Pediatric Nursing NCLEX Challenge
Exam Questions and 100% Verified
Answers A+ Graded
1. 1. Question
Nurse Elizabeth is administering medication via the intraosseous route to a child.
Intraosseous drug administration is typically used when a child is:
A. Under age 3
B. Over age 3
C. Critically ill and under age 3
D. Critically ill and over age 3
Correct Answer: C. Critically ill and under age 3
In an emergency, intraosseous drug administration is typically used when a child
is critically ill and under age 3. IO access provides a means of administering
medications, glucose, and fluids, as well as (potentially) a means of obtaining
blood samples. Such a situation would include any resuscitation;
cardiopulmonary arrest; shock, regardless of etiology; life-threatening status
epilepticus; or lack of venous access resulting from burns, edema, or obesity.
2. 2. Question
When administering an I.M. injection to an infant, the nurse in charge should use
which site?
A. Deltoid
B. Dorsogluteal
C. Ventrogluteal
D. Vastus lateralis
Correct Answer: D. Vastus lateralis
The recommended injection site for an infant is the vastus lateralis or rectus
femoris muscles. Skeletal muscle can accommodate larger volumes of medication
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, than subcutaneous tissue, and absorption is faster because muscle tissue is highly
vascular. Muscle has fewer pain-sensing nerves than subcutaneous tissue and is
less sensitive to irritating and viscous medications, so pain is lessened.
3. 3. Question
Nurse Charlotte suspects that a child, age 4, is being neglected physically. To best
assess the child’s nutritional status, the nurse should ask the parents which
question?
A. “Has your child always been so thin?”
B. “Is your child a picky eater?”
C. “What did your child eat for breakfast?”
Correct answer
D. “Do you think your child eats enough?”
Correct Answer: C. “What did your child eat for breakfast?”
The nurse should obtain objective information about the child’s nutritional intake,
such as by asking about what the child ate for a specific meal. In order to assess
the adequacy of a child’s nutritional intake, dietitians require detailed information
about all food and drink consumed. As all children admitted to the hospital are at
risk of nutritional deficit, a dietary record should be started on all in-patients,
although this may subsequently be discontinued when deemed appropriate.
4. 4. Question
During a well-baby visit, Liza asks the nurse when she should start giving her
infant solid foods. The nurse should instruct her to introduce which solid food
first?
A. Applesauce
B. Egg whites
C. Rice cereal
Correct answer
D. Yogurt
Correct Answer: C. Rice cereal
Page 2 of 47
, Rice cereal is the first solid food an infant should receive because it is easy to
digest and is associated with few allergies. Next, the infant can receive pureed
fruits, such as bananas, applesauce, and pears, followed by pureed vegetables,
egg yolks, cheese, yogurt, and finally, meat.
5. 5. Question
When performing a physical examination on an infant, the nurse in charge notes
abnormally low-set ears. This finding is associated with:
A. Otogenous tetanus
B. Tracheoesophageal fistula
C. Congenital heart defects
D. Renal anomalies
Correct Answer: D. Renal anomalies
Normally the top of the ear aligns with an imaginary line drawn across the inner
and outer canthus of the eye. Ears set below this line are associated with renal
anomalies or mental retardation. This is due to the observation that auricular
malformations often are associated with specific MCA syndromes that have high
incidences of renal anomalies.
6. 6. Question
The nurse is evaluating a female child with acute post streptococcal
glomerulonephritis for signs of improvement. Which finding typically is the
earliest sign of improvement?
A. Increased urine output
Correct answer
B. Increased appetite
C. Increased energy level
D. Decreased diarrhea
Correct Answer: A. Increased urine output
Increased urine output, a sign of improving kidney function, typically is the first
sign that a child with acute post-streptococcal glomerulonephritis (APSGN) is
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, improving. PSGN typically presents with features of the nephritic syndrome such
as hematuria, oliguria, hypertension, and edema, though it can also present with
significant proteinuria.
7. 7. Question
How should the nurse prepare a suspension before administration?
A. By diluting it with normal saline solution
B. By diluting it with 5% dextrose solution
C. By shaking it so that all the drug particles are dispersed uniformly
Correct answer
D. By crushing remaining particles with a mortar and pestle
Correct Answer: C. By shaking it so that all the drug particles are dispersed
uniformly.
The nurse should shake a suspension before administration to dispersed drug
particles uniformly. First, the bottle should be tabbed a few times to loosen the
powder, then approximately, half the volume of water should be added, the
bottle is shaken vigorously, the remaining water should be added and shaken
well.
Option A: In one study 75.5 % of mothers used boiled then cooled tap water
and 1.8 % of mothers used distilled water, which is a correct practice. The
addition of water in one step makes it difficult to get the lumps out while
measuring the volume of water several times increases the percentage of error
in measured volume.
Option B: Only tap water should be reconstituted with a powdered
suspension because a 5% dextrose solution contains chemicals that may cause
decomposition of drugs and complex reactions.
Option D: Crushing particles is not recommended for this drug form. Crushing
or opening modified or slow-release drug capsules will cause the drug to be
released all at once and could cause side effects. There may be times when
tablets will need to be crushed in order to deliver essential drug therapy. This
should only be done as a last resort and the practitioner must use her or his
professional judgment.
8. 8. Question
1 point(s)
Page 4 of 47
Exam Questions and 100% Verified
Answers A+ Graded
1. 1. Question
Nurse Elizabeth is administering medication via the intraosseous route to a child.
Intraosseous drug administration is typically used when a child is:
A. Under age 3
B. Over age 3
C. Critically ill and under age 3
D. Critically ill and over age 3
Correct Answer: C. Critically ill and under age 3
In an emergency, intraosseous drug administration is typically used when a child
is critically ill and under age 3. IO access provides a means of administering
medications, glucose, and fluids, as well as (potentially) a means of obtaining
blood samples. Such a situation would include any resuscitation;
cardiopulmonary arrest; shock, regardless of etiology; life-threatening status
epilepticus; or lack of venous access resulting from burns, edema, or obesity.
2. 2. Question
When administering an I.M. injection to an infant, the nurse in charge should use
which site?
A. Deltoid
B. Dorsogluteal
C. Ventrogluteal
D. Vastus lateralis
Correct Answer: D. Vastus lateralis
The recommended injection site for an infant is the vastus lateralis or rectus
femoris muscles. Skeletal muscle can accommodate larger volumes of medication
Page 1 of 47
, than subcutaneous tissue, and absorption is faster because muscle tissue is highly
vascular. Muscle has fewer pain-sensing nerves than subcutaneous tissue and is
less sensitive to irritating and viscous medications, so pain is lessened.
3. 3. Question
Nurse Charlotte suspects that a child, age 4, is being neglected physically. To best
assess the child’s nutritional status, the nurse should ask the parents which
question?
A. “Has your child always been so thin?”
B. “Is your child a picky eater?”
C. “What did your child eat for breakfast?”
Correct answer
D. “Do you think your child eats enough?”
Correct Answer: C. “What did your child eat for breakfast?”
The nurse should obtain objective information about the child’s nutritional intake,
such as by asking about what the child ate for a specific meal. In order to assess
the adequacy of a child’s nutritional intake, dietitians require detailed information
about all food and drink consumed. As all children admitted to the hospital are at
risk of nutritional deficit, a dietary record should be started on all in-patients,
although this may subsequently be discontinued when deemed appropriate.
4. 4. Question
During a well-baby visit, Liza asks the nurse when she should start giving her
infant solid foods. The nurse should instruct her to introduce which solid food
first?
A. Applesauce
B. Egg whites
C. Rice cereal
Correct answer
D. Yogurt
Correct Answer: C. Rice cereal
Page 2 of 47
, Rice cereal is the first solid food an infant should receive because it is easy to
digest and is associated with few allergies. Next, the infant can receive pureed
fruits, such as bananas, applesauce, and pears, followed by pureed vegetables,
egg yolks, cheese, yogurt, and finally, meat.
5. 5. Question
When performing a physical examination on an infant, the nurse in charge notes
abnormally low-set ears. This finding is associated with:
A. Otogenous tetanus
B. Tracheoesophageal fistula
C. Congenital heart defects
D. Renal anomalies
Correct Answer: D. Renal anomalies
Normally the top of the ear aligns with an imaginary line drawn across the inner
and outer canthus of the eye. Ears set below this line are associated with renal
anomalies or mental retardation. This is due to the observation that auricular
malformations often are associated with specific MCA syndromes that have high
incidences of renal anomalies.
6. 6. Question
The nurse is evaluating a female child with acute post streptococcal
glomerulonephritis for signs of improvement. Which finding typically is the
earliest sign of improvement?
A. Increased urine output
Correct answer
B. Increased appetite
C. Increased energy level
D. Decreased diarrhea
Correct Answer: A. Increased urine output
Increased urine output, a sign of improving kidney function, typically is the first
sign that a child with acute post-streptococcal glomerulonephritis (APSGN) is
Page 3 of 47
, improving. PSGN typically presents with features of the nephritic syndrome such
as hematuria, oliguria, hypertension, and edema, though it can also present with
significant proteinuria.
7. 7. Question
How should the nurse prepare a suspension before administration?
A. By diluting it with normal saline solution
B. By diluting it with 5% dextrose solution
C. By shaking it so that all the drug particles are dispersed uniformly
Correct answer
D. By crushing remaining particles with a mortar and pestle
Correct Answer: C. By shaking it so that all the drug particles are dispersed
uniformly.
The nurse should shake a suspension before administration to dispersed drug
particles uniformly. First, the bottle should be tabbed a few times to loosen the
powder, then approximately, half the volume of water should be added, the
bottle is shaken vigorously, the remaining water should be added and shaken
well.
Option A: In one study 75.5 % of mothers used boiled then cooled tap water
and 1.8 % of mothers used distilled water, which is a correct practice. The
addition of water in one step makes it difficult to get the lumps out while
measuring the volume of water several times increases the percentage of error
in measured volume.
Option B: Only tap water should be reconstituted with a powdered
suspension because a 5% dextrose solution contains chemicals that may cause
decomposition of drugs and complex reactions.
Option D: Crushing particles is not recommended for this drug form. Crushing
or opening modified or slow-release drug capsules will cause the drug to be
released all at once and could cause side effects. There may be times when
tablets will need to be crushed in order to deliver essential drug therapy. This
should only be done as a last resort and the practitioner must use her or his
professional judgment.
8. 8. Question
1 point(s)
Page 4 of 47
