Pediatric Nursing NCLEX Questions
and Answers with Detailed
Rationales 100% correct
1. Question
When assessing a child’s cultural background, the nurse in charge should keep in mind
that:
A. Cultural background usually has little bearing on a family’s health practices
B. Physical characteristics mark the child as part of a particular culture
C. Heritage dictates a group’s shared values
D. Behavioral patterns are passed from one generation to the next
Correct Answer: D. Behavioral patterns are passed from one generation to the
next.
A family’s behavioral patterns and values are passed from one generation to the next.
Pediatric health care providers must be aware of the demographic trends and be
culturally competent to deliver the safest, highest quality care possible to children of
widely differing groups.
• Option A: Cultural background commonly plays a major role in determining a
family’s health practices. Health and health care disparities are inextricably linked;
cultural competence on the part of the health care provider is necessary to minimize
and ultimately eliminate any differences in the quality of health care.
• Option B: Physical characteristics do not indicate a child’s culture. Folk illnesses
often do not have a corresponding illness from a biomedical or scientific perspective
and may not be perceived as an illness or affliction by another cultural group.
• Option C: Although heritage plays a role in culture, it does not dictate a group’s
shared values and its effect on culture is weaker than that of behavioral patterns. In
addition to language differences, cultural differences regarding nonverbal
communication can create communication barriers between a child, family, and the
health care provider.
,2. Question
A child with a poor nutritional status and weight loss is at risk for a negative nitrogen
balance. To help diagnose this problem, the nurse in charge anticipates that the doctor
will order which laboratory test?
A. Total iron-binding capacity
B. Hemoglobin
C. Total protein
Correct answer
D. Serum transferrin
Correct Answer: C. Total protein
A negative nitrogen balance may result from inadequate protein intake and is best
detected by measuring the total protein level. An increase in the protein intake
produces an increase in nitrogen losses via higher amino acid oxidation, especially in
the fed state, and a trend toward positivation of the nitrogen balance. Nitrogen balance
and nitrogen levels at four levels of nitrogen intake in healthy adult subjects (data from
Price et al. 1994).
• Option A: TIBC (total iron-binding capacity)—measures the total amount of iron
that can be bound by proteins in the blood. Since transferrin is the primary iron-
binding protein, the TIBC test is a good indirect measurement of transferrin
availability—the amount of transferrin that is available to bind to iron.
• Option B: Hemoglobin (Hb) is the protein contained in red blood cells that is
responsible for the delivery of oxygen to the tissues. To ensure adequate tissue
oxygenation, a sufficient hemoglobin level must be maintained. When the
hemoglobin level is low, the patient has anemia. An erythrocytosis is the
consequence of too many red cells; this results in hemoglobin levels above normal.
• Option D: Measuring serum transferrin levels would help detect iron-deficiency
anemia, not a negative nitrogen balance. Transferrin can be used to assess the iron
level in the body along with other markers in the body. Transferrin level testing is
used to determine the cause of anemia, examine iron metabolism and determine the
iron-carrying capacity of the blood.
3. Question
A female child, age 2, is brought to the emergency department after ingesting an
unknown number of aspirin tablets about 30 minutes earlier. On entering the
, examination room, the child is crying and clinging to the mother. Which data should the
nurse obtain first?
A. Heart rate, respiratory rate, and blood pressure
Correct answer
B. Recent exposure to communicable diseases
C. Number of immunizations received
D. Height and weight
Correct Answer: A. Heart rate, respiratory rate, and blood pressure
The most important data to obtain on a child’s arrival in the emergency department are
vital sign measurements. Salicylate toxicity is a medical emergency. Intentional
ingestion or accidental overdose can cause severe metabolic derangements, making
treatment difficult. In an acute salicylate overdose, the onset of symptoms will occur
within 3 to 8 hours. The severity of symptoms is dependent on the amount ingested.
• Option B: If the patient can provide history, there are several important pieces of
information to obtain. These include time of ingestion, amount ingested, as well as
formulation. The latter is important as it may affect the rate of absorption.
• Option C: It is critical to determine if there were any other substances ingested as
this may complicate treatment and increase mortality. Determine whether this was
accidental or intentional. This information should be corroborated by family,
friends, or EMS personnel.
• Option D: The nurse should gather these data later. Aspirin has the propensity to
form bezoars which will delay absorption. Aspirin can cause pyloric sphincter
spasms, which increases the amount of time in the stomach allowing for more
absorption.
4. Question
To decrease the likelihood of bradyarrhythmias in children during endotracheal
intubation, succinylcholine (Anectine) is used with which of the following agents?
A. epinephrine (Adrenalin)
B. isoproterenol (Isuprel)
C. atropine sulfate (Atropine)
Correct answer
and Answers with Detailed
Rationales 100% correct
1. Question
When assessing a child’s cultural background, the nurse in charge should keep in mind
that:
A. Cultural background usually has little bearing on a family’s health practices
B. Physical characteristics mark the child as part of a particular culture
C. Heritage dictates a group’s shared values
D. Behavioral patterns are passed from one generation to the next
Correct Answer: D. Behavioral patterns are passed from one generation to the
next.
A family’s behavioral patterns and values are passed from one generation to the next.
Pediatric health care providers must be aware of the demographic trends and be
culturally competent to deliver the safest, highest quality care possible to children of
widely differing groups.
• Option A: Cultural background commonly plays a major role in determining a
family’s health practices. Health and health care disparities are inextricably linked;
cultural competence on the part of the health care provider is necessary to minimize
and ultimately eliminate any differences in the quality of health care.
• Option B: Physical characteristics do not indicate a child’s culture. Folk illnesses
often do not have a corresponding illness from a biomedical or scientific perspective
and may not be perceived as an illness or affliction by another cultural group.
• Option C: Although heritage plays a role in culture, it does not dictate a group’s
shared values and its effect on culture is weaker than that of behavioral patterns. In
addition to language differences, cultural differences regarding nonverbal
communication can create communication barriers between a child, family, and the
health care provider.
,2. Question
A child with a poor nutritional status and weight loss is at risk for a negative nitrogen
balance. To help diagnose this problem, the nurse in charge anticipates that the doctor
will order which laboratory test?
A. Total iron-binding capacity
B. Hemoglobin
C. Total protein
Correct answer
D. Serum transferrin
Correct Answer: C. Total protein
A negative nitrogen balance may result from inadequate protein intake and is best
detected by measuring the total protein level. An increase in the protein intake
produces an increase in nitrogen losses via higher amino acid oxidation, especially in
the fed state, and a trend toward positivation of the nitrogen balance. Nitrogen balance
and nitrogen levels at four levels of nitrogen intake in healthy adult subjects (data from
Price et al. 1994).
• Option A: TIBC (total iron-binding capacity)—measures the total amount of iron
that can be bound by proteins in the blood. Since transferrin is the primary iron-
binding protein, the TIBC test is a good indirect measurement of transferrin
availability—the amount of transferrin that is available to bind to iron.
• Option B: Hemoglobin (Hb) is the protein contained in red blood cells that is
responsible for the delivery of oxygen to the tissues. To ensure adequate tissue
oxygenation, a sufficient hemoglobin level must be maintained. When the
hemoglobin level is low, the patient has anemia. An erythrocytosis is the
consequence of too many red cells; this results in hemoglobin levels above normal.
• Option D: Measuring serum transferrin levels would help detect iron-deficiency
anemia, not a negative nitrogen balance. Transferrin can be used to assess the iron
level in the body along with other markers in the body. Transferrin level testing is
used to determine the cause of anemia, examine iron metabolism and determine the
iron-carrying capacity of the blood.
3. Question
A female child, age 2, is brought to the emergency department after ingesting an
unknown number of aspirin tablets about 30 minutes earlier. On entering the
, examination room, the child is crying and clinging to the mother. Which data should the
nurse obtain first?
A. Heart rate, respiratory rate, and blood pressure
Correct answer
B. Recent exposure to communicable diseases
C. Number of immunizations received
D. Height and weight
Correct Answer: A. Heart rate, respiratory rate, and blood pressure
The most important data to obtain on a child’s arrival in the emergency department are
vital sign measurements. Salicylate toxicity is a medical emergency. Intentional
ingestion or accidental overdose can cause severe metabolic derangements, making
treatment difficult. In an acute salicylate overdose, the onset of symptoms will occur
within 3 to 8 hours. The severity of symptoms is dependent on the amount ingested.
• Option B: If the patient can provide history, there are several important pieces of
information to obtain. These include time of ingestion, amount ingested, as well as
formulation. The latter is important as it may affect the rate of absorption.
• Option C: It is critical to determine if there were any other substances ingested as
this may complicate treatment and increase mortality. Determine whether this was
accidental or intentional. This information should be corroborated by family,
friends, or EMS personnel.
• Option D: The nurse should gather these data later. Aspirin has the propensity to
form bezoars which will delay absorption. Aspirin can cause pyloric sphincter
spasms, which increases the amount of time in the stomach allowing for more
absorption.
4. Question
To decrease the likelihood of bradyarrhythmias in children during endotracheal
intubation, succinylcholine (Anectine) is used with which of the following agents?
A. epinephrine (Adrenalin)
B. isoproterenol (Isuprel)
C. atropine sulfate (Atropine)
Correct answer
