Care of Children assessmen
EXAM PREP
(NGN - STYLE QUESTIONS & CASE “SCENARIOS ”)
Answers with detailed Rationale
What You’ll Get:
➢ Exam has 60 assessment nursing questions
• PN / LPN-focused content
• Practice-style questions
• Answer explanations (rationales)
• Clear, organized format for easy studying
• Printable & digital-friendly
Not affiliated with ATI, VATI or NCLEX. For study purposes only.
,1.0 A nurse in an emergency department is assessing a 5-year-old child who has
a concussion. Which of the following manifestations should the nurse identify as
an early indication of ICP?
A. Nausea
B. Fixed dilated pupils
C. Bradycardia with hypertension
D. Decorticate posturing
Answer: A. Nausea
Rationale: Nausea is an early neurologic sign of rising intracranial pressure in
children.
Late findings such as pupillary changes, posturing, and Cushing responses occur
after significant deterioration.
2.0 A nurse is creating a plan of care for a school-age child who has moderate
partial thickness burns on both lower extremities. Which of the following
interventions should the nurse include in the plan?
A. Maintain aseptic technique during the child's dressing changes
B. Provide low-calorie snacks for the child several times each day
C. Apply continuous passive motion devices to the child's lower extremities during
periods of rest
D. Administer pain medication to the child 30 min following physical therapy
Answer: A. Maintain aseptic technique during the child's dressing changes
Rationale: Maintain aseptic technique during the child's dressing changes best
matches the expected priority finding or nursing action for this pediatric scenario.
It aligns with standard VATI pediatric nursing principles of safety, age-appropriate
care, and complication prevention.
,3.0 A charge nurse on a pediatric unit is reviewing informed consent guidelines
with newly licensed nurse. For which of the following clients should the nurse
obtain informed consent from a guardian?
A. A 15-year-old client who requires an open reduction of a fracture
B. A delayed or lower-priority nursing action
C. A finding expected in a different condition
D. An intervention that is contraindicated or not indicated
Answer: A. A 15-year-old client who requires an open reduction of a fracture
Rationale: A 15-year-old client who requires an open reduction of a fracture best
matches the expected priority finding or nursing action for this pediatric scenario.
It aligns with standard VATI pediatric nursing principles of safety, age-appropriate
care, and complication prevention.
4.0 A nurse is providing home care instructions to the parents of a child who is in
the edema phase of nephrotic syndrome. Which of the following instructions
should the nurse include in the teaching?
A. Provide quiet activities for the child
B. A delayed or lower-priority nursing action
C. A finding expected in a different condition
D. An intervention that is contraindicated or not indicated
Answer: A. Provide quiet activities for the child
Rationale: During the edema phase of nephrotic syndrome, the child should
conserve energy and avoid excessive activity. Quiet play supports comfort and
reduces physiologic stress while edema is managed.
5.0 A nurse is assessing a 2-year-old child following a surgical procedure. Which
of the following pain tools should the nurse use?
, A. Numeric rating scale
B. Wong-Baker FACES scale
C. Face, Legs, Activity, Cry Consolability (FLACC) scale
D. Visual analog scale
Answer: C. Face, Legs, Activity, Cry Consolability (FLACC) scale
Rationale: The FLACC scale is designed for infants and young children who cannot
reliably self-report pain.
A 2-year-old usually cannot use numeric or abstract pain scales consistently.
6.0 A nurse is providing discharge teaching to the parents of a school age child
who has epilepsy and a new prescription for phenytoin extended release
capsules. Which of the following instructions should the nurse include in the
teaching?
A. Administer the medication on an empty stomach
B. Encourage the child to brush their teeth after each meal
C. Crush the child's medication to mix with applesauce
D. Observe the child for diarrhea
Answer: B. Encourage the child to brush their teeth after each meal
Rationale: Phenytoin commonly causes gingival hyperplasia, so excellent oral
hygiene is a key teaching point. Extended-release capsules should not be crushed,
and routine administration should be consistent.
7.0 A nurse is caring for a 6 month old infant who has acute vomiting and
diarrhea. Which of the following manifestations should the nurse identify as an
indication of moderate hypovolemia?
A. Tachypnea
B. A delayed or lower-priority nursing action