ESSENTIALS OF PEDIATRIC NURSING, 5TH EDITION | NEWEST 2026
EDITION | COMPREHENSIVE STUDY GUIDE WITH PRACTICE
QUESTIONS, VERIFIED ANSWERS & EXPERT RATIONALES |
COMPLETE REVIEW FOR PEDIATRIC NURSING SUCCESS | UPDATED
RESOURCE | INSTANT PDF DOWNLOAD
1. A nurse is caring for a child who is receiving treatment for diabetic ketoacidosis
and has a current blood glucose level of 250 mg/dL. Which of the following
actions should the nurse take?
A. Administer regular insulin subcutaneously
B. CORRECT ANSWER Administer D5NS by continuous IV infusion
C. Administer glucagon intramuscularly
D. Administer 0.9% sodium chloride bolus
Rationale: When blood glucose reaches 250 mg/dL in DKA, IV fluids are
typically switched to D5NS to prevent hypoglycemia as insulin continues to work.
Regular insulin is still given, but the fluid type changes to provide glucose.
2. A nurse is caring for a child who has epistaxis. Which of the following actions
should the nurse take?
A. Tilt the child's head back and apply ice
B. CORRECT ANSWER Apply continuous pressure to the child's nose for at
least 10 minutes
C. Insert a cotton ball into the nostril and have the child blow their nose
D. Have the child lean forward and pinch the nose for 1 minute
Rationale: For epistaxis, the child should sit upright and lean forward while the
nurse applies continuous pressure to the soft part of the nose for at least 10
minutes. Tilting the head back can cause blood to flow down the throat.
3. A nurse is teaching the parents of a 3yearold who has persistent otitis media
about prevention. Which of the following statements by the parents indicates an
understanding of the teaching?
A. "We should keep our child indoors during cold weather"
B. CORRECT ANSWER "We should not smoke around our child"
C. "We should give our child antibiotics every month"
D. "We should avoid giving our child any fluids before bed"
Rationale: Secondhand smoke exposure is a major risk factor for recurrent otitis
media in children. Eliminating smoke exposure helps prevent infections.
Antibiotics are not used prophylactically, and fluid restriction is not indicated.
,4. A nurse is assessing the pain level of a 3yearold who is postoperative following
abdominal surgery. Which of the following pain scales should the nurse use?
A. Numeric rating scale (0–10)
B. CORRECT ANSWER FACES pain rating scale
C. Visual analog scale
D. FLACC scale
Rationale: The FACES scale is appropriate for children as young as 3 years old
who can point to a face representing their pain. FLACC is for younger or
nonverbal children. Numeric scales are for older children and adults.
5. A nurse is caring for a child who has acute glomerulonephritis. Which of the
following actions should the nurse take?
A. Limit fluid intake to 500 mL per day
B. CORRECT ANSWER Check the child's blood pressure every 4 hours
C. Administer potassium supplements as prescribed
D. Encourage a highsodium diet
Rationale: Acute glomerulonephritis often causes hypertension due to fluid
retention and renal dysfunction. Blood pressure must be monitored frequently.
Fluid restriction may be needed but is not the priority over BP monitoring.
Potassium is typically restricted, not supplemented.
6. A nurse on the pediatric unit is caring for a group of clients. Which of the
following findings should be the nurse's priority?
A. A child who has sickle cell anemia and a urine specific gravity of 1.010
B. CORRECT ANSWER A child who has sickle cell anemia and a urine specific
gravity of 1.030
C. A child who has sickle cell anemia and a hemoglobin of 9 g/dL
D. A child who has sickle cell anemia and a temperature of 37.8°C (100°F)
Rationale: A specific gravity of 1.030 indicates concentrated urine, suggesting
dehydration, which can trigger a sickle cell crisis. This is the priority finding.
Hemoglobin of 9 g/dL is expected in sickle cell disease, and a lowgrade fever is
common but less urgent.
7. A nurse is caring for a preschoolage child who has mucosal ulceration after
receiving chemotherapy. Which of the following actions should the nurse take?
A. Instruct the child to use a firmbristled toothbrush
B. CORRECT ANSWER Instruct the child to use a soft sponge toothbrush when
brushing her teeth
C. Avoid brushing the child's teeth entirely
D. Use a cotton swab to clean the teeth with alcohol
,Rationale: Chemotherapyinduced mucositis makes the oral mucosa fragile and
prone to bleeding. A soft sponge toothbrush minimizes trauma. A firmbristled
brush would cause further injury. Alcohol is irritating and should be avoided.
8. A nurse is caring for a group of infants who have congenital heart defects. For
which of the following defects should the nurse expect to observe cyanosis?
A. Ventricular septal defect (VSD)
B. Atrial septal defect (ASD)
C. Patent ductus arteriosus (PDA)
D. CORRECT ANSWER Transposition of the great arteries
Rationale: Transposition of the great arteries causes cyanosis because the aorta
arises from the right ventricle, sending deoxygenated blood to the systemic
circulation. VSD, ASD, and PDA are acyanotic defects (lefttoright shunts).
9. A nurse is teaching a schoolage child who has a new diagnosis of type 1 diabetes
mellitus. Which of the following statements should the nurse make?
A. "You can use a vial of insulin for up to 60 days"
B. CORRECT ANSWER "You can use a vial of insulin for up to 30 days"
C. "You can use a vial of insulin for up to 90 days"
D. "You can use a vial of insulin for up to 14 days"
Rationale: An opened vial of insulin is typically good for 30 days when stored at
room temperature or in the refrigerator. Unopened vials can be stored until the
expiration date. Using it beyond 30 days may decrease potency.
10. A nurse is teaching to a group of parents of adolescents about developmental
needs. Which of the following statements by a parent should the nurse investigate
further?
A. "My child spends 1 hour per day on homework"
B. "My child spends 2 hours per day playing sports"
C. CORRECT ANSWER "My child spends 4 hours per day in internet chat
rooms"
D. "My child spends 30 minutes per day reading"
Rationale: Spending 4 hours daily in internet chat rooms may indicate excessive
screen time, social isolation, or cyberbullying risk. The nurse should investigate
further. Moderate amounts of homework, sports, and reading are developmentally
appropriate.
11. A nurse is reviewing the medical record of a 2monthold infant who has
rotavirus. The nurse notes a hemoglobin level of 12 g/dL and a hematocrit of 51%.
, Which of the following statements by the nurse indicates an understanding of the
laboratory values?
A. "The infant has anemia"
B. "The infant has polycythemia"
C. CORRECT ANSWER "The infant might be dehydrated"
D. "The infant has normal laboratory values"
Rationale: A hematocrit of 51% is elevated for a 2monthold (normal 30–45%),
suggesting hemoconcentration from dehydration due to rotavirus. Hemoglobin of
12 g/dL is also elevated for this age. Anemia would show low values.
12. A school nurse is assessing an adolescent child who returned to school
following a case of mononucleosis. The child has a note from his provider
excusing him from gym class. Which of the following findings should the nurse
identify as the reason for this excusal?
A. Risk of cardiac arrhythmias
B. Risk of respiratory distress
C. CORRECT ANSWER Potential for sustaining abdominal trauma
D. Risk of dehydration
Rationale: Mononucleosis causes splenomegaly, making the spleen vulnerable to
rupture from abdominal trauma during physical activity. This is why the child is
excused from gym. Cardiac and respiratory risks are not the primary concern.
13. A nurse is teaching the parents of a 4monthold infant who has gastroesophageal
reflux. Which of the following statements by the parent indicates an understanding
of the teaching?
A. "I will lay my baby flat after feeding"
B. "I will give my baby water between feedings"
C. CORRECT ANSWER "I will add 1 teaspoon of rice cereal per ounce to my
baby's formula"
D. "I will feed my baby every 4 hours"
Rationale: Thickening formula with rice cereal (1 teaspoon per ounce) helps
reduce GER by increasing the viscosity of the feedings. The infant should be kept
upright after feedings, not flat. Water is not recommended between feedings. More
frequent, smaller feedings are preferred.
14. A nurse is caring for a child who has suspected nephrotic syndrome. Which of
the following laboratory values should the nurse expect?
A. Serum albumin 4.5 g/dL
B. Serum cholesterol 150 mg/dL
C. CORRECT ANSWER Serum cholesterol 700 mg/dL
EDITION | COMPREHENSIVE STUDY GUIDE WITH PRACTICE
QUESTIONS, VERIFIED ANSWERS & EXPERT RATIONALES |
COMPLETE REVIEW FOR PEDIATRIC NURSING SUCCESS | UPDATED
RESOURCE | INSTANT PDF DOWNLOAD
1. A nurse is caring for a child who is receiving treatment for diabetic ketoacidosis
and has a current blood glucose level of 250 mg/dL. Which of the following
actions should the nurse take?
A. Administer regular insulin subcutaneously
B. CORRECT ANSWER Administer D5NS by continuous IV infusion
C. Administer glucagon intramuscularly
D. Administer 0.9% sodium chloride bolus
Rationale: When blood glucose reaches 250 mg/dL in DKA, IV fluids are
typically switched to D5NS to prevent hypoglycemia as insulin continues to work.
Regular insulin is still given, but the fluid type changes to provide glucose.
2. A nurse is caring for a child who has epistaxis. Which of the following actions
should the nurse take?
A. Tilt the child's head back and apply ice
B. CORRECT ANSWER Apply continuous pressure to the child's nose for at
least 10 minutes
C. Insert a cotton ball into the nostril and have the child blow their nose
D. Have the child lean forward and pinch the nose for 1 minute
Rationale: For epistaxis, the child should sit upright and lean forward while the
nurse applies continuous pressure to the soft part of the nose for at least 10
minutes. Tilting the head back can cause blood to flow down the throat.
3. A nurse is teaching the parents of a 3yearold who has persistent otitis media
about prevention. Which of the following statements by the parents indicates an
understanding of the teaching?
A. "We should keep our child indoors during cold weather"
B. CORRECT ANSWER "We should not smoke around our child"
C. "We should give our child antibiotics every month"
D. "We should avoid giving our child any fluids before bed"
Rationale: Secondhand smoke exposure is a major risk factor for recurrent otitis
media in children. Eliminating smoke exposure helps prevent infections.
Antibiotics are not used prophylactically, and fluid restriction is not indicated.
,4. A nurse is assessing the pain level of a 3yearold who is postoperative following
abdominal surgery. Which of the following pain scales should the nurse use?
A. Numeric rating scale (0–10)
B. CORRECT ANSWER FACES pain rating scale
C. Visual analog scale
D. FLACC scale
Rationale: The FACES scale is appropriate for children as young as 3 years old
who can point to a face representing their pain. FLACC is for younger or
nonverbal children. Numeric scales are for older children and adults.
5. A nurse is caring for a child who has acute glomerulonephritis. Which of the
following actions should the nurse take?
A. Limit fluid intake to 500 mL per day
B. CORRECT ANSWER Check the child's blood pressure every 4 hours
C. Administer potassium supplements as prescribed
D. Encourage a highsodium diet
Rationale: Acute glomerulonephritis often causes hypertension due to fluid
retention and renal dysfunction. Blood pressure must be monitored frequently.
Fluid restriction may be needed but is not the priority over BP monitoring.
Potassium is typically restricted, not supplemented.
6. A nurse on the pediatric unit is caring for a group of clients. Which of the
following findings should be the nurse's priority?
A. A child who has sickle cell anemia and a urine specific gravity of 1.010
B. CORRECT ANSWER A child who has sickle cell anemia and a urine specific
gravity of 1.030
C. A child who has sickle cell anemia and a hemoglobin of 9 g/dL
D. A child who has sickle cell anemia and a temperature of 37.8°C (100°F)
Rationale: A specific gravity of 1.030 indicates concentrated urine, suggesting
dehydration, which can trigger a sickle cell crisis. This is the priority finding.
Hemoglobin of 9 g/dL is expected in sickle cell disease, and a lowgrade fever is
common but less urgent.
7. A nurse is caring for a preschoolage child who has mucosal ulceration after
receiving chemotherapy. Which of the following actions should the nurse take?
A. Instruct the child to use a firmbristled toothbrush
B. CORRECT ANSWER Instruct the child to use a soft sponge toothbrush when
brushing her teeth
C. Avoid brushing the child's teeth entirely
D. Use a cotton swab to clean the teeth with alcohol
,Rationale: Chemotherapyinduced mucositis makes the oral mucosa fragile and
prone to bleeding. A soft sponge toothbrush minimizes trauma. A firmbristled
brush would cause further injury. Alcohol is irritating and should be avoided.
8. A nurse is caring for a group of infants who have congenital heart defects. For
which of the following defects should the nurse expect to observe cyanosis?
A. Ventricular septal defect (VSD)
B. Atrial septal defect (ASD)
C. Patent ductus arteriosus (PDA)
D. CORRECT ANSWER Transposition of the great arteries
Rationale: Transposition of the great arteries causes cyanosis because the aorta
arises from the right ventricle, sending deoxygenated blood to the systemic
circulation. VSD, ASD, and PDA are acyanotic defects (lefttoright shunts).
9. A nurse is teaching a schoolage child who has a new diagnosis of type 1 diabetes
mellitus. Which of the following statements should the nurse make?
A. "You can use a vial of insulin for up to 60 days"
B. CORRECT ANSWER "You can use a vial of insulin for up to 30 days"
C. "You can use a vial of insulin for up to 90 days"
D. "You can use a vial of insulin for up to 14 days"
Rationale: An opened vial of insulin is typically good for 30 days when stored at
room temperature or in the refrigerator. Unopened vials can be stored until the
expiration date. Using it beyond 30 days may decrease potency.
10. A nurse is teaching to a group of parents of adolescents about developmental
needs. Which of the following statements by a parent should the nurse investigate
further?
A. "My child spends 1 hour per day on homework"
B. "My child spends 2 hours per day playing sports"
C. CORRECT ANSWER "My child spends 4 hours per day in internet chat
rooms"
D. "My child spends 30 minutes per day reading"
Rationale: Spending 4 hours daily in internet chat rooms may indicate excessive
screen time, social isolation, or cyberbullying risk. The nurse should investigate
further. Moderate amounts of homework, sports, and reading are developmentally
appropriate.
11. A nurse is reviewing the medical record of a 2monthold infant who has
rotavirus. The nurse notes a hemoglobin level of 12 g/dL and a hematocrit of 51%.
, Which of the following statements by the nurse indicates an understanding of the
laboratory values?
A. "The infant has anemia"
B. "The infant has polycythemia"
C. CORRECT ANSWER "The infant might be dehydrated"
D. "The infant has normal laboratory values"
Rationale: A hematocrit of 51% is elevated for a 2monthold (normal 30–45%),
suggesting hemoconcentration from dehydration due to rotavirus. Hemoglobin of
12 g/dL is also elevated for this age. Anemia would show low values.
12. A school nurse is assessing an adolescent child who returned to school
following a case of mononucleosis. The child has a note from his provider
excusing him from gym class. Which of the following findings should the nurse
identify as the reason for this excusal?
A. Risk of cardiac arrhythmias
B. Risk of respiratory distress
C. CORRECT ANSWER Potential for sustaining abdominal trauma
D. Risk of dehydration
Rationale: Mononucleosis causes splenomegaly, making the spleen vulnerable to
rupture from abdominal trauma during physical activity. This is why the child is
excused from gym. Cardiac and respiratory risks are not the primary concern.
13. A nurse is teaching the parents of a 4monthold infant who has gastroesophageal
reflux. Which of the following statements by the parent indicates an understanding
of the teaching?
A. "I will lay my baby flat after feeding"
B. "I will give my baby water between feedings"
C. CORRECT ANSWER "I will add 1 teaspoon of rice cereal per ounce to my
baby's formula"
D. "I will feed my baby every 4 hours"
Rationale: Thickening formula with rice cereal (1 teaspoon per ounce) helps
reduce GER by increasing the viscosity of the feedings. The infant should be kept
upright after feedings, not flat. Water is not recommended between feedings. More
frequent, smaller feedings are preferred.
14. A nurse is caring for a child who has suspected nephrotic syndrome. Which of
the following laboratory values should the nurse expect?
A. Serum albumin 4.5 g/dL
B. Serum cholesterol 150 mg/dL
C. CORRECT ANSWER Serum cholesterol 700 mg/dL
