RN NURSING CARE OF CHILDREN PROCTORED EXAM 2026
LATEST UPDATE QUESTIONS AND CORRECT VERIFIED
ANSWERS ALREADY GRADED A+
Iron deficiency anemia - ANS-Poor diet, drink a lot of cow milk (low in iron) Lab work - RBC,
hbg & hct low Diet in iron, protein, and vitamin C Iron supplement 1 hour before or 2 hours
after milk or antacids, vitamin C, straw, IM injection use z track method, stool is expected to
turn tarry green color if dose is adequate, brush teeth after Prevent overdosing of iron -
locked in cabinet
Sickle cell anemia - ANS-Autosomal recessive genetic disorder HbS is produced Increased
blood viscosity, obstruction of blood flow, tissue hypoxia Painful af Crisis - exacerbation
African American highest risks Fam history, reports of pain, SOB, pallor, jaundice (destruction
of RBC's) Vasoclusive crisis 4-6 days painful ischemia in the tissue Treatment: fluids *** and
pain control o Blood products Complications CVA and any reactions to the blood products
Hemophilia - ANS-Prolonged bleeding time due to lack of a specific factor that's needed to clot
properly A = lack of factor 8 B = lack of factor 9 Excessive bleeding, joint pain and stiffness,
bruising Labs: prolonged PTT, platelets and prothrombin will be normal No rectal temps, avoid
skin punctures when necessary, hold pressure 5 min, painful joints = elevate and apply ice to
that area Replace the factors that are missing Minimize the risk of bleeding o RICE
Complications: joint deformity
Rotavirus - ANS-- most common cause of diarrhea in kids <5 o Vaccine available o s/s: watery
diarrhea, vomiting, and fever
Pin worm (Enterobius vermicularis) - ANS-- cause perianal itching o Tape test for diagnosis
while sleeping
,When a kid has diarrhea, you need to know what foods/drinks they should and shouldn't have *
- ANS-o Should have oral rehydration therapy drink (ORT) o Shouldn't give fruit juices,
carbonated drinks, jello, caffeine, chicken or beef broth & no BRAT diet
Dehydration - ANS-o Mild - slight thirst and capillary refill is a little longer o Moderate - cap
refill between 2-4 seconds, thirst and irritability, dry mucous membranes, tears and skin
turgor are decreased o Severe - cap refill >4 seconds, tachycardia, extreme thirst, mm very
dry, tented skin, no tearing, sunken eyes, sunken anterior fontanel, oliguria or anuria
Cleft lip - ANS-repaired in 2-3m o Before sx: use a wide based nipple for feeding, encourage
breastfeeding, squeeze cheeks together to decrease gap o After sx: back and upright, elbow
restraints, ns water or diluted hydrogen peroxide to clean the suture line, antibiotic ointment
if prescribed
Cleft palate - ANS-repaired in 6-1m o Before sx: upright for feeing, one-way valve bottle with
specially cut nipple for feeding, burp frequently o After sx: prone position, IV fluids then clear
liquid for first 24 hours, nothing in mouth that could mess up the sutures, elbow restraints
Complications of cleft - ANS-ear infections and hearing loss - seen by specialists, Speech
therapists o Dental problems - teeth may not erupt normally
GERD - gastrointestinal reflex disease - ANS-Usually self resolves by 1 year of age s/s with
infants - spitting up, irritability, excessive crying, blood in the vomit, arching of back,
stiffening, resp. problems, FTT, apnea s/s with children - heartburn, abd pain, difficulty
swallowing, chronic cough, noncardiac chest pain nursing care small frequent meals, thicken
infant's formula with rice cereal, avoid foods that can make it worse, head elevated for 30 at
least 1 hour after eating o meds: PPI (omeprazole, pantoprazole); H2-receptor antagonists
(famotidine or ranitidine) Sx - nissen fundoplication
Pyloric stenosis - ANS-thickening of the pyloric sphincter = obstruction Projectile vomiting,
dehydration and constant hunger, olive shaped mass in the RUQ Sx - pylorotomy
,Hirschsprung's Disease - ANS-congenital aganglionic megacolon structural anomaly of the GI
tract caused by lack of ganglion cells in the segments of the colon resulting in decreased
motility and mechanical obstruction Ribbon like stool, vomiting bile, abd distention Risk
factor infant fails to pass meconium in 24-48 hours of life Nursing interventions - high calorie,
protein & low fiber diet o Surgery remove bad portion of the colon & may need a colostomy
for a while
Intussusception - ANS-- proximal segment of the bowel telescopes into a more distal segment,
resulting in lymphatic and venous obstruction causing edema in the area with progression,
ischemia and increase mucous into the intestine will occur Common in infants and children
3m-6 years Red currant jelly stool, sausage shaped abd mass CF at risk Air enema is
therapeutic procedure
Appendicitis - ANS-Avg age is around 10 years Abd pain in the RLQ, ↓ or absent bowel sounds,
fever, WBC ↑and inflammatory markers Diagnosis with CT Avoid heat to the abd Fluids, abx
prior to the stomach Suddenly feeling better - ruptured appendix medical emergency
Enuresis - ANS-uncontrolled or unintentional urination after the age of 5 years for at least
3m's Primary - never had control of bladder Secondary - have been potty trained and now
they are wetting their bed o Regression from stress of emotional trauma Self-esteem and
coping strategies Restrict fluids in the evenings, avoid constipation, etc.
UTI's - ANS-Frequent urination, foul smelling urine, fever, pallor, poor appetite, vomiting,
increase in thirst, swelling of the face, and seizures Diagnosis - urinalysis nitrates and
leukocytes elevation Educations - females wipe front to back, cotton underwear, avoid bubble
baths, void more, empty bladder fully Important constipation - high fiber diet
Bladder exstrophy - ANS-the bladder/urethra/ureteral orifices are coming through the
suprapubic area - medical emergency; requires immediate surgery Sterile gauze over that area
and prepare for sx
, Hypospadias - ANS-Urethral opening is on the underside (ventral) side of the penis No
circumcision
Epispadias - ANS-Urethral opening on the upper part of the penis (dorsal) side No circumcision
Phimosis - ANS-narrowing of the opening of the foreskin can't retract the foreskin
Cryptorchidism - ANS-undescended testes Sx at 6 and 24m's
Hydrocele - ANS-fluid in the scrotal sac
Testicular torsion - ANS-- medical emergency Enlargement of the effected testical and severe
and sudden onset of pain
Acute glomerulonephritis [AGN] - ANS-Associated with a strep infection Cloudy tea colored
urine, dec urine output, periorbital edema, facial edema that's worse in the am and then
spreads down over the day, mild -severe HTN, oliguria Proteinuria and Smokey or tea colored
urine, hematuria, increased specific gravity, ASO titer - for strep infection Nursing care o Restrict
sodium and fluid o Edema risk for skin breakdown o Diuretics, anti-hypertensives, abx for strep
infection
Nephrotic syndrome - ANS-alteration in the glomerular membrane that allows proteins [esp.
albumin] to pass through to the urine resulting in decreased serum osmotic pressure Facial and
periorbital edema, dec urine, frothy urine, norm BP, >2+ protein, hypoalbuminemia,
hyperlipidemia, hemoconcentrion, hyponatremia maybe Daily weights - same scale, same time,
same amount of clothing on everyday Monitor edema - measure abd girth @ the level of the
umbilicus Restrict fluids and salt Skin breakdown Meds - steroids monitor for GI bleeding,
hyperglycemia, etc o Albumin and diuretics help increase the plasma volume and decrease
edema in the pt.
LATEST UPDATE QUESTIONS AND CORRECT VERIFIED
ANSWERS ALREADY GRADED A+
Iron deficiency anemia - ANS-Poor diet, drink a lot of cow milk (low in iron) Lab work - RBC,
hbg & hct low Diet in iron, protein, and vitamin C Iron supplement 1 hour before or 2 hours
after milk or antacids, vitamin C, straw, IM injection use z track method, stool is expected to
turn tarry green color if dose is adequate, brush teeth after Prevent overdosing of iron -
locked in cabinet
Sickle cell anemia - ANS-Autosomal recessive genetic disorder HbS is produced Increased
blood viscosity, obstruction of blood flow, tissue hypoxia Painful af Crisis - exacerbation
African American highest risks Fam history, reports of pain, SOB, pallor, jaundice (destruction
of RBC's) Vasoclusive crisis 4-6 days painful ischemia in the tissue Treatment: fluids *** and
pain control o Blood products Complications CVA and any reactions to the blood products
Hemophilia - ANS-Prolonged bleeding time due to lack of a specific factor that's needed to clot
properly A = lack of factor 8 B = lack of factor 9 Excessive bleeding, joint pain and stiffness,
bruising Labs: prolonged PTT, platelets and prothrombin will be normal No rectal temps, avoid
skin punctures when necessary, hold pressure 5 min, painful joints = elevate and apply ice to
that area Replace the factors that are missing Minimize the risk of bleeding o RICE
Complications: joint deformity
Rotavirus - ANS-- most common cause of diarrhea in kids <5 o Vaccine available o s/s: watery
diarrhea, vomiting, and fever
Pin worm (Enterobius vermicularis) - ANS-- cause perianal itching o Tape test for diagnosis
while sleeping
,When a kid has diarrhea, you need to know what foods/drinks they should and shouldn't have *
- ANS-o Should have oral rehydration therapy drink (ORT) o Shouldn't give fruit juices,
carbonated drinks, jello, caffeine, chicken or beef broth & no BRAT diet
Dehydration - ANS-o Mild - slight thirst and capillary refill is a little longer o Moderate - cap
refill between 2-4 seconds, thirst and irritability, dry mucous membranes, tears and skin
turgor are decreased o Severe - cap refill >4 seconds, tachycardia, extreme thirst, mm very
dry, tented skin, no tearing, sunken eyes, sunken anterior fontanel, oliguria or anuria
Cleft lip - ANS-repaired in 2-3m o Before sx: use a wide based nipple for feeding, encourage
breastfeeding, squeeze cheeks together to decrease gap o After sx: back and upright, elbow
restraints, ns water or diluted hydrogen peroxide to clean the suture line, antibiotic ointment
if prescribed
Cleft palate - ANS-repaired in 6-1m o Before sx: upright for feeing, one-way valve bottle with
specially cut nipple for feeding, burp frequently o After sx: prone position, IV fluids then clear
liquid for first 24 hours, nothing in mouth that could mess up the sutures, elbow restraints
Complications of cleft - ANS-ear infections and hearing loss - seen by specialists, Speech
therapists o Dental problems - teeth may not erupt normally
GERD - gastrointestinal reflex disease - ANS-Usually self resolves by 1 year of age s/s with
infants - spitting up, irritability, excessive crying, blood in the vomit, arching of back,
stiffening, resp. problems, FTT, apnea s/s with children - heartburn, abd pain, difficulty
swallowing, chronic cough, noncardiac chest pain nursing care small frequent meals, thicken
infant's formula with rice cereal, avoid foods that can make it worse, head elevated for 30 at
least 1 hour after eating o meds: PPI (omeprazole, pantoprazole); H2-receptor antagonists
(famotidine or ranitidine) Sx - nissen fundoplication
Pyloric stenosis - ANS-thickening of the pyloric sphincter = obstruction Projectile vomiting,
dehydration and constant hunger, olive shaped mass in the RUQ Sx - pylorotomy
,Hirschsprung's Disease - ANS-congenital aganglionic megacolon structural anomaly of the GI
tract caused by lack of ganglion cells in the segments of the colon resulting in decreased
motility and mechanical obstruction Ribbon like stool, vomiting bile, abd distention Risk
factor infant fails to pass meconium in 24-48 hours of life Nursing interventions - high calorie,
protein & low fiber diet o Surgery remove bad portion of the colon & may need a colostomy
for a while
Intussusception - ANS-- proximal segment of the bowel telescopes into a more distal segment,
resulting in lymphatic and venous obstruction causing edema in the area with progression,
ischemia and increase mucous into the intestine will occur Common in infants and children
3m-6 years Red currant jelly stool, sausage shaped abd mass CF at risk Air enema is
therapeutic procedure
Appendicitis - ANS-Avg age is around 10 years Abd pain in the RLQ, ↓ or absent bowel sounds,
fever, WBC ↑and inflammatory markers Diagnosis with CT Avoid heat to the abd Fluids, abx
prior to the stomach Suddenly feeling better - ruptured appendix medical emergency
Enuresis - ANS-uncontrolled or unintentional urination after the age of 5 years for at least
3m's Primary - never had control of bladder Secondary - have been potty trained and now
they are wetting their bed o Regression from stress of emotional trauma Self-esteem and
coping strategies Restrict fluids in the evenings, avoid constipation, etc.
UTI's - ANS-Frequent urination, foul smelling urine, fever, pallor, poor appetite, vomiting,
increase in thirst, swelling of the face, and seizures Diagnosis - urinalysis nitrates and
leukocytes elevation Educations - females wipe front to back, cotton underwear, avoid bubble
baths, void more, empty bladder fully Important constipation - high fiber diet
Bladder exstrophy - ANS-the bladder/urethra/ureteral orifices are coming through the
suprapubic area - medical emergency; requires immediate surgery Sterile gauze over that area
and prepare for sx
, Hypospadias - ANS-Urethral opening is on the underside (ventral) side of the penis No
circumcision
Epispadias - ANS-Urethral opening on the upper part of the penis (dorsal) side No circumcision
Phimosis - ANS-narrowing of the opening of the foreskin can't retract the foreskin
Cryptorchidism - ANS-undescended testes Sx at 6 and 24m's
Hydrocele - ANS-fluid in the scrotal sac
Testicular torsion - ANS-- medical emergency Enlargement of the effected testical and severe
and sudden onset of pain
Acute glomerulonephritis [AGN] - ANS-Associated with a strep infection Cloudy tea colored
urine, dec urine output, periorbital edema, facial edema that's worse in the am and then
spreads down over the day, mild -severe HTN, oliguria Proteinuria and Smokey or tea colored
urine, hematuria, increased specific gravity, ASO titer - for strep infection Nursing care o Restrict
sodium and fluid o Edema risk for skin breakdown o Diuretics, anti-hypertensives, abx for strep
infection
Nephrotic syndrome - ANS-alteration in the glomerular membrane that allows proteins [esp.
albumin] to pass through to the urine resulting in decreased serum osmotic pressure Facial and
periorbital edema, dec urine, frothy urine, norm BP, >2+ protein, hypoalbuminemia,
hyperlipidemia, hemoconcentrion, hyponatremia maybe Daily weights - same scale, same time,
same amount of clothing on everyday Monitor edema - measure abd girth @ the level of the
umbilicus Restrict fluids and salt Skin breakdown Meds - steroids monitor for GI bleeding,
hyperglycemia, etc o Albumin and diuretics help increase the plasma volume and decrease
edema in the pt.
