1
NR 328 Exam Pediatric Nursing EXAM
NR 328 Exam FINAL PREDICTOR Pediatric
Nursing EXAM PREDICTOR VERIFIED
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH DETAILED RATIONALES
GRADED A+ GUARANTEED PASS ACE YR
EXAM
The nurse must prevent a 2-year old with severe eczema on the face, neck and scalp from
scratching the affected areas. Which nursing intervention is most effective in preventing
further excoriation due to the pruritis?
A. obtain gloves for the child's hands
B. apply finger cots on the child's fingers
C. place elbow restraints on the child's arms
D. apply soft restraints to the child's wrists
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NR 328 Exam Pediatric Nursing EXAM
C. place elbow restraints on the child's arms
Elbow restraints prevent arm flexion and scratching of involved areas, but do not inhibit use
of the hands for play activities. (A and B) can be easily removed by the child and would
restrict hand movement. (D) would be ineffective in preventing the child from scratching
because the upper body could be moved within reach of restrained hands, and would also
create the greatest restriction of hand movement.
The nurse assigning care for a 5-year old with otitis media is concerned about the child's
increasing temperature over the past 24 hours. Which statement is accurate and should be
considered when planning care for the remainder of the shift?
A. An RN should be assigned to take temperatures frequently.
B. tympanic and oral temperatures are equally accurate
C. the PN should take rectal temperatures on this child.
D. The pediatrician should decide how to assess the temperature
B. tympanic and oral temperatures are equally accurate
A tympanic membrane sensor approximates core temperatures because the hypothalamus
and eardrum are perfused by the same circulation. Tympanic readings obtained using proper
technique correlated moderately to strongly with oral temperatures in recent research
studies. The sensor is unaffected by the cerumen or the presence of suppurative or
unsuppurative otitis media. A RN is not required to take the child's temperature, but must
assess readings received from assistive personnel. Although rectal readings are highly
accurate, such an invasive procedure is unnecessary and it is not necessary to contact the
pediatrician.
A 3-year old boy is brought to the emergency room because he swallowed an entire bottle
of children's vitamin pills. Which intervention should the nurse implement first?
A. insert NG tube for gastric lavage
B. determine the child's pulse and respirations
C. assess the child's LOC
D. administer an IV D5/0.25 NS as prescribed
B. determine the child's pulse and respirations
The most important principle in dealing with a poisoning is to treat the child first, not the
poison. Initiate immediate life support measures with assessment of vital signs, in particular,
respirations. Inserting an airway or initiating mechanical ventilation may be necessary.
Assessment and identification of the poison should occur prior to insertion of an NG tube. (C
and D) should occur after assessing the airway.
, 3
NR 328 Exam Pediatric Nursing EXAM
A 2-year old with gastro-esophageal reflux has developed a fear of eating. What instruction
should the nurse include in the parents' teaching plan?
A. invite other children home to share meals
B. accept that he will eat when he is hungry
C. reward the child with a nap after eating
D. consistently follow a set mealtime routine.
D. consistently follow a set mealtime routine.
A 2-year old child is comforted by consistency. (A) is contraindicate because 2 year olds may
participate in parallel activities with other children but are too young to feel comfort and
support by the presence of other children when anxious or afraid. (B) may or may not be
true and does not address the child's fears. The child with reflux should remain upright at
least 2 hours after eating to reduce symptoms.
A 6-month old boy and his mother are at the healthcare provider's office for a well-baby
checkup and routine immunizations. the healthcare provider recommends to the mother
that the child receive an influenza vaccine. What medications should the nurse plan to
administer today?
A. The routine immunizations and schedule another appointment to administer the influenza
vaccine
B. All the immunizations with the influenza vaccine given at a separate site from any other
injection.
C. the influenza vaccine and schedule another appointment to administer the immunizations
D. The influenza vaccine and the polio vaccine and schedule another appointment to
administer the remaining immunizations.
B. All the immunizations with the influenza vaccine given at a separate site from any other
injection.
At 6 months of age, the routine immunizations include Hepatitis B, DTaP, Hib (Haemophilus
influenza type b), PCV (Pneumococcal), IPV (inactive poliovirus) and influenza. the influenza
vaccine should be given at a separate site from any other injection. Scheduling a return visit
increases the risk that the mother will not bring the child back for the immunizations.
The nurse is assessing a 13-year old girl with suspected hyperthyroidism. Which question is
most important for the nurse to ask her during the admission interview?
A. Have you lost any weight in the last month?
B. Are you experiencing any type of nervousness?
C. When was the last time you took synthroid?
D. Are you having any problems with your vision?
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NR 328 Exam Pediatric Nursing EXAM
B. Are you experiencing any type of nervousness?
Assessing the client's physiological state upon admission is a priority, and nervousness,
apprehension, hyperexcitability, and palpitations are signs of hyperthyroidism. Weight loss
(even with a hearty appetite) occurs in those with hyperthyroidism, but assessing the
client's neurological state has a higher priority. Hormone replacement is not administered to
a client who is already producing too much thyroid. The client may have exophthalmus
(bulging eyes), but hyperthyroidism does not cause vision problems.
The nurse is planning care for school aged children at a community care center. Which
activity is best for the children?
A. building model airplanes
B. playing follow-the-leader
C. stringing large and small beads
D. Playing with playdough and clay
B. playing follow-the-leader
School-aged children strive for independence and productivity (Erikson's Industry vs.
Inferiority) and enjoy individual and group activities related to real life situations, such as
playing follow the leader. (A) is an individual activity that could contribute to feelings of
inferiority and inadequacy if the task if too complex, although school-aged children enjoy
crafts. (C and D) are more appropriate for pre-school children.
Surgery is being delayed for an infant with undescended testes. In collaboration with the
healthcare provider and the family, which prescription should the nurse anticipate?
A. a trial of adrenocorticotropic hormone injections
B. Frequent stimulation of the cremasteric reflex
C. a trial of human chorionic gonadotrophic hormone
D. frequent warm baths to gently dilate the scrotal area.
C. a trial of human chorionic gonadotrophic hormone
A trial of HCG (human chorionic gonadotrophic) hormone may aid in testicular descent, but
does not replace surgical repair for true undescended testes. Undescended testes
(cryptorchidism) may be found in the inguinal canal due to exaggerated cremasteric reflex.
(A) is not indicated. Stimulation of the cremasteric reflex causes the testes to ascend rather
than to descend in the scrotum. (D) may relax the cremasteric muscle, but may not cause
the testes to descend.
A 3 year old client with sickle cell anemia is admitted to the Emergency Department with
abdominal pain. The nurse palpates an enlarged liver, an x-ray reveals an enlarged spleen,
and a CBC reveals anemia. these findings indicate which type of crisis?
NR 328 Exam Pediatric Nursing EXAM
NR 328 Exam FINAL PREDICTOR Pediatric
Nursing EXAM PREDICTOR VERIFIED
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH DETAILED RATIONALES
GRADED A+ GUARANTEED PASS ACE YR
EXAM
The nurse must prevent a 2-year old with severe eczema on the face, neck and scalp from
scratching the affected areas. Which nursing intervention is most effective in preventing
further excoriation due to the pruritis?
A. obtain gloves for the child's hands
B. apply finger cots on the child's fingers
C. place elbow restraints on the child's arms
D. apply soft restraints to the child's wrists
, 2
NR 328 Exam Pediatric Nursing EXAM
C. place elbow restraints on the child's arms
Elbow restraints prevent arm flexion and scratching of involved areas, but do not inhibit use
of the hands for play activities. (A and B) can be easily removed by the child and would
restrict hand movement. (D) would be ineffective in preventing the child from scratching
because the upper body could be moved within reach of restrained hands, and would also
create the greatest restriction of hand movement.
The nurse assigning care for a 5-year old with otitis media is concerned about the child's
increasing temperature over the past 24 hours. Which statement is accurate and should be
considered when planning care for the remainder of the shift?
A. An RN should be assigned to take temperatures frequently.
B. tympanic and oral temperatures are equally accurate
C. the PN should take rectal temperatures on this child.
D. The pediatrician should decide how to assess the temperature
B. tympanic and oral temperatures are equally accurate
A tympanic membrane sensor approximates core temperatures because the hypothalamus
and eardrum are perfused by the same circulation. Tympanic readings obtained using proper
technique correlated moderately to strongly with oral temperatures in recent research
studies. The sensor is unaffected by the cerumen or the presence of suppurative or
unsuppurative otitis media. A RN is not required to take the child's temperature, but must
assess readings received from assistive personnel. Although rectal readings are highly
accurate, such an invasive procedure is unnecessary and it is not necessary to contact the
pediatrician.
A 3-year old boy is brought to the emergency room because he swallowed an entire bottle
of children's vitamin pills. Which intervention should the nurse implement first?
A. insert NG tube for gastric lavage
B. determine the child's pulse and respirations
C. assess the child's LOC
D. administer an IV D5/0.25 NS as prescribed
B. determine the child's pulse and respirations
The most important principle in dealing with a poisoning is to treat the child first, not the
poison. Initiate immediate life support measures with assessment of vital signs, in particular,
respirations. Inserting an airway or initiating mechanical ventilation may be necessary.
Assessment and identification of the poison should occur prior to insertion of an NG tube. (C
and D) should occur after assessing the airway.
, 3
NR 328 Exam Pediatric Nursing EXAM
A 2-year old with gastro-esophageal reflux has developed a fear of eating. What instruction
should the nurse include in the parents' teaching plan?
A. invite other children home to share meals
B. accept that he will eat when he is hungry
C. reward the child with a nap after eating
D. consistently follow a set mealtime routine.
D. consistently follow a set mealtime routine.
A 2-year old child is comforted by consistency. (A) is contraindicate because 2 year olds may
participate in parallel activities with other children but are too young to feel comfort and
support by the presence of other children when anxious or afraid. (B) may or may not be
true and does not address the child's fears. The child with reflux should remain upright at
least 2 hours after eating to reduce symptoms.
A 6-month old boy and his mother are at the healthcare provider's office for a well-baby
checkup and routine immunizations. the healthcare provider recommends to the mother
that the child receive an influenza vaccine. What medications should the nurse plan to
administer today?
A. The routine immunizations and schedule another appointment to administer the influenza
vaccine
B. All the immunizations with the influenza vaccine given at a separate site from any other
injection.
C. the influenza vaccine and schedule another appointment to administer the immunizations
D. The influenza vaccine and the polio vaccine and schedule another appointment to
administer the remaining immunizations.
B. All the immunizations with the influenza vaccine given at a separate site from any other
injection.
At 6 months of age, the routine immunizations include Hepatitis B, DTaP, Hib (Haemophilus
influenza type b), PCV (Pneumococcal), IPV (inactive poliovirus) and influenza. the influenza
vaccine should be given at a separate site from any other injection. Scheduling a return visit
increases the risk that the mother will not bring the child back for the immunizations.
The nurse is assessing a 13-year old girl with suspected hyperthyroidism. Which question is
most important for the nurse to ask her during the admission interview?
A. Have you lost any weight in the last month?
B. Are you experiencing any type of nervousness?
C. When was the last time you took synthroid?
D. Are you having any problems with your vision?
, 4
NR 328 Exam Pediatric Nursing EXAM
B. Are you experiencing any type of nervousness?
Assessing the client's physiological state upon admission is a priority, and nervousness,
apprehension, hyperexcitability, and palpitations are signs of hyperthyroidism. Weight loss
(even with a hearty appetite) occurs in those with hyperthyroidism, but assessing the
client's neurological state has a higher priority. Hormone replacement is not administered to
a client who is already producing too much thyroid. The client may have exophthalmus
(bulging eyes), but hyperthyroidism does not cause vision problems.
The nurse is planning care for school aged children at a community care center. Which
activity is best for the children?
A. building model airplanes
B. playing follow-the-leader
C. stringing large and small beads
D. Playing with playdough and clay
B. playing follow-the-leader
School-aged children strive for independence and productivity (Erikson's Industry vs.
Inferiority) and enjoy individual and group activities related to real life situations, such as
playing follow the leader. (A) is an individual activity that could contribute to feelings of
inferiority and inadequacy if the task if too complex, although school-aged children enjoy
crafts. (C and D) are more appropriate for pre-school children.
Surgery is being delayed for an infant with undescended testes. In collaboration with the
healthcare provider and the family, which prescription should the nurse anticipate?
A. a trial of adrenocorticotropic hormone injections
B. Frequent stimulation of the cremasteric reflex
C. a trial of human chorionic gonadotrophic hormone
D. frequent warm baths to gently dilate the scrotal area.
C. a trial of human chorionic gonadotrophic hormone
A trial of HCG (human chorionic gonadotrophic) hormone may aid in testicular descent, but
does not replace surgical repair for true undescended testes. Undescended testes
(cryptorchidism) may be found in the inguinal canal due to exaggerated cremasteric reflex.
(A) is not indicated. Stimulation of the cremasteric reflex causes the testes to ascend rather
than to descend in the scrotum. (D) may relax the cremasteric muscle, but may not cause
the testes to descend.
A 3 year old client with sickle cell anemia is admitted to the Emergency Department with
abdominal pain. The nurse palpates an enlarged liver, an x-ray reveals an enlarged spleen,
and a CBC reveals anemia. these findings indicate which type of crisis?
