NR328/NR 328 Final Exam V3 | Pediatric Nursing
Q&A with Rationale | Chamberlain University
1. A nurse is assessing a 4-year-old child during a well-child visit. Which developmental task
should the nurse expect the child to be working on according to Erikson’s stages of
psychosocial development?
A. Initiative vs. Guilt
B. Autonomy vs. Shame and Doubt
C. Industry vs. Inferiority
D. Trust vs. Mistrust
Correct Answer: A
Explanation: According to Erikson, children in the preschool age range (3 to 6 years) are
in the stage of Initiative vs. Guilt. During this stage, children begin to assert power and
control over the world through directing play and other social interactions. Success in this
stage leads to a sense of purpose, while failure results in a sense of guilt.
2. An infant with Tetralogy of Fallot experiences a hypercyanotic ‘Tet spell.’ Which of the
following actions should the nurse perform first?
A. Place the infant in a knee-chest position.
B. Administer high-flow oxygen via a non-rebreather mask.
C. Administer an IV bolus of morphine sulfate.
,D. Prepare for immediate intubation and ventilation.
Correct Answer: A
Explanation: Placing the infant in a knee-chest position is the priority intervention to
increase systemic vascular resistance. This maneuver reduces the right-to-left shunt and
improves pulmonary blood flow immediately. Once the position is secured, the nurse may
then proceed with oxygen administration and prescribed medications.
3. A nurse is caring for a 10-year-old child with Type 1 Diabetes Mellitus who is experiencing
hypoglycemia. Which finding should the nurse expect?
A. Palpitations, diaphoresis, and shakiness
B. Extreme thirst and polyuria
C. Deep, rapid Kussmaul respirations
D. Abdominal pain and fruity breath odor
Correct Answer: A
Explanation: Hypoglycemia triggers the sympathetic nervous system, leading to clinical
manifestations such as sweating, tremors, and tachycardia. In contrast, deep respirations
and fruity breath are signs of diabetic ketoacidosis (hyperglycemia). It is vital for the nurse
to recognize these adrenergic symptoms to initiate rapid glucose replacement.
4. A 2-year-old child is hospitalized with Respiratory Syncytial Virus (RSV) and bronchiolitis.
What type of isolation precautions are required?
A. Airborne precautions
, B. Droplet precautions
C. Protective environment
D. Contact precautions
Correct Answer: D
Explanation: RSV is primarily transmitted through direct contact with respiratory
secretions or contaminated surfaces. Contact precautions, including the use of gowns and
gloves, are the standard of care for pediatric patients with RSV. Strict adherence to hand
hygiene is also essential to prevent the spread to other vulnerable patients in the unit.
5. A school-age child is diagnosed with Acute Glomerulonephritis. Which finding in the child’s
medical history is most likely associated with this condition?
A. A recent urinary tract infection
B. A history of congenital heart disease
C. A recent skin or throat infection (streptococcal)
D. Family history of cystic fibrosis
Correct Answer: C
Explanation: Acute post-streptococcal glomerulonephritis (APSGN) typically follows a
Group A beta-hemolytic streptococcal infection of the throat or skin. The condition is an
immune-complex disease that leads to inflammation of the glomeruli. Nurses must assess
Q&A with Rationale | Chamberlain University
1. A nurse is assessing a 4-year-old child during a well-child visit. Which developmental task
should the nurse expect the child to be working on according to Erikson’s stages of
psychosocial development?
A. Initiative vs. Guilt
B. Autonomy vs. Shame and Doubt
C. Industry vs. Inferiority
D. Trust vs. Mistrust
Correct Answer: A
Explanation: According to Erikson, children in the preschool age range (3 to 6 years) are
in the stage of Initiative vs. Guilt. During this stage, children begin to assert power and
control over the world through directing play and other social interactions. Success in this
stage leads to a sense of purpose, while failure results in a sense of guilt.
2. An infant with Tetralogy of Fallot experiences a hypercyanotic ‘Tet spell.’ Which of the
following actions should the nurse perform first?
A. Place the infant in a knee-chest position.
B. Administer high-flow oxygen via a non-rebreather mask.
C. Administer an IV bolus of morphine sulfate.
,D. Prepare for immediate intubation and ventilation.
Correct Answer: A
Explanation: Placing the infant in a knee-chest position is the priority intervention to
increase systemic vascular resistance. This maneuver reduces the right-to-left shunt and
improves pulmonary blood flow immediately. Once the position is secured, the nurse may
then proceed with oxygen administration and prescribed medications.
3. A nurse is caring for a 10-year-old child with Type 1 Diabetes Mellitus who is experiencing
hypoglycemia. Which finding should the nurse expect?
A. Palpitations, diaphoresis, and shakiness
B. Extreme thirst and polyuria
C. Deep, rapid Kussmaul respirations
D. Abdominal pain and fruity breath odor
Correct Answer: A
Explanation: Hypoglycemia triggers the sympathetic nervous system, leading to clinical
manifestations such as sweating, tremors, and tachycardia. In contrast, deep respirations
and fruity breath are signs of diabetic ketoacidosis (hyperglycemia). It is vital for the nurse
to recognize these adrenergic symptoms to initiate rapid glucose replacement.
4. A 2-year-old child is hospitalized with Respiratory Syncytial Virus (RSV) and bronchiolitis.
What type of isolation precautions are required?
A. Airborne precautions
, B. Droplet precautions
C. Protective environment
D. Contact precautions
Correct Answer: D
Explanation: RSV is primarily transmitted through direct contact with respiratory
secretions or contaminated surfaces. Contact precautions, including the use of gowns and
gloves, are the standard of care for pediatric patients with RSV. Strict adherence to hand
hygiene is also essential to prevent the spread to other vulnerable patients in the unit.
5. A school-age child is diagnosed with Acute Glomerulonephritis. Which finding in the child’s
medical history is most likely associated with this condition?
A. A recent urinary tract infection
B. A history of congenital heart disease
C. A recent skin or throat infection (streptococcal)
D. Family history of cystic fibrosis
Correct Answer: C
Explanation: Acute post-streptococcal glomerulonephritis (APSGN) typically follows a
Group A beta-hemolytic streptococcal infection of the throat or skin. The condition is an
immune-complex disease that leads to inflammation of the glomeruli. Nurses must assess
