NURS 328 COMPREHENSIVE
EXAMINATION: PEDIATRICS AND
MENTAL HEALTH. QUESTIONS AND
ANSWERS
1. A 4-year-old child with Tetralogy of Fallot experiences a hypercyanotic (‘tet’) spell. Which
nursing intervention should be prioritized first?
A. Administer 100% oxygen via face mask.
B. Prepare for immediate surgical intervention.
C. Administer morphine sulfate intravenously.
D. Place the child in the knee-chest position.
Answer: D
Conceptual Explanation: The knee-chest position increases systemic vascular resistance,
which reduces the right-to-left shunt and improves pulmonary blood flow during a tet
spell.
,2. A client diagnosed with Schizophrenia is experiencing command hallucinations to ‘hurt the
nurse.’ What is the nurse’s priority action?
A. Assess the client’s ability to resist the command and ensure safety.
B. Place the client in a seclusion room immediately.
C. Notify security and obtain extra PRN medication.
D. Ask the client why the voices want to hurt the nurse.
Answer: A
Conceptual Explanation: Safety is the priority. The nurse must assess the risk of the client
acting on the command and take steps to protect the client and others.
3. A nurse is caring for an infant with Pyloric Stenosis. Which clinical manifestation is most
characteristic of this condition?
A. Currant jelly-like stools.
B. Abdominal distention and bile-stained vomitus.
C. Projectile vomiting after feedings.
D. Failure to pass meconium within 24 hours.
Answer: C
Conceptual Explanation: Hypertrophic pyloric stenosis typically causes projectile, non-
bilious vomiting shortly after feeding due to the narrowing of the pyloric sphincter.
, 4. A client taking Lithium Carbonate for Bipolar Disorder reports blurred vision and tremors.
The serum lithium level is 1.8 mEq/L. The nurse should:
A. Administer the next scheduled dose as prescribed.
B. Request an increase in the dosage to stabilize mood.
C. Hold the dose and notify the healthcare provider.
D. Encourage the client to increase sodium intake.
Answer: C
Conceptual Explanation: A lithium level of 1.8 mEq/L indicates toxicity (normal
therapeutic range is 0.6-1.2 mEq/L). The nurse must hold the drug to prevent worsening
toxicity.
5. Which developmental task according to Erikson should the nurse focus on when caring for
a 10-year-old child?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Identity vs. Role Confusion
D. Industry vs. Inferiority
Answer: D
Conceptual Explanation: School-age children (6 to 12 years) are in the stage of Industry
vs. Inferiority, focusing on competence and mastery of skills.
EXAMINATION: PEDIATRICS AND
MENTAL HEALTH. QUESTIONS AND
ANSWERS
1. A 4-year-old child with Tetralogy of Fallot experiences a hypercyanotic (‘tet’) spell. Which
nursing intervention should be prioritized first?
A. Administer 100% oxygen via face mask.
B. Prepare for immediate surgical intervention.
C. Administer morphine sulfate intravenously.
D. Place the child in the knee-chest position.
Answer: D
Conceptual Explanation: The knee-chest position increases systemic vascular resistance,
which reduces the right-to-left shunt and improves pulmonary blood flow during a tet
spell.
,2. A client diagnosed with Schizophrenia is experiencing command hallucinations to ‘hurt the
nurse.’ What is the nurse’s priority action?
A. Assess the client’s ability to resist the command and ensure safety.
B. Place the client in a seclusion room immediately.
C. Notify security and obtain extra PRN medication.
D. Ask the client why the voices want to hurt the nurse.
Answer: A
Conceptual Explanation: Safety is the priority. The nurse must assess the risk of the client
acting on the command and take steps to protect the client and others.
3. A nurse is caring for an infant with Pyloric Stenosis. Which clinical manifestation is most
characteristic of this condition?
A. Currant jelly-like stools.
B. Abdominal distention and bile-stained vomitus.
C. Projectile vomiting after feedings.
D. Failure to pass meconium within 24 hours.
Answer: C
Conceptual Explanation: Hypertrophic pyloric stenosis typically causes projectile, non-
bilious vomiting shortly after feeding due to the narrowing of the pyloric sphincter.
, 4. A client taking Lithium Carbonate for Bipolar Disorder reports blurred vision and tremors.
The serum lithium level is 1.8 mEq/L. The nurse should:
A. Administer the next scheduled dose as prescribed.
B. Request an increase in the dosage to stabilize mood.
C. Hold the dose and notify the healthcare provider.
D. Encourage the client to increase sodium intake.
Answer: C
Conceptual Explanation: A lithium level of 1.8 mEq/L indicates toxicity (normal
therapeutic range is 0.6-1.2 mEq/L). The nurse must hold the drug to prevent worsening
toxicity.
5. Which developmental task according to Erikson should the nurse focus on when caring for
a 10-year-old child?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Identity vs. Role Confusion
D. Industry vs. Inferiority
Answer: D
Conceptual Explanation: School-age children (6 to 12 years) are in the stage of Industry
vs. Inferiority, focusing on competence and mastery of skills.
