Pediatric Nursing Exam 09/28/2026
Pediatric Nursing Exam (NUR 230):
Comprehensive Assessment of Gastrointestinal,
Genitourinary, Respiratory, Cardiac, and
Developmental Concepts in Pediatric Care
The parents of a child with Wilms tumor ask the nurse why surgery is necessary before a biopsy is performed. Which
information should the nurse provide?
A. Biopsy may rupture the encapsulated tumor and cause the cancer cells to spread.
B. Metal clips are surgically applied at the tumor site for exact marking for radiation.
C. Surgery is necessary to stage the tumor and determine metastasis to other sites.
D. The surgery provides a visualization of other pathology and dysfunction of the kidney
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, Pediatric Nursing Exam 09/28/2026
Correct Answer : A
A) Biopsy may rupture the encapsulated tumor and cause the cancer cells to spread: This is the primary reason why
surgery is performed before a biopsy in cases of Wilms tumor. The tumor is usually encapsulated, and performing a
biopsy could risk breaking the capsule, leading to the dissemination of cancer cells into surrounding tissues, which
can worsen the prognosis.
A child diagnosed with Kawasaki disease is brought to the clinic. The mother reports that her child is irritable, refuses
to eat, and has skin peeling on both hands and feet.
Which intervention should the nurse instruct the mother to implement first?
A. Apply lotion to hands and feet.
B. Encourage the child to rest when possible.
C. Place the child in a quiet environment.
D. Make a list of foods that the child likes.
C
Children with Kawasaki disease often experience irritability due to discomfort, fever, and the overall systemic effects
of the illness. Creating a quiet environment helps reduce sensory stimulation, which can soothe the child and
decrease irritability.
A mother brings her 3-month-old infant to the clinic because the baby does not sleep through the night. Which
finding is most significant in planning care for this family?
A. The mother states the baby is irritable during feedings.
B. The mother is a single parent and lives with her parents.
C. The infant's formula has been changed twice.
D. The diaper area shows severe skin breakdown.
Correct Answer : D
The most significant finding in planning care for this family is that the infant's diaper area shows severe skin
breakdown. Severe skin breakdown in the diaper area can be a sign of diaper rash or other skin irritation, which can
cause discomfort and disrupt the infant's sleep. Addressing this issue can help improve the infant's comfort and
promote beter sleep. The other options (A, B, and C) may also be relevant, but severe skin breakdown in the diaper
area is the most significant finding in this situation.
A mother brings her 2-month-old to the well-baby clinic. She states that when she kisses her baby, the infant's skin
tastes salty.
The nurse should prepare the mother for what standard diagnostic test to screen for cystic fibrosis (CF)?
JOYCEWWALES 2
, Pediatric Nursing Exam 09/28/2026
A. Sweat-chloride test.
B. Faecal-fat test.
C. Pulmonary-function test.
D. Potassium chloride test.
Correct Answer : A
The nurse should prepare the mother for a sweat-chloride test to screen for cystic fibrosis (CF). A sweat- chloride test
measures the amount of chloride in the sweat and is used to diagnose CF. CF is a genetic disorder that can cause the
body to produce thick, sticky mucus that can clog the lungs and pancreas. One of the symptoms of CF is salty-tasting
skin due to an increased amount of salt in the sweat. The other options (B, C, and D) are not standard diagnostic
tests for screening for CF.
A 9-week-old infant is scheduled for a cleft lip repair. Which information is most important for the nurse to convey to
the surgeon before transporting the infant to the surgical suite?
A. White blood cell count of 10,000/mm (10x 10/L).
B. Weight gain of 2 pounds (0.91 kg) since birth.
C. Red blood cell count of 2.3 cell/mcl or (2.3 x 10/L).
D. Urine specific gravity is 1.011.
Correct Answer : C
C. Red blood cell count of 2.3 cells/mcl or (2.3 x 10⁹/L): This low RBC count indicates anemia, which is critical
information for the surgeon. Anemia can increase the risk of complications during and after surgery due to potential
issues with oxygenation and healing, making it the most important information to convey.
A child receives a prescription for loratadine 5 mg by mouth once day. The botled is labelled "Loratadine for Oral
Suspension, USP 5 mg per 5 mL."
How many teaspoons should the nurse instruct the parent to administer with each dose?
(Enter numerical value only.)
1
The nurse is assessing a 6-month-old infant. Which response requires further evaluation by the nurse?
A. Has doubled birth weight.
B. Plays "peek-a-boo."
C. Demonstrates startle reflex.
D. Turns head to locate sound.
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, Pediatric Nursing Exam 09/28/2026
C
The startle reflex, also known as the Moro reflex, is a normal reflex in infants that is present at birth and usually
disappears by 3-4 months of age. The reflex is elicited by a sudden loud noise or change in position, and the infant
will extend their arms and legs, then bring them back in towards their body.
If a 6-month-old infant is still demonstrating the startle reflex, it may indicate a developmental delay or neurological
issue and requires further evaluation by the nurse or healthcare provider.
The other responses are all normal developmental milestones for a 6-month-old infant. By 6 months of age, most
infants will have doubled their birth weight, enjoy playing games like peek-a-boo, and have developed the ability to
turn their head to locate sounds.
A 7-year-old child is admited to the hospital with a diagnosis of acute rheumatic fever. In obtaining a health history
from the child's mother, the recent occurrence of which illness is most significant?
A. Mumps.
B. Chickenpox.
C. Sore throat.
D. Influenza.
C
Acute rheumatic fever is a serious inflammatory condition that can develop after a streptococcal infection,
particularly if the infection is not treated or resolved properly. The most common initial symptom of acute rheumatic
fever is a sore throat, which is usually accompanied by a fever and swollen lymph nodes.
While mumps, chickenpox, and influenza are all infectious diseases, they are not directly linked to the development
of acute rheumatic fever. However, a recent or untreated streptococcal infection (such as strep throat) can lead to
the development of acute rheumatic fever.
Therefore, when obtaining a health history from a child with a diagnosis of acute rheumatic fever, it is most
significant to inquire about recent or untreated sore throat, as this is the most likely cause of the condition.
The parents of a newborn infant with hypospadias are concerned about when the surgical correction should occur.
Which information should the nurse provide?
A. Repair should be done before the child is potty-trained.
B. The urethral repair should be done after sexual maturity.
C. Surgery should be done by one month to prevent bladder infections.
D. Delaying the repair until school age reduces castration fears.
A
(A) Repair should be done before the child is potty-trained: Surgical correction of hypospadias is typically
recommended before the child reaches the age of 18 months, ideally between 6 and 12 months. This timing ensures
that the child has not yet developed any psychological awareness of the surgery and helps avoid complications
JOYCEWWALES 4
Pediatric Nursing Exam (NUR 230):
Comprehensive Assessment of Gastrointestinal,
Genitourinary, Respiratory, Cardiac, and
Developmental Concepts in Pediatric Care
The parents of a child with Wilms tumor ask the nurse why surgery is necessary before a biopsy is performed. Which
information should the nurse provide?
A. Biopsy may rupture the encapsulated tumor and cause the cancer cells to spread.
B. Metal clips are surgically applied at the tumor site for exact marking for radiation.
C. Surgery is necessary to stage the tumor and determine metastasis to other sites.
D. The surgery provides a visualization of other pathology and dysfunction of the kidney
JOYCEWWALES 1
, Pediatric Nursing Exam 09/28/2026
Correct Answer : A
A) Biopsy may rupture the encapsulated tumor and cause the cancer cells to spread: This is the primary reason why
surgery is performed before a biopsy in cases of Wilms tumor. The tumor is usually encapsulated, and performing a
biopsy could risk breaking the capsule, leading to the dissemination of cancer cells into surrounding tissues, which
can worsen the prognosis.
A child diagnosed with Kawasaki disease is brought to the clinic. The mother reports that her child is irritable, refuses
to eat, and has skin peeling on both hands and feet.
Which intervention should the nurse instruct the mother to implement first?
A. Apply lotion to hands and feet.
B. Encourage the child to rest when possible.
C. Place the child in a quiet environment.
D. Make a list of foods that the child likes.
C
Children with Kawasaki disease often experience irritability due to discomfort, fever, and the overall systemic effects
of the illness. Creating a quiet environment helps reduce sensory stimulation, which can soothe the child and
decrease irritability.
A mother brings her 3-month-old infant to the clinic because the baby does not sleep through the night. Which
finding is most significant in planning care for this family?
A. The mother states the baby is irritable during feedings.
B. The mother is a single parent and lives with her parents.
C. The infant's formula has been changed twice.
D. The diaper area shows severe skin breakdown.
Correct Answer : D
The most significant finding in planning care for this family is that the infant's diaper area shows severe skin
breakdown. Severe skin breakdown in the diaper area can be a sign of diaper rash or other skin irritation, which can
cause discomfort and disrupt the infant's sleep. Addressing this issue can help improve the infant's comfort and
promote beter sleep. The other options (A, B, and C) may also be relevant, but severe skin breakdown in the diaper
area is the most significant finding in this situation.
A mother brings her 2-month-old to the well-baby clinic. She states that when she kisses her baby, the infant's skin
tastes salty.
The nurse should prepare the mother for what standard diagnostic test to screen for cystic fibrosis (CF)?
JOYCEWWALES 2
, Pediatric Nursing Exam 09/28/2026
A. Sweat-chloride test.
B. Faecal-fat test.
C. Pulmonary-function test.
D. Potassium chloride test.
Correct Answer : A
The nurse should prepare the mother for a sweat-chloride test to screen for cystic fibrosis (CF). A sweat- chloride test
measures the amount of chloride in the sweat and is used to diagnose CF. CF is a genetic disorder that can cause the
body to produce thick, sticky mucus that can clog the lungs and pancreas. One of the symptoms of CF is salty-tasting
skin due to an increased amount of salt in the sweat. The other options (B, C, and D) are not standard diagnostic
tests for screening for CF.
A 9-week-old infant is scheduled for a cleft lip repair. Which information is most important for the nurse to convey to
the surgeon before transporting the infant to the surgical suite?
A. White blood cell count of 10,000/mm (10x 10/L).
B. Weight gain of 2 pounds (0.91 kg) since birth.
C. Red blood cell count of 2.3 cell/mcl or (2.3 x 10/L).
D. Urine specific gravity is 1.011.
Correct Answer : C
C. Red blood cell count of 2.3 cells/mcl or (2.3 x 10⁹/L): This low RBC count indicates anemia, which is critical
information for the surgeon. Anemia can increase the risk of complications during and after surgery due to potential
issues with oxygenation and healing, making it the most important information to convey.
A child receives a prescription for loratadine 5 mg by mouth once day. The botled is labelled "Loratadine for Oral
Suspension, USP 5 mg per 5 mL."
How many teaspoons should the nurse instruct the parent to administer with each dose?
(Enter numerical value only.)
1
The nurse is assessing a 6-month-old infant. Which response requires further evaluation by the nurse?
A. Has doubled birth weight.
B. Plays "peek-a-boo."
C. Demonstrates startle reflex.
D. Turns head to locate sound.
JOYCEWWALES 3
, Pediatric Nursing Exam 09/28/2026
C
The startle reflex, also known as the Moro reflex, is a normal reflex in infants that is present at birth and usually
disappears by 3-4 months of age. The reflex is elicited by a sudden loud noise or change in position, and the infant
will extend their arms and legs, then bring them back in towards their body.
If a 6-month-old infant is still demonstrating the startle reflex, it may indicate a developmental delay or neurological
issue and requires further evaluation by the nurse or healthcare provider.
The other responses are all normal developmental milestones for a 6-month-old infant. By 6 months of age, most
infants will have doubled their birth weight, enjoy playing games like peek-a-boo, and have developed the ability to
turn their head to locate sounds.
A 7-year-old child is admited to the hospital with a diagnosis of acute rheumatic fever. In obtaining a health history
from the child's mother, the recent occurrence of which illness is most significant?
A. Mumps.
B. Chickenpox.
C. Sore throat.
D. Influenza.
C
Acute rheumatic fever is a serious inflammatory condition that can develop after a streptococcal infection,
particularly if the infection is not treated or resolved properly. The most common initial symptom of acute rheumatic
fever is a sore throat, which is usually accompanied by a fever and swollen lymph nodes.
While mumps, chickenpox, and influenza are all infectious diseases, they are not directly linked to the development
of acute rheumatic fever. However, a recent or untreated streptococcal infection (such as strep throat) can lead to
the development of acute rheumatic fever.
Therefore, when obtaining a health history from a child with a diagnosis of acute rheumatic fever, it is most
significant to inquire about recent or untreated sore throat, as this is the most likely cause of the condition.
The parents of a newborn infant with hypospadias are concerned about when the surgical correction should occur.
Which information should the nurse provide?
A. Repair should be done before the child is potty-trained.
B. The urethral repair should be done after sexual maturity.
C. Surgery should be done by one month to prevent bladder infections.
D. Delaying the repair until school age reduces castration fears.
A
(A) Repair should be done before the child is potty-trained: Surgical correction of hypospadias is typically
recommended before the child reaches the age of 18 months, ideally between 6 and 12 months. This timing ensures
that the child has not yet developed any psychological awareness of the surgery and helps avoid complications
JOYCEWWALES 4
