Maryville University NURS 629 Peds – High-Yield Chapter
Questions (Exams 1–4 Combined) | Latest Update 2026 |
100% Pass Guarantee
1. Which of the following as an appropriate nursing action to include in the care
of an 4 month old infant with a congenital heart defect who is admitted with
congestive heart failure.
Offering small frequent feedings.
Encouraging juice for extra calories for growth.
Positioning flat on the back.
Measuring the head circumference daily.
2. A 14-year-old male presents with recurrent fainting spells and normal
orthostatic blood pressures. What additional tests might a pediatric nurse
practitioner consider before making a referral to a specialist?
Vision acuity test and hearing assessment.
Chest X-ray and MRI of the brain.
Complete blood count (CBC) and urinalysis.
Electrocardiogram (ECG) and echocardiogram.
3. Your patient presents with ear pressure, and upon exam the TM appears to
have a white mass behind it. There are pockets of keratinous debris or
granulation tissue and the TM is retracted. They just recently developed some
hearing loss. What is most likely the condition?
Mastoiditis
Tympanic membrane perforation
Chronic Suppurative Otitis Media
, Cholesteatoma
4. Describe the significance of a midsystolic murmur in a 4-year-old child
during a physical examination.
A midsystolic murmur indicates a serious heart defect.
A midsystolic murmur can indicate a benign condition, often
referred to as a functional murmur, especially if it is louder when the
child is supine.
A midsystolic murmur is irrelevant in pediatric assessments.
A midsystolic murmur is always indicative of an infection.
5. Describe the significance of monitoring for complications in adolescents who
have undergone repair for tetralogy of Fallot.
Monitoring is crucial as complications like pulmonary regurgitation
can lead to heart failure and other cardiac issues.
Monitoring is only needed for the first year after surgery.
Monitoring focuses only on respiratory issues post-surgery.
Monitoring is unnecessary because the repair is permanent.
6. Describe the implications of a cloudy cornea in a pediatric patient after
fluorescein staining.
A cloudy cornea means there is no need for further examination.
A cloudy cornea suggests the presence of a foreign body that will
resolve on its own.
A cloudy cornea indicates that the eye is healthy and functioning
normally.
A cloudy cornea suggests potential damage or disease affecting
the cornea, such as an abrasion or ulcer, which requires further
evaluation and management.
,7. A patient is being seen in the clinic for complaints of "fainting episodes that
started last week." How should you proceed with the examination?
ask the person to walk a few paces and then take their blood pressure.
compare the reading to the resting blood pressure
record the blood pressure lying, sitting, and standing to determine
if orthostatic hypotension is the cause
take the blood pressure in both arms and thighs to determine
coarctation of the aorta is present.
record the blood pressure in the lying and sitting positions and
average these numbers to obtain a mean blood pressure
8. What is the recommended follow-up for a child with a vision of '20/50'?
Provide corrective lenses
No action needed
Reassess vision in 6 months
Referral to an eye specialist
9. A 5-year-old child has enlarged tonsils and a history of four throat infections
in the previous year with fever, cervical lymphadenopathy, and positive
Group A Streptococcus pyogenes (GABHS) cultures. The parent reports that
the child snores at night and expresses concerns about the child's quality of
sleep. What is the next step in managing this child's condition?
prescribe prophylactic antibiotics to prevent recurrent infection.
refer to an otolaryngologist for possible tonsillectomy.
refer to a pulmonologist for polysomnography evaluation.
continue to observe the child for two or more GABHS infections.
10. If the nurse practitioner learns that the toddler's pertussis diagnosis was
confirmed after the infant showed early signs of respiratory distress, what
, immediate action should be taken?
Only monitor the infant's symptoms without intervention.
Delay treatment until the infant is older.
Administer cough syrup to the infant.
Evaluate the infant for pertussis and consider hospitalization if
severe.
11. During a well child assessment of an African-American infant, the primary
care pediatric nurse practitioner notes a dark red-brown light reflex in the
left eye and a slightly brighter, red-orange light reflex in the right eye. The
nurse practitioner will
recheck the red reflex in 1 month
dilate the pupils and reassess the red reflex
order auto-refractor screening of the eyes
refer the infant to an ophthalmologist
12. A 4-year-old boy has been seen in your office in the past year for 7
episodes of tonsillitis in the last year. Tonsils have been moderately swollen
and inflamed, with exudate on 3 occasions. 4 of the 6 episodes have had
positive throat cultures for Group A Streptococcus; cultures were negative
for the other 2 episodes. She does describe intermittent nocturnal snoring
occurring nightly, but not throughout the night. Every so often, she has heard
him make a loud sound with a pause afterward when it sounds as if he is not
breathing. She has gone to check him and found him to be okay when she
arrives in his bedroom. The mother is concerned about his frequent
infections. On PE his tonsils are grade 3 with no pus, no difficulty with
swallowing or talking. The most appropriate next step is:
Treat family with penicillin
Prophylactic antibiotics for 3 months
Questions (Exams 1–4 Combined) | Latest Update 2026 |
100% Pass Guarantee
1. Which of the following as an appropriate nursing action to include in the care
of an 4 month old infant with a congenital heart defect who is admitted with
congestive heart failure.
Offering small frequent feedings.
Encouraging juice for extra calories for growth.
Positioning flat on the back.
Measuring the head circumference daily.
2. A 14-year-old male presents with recurrent fainting spells and normal
orthostatic blood pressures. What additional tests might a pediatric nurse
practitioner consider before making a referral to a specialist?
Vision acuity test and hearing assessment.
Chest X-ray and MRI of the brain.
Complete blood count (CBC) and urinalysis.
Electrocardiogram (ECG) and echocardiogram.
3. Your patient presents with ear pressure, and upon exam the TM appears to
have a white mass behind it. There are pockets of keratinous debris or
granulation tissue and the TM is retracted. They just recently developed some
hearing loss. What is most likely the condition?
Mastoiditis
Tympanic membrane perforation
Chronic Suppurative Otitis Media
, Cholesteatoma
4. Describe the significance of a midsystolic murmur in a 4-year-old child
during a physical examination.
A midsystolic murmur indicates a serious heart defect.
A midsystolic murmur can indicate a benign condition, often
referred to as a functional murmur, especially if it is louder when the
child is supine.
A midsystolic murmur is irrelevant in pediatric assessments.
A midsystolic murmur is always indicative of an infection.
5. Describe the significance of monitoring for complications in adolescents who
have undergone repair for tetralogy of Fallot.
Monitoring is crucial as complications like pulmonary regurgitation
can lead to heart failure and other cardiac issues.
Monitoring is only needed for the first year after surgery.
Monitoring focuses only on respiratory issues post-surgery.
Monitoring is unnecessary because the repair is permanent.
6. Describe the implications of a cloudy cornea in a pediatric patient after
fluorescein staining.
A cloudy cornea means there is no need for further examination.
A cloudy cornea suggests the presence of a foreign body that will
resolve on its own.
A cloudy cornea indicates that the eye is healthy and functioning
normally.
A cloudy cornea suggests potential damage or disease affecting
the cornea, such as an abrasion or ulcer, which requires further
evaluation and management.
,7. A patient is being seen in the clinic for complaints of "fainting episodes that
started last week." How should you proceed with the examination?
ask the person to walk a few paces and then take their blood pressure.
compare the reading to the resting blood pressure
record the blood pressure lying, sitting, and standing to determine
if orthostatic hypotension is the cause
take the blood pressure in both arms and thighs to determine
coarctation of the aorta is present.
record the blood pressure in the lying and sitting positions and
average these numbers to obtain a mean blood pressure
8. What is the recommended follow-up for a child with a vision of '20/50'?
Provide corrective lenses
No action needed
Reassess vision in 6 months
Referral to an eye specialist
9. A 5-year-old child has enlarged tonsils and a history of four throat infections
in the previous year with fever, cervical lymphadenopathy, and positive
Group A Streptococcus pyogenes (GABHS) cultures. The parent reports that
the child snores at night and expresses concerns about the child's quality of
sleep. What is the next step in managing this child's condition?
prescribe prophylactic antibiotics to prevent recurrent infection.
refer to an otolaryngologist for possible tonsillectomy.
refer to a pulmonologist for polysomnography evaluation.
continue to observe the child for two or more GABHS infections.
10. If the nurse practitioner learns that the toddler's pertussis diagnosis was
confirmed after the infant showed early signs of respiratory distress, what
, immediate action should be taken?
Only monitor the infant's symptoms without intervention.
Delay treatment until the infant is older.
Administer cough syrup to the infant.
Evaluate the infant for pertussis and consider hospitalization if
severe.
11. During a well child assessment of an African-American infant, the primary
care pediatric nurse practitioner notes a dark red-brown light reflex in the
left eye and a slightly brighter, red-orange light reflex in the right eye. The
nurse practitioner will
recheck the red reflex in 1 month
dilate the pupils and reassess the red reflex
order auto-refractor screening of the eyes
refer the infant to an ophthalmologist
12. A 4-year-old boy has been seen in your office in the past year for 7
episodes of tonsillitis in the last year. Tonsils have been moderately swollen
and inflamed, with exudate on 3 occasions. 4 of the 6 episodes have had
positive throat cultures for Group A Streptococcus; cultures were negative
for the other 2 episodes. She does describe intermittent nocturnal snoring
occurring nightly, but not throughout the night. Every so often, she has heard
him make a loud sound with a pause afterward when it sounds as if he is not
breathing. She has gone to check him and found him to be okay when she
arrives in his bedroom. The mother is concerned about his frequent
infections. On PE his tonsils are grade 3 with no pus, no difficulty with
swallowing or talking. The most appropriate next step is:
Treat family with penicillin
Prophylactic antibiotics for 3 months
