NSG 3180: PEDIATRIC NURSING
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A 4-year-old child is admitted to the pediatric unit with suspected bacterial meningitis.
Which nursing intervention is the highest priority?
A. Prepare the child for a lumbar puncture.
B. Administer the first dose of prescribed antibiotics.
C. Initiate droplet precautions immediately.
D. Dim the lights and minimize environmental noise.
Answer: C
Conceptual Explanation: Safety and infection control are the priority. Bacterial meningitis
is highly contagious; therefore, droplet precautions must be initiated before any other
interventions to protect staff and other patients.
2. A nurse is caring for an infant with Tetralogy of Fallot who suddenly becomes cyanotic and
dyspneic. What should the nurse do first?
A. Place the infant in a knee-chest position.
,B. Administer 100% oxygen via blow-by.
C. Prepare to administer morphine sulfate intramuscularly.
D. Call the rapid response team.
Answer: A
Conceptual Explanation: Placing the infant in a knee-chest position increases systemic
vascular resistance, which reduces the right-to-left shunt and improves oxygenation during
a ‘tet spell’.
3. Which developmental milestone should the nurse expect a 12-month-old infant to have
achieved?
A. Using a spoon to feed themselves independently.
B. Walking alone or with one hand held.
C. Speaking in 3- to 4-word sentences.
D. Jumping in place with both feet.
Answer: B
Conceptual Explanation: By 12 months, infants typically begin walking while holding onto
furniture or with one hand held. The other milestones occur later (18 months to 3 years).
4. A child is diagnosed with Nephrotic Syndrome. Which clinical finding should the nurse
anticipate?
A. Gross hematuria and hypertension.
, B. Weight loss and increased urinary output.
C. Elevated serum potassium and low sodium.
D. Massive proteinuria and hypoalbuminemia.
Answer: D
Conceptual Explanation: Nephrotic Syndrome is characterized by increased glomerular
permeability, leading to massive protein loss (proteinuria) and low serum protein
(hypoalbuminemia), resulting in edema.
5. A 10-year-old child with Type 1 Diabetes Mellitus presents with diaphoresis, shakiness, and
tachycardia. What is the nurse’s immediate action?
A. Encourage the child to drink 8 ounces of water.
B. Administer the scheduled dose of NPH insulin.
C. Check the urine for presence of ketones.
D. Administer 15 grams of rapid-acting carbohydrates.
Answer: D
Conceptual Explanation: Diaphoresis, shakiness, and tachycardia are signs of
hypoglycemia. The ‘15-15 rule’ involves giving 15g of simple carbs and rechecking blood
sugar in 15 minutes.
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A 4-year-old child is admitted to the pediatric unit with suspected bacterial meningitis.
Which nursing intervention is the highest priority?
A. Prepare the child for a lumbar puncture.
B. Administer the first dose of prescribed antibiotics.
C. Initiate droplet precautions immediately.
D. Dim the lights and minimize environmental noise.
Answer: C
Conceptual Explanation: Safety and infection control are the priority. Bacterial meningitis
is highly contagious; therefore, droplet precautions must be initiated before any other
interventions to protect staff and other patients.
2. A nurse is caring for an infant with Tetralogy of Fallot who suddenly becomes cyanotic and
dyspneic. What should the nurse do first?
A. Place the infant in a knee-chest position.
,B. Administer 100% oxygen via blow-by.
C. Prepare to administer morphine sulfate intramuscularly.
D. Call the rapid response team.
Answer: A
Conceptual Explanation: Placing the infant in a knee-chest position increases systemic
vascular resistance, which reduces the right-to-left shunt and improves oxygenation during
a ‘tet spell’.
3. Which developmental milestone should the nurse expect a 12-month-old infant to have
achieved?
A. Using a spoon to feed themselves independently.
B. Walking alone or with one hand held.
C. Speaking in 3- to 4-word sentences.
D. Jumping in place with both feet.
Answer: B
Conceptual Explanation: By 12 months, infants typically begin walking while holding onto
furniture or with one hand held. The other milestones occur later (18 months to 3 years).
4. A child is diagnosed with Nephrotic Syndrome. Which clinical finding should the nurse
anticipate?
A. Gross hematuria and hypertension.
, B. Weight loss and increased urinary output.
C. Elevated serum potassium and low sodium.
D. Massive proteinuria and hypoalbuminemia.
Answer: D
Conceptual Explanation: Nephrotic Syndrome is characterized by increased glomerular
permeability, leading to massive protein loss (proteinuria) and low serum protein
(hypoalbuminemia), resulting in edema.
5. A 10-year-old child with Type 1 Diabetes Mellitus presents with diaphoresis, shakiness, and
tachycardia. What is the nurse’s immediate action?
A. Encourage the child to drink 8 ounces of water.
B. Administer the scheduled dose of NPH insulin.
C. Check the urine for presence of ketones.
D. Administer 15 grams of rapid-acting carbohydrates.
Answer: D
Conceptual Explanation: Diaphoresis, shakiness, and tachycardia are signs of
hypoglycemia. The ‘15-15 rule’ involves giving 15g of simple carbs and rechecking blood
sugar in 15 minutes.
