Davis Nclex RN - Nursing Care of the Pediatric
Client questions and answers 2025-2026 update
A nurse is caring for a child diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH
Which laboratory test would the nurse be least likely to obtain?
A) Urine specific gravity.
B) Blood glucose.
C) Serum sodium.
D) Urine osmolality. - ANS >>B) Blood Glucose
Rationale-Obtaining a blood glucose level is not expected for a child diagnosed with SIADH since th
priority measures involve blood and urine osmolality. Blood glucose is a likely laboratory test in a chil
with diabetes insipidus.
A physician prescribes digoxin (Lanoxin) for a toddler with congestive heart failure (CHF). Befor
administering the medication, it is most important for the nurse to:
A) First obtain an apical heart rate.
B) Determine the serum potassium.
C) Review the child's admission electrocardiogram (ECG).
D) Mix the medication with a pleasant-tasting food. - ANS >>A) First obtain an apical heart rate
Rationale - Apical heart rate must be obtained by the nurse prior to the administration of digoxin (Lanoxin
to a child. Unless otherwise prescribed, the medication is typically withheld for a heart rate below 90 t
110 bpm in young children
A nurse prepares to administer spironolactone (Aldactone) to an infant with congenital heart disease. Th
nurse understands that the main purpose of this medication is to:
A) Preserve the patent ductus arteriosus.
B) Cause vasodilation of the blood vessels.
,C) Prevent the secretion of potassium.
D) Block aldosterone, which leads to diuresis. - ANS >>D) Block aldosterone, which leads to diuresis.
Rationale - Spironolactone (Aldactone) is a diuretic that blocks aldosterone. Use of this medication i
common among children with congenital heart disease for the prevention and treatment of congestiv
heart failure.
Which symptom(s), if present in a child, should a nurse recognize as being characteristic of Kawasak
disease? Select all that apply.
A) Strawberry tongue.
B) High fever.
C) Irritability.
D) Cough.
E) Desquamation of the extremities.
F) Elevated ESR. - ANS >>A) Strawberry tongue.
B) High fever.
C) Irritability.
E) Desquamation of the extremities.
F) Elevated ESR.
Rationale - Strawberry tongue is a symptom of Kawasaki disease (mucocutaneous lymph nod
syndrome), occur- ring as the skin of the tongue sloughs off, leaving a bright red tongue with white spots
A symptom of Kawasaki disease is high fever lasting more than 5 days. Irritability is a symptom o
Kawasaki disease.
The child with Kawasaki disease may experience peeling of the hands (on palms and fingertips) and fee
(on soles and tips of toes) following the initial inflammatory rash on these areas.
An elevated erythrocyte sedimentation rate (ESR) is a symptom of Kawasaki disease. Elevated ESR i
indicative of an inflammatory process, which would include Kawasaki disease.
Which orders should a nurse question for a 5-month-old infant with hypoplastic left heart syndrome wh
is hospitalized awaiting the second stage of surgical repair? Select all that apply.
A) Call physician for oxygen saturations below 85%.
B) Daily weights.
C) Hold digoxin (Lanoxin) for heart rate less than 80 beats per minute.
D) Strict I&O.
E) Enfamil formula ad lib. - ANS >>A) Call physician for oxygen saturations below 85%.
C) Hold digoxin (Lanoxin) for heart rate less than 80 beats per minute.
,E) Enfamil formula ad lib.
Rationale - The nurse should question an order that requires the nurse to call the physician for an oxyge
saturation that is appropriate for an infant waiting surgical repair for a severe cyanotic heart defect.
This parameter is too low. The heart rate should be at least 100 when administering digoxin (Lanoxin) t
an infant.
An infant with a con- genital heart defect frequently requires formula with extra calories per ounce
Regular Enfamil formula would not provide sufficient calories.
A nurse would be most correct in withholding digoxin (Lanoxin) prescribed to an infant if the heart rat
falls below which parameter?
A) Below 100 beats per minute.
B) Below 120 beats per minute.
C) Below 140 beats per minute.
D) Below 160 beats per minute. - ANS >>A) Below 100 beats per minute.
Rationale - digoxin (Lanoxin) should be withheld if the heart rate of the infant falls below 90 to 110 beat
per minute (bpm). If digoxin (Lanoxin) is given when the infant's heart rate is 100, the resulting cardia
output may not be adequate.
A hospitalized child is experiencing sickle cell vaso-occlusive crisis. The child is currently receiving a
intra- venous (IV) fluid bolus, pain medication every 4 hours, and warm compresses to the extremities pe
physician orders. During the midday assessment, the child reports no pain. Which action should a nurs
take?
A) Continue to apply warm compresses per physician order.
B) Hold the next dosage of pain medication.
C) Hold the next round of warm compresses.
D) Contact the physician for a change in orders. - ANS >>A) Continue to apply warm compresses pe
physician order.
Rationale - The child is currently receiving a fluid bolus, which may be providing temporary improvemen
of pain symptoms. Ongoing application of warm compresses will continue to promote circulation in th
extremities, thereby preventing pain. Once the fluid bolus is completed, the nurse should reassess th
child's pain and circulation.
What should be the expected weight of an infant at 12 months of age whose birth weight was 3600 grams
, A) 5600 grams.
B) 7200 grams.
C) 11 kilograms.
D) 15 kilograms. - ANS >>C) 11 kilograms.
Rationale - An infant is expected to triple its birth weight in the first year of life; therefore, 11 kilogram
(11,000 grams) is the best ANS >> of the options given.
An infant in a newborn nursery is identified as having phenylketonuria (PKU). What is the best initia
source of nutrients for an infant with this diagnosis?
A) Maternal breast milk.
B) Pregestimil.
C) Lofenalac.
D) Isomil. - ANS >>A) Maternal breast milk
Rationale - The child with PKU is missing the enzyme needed to digest the amino acid phenylalanine
Maternal breast milk has many beneficial properties and it contains low levels of phenylalanine. Therefore
breast milk should be given until laboratory findings demonstrate the child is not tolerating the breas
milk.
In assessing the reflexes of a 15-month-old child, which finding would indicate that the child
experiencing normal development?
A) Positive Babinski reflex.
B) Asymmetric tonic neck reflex.
C) Positive patellar reflex.
D) Presence of doll's eye reflex. - ANS >>C) Positive patellar reflex.
Rationale - A positive patellar reflex is part of a normal assessment. The reflex is obtained when th
practitioner strikes the patellar tendon, causing the leg to kick.
A child with type 1 diabetes is receiving insulin based on carbohydrate intake. The child's insulin-to
carbohydrate ratio is 15:1. Of the items listed on the child's lunch menu shown below, the child ate
slices of bread, a slice of cheese, a glass of milk, a cup of soup, and half of a banana. How many units o
insulin should the nurse administer based on the client's carbohydrate count? Round to the nearest whol
number.
Food Item with Carbohydrate level:
Client questions and answers 2025-2026 update
A nurse is caring for a child diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH
Which laboratory test would the nurse be least likely to obtain?
A) Urine specific gravity.
B) Blood glucose.
C) Serum sodium.
D) Urine osmolality. - ANS >>B) Blood Glucose
Rationale-Obtaining a blood glucose level is not expected for a child diagnosed with SIADH since th
priority measures involve blood and urine osmolality. Blood glucose is a likely laboratory test in a chil
with diabetes insipidus.
A physician prescribes digoxin (Lanoxin) for a toddler with congestive heart failure (CHF). Befor
administering the medication, it is most important for the nurse to:
A) First obtain an apical heart rate.
B) Determine the serum potassium.
C) Review the child's admission electrocardiogram (ECG).
D) Mix the medication with a pleasant-tasting food. - ANS >>A) First obtain an apical heart rate
Rationale - Apical heart rate must be obtained by the nurse prior to the administration of digoxin (Lanoxin
to a child. Unless otherwise prescribed, the medication is typically withheld for a heart rate below 90 t
110 bpm in young children
A nurse prepares to administer spironolactone (Aldactone) to an infant with congenital heart disease. Th
nurse understands that the main purpose of this medication is to:
A) Preserve the patent ductus arteriosus.
B) Cause vasodilation of the blood vessels.
,C) Prevent the secretion of potassium.
D) Block aldosterone, which leads to diuresis. - ANS >>D) Block aldosterone, which leads to diuresis.
Rationale - Spironolactone (Aldactone) is a diuretic that blocks aldosterone. Use of this medication i
common among children with congenital heart disease for the prevention and treatment of congestiv
heart failure.
Which symptom(s), if present in a child, should a nurse recognize as being characteristic of Kawasak
disease? Select all that apply.
A) Strawberry tongue.
B) High fever.
C) Irritability.
D) Cough.
E) Desquamation of the extremities.
F) Elevated ESR. - ANS >>A) Strawberry tongue.
B) High fever.
C) Irritability.
E) Desquamation of the extremities.
F) Elevated ESR.
Rationale - Strawberry tongue is a symptom of Kawasaki disease (mucocutaneous lymph nod
syndrome), occur- ring as the skin of the tongue sloughs off, leaving a bright red tongue with white spots
A symptom of Kawasaki disease is high fever lasting more than 5 days. Irritability is a symptom o
Kawasaki disease.
The child with Kawasaki disease may experience peeling of the hands (on palms and fingertips) and fee
(on soles and tips of toes) following the initial inflammatory rash on these areas.
An elevated erythrocyte sedimentation rate (ESR) is a symptom of Kawasaki disease. Elevated ESR i
indicative of an inflammatory process, which would include Kawasaki disease.
Which orders should a nurse question for a 5-month-old infant with hypoplastic left heart syndrome wh
is hospitalized awaiting the second stage of surgical repair? Select all that apply.
A) Call physician for oxygen saturations below 85%.
B) Daily weights.
C) Hold digoxin (Lanoxin) for heart rate less than 80 beats per minute.
D) Strict I&O.
E) Enfamil formula ad lib. - ANS >>A) Call physician for oxygen saturations below 85%.
C) Hold digoxin (Lanoxin) for heart rate less than 80 beats per minute.
,E) Enfamil formula ad lib.
Rationale - The nurse should question an order that requires the nurse to call the physician for an oxyge
saturation that is appropriate for an infant waiting surgical repair for a severe cyanotic heart defect.
This parameter is too low. The heart rate should be at least 100 when administering digoxin (Lanoxin) t
an infant.
An infant with a con- genital heart defect frequently requires formula with extra calories per ounce
Regular Enfamil formula would not provide sufficient calories.
A nurse would be most correct in withholding digoxin (Lanoxin) prescribed to an infant if the heart rat
falls below which parameter?
A) Below 100 beats per minute.
B) Below 120 beats per minute.
C) Below 140 beats per minute.
D) Below 160 beats per minute. - ANS >>A) Below 100 beats per minute.
Rationale - digoxin (Lanoxin) should be withheld if the heart rate of the infant falls below 90 to 110 beat
per minute (bpm). If digoxin (Lanoxin) is given when the infant's heart rate is 100, the resulting cardia
output may not be adequate.
A hospitalized child is experiencing sickle cell vaso-occlusive crisis. The child is currently receiving a
intra- venous (IV) fluid bolus, pain medication every 4 hours, and warm compresses to the extremities pe
physician orders. During the midday assessment, the child reports no pain. Which action should a nurs
take?
A) Continue to apply warm compresses per physician order.
B) Hold the next dosage of pain medication.
C) Hold the next round of warm compresses.
D) Contact the physician for a change in orders. - ANS >>A) Continue to apply warm compresses pe
physician order.
Rationale - The child is currently receiving a fluid bolus, which may be providing temporary improvemen
of pain symptoms. Ongoing application of warm compresses will continue to promote circulation in th
extremities, thereby preventing pain. Once the fluid bolus is completed, the nurse should reassess th
child's pain and circulation.
What should be the expected weight of an infant at 12 months of age whose birth weight was 3600 grams
, A) 5600 grams.
B) 7200 grams.
C) 11 kilograms.
D) 15 kilograms. - ANS >>C) 11 kilograms.
Rationale - An infant is expected to triple its birth weight in the first year of life; therefore, 11 kilogram
(11,000 grams) is the best ANS >> of the options given.
An infant in a newborn nursery is identified as having phenylketonuria (PKU). What is the best initia
source of nutrients for an infant with this diagnosis?
A) Maternal breast milk.
B) Pregestimil.
C) Lofenalac.
D) Isomil. - ANS >>A) Maternal breast milk
Rationale - The child with PKU is missing the enzyme needed to digest the amino acid phenylalanine
Maternal breast milk has many beneficial properties and it contains low levels of phenylalanine. Therefore
breast milk should be given until laboratory findings demonstrate the child is not tolerating the breas
milk.
In assessing the reflexes of a 15-month-old child, which finding would indicate that the child
experiencing normal development?
A) Positive Babinski reflex.
B) Asymmetric tonic neck reflex.
C) Positive patellar reflex.
D) Presence of doll's eye reflex. - ANS >>C) Positive patellar reflex.
Rationale - A positive patellar reflex is part of a normal assessment. The reflex is obtained when th
practitioner strikes the patellar tendon, causing the leg to kick.
A child with type 1 diabetes is receiving insulin based on carbohydrate intake. The child's insulin-to
carbohydrate ratio is 15:1. Of the items listed on the child's lunch menu shown below, the child ate
slices of bread, a slice of cheese, a glass of milk, a cup of soup, and half of a banana. How many units o
insulin should the nurse administer based on the client's carbohydrate count? Round to the nearest whol
number.
Food Item with Carbohydrate level:
