,NSG 434 Exam 4 | Pediatric Nursing Advanced | Grand
Canyon University | Q & A | 2026/2027 Edition (PDF)
1. At the beginning of the school year, the school nurse identifies several new children at the school. The
nurse knows that which factors place children at high risk for adjustment problems? (Select all that
apply)
A) The child is from a middle-class family
B) The child has not attended a preschool program
C) The child exhibits signs of emotional immaturity
D) The child appears physically immature
Correct Answer: B, C, and D
Rationale: Lack of preschool experience, emotional immaturity, and physical immaturity are risk factors
for adjustment problems at school entry. Middle-class family status and warm, loving parenting are
generally protective factors.
2. A nurse is caring for an infant with poor skin turgor, a sunken fontanel, lethargy, and tachycardia.
These findings are characteristic of which condition?
A) Calcium excess
B) Dehydration
C) Overhydration
D) Sodium excess
Correct Answer: Dehydration
Rationale: Signs of dehydration in infants include poor skin turgor, sunken fontanel, lethargy, and
tachycardia. These findings indicate significant fluid loss and require prompt intervention.
3. What type of food poses a high choking hazard for toddlers?
A) Applesauce
,B) Hard candy
C) Mashed potatoes
D) Scrambled eggs
Correct Answer: Hard candy
Rationale: Hard, round, or sticky foods such as hard candy, grapes, hot dogs, and nuts pose a high
choking hazard for toddlers. These foods should be avoided or prepared in a safe manner (e.g., cutting
grapes into quarters).
4. What is one of the primary causes of iron deficiency anemia in children?
A) Viral infections
B) Genetic mutations
C) Inadequate dietary iron
D) Excessive physical activity
Correct Answer: Inadequate dietary iron
Rationale: Inadequate dietary iron is a primary cause of iron deficiency anemia in children. Iron is
essential for hemoglobin production, and deficiency can lead to anemia, fatigue, and developmental
delays.
5. Why is it important for children to consume foods rich in iron?
A) Iron helps in the digestion of carbohydrates
B) Iron aids in the absorption of calcium
C) Iron is essential for the production of hemoglobin
D) Iron is necessary for the synthesis of vitamin C
Correct Answer: Iron is essential for the production of hemoglobin
, Rationale: Iron is essential for the production of hemoglobin, which carries oxygen in the blood.
Adequate iron intake prevents anemia and supports normal growth and cognitive development.
6. A child is undergoing cancer treatment and shows a significant decrease in weight over a month.
What should be the immediate course of action?
A) Focus solely on medication adjustments
B) Ignore the change as it may be temporary
C) Evaluate nutritional intake and adjust dietary support
D) Increase the child's physical activity
Correct Answer: Evaluate nutritional intake and adjust dietary support
Rationale: Significant weight loss in a child undergoing cancer treatment requires immediate evaluation
of nutritional intake and adjustment of dietary support. Malnutrition can compromise immune function
and treatment outcomes.
7. A child experiences nausea and vomiting after receiving chemotherapy. What should the nurse do to
help prevent these problems from recurring?
A) Administer ondansetron 30 to 60 minutes before the next chemotherapy session
B) Keep the child NPO for 8 hours after the chemotherapy session
C) Encourage increased fluid intake before the next chemotherapy session
D) Administer antiemetics only when nausea occurs
Correct Answer: Administer ondansetron 30 to 60 minutes before the next chemotherapy session
Rationale: Antiemetics should be administered prophylactically before chemotherapy, typically 30 to 60
minutes before the session. Waiting until nausea occurs is less effective for preventing chemotherapy-
induced nausea and vomiting.
8. A major clinical manifestation of rheumatic fever is:
A) Seizures
Canyon University | Q & A | 2026/2027 Edition (PDF)
1. At the beginning of the school year, the school nurse identifies several new children at the school. The
nurse knows that which factors place children at high risk for adjustment problems? (Select all that
apply)
A) The child is from a middle-class family
B) The child has not attended a preschool program
C) The child exhibits signs of emotional immaturity
D) The child appears physically immature
Correct Answer: B, C, and D
Rationale: Lack of preschool experience, emotional immaturity, and physical immaturity are risk factors
for adjustment problems at school entry. Middle-class family status and warm, loving parenting are
generally protective factors.
2. A nurse is caring for an infant with poor skin turgor, a sunken fontanel, lethargy, and tachycardia.
These findings are characteristic of which condition?
A) Calcium excess
B) Dehydration
C) Overhydration
D) Sodium excess
Correct Answer: Dehydration
Rationale: Signs of dehydration in infants include poor skin turgor, sunken fontanel, lethargy, and
tachycardia. These findings indicate significant fluid loss and require prompt intervention.
3. What type of food poses a high choking hazard for toddlers?
A) Applesauce
,B) Hard candy
C) Mashed potatoes
D) Scrambled eggs
Correct Answer: Hard candy
Rationale: Hard, round, or sticky foods such as hard candy, grapes, hot dogs, and nuts pose a high
choking hazard for toddlers. These foods should be avoided or prepared in a safe manner (e.g., cutting
grapes into quarters).
4. What is one of the primary causes of iron deficiency anemia in children?
A) Viral infections
B) Genetic mutations
C) Inadequate dietary iron
D) Excessive physical activity
Correct Answer: Inadequate dietary iron
Rationale: Inadequate dietary iron is a primary cause of iron deficiency anemia in children. Iron is
essential for hemoglobin production, and deficiency can lead to anemia, fatigue, and developmental
delays.
5. Why is it important for children to consume foods rich in iron?
A) Iron helps in the digestion of carbohydrates
B) Iron aids in the absorption of calcium
C) Iron is essential for the production of hemoglobin
D) Iron is necessary for the synthesis of vitamin C
Correct Answer: Iron is essential for the production of hemoglobin
, Rationale: Iron is essential for the production of hemoglobin, which carries oxygen in the blood.
Adequate iron intake prevents anemia and supports normal growth and cognitive development.
6. A child is undergoing cancer treatment and shows a significant decrease in weight over a month.
What should be the immediate course of action?
A) Focus solely on medication adjustments
B) Ignore the change as it may be temporary
C) Evaluate nutritional intake and adjust dietary support
D) Increase the child's physical activity
Correct Answer: Evaluate nutritional intake and adjust dietary support
Rationale: Significant weight loss in a child undergoing cancer treatment requires immediate evaluation
of nutritional intake and adjustment of dietary support. Malnutrition can compromise immune function
and treatment outcomes.
7. A child experiences nausea and vomiting after receiving chemotherapy. What should the nurse do to
help prevent these problems from recurring?
A) Administer ondansetron 30 to 60 minutes before the next chemotherapy session
B) Keep the child NPO for 8 hours after the chemotherapy session
C) Encourage increased fluid intake before the next chemotherapy session
D) Administer antiemetics only when nausea occurs
Correct Answer: Administer ondansetron 30 to 60 minutes before the next chemotherapy session
Rationale: Antiemetics should be administered prophylactically before chemotherapy, typically 30 to 60
minutes before the session. Waiting until nausea occurs is less effective for preventing chemotherapy-
induced nausea and vomiting.
8. A major clinical manifestation of rheumatic fever is:
A) Seizures
