NR328/NR 328 Exam 1 V1 | Pediatric Nursing Q&A
with Rationale | Chamberlain University
1. A nurse is assessing a 4-year-old child’s developmental progress. According to Erikson,
which developmental stage is this child expected to achieve?
A. Autonomy vs. Shame and Doubt
B. Trust vs. Mistrust
C. Industry vs. Inferiority
D. Initiative vs. Guilt
Correct Answer: D
Explanation: Children in the preschool years, aged 3 to 6, are in Erikson’s stage of
Initiative vs. Guilt. During this stage, children begin to assert power and control over their
environment by planning activities and facing challenges. If this initiative is stifled by over-
control or criticism, the child may develop a sense of guilt.
2. When providing education on SIDS (Sudden Infant Death Syndrome) prevention to new
parents, which instruction is most critical?
A. Use a soft mattress with plenty of blankets.
B. Place the infant on their back to sleep.
C. Keep the infant’s room very warm.
D. Allow the infant to sleep in the parent’s bed.
,Correct Answer: B
Explanation: The ‘Back to Sleep’ campaign has significantly reduced SIDS rates by
advocating for the supine sleeping position. Soft bedding, overheating, and co-sleeping are
all identified risk factors that should be avoided to ensure infant safety. Safe sleep
environments include a firm mattress in a crib free of loose items or toys.
3. An infant is admitted with suspected pyloric stenosis. Which clinical manifestation should
the nurse expect to find?
A. Steatorrhea or fatty stools
B. Projectile vomiting after feedings
C. Currant jelly-like stools
D. Abdominal distension and bile-stained emesis
Correct Answer: B
Explanation: Pyloric stenosis is characterized by the thickening of the pyloric sphincter,
which creates an obstruction. This leads to classic projectile vomiting typically occurring
shortly after feeding in an infant. Physical examination may also reveal an olive-shaped
mass in the right upper quadrant of the abdomen.
4. A 2-year-old child is hospitalized and requires a painful procedure. Which pain scale is most
appropriate for the nurse to use?
A. Wong-Baker FACES Scale
B. FLACC Scale
, C. Visual Analog Scale
D. Numeric Rating Scale
Correct Answer: B
Explanation: The FLACC scale (Face, Legs, Activity, Cry, Consolability) is an observational
tool used for infants and children who cannot yet communicate their pain level. It is the
gold standard for children aged 2 months to 7 years who are non-verbal or unable to use
other scales. The Wong-Baker FACES scale is generally used for children 3 years and older
who can understand the facial representations.
5. A nurse is caring for a child with Tetralogy of Fallot who suddenly becomes cyanotic and
dyspneic. Which action should the nurse take first?
A. Administer 100% oxygen via mask.
B. Prepare for immediate intubation.
C. Administer a dose of morphine sulfate.
D. Place the child in a knee-chest position.
Correct Answer: D
Explanation: Placing the child in a knee-chest position is the priority intervention for a
‘Tet spell’ or hypercyanotic episode. This maneuver increases systemic vascular resistance,
which helps force more blood into the pulmonary artery rather than through the
ventricular septal defect. Following this, oxygen and morphine may be administered as
secondary treatments.
with Rationale | Chamberlain University
1. A nurse is assessing a 4-year-old child’s developmental progress. According to Erikson,
which developmental stage is this child expected to achieve?
A. Autonomy vs. Shame and Doubt
B. Trust vs. Mistrust
C. Industry vs. Inferiority
D. Initiative vs. Guilt
Correct Answer: D
Explanation: Children in the preschool years, aged 3 to 6, are in Erikson’s stage of
Initiative vs. Guilt. During this stage, children begin to assert power and control over their
environment by planning activities and facing challenges. If this initiative is stifled by over-
control or criticism, the child may develop a sense of guilt.
2. When providing education on SIDS (Sudden Infant Death Syndrome) prevention to new
parents, which instruction is most critical?
A. Use a soft mattress with plenty of blankets.
B. Place the infant on their back to sleep.
C. Keep the infant’s room very warm.
D. Allow the infant to sleep in the parent’s bed.
,Correct Answer: B
Explanation: The ‘Back to Sleep’ campaign has significantly reduced SIDS rates by
advocating for the supine sleeping position. Soft bedding, overheating, and co-sleeping are
all identified risk factors that should be avoided to ensure infant safety. Safe sleep
environments include a firm mattress in a crib free of loose items or toys.
3. An infant is admitted with suspected pyloric stenosis. Which clinical manifestation should
the nurse expect to find?
A. Steatorrhea or fatty stools
B. Projectile vomiting after feedings
C. Currant jelly-like stools
D. Abdominal distension and bile-stained emesis
Correct Answer: B
Explanation: Pyloric stenosis is characterized by the thickening of the pyloric sphincter,
which creates an obstruction. This leads to classic projectile vomiting typically occurring
shortly after feeding in an infant. Physical examination may also reveal an olive-shaped
mass in the right upper quadrant of the abdomen.
4. A 2-year-old child is hospitalized and requires a painful procedure. Which pain scale is most
appropriate for the nurse to use?
A. Wong-Baker FACES Scale
B. FLACC Scale
, C. Visual Analog Scale
D. Numeric Rating Scale
Correct Answer: B
Explanation: The FLACC scale (Face, Legs, Activity, Cry, Consolability) is an observational
tool used for infants and children who cannot yet communicate their pain level. It is the
gold standard for children aged 2 months to 7 years who are non-verbal or unable to use
other scales. The Wong-Baker FACES scale is generally used for children 3 years and older
who can understand the facial representations.
5. A nurse is caring for a child with Tetralogy of Fallot who suddenly becomes cyanotic and
dyspneic. Which action should the nurse take first?
A. Administer 100% oxygen via mask.
B. Prepare for immediate intubation.
C. Administer a dose of morphine sulfate.
D. Place the child in a knee-chest position.
Correct Answer: D
Explanation: Placing the child in a knee-chest position is the priority intervention for a
‘Tet spell’ or hypercyanotic episode. This maneuver increases systemic vascular resistance,
which helps force more blood into the pulmonary artery rather than through the
ventricular septal defect. Following this, oxygen and morphine may be administered as
secondary treatments.
