTIONS AND
ANSWERS (2025 EDITION) WITH MOST TESTED
QUESTIONS
The nurse is caring for an infant born to a mother who abused cocaine during her pregnancy. The
nurse would likely notice that this infant: - CORRECT ANSWER-cries when touched.
Four weeks before the birth of a client's already large child, the primary care provider has told the
client that if the baby gets bigger and the baby's lungs are ready, the care provider would like to
perform a cesarean birth. The woman asks the nurse what the downside is to having a cesarean
rather than a vaginal birth. What is an appropriate response by the nurse? - CORRECT ANSWER-
"As the baby passes through the birth canal some of the excess fluid is expelled from the lungs, if
that doesn't happen there's a higher risk of respiratory distress."
A nursing student is caring for a newborn with a defect in the neural arch where the posterior
laminae of the vertebrae have failed to close. The nurse knows that this infant is suffering from
which disorder? - CORRECT ANSWER-Spina bifida
A nursing instructor is teaching about newborn congenital disorders and realizes that the student
needs further instruction after making which statement? - CORRECT ANSWER-All congenital
disorders can be diagnosed at birth.
An infant was born with a severely deformed hand. He is now 6 months old. The nurse informs the
parents that the orthopedic surgeon has recommended amputation of the hand and fitting of a
prosthesis. The mother objects and tells the nurse that they would like to wait and see how the hand
develops. Which of the following should the nurse say in response? - CORRECT ANSWER-"With
a deformity such as this, the hand is highly unlikely to improve."
Depending on the condition, in many children, there is a potential for better function if the
malformed portion of an extremity is amputated before a prosthesis is fitted. This creates a difficult
decision for parents because it is one they cannot undo later. They need assurance hands with
malformed fingers, for example, will not later grow to become normal and a well-fitted prosthesis
will allow their child a more usual childhood and adult life than if the original disorder was left
unchanged. It is not the nurse's place to insert her opinion about the matter.
The nurse is caring for 22-hour-old neonate Antonio, who had a good Apgar score, nursed without
difficulty, and seemed healthy when the nursing shift began. As the nurse's shift goes on, the nurse
,notices that the whites of his eyes and his skin have begun to take on a yellow hue. The nurse would
report this as a possible indication of what condition? - CORRECT ANSWER-hemolytic disease
Any infant admitted to the newborn nursery should be examined for jaundice during the first 36
hours or more. Early development of jaundice (within the first 24-48 hours) is a probable indication
of hemolytic disease. Heroin withdrawal symptoms commonly include tremors, restlessness,
hyperactivity, disorganized or hyperactive reflexes, increased muscle tone, sneezing, tachypnea,
vomiting, diarrhea, disturbed sleep patterns, and a shrill high-pitched cry. The hypoglycemic
newborn's blood glucose would be low and a newborn with hypoxia would show signs of respiratory
distress.
The nurse is caring for a pregnant woman with gestational diabetes mellitus, which the woman is
having great difficulty keeping under control. What effect is the woman's condition most likely to
have on the fetus? The fetus might - CORRECT ANSWER-Grow to an unsusually large size
Maternal diabetes is the most widely known contributing factor to large-for-gestational-age
newborns. LGA babies are frequently born to diabetic mothers with poor glucose control. Continued
high blood glucose levels in the mother lead to an increase in insulin production in the fetus.
Increased insulin levels act as a fetal growth hormone causing macrosomia, an unusually large
newborn with a birth weight of greater than 4,500 grams (9 pounds, 14 ounces). The incidence of
birth defects in the gestational diabetic is not greatly increased. IUGR is not a typical outcome of
uncontrolled gestational diabetes. It is more likely that the baby will be large-for-gestational-age
A nurse is caring for a newborn with a repaired cleft lip. What intervention can the nurse provide to
facilitate drainage of mucus and secretions to prevent aspiration? - CORRECT ANSWER-Position
the child on the side
To facilitate drainage of mucus and secretions, the nurse should position the infant on the side,
never on the abdomen, after a cleft lip repair.
A baby is born with spina bifida with meningocele. The parents are visibly upset. The father states,
"What did we do wrong? How will I ever love this child?" What is the priority action by the nurse? -
CORRECT ANSWER-Encourage the parents to express their feelings and emotions openly
The family of a newborn with such a major anomaly is in a state of shock on first learning of the
problems. The nurse should be especially sensitive to their needs and emotions. He or she should
encourage family members to express their feelings and emotions as openly as possible.
A nurse is working with a child who has spina bifida. The highest priority nursing goal for this child
would be which of the following? - CORRECT ANSWER-Preventing infection
The highest priority nursing goal is preventing infection because of the vulnerability of the
myelomeningocele sac. Promoting comfort is important but not as high a priority because the child
,does not usually have severe pain with this diagnosis. Reducing anxiety and teaching are lower
priorities; physical is a higher priority than psychosocial.
Immediately after delivery, the nurse is caring for a newborn with a myeolomeningocele. What
intervention should the nurse provide to prevent drying out of the sac to avoid damage? -
CORRECT ANSWER-Apply a sterile dressing moistened in a warm sterile saline solution
Until surgery is performed, the sac must be covered with a sterile dressing moistened in a warm
sterile solution (often saline). The nurse should change this dressing every 2 hours and not allow it to
dry to avoid damage to the covering of the sac.
In addition to newborns of diabetic mothers being at risk for hypoglycemia, these newborns are also
at risk for which of the following? - CORRECT ANSWER-Hypocalcemia
The newborn of the diabetic mother is at risk for hypocalcemia, hypomagnesemia, polycythemia
with hyperviscosity, and hyperbilirubinemia. Potassium concerns are not a risk for these newborns
The nurse is caring for an infant born to a mother who abused cocaine during her pregnancy. Which
of the following characteristics would the nurse likely see in this infant? - CORRECT ANSWER-
The infant cries when touched
In the child diagnosed with hydrocephalus, an obstruction occurs that blocks the normal process of
which of the following? - CORRECT ANSWER-Cerebrospinal fluid
The nurse is changing the diaper on a newborn and notices that there is a musty smell to the infant's
urine. This finding is a characteristic sign of which of the following disorders? - CORRECT
ANSWER-Phenylketonuria
There is a characteristic musty smell to the urine in the child with Phenylketonuria. None of the
other disorders effect the urine or the smell of the urine.
Immediately after delivery, the nurse is caring for a newborn with a myeolomeningocele. What
intervention should the nurse provide to prevent drying out of the sac to avoid damage? -
CORRECT ANSWER-Apply a sterile dressing moistened in a warm sterile saline solution
Until surgery is performed, the sac must be covered with a sterile dressing moistened in a warm
sterile solution (often saline). The nurse should change this dressing every 2 hours and not allow it to
dry to avoid damage to the covering of the sac.
, The nurse is working with a group of parents of children who have congenital heart disorders. Which
of the following statements made by the parents would most likely be an indication the child is
showing signs of congestive heart failure. - CORRECT ANSWER-"She gets so tired when she is
eating"
Hydrocephalus has the clinical manifestations of a larger head than normal with widening cranial
sutures. As the head enlarges, the suture lines separate and the spaces are felt through the scalp.
The anterior fontanelle becomes tense and bulging, the skull enlarges, the scalp becomes shiny, and
its veins dilate. If pressure continues, the eyes appear to be pushed downward slightly and the
sclerae visible above the irises. Spina bifida is a defect in the neural arch and is a failure of the
posterior laminae of the vertebrae to close. Both septal defect and coarctation are both defects that
involve the heart.
A nursing student is learning about newborn congenital defects. The defect with symptoms that
include a shiny scalp, dilated scalp veins, a bulging anterior fontanelle, and eyes pushed downward
with the sclerae visible above the irises is known as which of the following? - CORRECT
ANSWER-Hydrocephalus
Hydrocephalus has the clinical manifestations of a larger head than normal with widening cranial
sutures. As the head enlarges, the suture lines separate and the spaces are felt through the scalp.
The anterior fontanelle becomes tense and bulging, the skull enlarges, the scalp becomes shiny, and
its veins dilate. If pressure continues, the eyes appear to be pushed downward slightly and the
sclerae visible above the irises. Spina bifida is a defect in the neural arch and is a failure of the
posterior laminae of the vertebrae to close. Both septal defect and coarctation are both defects that
involve the heart
The nurse is caring for a newborn with hemolytic disease of the newborn who is receiving
phototherapy. Which of the following nursing interventions would be most appropriate for the nurse
to do? - CORRECT ANSWER-The nurse turns the newborn every 3 or 4 hours
Turn the newborn every 3 or 4 hours to rotate the area of exposure. Do not turn off the lights except
to feed and to change the diaper. The infant is nude to maximize the skin surface area exposed to
the light. Remove the patches every four hours to cleanse the eyes and examine for irritation,
inflammation, and/or dryness. Clean and change the patches daily.
After teaching a group of students about the physiologic jaundice in breast-fed and bottle-fed
newborns, the instructor determines that the teaching was successful when the students state
which of the following? - CORRECT ANSWER-The decline in bilirubin levels occurs more quickly
in bottle-fed newborns
Breast-fed newborns typically have peak bilirubin levels on the fourth day of life; bottle-fed
newborns usually have peak bilirubin levels on the third day of life. The rate of bilirubin decline is
less rapid in breast-fed newborns compared with bottle-fed newborns. Jaundice associated with
breastfeeding presents in two distinct patterns: early-onset and late-onset. Bottle-fed newborns
