NR328/NR 328 Exam 3 V2 | Pediatric Nursing Q&A
with Rationale | Chamberlain University
1. A nurse is assessing an infant who has a ventriculoperitoneal (VP) shunt. Which of the
following findings should indicate to the nurse that the shunt is malfunctioning?
A. Sunken anterior fontanelle
B. Increased appetite
C. Decreased head circumference
D. Irritability and high-pitched cry
Correct Answer: D
Explanation: Irritability and a high-pitched cry are classic signs of increased intracranial
pressure (ICP) in an infant, often indicating shunt malfunction or infection. Other signs
include bulging fontanelles, vomiting, and a setting-sun eye appearance. The nurse must
recognize these neurological changes quickly to prevent brain damage.
2. A school-age child with Type 1 Diabetes Mellitus is planning to participate in a soccer
match. What instruction should the nurse provide to the parents?
A. Administer an extra snack before the game
B. Decrease fluid intake during exercise
C. Increase the morning dose of NPH insulin
D. Avoid carbohydrates for 2 hours before the match
,Correct Answer: A
Explanation: Physical activity increases glucose utilization, which can lead to
hypoglycemia in children with Type 1 DM. Providing an extra carbohydrate snack before
and during exercise helps maintain stable blood glucose levels. The nurse should also
advise the child to monitor blood glucose more frequently on game days.
3. The nurse is reviewing the cerebrospinal fluid (CSF) analysis of a child suspected of having
bacterial meningitis. Which result is consistent with this diagnosis?
A. High glucose, low protein
B. Normal protein, high RBC count
C. Clear appearance, low WBC count
D. Low glucose, high protein
Correct Answer: D
Explanation: Bacterial meningitis typically presents with low glucose levels because
bacteria consume glucose as fuel. Additionally, protein levels are elevated due to the
presence of bacterial waste and inflammatory markers. The CSF will also show an
increased white blood cell count and a cloudy appearance.
4. A 14-year-old girl is being screened for scoliosis. Which instruction should the nurse give
the child during the Adams forward bend test?
A. Lie flat on the exam table
B. Walk across the room normally
, C. Bend forward at the waist with arms hanging freely
D. Sit with your legs crossed
Correct Answer: C
Explanation: The Adams forward bend test is the standard screening tool for scoliosis
where the nurse looks for rib hump or spinal asymmetry. By bending forward at the waist,
any rotation of the vertebrae becomes more apparent to the examiner. This screening is
typically performed during early adolescence when growth spurts occur.
5. The nurse is caring for a child with Spastic Cerebral Palsy. Which clinical manifestation
should the nurse expect to observe?
A. Tremors at rest
B. Wide-based, unsteady gait
C. Slow, worm-like writhing movements
D. Hypertonicity and poor control of posture
Correct Answer: D
Explanation: Spastic Cerebral Palsy is characterized by hypertonicity and persistent
primitive reflexes, such as the Moro or tonic neck reflex. Patients often demonstrate
exaggerated deep tendon reflexes and stiff, jerky movements. This is the most common
type of Cerebral Palsy seen in pediatric clinical settings.
with Rationale | Chamberlain University
1. A nurse is assessing an infant who has a ventriculoperitoneal (VP) shunt. Which of the
following findings should indicate to the nurse that the shunt is malfunctioning?
A. Sunken anterior fontanelle
B. Increased appetite
C. Decreased head circumference
D. Irritability and high-pitched cry
Correct Answer: D
Explanation: Irritability and a high-pitched cry are classic signs of increased intracranial
pressure (ICP) in an infant, often indicating shunt malfunction or infection. Other signs
include bulging fontanelles, vomiting, and a setting-sun eye appearance. The nurse must
recognize these neurological changes quickly to prevent brain damage.
2. A school-age child with Type 1 Diabetes Mellitus is planning to participate in a soccer
match. What instruction should the nurse provide to the parents?
A. Administer an extra snack before the game
B. Decrease fluid intake during exercise
C. Increase the morning dose of NPH insulin
D. Avoid carbohydrates for 2 hours before the match
,Correct Answer: A
Explanation: Physical activity increases glucose utilization, which can lead to
hypoglycemia in children with Type 1 DM. Providing an extra carbohydrate snack before
and during exercise helps maintain stable blood glucose levels. The nurse should also
advise the child to monitor blood glucose more frequently on game days.
3. The nurse is reviewing the cerebrospinal fluid (CSF) analysis of a child suspected of having
bacterial meningitis. Which result is consistent with this diagnosis?
A. High glucose, low protein
B. Normal protein, high RBC count
C. Clear appearance, low WBC count
D. Low glucose, high protein
Correct Answer: D
Explanation: Bacterial meningitis typically presents with low glucose levels because
bacteria consume glucose as fuel. Additionally, protein levels are elevated due to the
presence of bacterial waste and inflammatory markers. The CSF will also show an
increased white blood cell count and a cloudy appearance.
4. A 14-year-old girl is being screened for scoliosis. Which instruction should the nurse give
the child during the Adams forward bend test?
A. Lie flat on the exam table
B. Walk across the room normally
, C. Bend forward at the waist with arms hanging freely
D. Sit with your legs crossed
Correct Answer: C
Explanation: The Adams forward bend test is the standard screening tool for scoliosis
where the nurse looks for rib hump or spinal asymmetry. By bending forward at the waist,
any rotation of the vertebrae becomes more apparent to the examiner. This screening is
typically performed during early adolescence when growth spurts occur.
5. The nurse is caring for a child with Spastic Cerebral Palsy. Which clinical manifestation
should the nurse expect to observe?
A. Tremors at rest
B. Wide-based, unsteady gait
C. Slow, worm-like writhing movements
D. Hypertonicity and poor control of posture
Correct Answer: D
Explanation: Spastic Cerebral Palsy is characterized by hypertonicity and persistent
primitive reflexes, such as the Moro or tonic neck reflex. Patients often demonstrate
exaggerated deep tendon reflexes and stiff, jerky movements. This is the most common
type of Cerebral Palsy seen in pediatric clinical settings.
