“Comprehensive Pediatric Nursing Test
Bank | High-Yield Exam Prep Resource”
MULTIPLE RESPONSE
1. The nurse is caring for a 14-year-old child with disseminated intravascular coagulation (DIC).
What clinical manifestations should the nurse expect to observe? (Select all that apply.)
a. Petechiae
b. Chronic diarrhea
c. Hepatosplenomegaly
d. Bleeding from openings in the skin
e. Hypotension
f. Purpura
ANS: A, D, E, F
Some clinical manifestations of DIC are petechiae, bleeding from openings in the skin,
hypotension, and purpura. Hepatosplenomegaly and chronic diarrhea are clinical manifestations
of human immunodeficiency virus (HIV) infection in children.
DIF: Cognitive Level: Analyzing REF: MCS: 1364
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
,2. What activity should the school nurse recommend for a child with hemophilia A? (Select all
that apply.)
a. Golf
b. Soccer
c. Rugby
d. Jogging
e. Swimming
ANS: A, D, E
Children and adolescents with severe hemophilia can participate in noncontact sports such as
swimming, golf, walking, jogging, fishing, and bowling. Contact sports such as football, boxing,
hockey, soccer, and rugby are strongly discouraged because the risk of injury outweighs the
physical and psychosocial benefits of participating in these sports.
DIF: Cognitive Level: Applying REF: MCS: 1360
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
3. What are signs and symptoms of anemia? (Select all that apply.)
a. Pallor
b. Fatigue
c. Dilute urine
d. Bradycardia
e. Muscle weakness
ANS: A, B, E
Signs and symptoms of anemia include, pallor, fatigue, and muscle weakness. Tachycardia, not
bradycardia, and dark urine, not dilute, are signs and symptoms of anemia.
,DIF: Cognitive Level: Analyzing REF: MCS: 1329
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
4. The nurse is administering a unit of blood to a child. What are signs and symptoms of a
transfusion reaction? (Select all that apply.)
a. Chills
b. Shaking
c. Flank pain
d. Hypothermia
e. Sudden severe headache
ANS: A, B, C, E
Signs and symptoms of a transfusion reaction include chills, shaking, flank pain, and sudden
severe headache. Hyperthermia, not hypothermia, occurs.
DIF: Cognitive Level: Applying REF: MCS: 1332
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment
5. The nurse is teaching parents of a child being discharged from the hospital after a splenectomy
about the risk of infection. What should the nurse include in the teaching session? (Select all that
apply.)
a. Avoid obtaining the pneumococcal vaccination for the child.
b. Avoid obtaining the meningococcal vaccination for the child.
c. The child should receive prophylactic penicillin for certain procedures.
d. Have the child immunized with the Haemophilus influenzae type b vaccination.
e. Notify the health care provider if your child develops a fever of 38.5 C (101.3 F).
ANS: C, D, E
, Because of the risk of life-threatening bacterial infection after splenectomy, these children are
immunized with the pneumococcal, meningococcal, and H. influenzae type b vaccines before
surgery and receive prophylactic penicillin for several years after splenectomy. The parents
should be instructed in the importance of seeking immediate medical attention if their child
develops a fever of 38.5 C (101.3 F) or higher as a common sign of infection or postsplenectomy
sepsis.
DIF: Cognitive Level: Applying REF: MCS: 1339
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
6. The clinic nurse is evaluating causes for iron deficiency caused by inadequate supply of iron.
What should the nurse recognize as causes for iron deficiency caused by an inadequate iron
supply? (Select all that apply.)
a. Prematurity
b. Slow growth rate
c. Excessive milk intake
d. Severe iron deficiency in the mother
e. Exclusive breastfeeding of infant from birth to 3 months
ANS: A, C, D
Causes for iron deficiency caused by an inadequate supply of iron include prematurity, excessive
milk intake, and severe iron deficiency in the mother. Rapid growth rate, not slow, and exclusive
breastfeeding of infant after 6 months, not from birth to 3 months, can be causes of inadequate
supply of iron.
DIF: Cognitive Level: Analyzing REF: MCS: 1335
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
Bank | High-Yield Exam Prep Resource”
MULTIPLE RESPONSE
1. The nurse is caring for a 14-year-old child with disseminated intravascular coagulation (DIC).
What clinical manifestations should the nurse expect to observe? (Select all that apply.)
a. Petechiae
b. Chronic diarrhea
c. Hepatosplenomegaly
d. Bleeding from openings in the skin
e. Hypotension
f. Purpura
ANS: A, D, E, F
Some clinical manifestations of DIC are petechiae, bleeding from openings in the skin,
hypotension, and purpura. Hepatosplenomegaly and chronic diarrhea are clinical manifestations
of human immunodeficiency virus (HIV) infection in children.
DIF: Cognitive Level: Analyzing REF: MCS: 1364
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
,2. What activity should the school nurse recommend for a child with hemophilia A? (Select all
that apply.)
a. Golf
b. Soccer
c. Rugby
d. Jogging
e. Swimming
ANS: A, D, E
Children and adolescents with severe hemophilia can participate in noncontact sports such as
swimming, golf, walking, jogging, fishing, and bowling. Contact sports such as football, boxing,
hockey, soccer, and rugby are strongly discouraged because the risk of injury outweighs the
physical and psychosocial benefits of participating in these sports.
DIF: Cognitive Level: Applying REF: MCS: 1360
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
3. What are signs and symptoms of anemia? (Select all that apply.)
a. Pallor
b. Fatigue
c. Dilute urine
d. Bradycardia
e. Muscle weakness
ANS: A, B, E
Signs and symptoms of anemia include, pallor, fatigue, and muscle weakness. Tachycardia, not
bradycardia, and dark urine, not dilute, are signs and symptoms of anemia.
,DIF: Cognitive Level: Analyzing REF: MCS: 1329
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
4. The nurse is administering a unit of blood to a child. What are signs and symptoms of a
transfusion reaction? (Select all that apply.)
a. Chills
b. Shaking
c. Flank pain
d. Hypothermia
e. Sudden severe headache
ANS: A, B, C, E
Signs and symptoms of a transfusion reaction include chills, shaking, flank pain, and sudden
severe headache. Hyperthermia, not hypothermia, occurs.
DIF: Cognitive Level: Applying REF: MCS: 1332
TOP: Nursing Process: Assessment
MSC: Client Needs: Safe and Effective Care Environment
5. The nurse is teaching parents of a child being discharged from the hospital after a splenectomy
about the risk of infection. What should the nurse include in the teaching session? (Select all that
apply.)
a. Avoid obtaining the pneumococcal vaccination for the child.
b. Avoid obtaining the meningococcal vaccination for the child.
c. The child should receive prophylactic penicillin for certain procedures.
d. Have the child immunized with the Haemophilus influenzae type b vaccination.
e. Notify the health care provider if your child develops a fever of 38.5 C (101.3 F).
ANS: C, D, E
, Because of the risk of life-threatening bacterial infection after splenectomy, these children are
immunized with the pneumococcal, meningococcal, and H. influenzae type b vaccines before
surgery and receive prophylactic penicillin for several years after splenectomy. The parents
should be instructed in the importance of seeking immediate medical attention if their child
develops a fever of 38.5 C (101.3 F) or higher as a common sign of infection or postsplenectomy
sepsis.
DIF: Cognitive Level: Applying REF: MCS: 1339
TOP: Integrated Process: Teaching/Learning
MSC: Client Needs: Health Promotion and Maintenance
6. The clinic nurse is evaluating causes for iron deficiency caused by inadequate supply of iron.
What should the nurse recognize as causes for iron deficiency caused by an inadequate iron
supply? (Select all that apply.)
a. Prematurity
b. Slow growth rate
c. Excessive milk intake
d. Severe iron deficiency in the mother
e. Exclusive breastfeeding of infant from birth to 3 months
ANS: A, C, D
Causes for iron deficiency caused by an inadequate supply of iron include prematurity, excessive
milk intake, and severe iron deficiency in the mother. Rapid growth rate, not slow, and exclusive
breastfeeding of infant after 6 months, not from birth to 3 months, can be causes of inadequate
supply of iron.
DIF: Cognitive Level: Analyzing REF: MCS: 1335
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
