PN PEDIATRIC EXAM PROCTORED WITH VERIFIED NGN QUESTION AND
ANSWERS.
A nurse is caring for a 15-year-old adolescent who has cellulitis of the left lower call.
Nurses NotesVital SignsLaboratory Results
Day 1:
6 x 6 cm indurated area on the left calf. Warmth and tenderness noted over the area. Client
reports pain while walking as 6 on scale of 0 to 10. Small area of abscess, culture obtained.
Wound borders marked per policy and procedure. Peripheral IV initiated, antibiotic administered
as prescribed.
Day 2:
Warmth and tenderness persist, 5 x 5 cm indurated area noted. Adolescent ambulated in hall
twice, tolerated well.
The nurse is assessing the adolescent 24 hr after the initial visit. How should the nurse
interpret the findings?
For each finding, click to specify whether the finding is an Indication of potential
improvement or an indication of potential worsening condition. There must be at least 1
selection in every row. There does not need to be a selection in every column
WBC count
Temperature
Wound assessment
Weight-bearing ability on the affected leg
Answer
WBC count
- Indication of potential worsening condition
Temperature
- Indication of potential Improvement
Wound assessment
- Indication of potential Improvement
,Weight-bearing ability on the affected leg
- Indication of potential Improvement
A nurse is caring for an adolescent.
History and PhysicalNurses' NotesVital Signs
16-year-old female presents with abdominal and pelvic pain lasting 2 days. Past medical history
includes right arm fracture at the age of 7. Reproductive history includes sexual activity with 4
partners over the last 2 months. Oral contraceptives used for the past 12 months. Last menstrual
period 7 days ago. Current on all vaccinations; human papillomavirus vaccine deferred. Vaginal
examination: Noted cervical mucopurulent discharge.
Complete the diagram by dragging from the choices below to specify what condition the
client is most likely experiencing, 2 actions the nurse should take to address that condition,
and 2 parameters the nurse should monitor to assess the client's progress.
Action to Take Choices
Administer acetaminophen 650 mg PO every 6 hr PRN pain
Place the adolescent on bedrest in semi-Fowler's position.
Instruct the adolescent about the use of sitz baths
Administer an enema
Maintain an NPO status
Condition Most Likely Experiencing Choices
Pelvic Inflammatory Disease
Unary tract Infection
Ectopic pregnancy
Acute Appendicitis
Parameter to Monitor Choices
, Temperature greater than 38.3°C(100.9°F)
Rebound tenderness
Vaginal bleeding
Presence of a Cullen’s sign
Irritation of the phrenic nerve
A nurse is reinforcing the provider's explanation about treatment options to the parents of
a 1-month-old who has coarctation of the aorta. Which of the following statements should
the nurse include?
A "Surgical repair is the recommended treatment for infants younger than 6 months old."
B "The obstruction will be treated with a medication called indomethacin."
C "Most cases resolve spontaneously without treatment by 12 months of age."
D The cardiologist will monitor your infant closely until they are able to receive treatment
with a heart transplant."
A nurse in an emergency department is caring for a child who weighs 18 kg (39.7 lb) and
ingested six 500 mg acetaminophen tablets 4 hr ago. Which of the following actions should
the nurse take?
A Send the child home on increased fluid intake.
B Begin hemodialysis within the next 24 hr.
C Perform gastric lavage with activated charcoal.
D Prepare to give oral N-acetylcysteine.
A nurse is caring for a toddler admitted to the hospital.
Nurses' NotesVital SignsI&O
1200:
Caregiver reports toddler has had diarrhea and decreased appetite for 3 days. Toddler alert,
uncooperative but can be consoled by caregiver.
, Weight 12.7 kg (28 lb). Oral mucosa pink, slightly moist. Heart rate regular without murmur.
Respirations unlabored with clear breath sounds. Abdomen soft, no masses, hyperactive bowel
sounds. Liquid stool in diaper. Diaper area reddened. Capillary refill 2 seconds. IV started and
infusing at 45 mL/hr.
1400:
Caregiver reports toddler cried themselves to sleep. Reports no Reports no tears.
1600:
Toddler continues to sleep. IV site intact and patent. Awakens briefly with vital signs, vomits x1,
and is lethargic. Capillary refill 4 seconds. Extremities cool.
Click to highlight the findings that require immediate follow-up. To deselect a finding, click
on the finding again.
Body system Findings
Respiratory Respiratory rate 26/min
Cardiovascular Heart rate 112/min
Capillary refill 4 seconds
Gastrointestinal Hyperactive bowel sounds
Integumentary Diaper area reddened
Extremities cool
Reports no tears
Neurologic Lethargic
The Correct Answers:
Capillary refill 4 seconds: Prolonged capillary refill indicates poor peripheral
perfusion, often due to dehydration or shock in toddlers. This requires urgent
assessment and intervention to prevent further circulatory compromise.
Extremities cool: Cool extremities suggest vasoconstriction caused by decreased
circulating volume or shock. Immediate evaluation is necessary to prevent
progression of hypovolemia.
Reports no tears: Lack of tears while crying is a hallmark sign of moderate to severe
dehydration, signaling the need for urgent fluid replacement therapy.
Lethargic: Lethargy reflects altered mental status and possible systemic
compromise, requiring immediate medical evaluation to address underlying causes
such as severe dehydration or infection.
Hyperactive bowel sounds: Hyperactive bowel sounds correlate with diarrhea and
fluid loss, which can worsen dehydration. Prompt monitoring and management are
necessary to prevent complications.
ANSWERS.
A nurse is caring for a 15-year-old adolescent who has cellulitis of the left lower call.
Nurses NotesVital SignsLaboratory Results
Day 1:
6 x 6 cm indurated area on the left calf. Warmth and tenderness noted over the area. Client
reports pain while walking as 6 on scale of 0 to 10. Small area of abscess, culture obtained.
Wound borders marked per policy and procedure. Peripheral IV initiated, antibiotic administered
as prescribed.
Day 2:
Warmth and tenderness persist, 5 x 5 cm indurated area noted. Adolescent ambulated in hall
twice, tolerated well.
The nurse is assessing the adolescent 24 hr after the initial visit. How should the nurse
interpret the findings?
For each finding, click to specify whether the finding is an Indication of potential
improvement or an indication of potential worsening condition. There must be at least 1
selection in every row. There does not need to be a selection in every column
WBC count
Temperature
Wound assessment
Weight-bearing ability on the affected leg
Answer
WBC count
- Indication of potential worsening condition
Temperature
- Indication of potential Improvement
Wound assessment
- Indication of potential Improvement
,Weight-bearing ability on the affected leg
- Indication of potential Improvement
A nurse is caring for an adolescent.
History and PhysicalNurses' NotesVital Signs
16-year-old female presents with abdominal and pelvic pain lasting 2 days. Past medical history
includes right arm fracture at the age of 7. Reproductive history includes sexual activity with 4
partners over the last 2 months. Oral contraceptives used for the past 12 months. Last menstrual
period 7 days ago. Current on all vaccinations; human papillomavirus vaccine deferred. Vaginal
examination: Noted cervical mucopurulent discharge.
Complete the diagram by dragging from the choices below to specify what condition the
client is most likely experiencing, 2 actions the nurse should take to address that condition,
and 2 parameters the nurse should monitor to assess the client's progress.
Action to Take Choices
Administer acetaminophen 650 mg PO every 6 hr PRN pain
Place the adolescent on bedrest in semi-Fowler's position.
Instruct the adolescent about the use of sitz baths
Administer an enema
Maintain an NPO status
Condition Most Likely Experiencing Choices
Pelvic Inflammatory Disease
Unary tract Infection
Ectopic pregnancy
Acute Appendicitis
Parameter to Monitor Choices
, Temperature greater than 38.3°C(100.9°F)
Rebound tenderness
Vaginal bleeding
Presence of a Cullen’s sign
Irritation of the phrenic nerve
A nurse is reinforcing the provider's explanation about treatment options to the parents of
a 1-month-old who has coarctation of the aorta. Which of the following statements should
the nurse include?
A "Surgical repair is the recommended treatment for infants younger than 6 months old."
B "The obstruction will be treated with a medication called indomethacin."
C "Most cases resolve spontaneously without treatment by 12 months of age."
D The cardiologist will monitor your infant closely until they are able to receive treatment
with a heart transplant."
A nurse in an emergency department is caring for a child who weighs 18 kg (39.7 lb) and
ingested six 500 mg acetaminophen tablets 4 hr ago. Which of the following actions should
the nurse take?
A Send the child home on increased fluid intake.
B Begin hemodialysis within the next 24 hr.
C Perform gastric lavage with activated charcoal.
D Prepare to give oral N-acetylcysteine.
A nurse is caring for a toddler admitted to the hospital.
Nurses' NotesVital SignsI&O
1200:
Caregiver reports toddler has had diarrhea and decreased appetite for 3 days. Toddler alert,
uncooperative but can be consoled by caregiver.
, Weight 12.7 kg (28 lb). Oral mucosa pink, slightly moist. Heart rate regular without murmur.
Respirations unlabored with clear breath sounds. Abdomen soft, no masses, hyperactive bowel
sounds. Liquid stool in diaper. Diaper area reddened. Capillary refill 2 seconds. IV started and
infusing at 45 mL/hr.
1400:
Caregiver reports toddler cried themselves to sleep. Reports no Reports no tears.
1600:
Toddler continues to sleep. IV site intact and patent. Awakens briefly with vital signs, vomits x1,
and is lethargic. Capillary refill 4 seconds. Extremities cool.
Click to highlight the findings that require immediate follow-up. To deselect a finding, click
on the finding again.
Body system Findings
Respiratory Respiratory rate 26/min
Cardiovascular Heart rate 112/min
Capillary refill 4 seconds
Gastrointestinal Hyperactive bowel sounds
Integumentary Diaper area reddened
Extremities cool
Reports no tears
Neurologic Lethargic
The Correct Answers:
Capillary refill 4 seconds: Prolonged capillary refill indicates poor peripheral
perfusion, often due to dehydration or shock in toddlers. This requires urgent
assessment and intervention to prevent further circulatory compromise.
Extremities cool: Cool extremities suggest vasoconstriction caused by decreased
circulating volume or shock. Immediate evaluation is necessary to prevent
progression of hypovolemia.
Reports no tears: Lack of tears while crying is a hallmark sign of moderate to severe
dehydration, signaling the need for urgent fluid replacement therapy.
Lethargic: Lethargy reflects altered mental status and possible systemic
compromise, requiring immediate medical evaluation to address underlying causes
such as severe dehydration or infection.
Hyperactive bowel sounds: Hyperactive bowel sounds correlate with diarrhea and
fluid loss, which can worsen dehydration. Prompt monitoring and management are
necessary to prevent complications.
