,NUR 254 Exam 4 | Maternal & Pediatric Nursing
(2026) PDF | Galen College
1. A child with sickle cell disease is admitted with severe pain. Which
intervention is the priority?
A) Administer oxygen via mask
B) Initiate aggressive IV hydration and pain management
C) Apply cold compresses to painful joints
D) Draw blood for hemoglobin electrophoresis
Correct Answer: Initiate aggressive IV hydration and pain management
Rationale: Vaso‑occlusive crisis requires hydration to reduce blood viscosity and
opioids for pain. Cold compresses can worsen sickling. Oxygen is used if hypoxic,
but pain and hydration are the immediate priorities.
2. A 5‑year‑old with sickle cell crisis on IV morphine is found unarousable with
respirations of 10/min. What is the nurse's first action?
A) Increase IV fluids
B) Obtain a complete metabolic panel
C) Administer naloxone as prescribed
D) Elevate the head of the bed
Correct Answer: Administer naloxone as prescribed
,Rationale: Unresponsiveness and bradypnea indicate opioid overdose. Naloxone
is an opioid antagonist that reverses respiratory depression. It must be given
immediately.
3. A child with hemophilia A has a swollen knee after a fall. The nurse should
instruct the parents to:
A) Apply an ice pack and compression dressing, and elevate the leg
B) Administer aspirin for pain
C) Apply heat to the joint
D) Perform active range‑of‑motion exercises
Correct Answer: Apply an ice pack and compression dressing, and elevate the
leg
Rationale: RICE (rest, ice, compression, elevation) helps control bleeding.
Aspirin is contraindicated; heat and exercise could worsen bleeding. Factor VIII
replacement is also needed.
4. The nurse is teaching parents of a child with iron deficiency anemia. Which
statement indicates understanding?
A) "I will give the iron supplement with milk to prevent stomach upset."
B) "I will give the iron on an empty stomach with orange juice."
C) "I will stop the iron once my child's color improves."
D) "I will be concerned if my child's stools turn black."
Correct Answer: "I will give the iron on an empty stomach with orange juice."
, Rationale: Iron absorption is enhanced by vitamin C and inhibited by milk. Black
stools are expected. Therapy should continue for several months to replenish
stores.
5. A child is suspected of having a Wilms tumor. Which action by the nurse
requires immediate intervention?
A) Palpating the child's abdomen
B) Measuring abdominal girth
C) Obtaining a urine sample
D) Assessing blood pressure
Correct Answer: Palpating the child's abdomen
Rationale: Palpation can rupture the tumor capsule, spreading malignant cells. A
sign stating "Do Not Palpate Abdomen" should be posted.
6. A child with leukemia has a white blood cell count of 900/mm³. The nurse's
priority is to:
A) Administer the prescribed influenza vaccine
B) Institute neutropenic precautions and monitor for fever
C) Encourage fresh fruits and vegetables
D) Schedule a dental cleaning
Correct Answer: Institute neutropenic precautions and monitor for fever
(2026) PDF | Galen College
1. A child with sickle cell disease is admitted with severe pain. Which
intervention is the priority?
A) Administer oxygen via mask
B) Initiate aggressive IV hydration and pain management
C) Apply cold compresses to painful joints
D) Draw blood for hemoglobin electrophoresis
Correct Answer: Initiate aggressive IV hydration and pain management
Rationale: Vaso‑occlusive crisis requires hydration to reduce blood viscosity and
opioids for pain. Cold compresses can worsen sickling. Oxygen is used if hypoxic,
but pain and hydration are the immediate priorities.
2. A 5‑year‑old with sickle cell crisis on IV morphine is found unarousable with
respirations of 10/min. What is the nurse's first action?
A) Increase IV fluids
B) Obtain a complete metabolic panel
C) Administer naloxone as prescribed
D) Elevate the head of the bed
Correct Answer: Administer naloxone as prescribed
,Rationale: Unresponsiveness and bradypnea indicate opioid overdose. Naloxone
is an opioid antagonist that reverses respiratory depression. It must be given
immediately.
3. A child with hemophilia A has a swollen knee after a fall. The nurse should
instruct the parents to:
A) Apply an ice pack and compression dressing, and elevate the leg
B) Administer aspirin for pain
C) Apply heat to the joint
D) Perform active range‑of‑motion exercises
Correct Answer: Apply an ice pack and compression dressing, and elevate the
leg
Rationale: RICE (rest, ice, compression, elevation) helps control bleeding.
Aspirin is contraindicated; heat and exercise could worsen bleeding. Factor VIII
replacement is also needed.
4. The nurse is teaching parents of a child with iron deficiency anemia. Which
statement indicates understanding?
A) "I will give the iron supplement with milk to prevent stomach upset."
B) "I will give the iron on an empty stomach with orange juice."
C) "I will stop the iron once my child's color improves."
D) "I will be concerned if my child's stools turn black."
Correct Answer: "I will give the iron on an empty stomach with orange juice."
, Rationale: Iron absorption is enhanced by vitamin C and inhibited by milk. Black
stools are expected. Therapy should continue for several months to replenish
stores.
5. A child is suspected of having a Wilms tumor. Which action by the nurse
requires immediate intervention?
A) Palpating the child's abdomen
B) Measuring abdominal girth
C) Obtaining a urine sample
D) Assessing blood pressure
Correct Answer: Palpating the child's abdomen
Rationale: Palpation can rupture the tumor capsule, spreading malignant cells. A
sign stating "Do Not Palpate Abdomen" should be posted.
6. A child with leukemia has a white blood cell count of 900/mm³. The nurse's
priority is to:
A) Administer the prescribed influenza vaccine
B) Institute neutropenic precautions and monitor for fever
C) Encourage fresh fruits and vegetables
D) Schedule a dental cleaning
Correct Answer: Institute neutropenic precautions and monitor for fever
