Test Bank Davis Advantage for Pediatric
Nursing The Critical Components of Nursing
Care Second Edition by Kathryn Rudd
Chapter 1-22
1. A 6-month-old infant is brought for a well visit. Which development milestone should the
nurse expect?
A. Runs well without falling
B. Sits unsupported and begins to roll over both ways
C. Uses two-word phrases
D. Dresses self partially
Answer: B. Rationale: At 6 months infants typically sit unsupported and can roll
front-to-back and back-to-front.
2. Which immunization is contraindicated for a child with severe combined
immunodeficiency (SCID)?
A. Inactivated influenza vaccine
B. MMR (measles, mumps, rubella) live vaccine
C. Tdap (tetanus, diphtheria, pertussis)
D. Hepatitis B vaccine
Answer: B. Rationale: Live vaccines (like MMR) are contraindicated in severe
immunodeficiency.
3. For a toddler with otitis media, which sign is most characteristic?
A. Bradycardia
B. Pulling at the ear and irritability
C. Increased appetite
D. Productive cough with green sputum
Answer: B. Rationale: Ear pulling, irritability, and ear pain are common in otitis media in
, toddlers.
4. A 4-year-old’s normal respiratory rate during play is most likely:
A. 60 breaths/min
B. 30 breaths/min
C. 12 breaths/min
D. 8 breaths/min
Answer: B. Rationale: Preschoolers typically have respiratory rates about 20–30
breaths/min; 30 is within range during activity.
5. Which action promotes parent-infant attachment in the NICU?
A. Limiting visiting hours to reduce stimulation
B. Encouraging kangaroo care (skin-to-skin) when stable
C. Performing all care by staff to avoid parental mistakes
D. Restricting parents to phone updates only
Answer: B. Rationale: Kangaroo care promotes bonding and physiologic stability for
infants and parents.
6. A child with type 1 diabetes has blood glucose 55 mg/dL and is conscious — best
immediate action:
A. Give 4 oz juice or regular soda orally
B. Administer subcutaneous insulin
C. Give a high-fat snack
D. Call for emergent IV dextrose only
Answer: A. Rationale: For conscious hypoglycemia give quick-acting carbohydrate
(juice) and recheck glucose.
7. Which is the priority when caring for a child with epiglottitis?
A. Obtain throat cultures immediately
B. Keep the child calm and prepare for airway support
C. Encourage oral fluids to soothe throat
D. Administer throat lozenges
Answer: B. Rationale: Epiglottitis can cause sudden airway obstruction; keep calm and
ensure airway readiness.
8. A 10-year-old with asthma uses a metered-dose inhaler (MDI). The nurse should teach
to:
A. Exhale fully, place inhaler, inhale slowly while actuating, hold breath 10 seconds
B. Inhale rapidly and then exhale forcefully immediately
C. Use only when symptoms begin to improve
D. Shake the inhaler only after priming and never use a spacer
Answer: A. Rationale: Proper MDI technique requires slow deep inhalation with
actuation and breath holding.
,9. Which sign suggests dehydration in an infant?
A. Moist mucous membranes and a soft fontanel
B. Sunken fontanel, decreased urine output, dry mucous membranes
C. Increased tear production and weight gain
D. Clear urine and frequent wet diapers
Answer: B. Rationale: Sunken fontanel and oliguria are classic signs of dehydration in
infants.
10.For a child receiving ototoxic medication, which assessment is important?
A. Visual acuity checks weekly
B. Hearing assessment and report of tinnitus or balance changes
C. Periodic CBC only
D. Check blood glucose levels daily
Answer: B. Rationale: Ototoxic drugs can affect hearing and vestibular function, so
monitor hearing and balance.
11.A school-age child with Kawasaki disease should be monitored for which complication?
A. Renal calculi
B. Coronary artery aneurysms
C. Osteoporosis
D. Hypothyroidism
Answer: B. Rationale: Kawasaki disease can cause coronary artery aneurysms and
cardiac complications.
12.Which play activity is appropriate for a hospitalized 3-year-old?
A. Competitive team sports
B. Parallel play with blocks and dolls
C. Solitary crossword puzzles
D. Complex board games requiring reading
Answer: B. Rationale: Three-year-olds engage in parallel play with simple toys.
13.When preparing a child for a painful procedure, best technique to reduce anxiety:
A. Use medical jargon to be precise
B. Encourage parental presence, explain simply, use distraction techniques
C. Isolate the child from parents to speed procedure
D. Restrain the child without explanation
Answer: B. Rationale: Parental presence, age-appropriate explanations, and distraction
reduce anxiety and improve coping.
14.A 2-year-old with suspected lead poisoning should be tested using:
A. Serum lead level (venous) or capillary screening confirmed by venous sample
B. Hair analysis only
C. Urine toxicology without blood test
D. Salivary lead measurement
, Answer: A. Rationale: Blood lead level (venous) is the diagnostic test; capillary screens
must be confirmed by venous sample.
15.Best nursing action for a child in skeletal traction:
A. Remove weights for comfort periodically
B. Ensure weights hang freely and maintain alignment
C. Encourage the child to sit up without assistance
D. Allow weights to rest on the floor
Answer: B. Rationale: Proper traction requires free-hanging weights and maintained
alignment; do not remove or rest weights.
16.A newborn with suspected congenital heart defect is cyanotic and has a heart murmur —
immediate priority:
A. Feed and observe for 24 hours
B. Assess oxygenation and prepare for further cardiac evaluation (e.g., echo)
C. Provide ibuprofen for pain
D. Discontinue all oxygen therapy
Answer: B. Rationale: Cyanosis and murmur need immediate assessment of
oxygenation and cardiac workup.
17.Which food should be avoided in children under 1 year?
A. Pureed bananas
B. Cow’s milk as main drink
C. Breast milk or formula
D. Iron-fortified infant cereal
Answer: B. Rationale: Whole cow’s milk before 12 months can cause iron deficiency
and is not recommended as main drink.
18.A 15-year-old requests confidentiality about sexual activity. Nursing action:
A. Refuse confidentiality and inform parents immediately
B. Explain confidentiality limits but provide counseling and safe care (STI testing,
contraception)
C. Ignore the request
D. Report to authorities for sexual activity alone
Answer: B. Rationale: Adolescents are entitled to confidential sexual health services;
explain limits (risk, abuse) and provide care.
19.Pain assessment for a 4-year-old is best achieved with:
A. Numeric 0–10 scale only
B. Wong-Baker FACES pain scale
C. Parent report without child input
D. Observation only—no scales for preschoolers
Answer: B. Rationale: FACES scale is validated for preschool children to self-report
Nursing The Critical Components of Nursing
Care Second Edition by Kathryn Rudd
Chapter 1-22
1. A 6-month-old infant is brought for a well visit. Which development milestone should the
nurse expect?
A. Runs well without falling
B. Sits unsupported and begins to roll over both ways
C. Uses two-word phrases
D. Dresses self partially
Answer: B. Rationale: At 6 months infants typically sit unsupported and can roll
front-to-back and back-to-front.
2. Which immunization is contraindicated for a child with severe combined
immunodeficiency (SCID)?
A. Inactivated influenza vaccine
B. MMR (measles, mumps, rubella) live vaccine
C. Tdap (tetanus, diphtheria, pertussis)
D. Hepatitis B vaccine
Answer: B. Rationale: Live vaccines (like MMR) are contraindicated in severe
immunodeficiency.
3. For a toddler with otitis media, which sign is most characteristic?
A. Bradycardia
B. Pulling at the ear and irritability
C. Increased appetite
D. Productive cough with green sputum
Answer: B. Rationale: Ear pulling, irritability, and ear pain are common in otitis media in
, toddlers.
4. A 4-year-old’s normal respiratory rate during play is most likely:
A. 60 breaths/min
B. 30 breaths/min
C. 12 breaths/min
D. 8 breaths/min
Answer: B. Rationale: Preschoolers typically have respiratory rates about 20–30
breaths/min; 30 is within range during activity.
5. Which action promotes parent-infant attachment in the NICU?
A. Limiting visiting hours to reduce stimulation
B. Encouraging kangaroo care (skin-to-skin) when stable
C. Performing all care by staff to avoid parental mistakes
D. Restricting parents to phone updates only
Answer: B. Rationale: Kangaroo care promotes bonding and physiologic stability for
infants and parents.
6. A child with type 1 diabetes has blood glucose 55 mg/dL and is conscious — best
immediate action:
A. Give 4 oz juice or regular soda orally
B. Administer subcutaneous insulin
C. Give a high-fat snack
D. Call for emergent IV dextrose only
Answer: A. Rationale: For conscious hypoglycemia give quick-acting carbohydrate
(juice) and recheck glucose.
7. Which is the priority when caring for a child with epiglottitis?
A. Obtain throat cultures immediately
B. Keep the child calm and prepare for airway support
C. Encourage oral fluids to soothe throat
D. Administer throat lozenges
Answer: B. Rationale: Epiglottitis can cause sudden airway obstruction; keep calm and
ensure airway readiness.
8. A 10-year-old with asthma uses a metered-dose inhaler (MDI). The nurse should teach
to:
A. Exhale fully, place inhaler, inhale slowly while actuating, hold breath 10 seconds
B. Inhale rapidly and then exhale forcefully immediately
C. Use only when symptoms begin to improve
D. Shake the inhaler only after priming and never use a spacer
Answer: A. Rationale: Proper MDI technique requires slow deep inhalation with
actuation and breath holding.
,9. Which sign suggests dehydration in an infant?
A. Moist mucous membranes and a soft fontanel
B. Sunken fontanel, decreased urine output, dry mucous membranes
C. Increased tear production and weight gain
D. Clear urine and frequent wet diapers
Answer: B. Rationale: Sunken fontanel and oliguria are classic signs of dehydration in
infants.
10.For a child receiving ototoxic medication, which assessment is important?
A. Visual acuity checks weekly
B. Hearing assessment and report of tinnitus or balance changes
C. Periodic CBC only
D. Check blood glucose levels daily
Answer: B. Rationale: Ototoxic drugs can affect hearing and vestibular function, so
monitor hearing and balance.
11.A school-age child with Kawasaki disease should be monitored for which complication?
A. Renal calculi
B. Coronary artery aneurysms
C. Osteoporosis
D. Hypothyroidism
Answer: B. Rationale: Kawasaki disease can cause coronary artery aneurysms and
cardiac complications.
12.Which play activity is appropriate for a hospitalized 3-year-old?
A. Competitive team sports
B. Parallel play with blocks and dolls
C. Solitary crossword puzzles
D. Complex board games requiring reading
Answer: B. Rationale: Three-year-olds engage in parallel play with simple toys.
13.When preparing a child for a painful procedure, best technique to reduce anxiety:
A. Use medical jargon to be precise
B. Encourage parental presence, explain simply, use distraction techniques
C. Isolate the child from parents to speed procedure
D. Restrain the child without explanation
Answer: B. Rationale: Parental presence, age-appropriate explanations, and distraction
reduce anxiety and improve coping.
14.A 2-year-old with suspected lead poisoning should be tested using:
A. Serum lead level (venous) or capillary screening confirmed by venous sample
B. Hair analysis only
C. Urine toxicology without blood test
D. Salivary lead measurement
, Answer: A. Rationale: Blood lead level (venous) is the diagnostic test; capillary screens
must be confirmed by venous sample.
15.Best nursing action for a child in skeletal traction:
A. Remove weights for comfort periodically
B. Ensure weights hang freely and maintain alignment
C. Encourage the child to sit up without assistance
D. Allow weights to rest on the floor
Answer: B. Rationale: Proper traction requires free-hanging weights and maintained
alignment; do not remove or rest weights.
16.A newborn with suspected congenital heart defect is cyanotic and has a heart murmur —
immediate priority:
A. Feed and observe for 24 hours
B. Assess oxygenation and prepare for further cardiac evaluation (e.g., echo)
C. Provide ibuprofen for pain
D. Discontinue all oxygen therapy
Answer: B. Rationale: Cyanosis and murmur need immediate assessment of
oxygenation and cardiac workup.
17.Which food should be avoided in children under 1 year?
A. Pureed bananas
B. Cow’s milk as main drink
C. Breast milk or formula
D. Iron-fortified infant cereal
Answer: B. Rationale: Whole cow’s milk before 12 months can cause iron deficiency
and is not recommended as main drink.
18.A 15-year-old requests confidentiality about sexual activity. Nursing action:
A. Refuse confidentiality and inform parents immediately
B. Explain confidentiality limits but provide counseling and safe care (STI testing,
contraception)
C. Ignore the request
D. Report to authorities for sexual activity alone
Answer: B. Rationale: Adolescents are entitled to confidential sexual health services;
explain limits (risk, abuse) and provide care.
19.Pain assessment for a 4-year-old is best achieved with:
A. Numeric 0–10 scale only
B. Wong-Baker FACES pain scale
C. Parent report without child input
D. Observation only—no scales for preschoolers
Answer: B. Rationale: FACES scale is validated for preschool children to self-report
