NEW 2023 TO 2024 NCLEX RN PEADIATRIC
NURSING EXAM WITH 100% ACCURATE
ANSWERS AND RATIONALES ALREADY GRADED
A+
1. A 13-month-old child has just been placed in a plaster hip spica cast to
correct a congenital anomaly. Which nursing actions should be included in
the plan of care?
1. Turn the child no more than every four hours to minimize manipulation of
the wet cast.
2. Use only fingertips when moving the child to prevent indentations in the
cast.
3. Assess and document neurovascular function at least every two hours.
4. Use a hair dryer to speed the cast-drying process. - ANSWERS-3.
Neurovascular function must be assessed every two hours. The child should
be turned at least every two hours to prevent skin damage and to facilitate
plaster cast drying. Fingertips should be avoided when handling a wet
plaster cast because they can leave indentations on a wet cast. The nurse
should palm the cast. A hair dryer should not be used to dry the cast. This
causes the cast to dry from the outside in and may leave the inside wet and
soft.
2.A 13-year-old child has just arrived on the nursing care unit from the
postanesthesia care unit (PACU). This morning, the child underwent a
surgical spinal fusion procedure that included the placement of Harrington
rods for the treatment of scoliosis. After receiving a report from the PACU
nurse, which action should the nurse perform first?
1. Assess the pain level and administer analgesics as needed
1
,2. Offer clear liquids to ensure adequate hydration
3. Drain the Hemovac and record the output on the intake and output record
4. Notify the child's parents of his/her arrival on the unit - ANSWERS-1.
Pain management is a high priority. The child probably is not taking liquids
at this time. Even if she is taking clear liquids, pain management is a higher
priority. The nurse may drain the Hemovac, but that is not the highest
priority. The nurse will notify the child's parents, but pain management is of
a higher priority.
3.A newborn has been diagnosed as having mild hip dysplasia. The mother
asks the nurse why the physician told her to "triple diaper" the baby. What
should the nurse include when responding?
1. It is important that there be no contamination of the area.
2. Extra diapers will abduct the hips and help to put the hip in the socket
correctly.
3. Triple diapers cause the baby's legs to be sharply flexed and realign the
hip.
4. Hip dysplasia can cause abnormal
stooling. - ANSWERS-2. The treatment for hip dysplasia is abduction.
Triple diapers are the easiest way to abduct the hips in mild cases. If that is
not successful, then a pillow splint or harness can be used. There is no open
wound with hip dysplasia and no worry about contamination of the area.
Hip dysplasia does not cause abnormal stooling. Triple diapers do not cause
increased flexion; they actually cause less flexion. Less flexion is
recommended for children with hip dysplasia.
4. A 6-month-old baby is placed in bilateral leg casts because she has talipes
equinovarus. The mother asks how to bathe the baby. What should the nurse
2
,tell the mother?
1. "Bathe the baby as you usually do."
2. "Put the baby's buttocks in the bath
water, but try to keep the feet out of the water."
3. "Sponge bathe your baby until the casts are removed."
4. "Give the baby a bath in the baby bath tub, but limit the time in the
water." - ANSWERS-3. The baby who has bilateral casts should not be
placed in water but should receive a sponge bath. Answers 2 and 4 put the
baby in water and are not correct. The nurse should not tell the mother to
bathe the baby as usual without knowing what the usual is. By 6 months of
age, most babies
are being bathed in a baby bath tub. This is not appropriate when there are
casts.
5. The nurse is monitoring a child with burns during treatment for burn
shock. The nurse understands that which assessment provides the most
accurate guide to determine the adequacy of fluid resuscitation?
A. skin turgor
B. neurological assessment
C. Level of edema at burn site
D. quality of peripheral pulses - ANSWERS-B. neurological assessment
Sensorium is an accurate guide to determine the adequacy of fluid
resuscitation. The burn injury itself does not affect the sensorium, so the
child should be alert and oriented. Any alteration in sensorium should be
evaluated further. A neurological assessment would determine the level of
3
, sensorium in the child.
6. The mother of a 3 year old child arrives at a clinic and tells the nurse that
the child has been scratching the skin continuously and has developed a
rash. The nurse assesses the child and suspects the presence of scabies. The
nurse bases this suspicion on which finding noted on assessment of the
child's skin?
A. fine grayish red lines
B. Purple-colored lesions
C. thick, honey-colored crusts
D. clusters of fluid-filled vesicles - ANSWERS-A. Fine grayish red lines
7. A 3-month-old infant is admitted. Upon admission, the nurse assesses her
developmental status as appropriate for age. Which of the following is the
child least likely to be able to do?
1. Smile in response to mother's face
2. Reach for shiny objects but miss them
3. Hold head erect and steady
4. Sit with slight support - ANSWERS-4. Sitting with slight support would
be expected in a child of 5 months. All of the other tasks are appropriate for
this age.
8. A 3-month-old infant is doing well after the repair of a cleft lip. The nurse
wants to provide the client with appropriate stimulation. What is the best toy
for the nurse to provide?
1. Colorful rattle
4
NURSING EXAM WITH 100% ACCURATE
ANSWERS AND RATIONALES ALREADY GRADED
A+
1. A 13-month-old child has just been placed in a plaster hip spica cast to
correct a congenital anomaly. Which nursing actions should be included in
the plan of care?
1. Turn the child no more than every four hours to minimize manipulation of
the wet cast.
2. Use only fingertips when moving the child to prevent indentations in the
cast.
3. Assess and document neurovascular function at least every two hours.
4. Use a hair dryer to speed the cast-drying process. - ANSWERS-3.
Neurovascular function must be assessed every two hours. The child should
be turned at least every two hours to prevent skin damage and to facilitate
plaster cast drying. Fingertips should be avoided when handling a wet
plaster cast because they can leave indentations on a wet cast. The nurse
should palm the cast. A hair dryer should not be used to dry the cast. This
causes the cast to dry from the outside in and may leave the inside wet and
soft.
2.A 13-year-old child has just arrived on the nursing care unit from the
postanesthesia care unit (PACU). This morning, the child underwent a
surgical spinal fusion procedure that included the placement of Harrington
rods for the treatment of scoliosis. After receiving a report from the PACU
nurse, which action should the nurse perform first?
1. Assess the pain level and administer analgesics as needed
1
,2. Offer clear liquids to ensure adequate hydration
3. Drain the Hemovac and record the output on the intake and output record
4. Notify the child's parents of his/her arrival on the unit - ANSWERS-1.
Pain management is a high priority. The child probably is not taking liquids
at this time. Even if she is taking clear liquids, pain management is a higher
priority. The nurse may drain the Hemovac, but that is not the highest
priority. The nurse will notify the child's parents, but pain management is of
a higher priority.
3.A newborn has been diagnosed as having mild hip dysplasia. The mother
asks the nurse why the physician told her to "triple diaper" the baby. What
should the nurse include when responding?
1. It is important that there be no contamination of the area.
2. Extra diapers will abduct the hips and help to put the hip in the socket
correctly.
3. Triple diapers cause the baby's legs to be sharply flexed and realign the
hip.
4. Hip dysplasia can cause abnormal
stooling. - ANSWERS-2. The treatment for hip dysplasia is abduction.
Triple diapers are the easiest way to abduct the hips in mild cases. If that is
not successful, then a pillow splint or harness can be used. There is no open
wound with hip dysplasia and no worry about contamination of the area.
Hip dysplasia does not cause abnormal stooling. Triple diapers do not cause
increased flexion; they actually cause less flexion. Less flexion is
recommended for children with hip dysplasia.
4. A 6-month-old baby is placed in bilateral leg casts because she has talipes
equinovarus. The mother asks how to bathe the baby. What should the nurse
2
,tell the mother?
1. "Bathe the baby as you usually do."
2. "Put the baby's buttocks in the bath
water, but try to keep the feet out of the water."
3. "Sponge bathe your baby until the casts are removed."
4. "Give the baby a bath in the baby bath tub, but limit the time in the
water." - ANSWERS-3. The baby who has bilateral casts should not be
placed in water but should receive a sponge bath. Answers 2 and 4 put the
baby in water and are not correct. The nurse should not tell the mother to
bathe the baby as usual without knowing what the usual is. By 6 months of
age, most babies
are being bathed in a baby bath tub. This is not appropriate when there are
casts.
5. The nurse is monitoring a child with burns during treatment for burn
shock. The nurse understands that which assessment provides the most
accurate guide to determine the adequacy of fluid resuscitation?
A. skin turgor
B. neurological assessment
C. Level of edema at burn site
D. quality of peripheral pulses - ANSWERS-B. neurological assessment
Sensorium is an accurate guide to determine the adequacy of fluid
resuscitation. The burn injury itself does not affect the sensorium, so the
child should be alert and oriented. Any alteration in sensorium should be
evaluated further. A neurological assessment would determine the level of
3
, sensorium in the child.
6. The mother of a 3 year old child arrives at a clinic and tells the nurse that
the child has been scratching the skin continuously and has developed a
rash. The nurse assesses the child and suspects the presence of scabies. The
nurse bases this suspicion on which finding noted on assessment of the
child's skin?
A. fine grayish red lines
B. Purple-colored lesions
C. thick, honey-colored crusts
D. clusters of fluid-filled vesicles - ANSWERS-A. Fine grayish red lines
7. A 3-month-old infant is admitted. Upon admission, the nurse assesses her
developmental status as appropriate for age. Which of the following is the
child least likely to be able to do?
1. Smile in response to mother's face
2. Reach for shiny objects but miss them
3. Hold head erect and steady
4. Sit with slight support - ANSWERS-4. Sitting with slight support would
be expected in a child of 5 months. All of the other tasks are appropriate for
this age.
8. A 3-month-old infant is doing well after the repair of a cleft lip. The nurse
wants to provide the client with appropriate stimulation. What is the best toy
for the nurse to provide?
1. Colorful rattle
4
