West Coast University NURS 307 Peds Exam 2 (pdf) | 2026/2027 |
Peds Q&A | Pediatric Nursing
1. A nurse is caring for a child with acute epiglottitis. Which of the following
assessment findings would the nurse expect to observe?
A) Barking cough and inspiratory stridor
B) Gradual onset of symptoms over several days
C) Drooling and sitting in a tripod position
D) Wheezing on expiration
Correct Answer: Drooling and sitting in a tripod position
Rationale: Epiglottitis is a medical emergency typically caused by
*Haemophilus influenzae* type B. Children present with a sudden onset of
high fever, drooling, dysphagia, and respiratory distress, often assuming a
tripod position (leaning forward with hands on knees) to maintain an open
airway. A barking cough is more characteristic of croup.
2. A 2-year-old child is brought to the emergency department with a barking
cough, inspiratory stridor, and hoarseness. The child is restless and has mild
intercostal retractions. What is the most likely diagnosis?
A) Epiglottitis
B) Bronchiolitis
C) Laryngotracheobronchitis (Croup)
D) Foreign body aspiration
Correct Answer: Laryngotracheobronchitis (Croup)
Rationale: Croup is characterized by a barking cough, inspiratory stridor,
hoarseness, and respiratory distress. It is most common in children ages 6
,months to 3 years and is typically viral in origin. Unlike epiglottitis, croup has
a gradual onset and does not present with drooling or the tripod position.
3. Which nursing intervention is most important for a child hospitalized with
respiratory syncytial virus (RSV) bronchiolitis?
A) Maintaining strict bed rest
B) Administering antibiotics as prescribed
C) Maintaining strict contact precautions
D) Encouraging oral fluid intake
Correct Answer: Maintaining strict contact precautions
Rationale: RSV is highly contagious and transmitted through direct contact
with respiratory secretions and contaminated surfaces. Contact precautions,
including gowns and gloves, are essential to prevent the spread of the virus
to other patients and staff. Antibiotics are not effective against viral
infections like RSV.
4. A nurse is providing discharge teaching for a child who has cystic fibrosis.
Which instruction is most important to include?
A) Restrict the child's fluid intake
B) Administer pancreatic enzymes with meals and snacks
C) Encourage a low-fat diet
D) Avoid all physical activity
Correct Answer: Administer pancreatic enzymes with meals and snacks
Rationale: Children with cystic fibrosis have pancreatic insufficiency and
require pancreatic enzyme replacement with all meals and snacks to aid
,digestion and absorption of nutrients. This is crucial for maintaining
adequate nutrition and preventing malabsorption.
5. A school nurse is assessing an adolescent who returned to school following
a case of mononucleosis. The child has a note from the provider excusing
him from gym class. Which finding should the nurse identify as the reason for
this excusal?
A) Potential for sustaining abdominal trauma
B) Deficient dietary intake
C) Exposing peers to the illness
D) Straining sore joints
Correct Answer: Potential for sustaining abdominal trauma
Rationale: Mononucleosis can cause splenomegaly, which increases the risk
of splenic rupture from abdominal trauma. Therefore, contact sports and gym
class are avoided until the spleen has returned to normal size.
6. A nurse is assessing a child suspected of having pinworms. Which is the
most common symptom the nurse expects to assess?
A) Restlessness
B) Distractibility
C) Rectal discharge
D) Intense perianal itching
Correct Answer: Intense perianal itching
Rationale: Intense perianal itching is the most common symptom of pinworm
infection. The itching is caused by the female worm laying eggs in the
perianal area, especially at night.
, 7. A child has been diagnosed with scabies. Which statement by the parent
indicates understanding of the nurse's teaching about scabies?
A) "The itching will stop after the cream is applied."
B) "We will complete extensive aggressive housecleaning."
C) "We will apply the cream to only the affected areas as directed."
D) "Everyone who has been in close contact with my child will need to be
treated."
Correct Answer: "Everyone who has been in close contact with my child will
need to be treated."
Rationale: Scabies is highly contagious, and all close contacts should be
treated simultaneously to prevent re-infestation. Itching may persist for up to
2-3 weeks after treatment due to the allergic reaction to the mites.
8. The nurse observes flaring of nares in a newborn. What should this be
interpreted as?
A) Nasal occlusion
B) Sign of respiratory distress
C) Snuffles of congenital syphilis
D) Appropriate newborn breathing
Correct Answer: Sign of respiratory distress
Rationale: Nasal flaring is a sign of respiratory distress in a newborn. It
indicates the infant is using accessory muscles to breathe and requires
further assessment.
Peds Q&A | Pediatric Nursing
1. A nurse is caring for a child with acute epiglottitis. Which of the following
assessment findings would the nurse expect to observe?
A) Barking cough and inspiratory stridor
B) Gradual onset of symptoms over several days
C) Drooling and sitting in a tripod position
D) Wheezing on expiration
Correct Answer: Drooling and sitting in a tripod position
Rationale: Epiglottitis is a medical emergency typically caused by
*Haemophilus influenzae* type B. Children present with a sudden onset of
high fever, drooling, dysphagia, and respiratory distress, often assuming a
tripod position (leaning forward with hands on knees) to maintain an open
airway. A barking cough is more characteristic of croup.
2. A 2-year-old child is brought to the emergency department with a barking
cough, inspiratory stridor, and hoarseness. The child is restless and has mild
intercostal retractions. What is the most likely diagnosis?
A) Epiglottitis
B) Bronchiolitis
C) Laryngotracheobronchitis (Croup)
D) Foreign body aspiration
Correct Answer: Laryngotracheobronchitis (Croup)
Rationale: Croup is characterized by a barking cough, inspiratory stridor,
hoarseness, and respiratory distress. It is most common in children ages 6
,months to 3 years and is typically viral in origin. Unlike epiglottitis, croup has
a gradual onset and does not present with drooling or the tripod position.
3. Which nursing intervention is most important for a child hospitalized with
respiratory syncytial virus (RSV) bronchiolitis?
A) Maintaining strict bed rest
B) Administering antibiotics as prescribed
C) Maintaining strict contact precautions
D) Encouraging oral fluid intake
Correct Answer: Maintaining strict contact precautions
Rationale: RSV is highly contagious and transmitted through direct contact
with respiratory secretions and contaminated surfaces. Contact precautions,
including gowns and gloves, are essential to prevent the spread of the virus
to other patients and staff. Antibiotics are not effective against viral
infections like RSV.
4. A nurse is providing discharge teaching for a child who has cystic fibrosis.
Which instruction is most important to include?
A) Restrict the child's fluid intake
B) Administer pancreatic enzymes with meals and snacks
C) Encourage a low-fat diet
D) Avoid all physical activity
Correct Answer: Administer pancreatic enzymes with meals and snacks
Rationale: Children with cystic fibrosis have pancreatic insufficiency and
require pancreatic enzyme replacement with all meals and snacks to aid
,digestion and absorption of nutrients. This is crucial for maintaining
adequate nutrition and preventing malabsorption.
5. A school nurse is assessing an adolescent who returned to school following
a case of mononucleosis. The child has a note from the provider excusing
him from gym class. Which finding should the nurse identify as the reason for
this excusal?
A) Potential for sustaining abdominal trauma
B) Deficient dietary intake
C) Exposing peers to the illness
D) Straining sore joints
Correct Answer: Potential for sustaining abdominal trauma
Rationale: Mononucleosis can cause splenomegaly, which increases the risk
of splenic rupture from abdominal trauma. Therefore, contact sports and gym
class are avoided until the spleen has returned to normal size.
6. A nurse is assessing a child suspected of having pinworms. Which is the
most common symptom the nurse expects to assess?
A) Restlessness
B) Distractibility
C) Rectal discharge
D) Intense perianal itching
Correct Answer: Intense perianal itching
Rationale: Intense perianal itching is the most common symptom of pinworm
infection. The itching is caused by the female worm laying eggs in the
perianal area, especially at night.
, 7. A child has been diagnosed with scabies. Which statement by the parent
indicates understanding of the nurse's teaching about scabies?
A) "The itching will stop after the cream is applied."
B) "We will complete extensive aggressive housecleaning."
C) "We will apply the cream to only the affected areas as directed."
D) "Everyone who has been in close contact with my child will need to be
treated."
Correct Answer: "Everyone who has been in close contact with my child will
need to be treated."
Rationale: Scabies is highly contagious, and all close contacts should be
treated simultaneously to prevent re-infestation. Itching may persist for up to
2-3 weeks after treatment due to the allergic reaction to the mites.
8. The nurse observes flaring of nares in a newborn. What should this be
interpreted as?
A) Nasal occlusion
B) Sign of respiratory distress
C) Snuffles of congenital syphilis
D) Appropriate newborn breathing
Correct Answer: Sign of respiratory distress
Rationale: Nasal flaring is a sign of respiratory distress in a newborn. It
indicates the infant is using accessory muscles to breathe and requires
further assessment.
