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1 PEDIATRIC NURSING
PEDIATRIC NURSING
Situation: The school health nurse conducts health education classes to graduating high school
students.
1. When teaching an adolescent about the rules for safer sex, which of the following would you
include?
A. Anal sex carries a little risk in contracting STD’s.
B. Choosing sexual partner is extremely important.
C. Sex during menstrual flow carries little risk.
D. Always use a condom when having sexual intercourse
Answer: B
Rationale: Sexual relationships expose both partners to any diseases of the other partner.
Choosing partners carefully reduces the risk of disease.
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3 rd Edition, 2003, Vol. 1, p.88)
2. Responsible Parenthood means:
A. The couple must focus on the use of contraception to prevent pregnancy.
B. The parents understands their responsibility and have appropriate plan for their
family based on their capability to support them.
C. The use of natural family planning and attending seminars before marriage.
D. Both parents save up for the future of their children
Answer: B
Rationale: Responsible parenthood involves understanding of couple’s responsibility and having
appropriate plan for their family based on the ability to sustain their needs. It does not solely focus
on the use of contraception or any form of family planning. It includes all the decisions an individual
or couple make about having children. These decisions usually include if and when to have children,
how many children to have, and how they are spaced.
(Reference: Cuevas F. Public Health Nursing in the Philippines,10 th Edition, 2007)
3. An example of methods used in natural family planning includes:
A. Calendar Method and Billings Method
B. Calendar Method and Condom
C. Contraceptive pills and Cervical Mucus
D. Tubal ligation and vasectomy
Rationale: A. Calendar and Billings Method are both natural family planning methods. Condom
and contraceptive pills are artificial methods whereas Tubal ligation and vasectomy are permanent
methods of family planning.
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3 rd Edition, Vol. 1, 2003, p.101-116)
4. A 40 year old woman, a heavy smoker, visits your family planning clinic. She told you that she
has a very irregular menstrual cycle. She wants a highly reliable contraceptives. Assuming that all
of the following methods of birth control are acceptable for her, which of the following would be
the best recommendation?
A. The Mini pill
B. A spermicidal suppository
C. A diaphragm and spermicidal suppository
D. Calendar and Billings method
Rationale: C. Combined diaphragm and suppository is the best choice for her considering her age
and smoking habits. The combined effect of two methods is more reliable. Mini-pill contains only
progesterone. Without estrogen content, ovulation may occur, but because the progestins have
not allowed the endometrium to develop fully, implantation will not take place. When used
correctly, they 99.5% effective in preventing conception. Because women occasionally forget to
take them and there are individual differences in women’s physiology, the typical failure rate is
round 3%.
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2 PEDIATRIC NURSING
Effectiveness of natural family planning methods such as calendar and Billings methods vary mainly
on couple’s ability to refrain from having sex on fertile days. Failure rates usually range from 10%
to 20%.
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3 rd Edition, Vol. 1, 2003, p.101-114)
5. A young client who has become sexually active asks the nurse. “What is the most effective way
to prevent a pregnancy?” the nurse’s best response would be:
A. “Abstain from sex”
B. “Use birth control pills”
C. “Have an IUD inserted
D. “Use condom and foam”
Rationale: A. Health teaching guidelines for adolescents regarding sexuality involves saying “no”
and being firm about their intentions to participate in sexual relations. Pregnancy can occur with
any sexual encounter unless you use prevention to avoid it.
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3 rd Edition, Vol. 1, 2003, p.924)
Situation: Nurse Matteo is assigned at the nursery of the National General Medical Center. His
clinical exposure as a novice nurse is proving to be professionally satisfying.
6. Vitamin K is administered to all neonates immediately after birth because:
A. their fetal blood cells are prone to coagulation problems
B. their immature livers predispose them to low vitamin K levels
C. they lack intestinal organisms to synthesize vitamin K
D. they all experience avitaminosis
Answer: C. Neonates have sterile GI tracts at birth and, therefore, are incapable of synthesizing
vitamin K until about 8 days after birth. At 8 days, the intestinal tract becomes colonized with
organisms.
Reference: Straight A’s in Maternal – Neonatal Nursing © 2004 Lippincott Williams & Wilkins
Companion CD. The Normal Neonate. Item No. 2.
7. While evaluating a neonate in the surgery, you check his hips for signs of dislocation. Which of
the following signs indicates that the hips are in the normal position?
A. Both legs abduct easily
B. Skin folds are asymmetrical
C. A click is heard when hip integrity is assessed
D. The femur head is felt to slip forward in the acetabulum
Answer: A. Inspection of a neonate’s hips during assessment should reveal symmetrical skin folds,
easy abduction of both legs, and absence of a click or sense that the femur is moving within the
acetabulum.
Reference: Straight A’s in Maternal – Neonatal Nursing © 2004 Lippincott Williams & Wilkins
Companion CD. The Normal Neonate. Item No. 5.
8. A new mother asks you why her neonate is voiding so often. Your best reply is that the:
A. kidneys of the neonate can’t concentrate urine well
B. intestines of a neonate aren’t yet absorbing fluid
C. fluid retained during fetal life is being excreted
D. neonate’s fluid intake is too great for his age
Answer: A. The neonate’s kidneys are immature at birth and, therefore, unable to properly
concentrate urine. This causes the neonate to void frequently. A neonate’s intestines don’t regulate
the amount of fluid excreted. Fluid isn’t retained during fetal life; it’s excreted after the kidneys
form. Frequent voiding in neonates isn’t a sign of excess fluid intake.
Reference: Straight A’s in Maternal – Neonatal Nursing © 2004 Lippincott Williams & Wilkins
Companion CD. The Normal Neonate. Item No. 6.
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3 PEDIATRIC NURSING
9. Which characteristic best describes a breast-fed neonate’s stools, as compared with a formula-
fed neonate’s stools?
A. Soft and seedy C. Light yellow in color
B. Dry D. Less frequent
Answer: A. A breast-fed infant passes soft, seedy stools that have a sweet-and-sour odor and are
mustard yellow. Breast milk is easier to digest than formula, so a breast-fed neonate also has more
frequent stools. A formula-fed neonate has less frequent, dry, light yellow stools.
Reference: Straight A’s in Maternal – Neonatal Nursing © 2004 Lippincott Williams & Wilkins
Companion CD. The Normal Neonate. Item No. 8.
10. You’re assessing a neonate. Normal assessment findings include:
A. absent Babinski’s reflex and pale skin
B. heart rate of 130 to 140 beats/minute and acrocyanosis
C. absence of head control and a relaxed posture while awake
D. respiratory rate of 60 breaths/minute and expiratory grunting
Answer: B. Heart rate of 130 to 140 beats/minute is within normal range, and acrocyanosis
(cyanosis of the extremities) is normal in the neonate. Acrocyanosis generally lasts 7 to 10 days.
If Babinski’s reflex is absent and the skin is pale, the neonate may have central nervous system
damage. Absence of head control and a relaxed posture while awake are signs of prematurity. A
respiratory rate of 60 breaths/minute and expiratory grunting may indicate a respiratory disorder.
Reference: Straight A’s in Maternal – Neonatal Nursing © 2004 Lippincott Williams & Wilkins
Companion CD. The Normal Neonate. Item No. 15.
Situation: On her duty to the rural health center, Jean, a student nurse assist the doctor on duty
in examination of children. Aaron, a two year old, is hyperactive, negativistic and exhibit tantrums
and mother verbalize that she has difficulty in caring for Aaron. She asks Jean what she can do for
him. Jean then reviewed Aaron’s stage of development and considered this in taking care of him
and in providing health education for Aaron’s mother.
11. Jean reviewed Kohlberg’s theory of development. According to the theorist, toddlers:
A. Do the right thing because their parent tells him or her to and to avoid punishment
B. Have moral judgments that are based on universal human rights
C. Act base on their value, care and loyalty to others
D. Judge based on understanding and social order
Rationale: A toddler is considered to be in preconventional stage of moral development wherein
child does right because a parent tells him or her to and to avoid punishment. Option B pertains to
post conventional stage whereas options C and D pertain to conventional stage.
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3 rd Edition, Vol. 2, 2003, 789)
12. Aaron’s mother asked Jean why her son is negativistic and has temper tantrums. Which of the
following would be the student nurse’s best response?
A. “Aaron is not effectively coping with stress“
B. “Aaron’s need for affection isn’t met.”
C. “This is a normal behavior for his age.”
D. “He is expressing his need for identity.”
Rationale: Negativism and temper tantrums are common behaviors exhibited by toddlers. Through
these behaviors, they can show degree of autonomy and independence enough to know what they
want, but do not have the vocabulary or the wisdom to express their feelings in a more socially
acceptable way.
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3 rd Edition, Vol. 2, 2003, 843)
13. When you examine a toddler, you suggest to his mother that the activity that could foster his
developmental task according to Erickson would be;
A. Spoon feed him every meal time C. Allow him push pull toys
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4 PEDIATRIC NURSING
B. Read him story every night D. Have him watch puppet show and TV
Rationale: Toddlers should develop sense of autonomy or independence. Expression of
autonomy can be shown through provision of toys that exhibits sense of power in manipulation or
toys they can play with by themselves and that require action. These toys include push pull toys,
squeaky frogs they can squeeze, blocks they can stack, and toy telephone they can talk on.
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3rd Edition, Vol. 2, 2003, 834)
14. The child’s universal language is:
A. Behavior C. Touching
B. Crying D. Play
Rationale: According to Pilliterri, urge parents to encourage language development by naming
objects as they play with their child. Option B pertains to infants. Option A and C are not applicable
for toddlers.
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3 rd Edition, Vol. 1,2003, p.863)
15. Which of the following describes the type of play observed with toddlers?
A. Solitary C. Competitive
B. Parallel D. Fantasy
Rationale: All during toddler period, children play beside the children next to them or parallel play
(side by side play). Option A is for infants. Competitive play is for school-age. Fantasy is among
preschool
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3 rd Edition, Vol. 1,2003, p.865)
16. While observing a two-year-old girl recently admitted to the hospital, the nurse becomes
concerned by which of the following characteristics?
A. the child is not yet potty trained
B. the child replies “no” to every questions
C. the child cannot share toys
D. the child recognizes 4-6 words
Rationale: D. A two-year-old should have a 300 word vocabulary. A 4-6 word vocabulary indicate
health problems, such as hearing or motor loss.
17. A three-year-old girl is brought to the physician’s office with persistent otitis media. In order to
assess factors which may be contributing to the unresolved illness, the nurse should ask the parents
which question?
A. “Is anyone smoking around the child?”
B. “Is the child playing with other children with otitis media?”
C. “Does the child get water is her ears during the bath?”
D. “Has the child had a fever recently?”
Rationale: A. Allergies to common irritants such as smoke can cause congestion and chronic otitis
media.
18. An 18-month-old girl is admitted for a surgical repair of the cleft palate. She returns from the
operating room, supine, with an IV, and a mist tent on room air. Which is the priority nursing
action?
A. medicate for pain
B. check the IV for signs of infiltration
C. turn the child on her side
D. review the postoperative orders
Rationale C. Airway is always an immediate priority. Turning the child on her side will protect the
child from aspiration.
19. In planning care for the four-year-old admitted to the hospital, the nurse would include which
toy?
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1 PEDIATRIC NURSING
PEDIATRIC NURSING
Situation: The school health nurse conducts health education classes to graduating high school
students.
1. When teaching an adolescent about the rules for safer sex, which of the following would you
include?
A. Anal sex carries a little risk in contracting STD’s.
B. Choosing sexual partner is extremely important.
C. Sex during menstrual flow carries little risk.
D. Always use a condom when having sexual intercourse
Answer: B
Rationale: Sexual relationships expose both partners to any diseases of the other partner.
Choosing partners carefully reduces the risk of disease.
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3 rd Edition, 2003, Vol. 1, p.88)
2. Responsible Parenthood means:
A. The couple must focus on the use of contraception to prevent pregnancy.
B. The parents understands their responsibility and have appropriate plan for their
family based on their capability to support them.
C. The use of natural family planning and attending seminars before marriage.
D. Both parents save up for the future of their children
Answer: B
Rationale: Responsible parenthood involves understanding of couple’s responsibility and having
appropriate plan for their family based on the ability to sustain their needs. It does not solely focus
on the use of contraception or any form of family planning. It includes all the decisions an individual
or couple make about having children. These decisions usually include if and when to have children,
how many children to have, and how they are spaced.
(Reference: Cuevas F. Public Health Nursing in the Philippines,10 th Edition, 2007)
3. An example of methods used in natural family planning includes:
A. Calendar Method and Billings Method
B. Calendar Method and Condom
C. Contraceptive pills and Cervical Mucus
D. Tubal ligation and vasectomy
Rationale: A. Calendar and Billings Method are both natural family planning methods. Condom
and contraceptive pills are artificial methods whereas Tubal ligation and vasectomy are permanent
methods of family planning.
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3 rd Edition, Vol. 1, 2003, p.101-116)
4. A 40 year old woman, a heavy smoker, visits your family planning clinic. She told you that she
has a very irregular menstrual cycle. She wants a highly reliable contraceptives. Assuming that all
of the following methods of birth control are acceptable for her, which of the following would be
the best recommendation?
A. The Mini pill
B. A spermicidal suppository
C. A diaphragm and spermicidal suppository
D. Calendar and Billings method
Rationale: C. Combined diaphragm and suppository is the best choice for her considering her age
and smoking habits. The combined effect of two methods is more reliable. Mini-pill contains only
progesterone. Without estrogen content, ovulation may occur, but because the progestins have
not allowed the endometrium to develop fully, implantation will not take place. When used
correctly, they 99.5% effective in preventing conception. Because women occasionally forget to
take them and there are individual differences in women’s physiology, the typical failure rate is
round 3%.
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2 PEDIATRIC NURSING
Effectiveness of natural family planning methods such as calendar and Billings methods vary mainly
on couple’s ability to refrain from having sex on fertile days. Failure rates usually range from 10%
to 20%.
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3 rd Edition, Vol. 1, 2003, p.101-114)
5. A young client who has become sexually active asks the nurse. “What is the most effective way
to prevent a pregnancy?” the nurse’s best response would be:
A. “Abstain from sex”
B. “Use birth control pills”
C. “Have an IUD inserted
D. “Use condom and foam”
Rationale: A. Health teaching guidelines for adolescents regarding sexuality involves saying “no”
and being firm about their intentions to participate in sexual relations. Pregnancy can occur with
any sexual encounter unless you use prevention to avoid it.
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3 rd Edition, Vol. 1, 2003, p.924)
Situation: Nurse Matteo is assigned at the nursery of the National General Medical Center. His
clinical exposure as a novice nurse is proving to be professionally satisfying.
6. Vitamin K is administered to all neonates immediately after birth because:
A. their fetal blood cells are prone to coagulation problems
B. their immature livers predispose them to low vitamin K levels
C. they lack intestinal organisms to synthesize vitamin K
D. they all experience avitaminosis
Answer: C. Neonates have sterile GI tracts at birth and, therefore, are incapable of synthesizing
vitamin K until about 8 days after birth. At 8 days, the intestinal tract becomes colonized with
organisms.
Reference: Straight A’s in Maternal – Neonatal Nursing © 2004 Lippincott Williams & Wilkins
Companion CD. The Normal Neonate. Item No. 2.
7. While evaluating a neonate in the surgery, you check his hips for signs of dislocation. Which of
the following signs indicates that the hips are in the normal position?
A. Both legs abduct easily
B. Skin folds are asymmetrical
C. A click is heard when hip integrity is assessed
D. The femur head is felt to slip forward in the acetabulum
Answer: A. Inspection of a neonate’s hips during assessment should reveal symmetrical skin folds,
easy abduction of both legs, and absence of a click or sense that the femur is moving within the
acetabulum.
Reference: Straight A’s in Maternal – Neonatal Nursing © 2004 Lippincott Williams & Wilkins
Companion CD. The Normal Neonate. Item No. 5.
8. A new mother asks you why her neonate is voiding so often. Your best reply is that the:
A. kidneys of the neonate can’t concentrate urine well
B. intestines of a neonate aren’t yet absorbing fluid
C. fluid retained during fetal life is being excreted
D. neonate’s fluid intake is too great for his age
Answer: A. The neonate’s kidneys are immature at birth and, therefore, unable to properly
concentrate urine. This causes the neonate to void frequently. A neonate’s intestines don’t regulate
the amount of fluid excreted. Fluid isn’t retained during fetal life; it’s excreted after the kidneys
form. Frequent voiding in neonates isn’t a sign of excess fluid intake.
Reference: Straight A’s in Maternal – Neonatal Nursing © 2004 Lippincott Williams & Wilkins
Companion CD. The Normal Neonate. Item No. 6.
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3 PEDIATRIC NURSING
9. Which characteristic best describes a breast-fed neonate’s stools, as compared with a formula-
fed neonate’s stools?
A. Soft and seedy C. Light yellow in color
B. Dry D. Less frequent
Answer: A. A breast-fed infant passes soft, seedy stools that have a sweet-and-sour odor and are
mustard yellow. Breast milk is easier to digest than formula, so a breast-fed neonate also has more
frequent stools. A formula-fed neonate has less frequent, dry, light yellow stools.
Reference: Straight A’s in Maternal – Neonatal Nursing © 2004 Lippincott Williams & Wilkins
Companion CD. The Normal Neonate. Item No. 8.
10. You’re assessing a neonate. Normal assessment findings include:
A. absent Babinski’s reflex and pale skin
B. heart rate of 130 to 140 beats/minute and acrocyanosis
C. absence of head control and a relaxed posture while awake
D. respiratory rate of 60 breaths/minute and expiratory grunting
Answer: B. Heart rate of 130 to 140 beats/minute is within normal range, and acrocyanosis
(cyanosis of the extremities) is normal in the neonate. Acrocyanosis generally lasts 7 to 10 days.
If Babinski’s reflex is absent and the skin is pale, the neonate may have central nervous system
damage. Absence of head control and a relaxed posture while awake are signs of prematurity. A
respiratory rate of 60 breaths/minute and expiratory grunting may indicate a respiratory disorder.
Reference: Straight A’s in Maternal – Neonatal Nursing © 2004 Lippincott Williams & Wilkins
Companion CD. The Normal Neonate. Item No. 15.
Situation: On her duty to the rural health center, Jean, a student nurse assist the doctor on duty
in examination of children. Aaron, a two year old, is hyperactive, negativistic and exhibit tantrums
and mother verbalize that she has difficulty in caring for Aaron. She asks Jean what she can do for
him. Jean then reviewed Aaron’s stage of development and considered this in taking care of him
and in providing health education for Aaron’s mother.
11. Jean reviewed Kohlberg’s theory of development. According to the theorist, toddlers:
A. Do the right thing because their parent tells him or her to and to avoid punishment
B. Have moral judgments that are based on universal human rights
C. Act base on their value, care and loyalty to others
D. Judge based on understanding and social order
Rationale: A toddler is considered to be in preconventional stage of moral development wherein
child does right because a parent tells him or her to and to avoid punishment. Option B pertains to
post conventional stage whereas options C and D pertain to conventional stage.
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3 rd Edition, Vol. 2, 2003, 789)
12. Aaron’s mother asked Jean why her son is negativistic and has temper tantrums. Which of the
following would be the student nurse’s best response?
A. “Aaron is not effectively coping with stress“
B. “Aaron’s need for affection isn’t met.”
C. “This is a normal behavior for his age.”
D. “He is expressing his need for identity.”
Rationale: Negativism and temper tantrums are common behaviors exhibited by toddlers. Through
these behaviors, they can show degree of autonomy and independence enough to know what they
want, but do not have the vocabulary or the wisdom to express their feelings in a more socially
acceptable way.
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3 rd Edition, Vol. 2, 2003, 843)
13. When you examine a toddler, you suggest to his mother that the activity that could foster his
developmental task according to Erickson would be;
A. Spoon feed him every meal time C. Allow him push pull toys
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4 PEDIATRIC NURSING
B. Read him story every night D. Have him watch puppet show and TV
Rationale: Toddlers should develop sense of autonomy or independence. Expression of
autonomy can be shown through provision of toys that exhibits sense of power in manipulation or
toys they can play with by themselves and that require action. These toys include push pull toys,
squeaky frogs they can squeeze, blocks they can stack, and toy telephone they can talk on.
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3rd Edition, Vol. 2, 2003, 834)
14. The child’s universal language is:
A. Behavior C. Touching
B. Crying D. Play
Rationale: According to Pilliterri, urge parents to encourage language development by naming
objects as they play with their child. Option B pertains to infants. Option A and C are not applicable
for toddlers.
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3 rd Edition, Vol. 1,2003, p.863)
15. Which of the following describes the type of play observed with toddlers?
A. Solitary C. Competitive
B. Parallel D. Fantasy
Rationale: All during toddler period, children play beside the children next to them or parallel play
(side by side play). Option A is for infants. Competitive play is for school-age. Fantasy is among
preschool
(Reference: Pillitteri A. Maternal and Child Health Nursing, 3 rd Edition, Vol. 1,2003, p.865)
16. While observing a two-year-old girl recently admitted to the hospital, the nurse becomes
concerned by which of the following characteristics?
A. the child is not yet potty trained
B. the child replies “no” to every questions
C. the child cannot share toys
D. the child recognizes 4-6 words
Rationale: D. A two-year-old should have a 300 word vocabulary. A 4-6 word vocabulary indicate
health problems, such as hearing or motor loss.
17. A three-year-old girl is brought to the physician’s office with persistent otitis media. In order to
assess factors which may be contributing to the unresolved illness, the nurse should ask the parents
which question?
A. “Is anyone smoking around the child?”
B. “Is the child playing with other children with otitis media?”
C. “Does the child get water is her ears during the bath?”
D. “Has the child had a fever recently?”
Rationale: A. Allergies to common irritants such as smoke can cause congestion and chronic otitis
media.
18. An 18-month-old girl is admitted for a surgical repair of the cleft palate. She returns from the
operating room, supine, with an IV, and a mist tent on room air. Which is the priority nursing
action?
A. medicate for pain
B. check the IV for signs of infiltration
C. turn the child on her side
D. review the postoperative orders
Rationale C. Airway is always an immediate priority. Turning the child on her side will protect the
child from aspiration.
19. In planning care for the four-year-old admitted to the hospital, the nurse would include which
toy?
Prepared by: Archie D. Alviz, R.N., R.M., N.C.II | | facebook fan
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