NUR203 Exam 2 - Pediatric Nursing Newest Exam
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QUESTION 1
A 4-year-old child is admitted with dehydration secondary to
gastroenteritis. The nurse notes that the child's urine output has been 1
mL/kg/hour for the past 4 hours. Which action should the nurse take
first?
A) Continue to monitor as this is an acceptable output
B) Notify the healthcare provider immediately
C) Increase the IV fluid rate as prescribed
D) Obtain a stat serum potassium level
Answer: C) Increase the IV fluid rate as prescribed
Explanation: In a 4-year-old child, the minimum acceptable urine output
is 1-2 mL/kg/hour. While 1 mL/kg/hour is at the lower limit of normal,
the context of dehydration secondary to gastroenteritis suggests that
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fluid resuscitation may still be ongoing. However, the first action should
be to increase the IV fluid rate as prescribed to improve urine output
and correct dehydration. Continuing to monitor without intervention
would be inappropriate because the child is already dehydrated and
urine output is borderline. Notifying the provider is not the first step
because the nurse can implement prescribed interventions. Obtaining a
potassium level is important but not the immediate priority.
QUESTION 2
The nurse is caring for an infant with bronchiolitis caused by respiratory
syncytial virus (RSV). Which intervention is most appropriate to manage
this infant's respiratory distress?
A) Administer antibiotics as prescribed
B) Position the infant in a prone position
C) Provide cool mist humidified oxygen
D) Suction the nares before each feeding
Answer: D) Suction the nares before each feeding
Explanation: Infants are obligate nose breathers, and nasal congestion
from RSV bronchiolitis can significantly impair feeding and breathing.
Suctioning the nares before each feeding helps clear the airway and
reduces the work of breathing, promoting adequate nutrition and
hydration. Antibiotics are not effective against viral infections like RSV
and are only indicated if a secondary bacterial infection develops. The
prone position is not recommended as it increases the risk of sudden
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infant death syndrome and does not improve ventilation. Cool mist
humidified oxygen may be used, but suctioning is the most direct and
immediate intervention to manage airway patency.
QUESTION 3
A 6-month-old infant is brought to the emergency department with a
fever of 102.2°F (39°C), irritability, and a bulging fontanel. The nurse
suspects meningitis. Which diagnostic test is the priority?
A) Complete blood count
B) Blood culture
C) Lumbar puncture
D) CT scan of the head
Answer: C) Lumbar puncture
Explanation: In an infant presenting with fever, irritability, and a bulging
fontanel, meningitis is a primary concern. A lumbar puncture is the
definitive diagnostic test to obtain cerebrospinal fluid for analysis to
confirm or rule out meningitis. While a CBC and blood culture are
important, they are not the priority diagnostic test. A CT scan may be
performed before a lumbar puncture if there is concern for increased
intracranial pressure, but it is not the priority diagnostic test.
QUESTION 4
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The nurse is providing discharge teaching to the parents of a child with
a new diagnosis of type 1 diabetes mellitus. Which statement by the
parent indicates a need for further teaching?
A) "I will check my child's blood glucose before meals and at bedtime."
B) "I will administer insulin at room temperature."
C) "I will rotate injection sites to prevent lipodystrophy."
D) "I will give extra insulin if my child is sick and not eating."
Answer: D) "I will give extra insulin if my child is sick and not eating."
Explanation: During illness, children with type 1 diabetes require insulin
even if they are not eating due to the risk of diabetic ketoacidosis.
However, insulin adjustments should be guided by blood glucose
monitoring and a sick-day management plan provided by the healthcare
team. The parent should not give extra insulin without specific
instructions. Checking blood glucose before meals and at bedtime is
appropriate. Administering insulin at room temperature is acceptable
and helps reduce injection site irritation. Rotating injection sites is
essential to prevent lipodystrophy.
QUESTION 5
A child with nephrotic syndrome is receiving corticosteroid therapy. The
nurse should monitor for which complication?
A) Hypoglycemia
B) Hypotension